The Impact of Engagement Processes on the First Appointment Attendance Rate at a Regional Outpatient Psychological Trauma Service.

The effectiveness of simple measures to increase attendance at first appointments is briefly reviewed. The Family Trauma Centre’s remit and pre-study engagement process are described. The perceived idiosyncratic aspects of inviting people suffering from psychological trauma to attend a clinical service are noted as contributory factors in initially tolerating a high first appointment DNA rate. Three new initial engagement processes are then described and results of their application to 30 referrals in total are presented. The overwhelming finding is that paying close attention to any of the three initial engagement processes significantly increases first appointment attendance. Based on these findings the Centre developed a new initial engagement protocol.. The principle that services should pay more attention to their engagement processes than on the characteristics of their client groups when seeking to reduce first appointment DNA rates is supported.

Lamprey (Lampetra fluviatilis and Lampetra planeri) ammocoete habitat associations at regional, catchment and microhabitat scales in Northern Ireland

Habitat characteristics associated with lamprey ammocoetes (Lampetra spp.) were investigated at three different spatial scales: regional (Northern Ireland), catchment (Ballinderry River) and microhabitat. At the regional scale, ammocoetes were more abundant in rivers with a pH >= 8.2, while within a catchment, abundance was negatively related to the number of potential lamprey barriers and distance upstream. At the microhabitat scale, at sites where ammocoetes were present, ammocoetes were more abundant where median phi >= 1.94 (very coarse sand), where sediment depth >= 11.5 cm, and where kurtosis was >1.71. This study provides information on habitat associations of lamprey in the UK which may be of use in their conservation, in particular it highlights the negative association of migration barriers with lamprey abundance.

Disparities in breast cancer mortality trends between 30 European countries: Retrospective trend analysis of WHO mortality database

Objective: To examine changes in temporal trends in breast cancer mortality in women living in 30 European countries.
Design: Retrospective trend analysis.
Data source: WHO mortality database on causes of deaths
Subjects reviewed: Female deaths from breast cancer from 1989 to 2006
Main outcome measures: Changes in breast cancer mortality for all women and by age group (<50, 50-69, and >= 70 years) calculated from linear regressions of log transformed, age adjusted death rates. Joinpoint analysis was used to identify the year when trends in all age mortality began to change.
Results: From 1989 to 2006, there was a median reduction in breast cancer mortality of 19%, ranging from a 45% reduction in Iceland to a 17% increase in Romania. Breast cancer mortality decreased by >= 20% in 15 countries, and the reduction tended to be greater in countries with higher mortality in 1987-9. England and Wales, Northern Ireland, and Scotland had the second, third, and fourth largest decreases of 35%, 29%, and 30%, respectively. In France, Finland, and Sweden, mortality decreased by 11%, 12%, and 16%, respectively. In central European countries mortality did not decline or even increased during the period. Downward mortality trends usually started between 1988 and 1996, and the persistent reduction from 1999 to 2006 indicates that these trends may continue. The median changes in the age groups were -37% (range -76% to -14%) in women aged <50, -21% (-40% to 14%) in 50-69 year olds, and -2% (-42% to 80%) in >= 70 year olds.
Conclusions: Changes in breast cancer mortality after 1988 varied widely between European countries, and the UK is among the countries with the largest reductions. Women aged <50 years showed the greatest reductions in mortality, also in countries where screening at that age is uncommon. The increasing mortality in some central European countries reflects avoidable mortality.

Voodoo Institution or Entrepreneurial University? Spin-off Companies, the Entrepreneurial System and Regional Development in the UK

University spin-off companies occupy a prominent position in both government and university policies and aspirations for the commercialization of university research for economic benefit at regional and national levels. However, most university spin-off companies start small and remain small, reflecting founder aspirations, capabilities, and resource endowments. Based on detailed analysis of university spin-offs in Northern Ireland, it is concluded that these companies are technology lifestyle businesses not dynamic high-growth potential start-ups, and it is suggested that the prominence given to spin-offs in the analysis of technology transfer and in discussions of the economic impacts of universities is misplaced.

Utility, Caller, and Patient Profile of a Novel Chemotherapy Telephone Helpline Service Within a Regional Cancer Centre in Northern Ireland

Background: The telephone is an accepted and useful means of communication for the management of patient care. The Chemotherapy Telephone Helpline (CTH) service, located in a large inner-city Trust within the United Kingdom, is a unique nurse-led service within Northern Ireland.

Objective: The objective of the study was to investigate the utility, caller, and patient profile of a novel CTH.

Methods: This was a retrospective study of telephone contacts during 2007 to the CTH. Calls were categorized by caller and patient characteristics, reason for call, and subsequent action.

Results: A total of 7498 calls were made to the CTH during 2007. Of these, 25.6% occurred outside 8AM-4PM. Callers included patients (45.8%), lay carers (31%), and health care professionals (20.5%); 35.2% of calls concerned patients with polysymptomatic problems; 36.8% of calls led directly to patients being medically assessed.

Conclusions: The utility of the CTH service confirms the need of this nurse-led service. This service facilitates access to specialist advice and support for patients, their families, and allied health care professionals.

Implications for Practice: The international significance of these findings for practice includes its demonstration of the multifaceted symptom experience of patients receiving chemotherapy and highlights the importance of rapid access to specialist cancer services for patients and their lay and professional carers. In addition, it demonstrates the capacity of helplines to identify gaps in professional skills and training.

The development of University Technology Transfer stakeholder relationships at a regional level: Lessons for the future

The increasing importance placed upon regional development and the knowledge-based economy as economic growth stimuli has led to a changing role for Universities and their interaction with the business community through (though not limited to) the transfer of technology from academia to industry. With the emergence of Local Enterprise Partnerships (LEPs) replacing the Regional Development Agencies (RDAs), there is a need for policy and practice going forward to be clearly informed by a critique of TTO (Technology Transfer Office)–RDA stakeholder relationship in a lessons learned approach so that LEPs can benefit from a faster learning curve. Thus, the aim of this paper is to examine the stakeholder relationship between three regional universities in the context of its TTO and the RDA with a view to determining lessons learned for the emerging LEP approach. Although the issues raised are contextual, the abstracted stakeholder conceptualisation of the TTO–RDA relationship should enable wider generalisation of the issues raised beyond the UK. Stakeholder theory relationship and stage development models are used to guide a repeat interview study of the TTO and RDA stakeholder groupings. The findings, interpreted using combined category and stage based stakeholder models, show how the longitudinal development of the TTO–RDA stakeholder relationship for each case has progressed through different stakeholder pathways, and stages where specific targeting of funding was dependant on the stakeholder stage. Greater targeted policy and funding, based on the stakeholder relationship approach, led to the development of joint mechanisms and a closer alignment of performance measures between the TTO and the RDA. However, over-reliance on the unitary nature of the TTO–RDA relationship may lead to a lack of cultivation and dependency for funding from other stakeholders.

The Hekla 1947 tephra in the North of Ireland: regional distribution, concentration and geochemistry.

A cryptotephra layer from the eruption of Hekla in 1947 has recently been discovered in Irish peatlands. This tephra layer represents the most recent deposition of volcanic ash in the UK prior to the eruption of Eyjafjallajökull in 2010. Here we examine the concentration and geochemistry of the Hekla 1947 tephra in 14 peat profiles from across Northern Ireland. Electron probe microanalysis of individual tephra shards (n?=?91) reveals that the tephra is of dacitic–andesitic geochemistry and is highly similar to the Hekla 1510 tephra, although spheroidal carbonaceous particle profiles can be used for successful discrimination of the two layers. The highest concentrations of Hekla 1947 are found in western sites, probably reflecting the pathway of the ash fall event due to the prevailing wind direction. Comparable tephra concentrations from two cores (1?km apart) from a single bog and from nearby sites may suggest that tephra shard concentrations in peat profiles reflect ash fallout densities across a specific region, rather than site-specific factors associated with peatlands. This paper firmly establishes Hekla 1947 as a useful chronostratigraphic marker for the twentieth century, although within a restricted zone.