The effects of mixed membership in a deliberative forum: the Irish Constitutional Convention of 2012-2014

The Constitutional Convention was established by the Irish government in 2012. It was tasked with making recommendations on a number of constitutional reform proposals. As a mini-public, its membership was a mix of 66 citizens (randomly selected) and 33 politicians (self-selected). Its recommendations were debated on the floor of the Irish parliament with three of them leading to constitutional referendums; other recommendations are in the process of being implemented. This article uses data gathered during and after the operation of the Convention to examine this real-world example of a mixed-membership mini-public. The focus is on how the inclusion of politicians may have impacted on the Convention's mode of operation and/or its outcomes. We find little impact in terms of its operation (e.g. no evidence that politicians dominated the discussions). There is evidence of a slight liberal bias among the politician membership, but this had little effect on the outcomes

Perceived discourse quality in the Irish Citizens' Assembly deliberations on abortion

Working PaperThis paper contributes to a growing interest in process related approaches in the study of deliberative mini-publics. Its focus is on the perceived quality of deliberation in the Irish Citizens’ Assembly’s discussions on Ireland’s constitutional ban on abortion, which occurred over the course of five weekends of meetings from late 2016 through to the spring of 2017, culminating in recommendations for a referendum to remove Ireland’s constitutional ban on abortion. This paper makes use of survey data to examine the Citizens’ Assembly’s members’ perceptions of the quality of the deliberative process. We find that, by one measure of discourse quality (individual access to the conversation), levels of satisfaction were greatest among the less educated. Over time the levels of discourse quality (again by this measure) rose particularly among the minority of Assembly members who were ‘pro-life’

Taking balance measurement out of the laboratory and into the home: discriminatory capability of novel centre of pressure measurement in fallers and non-fallers

We investigated three methods for estimating centre of pressure excursions, as measured using a portable pressure sensor matrix, in order to deploy similar technology into the homes of older adults for longitudinal monitoring of postural control and falls risk. We explored the utility of these three methods as markers of falls risk in a cohort of 120 community dwelling older adults with and without a history of falls (65 fallers, 55 non-fallers). A number of standard quantitative balance parameters were derived using each centre of pressure estimation method. Rank sum tests were used to test for significant differences between fallers and non-fallers while intra-class correlation coefficients were also calculated to determine the reliability of each method. A method based on estimating the changes in the magnitude of pressure exerted on the pressure sensor matrix was found to be the most reliable and discriminative. Our future work will implement this method for home-based balance measurement

Large-scale mapping of cortical alterations in 22q11.2 deletion syndrome: Convergence with idiopathic psychosis and effects of deletion size

The 22q11.2 deletion (22q11DS) is a common chromosomal microdeletion and a potent risk factor for psychotic illness. Prior studies reported widespread cortical changes in 22q11DS, but were generally underpowered to characterize neuroanatomic abnormalities associated with psychosis in 22q11DS, and/or neuroanatomic effects of variability in deletion size. To address these issues, we developed the ENIGMA (Enhancing Neuro Imaging Genetics Through Meta-Analysis) 22q11.2 Working Group, representing the largest analysis of brain structural alterations in 22q11DS to date. The imaging data were collected from 10 centers worldwide, including 474 subjects with 22q11DS (age = 18.2 ± 8.6; 46.9% female) and 315 typically developing, matched controls (age = 18.0 ± 9.2; 45.9% female). Compared to controls, 22q11DS individuals showed thicker cortical gray matter overall (left/right hemispheres: Cohen’s d = 0.61/0.65), but focal thickness reduction in temporal and cingulate cortex. Cortical surface area (SA), however, showed pervasive reductions in 22q11DS (left/right hemispheres: d = −1.01/−1.02). 22q11DS cases vs. controls were classified with 93.8% accuracy based on these neuroanatomic patterns. Comparison of 22q11DS-psychosis to idiopathic schizophrenia (ENIGMA-Schizophrenia Working Group) revealed significant convergence of affected brain regions, particularly in fronto-temporal cortex. Finally, cortical SA was significantly greater in 22q11DS cases with smaller 1.5 Mb deletions, relative to those with typical 3 Mb deletions. We found a robust neuroanatomic signature of 22q11DS, and the first evidence that deletion size impacts brain structure. Psychotic illness in this highly penetrant deletion was associated with similar neuroanatomic abnormalities to idiopathic schizophrenia. These consistent cross-site findings highlight the homogeneity of this single genetic etiology, and support the suitability of 22q11DS as a biological model of schizophrenia

Reformacija kao proces uspostavljanja i obnavljanja odnosa s Bogom

22q11.2 deletion syndrome (22q11DS)—a neurodevelopmental condition caused by a hemizygous deletion on chromosome 22—is associated with an elevated risk of psychosis and other developmental brain disorders. Prior single-site diffusion magnetic resonance imaging (dMRI) studies have reported altered white matter (WM) microstructure in 22q11DS, but small samples and variable methods have led to contradictory results. Here we present the largest study ever conducted of dMRI-derived measures of WM microstructure in 22q11DS (334 22q11.2 deletion carriers and 260 healthy age- and sex-matched controls; age range 6–52 years). Using harmonization protocols developed by the ENIGMA-DTI working group, we identified widespread reductions in mean, axial and radial diffusivities in 22q11DS, most pronounced in regions with major cortico-cortical and cortico-thalamic fibers: the corona radiata, corpus callosum, superior longitudinal fasciculus, posterior thalamic radiations, and sagittal stratum (Cohen’s d’s ranging from −0.9 to −1.3). Only the posterior limb of the internal capsule (IC), comprised primarily of corticofugal fibers, showed higher axial diffusivity in 22q11DS. 22q11DS patients showed higher mean fractional anisotropy (FA) in callosal and projection fibers (IC and corona radiata) relative to controls, but lower FA than controls in regions with predominantly association fibers. Psychotic illness in 22q11DS was associated with more substantial diffusivity reductions in multiple regions. Overall, these findings indicate large effects of the 22q11.2 deletion on WM microstructure, especially in major cortico-cortical connections. Taken together with findings from animal models, this pattern of abnormalities may reflect disrupted neurogenesis of projection neurons in outer cortical layers

The relationship between increased body mass index and frailty on falls in community dwelling older adults

BACKGROUND: The global population is becoming older and more overweight. The inter-relationship between frailty and falls is often seen in the older adult and is associated with poor health outcomes. Little is known about this relationship for those with excess body mass. This study aimed to assess the relationships between BMI, frailty and falls. METHODS: Frailty, body mass index, clinical and demographic characteristics were assessed at baseline for 606 community dwelling adults aged 60 years and older. Falls were assessed prospectively with a semi-structured telephone interview two years later. RESULTS: An increase in BMI contributed significantly to the identification of frail (Odds Ratio: 4.4; 95% Confidence Interval: 1.4, 13.6) older adults. A total of 346 falls by 148 participants were reported at follow up. Those with an increased BMI were significantly less likely to have experienced a fall between baseline and follow up assessments (p = 0.03). Despite these opposing trends a BMI greater than or equal to 30.0 kg.m(2) did not alter the relationship between falls and frailty for the current cohort. CONCLUSIONS: This is the first study to assess the falls-frailty relationship for those with an increased BMI. Obesity was found to be protective against falling but not specifically in frail older adults

“I fell out of my standing”: falls, narratives and the language of ageing

There is a wealth of research addressing falls aetiology in older persons. This may be framed within western world, ageing demographics and financial concerns that require evidence of effective bio-medical interventions (Kingston 2000). Drawing on older persons’ falls narratives and building on a small body of work (see, for example, Horton and Arber 2004; Kingston 2000; McKee et al 1999; Yardley 2004), this paper highlights ways in which fallers view falls and calls for complementary, social and cultural analyses. In so doing, negative culturally and linguistically embedded notions of falling in relation to ageing, usefulness, personal control, autonomy, social embarrassment and social standing, may be challenged. In turn, the ‘faller’ may position him- or herself beyond connotations of ‘loss of control’ and decline (Horton and Arber 2004; McKee et al 1999). The falls narratives have been collected as part of an ongoing, multi-sited and multi-disciplinary Irish study Technologies for Independent Living (TRIL) that is addressing physical, cognitive and social consequences of ageing. Narrative data collection is part of an ethnography underpinning this large study.* This includes falls histories taken at the time of telephone recruitment by a clinical nurse manager and during a comprehensive medical assessment within a clinic setting and an audio recorded, qualitative interview in study participants’ homes. Collection of falls narratives is ongoing and the following discussion is developed from the recruitment and medical falls history-taking of twenty TRIL participants and the qualitative interviews of eight further participants. Exploration of falls narratives offers insights into negative and pervasive associations between ageing and falling that can culturally inform clinicians’ understanding of falls. The paper also reflects on how this understanding is being used to develop falls prevention technologies

I fell out of my standing. Falls narratives, ageism and socio-medical understanding of falls in older persons

There is a wealth of research addressing falls aetiology in older persons. This may be framed within western world, ageing demographics and financial concerns that require evidence of effective bio-medical interventions (Kingston 2000). Drawing on older persons’ falls narratives and building on a small body of work (see, for example, Horton and Arber 2004; Kingston 2000; McKee et al 1999; Yardley 2004), this paper highlights ways in which fallers view falls and calls for complementary, social and cultural analyses. In so doing, negative culturally and linguistically embedded notions of falling in relation to ageing, usefulness, personal control, autonomy, social embarrassment and social standing, may be challenged. In turn, the ‘faller’ may position him- or herself beyond connotations of ‘loss of control’ and decline (Horton and Arber 2004; McKee et al 1999)

When mini-publics and maxi-publics coincide: Ireland\u27s national debate on abortion

Ireland\u27s Citizens\u27 Assembly (CA) of 2016-18 was tasked with making recommendations on abortion. This paper shows that from the outset its members were in large part in favour of the liberalisation of abortion (though a fair proportion were undecided), that over the course of its deliberations the CA as a whole moved in a more liberal direction on the issue, but that its position was largely reflected in the subsequent referendum vote by the population as a whole