Professing translation: the acts-in-between

Drawing on scholarship in translation ethics (Berman 1992; Cronin 2003) and performance studies (Conquergood 2002; Jackson 2004), this article approaches translation in the theatre from the double perspective of theory and practice. Professing translation as a model for the resolution of entrenched binaries (scholar/artist; theoretician/practitioner), the author sees the practice of translating for performance not just as a method of discovery or a hermeneutic tool but also as a mode of reflection that brings together both “readerly” and “writerly” approaches to text (Barthes 1974). By drawing on the experience of writing translations of García Lorca for the Belgrade Theatre, Calderón for the Royal Shakespeare Company, and Lope de Vega for the Watermill Theatre and the Washington Shakespeare Theatre, the article attempts to characterise such translation as an act of physical imagination, of a holistic understanding of both language and performance, into which textuality is incorporated and by which it is superseded. © John Benjamins Publishing Company

An evaluation of a domiciliary blood transfusion serivce for palliative care patients in Northern Ireland

Marie Curie Cancer Care (MCCC) is a national charitable organisation which provides specialist palliative care services to patients with cancer and other life limiting illnesses. Marie Curie Nursing Service (MCNS) provides nursing services to patients in their own homes. The administration of blood transfusions to palliative care patients is required to improve symptom management and quality of life; however this procedure often results in unnecessary hospital admissions. Recognising that the majority of patients wish to be cared for and die in their own home, and with National Guidance recommending that specialist palliative care services should be provided to patients in their preferred place of care, a recent service initiative by MCNS was domiciliary blood transfusions. Whilst this is not a new service within domiciliary care, this pilot project aimed to capture patient views to evaluate this service initiative. Telephone interviews were conducted, using a questionnaire, with 11 patients who had received the service. Findings indicated positive evaluation of the service. Domiciliary blood transfusions helped to avoid unnecessary hospital admissions, the quality of life of patients and their families was improved in the palliative phase of illness and they received the service in their preferred place of care.

Understanding Accountability in Social Enterprise Organisations: A Framework

Purpose: Social enterprise organisations (SEOs) operate across the boundaries of the public, private and not‐for‐profit (NFP) sectors in delivering public services and competing for resources and legitimacy. While there is a rich literature on accountability in the private and public sectors, together with the wider NFP sector, SEOs have received comparatively little attention and remain a relatively under‐researched organisational form. Drawing on accountability, legitimacy and user‐needs theories, the purpose of this paper is to develop a practical framework which can be used to explore how accountability within SEOs is constructed and discharged.

Design/methodology/approach: This paper draws on user‐needs, accountability, legitimacy and impression management theories expounded in relation to the private, public and NFP sectors.

Findings: A framework to better understand how accountability can be discharged by SEOs is developed and discussed.

Research limitations/implications: While a framework for better understanding SEO accountability is presented, it is not empirically tested. However, the framework has the potential to facilitate a deeper appreciation of the theory and practice of accountability within SEOs and, notwithstanding the inherent difficulties in measuring and managing accountability, could be used to stimulate practitioner involvement.

Practical implications
– As little is known about the current extent of SEO information disclosure or accountability relationships, the framework could be used to assess the discharge of accountability by SEOs, with the findings informing future developments. This should provide useful insights into internal processes and organisational views on accountability bases and mechanisms and can then be used to inform the debate on how SEOs can best discharge their duty to account.

Social implications
– Understanding the nature of SEO accountability reporting has important implications for those involved in advancing the SEO agenda. At a time of public sector cutbacks, and with the government searching for new and more effective ways of delivering services, the role of SEOs in this process is likely to receive greater attention and scrutiny.

Originality/value
– SEOs have grown extensively in size and prominence in recent years and policymakers have come to embrace the role that they play in societal development. This paper responds to a gap in the theoretical literature and contributes to the debate by developing a framework which can be empirically tested. Moreover, it can be used to prompt practitioner involvement and facilitate a better understanding of the complex issues surrounding accounting and accountability in this under‐researched area.

An On Demand Queue Management Architecture for a Programmable Traffic Manager

A queue manager (QM) is a core traffic management (TM) function used to provide per-flow queuing in access andmetro networks; however current designs have limited scalability. An on-demand QM (OD-QM) which is part of a new modular field-programmable gate-array (FPGA)-based TM is presented that dynamically maps active flows to the available physical resources; its scalability is derived from exploiting the observation that there are only a few hundred active flows in a high speed network. Simulations with real traffic show that it is a scalable, cost-effective approach that enhances per-flow queuing performance, thereby allowing per-flow QM without the need for extra external memory at speeds up to 10 Gbps. It utilizes 2.3%–16.3% of a Xilinx XC5VSX50t FPGA and works at 111 MHz.

Patient anxiety and IV sedation in Northern Ireland

Background In recent years there has been an increase in the provision of conscious sedation, which is said to be a safe and effective means of managing the anxious patient. However, there are no guidelines to aid the dental practitioner in assessing the patient's need for sedation based on their level of anxiety.

Aims and methods The present study investigated the importance of patient anxiety as an indicator for IV sedation, using focus groups to inform the development of narrative vignettes. Ninety-nine practitioners responded to a series of scenarios to determine whether the level of patient anxiety and the patient's demand for IV sedation influenced their decision making.

Results Level of dental anxiety had a stronger influence on the clinician's decision making than patient demand, with increasing levels of dental anxiety being positively associated with the likelihood of clinicians indicating a need for IV patient sedation and also, the likelihood of clinicians providing IV sedation to these patients. Only 14% (n = 14) of respondents reported formally assessing dental anxiety.

Conclusions While dental anxiety is considered to be a key factor in determining the need for IV sedation, there is a lack of guidance regarding the assessment of anxiety among patients.

False-positive PCR results linked to administration of seasonal influenza vaccine

False-positive PCR results usually occur as a consequence of specimen-to-specimen or amplicon-to-specimen contamination within the laboratory. Evidence of contamination at time of specimen collection linked to influenza vaccine administration in the same location as influenza sampling is described. Clinical, circumstantial and laboratory evidence was gathered for each of five cases of influenza-like illness (ILI) with unusual patterns of PCR reactivity for seasonal H1N1, H3N2, H1N1 (2009) and influenza B viruses. Two 2010 trivalent influenza vaccines and environmental swabs of a hospital influenza vaccination room were also tested for influenza RNA. Sequencing of influenza A matrix (M) gene amplicons from the five cases and vaccines was undertaken. Four 2009 general practitioner (GP) specimens were seasonal H1N1, H3N2 and influenza B PCR positive. One 2010 GP specimen was H1N1 (2009), H3N2 and influenza B positive. PCR of 2010 trivalent vaccines showed high loads of detectable influenza A and B RNA. Sequencing of the five specimens and vaccines showed greatest homology with the M gene sequence of Influenza A/Puerto Rico/8/1934 H1N1 virus (used in generation of influenza vaccine strains). Environmental swabs had detectable influenza A and B RNA. RNA detection studies demonstrated vaccine RNA still detectable for at least 66 days. Administration of influenza vaccines and clinical sampling in the same room resulted in the contamination with vaccine strains of surveillance swabs collected from patients with ILI. Vaccine contamination should therefore be considered, particularly where multiple influenza virus RNA PCR positive signals (e.g. H1N1, H3N2 and influenza B) are detected in the same specimen.

Working across boundaries to improve health outcomes: a case study of a housing support and outreach service for homeless people living with HIV

This paper reports the findings of an evaluation of the ‘Housing Support, Outreach and Referral’ service developed to support people living with HIV who were homeless or at risk of homelessness. The service was set up as part of the Supporting People Health Pilot programme established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper considers the role of housing support in improving people's health, and considers the challenges of working across housing, health and social care boundaries. The evaluation of the health pilot employed two main sources of data collection: quarterly project evaluation reports, which collected process data as well as reporting progress against aims and objectives, and semi-structured interviews with professionals from all key stakeholder groups and agencies, and with people who used services. Over the course of 15 months, 56 referrals were received of which 27 were accepted. Fifteen people received tenancy support of whom 12 were helped to access temporary accommodation. At the end of the 15 months, all of the tenancies had been maintained. In addition, 18 people registered with a general practitioner and 13 registered with an HIV clinic. Interviews with professionals emphasised the importance of the local joint working context, the involvement of the voluntary sector and the role of the support workers as factors that accounted for these outcomes. Those using services placed most emphasis on the flexibility of the support worker role. Importantly, interviews with professionals and those using services suggest that the role of support worker incorporates two dimensions – those of networker/navigator as well as advocate – and that both dimensions are important in determining the effectiveness of the service.

'The Grass is always Greener: Reflecting on Global Disparity in CSR'

The corporate landscape is ever changing. From the idea that the social responsibility of business was solely profit maximisation, toward the approach today, encompassing the inter-relationships of business, state and voluntary sectors through sets of relationships that transcend the nation state, the role of the corporation in society is being constantly remoulded to incorporate changes in said society. This evolution has benefitted many through the various Corporate Social Responsibility (CSR) programmes that have been promoted by various Multinational Corporations (MNCs).

This article argues that whereas many have benefitted from these policies, social responsibility can only be a by-product of the corporation. CSR exists as a powerful marketing tool and merely represents the repackaging of profit maximisation. This article will track the development of CSR in recent years. Noting that there is some disparity in regional trends for CSR, the article will then focus on how governments have enhanced the development of CSR practise within their nation states. This highlights a significant issue: if corporations are truly global in nature, why is there such a disparity over the level and intensity of CSR in differing nation states? As this article suggests, the role of government, the rise in power of the multinational corporation, together with the “strength” of that economy, the size of the population in that region, all impact on how robust, or otherwise, CSR is. What this highlights therefore is that CSR cannot be a form of regulation in its own right, and instead is a tool for profit maximisation, with social good being a by-product.

Deep vein thrombosis and caesarean section

Deep vein thrombosis (DVT) presents a significant risk for women requiring Caesarean section.
Venous thromboembolism (VTE) remains the leading direct cause of maternal death in the
UK and is the second most common cause of maternal death worldwide, accounting for 11%
of maternal deaths (RCOG 2009). This article uses a reflective cycle to explore the role of the
preoperative practitioner in the prevention of DVT for women undergoing elective Caesarean
section.

Psychosocial factors in GP work:the effects of taking a GP position or leaving GP work

BACKGROUND: We examined the effects of leaving public sector general practitioner (GP) work and of taking a GP position on changes in work-related psychosocial factors, such as time pressure, patient-related stress, distress and work interference with family. In addition, we examined whether changes in time pressure and patient-related stress mediated the association of employment change with changes of distress and work interference with family. METHODS: Participants were 1705 Finnish physicians (60% women) who responded to surveys in 2006 and 2010. Analyses of covariance were conducted to examine the effect of employment change to outcome changes adjusted for gender, age and response format. Mediational effects were tested following the procedures outlined by Baron and Kenny. RESULTS: Employment change was significantly associated with all the outcomes. Leaving public sector GP work was associated with substantially decreased time pressure, patient-related stress, distress and work interference with family. In contrast, taking a position as a public sector GP was associated with an increase in these factors. Mediation tests suggested that the associations of employment change with distress change and work interference with family change were partially explained by the changes in time pressure and patient-related stress. CONCLUSIONS: Our results showed that leaving public sector GP work is associated with favourable outcomes, whereas taking a GP position in the public sector is associated with adverse effects. Primary health-care organizations should pay more attention to the working conditions of their GPs, in particular, to time pressure and patient-related stress.

More equitable systems for allocating general practice deprivation payments:financial consequences

The allocation of general practitioner (GP) deprivation payments has been a controversial topic since they were first proposed. It has recently been suggested that the current system could be made more equitable if the payments were allocated at enumeration districts and if there was a more graded relationship between Jarman score and funding. However, the implications of these changes on the distribution of deprivation payments have not been worked out.

Patients on H2-receptor antagonists--are we investigating them?

A survey was made of patients receiving H2-receptor antagonists in a group practice serving 8600 patients. Two hundred and twelve patients (2%) who had received at least one prescription for H2 antagonists in a 12 month period were identified. When compared with the practice population, men and patients over 50 years old were more likely to be taking these drugs (P less than 0.01 and P less than 0.001, respectively). One hundred and fifty-seven patients (74%) were investigated before commencing therapy; 114 (73%) of these patients were investigated via the hospital outpatient department, despite the general practitioners having full open access to barium meals. Only 23 (15%) of the patients investigated were found to have no active pathology. Twenty-nine (14%) of the 212 study patients had received one or more gastrointestinal investigations in the 18 months subsequent to starting H2-antagonist therapy. Twenty-five of these patients had also received an investigation before starting therapy. One hundred and eleven patients (52%) had had their H2 antagonist therapy initiated by their general practitioner.

A study of HPV 1, 2 and 4 antibody prevalence in patients presenting for treatment with cutaneous warts to general practitioners in N. Ireland

Three hundred and seventy-six patients attending their general practitioner with cutaneous warts at five health centres in Northern Ireland were screened for human papilloma virus (HPV) types 1 and 2 IgM antibody using an indirect immunofluorescence test. Eight-eight (23.4%) patients were positive for HPV type 1 IgM and 156 (41.5%) for HPV type 2 IgM. HPV 1 IgM antibody was significantly more likely to be associated with plantar warts than warts elsewhere (P less than 0.0001). HPV 2 IgM was present in 45 (34.1%) patients with plantar warts and 99 (45.6%) patients with warts at other sites (P = 0.1). Evidence of multiple infection by HPV types 1 and 2 was demonstrated by the finding of HPV 1 and 2 IgM antibodies in the sera of 16 (4.3%). HPV 4 was found in only 1 out of 30 biopsies and HPV 4 IgM was undetectable in 50 randomly chosen sera.