Who do we treat when resources are scarce?

In a health service with limited resources we must make decisions about who to treat ?rst. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don’t know in a particular case that the illness is self-in?icted, that it seems that all illness is self-in?icted in the sense used in my argument, and ?nally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like ?re-?ghters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections.

Understanding Parental Influence on Educational Outcomes Among 9 Year Olds in Ireland: The Mediating Role of Resources, Attitudes and Children's Own Perspectives

The relationship between parental background and children's educational outcomes has been a dominant theme within the sociology of education. There has been an on-going debate as to the relative merits of explanations which focus on the role of socio-cultural reproduction and those which focus on rational choice. However, many empirical studies within the social stratification tradition fail to allow for children's own agency in shaping the relationship between social background and schooling outcomes. This paper draws on the first wave of a large-scale longitudinal study of over 8,000 nine-year-old children in Ireland, which combines information from parents, school principals, teachers and children themselves. Both social class and parental education are found to have significant effects on reading and mathematics test scores among nine year olds. These effects are partly mediated by home-based educational resources and activities, parents' educational expectations for their child, and parents' formal involvement in the school. More importantly, children's own engagement with, and attitudes to, school significantly influence their academic performance. The influence of children's own attitudes and actions can thus reinforce or mitigate the effect of social background factors. The analysis therefore provides a bridge between the large body of research on the intergenerational transmission of inequality and the emerging research and policy literature on children's rights.

RESOURCES, DEPRIVATION AND THE MEASUREMENT OF POVERTY

Ringen has advocated the use of both income and deprivation criteria in identifying those excluded from society due to lack of resources, a widely accepted definition of poverty. We illustrate with Irish data how this might be done, paying particular attention to how appropriate indicators of deprivation are to be selected. The results show that employing both income and deprivation criteria rather than income alone can make a substantial difference to both the extent and composition of measured poverty. This highlights the restrictive nature of poverty conceived in terms of exclusion rather than minimum rights to resources.

Direct reprogramming of fibroblasts into endothelial cells capable of angiogenesis and reendothelialization in tissue-engineered vessels

The generation of induced pluripotent stem (iPS) cells is an important tool for regenerative medicine. However, the main restriction is the risk of tumor development. In this study we found that during the early stages of somatic cell reprogramming toward a pluripotent state, specific gene expression patterns are altered. Therefore, we developed a method to generate partial-iPS (PiPS) cells by transferring four reprogramming factors (OCT4, SOX2, KLF4, and c-MYC) to human fibroblasts for 4 d. PiPS cells did not form tumors in vivo and clearly displayed the potential to differentiate into endothelial cells (ECs) in response to defined media and culture conditions. To clarify the mechanism of PiPS cell differentiation into ECs, SET translocation (myeloid leukemia-associated) (SET) similar protein (SETSIP) was indentified to be induced during somatic cell reprogramming. Importantly, when PiPS cells were treated with VEGF, SETSIP was translocated to the cell nucleus, directly bound to the VE-cadherin promoter, increasing vascular endothelial-cadherin (VE-cadherin) expression levels and EC differentiation. Functionally, PiPS-ECs improved neovascularization and blood flow recovery in a hindlimb ischemic model. Furthermore, PiPS-ECs displayed good attachment, stabilization, patency, and typical vascular structure when seeded on decellularized vessel scaffolds. These findings indicate that reprogramming of fibroblasts into ECs via SETSIP and VEGF has a potential clinical application.

Sca-1+ progenitors derived from embryonic stem cells differentiate into endothelial cells capable of vascular repair after arterial injury

Embryonic stem cells possess the ability to differentiate into endothelium. The ability to produce large volumes of endothelium from embryonic stem cells could provide a potential therapeutic modality for vascular injury. We describe an approach that selects endothelial cells using magnetic beads that may be used therapeutically to treat arterial injury.

Maternal Religiosity, Family Resources and Stressors, and Parent-Child Attachment Security in Northern Ireland

This study explores the associations between mothers' religiosity, and families' and children's functioning in a stratified random sample of 695 Catholic and Protestant motherchild dyads in socially deprived areas in Belfast, Northern Ireland, a region which has experienced centuries of sectarian conflict between Protestant Unionists and Catholics Nationalists. Findings based on mother and child surveys indicated that even in this context of historical political violence associated with religious affiliation, mothers' religiosity played a consistently positive role, including associations with multiple indicators of better family functioning (i.e., more cohesion and behavioral control and less conflict, psychological distress, and adjustment problems) and greater parentchild attachment security. Mothers' religiosity also moderated the association between parentchild attachment security and family resources and family stressors, enhancing positive effects of cohesion and mother behavioral control on motherchild attachment security, and providing protection against risks associated with mothers' psychological distress. Findings are discussed in terms of implications for understanding the role of religiosity in serving as a protective or risk factor for children and families.

JISC Workshop Report: E-Research Resources, Tools and Methods for Historic Place Name Analysis

A substantial amount of the 'critical mass' of digital data available to scholarship contains place-names, and it is now recognised that spatial and temporal data points, including place-names, are a vital part of the e-research infrastructure that supports the use, re-use and advanced analysis of data using ICT tools and methods. Place-names can also be linked semantically to contribute to the web of data, and to enrich content through linking existing data, and identifying new collections for digitization to strategically enhance existing digital collections. However, existing e-projects rely on modern gazetteers limiting them to the modern and the near-contemporary. This workshop explored how to further integrate the wealth of historical place-name scholarship, and the resulting digital resources generated within UK academia, so enabling integration of local knowledge over much longer periods.