Direct Payment Schemes for People with Disabilities: A New and Innovative Policy Approach to Providing Services to Disabled People in Ireland

[Excerpt] This research project commenced initially in August 2002 and was initiated by the Disability Cluster Group – a network of local disability groups and service-providers, facilitated by the Bray Partnership. The Disability Cluster Group established a Disability Research Steering Committee for the project which, in turn, employed 80:20 Educating and Acting for a Better World – a non-governmental development education organisation – to undertake the research. The core objective of the work is to explore and move forward the agenda relating to direct payments in the East Coast Area Health Board (ECAHB). This is primarily a piece of qualitative research focusing on the many elements that make up a direct payment scheme from a number of stakeholder perspectives. In terms of the cross-border comparative element of the research, 10% of the total number of direct payments users in NI were interviewed. Given low overall numbers of direct payments service users, this figure is too limited for any significant statistical analysis. Instead, they serve to highlight some of the issues, experiences and challenges associated with introducing direct payments for a number of people with disabilities in Northern Ireland and allows for a range of conclusions to be drawn out

International migration : human rights and development dimensions

According to the United Nations and the OECD, more than 230 million people were living outside their countries of birth in 2013 with an additional 700 million migrating internally within their countries (UN DESA and OECD 2013). Current research and analysis has suggested that in the coming decades, demographic changes, increasing globalisation in a context of growing international inequality and climate change will significantly increase migration pressures within and across borders, at least in the short to medium term (see, for example UNDP 2009, IOM 2010, OECD 2007 and 2009).peer-reviewe

Conflict and human rights : Northern Ireland explored

On April 10, 1998, after thirty years of bloody conflict, political parties from all sides of the Northern Ireland conflict signed the Good Friday Agreement , pledging to dedicate themselves to ‘…the achievement of reconciliation, tolerance, and mutual trust, and to the protection and vindication of the human rights of all.’ The peace agreement placed at its core an agenda of human rights including a Bill of Rights for Northern Ireland, a Human Rights Commission and the reform of policing and justice procedures and provision.peer-reviewe

Dependence and Underdevelopment: The Case of Mineral Resources

Dependence and underdevelopment are the results of the penetration of capitalism into societies which were pre-capitalist in the past. The emergence of capitalism in central Europe and its expansion to incorporate all of Europe and later all of the world into its framework marked the beginning of the process of dependence. This situation was first established through direct colonialism and continues today in the form of Neo-colonialism. (Incorporation into the world capitalist system has never been on equal terms.) Such inequality manifests itself primarily between classes but also within space. Recent studies within geography have concentrated upon documenting this process with regard to what has been called the "Third World," (and as a result there has been little, if no, assessment of the impact of Imperialism upon the "Metropole" or "centre"). 1 This paper seeks to redress this imbalance, by way of an empirical analysis of dependence and underdevelopment in the context of mineral resources in the Irish Republic

An inherited duplication at the gene p21 protein-activated Kinase 7 (PAK7) is a risk factor for psychosis

FUNDING Funding for this study was provided by the Wellcome Trust Case Control Consortium 2 project (085475/B/08/Z and 085475/Z/08/Z), the Wellcome Trust (072894/Z/03/Z, 090532/Z/09/Z and 075491/Z/04/B), NIMH grants (MH 41953 and MH083094) and Science Foundation Ireland (08/IN.1/B1916). We acknowledge use of the Trinity Biobank sample from the Irish Blood Transfusion Service; the Trinity Centre for High Performance Computing; British 1958 Birth Cohort DNA collection funded by the Medical Research Council (G0000934) and the Wellcome Trust (068545/Z/02) and of the UK National Blood Service controls funded by the Wellcome Trust. Chris Spencer is supported by a Wellcome Trust Career Development Fellowship (097364/Z/11/Z). Funding to pay the Open Access publication charges for this article was provided by the Wellcome Trust. ACKNOWLEDGEMENTS The authors sincerely thank all patients who contributed to this study and all staff who facilitated their involvement. We thank W. Bodmer and B. Winney for use of the People of the British Isles DNA collection, which was funded by the Wellcome Trust. We thank Akira Sawa and Koko Ishzuki for advice on the PAK7–DISC1 interaction experiment and Jan Korbel for discussions on mechanism of structural variation.Peer reviewedPublisher PD

Emerging infectious disease implications of invasive mammalian species : the greater white-toothed shrew (Crocidura russula) is associated with a novel serovar of pathogenic Leptospira in Ireland

The greater white-toothed shrew (Crocidura russula) is an invasive mammalian species that was first recorded in Ireland in 2007. It currently occupies an area of approximately 7,600 km2 on the island. C. russula is normally distributed in Northern Africa and Western Europe, and was previously absent from the British Isles. Whilst invasive species can have dramatic and rapid impacts on faunal and floral communities, they may also be carriers of pathogens facilitating disease transmission in potentially naive populations. Pathogenic leptospires are endemic in Ireland and a significant cause of human and animal disease. From 18 trapped C. russula, 3 isolates of Leptospira were cultured. However, typing of these isolates by standard serological reference methods was negative, and suggested an, as yet, unidentified serovar. Sequence analysis of 16S ribosomal RNA and secY indicated that these novel isolates belong to Leptospira alstonii, a unique pathogenic species of which only 7 isolates have been described to date. Earlier isolations were limited geographically to China, Japan and Malaysia, and this leptospiral species had not previously been cultured from mammals. Restriction enzyme analysis (REA) further confirms the novelty of these strains since no similar patterns were observed with a reference database of leptospires. As with other pathogenic Leptospira species, these isolates contain lipL32 and do not grow in the presence of 8-azagunaine; however no evidence of disease was apparent after experimental infection of hamsters. These isolates are genetically related to L. alstonii but have a novel REA pattern; they represent a new serovar which we designate as serovar Room22. This study demonstrates that invasive mammalian species act as bridge vectors of novel zoonotic pathogens such as Leptospira

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Contemporary issues in conflict resolution

Posing the question ‘How many pairs of shoes do you have?’ in any group setting, educational or otherwise routinely generates a number of responses - guilt being one of the most common as the style and branding of shoes has become a status symbol in many societies. Guilt also because so many of us have more shoes than we can possibly wear and because they then represent that other characteristic of society (especially in the West) - waste. A simple survey of the volume of water required to manufacture a pair of shoes (7,000 litres per pair of leather shoes1) reveals another dimension of that culture: continuing waste of key resources. If the initial question on shoes is extended to include daily behaviours based on waste (e.g. water, food, energy, clothes etc.), then the discussion moves up a notch. Why is waste such a core feature of our lives and why do we engage in it so readily and habitually? Is waste simply a matter of personal responsibility or does it have systemic relevance and meaning? Where does personal responsibility and culpability begin and end and how do we mediate the conflicts that arise accordingly? In what ways does our embrace of waste represent a deeper malaise or challenge in the context of climate change, environmental degradation and a globalisation based increasingly on inequality? In what ways are the resource or environment conflicts of today different or more urgent than those of previous colonial and imperial eras? Such questions and the debates they generate represent a fundamental challenge to both the theory and practice of conflict resolution, one that the discipline simply must address.peer-reviewe

Zur Integration von Umwelt- und Entwicklungspädagogik. Der Ansatz der Development Education Commission

Es ist weder sinnvoll noch wünschenswert, die ökologischen Notwendigkeiten über die entwicklungspolitischen Notwendigkeiten zu stellen, oder über die Perspektive der Menschenrechte, der Rassen-, Geschlechter-, Friedens- und Armutsdiskussion. Ein umfassender Ansatz ist der einzig mögliche und nur er läßt sich mit der Realität der Schüler und Lehrer vereinbaren, die sich doch täglich mit all diesen Themen auseinandersetzen müssen. Innerhalb eines solchen Basiscurriculums können sicherlich einzelne Lehrplaneinheiten entwickelt werden, die eine tiefere Einsicht in die jeweiligen Teilgebiete ermöglichen. Einzelne Regionen, Schulen oder Gruppen von Schülern können sich in speziellen Gebieten weiterbilden. Das ist die Richtung, die derzeit die verschiedenen Lehrplankommissionen in England. Wales, Irland und Schottland einschlagen. (DIPF/Orig.