Health and Social Care Workers Perceptions of Novel Psychoactive substances in Northern Ireland

Background: The EU Early Warning System currently monitors more than 450 new psychoactive substances (EMCDDA, 2015), far outweighing the total number of illicit drugs under international control (UNODC, 2013). Due to the recent emergence of NPS and rapidly changing nature of the market, evidence about the way in which the emerging drugs are managed in health and social care settings is limited. Methods: The study adopted a mixed methods design, utilising a cross sectional survey and follow up telephone interviews to capture data from staff working in drug and alcohol related services in statutory and voluntary sectors, across the five Health and Social Care (HSC) Trust areas in Northern Ireland. 196 staff participated in the survey and 13 took part in follow up telephone interviews. Results: Study respondents reported that addressing NPS related issues with service users was a key aspect of their daily role and function. Levels of injecting behaviours were also viewed as relatively high by the study participants. Almost all workers used harm reduction as their primary approach when working with service users and the majority of respondents called for additional practical training in relation to addressing drug interactions and intervening with NPS related issues.

An Evaluation of the Dual Diagnosis (substance use and mental health )Strategy in the South Eastern Trust Workers and Service Users Perceptions of Dual Diagnosis Issues

In the UK it is estimated that over 33% of psychiatric patients with enduring mental illness have a substance misuse problem, whilst over 50 % of clients currently accessing drug and alcohol services have a mental health problem. Between 2003 and 2013 in Northern Ireland, there were 741 recorded suicides by patients who were in contact with mental health services. Of this number, 68% (n=501) had a history of either alcohol or drug misuse or both, resulting in an average of 46 patient suicides per year associated with dual diagnosis (University of Manchester 2015).
The current evaluation examined staff attitudes towards working with dual diagnosis (co-existing difficulties) issues, staff confidence in working with clients with dual diagnosis, workers’ perceptions of the South Eastern dual diagnosis strategy and service user perspectives of dual diagnosis service provision.
The purpose of the evaluation was to provide evidence regarding the following in accordance with the current dual diagnosis strategy;
Staff understanding of the concept of dual diagnosis,
Staff attitudes towards working with dual diagnosis,
Staff confidence in working with individuals, who present with dual diagnosis,
Service users’ perspectives of SE Trust provision for dual diagnosis.
Staff views on the South Eastern Trust Dual Diagnosis Strategy.

Pro-internationalisation policies and outward foreign direct investment

This thesis addresses the impacts of public policies on outward foreign direct investment, seeking to contribute to a better understanding of the interplay between pro-internationalisation policies and firm behaviour. Home country measures associated with these policies are explored in terms of use and awareness, as determinants of foreign direct investment, as drivers of policy objectives, in terms of perceived importance and impact in different scenarios of internationalisation. Using a comprehensive database of 441 Portuguese firms, being those that had participated at least in one of the 11 types of public support between 1994 and 2009. The empirical papers presented here reveal a moderating effect of firm capabilities and internationalisation conditions on policy objectives. In fact, firms’ resources and capabilities frame the awareness and use of home country support measures, the existence of public policy determinants of foreign direct investment, the decision to carry out more aggressive modes of entry and the choice of more demanding environments, the impact of policy objectives, and the perceived importance of incentives. In practical terms, the findings of this thesis points that firms’ resources and capabilities are negatively associated with the use of public support, contrasting with awareness, which is found to increase with firms’ resources and capabilities. This insight sheds light on a potential problem of incentives allocation. Our results support the established theorizing about the co-evolution of government and firms' policies, home country measures being found as determinants of foreign direct investment. It is also shown that prointernationalization policies reinforce the firms’ resources and capabilities, which seems to have a positive impact on international growth. An evaluation of public policy, from the foreign direct investor's lens, supports the argument that firms involved in more demanding projects tend to attribute more importance to public supports. Behind the specific and concrete contributions identified in each of the empirical papers, as a whole this thesis makes methodological contributions by introducing the evaluation of impacts of public policies to the field of international business through the firm perspective; these contributions are achieved by taking the pro-internationalisation policies of a small open economy to better understand the impacts of public policies, and by shedding light on co-evolution between resource and institutional-based views.

Reinventing America on the battlefields of Spain or following the party line: conflicting perceptions of the Spanish Civil War in the present and in the past

Isolationism and neutrality are two of the recurrent themes in the study of the history of the U.S. foreign policy in the interwar years. The trauma of the Great War, which had swept away 130.000 U.S. lives and had cost $30 billion, had led public opinion to strongly oppose any involvement with European affairs. Besides, the urgent need for economic recovery during the dismal years of the Great Depression did not leave Roosevelt much room for manoeuvre to influence international events. His positions regarding the intentions of the Fascist states remained, at best, ambivalent. These facts notwithstanding, about 2800 U.S. citizens crossed the Atlantic and rushed in to help democratic Spain, which was on the verge of becoming one more hostage in the hands of the Fascism. They joined the other British, Irish and Canadian volunteers and formed the XV International Brigade. 900 Americans never returned home. This alone should challenge the commonly held assumption that the American people were indifferent to the rise of the Fascist threat in Europe. But it also begs other questions. Considering the prevailing isolationist mood, what really motivated them? With what discursive elements did these men construct their anti Fascist representations? How far did their understanding of the Spanish democracy correspond to their own American democratic ideal? In what way did their war experience across the Atlantic mould their perception of U.S. politics (both domestic and foreign)? How far did the Spanish Civil War constitute one first step towards the realization that the U.S. might actually be drawn into another international conflict of unpredictable consequences? Last but not the least, what ideological, political and cultural complicity existed between the men from the English-speaking battalions? In order to unearth some of the answers, I intend to examine their letters and see how these men recorded the historical events in which they took part. Their correspondence emerged from the desire to prove their commitment to a common cause and spoke of a common war experience, but each letter, in its uniqueness, ends up mirroring not only the social and political background of each individual fighter, but also his own particular perspective of the war, of world politics and of the Spanish people. We shall see how these letters differ and converge and how these particular accounts weave, as in an epistolary novel, a larger-than-life narrative of outrage and solidarity, despair and hope.

Re-employment hazard of displaced German workers: evidence from the GSOEP

This study investigates the re-employment hazard of displaced German workers using the first fourteen sweeps of the German Socio-Economic Panel (GSOEP) data. As well as parametric and non-parametric discrete-time specifications for the baseline hazard, the study employs alternative mixing distributions to account for unobserved heterogeneity. Findings of the study suggest negative duration dependence, even after accounting for unobserved heterogeneity. In terms of covariate effects, those at the lower end of the skills ladder, those who had been working in manufacturing and those with previous experience of non-employment are found to have lower hazard of exit via reemployment.

Pilot study of the utility and acceptability of tampon sampling for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infections by duplex realtime polymerase chain reaction in United Kingdom sex workers

We aimed to evaluate the acceptability of self-collected tampon samples for the screening of female sex workers for sexually transmitted infections. We recruited 65 sex workers, and 63 agreed to provide tampon samples. The tampon samples were processed by realtime polymerase chain reaction (PCR) targeting Neisseria gonorrhoeae and Chlamydia trachomatis. Urethral and endocervical swabs were also obtained from 61 of 63 participants and tested using culture (N. gonorrhoeae) and the BD ProbeTec strand displacement amplification (SDA) (C. trachomatis) assay. Tampon sampling was preferred by 95% of the women and all favoured being tested away from genitourinary medicine clinics; the most common reasons cited were avoidance of embarrassment (40%) and convenience (30%). Besides near-universal acceptability of tampon sampling, the tampon sampling-PCR approach described in this study appeared to have enhanced sensitivity compared with conventional testing, suggesting the possibility of a residual hidden burden of N. gonorrhoeae and/or C. trachomatis genital infections in UK female sex workers.

Training the public health workforce we need. Exploring perceptions for future public heath workers in Ecuador

Thesis (Master's)--University of Washington, 2015

Home bias persistence in foreign direct investments

The purpose of this paper is to analyse the issues related to home bias and foreign direct investments (FDIs). We study the role of physical, cultural, and institutional distances from home on FDI decisions taken by corporations to assess whether the globalization of the past two decades has reduced their influence. Using the ‘home bias’ framework from the finance literature and the gravity model from the economics literature, we utilize a large sample of both developed and emerging markets, using FDI flows of 6263 unique bilateral country pairs over a 30-year period. We find strong empirical evidence of persistent home bias in FDI outflows, and we show that not only physical distance but also cultural and institutional similarities between host and source countries remain a decisive factor in foreign corporate investment decisions. We also show that such home bias is persistent over time and is observed around the world.

Against divisiveness: Digital workers of the world unite! A rejoinder to César Bolaño and Eloy Vieira

This piece is a short rejoinder to César Bolaño’s paper The Political Economy of the Internet and related articles (e.g., Comor, Foley, Huws, Reveley, Rigi and Prey, Robinson) that center around the relevance of Marx’s labor theory of value for understanding social media. I argue that Dallas Smythe’s assessment of advertising was made to distinguish his approach from the one by Baran and Sweezy. Smythe developed the idea of capital’s exploitation of the audience at a time when both feminist and anti-imperialist Marxists challenged the orthodox idea that only white factory workers are exploited. The crucial question is how to conceptualize productive labor. This is a theoretical, normative, and political question. A mathematical example shows the importance of the “crowdsourcing” of value-production on Facebook. I also point out parallels of the contemporary debate to the Soviet question of who is a productive or unproductive worker in the Material Product System.

Re-evaluation of a reported increased micronucleus frequency in lymphocytes of workers occupationally exposed to formaldehyde

A replicate evaluation of increased micronucleus (MN) frequencies in peripheral lymphocytes of workers occupationally exposed to formaldehyde (FA) was undertaken to verify the observed effect and to determine scoring variability. May–Grünwald–Giemsa-stained slides were obtained from a previously performed cytokinesis-block micronucleus test (CBMNT) with 56 workers in anatomy and pathology laboratories and 85 controls. The first evaluation by one scorer (scorer 1) had led to a highly significant difference between workers and controls (3.96 vs 0.81 MN per 1000 cells). The slides were coded before re-evaluation and the code was broken after the complete re-evaluation of the study. A total of 1000 binucleated cells (BNC) were analysed per subject and the frequency of MN (in ‰) was determined. Slides were distributed equally and randomly between two scorers, so that the scorers had no knowledge of the exposure status. Scorer 2 (32 exposed, 36 controls) measured increased MN frequencies in exposed workers (9.88 vs 6.81). Statistical analysis with the two-sample Wilcoxon test indicated that this difference was not significant (p = 0.17). Scorer 3 (20 exposed, 46 controls) obtained a similar result, but slightly higher values for the comparison of exposed and controls (19.0 vs 12.89; p = 0.089). Combining the results of the two scorers (13.38 vs 10.22), a significant difference between exposed and controls (p = 0.028) was obtained when the stratified Wilcoxon test with the scorers as strata was applied. Interestingly, the re-evaluation of the slides led to clearly higher MN frequencies for exposed and controls compared with the first evaluation. Bland–Altman plots indicated that the agreement between the measurements of the different scorers was very poor, as shown by mean differences of 5.9 between scorer 1 and scorer 2 and 13.0 between scorer 1 and scorer 3. Calculation of the intra-class correlation coefficient (ICC) revealed that all scorer comparisons in this study were far from acceptable for the reliability of this assay. Possible implications for the use of the CBMNT in human biomonitoring studies are discussed.

Occupational exposure to particulate matter and respiratory symptoms in Portuguese swine barn workers

Certain environmental conditions in animal and plant production have been associated with increased frequency in respiratory illnesses, including asthma, chronic bronchitis, and hypersensitivity pneumonitis, in farmers occupationally exposed in swine production. The aim of this study was to characterize particulate matter (PM) contamination in seven Portuguese swine farms and determine the existence of clinical symptoms associated with asthma and other allergy diseases, utilizing the European Community Respiratory Health Survey questionnaire. Environmental assessments were performed with portable direct-reading equipment, and PM contamination including five different sizes (PM0.5, PM1.0, PM2.5, PM5.0, PM10) was determined. The distribution of particle size showed the same trend in all swine farms, with high concentrations of particles with PM5 and PM10. Results from the questionnaire indicated a trend such that subjects with diagnosis of asthma were exposed to higher concentrations of PM with larger size (PM2.5, PM5, and PM10) while subjects with sneezing, runny nose, or stuffy nose without a cold or flu were exposed to higher concentrations of PM with smaller size (PM0.5 and PM1). Data indicate that inhalation of PM in swine farm workers is associated with increased frequency of respiratory illnesses.