Sex offender risk assessment and management in Ireland

This research examined sex offender risk assessment and management in Ireland. It focused on the statutory agencies with primary responsibility (Garda Síochána and the Probation Service). The goal was to document the historical, contextual and current systems, in addition to identifying areas of concern/improvements. The research was a mixed-methods approach. Eight studies were conducted. This incorporated documentary reviews of four Commission to Inquire Reports, qualitative interviews/focus groups with Garda staff, Probation Service staff, statutory agencies, community stakeholders, various Non-Governmental Organisations (NGOs) and sex offenders. Quantitative questionnaires were also administered to Garda staff. In all over 70 interviews were conducted and questionnaires were forwarded to 270 Garda members. The overall findings are: •Sex offender management in Ireland has become formal only since 2001. Knowledge, skills and expertise is in its infancy and is still evolving. •Mixed reviews and questions regarding fitness for purpose of currently used risk assessments tools were noted. •The Sex Offender Act 2001 requires additional elements to ensure safe sex offender monitoring and public protection. A judicial review of the Sex Offender Act 2001 was recommended by many respondents. •Interagency working under SORAM was hugely welcomed. The sharing of information has been welcomed by managing agencies as the key benefit to improving sex offender management. •Respondents reported that in practice, sex offender management in Ireland is fragmented and unevenly implemented. The research concluded that an independent National Sex Offender Authority should be established as an oversight and regulatory body for policy, strategy and direction in sex offender management. Further areas of research were also highlighted: ongoing evaluation and audits of the joint agency process and systems in place; recidivism studies tracking the risk assessment ratings and subsequent offending; and an evaluation of the current status of sex offender housing in Ireland.

Treatment of lean and diet-induced obesity (DIO) mice with a novel stable obestatin analogue alters plasma metabolite levels as detected by untargeted LC–MS metabolomics

Introduction: Obestatin is a controversial gastrointestinal peptide purported to have metabolic actions.

Objectives: This study investigated whether treatment with a stable obestatin analogue (PEG-OB(Cys10, Cys13)) changed plasma metabolite levels firstly in lean and subsequently in diet-induced obesity (DIO) C57BL6/J mice.

Methods: Untargeted LC-HRMS metabolomics experiments were carried out in ESI + mode with plasma extracts from both groups of animals. Data were normalised, multivariate and univariate statistical analysis performed and metabolites of interest putatively identified.

Results: In lean mice, 39 metabolites were significantly changed by obestatin treatment and the majority of these were increased, including various C16 and C18 moieties of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine and monoacylglycerol, along with vitamin A, vitamin D3, tyrosine, acetylcarnitine and 2α-(hydroxymethyl)-5α-androstane-3β,17β-diol. Decreased concentrations of glycolithocholic acid, 3-dehydroteasterone and various phospholipids were observed. In DIO mice, 25 metabolites were significantly affected and strikingly, the magnitudes of changes here were generally much greater in DIO mice than in lean mice, and in contrast, the majority of metabolite changes were decreases. Four metabolites affected in both groups included glycolithocholic acid, and three different long-chain (C18) phospholipid molecules (phosphatidylethanolamine, platelet activating factor (PAF), and monoacylglycerol). Metabolites exclusively affected in DIO mice included various phosphatidylcholines, lysophosphatidylcholines and fatty acyls, as well as creatine and oxidised glutathione.

Conclusion: This investigation demonstrates that obestatin treatment affects phospholipid turnover and influences lipid homeostasis, whilst providing convincing evidence that obestatin may be acting to ameliorate diet-induced impairments in lipid metabolism, and it may influence steroid, bile acid, PAF and glutathione metabolism.

ARB: Phase II window of opportunity study of short-term preoperative treatment with enzalutamide in ER-positive and triple-negative breast cancer

The androgen receptor (AR) is expressed in 60-80% of breast cancers (BC) across all molecular phenotypes, with a higher incidence in oestrogen receptor positive (ER+) BC compared to ER negative tumours. In ER+ disease, AR-expression has been linked to endocrine resistance which might be reversed with combined treatment targeting ER and AR. In triple negative BCs (TNBC), preclinical and clinical investigations have described a subset of patients that express the AR and are sensitive to androgen blockade, providing a novel therapeutic target. Enzalutamide, a potent 2nd generation anti-androgen, has demonstrated substantial preclinical and clinical anti-tumour activity in AR+ breast cancer. Short-term preoperative window of opportunity studies are a validated strategy for novel treatments to provide proof-of-concept and define the most appropriate patient population by directly assessing treatment effects in tumour tissue before and after treatment. The ARB study aims to assess the anti-tumour effects of enzalutamide in early ER+ breast cancer and TNBC, to identify the optimal target population for further studies and to directly explore the biologic effects of enzalutamide on BC and stromal cells. Methods: ARB is an international, investigator sponsored WOO phase II study in women with newly diagnosed primary ER+ BC or AR+ TNBC of ≥ 1cm. The study has two cohorts. In the ER+ cohort, postmenopausal patients will be randomised 2:1 to receive either enzalutamide (160mg OD) plus exemestane (50mg OD) or exemestane (25mg OD). In the TNBC cohort, AR+ will receive single agent treatment with enzalutamide (160mg OD). Study treatment is planned for 15–29 days, followed by surgery or neo-adjuvant therapy. Tissue and blood samples are collected before treatment and on the last day of study treatment. The primary endpoint is inhibition of tumour-cell proliferation, as measured by change in Ki67 expression, determined centrally by 2 investigators. Secondary endpoints include induction of apoptosis (Caspase3), circulating hormone levels and safety. ARB aims to recruit ≈235 patients from ≈40 sites in the UK, Germany, Spain and USA. The study is open to recruitment.

Sex Offending and Situational Motivation: Findings from a Qualitative Analysis of Desistance from Sexual Offending

Sex offending is typically understood from a pathology perspective with the origin of the behavior thought to be within the offending individual. Such a perspective may not be beneficial for those seeking to desist from sexual offending and reintegrate into mainstream society. A thematic analysis of 32 self-narratives of men convicted of sexual offences against children suggests that such individuals typically explain their pasts utilizing a script consistent with routine activity theory, emphasizing the role of circumstantial changes in both the onset of and desistance from sexual offending. It is argued that the self-framing of serious offending in this way might be understood as a form of ‘shame management’, a protective cognition that enables desistance by shielding individuals from internalizing stigma for past violence.

Comparing Shame in Clinical and Nonclinical Populations: Preliminary Findings

OBJECTIVES: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt.

METHODS: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of "withdrawal," "attack self," "attack other," and "avoidance," and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride.

RESULTS: The DID group exhibited significantly higher levels of "attack self," "withdrawal," and "avoidance" relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the "withdrawal" coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. "Attack self" emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas "withdrawal" was the sole predictor of state shame in the DID group.

CONCLUSIONS: DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment. (PsycINFO Database Record

The importance of patient involvement in stroke rehabilitation

OBJECTIVE: To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. METHOD: Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. RESULTS: The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. CONCLUSIONS: The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health services needs.

Social Theory and Nursing

Despite noteworthy exceptions, nursing’s literature largely disregards the ways in which social and sociological theory permeates, guides and shapes research, education, and practice. Likewise, social theory’s ability to position nursing within wider structures of healthcare and educational provision is similarly and puzzlingly downplayed. The questions nurses ask and the problems they face cannot however, adequately be addressed without engaging with social and sociological theory and, to progress this engagement, contributors to this book explore how social theories are used by and might apply to nursing and nursing practice. This work brings together leading international nursing and non-nursing scholars to stimulate thought and debate around a fascinating and enduring topic.

Knowledge of the patients regarding leprosy and adherence to treatment

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It is known for its great disfiguring capacity and is considered an extremely serious disease to public health worldwide. The state of Ceará ranks 13th in number of cases of leprosy in Brazil, and fourth in Northeastern region, with an average of 2,149 new cases diagnosed every year. This study aimed to evaluate the knowledge of leprosy patients regarding treatment, and to assess the level of treatment adherence and its possible barriers. The study was conducted in the reference center for dermatology, from September 2010 to October 2010, in Fortaleza, Ceará. The study data were collected by means of a structured interview, along with the Morisky-Green test, in order to assess treatment adherence and barriers to adherence. A total of 70 patients were interviewed, out of whom 66 were new cases. The majority of patients were between 42 and 50 years old, and 37 (52.9%) were male. Most patients were clinically classified as presentingmultibacillary leprosy (80%), and 78.6% of them were from Fortaleza, Brazil. The Morisky-Green test indicated that 62.9% of patients presented a low level of adherence (p < 0.005), despite claiming to aware of the disease risks. However, it was observed that 57.1% of the patients had no difficulty adhering to treatment, while 38.6% reported little difficulty. This study shows that despite the patients claiming to be familiar with leprosy and its treatment, the Morisky-Green test clearly demonstrated that they actually were not aware of the principles of therapy, which is evidenced by the low degree of treatment adherence

Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

Context-Based Sound and the Ecological Theory of Perception

This paper aims to investigate the ways in which context-based sonic art is capable of furthering a knowledge and understanding of place based on the initial perceptual encounter. How might this perceptual encounter operate in terms of a sound work’s affective dimension? To explore these issues I draw upon James J. Gibson’s ecological theory of perception and Gernot Böhme’s concept of an ‘aesthetic of atmospheres’. Within the ecological model of perception an individual can be regarded as a ‘perceptual system’: a mobile organism that seeks information from a coherent environment. I relate this concept to notions of the spatial address of environmental sound work in order to explore (a) how the human perceptual apparatus relates to the sonic environment in its mediated form and (b) how this impacts on individuals’ ability to experience such work as complex sonic ‘environments’. Can the ecological theory of perception aid the understanding of how the listener engages with context-based work? In proposing answers to this question, this paper advances a coherent analytical framework that may lead us to a more systematic grasp of the ways in which individuals engage aesthetically with sonic space and environment. I illustrate this methodology through an examination of some of the recorded work of sound artist Chris Watson.

Conceptualising cosmopolitanism and entrepreneurship through the lens of the three-dimensional theory of power

Purpose – The paper aims to conceptualise cosmopolitanism drivers from the third-level power perspective by drawing on Lukes’ (1974; 2005) theory of power. In addition, the paper aims to investigate the relationship between entrepreneurs’ cosmopolitan dispositions and habitus, i.e. a pattern of an individual’s demeanour, as understood by Bourdieu. Design/methodology/approach – This conceptual paper makes use of Bourdieu’s framework (habitus) by extending it to the urban cosmopolitan environment and linking habitus to the three-dimensional theory of power and, importantly, to the power’s third dimension – preference-shaping. Findings – Once cosmopolitanism is embedded in the urban area’s values, this creates multiple endless rounds of mutual influence (by power holders onto entrepreneurs via political and business elites, and by entrepreneurs onto power holders via the same channels), with mutual benefit. Therefore, mutually beneficial influence that transpires in continuous support of a cosmopolitan city’s environment may be viewed as one of the factors that enhances cosmopolitan cities’ resilience to changes in macroeconomic conditions. Originality/value – The paper offers a theoretical model that enriches the understanding of the power-cosmopolitanism-entrepreneurship link, by emphasising the preference-shaping capacity of power, which leads to the embedment of cosmopolitanism in societal values. As a value shared by political and business elites, cosmopolitanism is also actively promoted by entrepreneurs through their disposition and habitus. This ensures not only their willing compliance with power and the environment, but also their enhancement of favourable business conditions. Entrepreneurs depart from mere acquiescence (to power and its explicit dominance), and instead practice their cosmopolitan influence by active preference-shaping.

AN ENTROPIC THEORY OF DAMAGE WITH APPLICATIONS TO CORROSION-FATIGUE STRUCTURAL INTEGRITY ASSESSMENT

This dissertation demonstrates an explanation of damage and reliability of critical components and structures within the second law of thermodynamics. The approach relies on the fundamentals of irreversible thermodynamics, specifically the concept of entropy generation due to materials degradation as an index of damage. All failure mechanisms that cause degradation, damage accumulation and ultimate failure share a common feature, namely energy dissipation. Energy dissipation, as a fundamental measure for irreversibility in a thermodynamic treatment of non-equilibrium processes, leads to and can be expressed in terms of entropy generation. The dissertation proposes a theory of damage by relating entropy generation to energy dissipation via generalized thermodynamic forces and thermodynamic fluxes that formally describes the resulting damage. Following the proposed theory of entropic damage, an approach to reliability and integrity characterization based on thermodynamic entropy is discussed. It is shown that the variability in the amount of the thermodynamic-based damage and uncertainties about the parameters of a distribution model describing the variability, leads to a more consistent and broader definition of the well know time-to-failure distribution in reliability engineering. As such it has been shown that the reliability function can be derived from the thermodynamic laws rather than estimated from the observed failure histories. Furthermore, using the superior advantages of the use of entropy generation and accumulation as a damage index in comparison to common observable markers of damage such as crack size, a method is proposed to explain the prognostics and health management (PHM) in terms of the entropic damage. The proposed entropic-based damage theory to reliability and integrity is then demonstrated through experimental validation. Using this theorem, the corrosion-fatigue entropy generation function is derived, evaluated and employed for structural integrity, reliability assessment and remaining useful life (RUL) prediction of Aluminum 7075-T651 specimens tested.

'Malicious Code Execution Detection and Response Immune System inspired by the Danger Theory'

The analysis of system calls is one method employed by anomaly detection systems to recognise malicious code execution. Similarities can be drawn between this process and the behaviour of certain cells belonging to the human immune system, and can be applied to construct an artificial immune system. A recently developed hypothesis in immunology, the Danger Theory, states that our immune system responds to the presence of intruders through sensing molecules belonging to those invaders, plus signals generated by the host indicating danger and damage. We propose the incorporation of this concept into a responsive intrusion detection system, where behavioural information of the system and running processes is combined with information regarding individual system calls.

Semantic Mining based on graph theory and ontologies. Case Study: Cell Signaling Pathways

In this paper we use concepts from graph theory and cellular biology represented as ontologies, to carry out semantic mining tasks on signaling pathway networks. Specifically, the paper describes the semantic enrichment of signaling pathway networks. A cell signaling network describes the basic cellular activities and their interactions. The main contribution of this paper is in the signaling pathway research area, it proposes a new technique to analyze and understand how changes in these networks may affect the transmission and flow of information, which produce diseases such as cancer and diabetes. Our approach is based on three concepts from graph theory (modularity, clustering and centrality) frequently used on social networks analysis. Our approach consists into two phases: the first uses the graph theory concepts to determine the cellular groups in the network, which we will call them communities; the second uses ontologies for the semantic enrichment of the cellular communities. The measures used from the graph theory allow us to determine the set of cells that are close (for example, in a disease), and the main cells in each community. We analyze our approach in two cases: TGF-β and the Alzheimer Disease.