Interculturalism and multiculturalism in lreland: textual strategies at work in the media landscape

This essay is based on qualitative research undertaken by the Working Group on Media and Interculturalism, based at Dublin City University. The working group is a series of ongoing research projects exploring recent initiatives in the Irish media that have introduced and activated discourses on multiculturalism, interculturalism, anti-racism, diversity and citizenship. The purpose of this project was to explore how the Irish media is contributing to structuring (and normalising) the discourses in which, and through which, public understandings of and responses to socio-cultural changes are being formed

Soils of western Wright Valley, Antarctica

Western Wright Valley, from Wright Upper Glacier to the western end of the Dais, can be divided into three broad geomorphic regions: the elevated Labyrinth, the narrow Dais which is connected to the Labyrinth, and the North and South forks which are bifurcated by the Dais. Soil associations of Typic Haplorthels/Haploturbels with ice-cemented permafrost at 70 cm. They are developed in situ in strongly weathered drift with very low surface boulder frequency and occur on the upper erosion surface of the Labyrinth and on the Dais. Typic Anhyorthels also occur at lower elevation on sinuous and patchy Wright Upper III drift within the forks. Salic Aquorthels exist only in the South Fork marginal to Don Juan Pond, whereas Salic Haplorthels occur in low areas of both South and North forks where any water table is> 50 cm. Most soils within the study area have an alkaline pH dominated by Na+ and Cl- ions. The low salt accumulation within Haplorthels/Haploturbels may be due to limited depth of soil development and possibly leaching

The investigation of unexpected arsenic compounds observed in routine biological monitoring urinary speciation analysis

This study investigates the identity of two unexpected arsenic species found separately in a number of urine samples sent to the Health and Safety Executive's Health and Safety Laboratory for arsenic speciation (arsenobetaine, AB; arsenite, As3+; arsenate, As5+; monomethylarsonic acid, MMA5+; and dimethylarsinic acid, DMA5+). Micro liquid chromatography coupled to inductively coupled plasma mass spectrometry (μLC-ICP-MS) and electrospray time of flight tandem mass spectrometry (ESI-QqTOF-MS/MS) were used to identify the two arsenic peaks by comparison to several characterized arsenicals: arsenocholine, AC; trimethyl arsine oxide, TMAO; dimethylarsenoacetate, DMAA; dimethylarsenoethanol, DMAE; thio-dimethylarsinate, thio-DMA; thio-dimethylarsenoacetate, thio-DMAA and thio-dimethylarsenoethanol, thio-DMAE. The results from both the ICP-MS and ESI-QqTOF-MS/MS investigations indicate that the unexpected arsenic species termed peak 1 was thio-DMA. While the unexpected arsenic species termed peak 2 has yet to be identified, this investigation shows that it was not AC, TMAO, DMAA, DMAE, thio-DMA, thio-DMAA or thio-DMAE. This study demonstrates the incidence of unexpected arsenic species in both routine and non-routine urine samples from both workers and hospital patients

Should free text data in electronic medical records be shared for research? A citizens’ jury study in the United Kingdom

Background Use of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical policy. Methods Eighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns. Results Jurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing. Conclusions Informed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data

Implementing the Flinders Model of self-management support with Aboriginal people who have diabetes: findings from a pilot study

Programs to increase patients' capacity to manage their chronic disease are growing in popularity with policy makers, health professionals and the general public. However, until this pilot in regional South Australia, Indigenous people rarely participated in such programs. The pilot included extensive consultations with the Indigenous community, ownership of the program by an Aboriginal community-controlled health service, and a key role for Aboriginal and Torres Strait Islander Health Workers as the main coordinators of self-management support. The result was that 60 Aboriginal people participated and achieved notable improvements in health outcomes and personal goals. This pilot demonstrates that mainstream programs are relevant for Aboriginal communities as long as Aboriginal people lead the adaptation process

Chronic disease self-management in Aboriginal communities: towards a sustainable program of care in rural communities

Bundoora, VI

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common