The adaptations of a quality of life questionnaire for routine use in clinical practice: the Chronic Respiratory Disease Questionnaire in Cystic Fibrosis.

The assessment of quality of life (QOL) is necessary to monitor the course of disease and to assess the effect of new and existing interventions in clinical practice. This will only be achieved if QOL can be measured accurately and routinely. The aim of this study was to demonstrate the methodology involved in the adaptation and shortening of the Chronic Respiratory Disease Questionnaire (CRDQ) in a population of adults with cystic fibrosis (CF). A single interviewer administered the CRDQ to a sample of 45 adult patients (32 males) with CF prior to assessment of spirometric measures of lung function. Those patients whose lung function was stable at the time of study, and who could attend for a retest within 14 days, were asked to complete the questionnaire at a subsequent visit (n=10). The average interval between visits was 7 days (range 5-14 days). Correlations between spirometry and CRDQ dimensions ranged from -0.003 to 0.426. The fatigue, emotion and mastery dimensions showed high internal consistency, and adequate construct validity. In the small number of patients suitable for retest, the results indicated that the dimensions exhibited adequate test retest reliability. In contrast low internal consistency was demonstrated for the dyspnoea dimension. The fatigue, emotion and mastery dimensions could be reduced, in terms of their number of items without a substantial loss in explanatory power. This study suggests that QOL measurement can be made convenient, and so more easily accessible for routine clinical assessment.

The IHS monogram as a symbol of Catholic resistance in 17th century Ireland

It has been suggested that the presence of religious images and scenes in secular buildings of sixteenth-century date can be viewed as an expression of resistance by the native Irish to English colonial activity in the aftermath of the Munster Plantation (J. A. Delle, 1999, International Journal of Historical Archaeology 3: 11–35). Such images, however, may merely represent a continuation into the early modern period of a Medieval tradition of adorning secular houses with devotional images. If a religious symbol of native Catholic resistance to English colonization and Protestantism in Munster is to be sought then perhaps a more appropriate image would be the I.H.S. monogram—a symbol associated with the Counter Reformation and the Jesuits. The paper presents an example of the monogram located within a tower house at Gortnetubbrid in County Limerick, Ireland.

Obesity in People with Learning Disabilities: the impact of nurse led health screenings and health promotion activities

Background. Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. Aim. Firstly, to follow up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. Methods. A clinic led by two learning disbaility nurses was held for all people aged 10 years and over (n=464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organised health promotion classes for 20 people over a 6 - 8 week period. Findings. The health screen identified 64% of adults and 26% of 10 - 19 year olds as being overweight or obese. Moreover, those aged 40 - 49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow up questionnaire sent after 3 months suggested that of the 122 people identified for wiehgt reduciton, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. Conclusion. Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabiltieis to create more active lifestyles.

Temporal patterns of territory settlement and detectability in mated and unmated Nightingales Luscinia megarhynchos

In many bird species the sex ratio of adults is male-biased, which is likely to have consequences for the ecology as well as for the conservation of a species. For example, when some males remain unpaired in a population, there should be strong selection on behavioural traits that enhance pairing success. A surplus of males is also likely to have important implications for the interpretation of breeding bird survey data. In our study population of Nightingales Luscinia megarhynchos, about half of the males stayed unpaired, suggesting that the number of males encountered singing was greater than the number of breeding pairs. Furthermore, the detectability (the probability of encountering a male singing) of mated males was only two-thirds that of unmated males when censused in the morning or late in the breeding season. The relative detectability was more similar early in the season and during the twilight periods before sunrise and after sunset. Males that arrived earlier on the breeding grounds were more successful in attracting a mate than males arriving later. Some of the unmated males deserted their territories and prospected areas up to 4000 m distant, whereas others settled on the study site only late in the season and may actually have changed territories. We suggest that adult sex ratios and the time of the census should be taken into account when interpreting the results of breeding bird surveys.

A Longitudinal Study of the Effects of Childhood Trauma on Symptoms and Functioning of People with Severe Mental Health Problems

This study examines the relationship between childhood trauma and the psychiatric symptoms and psychosocial functioning of adults with severe mental health problems. Participants (n = 31) were recruited from the caseloads of community mental health services in Northern Ireland and assessed at baseline, 9 months, and 18 months. More than half had a history of childhood trauma (n = 17). There were no differences between the no childhood trauma (n = 14) and childhood trauma groups on psychiatric symptoms, but a significant relationship was found between trauma history and all aspects of social functioning. Those with no history of trauma showed improved psychosocial functioning over time, whereas those with a history of trauma deteriorated. These findings have implications for current service provision.

The role of theory in promoting social work values and its potential effect on outcomes in work with domestically violent men

This article is concerned with the ethical conflicts that arise for social workers when dealing with males that perpetrate violence against women and children with whom they have or had intimate relationships. In particular, the article seeks to highlight how a strong social work value base is essential when working with perpetrators whose apparent wilful violent controlling behaviour creates a major ethical dilemma for the practising social worker. The argument contends that strategies designed to protect and enhance the welfare of domestic violence victims, particularly those aimed at the re-education of perpetrators, are weakened when social workers do not adhere to a social work value base.

Temporal information and children's and adults' causal inferences

Three experiments examined whether children and adults would use temporal information as a cue to the causal structure of a three-variable system, and also whether their judgements about the effects of interventions on the system would be affected by the temporal properties of the event sequence. Participants were shown a system in which two events B and C occurred either simultaneously (synchronous condition) or in a temporal sequence (sequential condition) following an initial event A. The causal judgements of adults and 6-7-year-olds differed between the conditions, but this was not the case for 4-year-olds' judgements. However, unlike those of adults, 6-7-year-olds' intervention judgements were not affected by condition, and causal and intervention judgements were not reliably consistent in this age group. The findings support the claim that temporal information provides an important cue to causal structure, at least in older children. However, they raise important issues about the relationship between causal and intervention judgements.

The discursive capacity of graphic design

The relationship between rhetoric and graphic design is presented in this article. The comparison between a classical orator and a graphic designer, between a discourse and a piece of design comes from the connections between with the communication and creativity. We will see how an application of the fundamentals of rhetoric can open new doors to the professional practice, the education of graphic design and the same theory of the rhetoric of the image.By the analysis of a design is exemplified the points of union that show how the arguments, operations, figures of discourse and rhetorical phases are present in the creative process of graphic design and how designers, perhaps unconsciously, use techniques that were traditional. In other words, graphic design is a rhetorical construction.There is then a transposition of a discourse model created by linguistic signs to a discourse model consists of visual and typographic signs, causing design is seen as a discursivediscipline that goes beyond the aesthetic component.

Avoidance of filial cannibalism in the amphipod Gammarus pulex.

Adult animals that cannibalise juvenile conspecifics may gain energy but also risk filial cannibalism, that is, consumption of their own offspring. However, individuals vary in the magnitude of the costs and benefits of cannibalism depending on factors such as their current energy reserves or the probability that they have offspring in the vicinity. They may therefore also vary in the extent to which they participate in cannibalism. This study investigated whether the sex or brooding status of adult amphipods (Gammarus pulex) influenced whether they participated in cannibalism of juveniles. For females carrying embryos within their brood pouch, we also investigated two hypotheses to explain the presence or absence of cannibalistic behaviour by determining whether cannibalism was correlated with factors that might reflect energy demands (body length, brood size), or that might reflect a temporal change in cannibalistic behaviour (corresponding to stage of brood development). All reproductive classes of adults participated in some level of juvenile cannibalism, but females carrying offspring at an advanced stage of development (close to emergence from the brood pouch) consumed significantly fewer juveniles than other groups. Females thus appear to significantly reduce cannibalism of juveniles concurrent with the time when their own eggs are hatching within the brood pouch, prior to the release of their offspring. Because the experiment tested female responses to unfamiliar juveniles, this reflects a temporal change in behaviour rather than a response to phenotypic recognition cues, although additional direct recognition cannot be ruled out. Brooding females with large brood sizes or large body lengths, which might have disproportionately greater energetic demands, were not more likely to cannibalise juveniles. We also noted that juveniles that survived in trials where cannibalism occurred were significantly more likely to be found at the water surface, suggesting a possible adaptation to escape cannibalistic adults. Overall, our results provide evidence that amphipods use indirect temporal cues to avoid filial cannibalism.

Costing the hospital-based process of resettling people with learning disability in the community

Objectives: Much has been written about the costs and cost-effectiveness of community care for people with learning disabilities resettled from long stay hospital care. However, comparatively little has been published about the cost of hospital services relating to the preparatory process before eventual resettlement and the disengagement of formal, sustained input from hospital staff. This study describes and costs the input provided by a hospital based multi-disciplinary team into the resettlement of adults with learning disabilities, from long stay wards in Muckamore Abbey Hospital in Northern Ireland between 1996 and 1999 (n = 71).