The Evolution of a Collective Response to Rural Underdevelopment

Versions of this paper were presented at The National Jobs Conference, April 23rd, 2010, Dunhill Ecopark, Ballyphilip, Co. Waterford and at the 2nd Irish Rural Studies Symposium, August 31st 2010, University College Cork. Thanks are due for comments and suggestions received from participants at both events.The downturn in the Irish economy coupled with high levels of unemployment has focused attention on the need to promote economic development throughout the economy. This paper provides case study evidence on one successful approach to rural economic development by outlining the evolution, outcomes and key capabilities involved in a collective action response to the challenge of rural underdevelopment in North West Connemara. Reviewing a fifty year period, the case study shows that collective action in the region has not only been a series of events, but more crucially from a development perspective, it is embedded as an institution and a process. Therefore, as a result of learning by this community over a fifty year period, a collective action response has evolved as a key strategy to overcome government and market failure in relation to rural development. This case provides a good example to other communities of how locality can be drawn upon and used as an advantage in an increasingly globalised environment and how a local community can seek to ameliorate the negative aspects of globalisation by harnessing its local resources. In broad policy terms, the implication is that there are public good benefits to be gained from assisting and encouraging local communities through the provision of finance and capability building support, to deliver collective action responses to their particular challenges

Modelling the Gross Cost of Transporting Pig Slurry to Tillage Spread Lands in a Post Transition Arrangement within the Nitrates Directive.

working paperThe context of this paper is in the phasing out of the transitional arrangement under the Nitrates Directive. As there is relatively little grassland capable of taking significant amounts of pig slurry available in the vicinity of the main pig production areas, in this paper we attempt to quantify the cost of transporting this slurry to the nearest available tillage land. The approach taken was to examine the geographic structure underlying the pig sector in Ireland using Geographic Information Systems (GIS) technology. The study highlighted the differential cost with, amounting to 10% of gross margin on average and as high in major pig producing areas as 21.5% in Longford and 16.6% in Cavan, while lower at 7-9% in South Tipperary and Cork. Thus while the problem is significant, the impact is not constant across the country, highlighting the value of a spatial analytical approach. Future work should assess the existing cost of spreading manure in order to be able to ascertain the net cost of spreading on tillage lands. The robustness of the results also need to be tested to assess the implications of changes in the prices of fossil fuels and fertilisers, both in terms of the cost function and in terms of the cost of substitutable mineral fertilise

A formative evaluation of a programme for street people

Includes summary.Includes bibliographical references.This dissertation is a theory-driven process evaluation of a programme for street people. The programme is run by Living Grace, a faith-based organisation which aims to help clients leave a life on the street and reintegrate into mainstream society. The evaluation is intended to be formative in nature and the primary audience is the programme manager

Recommended Personal Protective Equipment for Cochlear Implant and Other Mastoid Surgery During the COVID-19 Era

© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA) Objectives/Hypothesis: The overall aim of this study was to evaluate personal protective equipment (PPE) that may facilitate the safe recommencement of cochlear implantation in the COVID-19 era, with the broader goal of minimizing the period of auditory deprivation in prelingually deaf children and reducing the risk of cochlear ossification in individuals following meningitis. Methods: The study design comprised 1) an objective assessment of mastoid drilling-induced droplet spread conducted during simulated cochlear implant (CI) surgery and its mitigation via the use of a protective drape tent and 2) an evaluation of three PPE configurations by otologists while performing mastoid drilling on ex vivo temporal bones. The various PPE solutions were assessed in terms of their impact on communication, vital physiological parameters, visual acuity and fields, and acceptability to surgeons using a systematic risk-based approach. Results: Droplet spread during simulated CI surgery extended over 2 m, a distance greater than previously reported. A drape tent significantly reduced droplet spread. The ensemble of a half-face mask and safety spoggles (foam lined safety goggles) had consistently superior performance across all aspects of clinical usability. All other PPE options were found to substantially restrict the visual field, making them unsafe for microsurgery. Conclusions: The results of this preclinical study indicate that the most viable solution to enable the safe conduct of CI and other mastoid surgery is a combination of a filtering facepiece (FFP)3 mask or half-face respirator with safety spoggles as PPE. Prescription spoggles are an option for surgeons who need to wear corrective glasses to operate. A drape tent reduces droplet spread. A multicenter clinical trial to evaluate the effectiveness of PPE should be the next step toward safely performing CI surgery during the COVID-19 era. Level of Evidence: 4 Laryngoscope, 2020

A bespoke mobile application for the longitudinal assessment of depression and mood during pregnancy: protocol of a feasibility study.

INTRODUCTION: Depression is a common mental health disorder during pregnancy, with important consequences for mothers and their children. Despite this, it goes undiagnosed and untreated in many women attending antenatal care. Smartphones could help support the prompt identification of antenatal depression in this setting. In addition, these devices enable the implementation of ecological momentary assessment techniques, which could be used to assess how mood is experienced during pregnancy. With this study, we will assess the feasibility of using a bespoke mobile application (app) running on participants' own handsets for the longitudinal (6 months) monitoring of antenatal mood and screening of depression. METHODS AND ANALYSIS: We will use a randomised controlled study design to compare two types of assessment strategies: retrospective + momentary (consisting of the Edinburgh Postnatal Depression Scale plus five momentary and two contextual questions), and retrospective (consisting of the Edinburgh Postnatal Depression Scale only). We will assess the impact that these strategies have on participant adherence to a prespecified sampling protocol, dropout rates and timeliness of data completion. We will evaluate differences in acceptance of the technology through a short quantitative survey and open-ended questions. We will also assess the potential effect that momentary assessments could have on retrospective data. We will attempt to identify any patterns in app usage through the analysis of log data. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the National Research Ethics Service Committee South East Coast-Surrey on 15 April 2016 as a notice of substantial amendment to the original submission (9 July 2015) under the Research Ethics Committee (REC) reference 15/LO/0977. This study is being sponsored by Imperial College London under the reference number 15IC2687 and has been included in the UK Clinical Research Network Study Portfolio under the Central Portfolio Management System number 19280. The findings of this study will be disseminated through academic peer-reviewed publications, poster presentations and abstracts at academic and professional conferences, discussion with peers, and social media. The findings of this study will also inform the PhD theses of JSMB and KD

Amniotic fluid C-reactive protein as a predictor of infection in caesarean section: a feasibility study

This study evaluated the feasibility of maternal C-reactive protein (CRP) in amniotic fluid (AF) as a predictor of post-partum infection in women who undergo emergency or elective caesarean section (CS). AF bacterial culture and levels of hs-CRP in maternal serum and AF were evaluated in Day 0 and three days thereafter (Day 3) in 79 women undergoing CS. Univariate analyses assessed the clinical and demographic characteristics, whereas the ROC curves assessed the feasibility of hs-CRP as marker of inflammation in women who undergo CS. There was no difference in AF, Day 0, and Day 3 serum hs-CRP levels between women with sterile compared to those with bacterial growth in AF. Among women with positive AF cultures, AF and Day 0 serum hs-CRP levels were higher in women who underwent emergency compared to those who had elective CS (p = 0.04, and p = 0.02 respectively). hs-CRP in Day 0 and Day 3 serum but not in AF has a fair predictor value of infection in emergency CS only (AUC 0.767; 95% CI 0.606-0.928, and AUC 0.791; 95% CI 0.645-0.036, respectively). We conclude that AF hs-CRP is not feasible in assessing the risk of post-cesarean inflammation or infection

Cassini VIMS observations of H3+ emission on the nightside of Jupiter

We present the first detailed analysis of H3+ nightside emission from Jupiter, using Visual and Infrared Mapping Spectrometer (VIMS) data from the Cassini flyby in 2000–2001, producing the first Jovian maps of nightside H3+ emission, temperature, and column density. Using these, we identify and characterize regions of H3+ nightside emission, compared against past observations of H3+ emission on the dayside. We focus our investigation on the region previously described as “mid-to-low latitude emission,” the source for which has been controversial. We find that the brightest of this emission is generated at Jovigraphic latitudes similar to the most equatorward extent of the main auroral emission but concentrated at longitudes eastward of this emission. The emission is produced by enhanced H3+ density, with temperatures dropping away in this region. This emission has a loose association with the predicted location of diffuse aurora produced by pitch angle scattering in the north, but not in the south. This emission also lays in the path of subrotating winds flowing from the aurora, suggesting a transport origin. Some differences are seen between dayside and nightside subauroral emissions, with dayside emission extending more equatorward, perhaps caused by the lack of sunlight ionization on the nightside, and unmeasured changes in temperature. Ionospheric temperatures are hotter in the polar region (~1100–1500 K), dropping away toward the equator (as low as 750 K), broadly similar to values on the dayside, highlighting the dominance of auroral effects in the polar region. No equatorial emission is observed, suggesting that very little particle precipitation occurs away from the polar regions

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients