Toward developing a model of responsive pastoral care for adult children of divorce

Reports on consequences of parental divorce identify a crucial need for involvement with caring adults in recovery and healing. The literature review includes reports of research and anecdotal surveys of adult children of divorce. The literature review stimulates questions for qualitative research with a pastoral care focus. The thesis incorporates discussion about the church\u27s role in helping individuals recover from divorce pain. It addresses contemporary concerns in group function, particularly in issues of pastoral care. An underlying assumption is a personal understanding that providing a healing community and participating in healing process is at the core of Christian mission. The thesis addresses basic theological and pastoral care assumptions. The central organizing questions informing and shaping literary review and qualitative research for this thesis are: How has the church/community of faith provided a healing community and participated in the healing process for adult children of divorce? and, How do adult children of divorce want the church/community of faith to respond to their need for healing? The research component surveys respondents about their experience of parental divorce and needs for pastoral care. Participants in this project identified inner resources as primary coping resources. Abandonment, isolation and loss of trust recurred as themes in their responses. Each respondent articulated an ideal for pastoral care within the context of their experience. Drawing from their input, this project envisions and describes a responsive model for pastoral care within communities of faith. The responsive model for care is portrayed in images of piece work quilts. A trampoline as symbol of a relational network of support conveys the communal aspect of relational healing. A Slinky depicts the dynamic cycle of change through CARE

Global EU Climate Action and the Principle of Common but Differentiated Responsibilities and Respective Capabilities

This Working Paper examines two instances of global EU climate action which extend the carbon price under the European Emissions Trading Scheme (ETS) to greenhouse gas emissions (GHG emissions) which are generated outside of the territory of EU Member States. The first is the EU Regulation establishing a carbon border adjustment mechanism (CBAM) and the second is the EU Directive including maritime emissions within the scope of the ETS. It appraises these measures from the point of view of the principle of Common but Differentiated Responsibilities and Respective Capabilities (CBDR-RC) that is enshrined in the United Nations Framework Agreement on Climate Change and the Paris Agreement. Drawing a distinction between the EU’s first-order and second-order climate responsibilities, the paper argues that the EU has acted consistently with the CBDR-RC principle in relation to international shipping emissions. By contrast, it argues that the EU has acted inconsistently with the principle of CBDR-RC in relation to CBAM and proposes two adjustments to the design of this measure to bring it in to line with this principle

In Sickness and in Health: The Influence of State and Federal Health Insurance Coverage Mandates on Marriage of Young Adults in the USA

We study the effects of state and federal dependent health insurance mandates on marriage rates of young adults, ages 19 to 25. Motivated by low rates of coverage among this age group, state governments began mandating health insurers in the 1970s to allow adult children to stay on their parents’ insurance plans. These state level efforts successfully increased insurance coverage rates, but also came with unintended implications for the marriage decisions of young adults. Almost all state mandates explicitly prohibited marriage as a condition of eligibility, thereby directly discouraging marriage. Additionally, by making access to health insurance through parents easier, the mandates made access through spouses’ employers relatively less attractive. To the extent that young adults were altering their marriage plans to gain access through potential spouses, they no longer needed to do so under the mandates, thereby implicitly discouraging marriage. When the dependent coverage mandate of the Affordable Care Act (ACA) was enacted, it effectively ended the state-based marriage restrictions, thereby encouraging marriage among young adults previously eligible for state mandates. On the other hand, for those who were not eligible for state mandates, the ACA represented an attractive new path to obtain coverage, thereby discouraging marriage for these young adults, just as the state mandates had implicitly done previously for others. Thus, the separate efforts at the state and federal level to address low coverage rates for young adults ended up interacting and influencing incentives for marriage in opposite directions. We study these interaction effects on marriage empirically using a new dataset we compiled on state-level dependent coverage mandates. Consistent with theoretical arguments, we find that, before the implementation of the ACA, state mandates lowered marriage rates by about 2 percentage points, but this pattern reversed upon the passage of the ACA. We also find that state mandates increased the probability of out-of-wedlock births among state-mandate-eligible women as compared to ineligible ones, but the ACA reversed this trend as well. Our study provides an important example where fundamental understanding of the effects of the ACA dependent coverage mandate can only be had with full consideration of the pre-existing state laws

Phosphorylation of androgen receptors at serine 515 is a potential prognostic marker for triple negative breast cancer

1.7 million cases of breast cancer are diagnosed every year with 522,000 deaths. Molecular classifications of breast cancer have resulted in improved treatments. However, treatments for triple negative breast cancer (TNBC) are lacking. Analysis of molecular targets for TNBC is a priority. One potential candidate is androgen receptor (AR) phosphorylation. This study assessed the role of AR phosphorylation at ser81/ser515 and their two upstream effectors, cyclin-dependent kinase 1 (pCDK1) and extracellular-regulated kinase 1/2 (pERK1/2) in 332 ductal breast cancer patients by immunohistochemistry. pERK1/2 combined with AR-515 associated with improved cancer-specific survival (CSS, p = 0.038), decreased size (p = 0.001), invasive grade (p < 0.001), necrosis (p = 0.003), b-lymphocytes (p = 0.020), molecular subtype (p < 0.001) and estrogen receptor (ER)/progesterone receptor (PR)-status (p < 0.001). The cohort was therefore stratified into ER+ve and ER-ve patients. In ER+ve tumours, pERK1/2 combined with AR-515 associated with improved CSS (p = 0.038), smaller size (p = 0.004), invasive grade (p = 0.001), decreased b-lymphocytes (p = 0.013) and increased plasma cells (p = 0.048). In contrast, in TNBC patients, phosphorylation of AR-515 associated with poorer CSS (p = 0.007). pERK1/2 combined with AR-515 associated with decreased inflammation (p = 0.003), increased tumour stroma (p = 0.003) and tumour budding (p = 0.011), with trends towards decrease CSS (p = 0.065) and macrophage levels (p = 0.093). In Conclusions, AR-515 may be an important regulator of inflammation in breast cancer potential via ERK1/2 phosphorylation. AR-515 is a potential prognostic marker and therapeutic target for TNBC

Case study: using PebblePad to enhance the effectiveness of personal tutoring and improve student engagement

It is widely recognised that there has been an increase in the proportion of students accessing a university education, in particular from groups who would not traditionally enter higher education (HE). With widening participation (WP) comes some key challenges, and pressure on institutions to retain students is ever growing. Therefore, the need for increasing achievement and reducing attrition requires an effective support mechanism for students through a university personal tutoring process (Stuart, Willock & Browning, 2019)

Health inequalities and health-related economic inactivity:Why good work needs good health

Tackling health inequalities demands whole systems strategies with reach beyond the traditional sphere of influence of health care systems. Practitioners and researchers have long recognised that wider social determinants, where people are born, the communities they live in, their built environment, access to education and resources and, most significantly for this discussion, their relationship to the labour market, profoundly shape health experiences and expectations over the lifecourse. At macro-level, economic structures and systems play a fundamental role in the distribution of good health and incidence of inequalities. Regionally, the health of local labour markets, a phenomenon shaped by macro, national and global economic forces, is a powerful determinant of opportunities to access and remain in work. Simultaneously, health status impacts significantly on ability to participate in paid employment. Absence from the labour market is both a cause and symptom of health inequalities.Economic inactivity, where people are both not participating in the labour market, or actively seeking or available for work, is strongly correlated with poor health. In the UK, over one third of the economically inactive experience long-term health problems. The implications for health inequalities, as both cause and symptom are clear. Participation in paid work, where appropriate, can be beneficial both economically and for health and wellbeing. Continued absence from the labour market is directly correlated with ill health. The determinants of health-related economic inactivity are complex and can only be understood using ecological models of public health. This presents significant challenges for politicians and policymakers alike concerned with reducing economic inactivity, delivering economic growth and redressing regional disparities

A legacy of lingering uncertainty: the experience of long-term cancer survivorship: a multiple-case study

More people are surviving cancer, and for longer. As a result, ‘cancer survivorship’ is a key policy and research issue. This exploratory study aimed to describe, and further understanding of, the cancer experience of individuals living five years or more post-treatment. A multiple-case study design was adopted. A narrative interview and semi-structured follow-up interview were held with thirteen participants and their ‘significant others’. ‘Restorying’ of narratives was followed by a cross-case analysis to explore similarities and differences across cases. The utility of liminality as a framework for understanding cancer survivorship was then explored. Little et al. (1998) argue individuals live in a state of ‘sustained’ liminality that persists until end-of-life. However, some individuals may ‘transcend’ the liminal phase. Individuals diagnosed with breast, gynaecological, prostate, testicular and colorectal cancer, five to sixteen years post-treatment, took part. A legacy of lingering uncertainty was evident across cases. The most common manifestation was fear of recurrence. A typology of the place of cancer was developed. Cancer was situated in the past, past-present or present-future. However, the place of cancer is not static; it oscillates between the past, present and future, and foreground and background of participants’ lives as a result of the lingering uncertainty and various ‘reality checks’ experienced. Most, but not all, participants live in a state of ‘sustained’ liminality. Perceiving the five-year survival marker as a ‘milestone’ is key to transitioning out of the liminal state. Some participants have put cancer (the disease) in the past, but consequences of treatment result in them living in an on-going state of physical liminality. Others perceive they are living with cancer within them and experience liminality existentially. However, whilst liminality is often construed negatively, it can be a catalyst for positive change to self. Implications for practice are positioned within the context of new models of ‘aftercare’ implemented in England. Holistic needs assessments at key transition points along the survivorship trajectory are crucial to providing tailored care within the context of individuals’ wider lives

Live Intermediality: A New Mode of Intermedial Praxis

This Practice as Research thesis is a contribution to and intervention in the fields of intermedial performance studies and live media practice. Its arguments are formulated through live intermediality, a mode of practice whereby the solo performer activates image, sound, object and body in the presence of and sometimes with the ‘experiencers’ (Nelson 2010), in order to compose a series of shifting intermedial combinations. The thesis interrogates current discourses around intermediality in performance, the role and actions of the live media performer and the generation of events in intermedial and live media practice, arguing that each can be productively re-­-viewed through live intermedial practice. In positioning the practice clearly within the various lineages from which it draws and positing the particular ‘knowings’ it produces, live intermediality is formulated as distinctive ‘praxis’ or ‘doing-thinking’ (Nelson 2013). In addition, the specific characteristics of live intermediality – the dualities, discourses and collisions it generates - are presented both as form of new knowledge through practice and employed as the tools to pierce existing thinking from an ‘insider’ perspective. Working from a Practice as Research methodology, live intermediality is placed in dialogue with resonant conceptual frameworks, such as the work of intermedial theorists, Kattenbelt (2008) and Lavender (2006), new media theorists, Bolter and Grusin (2000), as well as broader paradigms of presence (Power 2008), autopoiesis (Fischer-­-Lichte 2008, Maturana and Varela 1987) and event (Derrida 1978, Deleuze 2006). The praxis, through its dialogue with such frame works, reconfigures current theories around the activation, operation and experience of intermediality in live media forms. In addition, through its distinctive features and the ‘knowings’ they generate, live intermediality is proposed as new mode of praxis within these fields