An ethos or an afterthought?: an exploratory study into the educational inclusion of Gypsy/Travellers in a local authority / Caitriona Ni Mhuircheartaigh

This study explored the educational inclusion of Gypsy/Travellers (G/Ts) in a Local Authority (LA). Using a qualitative design, underpinned by a transformative ethos, it employed unstructured interviews to gather the perspectives of Irish Traveller (IT) parents and School Staff (SS) on the barriers and opportunities for inclusive education (IE) in the local context. Thematic analysis carried out separately on both data sets revealed that similar topics were raised by both sets of participants, which can be understood within three overarching concepts (‘over-arching-concept’s); Discriminatory Attitudes, Achieving Education for All and Creating Welcoming Communities. However, critical differences between how similar issues were understood emerged. These related particularly to understandings of equality and equity and the responsibility for inclusion. These ‘over-arching-concept’s are discussed in relation to how they create a story of exclusion from, rather than inclusion in education for these communities. The study concludes that in order to redress the historical and ongoing discrimination and exclusion experienced by these communities, a positive action approach to developing policies and practices, which complements a more equitable understanding of IE among educational services in this context is needed. Implications for Educational Psychology (EP) practice to support the development of IE in targeted areas within Bronfenbrenner’s (1979) eco-systems are suggested

Intra-tester and inter-tester reliability of the MicroFET 3 hand-held dynamometer.

Background: The reliability of the MicroFET 3 has not previously been reported in the literature. The aim of this study was to evaluate intra-tester and inter-tester reliability of the MicroFET3 hand-held dynamometer (HHD) in three lower limb muscle groups. Methods: Maximum voluntary isometric contraction (MVIC) of hip extension, knee extension and ankle plantar-flexion were measured in 38 healthy participants (males=18, females= 20) by two testers on separate days using the MicroFET3 HHD. The reliability analysis was carried out using intra-class correlation coefficients (ICCs) to measure association and Band and Altman plots to demonstrate agreement. Results: The results showed that intra-tester reliability was moderate to excellent; with associations ranging from ICC 0.56 - 0.92 and higher agreement for knee and ankle than hip measurements was shown. Inter-tester reliability was lower, with hip and knee associations ranging from ICC 0.60 - 0.66. Ankle measurements intertester associations were particularly low (ICC 0.23 and 0.15). These values would not be considered acceptable for clinical use. Bland and Altman plots used to demonstrate agreement between testers displayed a considerable lack of agreement with discrepancies of up to 150N noted in measurements. Conclusion: The results suggest that the MicroFET3 HHD displayed moderate to excellent intra-tester reliability and poor to moderate inter-tester reliability and agreement with discrepancies noted between muscle groups. While use of this instrument can be recommended when consistently used by a single tester, further reliability analysis should be carried out before this instrument could be recommended for use by different testers in the clinical setting

Carbon supported CdSe nanocrystals

Insights to the mechanism of CdSe nanoparticle attachment to carbon nanotubes following the hot injection method are discussed. It was observed that the presence of water improves the nanotube coverage while Cl containing media are responsible for the shape transformation of the nanoparticles and further attachment to the carbon lattice. The experiments also show that the mechanism taking place involves the right balance of several factors, namely, low passivated nanoparticle surface, particles with well-defined crystallographic facets, and interaction with an organics-free sp2 carbon lattice. Furthermore, this procedure can be extended to cover graphene by quantum dots.Comment: 5 pages, 5 figure

Age-dependent electroencephalogram (EEG) patterns during sevoflurane general anesthesia in infants

Electroencephalogram (EEG) approaches may provide important information about developmental changes in brain-state dynamics during general anesthesia. We used multi-electrode EEG, analyzed with multitaper spectral methods and video recording of body movement to characterize the spatio-temporal dynamics of brain activity in 36 infants 0–6 months old when awake, and during maintenance of and emergence from sevoflurane general anesthesia. During maintenance: (1) slow-delta oscillations were present in all ages; (2) theta and alpha oscillations emerged around 4 months; (3) unlike adults, all infants lacked frontal alpha predominance and coherence. Alpha power was greatest during maintenance, compared to awake and emergence in infants at 4–6 months. During emergence, theta and alpha power decreased with decreasing sevoflurane concentration in infants at 4–6 months. These EEG dynamic differences are likely due to developmental factors including regional differences in synaptogenesis, glucose metabolism, and myelination across the cortex. We demonstrate the need to apply age-adjusted analytic approaches to develop neurophysiologic-based strategies for pediatric anesthetic state monitoring.National Institutes of Health (U.S.) (R01-GM104948)National Institutes of Health (U.S.) (DP2-OD006454)Massachusetts General Hospita

Opioid-Independent and Opioid-Mediated Modes of Pain Modulation.

Pain is regulated endogenously through both opioid and non-opioid mechanisms. We hypothesized that two novel pain modulation tasks, one drawing on context/expectations and one using voluntary reappraisal, would show differing levels of opioid dependence. Specifically, we expected that naloxone would block context-related analgesia, whereas mental imagery-based pain reappraisal would be opioid-independent.A double-blind, placebo-controlled intravenous naloxone versus saline crossover design was used. Twenty healthy volunteers completed the two modulation tasks with acute heat stimuli calibrated to induce moderate pain. In the mental imagery task, participants imagined either a "pleasant" or a "comparison" scenario during painful heat. In the relative relief task, moderate heat stimuli coincided with visual cues eliciting relief from the expectation of intense pain, and were compared with moderate heat stimuli delivered under the expectation of non-painful warmth. Both "pleasant imagery" and "relative relief" conditions significantly improved ratings of pain intensity and pleasantness during saline treatment. Indeed, the target stimuli in both tasks, which had been calibrated to induce moderate pain, were rated as mildly pleasant. Furthermore, consistently with the main hypothesis, blocking endogenous opioid signaling with naloxone did not significantly affect imagery-induced regulation of pain intensity or pleasantness. In contrast, the relative relief-induced pain regulation (i.e., context/expectation) was blocked by naloxone. We conclude that endogenous opioid signaling is necessary for expectation-related relative relief analgesia, but not for pain reappraisal through mental imagery. These results support mental imagery as a powerful and clinically relevant strategy for regulating pain affect also in patients where endogenous opioid mechanisms might be compromised.SIGNIFICANCE STATEMENT Neurotransmitter systems in the human brain can be probed through antagonist drugs. Studies using the opioid antagonist naloxone have demonstrated that the brain relies on both opioid and non-opioid mechanisms to downregulate pain. This holds clinical relevance given altered endogenous opioid processes in many chronic pain conditions. The present study used a double-blinded, placebo-controlled naloxone blockage of endogenous opioids in healthy humans to show differential opioid involvement in two pain modulation tasks. Context/expectation-driven (relative relief-related) analgesia was blocked by naloxone. In contrast, pain reappraisal through mental imagery was intact despite opioid receptor blockade, suggesting opioid independence. These results support mental imagery as a powerful, clinically relevant strategy for regulating pain as it does not rely on a functioning opioidergic system

Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions:a necessary test or an obsolete skill?

OBJECTIVE: The vast majority of breast cancers are diagnosed via image-guided procedures yet despite significant advances, imaging does not identify all breast malignancies. Clinically suspicious breast lesions with normal breast imaging remain a cause for concern. The aim of this study is to determine the diagnostic value of clinical core and cutaneous punch biopsies in the diagnosis of breast malignancy in clinically suspicious lesions with normal breast imaging. METHODS: All patients with suspicious clinical breast findings and normal imaging who underwent a clinical core and/or cutaneous punch biopsy from 2012 to 2019 were reviewed retrospectively. Patients with subsequent breast malignant diagnosis were analysed. RESULTS: A total of 283 biopsies (166 clinical core, 117 cutaneous punch) performed over the 7-year period were included in the analysis. A total of 263/283 (93%) yielded a benign outcome. A total of 2/283 (0.7%) yielded B3 lesions (probably benign). These lesions were benign on final surgical excision. A total of 18/283 (6.3%) yielded a malignant histopathology. Sixteen out of 18 were cutaneous punch biopsies, and 2/18 were clinical core biopsies. A total of 14/18 patients presented with nipple changes, while 4/18 had a palpable area of concern. Histopathological analysis demonstrated Paget’s disease of the nipple in 8/18, invasive carcinoma in 9/18 out of which two represented a recurrence of breast malignancy. Cutaneous squamous cell carcinoma was diagnosed in 1/18. CONCLUSION: Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies

New insights into the impact of neuro-inflammation in rheumatoid arthritis.

Rheumatoid arthritis (RA) is considered to be, in many respects, an archetypal autoimmune disease that causes activation of pro-inflammatory pathways resulting in joint and systemic inflammation. RA remains a major clinical problem with the development of several new therapies targeted at cytokine inhibition in recent years. In RA, biologic therapies targeted at inhibition of tumor necrosis factor alpha (TNFα) have been shown to reduce joint inflammation, limit erosive change, reduce disability and improve quality of life. The cytokine TNFα has a central role in systemic RA inflammation and has also been shown to have pro-inflammatory effects in the brain. Emerging data suggests there is an important bidirectional communication between the brain and immune system in inflammatory conditions like RA. Recent work has shown how TNF inhibitor therapy in people with RA is protective for Alzheimer's disease. Functional MRI studies to measure brain activation in people with RA to stimulus by finger joint compression, have also shown that those who responded to TNF inhibition showed a significantly greater activation volume in thalamic, limbic, and associative areas of the brain than non-responders. Infections are the main risk of therapies with biologic drugs and infections have been shown to be related to disease flares in RA. Recent basic science data has also emerged suggesting that bacterial components including lipopolysaccharide induce pain by directly activating sensory neurons that modulate inflammation, a previously unsuspected role for the nervous system in host-pathogen interactions. In this review, we discuss the current evidence for neuro-inflammation as an important factor that impacts on disease persistence and pain in RA

Consultant psychiatrists's experience of the impact of the COVID19 pandemic on mental health services in Ireland

Objectives: The novel coronavirus 2019 (COVID-19) has spread worldwide threatening human health. To reduce transmission, a ‘lockdown’ was introduced in Ireland between March-May 2020. The aim of this study is to capture the experiences of Consultant Psychiatrists during lockdown and their perception of its impact on Mental Health Services. Methods: A questionnaire designed by the Royal College of Psychiatrists was adapted and circulated to Consultant members of the College of Psychiatrists following the easing of restrictions. The questionnaire assessed the perceived impact on referral rates, mental health act provision, availability of Information Technology (IT), consultant well-being and availability of Personal Protective Equipment (PPE). Thematic analysis was employed to analyse free-text sections. Results: Response rate was 32% (N=197/623). Consultants reported an initial decrease/significant decrease in referrals in the first month of lockdown (68%, N=95/140) followed by an increase/significant increase in the second month for both new (83%, N=100/137) and previously attending patients (65%, N=88/136). Social isolation and reduced face-to-face mental health supports were among the main reasons identified. The needs of children and older adults were highlighted. Most consultants (76%, N=98/129) felt their working day was affected and their well-being reduced (52%, N=61/119). The majority felt IT equipment availability was inadequate (67%, N=88/132). Main themes identified from free-text sections were service management, relationship between patients and healthcare service and effects on consultants’ lives. Conclusions: The COVID19 pandemic has placed increased pressure on service provision and consultant wellness. This further supports the longstanding need to increase mental health service investment in Ireland