Understanding coronary heart disease-related disability in older adults in the Republic of Ireland and Northern Ireland in 2010/2011

Background

Although life expectancy continues to increase in the Republic of Ireland (ROI) and Northern Ireland (NI), coronary heart disease (CHD) remains a leading cause of death and disability in older adults. Some, but not all, of the socioeconomic inequality in cardiovascular disability can be explained by a social gradient in conventional risk factors. The aims of the research were to assess CHD-related disability, and to establish the prevalence and population attributable fractions (PAFs) of risk factors for CHD-related disability across gender and socioeconomic groups in older adults in NI and ROI.

Contractile properties of human renal cell carcinoma recruited arteries and their response to nicotinamide

Background and purpose: The manipulation of tumour blood supply and thus oxygenation is a potentially important strategy for improving the treatment of solid tumours by radiation. Increased knowledge about the characteristics that distinguish the tumour vasculature from its normal counterparts may enable tumour blood flow to be more selectively modified, Nicotinamide (NA) causes relaxation of preconstricted normal and tumour-supply arteries in rats. It has also been shown to affect microregional blood flow in human tumours. Direct effects of NA on human tumour supply arteries have not previously been reported. This paper describes our evaluation of the effects of NA on two parameters: 'spontaneous', oscillatory contractile activity and agonist (phenylephrine)-induced constriction in the arteries supplying human renal cell carcinomas.

Materials and methods: Isolated renal cell carcinoma feeder vessels were perfused in an organ bath with the alpha(1)-adrenoceptor agonist phenylephrine (PE). When the arteries had reached a plateau of constriction, nicotinamide (8.2 mM) was added to the perfusate and changes in perfusion pressure were measured.

Results: PE (10 mu M) induced a sustained constriction in the majority of the renal cell carcinoma feeder vessels examined, demonstrating that they retain contractile characteristics, at least in response to this alpha(1)-adrenoceptor agonist. In combination with NA (8.2 mM) the constriction was significantly attenuated in half of the preparations. In addition, seven arteries exhibited spontaneous contractile activity which was significantly attenuated by NA in six of them.

Conclusions: NA can significantly attenuate both 'spontaneous' and agonist-induced constrictions in tumour-recruited human arteries, though not all arteries are sensitive. Published by Elsevier Science Ireland Ltd.

The EU Charter of Fundamental Rights in the case law of the European Court of Human Rights

The European Court of Human Rights has begun to refer to the EU Charter of Fundamental Rights in order to support its reasoning for interpreting the European Convention on Human Rights in a particular way. But the EU Charter does not yet have any special status in that regard, being treated by the Court as on a par with numerous other documents of international law. The Court’s use of the Charter began in connection with arts 8 and 12 of the Convention (the right to a family life and the right to marry) but in subsequent years it has been extended to many other Articles of the Convention. It is in relation to art.6 (the right to a fair trial) that the Charter’s influence has been most noticeable so far, the Court having changed its position on two important aspects of Article 6 partly because of the wording of the EU Charter. But the influence on art.3 (in relation to the rights of asylum seekers), art.7 (in relation to retroactive penal laws), art.9 (in relation to the right to conscientious objection) and art.11 (in relation to rights of trades unions) has also been significant. The potential for the Charter to have greater influence on the Court’s jurisprudence in years to come remains considerable.

Changing policy and legislation in special and inclusive education: a perspective from Northern Ireland

It is now 15 years since the signing of the 1998 Belfast (or ‘Good Friday’) Peace Agreement which committed all participants to exclusively democratic and peaceful means of resolving differences, and towards a shared and inclusive society defined by the principles of respect for diversity, equality and the interdependence of people. In particular, it committed participants to the protection and vindication of the human rights of all. This is, therefore, a precipitous time to undertake a probing analysis of educational reforms in Northern Ireland associated with provision in the areas of inclusion and special needs education. Consequently, by drawing upon analytical tools and perspectives derived from critical policy analysis, this article, by Ron Smith from the School of Education, Queen’s University Belfast, discusses the policy cycle associated with the proposed legislation entitled Every School a Good School: the way forward for special educational needs and inclusion. It examines how this policy text structures key concepts such as ‘inclusion’, ‘additional educational needs’ and ‘barriers to learning’, and how the proposals attempt to resolve the dilemma of commonality and difference. Conceived under direct rule from Westminster (April 2006), issued for consultation when devolved powers to a Northern Ireland Assembly had been restored, and with the final proposals yet to be made public, this targeted educational strategy tells a fascinating story of the past, present and likely future of special needs education in Northern Ireland. Before offering an account of this work, it is placed within some broader ecological frameworks.

OLDER WOMEN’S LIFELONG EXPERIENCES OF DOMESTIC VIOLENCE IN NORTHERN IRELAND

Violence against women is a serious criminal and public health issue with devastating consequences for women, families and society. To date, little international research has been given to understanding the needs of older women, who are experiencing domestic violence; that is, physical, sexual, emotional or financial abuse carried out by a spouse or partner. This study fills a significant gap in the literature as the needs of older women who have experienced a lifetime of domestic violence in Northern Ireland are unknown. Health professionals, service providers and policy makers often assume that violence stops at age 55 and there is a noticeable lack of literature, research and guidelines on the issue. The greatest challenge for health visitors is that abuse remains hidden, with women remaining silent and finding it difficult to speak openly or seek help.

'Leptorapide' - a one-step assay for rapid diagnosis of human leptospirosis

Leptospirosis is a globally important zoonotic infection caused by spirochaetes of the genus Leptospira. It is transmitted to humans by direct contact with infected animals or indirectly via contaminated water. It is mainly a problem of the resource-poor developing countries of the tropical and sub-tropical regions of the world but outbreaks due to an increase in travel and recreational activities have been reported in developed and more industrialized areas of the world. Current methods of diagnosis are costly, time-consuming and require the use of specialized laboratory equipment and personnel. The purpose of this paper is to report the validation of the 'Leptorapide®' test (Linnodee Ltd, Northern Ireland) for the diagnosis of human leptospirosis. It is a simple one-step latex agglutination assay performed using equal volumes of serum sample and antigen-bound latex beads. Evidence of leptospiral antibodies is determined within minutes. Agglutination is scored on a scale of 1-5 and the results interpreted using a score card provided with the kit. Validation has been performed with a large sample size obtained from individuals originating from various parts of the world including Brazil and India. The test has shown sensitivity and specificity values of 97·1% and 94·0%, respectively, relative to the microscopic agglutination test. The results demonstrate that Leptorapide offers a cost-effective and accurate alternative to the more historical methods of antibody detection.

Time for Reform? Refugees, Asylum-seekers and Protection Under International Human Rights Law

The aim is to explore the protection that international human rights law offers to refugees, asylum-seekers, and the forcibly displaced. The ambition of the global rights framework is to guarantee a defined range of rights to all human beings, and thus move the basis for normative entitlement from exclusive reliance on national membership to a common humanity. This comprehensive and international perspective remains formally tied to states - acting individually or collectively - in terms of creation and implementation. The norms must find an entry point into the empirical world, and there must be clarity on responsibilities for practical delivery. It should remain unsurprising that the expectations raised by the normative reach of the law are frequently dashed in the complex and difficult human world of instrumental politics, power, and conflict. The intention here is to outline the international human rights law context, and indicate the value and limitations for the protection of refugees and asylum-seekers. A question is then raised about possible reform.

'A Breath of Fresh Air': The experiences of undergraduate nursing students' participating in a creative learning project:This paper presents the experiences of undergraduate nursing students who participated in a creative learning project to explore the cells, tissues and organs of the human body through felt making.

Aim of the study
This paper presents the experiences of undergraduate nursing students who participated in a creative learning project to explore the cells, tissues and organs of the human body through felt making.

Context and Background
This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queen’s University Belfast to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between University Teaching staff and Arts Care, a unique arts and health charity in Northern Ireland.

Methodology
Twelve year one students participated in four workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, students translated their learning into striking felt images. The project culminated in the exhibition of this unique collection of work which has been viewed by fellow students, teaching staff, nurses from practice, and artists from Arts Care, friends, family and members of the public.

Key Findings and conclusions
The opportunity to learn in a more diverse way within a safe and non-judgmental environment was valued, with students’ reporting a greater confidence in life science knowledge. Self- reflection and group discussion revealed that the project was a unique creative learning experience for all involved – students, teaching staff and artist – resulting in individual and collective benefits far beyond knowledge acquisition. As individuals we each felt respected and recognised for our unique contribution to the project. Working in partnership with Arts Care enabled us to experience the benefits of creativity to well-being and reflect upon how engagement in creative activities can help healthcare professionals to focus on the individual patient’s needs and how this is fundamental to enhancing patient-centred care

Alternative Care and Children’s Rights in Northern Ireland

This report covers the rights of the most vulnerable children in Northern Ireland who cannot be cared for within their own family. The purpose of the report is to review the current provision and circumstances facing such children and young people and how international human rights standards can offer protection and support.