The practice of home in old Cairo: Towards socio-spatial models of sustainable living

The article investigates the practice of home as an everyday system for sustainable living in Old Cairo. The idea of home in this historic urban space has long involved fluid socio-spatial associations and made efficient use of space-activity-time dynamics. As in the past, a individual’s sense of home may here extend beyond or shrink within the physical boundaries of a particular house, as spatial settings are produced and consumed according to time of day, gender association, or special events. The article argues that architects working in this context must understand the dynamics of this complex traditional system if they are to develop locally informed, genuine designs that build on everyday spatial practices. Work by the architect Salah Zaki Said and by the Historic Cities Program of the Aga Khan Trust for Culture is described to illustrate the potential of such engagement, especially as it contrasts to more abstract architectural proposals.

The European oyster (Ostrea edulis) and its epibiotic succession

This study aimed to investigate intra- and inter-site differences in the epibiota on the European oyster Ostrea edulis of different ages and on hard substrata to assess their contribution to biodiversity. This research has shown that shells of O. edulis do show higher species diversity than non-living hard substrata and as oysters grow larger epibiotic diversity will increase. This investigation has revealed that O. edulis possesses biogenic engineering qualities and the value of O. edulis as a vehicle for increasing biodiversity should not be underestimated. Relatively few studies have examined the shell surfaces of Ostrea edulis, which, together with their associated epifauna provide a large portion of the natural hard substrata for sessile filter-feeding organisms, including oysters, in coastal and estuarine ecosystems. It can be considered a keystone species which has an influence on intertidal and subtidal community structures.

Exploring and comparing the experience and coping behaviour of men and women with colorectal cancer after chemotherapy treatment:A qualitative longitudinal study

Objectives: Men have higher incidence and mortality rates for nearly all cancers. They are less likely than women to utilise cancer information services and other social support services. The aim of this study was to explore and compare the experience and coping behaviour of men and women after treatment for colorectal cancer (CRC). Methods: A longitudinal qualitative study was conducted involving 38 individuals (24 men and 14 women) with CRC. Data were generated using semi-structured interviews at four time points over an 18-month period, post-diagnosis. Interviews focused on participant's experience of CRC and on how gender affected their coping. This paper reports the findings of interviews 3 and 4 which examined the participant's experience after chemotherapy. Results: Three themes emerged from the interviews ('new normal', living with uncertainty and support needs). Many men and women reacted similarly; however, there was some variation evident between and within sexes. The main difference was with regard to the long-term physical side effects of the illness. Many women admitted to still experiencing side effects, whereas many men indicated that they had no problems. These men engaged in practices that aligned with their gender identity and view of masculinity. It must be noted that some men and women were still experiencing an impact. Conclusions: Recovery from the physical and psychological effects of CRC does not occur simultaneously. Healthcare professionals should be aware that not all men (or women) conform to the social stereotypes of masculinity (or femininity). Copyright © 2010 John Wiley & Sons, Ltd.

Segregation Preferences of Urban and Rural 16-year-olds in Northern Ireland

Sectarian violence in the Northern Ireland is often perceived to be mostly confined to cities. The aim of this paper is to explore statistically what factors contribute to segregation preferences among young people living in rural and urban areas, using the 2005–2009 Young Life and Times (YLT) survey – an annual attitudes survey of 16-year-olds. The findings show that religious and national identities are the strongest predictors of segregation preferences among 16-year-olds, regardless of where they live and what background they have. Those living in rural areas of Northern Ireland are more supportive of residential, workplace and educational segregation than those living in more urban areas. This research highlights the need for government policy to take rurality into account. Nevertheless, some variables significantly determine segregation preferences regardless of where respondents live, such as attendance of segregated schools, being female, or strength of national and religious identity. Consequently, policy initiatives should continue to address the effect of segregation, especially in relation to education, and future research exploring social class and gender is recommended. In conclusion, the perception of the violent ‘urban spaces’ and the ‘peaceful countryside’ has to be challenged.

The distribution of arsenic in the body tissues of wood mice and bank voles

Arsenic is accumulated by free-living small mammals, but there is little information on the resultant concentrations in different tissues other than liver and kidney. Such information is important because the severity of toxicological effects may be related to the amount of arsenic accumulated in specific organs, and the availability of arsenic to predators is, in part, dependent on which tissues accumulate arsenic. The objective of this study was to quantify the arsenic concentrations and the percentage of the total body burden (%TBB) accumulated in different body tissues of free-living small mammals and to determine how these factors varied with severity of habitat contamination. Arsenic concentrations were measured in various tissues of wood mice (Apodemus sylvaticus) and bank voles (Clethrionomys glareolus) from a range of arsenic-contaminated sites in southwest Britain. Arsenic concentrations in the gastrointestinal (GI) tract (including contents), liver, kidneys, spleen, lung, femur, and fur of both species varied significantly between sites and were higher in mice and voles from heavily contaminated areas. Heart and brain arsenic concentrations did not vary with degree of environmental contamination. The GI tract and excised carcass contained roughly equal amounts of arsenic and, in sum, comprised 75-85% of the TBB on uncontaminated sites and 90-99% on contaminated sites. Although the excised carcass contains about half of the TBB, its importance in food-chain transfer of arsenic to predators may depend on the bioavailability of arsenic sequestered in fur. In contrast, the GI tract and its contents, provided that it is consumed, will always be a major transfer pathway for arsenic to predators, regardless of the severity of habitat contamination.

Incidence and natural history of proliferative sickle cell retinopathy:Observations from a cohort study

Objective: To describe the incidence, prevalence, and natural history of proliferative sickle cell retinopathy (PSR). Design: Prospective longitudinal study over 20 years. Participants: Newborn screening of 100000 consecutive deliveries from 1973 to 1981 identified 315 children with homozygous sickle cell (SS) disease and 201 with SS-hemoglobin C (SC) disease. By the age of 5 years, 307 SS patients and 166 SC patients were alive and living in Jamaica and were recruited for this ophthalmic study. Methods: Description of retinal vascular changes on annual angiography and angioscopy. Main Outcome Measures: Incidence and prevalence of PSR and its behavior on follow-up. Progression of PSR was investigated using the number of eyes affected (none, one, both) and the interval until PSR onset. Results: At last review in January 2000, PSR had developed in 59 patients (14 SS, 45 SC), unilaterally in 36 patients and bilaterally in 23. Incidence increased with age in both genotypes, with crude annual incidence rates of 0.5 cases (95% confidence interval [CI], 0.3-0.8) per 100 SS subjects and 2.5 cases (95% CI, 1.9-3.3) per 100 SC subjects. Prevalence was greater in SC disease, and by the ages of 24 to 26 years, PSR had occurred in 43% subjects with SC disease and in 14% subjects with SS disease. Patients with unilateral PSR had a 16% (11% SS, 17% SC) probability of regressing to no PSR and a 14% (16% SS, 13% SC) probability of progressing to bilateral PSR. Those with bilateral PSR had an 8% (8% SS, 8% SC) probability of regressing to unilateral PSR and a 1% (0 SS, 2% SC) probability of regressing to a PSR-free state. Irretrievable visual loss occurred in only 1 of 82 PSR-affected eyes, and 1 required detachment surgery and recovered normal visual acuity. Conclusions: Longitudinal observations over 20 years in a cohort of patients followed from birth confirms a greater incidence and severity of PSR in SC disease, and shows that spontaneous regression occurred in 32% of PSR-affected eyes. Permanent visual loss was uncommon in subjects observed up to the age of 26 years. © 2005 by the American Academy of Ophthalmology.

MacIntyre and Havel as green political thinkers: Unreasonable thinking in turbulent times

Purpose This chapter explores the ideas of Alasdair MacIntyre and Vaclav Havel and what these two thinkers can contribute to green political theory. Design/methodology/approach This chapter includes examination of some of the key works of Havel and MacIntyre and analysis of these works from the point of view of green political theory. Findings The section ‘Havel and the Imperative to “Live in Truth”: Dissent and Green Politics’ explores Havel’s thought with a particular emphasis on his ethicised notion of political action and critique (‘living in truth’) and his focus on the centrality of dissent (both intellectually and in practice) as central to political critique and action. The section ‘MacIntyre as a Green Thinker: Vulnerability in Political and Moral Theory’ offers an overview of MacIntyre interpreted as a putative green thinker, with a particular emphasis on his ideas of dependence and vulnerability. The Conclusion attempts to draw some common themes together from both thinkers in terms of what they have to offer contemporary green political thought. Research limitations/implications What is presented here is introductory, ground clearing and therefore necessarily suggestive (as well as under-developed). That is, it is the start of a new area of exploration rather than an analysis based on any exhaustive and comprehensive knowledge of both thinkers. Practical implications This chapter offers some initial lines of exploration for scholars interested in the overlap between green thinking and the work of Havel and MacIntyre. Originality/value This is the first exploration of the connections between the works of Havel and MacIntyre and green political theory.

Physical activity, sedentary behaviour and fetal macrosomia in uncomplicated pregnancies: A prospective cohort study

Objective: to explore maternal energy balance, incorporating free living physical activity and sedentary behaviour, in uncomplicated pregnancies at risk of macrosomia.

Methods: a parallel-group cross-sectional analysis was conducted in healthy pregnant women predicted to deliver infants weighing Z4000 g (study group) or o4000 g (control group). Women were recruited in a 1:1 ratio from antenatal clinics in Northern Ireland. Women wore a SenseWears Body Media Pro3 physical activity armband and completed a food diary for four consecutive days in the third trimester. Physical activity was measured in Metabolic Equivalent of Tasks (METs) where 1 MET¼1 kcal per kilogram of body weight per hour. Analysis of covariance (ANCOVA) was employed using the General Linear Model to adjust for potential confounders.

Findings: of the 112 women recruited, 100 complete datasets were available for analysis. There was no significant difference in energy balance between the two groups. Intensity of free living physical activity (average METs) of women predicted to deliver macrosomic infants (n¼50) was significantly lower than that of women in the control group (n¼50) (1.3 (0.2) METs (mean, standard deviation) versus 1.2 (0.2) METs; difference in means 0.1 METs (95% confidence interval: 0.19, 0.01); p¼0.021). Women predicted to deliver macrosomic infants also spent significantly more time in sedentary behaviour (r1 MET) than the control group (16.1 (2.8) hours versus 13.8 (4.3) hours; 2.0 hours (0.3, 3.7), p¼0.020).

Key conclusions and implications for practice: although there was no association between predicted fetal macrosomia and energy balance, those women predicted to deliver a macrosomic infant exhibited increased sedentary behaviour and reduced physical activity in the third trimester of pregnancy. Professionals caring for women during pregnancy have an important role in promoting and supporting more active lifestyles amongst women who are predicted to deliver a macrosomic infant given the known associated risks.

Psychosocial, educational and communicative interventions for patients with cachexia and their family carers

Purpose of review: Cancer cachexia has a substantial impact on both patients and their family carers. It has been acknowledged as one of the two most frequent and devastating problems of advanced cancer. The impact of cachexia spans biopsychosocial realms. Symptom management in cachexia is fraught with difficulties and globally, there remains no agreed standard care or treatment for this client group. There is a need to address the psychosocial impact of cachexia for both patients and their family carers.

Recent findings: Patients living at home and their family carers are often left to manage the distressing psychosocial impacts of cancer cachexia themselves. Successful symptom management requires healthcare professionals to address the holistic impact of cancer cachexia. High quality and rigorous research details the existential impact of cachexia on patients and their family carers. This information needs to inform psychosocial, educational and communicative supportive healthcare interventions to help both patients and their family carers better cope with the effects of cachexia.

Summary: Supportive interventions need to inform both patients and their family carers of the expected impacts of cachexia, and address how to cope with them to retain a functional, supported family unit who are informed about and equipped to care for a loved one with cachexia.

A comparison of biodegradable municipal waste (BMW) management strategies in Ireland and the Czech Republic and the lessons learned

In order to meet the recycling and recovery targets set forth by the European Union's (EU) Waste and Landfill Directives, both the Irish and Czech governments’ policy on waste management is changing to meet these pressures, with major emphasis being placed upon the management of biodegradable municipal waste (BMW). In particular, the EU Landfill Directive requires reductions in the rate of BMW going to landfill to 35% of 1995 values by 2016 and 2020 for Ireland and the Czech Republic, respectively. In this paper, the strategies of how Ireland and the Czech Republic plan to meet this challenge are compared. Ireland either landfills or exports its waste for recovery, while the Czech Republic has a relatively new waste management infrastructure. While Ireland met the first target of 75% diversion of BMW from landfill by 2010 and preliminary 2012 data indicate that Ireland is on track to meet the 2013 target, the achievement of the 2016 target remains at risk. Indicators that were developed to monitor the Czech Republic's path to meeting the targets demonstrate that it did not meet the first target that was set for 2010 and will probably not meet its 2013 target either. The evaluation reports on the implementation of Waste Management Plan of Czech Republic suggest that the currently applied strategy to divert biodegradable waste from landfill is not effective enough. For both countries, the EU Waste Framework and Landfill Directives will be a significant influence and driver of change in waste management practices and governance over the coming decade. This means that both countries will not only have to invest in infrastructure to achieve the targets, but will also have to increase awareness among the public in diverting this waste at the household level. Improving environmental education is part of increased awareness as it is imperative for citizens to understand the consequences of their actions as affluence continues to grow producing increased levels of waste.

Graphical abstract
Despite the differences in the levels of waste generation in both the Czech Republic and Ireland, each country can learn from each other in order to meet the recycling and recovery targets set by the European Union's (EU) Waste and Landfill Directives. Both countries will not only have to invest in infrastructure to achieve the targets, but will also have to increase awareness among the public in diverting this waste at the household level. In addition, there needs to be minimum safe standards when land-spreading organic agricultural and organic municipal and industrial materials on agricultural land used for food production, as well as incentives to increase BMW diversion from landfill such as the increased landfill levy implemented in Ireland and the acceptance of MBT and/or incineration as a means of treating residual waste.

Ethnic Segregation, Moral Panics and Social Class: A Comparative Study of the Experiences and Perspectives of Working Class and Middle Class Children in Belfast

This paper begins by describing the moral panics that have tended to emerge sporadically in Northern Ireland over the last few years with regard to young people’s involvement in sectarian violence in Belfast. Within this, while these young people have been cast in the traditional role of folk devils, the paper will show how younger children also tend to be explicitly identified and named in an ambiguous way through such moral panics; playing a deviant role as participators, and sometimes instigators, of sectarian violence but also carrying the symbolic responsibility of representing Belfast’s future. It will be shown that it is because of this ambiguous position that it is adults rather than the children themselves that tend to be held responsible for their actions; either as rioters using the children as political pawns or as parents guilty of neglect. With this as a starting point the paper then explores the perspectives and experiences of two groups of 10-11 year old children living in Belfast and the impact of these moral panics on them. One group of children, living in affluent middle class areas were found to be appropriating and re-working these broader moral panics into more general discourses of derision that tended to pathologize working class children and communities more generally. For the other group of children, living in economically deprived areas with high levels of sectarian tensions and violence, their experiences of such violence and their participation in it are discussed. It will be shown that for these children, the broader moral panics that exist tend to have the effect of reinforcing the processes that tend to segregate and exclude them.

Designing for dementia : an assessment of the impact of the physical environment on wayfinding success for residents in long term care settings

It is acknowledged that one of the consequences of the ageing process is cognitive decline, which leads to an increase in the incidence of illnesses such as dementia. This has become ever more relevant due to the projected increase in the ageing demographic. Dementia affects visuo-spatial perception, causing difficulty with wayfinding, even during the early stages of the disease. The literature widely recognises the physical environment’s role in alleviating symptoms of dementia and improving quality of life for residents. It also identifies the lack of available housing options for older people with dementia and consequently the current stock is ill-equipped to provide adequate support.
Recent statistics indicate that 80% of those residing in nursing or residential care homes have some form of dementia or severe memory problems. The shift towards institutional care settings, the need for specialist support and care, places a greater impetus on the need for a person-centred approach to tackle issues related to wayfinding and dementia.
This thesis therefore aims to improve design for dementia in nursing and residential care settings in the context of Northern Ireland. This will be undertaken in order to provide a better understanding of how people with dementia experience the physical environment and to highlight features of the design that assist with wayfinding. Currently there are limited guidelines on design for dementia, meaning that many of these are theoretical, anecdotal and not definitive. Hence a greater verification to address the less recognised design issues is required. This is intended to ultimately improve quality of life, wellbeing, independence and uphold the dignity of people with dementia living in nursing or residential care homes.
The research design uses a mixed methods approach. A thorough preparation and consideration of ethical issues informed the methodology. The various facets were also trialled and piloted to identify any ethical, technological, methodological, data collection and analysis issues. The protocol was then amended to improve or resolve any of the aforementioned issues. Initially a questionnaire based on leading design recommendations was conducted with home managers. Semi-structured interviews were developed from this and conducted with staff and resident’s next of kin. An evidence-based approach was used to design a study which used ethnographic methods, including a wayfinding task. This followed a repeated measures design which would be used to actively engage residents with dementia in the research. Complementary to the wayfinding task, conversational and semi-structured interviews were used to promote dialogue and direct responses with the person with dementia. In addition to this, Space Syntax methodologies were used to examine the physical properties of the architectural layout. This was then cross-examined with interview responses and data from the wayfinding tasks.
A number of plan typologies were identified and were determined as synonymous with decision point types which needed to be made during the walks. The empirical work enabled the synthesis of environmental features which support wayfinding.
Results indicate that particular environmental features are associated with improved performance on the wayfinding tasks. By enhancing design for dementia, through identifying the attributes, challenges with wayfinding may be overcome and the benefits of the physical environment can be seen to promote wellbeing.
The implications of this work mean that the environmental features which have been highlighted from the project can be used to inform guidelines, thus adding to existing knowledge. Future work would involve the dissemination of this information and the potential for it to be made into design standards or regulations which champion design for dementia. These would increase awareness for designers and stakeholders undertaking new projects, extensions or refurbishments.
A person-centred, evidence-based design was emphasised throughout the project which guaranteed an in-depth study. There were limitations due to the available resources, time and funding. Future research would involve testing the identified environmental features within a specific environment to enable measured observation of improvements.

The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK).

Background
The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention.

Methods
Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff.

Results
Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision.

Conclusions
We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes.

HRM and the employment of older workers: Germany and Britain compared

This study examines Human Resource Management (HRM) policies and practices towards older workers in Britain and Germany. While it is widely suggested that older workers have to be better integrated into the labour market, youth-centric HRM is still prevalent. However, HRM is shaped by multiple and contradictory pressures from the international and national institutional environments. We test this dynamic by analysing two national surveys, the German firm panel (IAB)1 and the British Workplace and Employment Relations Survey (WERS).2 Our findings suggest that the institutional environment shapes HR policies and practices distinctively in both countries. We find that age discrimination at the workplace is more prevalent in Germany than in Britain, which can be explained by divergent institutional patterns. As a result, we argue that although both countries will have to continue fostering an age-neutral HR approach, this has to take country-specific institutional peculiarities into account.

The role of the seed bank in recovery of temperate heath and blanket bog following wildfires

Questions - Are the germinable seed banks of upland heath and blanket bog reduced following wildfires? Are some species at particular risk? Do the impacts of wildfires on seed banks differ between heathlands and blanket bog?

Location - Northern Ireland, United Kingdom.

Methods - Vegetation surveys and seed bank sampling were conducted in 2012 at burned and unburned areas within six upland sites where large wildfires had occurred during spring 2011. Differences in seedling abundance, species richness and Jaccard similarity indices between burned and unburned areas were compared using GLMMs. Differences in the community composition were examined using pRDA.

Results - In total, 24 of the 51 species in the vegetation were detected in the germinable seed bank. Species richness and the abundance of seedlings other than Calluna vulgaris were lower in areas where wildfires had occurred. Species composition of both germinable seed banks and vegetation differed between burned and unburned areas within sites; with negative associations between burned areas and some key indicator species including Drosera rotundifolia, Eriophorum vaginatum, Empetrum nigrum, Narthecium ossifragum and Trichophorum germanicum. We did not find any evidence of significant interactions between burning and habitat, suggesting that wildfires had similar impacts on each species regardless of the habitat in which they occurred.

Conclusions - This study differs from other UK studies in that it examines impacts of wildfires at sites that have not been previously intensively managed by burning. In particular, we highlight potential impacts on N. ossifragum and D. rotundifolia, which are key components of the upland flora and, to our knowledge, were not present in previous UK studies.