Emotional insecurity in the family and community and youth delinquency in Northern Ireland: A person-oriented analysis across five-waves

Background: Over one billion children are exposed worldwide to political violence and armed conflict. Currently, conclusions about bases for adjustment problems are qualified by limited longitudinal research from a process-oriented, social-ecological perspective. In this study, we examined a theoretically-based model for the impact of multiple levels of the social ecology (family, community) on adolescent delinquency. Specifically, this study explored the impact of children’s emotional insecurity about both the family and community on youth delinquency in Northern Ireland. Methods: In the context of a five-wave longitudinal research design, participants included 999 mother-child dyads in Belfast (482 boys, 517 girls), drawn from socially-deprived, ethnically-homogenous areas that had experienced political violence. Youth ranged in age from 10 to 20 and were 12.18 (SD = 1.82) years old on average at Time 1. Findings: The longitudinal analyses were conducted in hierarchical linear modeling (HLM), allowing for the modeling of inter-individual differences in intra-individual change. Intra-individual trajectories of emotional insecurity about the family related to children’s delinquency. Greater insecurity about the community worsened the impact of family conflict on youth’s insecurity about the family, consistent with the notion that youth’s insecurity about the community sensitizes them to exposure to family conflict in the home. Conclusions: The results suggest that ameliorating children’s insecurity about family and community in contexts of political violence is an important goal toward improving adolescents’ well-being, including reduced risk for delinquency.

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.

Differences Between Irish and Australian Psychiatric Nurses' Family Focused Practice in Adult Mental Health Services

Psychiatric nurses’ practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses’ family focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

Supervisor Continuity or Co-Location: Which Matters in Residency Education? Findings From a Qualitative Study of Remote Supervisor Family Physicians in Australia and Canada

Purpose: Changes to health care systems andworking hours have fragmentedresidents’ clinical experiences withpotentially negative effects ontheir development as professionals.Investigation of off-site supervision,which has been implemented in isolatedrural practice, could reveal importantbut less overt components of residencyeducation. 

Method: Insights from sociocultural learningtheory and work-based learning provideda theoretical framework. In 2011–2012,16 family physicians in Australia andCanada were asked in-depth how theyremotely supervised residents’ workand learning, and for their reflectionson this experience. The verbatiminterview transcripts and researchers’memos formed the data set. Templateanalysis produced a description andinterpretation of remote supervision. 

Results: Thirteen Australian family physiciansfrom five states and one territory, andthree Canadians from one province,participated. The main themes werehow remoteness changed the dynamicsof care and supervision; the importanceof ongoing, holistic, nonhierarchical,supportive supervisory relationships; andthat residents learned “clinical courage”through responsibility for patients’ careover time. Distance required supervisorsto articulate and pass on their expertiseto residents but made monitoringdifficult. Supervisory continuityencouraged residents to build on pastexperiences and confront deficiencies. 

Conclusions: Remote supervision enabled residents todevelop as clinicians and professionals.This questions the supremacy of co-locationas an organizing principle forresidency education. Future specialists maybenefit from programs that give themongoing and increasing responsibilityfor a group of patients and supportive.

The Effect of Community-Based Specialist Palliative Care Teams on Place of Care

BACKGROUND: Prior research on community-based specialist palliative care teams used outcome measures of place of death and/or dichotomous outcome measures of acute care use in the last two weeks of life. However, existing research seldom measured the diverse places of care used and their timing prior to death.

OBJECTIVE: The study objective was to examine the place of care in the last 30 days of life.

METHODS: In this retrospective cohort study, patients who received care from a specialist palliative care team (exposed) were matched by propensity score to patients who received usual care in the community (unexposed) in Ontario, Canada. Measured was the percentage of patients in each place of care in the last month of life as a proportion of the total cohort.

RESULTS: After matching, 3109 patients were identified in each group, where 79% had cancer and 77% received end-of-life home care. At 30 days compared to 7 days before death, the exposed group's proportions rose from 33% to 41% receiving home care and 14% to 15% in hospital, whereas the unexposed group's proportions rose from 28% to 32% receiving home care and 16% to 22% in hospital. Linear trend analysis (proportion over time) showed that the exposed group used significantly more home care services and fewer hospital days (p < 0.001) than the unexposed group. On the last day of life (place of death), the exposed group had 18% die in an in-patient hospital bed compared to 29% in usual care.

CONCLUSION: Examining place of care in the last month can effectively illustrate the service use trajectory over time.

Mental Health Nurses' Family Focused Practice with Parents who have Mental Illness, their Children and Families in Adult Mental Health Services in Ireland

Introduction: While it is recommended that mental health professionals engage in family focused practice (FFP), there is limited understanding regarding psychiatric nurses’ practice with parents who have mental illness, their children and families in adult mental health services.

Methods: This study utilized a mixed methods approach to measure the extent of psychiatric nurses’ family focused practice and factors that predicted it. It also sought to explore the nature and scope of high scoring psychiatric nurses’ FFP and factors that affected their capacity to engage in FFP. Three hundred and forty three psychiatric nurses in 12 mental health services throughout Ireland completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Fourteen nurses who achieved high scores on the FFMHPQ also participated in semi-structured interviews.

Results: Whilst the majority of nurses were not family focused a substantial minority were. High scoring nurses’ practice was complex and multifaceted, comprising various family focused activities, principles and processes. Nurses’ capacity to engage in FFP was determined by their knowledge and skills, working in community settings and own parenting experience.

Conclusions: Generally, low levels of family focused practice suggest the need for organizations to develop and implement guidelines, policies and training to support mental health professionals to adopt a whole family approach.

Handbook of Disabled Children's Childhoods: Building Understandings: Child, Youth, Family and Disability. Palgrave Macmillan:Disabled Children in Out-of-Home Care: Issues and Challenges for Practice Kelly, B., Sandra, D. & Winter, K. 2016

This chapter provides an overview of some of the key findings from a large mixed methods study regarding disabled children in care in Northern Ireland

A revision of the polychaete family Nephtyidae, based on morphological and molecular data

A família Nephtyidae é uma das mais frequentes em habitats costeiros e marinhos de todo o mundo. São organismos errantes típicos de sedimentos arenosos e lodosos, ocorrendo frequentemente no domínio costeiro até 100 m de profundidade, e mais raramente em profundidades batiais e abissais. As primeiras espécies descritas foram o Nephtys caeca (Fabricius, 1780) e o N. ciliata (O. F. Müller, 1789), ambas atribuídas inicialmente ao género Nereis e posteriormente transferidas para o género Nephtys por Savigny, em 1818. A família Nephtyidae foi criada em 1851 por Grube para o género Nephtys Cuvier, 1817. No âmbito desta tese é feito um estudo taxonómico e filogenético da família Nephtyidae. O estudo filogenético inclui dados morfológicos e moleculares de 24 taxa representantes dos cinco géneros da família, Nephtys Cuvier, 1817, Aglaophamus Kinberg, 1866, Micronephthys (Friedrich, 1939), Inermonephtys Fauchald, 1967 e Dentinephtys Imajima e Takeda, 1987. A análise evidenciou dois grandes grupos correspondentes aos dois principais géneros, Aglaophamus e Nephtys. Duas espécies do género Nephtys (N. pulchra e N. australiensis) são transferidas para o género Aglaophamus, e consequentemente são propostas novas diagnoses para os géneros. O género Dentinephtys é sinonimizado com Nephtys e um novo género, Bipalponephtys, é descrito para acomodar as espécies Nephtys cornuta, N. danida e Micronephthys neotena. As relações filogenéticas entre os géneros são discutidas. Do estudo taxonómico resultou a revisão da família Nephtyidae para o Sul da Europa (entre o Canal da Mancha e o Mediterrâneo), com a descrição de uma nova espécie, Inermonephtys foretmontardoi. A espécie Micronephthys maryae é sinonimizada com M. stammeri. Para cada espécie são incluídas notas sobre a sua ecologia bem como a distribuição geográfica e batimétrica. São propostas novas diagnoses para os géneros do Sul da Europa bem como uma chave de identificação taxonómica para as espécies desta região. Após uma exaustiva revisão bibliográfica da família, e da observação de material museológico relativo a 44 espécies, foi compilada uma lista completa para a família de 128 espécies, distribuídas por cinco géneros (57 Nephtys, 53 Aglaophamus, sete Micronephthys, oito Inermonephtys e três Bipalponephtys), na qual são incluídas sinonímias e considerações taxonómicas para cada espécie. A espécie Nephtys serrata é sinonimizada com N. serratifolia. São apresentados as distribuições geográficas e batimétricas das diferentes espécies e notas sobre o seu habitat. São também incluídas tabelas de identificação com as principais características taxonómicas das espécies. O valor diagnóstico dos caracteres morfológicos é discutido. Vários problemas taxonómicos são realçados, indicando a necessidade de revisões adicionais para 23 espécies. Este trabalho realça a existência de vários problemas taxonómicos e filogenéticos dentro da família Nephtyidae, podendo ser considerado como a base para estudos futuros. Análises filogenéticas adicionais incluindo dados morfológicos e moleculares de um maior número de espécies vão certamente conduzir a uma melhor avaliação do estatuto e relações entre os géneros dentro da família.

A Designer’s Approach: Exploring how Autistic Adults with Additional Learning Disabilities Experience their Home Environment

Autistic adults with limited speech and additional learning disabilities are people whose perceptions and interactions with their environment are unique, but whose experiences are under-explored in design research. This PhD by Practice investigates how people with autism experience their home environment through a collaboration with the autism charity Kingwood Trust, which gave the designer extensive access to a community of autistic adults that it supports. The PhD reflects upon a neurotypical designer’s approach to working with autistic adults to investigate their relationship with the environment. It identifies and develops collaborative design tools for autistic adults, their support staff and family members to be involved. The PhD presents three design studies that explore a person’s interaction with three environmental contexts of the home i.e. garden, everyday objects and interiors. A strengths-based rather than a deficit-based approach is adopted which draws upon an autistic person’s sensory preferences, special interests and action capabilities, to unravel what discomfort and delight might mean for an autistic person; this approach is translated into three design solutions to enhance their experience at home. By working beyond the boundaries of a neurotypical culture, the PhD bridges the autistic and neurotypical worlds of experience and draws upon what the mainstream design field can learn from designing with autistic people with additional learning disabilities. It also provides insights into the subjective experiences of people who have very different ways of seeing, doing and being in the environment

ANN based day-ahead ancillary services forecast for electricity market simulation

Adequate decision support tools are required by electricity market players operating in a liberalized environment, allowing them to consider all the business opportunities and take strategic decisions. Ancillary services (AS) represent a good negotiation opportunity that must be considered by market players. Based on the ancillary services forecasting, market participants can use strategic bidding for day-ahead ancillary services markets. For this reason, ancillary services market simulation is being included in MASCEM, a multi-agent based electricity market simulator that can be used by market players to test and enhance their bidding strategies. The paper presents the methodology used to undertake ancillary services forecasting, based on an Artificial Neural Network (ANN) approach. ANNs are used to day-ahead prediction of non-spinning reserve (NS), regulation-up (RU), and regulation down (RD). Spinning reserve (SR) is mentioned as past work for comparative analysis. A case study based on California ISO (CAISO) data is included; the forecasted results are presented and compared with CAISO published forecast.

Mixed integer non linear programming and artificial neural network based approach to ancillary services dispatch in competitive electricity markets

Ancillary services represent a good business opportunity that must be considered by market players. This paper presents a new methodology for ancillary services market dispatch. The method considers the bids submitted to the market and includes a market clearing mechanism based on deterministic optimization. An Artificial Neural Network is used for day-ahead prediction of Regulation Down, regulation-up, Spin Reserve and Non-Spin Reserve requirements. Two test cases based on California Independent System Operator data concerning dispatch of Regulation Down, Regulation Up, Spin Reserve and Non-Spin Reserve services are included in this paper to illustrate the application of the proposed method: (1) dispatch considering simple bids; (2) dispatch considering complex bids.

Multi-agent system for personalization of location-based services

The current ubiquitous network access and increase in network bandwidth are driving the sales of mobile location-aware user devices and, consequently, the development of context-aware applications, namely location-based services. The goal of this project is to provide consumers of location-based services with a richer end-user experience by means of service composition, personalization, device adaptation and continuity of service. Our approach relies on a multi-agent system composed of proxy agents that act as mediators and providers of personalization meta-services, device adaptation and continuity of service for consumers of pre-existing location-based services. These proxy agents, which have Web services interfaces to ensure a high level of interoperability, perform service composition and take in consideration the preferences of the users, the limitations of the user devices, making the usage of different types of devices seamless for the end-user. To validate and evaluate the performance of this approach, use cases were defined, tests were conducted and results gathered which demonstrated that the initial goals were successfully fulfilled.