The Tamaricetea arceuthoidis: a new class for the continental riparian thickets of the Middle East, Central Asia and the subarid regions of the Lower Volga valley

The new class, the Tamaricetea arceuthoidis, is described covering riparian and intermittent shrubby vegetation of the Irano-Turanian Region in the southwestern and Central Asia and the Lower Volga valley. The dominating species are species of the genus Tamarix that refer high water table in arid and semi-arid habitats with high to moderate salinity. This new class is an ecological analogon of the Nerio-Tamaricetea occurring in the Mediterranean Basin.

HOME-BASED REHABILITATION AND ITS IMPACT ON HOSPITAL UTILIZATION

There is compelling evidence for the effectiveness of home-based occupational therapy and physiotherapy rehabilitation for community dwelling elderly who may struggle with basic activities and the functions of daily living and mobility. Nonetheless, an estimated 2% of home care’s elderly clients receive these therapies. Ontario’s home care data indicates that 78% of clients that could benefit from these specific therapies are not receiving them. The study examined a subset of elderly clients receiving home care following a hospital discharge during 2009-2010. The aim of this study was to: understand the difference between those home care clients who received occupational therapy or physiotherapy and those who did not; and determine if receiving these therapies impacted the utilization of hospital emergency departments and inpatient admissions. A retrospective cohort design and multivariate and survival analysis of hospital and home care administrative data structured the study. Results suggest that home-based rehabilitation is offered to a minority of the home care population. Distinct client characteristics and process variables significantly associated with the increased likelihood of receiving home-based occupational and physical therapies included: clients who were older, females, admitted to home care from hospital inpatient units, assessed as non-acute for clinical and service needs and required more home making support and assistance with activities of daily living. Almost one quarter of the total sample returned to hospital. Visits to emergency departments accounted for the greater part of hospital utilization and primarily for sub-acute general symptoms and signs, post-procedural complications, infections or acute episodes from chronic obstructive pulmonary disease and renal failure. Slightly over half of the clients returning to hospital did not receive home-based rehabilitation. Clients who received occupational therapy returned to the hospital sooner following their home care admission whereas clients receiving physiotherapy spent the longest time before rehospitalizing. The majority of the clients receiving occupational therapy were admitted to home care having just resolved sub-acute conditions or symptoms, many of which are known to influence functional and physical decline. Moreover, analysis of process variables indicated that the wait time for a referral to occupational therapy was two times longer compared to physiotherapy. These same clients also waited, on average, over one month before an occupational therapist’s first visit. The need to discriminate who receives home-based rehabilitation is essential to understanding how specific therapies contribute to improving systems outcomes. This study is the first examination that focuses specifically on home-based occupational therapy and physiotherapy rehabilitation and the client characteristics and process variables associated with receiving/not receiving these therapies and the impact these factors have on the time-to-rehospitalization.

Use of physiotherapy and alternatives by children with cerebral palsy: a population study

Objectives: To describe the use of physiotherapy services and alternative therapies by a population of children with moderate to severe cerebral palsy (CP).
Design: Descriptive cross-sectional survey.
Subjects: A total of 212 parents of children aged 4–14 years with moderate to severe CP were identified from the Northern Ireland Cerebral Palsy Register (NICPR) and a random subsample of their paediatric physiotherapists.
Main measures: A standardized description of motor impairment or assessment form; a postal questionnaire to parents and paediatric physiotherapists (to validate parents’ reports of service use).
Response rates: In total, 85% of parent questionnaires were returned and 100% of paediatric physiotherapists responded.
Results: Service use among families was high; on average the families had contact with approximately seven services in a 6-month time interval. The overwhelming majority of children (96%) received physiotherapy during the school term and most (59%) received treatment at least twice a week for 30 min; 43% of children had their physiotherapy discontinued over the summer holidays. Over one-quarter (28%) of families had opted out of the NHS and bought alternatives like conductive education (21%) or private forms of conventional physiotherapy (16%). Children with more severe forms of CP, in special education, particularly at schools for physical disability, were high-intensity users of the physiotherapy service. Despite this, 74% of parents wanted more physiotherapy for their child.
Conclusions and implications: The demand for physiotherapy services is likely to continue given the relatively stable prevalence rate of CP, the proportion of children with disabling CP and the level of parent interest in the service. A number of quality aspects and gaps in the service have been identified.

UKCP: A Collaborative network of cerebral palsy registers in the United Kingdom

Cerebral palsy (CP) is a relatively rare condition with enormous social and financial impact. Information about CP is not routinely collected in the United Kingdom. We have pooled non-identifiable data from the five currently active UK CP registers to form the UKCP database: birth years 1960–1997. This article describes the rationale behind this collaboration and the creation of the database. Data about 6910 children with CP are currently held. The mean annual prevalence rate was 2.0 per 1000 live births for birth years 1986–1996. Where type is known, 91 per cent have spastic CP. Where data are available, nearly one-third of children have severely impaired lower limb function, and nearly a quarter have severely impaired upper limb function. As well as describing the range and complexity of motor and associated impairments, the pooled data from the UKCP database provide a platform for studies of aetiology, long-term outcomes, participation and service needs. The UKCP database is an important national resource for the surveillance of CP and the study of its epidemiology in the United Kingdom.

Chronic child abuse: The characteristics and careers of children caught in the child protection system

The introduction of the Quality Protects initiative in England and the focus on performance management has challenged social services departments to examine the systems, processes and outcomes for children who have their name on a child protection register. Research indicates that approximately one-quarter of the situations in which children are registered could be described as chronic—that is, they remain on the child protection register for significant periods of time, experience more than one period of registration or suffer a further incident of significant harm whilst subject to a child protection plan. In this article, the findings from a research study conducted into this group of vulnerable children are reported, focusing on the characteristics of the children and their families, and their careers in the child protection system. The paper concludes with observations about the weak conceptualization of performance management and the need to recognize the complexity of the factors that influence children’s careers in the child protection system.

El conjunto de azulejos nazaríes de principios del siglo XV del Museo Arqueológico de Córdoba

En este trabajo se analiza la iconografía y se concreta la datación y el origen del conjunto de treinta y cinco azulejos nazaríes decorados en cobalto y reflejo metálico procedentes de la que hemos identificado como capilla de Santiago en la antigua iglesia de San Bartolomé, erigida en la Judería de Córdoba tras el asalto de 1391. Se plantea, asimismo, que Diego Fernández Abencaçin, judeoconverso y alfaqueque mayor del rey y presumiblemente el comitente de la capilla funeraria, fue quien adquirió los azulejos. Hasta ahora, la única interpretación de las escenas figuradas que los decoran apuntaba a una supuesta representación de alegorías de los sentidos; no obstante, la comparación con ejemplos paralelos, el estudio de la indumentaria de los personajes y el estilo nos lleva a identificarlas como materialización de los gustos y aficiones de las clases privilegiadas a comienzos del s. XV: el amor cortés, la caza, la fauna, los ministriles –especialmente el ciego acompañado de lazarillo–, las danzarinas y los catadores de vino; costumbres que el alfaqueque conoció durante sus estancias en la corte y en el desempeño de sus obligaciones, no sólo como redentor de cautivos cristianos, sino como trujimán y enviado del infante don Fernando –futuro rey de Aragón– durante la campaña de Antequera ante la corte nazarita de Granada y en las treguas posteriorment e firmadas con Yusuf III, lo que ha posibilitado concretar la datación de los azulejos entre 1410 y 1415.

Psychological problems in children with cerebral palsy: A cross-sectional European study

Objectives: To describe psychological symptoms in 8–12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family.

Design: A cross-sectional multi-centre survey.

Participants: Eight hundred and eighteen children with cerebral palsy, aged 8–12 years, identified from population-based registers of cerebral palsy in eight European regions and from multiple sources in one further region.

Main outcome measures: The Strengths and Difficulties Questionnaire (SDQ)P4-16 and the Total Difficulties Score (TDS) dichotomised into normal/borderline (TDS = 16) versus abnormal (TDS > 16).

Statistical analysis: Multilevel, multivariable logistic regression to relate the presence of psychological symptoms to child and family characteristics.

Results: About a quarter of the children had TDS > 16 indicating significant psychological symptoms, most commonly in the domain Peer Problems. Better gross motor function, poorer intellect, more pain, having a disabled or ill sibling and living in a town were independently associated with TDS > 16. The risk of TDS > 16 was odds ratio (OR) = .2 (95% CI: .1 to .3) comparing children with the most and least severe functional limitations; OR = 3.2 (95%CI: 2.1 to 4.8) comparing children with IQ < 70 and others; OR = 2.7 (95% CI: 1.5 to 4.6) comparing children in severe pain and others; OR = 2.7 (95% CI:1.6 to 4.6) comparing children with another disabled sibling or OR = 1.8 (95%CI: 1.2 to 2.8) no siblings and others; OR = 1.8 (95% CI: 1.1 to 2.8) comparing children resident in a town and others. Among parents who reported their child to have psychological problems, 95% said they had lasted over a year, 37% said they distressed their child and 42% said they burdened the family at least ‘quite a lot’.

Conclusions: A significant proportion of children with cerebral palsy have psychological symptoms or social impairment sufficiently severe to warrant referral to specialist services. Care must be taken in the assessment and management of children with cerebral palsy to ensure psychological problems are not overlooked and potentially preventable risk factors like pain are treated effectively. The validity of the SDQ for children with severe disability warrants further assessment.

Role of peripheral afference during acquisition of a complex coordination task

It has long been supposed that the interference observed in certain patterns of coordination is mediated, at least in part, by peripheral afference from the moving limbs. We manipulated the level of afferent input, arising from movement of the opposite limb, during the acquisition of a complex coordination task. Participants learned to generate flexion and extension movements of the right wrist, of 75degrees amplitude, that were a quarter cycle out of phase with a 1-Hz sinusoidal visual reference signal. On separate trials, the left wrist either was at rest, or was moved passively by a torque motor through 50degrees, 75degrees or 100degrees, in synchrony with the reference signal. Five acquisition sessions were conducted on successive days. A retention session was conducted I week later. Performance was initially superior when the opposite limb was moved passively than when it was static. The amplitude and frequency of active movement were lower in the static condition than in the driven conditions and the variation in the relative phase relation across trials was greater than in the driven conditions. In addition, the variability of amplitude, frequency and the relative phase relation during each trial was greater when the opposite limb was static than when driven. Similar effects were expressed in electromyograms. The most marked and consistent differences in the accuracy and consistency of performance (defined in terms of relative phase) were between the static condition and the condition in which the left wrist was moved through 50degrees. These outcomes were exhibited most prominently during initial exposure to the task. Increases in task performance during the acquisition period, as assessed by a number of kinematic variables, were generally well described by power functions. In addition, the recruitment of extensor carpi radialis (ECR), and the degree of co-contraction of flexor carpi radialis and ECR, decreased during acquisition. Our results indicate that, in an appropriate task context, afferent feedback from the opposite limb, even when out of phase with the focal movement, may have a positive influence upon the stability of coordination.

Artificial magnetic conductor surfaces and their application to low-profile high-gain planar antennas

Planar periodic metallic arrays behave as artificial magnetic conductor (AMC) surfaces when placed on a grounded dielectric substrate and they introduce a zero degrees reflection phase shift to incident waves. In this paper the AMC operation of single-layer arrays without vias is studied using a resonant cavity model and a new application to high-gain printed antennas is presented. A ray analysis is employed in order to give physical insight into the performance of AMCs and derive design guidelines. The bandwidth and center frequency of AMC surfaces are investigated using full-wave analysis and the qualitative predictions of the ray model are validated. Planar AMC surfaces are used for the first time as the ground plane in a high-gain microstrip patch antenna with a partially reflective surface as superstrate. A significant reduction of the antenna profile is achieved. A ray theory approach is employed in order to describe the functioning of the antenna and to predict the existence of quarter wavelength resonant cavities.

Low-profile resonant cavity antenna with artificial magnetic conductor ground plane

A planar artificial magnetic conductor (AMC) ground plane is proposed as a means to reduce the profile of a highly directive resonant cavity antenna. The structure is formed by a printed microstrip patch antenna and a superimposed partially reflective surface. The antenna profile is reduced to approximately half by virtue of employing the AMC ground plane. A ray theory model is used to qualitatively describe the functioning of the antenna and theoretically predict the existence of quarter wavelength resonant cavities.

Minimum Wage Regulation under Devolution in Northern Ireland

This paper assesses the development and functioning of regional minimum wage regulation in Northern Ireland in the interwar period under a federal form of devolution. Unlike current devolution arrangements in Scotland and Wales, this gave the Stormont Parliament powers over employment and minimum wage regulation. Northern Ireland Trade Boards were set up by the Ulster Unionist Government under the Trade Boards (Northern Ireland) Act 1923 and functioned along the same lines as those in Great Britain. Uniquely in the UK in this period, employer opposition resulted in the main Trade Board in the Irish Linen Industry being replaced by voluntary collective bargaining machinery. About one-quarter of employees were covered by minimum wage regulation, including two-thirds of females in Belfast, keeping a protective floor under low pay.

An audit of assessment and reporting by Approved Social Workers (ASWs)

This paper examines the routine practice of Approved Social Workers (ASWs) in adult mental health services in Northern Ireland. It begins with a review of existing literature on the ASW role before describing how a retrospective audit, using a mixed methods approach, was used to collect data on eighty-four assessments carried out to determine whether compulsory admission to hospital was needed. Respondents were also asked to consider how such assessments might be affected by proposed changes to the law in this field. The key findings highlighted a number of areas of practice that may be improved. There were inconsistencies in how the assessments were recorded and an uneven distribution of workloads across ASWs. Some problems were identified with interagency working and, in a quarter of the assessments, the ASW reported having felt afraid or at risk. The authors make a number of recommendations, which include: the use of a standard reporting procedure; that organisations should consider how to deliver a more even distribution of ASW workload; that protocols should be developed that ensure that ASWs are not left alone in potentially risky situations; and that joint assessments with General Practitioners should be required, rather than just recommended.

Antennas for over-body-surface communication at 2.45 GHz

In this paper, the on-body performance of a range of wearable antennas was investigated by measuring vertical bar S-21 vertical bar path gain between two devices mounted on tissue-equivalent numerical and experimental phantoms, representative of human muscle tissue at 2.45 GHz. In particular, the study focused on the performance of a compact higher mode microstrip patch antenna (HMMPA) with a profile as low as lambda/20. The 5- and 10-mm-high HMMPA prototypes had an impedance bandwidth of 6.7% and 8.6%, respectively, sufficient for the operating requirements of the 2.45-GHz industrial, scientific, and medical (ISM) band and both antennas offered 11-dB higher path gain compared to a fundamental-mode microstrip patch antenna. It was also dernonstrated that a 7-dB improvement in path gain can be obtained for a fundamental-mode patch through the addition of a shortening wall. Notably, on-body HMMPA performance was comparable to a quarter wave monopole antenna on the same size of ground-plane, mounted normal to the tissue surface, indicating that the low-profile and physically more robust antenna is a promising solution for bodyworn antenna applications.

Recognising the co-occurance of domestic and child abuse: a comparison of community and hospital-based midwives

This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the cooccurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P <0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.