Comparing a trauma focused and non trauma focused intervention with war affected Congolese youth: a preliminary randomised trial

While there is broad consensus about the need for interventions to help psychologically distressed, war affected youth, there is also limited research and even less agreement on which interventions work best. Therefore, this paper presents a randomised trial of trauma focused, and non trauma focused, interventions with war affected Congolese youth. Fifty war affected Congolese youth, who had been exposed to multiple adverse life events, were randomly assigned to either a Trauma Focused Cognitive Behavioural Therapy group or a non trauma based psychosocial intervention (Child Friendly Spaces). Non clinically trained, Congolese facilitators ran both groups. A convenience sample, waiting list group was also formed. Using blind assessors, participants were individually interviewed at pre intervention, post intervention and a 6-month follow-up using self-report posttraumatic stress and internalising symptoms, conduct problems and pro social behaviour. Both treatment groups made statistically significant improvements, compared to the control group. Large, within subject, effect sizes were reported at both post intervention and follow-up. At the 6-month follow-up, only the Child Friendly Spaces group showed a significant decrease in pro social behaviour. The paper concludes that both trauma focused and non trauma focused interventions led to reductions in psychological distress in war affected youth.

Potential of Microneedles in Enhancing Delivery of Photosensitising Agents for Photodynamic Therapy

Photodynamic therapy can be used in the treatment of pre-malignant and malignant diseases. It offers advantages over other therapies currently used in the treatment of skin lesions including avoidance of damage to surrounding tissue and minimal or no scarring. Unfortunately, systemic delivery of photosensitising agents can result in adverse effects, such as prolonged cutaneous photosensitivity; while topical administration lacks efficacy in the clearance of deeper skin lesions and those with a thick overlying keratotic layer. Therefore, enhancement of conventional photosensitiser delivery is desired. However, the physicochemical properties of photosensitising agents, such as extreme hydrophilicity or lipophilicity and large molecular weights make this challenging. This paper reviews the potential of microneedles as a viable method to overcome these delivery-limiting physicochemical characteristics and discusses the current benefits and limitations of solid, dissolving and hydrogel-forming microneedles. Clinical studies in which microneedles have successfully improved photodynamic therapy are also discussed, along with benefits which microneedles offer, such as precise photosensitiser localisation, painless application and reduction in waiting times between photosensitiser administration and irradiation highlighted.

Rent: Prostitution and the Irish apartment block

In 1974, pursuing his interest in the infra-ordinary – ‘the banal, the quotidian, the obvious, the common, the ordinary, the back-ground noise, the habitual’ – Georges Perec wrote about an idea for a novel:

‘I imagine a Parisian apartment building whose façade has been removed … so that all the rooms in the front, from the ground floor up to the attics, are instantly and simultaneously visible’.

In Life A User’s Manual (1978) the consummation of this precis, patterns of existence are measured within architectural space with an archaeological sensibility that sifts through narrative and décor, structure and history, services and emotion, the personal and the system, ascribing commensurate value to each. Borrowing methods from Perec, to move somewhere between conjecture, analysis and other documentation and tracing relationships between form, structure, materiality, technology, organisation, tenure and narrative use, this paper interrogates the late twentieth-century speculative apartment block in Britain and Ireland arguing that its speculative and commodified purpose often allows a series of lives that are less than ordinary to inhabit its spaces.

Long-term health-related quality of life of prostate cancer survivors varies by primary treatment. Results from the PiCTure (Prostate Cancer Treatment, your experience) study

PURPOSE: Men are living longer with prostate cancer. In a two-country study, we investigated the health-related quality of life (HRQoL) of prostate cancer survivors up to 18 years post-diagnosis.

METHODS: Postal questionnaires were administered in 2012 to 6559 prostate cancer (ICD10 C61) survivors 2-18 years post-diagnosis, identified through population-based cancer registries in Ireland. HRQoL was measured using QLQ-C30 and QLQ-PR25. HRQoL, functional and symptom scores were compared by primary treatment(s) using multiple linear regression.

RESULTS: Fifty-four percent responded (n = 3348). After controlling for socio-demographic and clinical factors, global HRQoL varied significantly by primary treatment (p < 0.001); compared to radical prostatectomy (RP), survivors who received androgen deprivation therapy alone (ADT; p < 0.001) or external beam radiotherapy (EBRT) without concurrent ADT (p = 0.001) had significantly lower global HRQoL. The global HRQoL of men who received brachytherapy (p = 0.157), EBRT with concurrent ADT (p = 0.940) or active surveillance/watchful waiting (p = 0.388) was not significantly different from men treated with RP. There were statistically and clinically significant differences in general (fatigue, pain, dyspnoea, appetite loss, constipation, diarrhoea, financial difficulties) and disease-specific symptoms (sexual, urinary, bowel, ADT) by primary treatment. Fatigue and insomnia scores were high for survivors in all treatment groups.

CONCLUSIONS: Prostate cancer survivors' long-term HRQoL varied with primary treatment.

IMPLICATIONS OF CANCER SURVIVORS: Population-based information regarding statistically and clinically significant treatment effects on long-term global HRQoL, symptom burden and functionality should be provided during treatment decision-making. Screening for symptoms and utilising interventions during long-term follow-up may improve survivors' HRQoL.

Performative Book launch of "Soundweaving: Writings on improvisation" (ed. Schroeder) with colleagues from SARC

A whole day event curated by F. Schroeder for the "2014 Sounds Alive Audio Festival, Dublin", included lecture, listening rooms and performance events

Gender Equality under the Charter of Fundamental Rights - a new lease for positive action?

This paper, which was published as a chapter of a Festskrift for Professor Ruth Nielsen, analyses Article 23 CFREU, the new provision on gender equality. It argues that Article 23 adds to the notion of gender equality in EU law, and not only allows, but also demands positive action measures if necessary to ensure equality between women and men. The provision also demands that positive action measures are suitable to achieve their aim. This implies that the EU legislator has to adapt positive action measure to the specific needs of the sector. The paper offers a critique of the proposal to introduce women quotas in board rooms, as proposed by the EU Commission in late 2012. It argues that the Commission unimaginatively copied rules developed for the German public service into a different sector, although these rules have not proven particularly efficient even in the public service. Consequently, a proposal that is demanding, but adapted to the sector should be developed.

Making space: English women, letter-writing, and the life of the mind, c.1650-1750

This article uses women's letter-writing from the late seventeenth and early eighteenth centuries to explore the home as a site of female intellectual endeavour. Far from representing a static backdrop to the action of domestic life, the home played a dynamic role in women's experiences of the life of the mind and shaped the ways in which women thought and wrote. Letters were penned in dining rooms, parlours and closets, by firesides, and on desks and laps. In their letters, women projected images of themselves scribbling epistles to friends in order to maintain their mental intimacy. Space was both real and imagined and the physical realities of a hand-written and hand-delivered letter gave way to the imaginative possibilities brought by networks of epistolary exchange and the alternative spaces of creative thought. By reinstating the home more fully in the history of female intellectual experience, a more nuanced view of the domestic arena can be developed: one that sees the home not as a site of exclusion and confinement, but as a space for scholarship and exchange. 

Musculoskeletal (MSK) and Sport and Exercise Medicine (SEM) in General Practice (GP): A Novel GP-based MSK and SEM Clinic for Managing Musculoskeletal symptoms in a GP

Musculoskeletal (MSK) complaints are common within primary care (1) (2) (3) but some General Practitioners (GPs)/family physicians do not feel comfortable managing these symptoms (3), preferring to refer onto hospital specialists or Integrated Clinical Assessment and Treatment Services (ICATs). Long waiting times for hospital outpatient reviews are a major cause of patient inconvenience and complaints (4). We therefore aimed to establish a GP-ran MSK and sport and exercise medicine (SEM) clinic based within a Belfast GP surgery that would contribute to a sustainable improvement in managing these common conditions within primary care as well as reducing waiting times for patients with these conditions to see a specialist. This shift from hospital-based to community-based management is in-keeping with recent policy changes within the UK health-system, including Transforming Your Care within Northern Ireland (NI) (5). The GP-ran MSK and SEM clinic was held monthly within a Belfast GP practice, staffed by one GP with a specialist interest in MSK and SEM conditions and its performance was reviewed over a three month period. Parameters audited included cases seen, orthopaedic and x-ray referral rates and secondary care referrals comparing the GP practice’s performance to the same time period in the previous year as well as patient satisfaction questionnaires.

Oscar Wilde at Home

Oscar, Constance, Speranza (and Bosie) are “at home” in the exquisitely beautiful Florence Court House this Mayday weekend. House guests will include Jack, Algy, Gwendolen and Cecily from the Importance of Being Earnest, (not to mention the redoubtable Lady Bracknell), Lord and Lady Windermere, the impetuous Lord Darlington, and the precocious Dorian Gray. Visitors will be conducted throughout the house where a range of short scenes from Wilde’s most popular works will be performed live by actors in each of the principal rooms. Is it life or is it art? Come and decide for yourself as we welcome you to the witty, complex and contradictory world of Oscar Wilde. Conceived and directed by David Grant.

Dramatis Personae
Oscar Wilde (and Lord Henry Wotton) – Donal Morgan
Constance Wilde (Lady Wotton, and Cecily Cardew) – Julie Lamberton
Lady Speranza Wilde (Lady Bracknell and Mrs Erlynne) – Antoinette Morelli
Lord Alfred Douglas (and Dorian Gray) – Sydney Bull
Lord Darlington and Basil Hallward – Richard Croxford
Lady Windermere and Gwendolen Fairfax – Stephanie Dale
Jack Worthing – Patrick McBrearty
Algernon Moncrieff and Lord Windermere – Stefan Dunbar
Lane and Parker – Curtis Reed and tbc

Production Team
Costume Design – Enda Kenny
Sound Design – Sydney Bull
Sound Operator – Seth Taylor
Stage Manager – Bronagh McFeely
Company Manager – Eamon Quinn
Director – David Grant

Long-Term Follow-Up of a Large Active Surveillance Cohort of Patients With Prostate Cancer

PURPOSE: Active surveillance is increasingly accepted as a treatment option for favorable-risk prostate cancer. Long-term follow-up has been lacking. In this study, we report the long-term outcome of a large active surveillance protocol in men with favorable-risk prostate cancer.

PATIENTS AND METHODS: In a prospective single-arm cohort study carried out at a single academic health sciences center, 993 men with favorable- or intermediate-risk prostate cancer were managed with an initial expectant approach. Intervention was offered for a prostate-specific antigen (PSA) doubling time of less than 3 years, Gleason score progression, or unequivocal clinical progression. Main outcome measures were overall and disease-specific survival, rate of treatment, and PSA failure rate in the treated patients.

RESULTS: Among the 819 survivors, the median follow-up time from the first biopsy is 6.4 years (range, 0.2 to 19.8 years). One hundred forty-nine (15%) of 993 patients died, and 844 patients are alive (censored rate, 85.0%). There were 15 deaths (1.5%) from prostate cancer. The 10- and 15-year actuarial cause-specific survival rates were 98.1% and 94.3%, respectively. An additional 13 patients (1.3%) developed metastatic disease and are alive with confirmed metastases (n = 9) or have died of other causes (n = 4). At 5, 10, and 15 years, 75.7%, 63.5%, and 55.0% of patients remained untreated and on surveillance. The cumulative hazard ratio for nonprostate-to-prostate cancer mortality was 9.2:1.

CONCLUSION: Active surveillance for favorable-risk prostate cancer is feasible and seems safe in the 15-year time frame. In our cohort, 2.8% of patients have developed metastatic disease, and 1.5% have died of prostate cancer. This mortality rate is consistent with expected mortality in favorable-risk patients managed with initial definitive intervention.

The SEMAINE corpus of emotionally coloured character interactions

We have recorded a new corpus of emotionally coloured conversations. Users were recorded while holding conversations with an operator who adopts in sequence four roles designed to evoke emotional reactions. The operator and the user are seated in separate rooms; they see each other through teleprompter screens, and hear each other through speakers. To allow high quality recording, they are recorded by five high-resolution, high framerate cameras, and by four microphones. All sensor information is recorded synchronously, with an accuracy of 25 μs. In total, we have recorded 20 participants, for a total of 100 character conversational and 50 non-conversational recordings of approximately 5 minutes each. All recorded conversations have been fully transcribed and annotated for five affective dimensions and partially annotated for 27 other dimensions. The corpus has been made available to the scientific community through a web-accessible database.

Musculoskeletal (MSK) and Sport and Exercise Medicine (SEM) in General Practice (GP): A Novel GP-based clinic

The problem-Musculoskeletal (MSK) symptoms are common within primary care but some GPs are not comfortable managing these; waiting times for hospital appointments are a major cause of patients’ complaints. Current UK healthcare policies emphasise a need for more community-based management. We aimed to pilot an innovative general practice-based clinic to improve the management of MSK and Sport and Exercise Medicine (SEM) symptoms within general practice.

The approach-This project was conducted in an inner-city practice of approximately 9,000 patients and 5 GP partners. The practice commissioned a novel monthly 4-hour clinic staffed by one GP with a specialist interest in MSK and SEM conditions. Each patient was allocated a 20-minute appointment. All primary care staff within the practice could refer any patient for whom they considered hospital referral appropriate, with no specific exclusion criteria. Management plans included injection therapy, exercise prescription and onward referral. After three months (August-October 2014) numbers of consultations, sources of referral, reasons for referral and management outcomes were described; patient satisfaction was assessed by questionnaire, offered to 10 randomly selected patients by reception staff and self-completed by patients. Costs of the clinic were compared to current options.

Findings- All patients (14 males; 21 females; aged 35-77 years), were seen within four weeks of referral (one third of orthopaedic referrals in 2013 waited over 9 weeks for appointment). Most were referred from other GPs; some came from physiotherapy and podiatry. Shoulder problems were the most frequent reason for referral. The commonest management option was steroid injection, with most patients being given advice regarding exercise and analgesia; there were 3 onward referrals (2 physiotherapy; 1 rheumatology).

Comparing August-October data in 2014 and 2013, total, orthopaedic and rheumatology referrals were reduced by 147, 2 and 3, respectively; within the practice MSK presentations and physiotherapy and x-ray referrals were 60, 47 and 90 fewer, respectively.

The cost per attendance at the clinic was £61; initial orthopaedic-ICAT assessments cost £82 and a consultant appointment £213.

Satisfaction questionnaires were returned by all 10 selected participants and provided positive feedback, expressing preference for community-based, rather than hospital, management.

Consequence- Our pilot study indicates that this novel service model has potential for efficient and effective management of MSK and SEM complaints in primary care, reducing the need for hospital referral and the clinical burden on general practices. The innovation deserves further evaluation in a full-scale trial to determine its generalisability to other practice settings and populations.

Cidade Museu

Through the concept of sonic resonance, the project Cidade Museu – Museum City explores five derelict or transitional spaces in the city of Viseu. The activation and capture of these spaces develops an audio- visual memory that reflects architectures, stories and experiences, while creating a sense of place through sounds and images.

The project brings together musicians with a background in contemporary music, electroacoustic music and improvisation and a visual artist focusing on photography and video.

Each member of the collective explores the selected spaces in order to activate them with the help of their respective instruments and through sound projection in an iterative process in which the source of activation gradually gives way to the characteristics of each space, their resonances and acoustic characteristics. The museum city (a nickname for the city of Viseu), in this performance, exposes the contrast between the grandeur and multi-faceted architecture of Viseu’s Cathedral with spaces that spread throughout the city waiting for a new future.

The performance in the Cathedral (Sé) is characterised by a trio ensemble, an eight channel sound system and video projecting audio recordings and images made in each of the five spaces. The audience is invited to explore the relations between the various buildings and their stories while being immersed in their resonances and visual projections.

The performance explores the following spaces in Viseu: the old Orfeão (music hall), an old wine cellar, a mansion home to the national road services, a house with its grounds in Rua Silva Gaio and an old slaughterhouse.

A Conditional Approach for Modelling Patient Re-admissions in Hospital using a mixture of Coxian phase-type distributions incorporating Bayes Theorem

The number of elderly patients requiring hospitalisation in Europe is rising. With a greater proportion of elderly people in the population comes a greater demand for health services and, in particular, hospital care. Thus, with a growing number of elderly patients requiring hospitalisation competing with non-elderly patients for a fixed (and in some cases, decreasing) number of hospital beds, this results in much longer waiting times for patients, often with a less satisfactory hospital experience. However, if a better understanding of the recurring nature of elderly patient movements between the community and hospital can be developed, then it may be possible for alternative provisions of care in the community to be put in place and thus prevent readmission to hospital. The research in this paper aims to model the multiple patient transitions between hospital and community by utilising a mixture of conditional Coxian phase-type distributions that incorporates Bayes' theorem. For the purpose of demonstration, the results of a simulation study are presented and the model is applied to hospital readmission data from the Lombardy region of Italy.

Building information modeling based building design optimization for sustainability

Environmental problems, especially climate change, have become a serious global issue waiting for people to solve. In the construction industry, the concept of sustainable building is developing to reduce greenhouse gas emissions. In this study, a building information modeling (BIM) based building design optimization method is proposed to facilitate designers to optimize their designs and improve buildings’ sustainability. A revised particle swarm optimization (PSO) algorithm is applied to search for the trade-off between life cycle costs (LCC) and life cycle carbon emissions (LCCE) of building designs. In order tovalidate the effectiveness and efficiency of this method, a case study of an office building is conducted in Hong Kong. The result of the case study shows that this method can enlarge the searching space for optimal design solutions and shorten the processing time for optimal design results, which is really helpful for designers to deliver an economic and environmental friendly design scheme.