The politics of age in Northern Ireland

This paper examines the attempt to strengthen the political, social and policy status of aging in Northern Ireland in the context of the regions emergence from decades of ethno-religious conflict. Supported by the US based Atlantic Philanthropies, the paper shows how the NGO sector restructured, became more tactical about its use of evidence and experimented with social enterprise models to strengthen the rights of the most excluded old in the region. This change process is inevitably incomplete and not everything worked but it did create a new political landscape that placed older people at the heart of protest and advocacy about the issues that affect their daily lives.

Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients

BACKGROUND:
A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress.
OBJECTIVES:
To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis.
SEARCH METHODS:
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE, EMBASE, and PsycINFO up to January 2011. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Electronic searches were carried out across all primary sources of peer-reviewed publications using detailed criteria. No language restrictions were imposed.
SELECTION CRITERIA:
Randomised controlled trials of psychosocial interventions involving interpersonal dialogue between a 'trained helper' and individual newly diagnosed cancer patients were selected. Only trials measuring QoL and general psychological distress were included. Trials involving a combination of pharmacological therapy and interpersonal dialogue were excluded, as were trials involving couples, family members or group formats.
DATA COLLECTION AND ANALYSIS:
Trial data were examined and selected by two authors in pairs with mediation from a third author where required. Where possible, outcome data were extracted for combining in a meta-analyses. Continuous outcomes were compared using standardised mean differences and 95% confidence intervals, using a random-effects model. The primary outcome, QoL, was examined in subgroups by outcome measurement, cancer site, theoretical basis for intervention, mode of delivery and discipline of trained helper. The secondary outcome, general psychological distress (including anxiety and depression), was examined according to specified outcome measures.
MAIN RESULTS:
A total of 3309 records were identified, examined and the trials subjected to selection criteria; 30 trials were included in the review. No significant effects were observed for QoL at 6-month follow up (in 9 studies, SMD 0.11; 95% CI -0.00 to 0.22); however, a small improvement in QoL was observed when QoL was measured using cancer-specific measures (in 6 studies, SMD 0.16; 95% CI 0.02 to 0.30). General psychological distress as assessed by 'mood measures' improved also (in 8 studies, SMD - 0.81; 95% CI -1.44 to - 0.18), but no significant effect was observed when measures of depression or anxiety were used to assess distress (in 6 studies, depression SMD 0.12; 95% CI -0.07 to 0.31; in 4 studies, anxiety SMD 0.05; 95% CI -0.13 to 0.22). Psychoeducational and nurse-delivered interventions that were administered face to face and by telephone with breast cancer patients produced small positive significant effects on QoL (in 2 studies, SMD 0.23; 95% CI 0.04 to 0.43).
AUTHORS' CONCLUSIONS:
The significant variation that was observed across participants, mode of delivery, discipline of 'trained helper' and intervention content makes it difficult to arrive at a firm conclusion regarding the effectiveness of psychosocial interventions for cancer patients. It can be tentatively concluded that nurse-delivered interventions comprising information combined with supportive attention may have a beneficial impact on mood in an undifferentiated population of newly diagnosed cancer patients.

The prevalence of caries in patients referred for orthodontic assessment in Northern Ireland – A retrospective study

Objectives: To determine the prevalence of untreated carious lesions in permanent teeth in patients (under the age of 18) referred for an orthodontic assessment in specialist practice. In addition, the figures shall be compared with national data for Northern Ireland (as outlined in the recent Child Dental Health Survey 2013)
The Gold standard would be that 100% of patients would be caries free upon presentation.

Methods: The clinical records and radiographs (OPT of quality grading 1 or 2) of 337 patients were reviewed. This encompassed patients who had an orthodontic assessment carried out in specialist practice over a 6 month period (following referral from their general dental practitioner)

Results: A total of 337 patient records were examined. Of these, 149 were male (44.2%) and 188 were female (55.8%), with an age range of 7-17 years at the time of new patient assessment. It was found that 36 patients (10.7%) had evidence (clinical and/or radiographic) of active and untreated dental caries. Of those affected, 14 were male and 22 were female.
Breaking the data down in terms of age, we can also get some indication as to how this cohort compares with national data for Northern Ireland :⃰

7-10 years (Mean = 9.3) = 14.3% caries (versus NI average of 6% for 8 year olds)
11-13 years (Mean = 12.1) = 10.1% caries, (versus NI average of 16% for 12 year olds)
14-17 years (Mean = 15.2) = 9.1% caries (versus NI average of 15% for 15 year olds)

⃰using the diagnostic threshold “Decay into dentine (visual dentine caries excluded)”


Conclusion: In this sample group, a total of 10.7% of patients (9.4% of males, 11.7% of females) presented with evidence of undiagnosed caries upon being assessed as a new patient in specialist orthodontic practice. Hence, the gold standard was not met.

Length of stay comparisons for private and public hospitals.

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospital sectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care provided by private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector. The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

Experiencing Youth Justice and Penality

Much of the recent literature on youth justice has focused on administrative aspects of the system and the socio-political contexts that have led to the ‘production’ of the youthful offender as a subject and locus of intervention. This has largely been driven by the extent to which youth justice has been crafted as a distinct penal sphere, evident in its unyoking from universal children’s services (Muncie and Goldson, 2013) and the establishment of separate agencies to administer and govern this ‘system’ (Souhami, 2014). Driven by policy hyperactivity and a plethora of legislation expanding the reach of the system, for much of the 1990s and 2000s increasing numbers of young people were brought under its gaze.

Particular attention has been paid to the impact of neo-liberal governance on the discourses, rationales and philosophies underpinning contemporary youth justice policy and practice. Writing specifically in the English and Welsh context, several authors have identified that the resulting ‘system’ embodies multiple, contradictory and competing discourses (Muncie, 2006; Fergusson, 2007; Gray, 2013). Within this ‘melting pot’ Fergusson (2007) notes the disjuncture between policy rhetoric, implementation and lived experience and Phoenix (2015) argues that systems-based analyses, much in favour amongst academics, foreclose a wider consideration of questions of what ‘justice’ actually means.

Recent attention towards the perspectives of practitioners working in this sphere has pointed to greater nuances than broader penal narratives suggest (see: Field, 2007; Briggs, 2013; Gray, 2013; Kelly and Armitage, 2015). Yet similar attention has not been given to experiences of youth justice (for an exception see – Phoenix and Kelly, 2013). However, it is precisely young people’s experiences, which would add significantly to current knowledge and potentially bridge the gap between discussions about penal philosophies, how youth justice policies are framed, how they are enacted and how they are experienced.

This chapter provides an overview of recent developments in the field of youth justice and penality in the United Kingdom. The chapter argues that a theoretical focus on macro-level trends (Hannah-Moffat and Lynch, 2012), alongside a narrowly defined research agenda, have largely excluded young people’s experiences of justice and punishment from contemporary analysis. Drawing on young people experiences of different aspects of youth justice in Northern Ireland and beyond, the chapter illuminates what a close understanding of lived experience can add to knowledge. In particular it demonstrates that the effects of interventions can be different to their aims and intentions; and that re-instating the youth experience can add support to calls for greater attention to wider issues of social justice.

Epidemiology of painful procedures performed in neonates: A systematic review of observational studies

Procedural pain in neonates has been a concern in the last two decades. The purpose of this review was to provide a critical appraisal and a synthesis of the published epidemiological studies about procedural pain in neonates admitted to intensive care units. The aims were to determine the frequency of painful procedures and pain management interventions as well as to identify their predictors. Academic Search, CINAHL, LILACS, Medic Latina, MEDLINE and SciELO databases were searched for observational studies on procedural pain in neonates admitted to intensive care units. Studies in which neonatal data could not be extracted from the paediatric population were excluded. Eighteen studies were included in the review. Six studies with the same study duration, the first 14 days of the neonate life or admission in the unit of care, identified 6832 to 42,413 invasive procedures, with an average of 7.5-17.3 per neonate per day. The most frequent procedures were heel lance, suctioning, venepuncture and insertion of peripheral venous catheter. Pharmacological and nonpharmacological approaches were inconsistently applied. Predictors of the frequency of procedures and analgesic use included the neonate's clinical condition, day of unit stay, type of procedure, parental presence and pain assessment. The existence of pain protocols was not a predictor of analgesia. Painful procedures were performed frequently and often with inadequate pain management. Unlike neonate clinical factors, organizational factors may be modified to promote a context of care more favourable to pain management. © 2015 European Pain Federation - EFIC®

Diagnostic value of surgical lung biopsy: comparison with clinical and radiological diagnosis

OBJECTIVE: To determine overall and disease-related accuracy of the clinical/imagiological evaluation for pulmonary infiltrates of unknown aetiology, compared with the pathological result of the surgical lung biopsy (SLB) and to evaluate the need for the latter in this setting. METHODS: We conducted a retrospective review of the experiences of SLB in 366 consecutive patients during the past 5 years. The presumptive diagnosis was based on clinical, imagiological and non-invasive or minimally invasive diagnostic procedures and compared with the gold standard of histological diagnosis by SLB. We considered five major pathological groups: diffuse parenchymal lung disease (DPLD), primitive neoplasms, metastases, infectious disease and other lesions. Patients with previous histological diagnosis were excluded. RESULTS: In 56.0% of patients (n=205) clinical evaluation reached a correct diagnosis, in 42.6% a new diagnosis was established (n=156) by the SLB, which was inconclusive in 1.4% (n=5). The pre-test probability for each disease was 85% for DPLD, 75% for infectious disease, 64% for primitive neoplasms and 60% for metastases. Overall sensitivity, specificity, positive and negative predictive values for the clinical/radiological diagnosis were 70%, 90%, 62% and 92%, respectively. For DPLD: 67%, 90%, 76% and 85%; primitive neoplasms: 47%, 90%, 46% and 90%; metastases: 99%, 79%, 60% and 99%; infectious disease 38%, 98%, 53% and 96%. CONCLUSIONS: Despite a high sensitivity and specificity of the clinical and imagiological diagnosis, the positive predictive value was low, particularly in the malignancy group. SLB should be performed in pulmonary infiltrates of unknown aetiology because the clinical/imagiological assessment missed and/or misdiagnosed an important number of patients.

Catalisadores ou precursores de espécies activas à base de molibdénio

Atendendo à produção de epóxidos em larga escala e à sua importância como intermediários versáteis, muita atenção tem sido dada à epoxidação de olefinas. Destaca-se a implementação do processo industrial de epoxidação de propileno em fase líquida com tBHP, usando complexos de molibdénio como catalisadores homogéneos (Halcon-ARCO). Neste trabalho foram investigados novos complexos à base de molibdénio como catalisadores (ou precursores) para epoxidação de olefinas em fase líquida. Foi objecto de estudo a identificação das espécies activas e a estabilidade dos catalisadores através da sua separação no final das reacções catalíticas, caracterização e reutilização. Escolheu-se como reacção modelo a epoxidação do ciscicloocteno com tBHP (em decano, tBHPdec), a 55 ºC. Estendeu-se o estudo dos desempenhos catalíticos a diferentes substratos, oxidantes, solventes e métodos de aquecimento. A maior actividade catalítica foi observada para os complexos [MoO2Cl2L2] (L=ligando dialquilamida), mais estáveis e fáceis de manusear que [MoO2Cl2] e complexos análogos com L {THF, MeCN} (Cap. 2). A partir destes complexos podem-se formar in situ espécies activas intermediárias do tipo [(MoO2ClL2)2(μ-O)]. O complexo [MoO2(Lzol)], Lzol= ligando oxazolina quiral (Cap. 3), é um catalisador estável e versátil, activo para a epoxidação de diversas olefinas (selectividades elevadas para epóxidos, mas enantioselectividades baixas), desidrogenação oxidativa de álcoois e sulfoxidação de sulfuretos. O catalisador foi também reciclado eficientemente, usando um líquido iónico (LI). O complexo iónico [MoO2Cl{HC(3,5-Me2pz)3}]BF4 (Cap.4) converteu-se nos complexos activos [{MoO2(HC(3,5-Me2pz)3)}2(μ-O)](BF4)2, [Mo2O3(O2)2(μ-O){HC(3,5-Me2pz)3}] e [MoO3{HC(3,5-Me2pz)3}]; quando dissolvido num LI, o catalisador foi reciclado com sucesso. A presença de água e o meio oxidante influenciaram a formação destas espécies. Os complexos [CpMo(CO)3Me] (Cap.5) e [CpMo(CO)2(η3- C3H5)] (Cap.6) originaram espécies activas similares (baseado nos testes catalíticos e nos espectros FT-IR ATR dos sólidos recuperados). Para [Cp'Mo(CO)2(η3-C3H5)], a influência do Cp' na actividade catalítica sugeriu a formação de espécies activas com este ligando. A partir dos complexos [Mo(CO)4L] formaram-se in situ catalisadores estáveis, que podem ser heterogéneos: para L=2-[3(5)-pirazolil]piridina formou-se [Mo4O12L4]; para L=[3- (2-piridil)-1-pirazolil]acetato de etilo formou-se [Mo8O24L4] (Cap.7). O uso de microondas (MO) como método de aquecimento em vez de um banho de óleo (BO) resultou no aumento da velocidade da reacção catalítica, devido ao aquecimento mais rápido da mistura reaccional (Caps. 5 e 7). A utilização da solução aquosa de tBHP em vez de tBHPdec era preferível, porque excluía o decano do sistema reaccional e mantinham-se elevados os rendimentos em epóxido (Caps. 2 e 6); optimizou-se o desempenho catalítico removendo a água das misturas reaccionais (Caps. 4 e 7). O melhor resultado para a epoxidação de limoneno foi observado para [CpMoCO3Me]: 88% de rendimento em epóxido (2 h, 55 ºC, método de aquecimento MO).

Ensino superior como princípio hegemónico de cidadania na sociedade civil: um diálogo com António Gramsci no sul da Amazónia brasileira

A tese tem como foco quatro eixos centrais: o ensino superior, a sociedade civil, a cidadania e a hegemonia. Na primeira parte da tese, estes eixos teórico-conceptuais são explanados numa perspectiva da promoção de uma compreensão mais ampla da sociedade civil e do estado, nomeadamente o contratualismo, o liberalismo, o materialismo e o neoliberalismo. Um protagonismo fundamental é atribuído às concepções de Antonio Gramsci de sociedade civil, cidadania e estado aplicadas no ensino superior no Sul da Amazónia brasileira. A segunda parte da tese concentra-se num estudo de caso com três premissas de análise: a fragmentação do ensino superior brasileiro; a reconfiguração da cidadania e hegemonia; e o ensino superior no contexto do Amazonas. O ensino superior no Brasil teve início com as escolas jesuíticas, que, depois de encerradas pelo Marquês de Pombal não tiveram sucessoras em solo brasileiro, ao nível do que poderia ter sido o embrião de um sistema de ensino superior. A chegada da Corte Imperial Portuguesa, em 1808, permite reinstalar novos cursos. A primeira unidade de ensino superior no Amazonas surge apenas no princípio do século XX. Um século depois, tem início o processo de expansão com a implantação de unidades no interior do estado. O ensino superior no Brasil, nas últimas décadas, assumiu um caráter híbrido e de massificação. A massificação, no entanto, ainda é uma realidade a ser alcançada. Apesar dos avanços realizados na última década, ainda subsiste ainda uma forte exclusão de estudantes. O enfoque sobre o ensino superior e a cidadania, no contexto do Amazonas, surge na articulação de um conjunto de informação empírica, extraída de entrevistas realizadas com atores chave locais, com as categorias de pensamento de Antonio Gramsci, que sustentam teoricamente o estudo. Esta articulação tem no ensino superior a possibilidade de desenvolver a cidadania como o princípio organizador e fim último deste nível de ensino. Neste sentido, a hegemonia ganha um estatuto de orientação e direção que permite aos sujeitos envolvidos no ensino superior maior possibilidade de autonomia, liberdade, justiça social, empregabilidade e desenvolvimento social. O modelo de universidade para a cidadania apresenta-se como uma possibilidade de mudanças no horizonte social, económico e também político, no interior da própria universidade. O ensino superior, perspectivado como um instrumento essencial para a cidadania, tem como objetivo primordial a qualificação de professores para a educação de base, Reflexivamente, esta qualificação não deixará potencialmente de produzir retornos positivos na própria expansão e abrangência numérica e educativa do próprio ensino superior. Desta forma, a cidadania no ensino superior é perspectivada neste estudo como um deslocamento de lógicas de compreensão individual e de individualização elitista dos benefícios para lógicas assentes em construções mais coletivas, portadoras de benefícios sociais. A interiorização do ensino superior no Amazonas é assumida no estudo como uma possibilidade de formação académica para o desenvolvimento de práticas pedagógicas e científicas críticas e mais conscientes, constituindo um horizonte determinante para a ativação de processos de integração regional e nacional. Em suma, os pontos de confluência entre o ensino superior, a sociedade civil, a cidadania e as propostas de Gramsci, estão relacionados com a formação, a conscientização política, e o bem-estar económico e social.

Crafting Modern Design in Italy, from Post-War to Postmodernism

The years between 1945 and the early 1980s are the most celebrated in Italy’s design history. From the rhetoric of reconstruction to the postmodern provocations of the Memphis design collective, Italy’s architects played a vital role in shaping the country’s encounter with post-war modernity. Yet as often as this story has been told, it is incomplete. Craft was vital to the realisation of post-war Italian design, and an area of intense creativity in its own right, and yet has been marginalised and excluded in design historiography.

Conspicuous by their abstinence: the limited engagement of heroin users in English and Welsh Drug Recovery Wings

Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain.

Speech of Hon. John Lowndes McLaurin, of South Carolina, in the Senate of the United States, Monday, December 9, 1901

This speech is to address the statement that Mr. McLaurin has been excluded from the caucuses of his party and thus that he will be without assignment on any committee. He goes on to explain his exclusion and defend his views that led to his exclusion.

Ensino profissional rural como ferramenta ao serviço das dificuldades de aprendizagem

Relatório da prática de ensino supervisionada, Mestrado em Ensino de Economia e Contabilidade, Universidade de Lisboa, 2011

Contribuição da ecografia cerebral transfontanelar para a avaliação do crescimento cerebral do recém-nascido pré-termo

Tese de doutoramento, Medicina (Pediatria), Universidade de Lisboa, Faculdade de Medicina, 2013

Application of Redundancy Analysis for Aerobiological Data

An aerobiological survey was conducted through five consecutive years (2006–2010) at Worcester (England).The concentration of 20 allergenic fungal spore types was measured using a 7-day volumetric spore trap. The relationship between investigated fungal spore genera and selected meteorological parameters (maximum, minimum, mean and dew point temperatures, rainfall, relative humidity, air pressure,wind direction) was examined using an ordination method(redundancy analysis) to determine which environmental factors favoured their most abundance in the air and whether it would be possible to detect similarities between different genera in their distribution pattern. Redundancy analysis provided additional information about the biology of the studied fungi through the results of the Spearman’s rank correlation. Application of the variance inflation factor in canonical correspondence analysis indicated which explanatory variables were auto-correlated and needed to be excluded from further analyses. Obtained information will be consequently implemented in the selection of factors that will be a foundation for forecasting models for allergenic fungal spores in the future.