Equity of access to adult hospice inpatient care within north-west England.

There is a growing debate about the question of equity of access to hospice and palliative care services. Even countries with relatively well developed palliative care systems are considered to have problems of access and inequity of provision. Despite these concerns, we still lack a relevant evidence base to serve as a guide to action. We present an analysis of access to adult hospice inpatient provision in the north-west region of England that employs Geographical Information Systems (GIS). Measures of the possible demand for, and supply of, hospice inpatient services are used to determine the potential accessibility of cancer patients, assessed at the level of small areas (electoral wards). Further, the use of deprivation scores permits an analysis of the equity of access to adult inpatient hospice care, leading to the identification of areas where additional service provision may be warranted. Our research is subject to a number of caveats�it is limited to inpatient hospice provision and does not include other kinds of inpatient and community-based palliative care services. Likewise, we recognise that not everyone with cancer will require palliative care and also that palliative care needs exist among those with nonmalignant conditions. Nevertheless, our methodology is one that can also be applied more generally

Monstrous motherhood versus magical maternity?:an exploration of conflicting attitudes to maternity within health discourses and organizational settings

Purpose – The purpose of this paper is to compare public health discourses on the importance of motherhood with organizational attitudes towards childbearing. It shows how pregnancy and the nurturing of infant children are valorized within public health discourses, which treat pregnancy and new maternity as a miraculous “project”, encouraging mothers to position maternity as central to their lives. By contrast, the paper shows how employers treat pregnancy and new motherhood as inconvenient and messy: as monstrous, at work. Design/methodology/approach – The paper draws upon a database of qualitative netnographic (or internet-based) research. It analyses netnographic interactions between pregnant and newly maternal women. These virtual data are afforded the same validity as face-to-face research. Findings – The paper demonstrates how maternal responsibilities for nurturing pregnancy and infant children, and the bio-medical properties of the maternal body, are central to public health discourses. By contrast, the maternal body is treated within organizations as alien, or monstrous. Originality/value – The paper compares and contrasts public health valorizations of motherhood, with organizational tendencies to treat pregnancy/newly maternal bodies as monstrous. It highlights dichotomies faced by employed mothers. A continuing chasm between the social organization of maternity, and the attitudes of employers towards children and maternal bodies, is identified

An empirical investigation into contributory factors of change and fault propensity in large-scale commercial object-oriented software

This thesis was submitted for the degree of Doctor of Philosophy and was awarded by Brunel UniversityObject-Oriented design and development dominates both commercial and open source software projects. One of the principal goals of object-oriented design is to aid reuse, and hence, reduce future maintenance efforts of software systems. However, the on-going maintenance of large-scale software systems (both changes and faults) continues to be a significant proportion of the lifecycle of the system and the total investment cost. Understanding and thus being able to predict - or even reduce - the impact of the contributing factors of future maintenance efforts of a software system is thus highly beneficial to software practitioners. In this Thesis we empirically study a large, commercial software system with the principal aim to determine the contributing factors to the change and fault propensity over a three-year period. We consider the object-oriented design context of the software, specifically its inheritance characteristics, coupling and cohesion properties, object-oriented design pattern participation, and size. We also explore the effect of refactoring and test classes in the software. Our results show that several aspects of the design context of a class have an impact to the change and fault-proneness of the software. Specifically, we show that classes with high afferent or efferent coupling are more change and fault-prone; we also identify a number of design patterns whose participants tend to have a higher change and fault propensity than non-participants and we identify a range of inheritance characteristics (in terms of depth of inheritance and number of children) that result in an increase to change and fault-proneness. Furthermore we show that refactoring is a commonly occurring maintenance activity, although it is largely limited to simpler types of refactorings. Finally, we provide some insight into the co-evolution of production and test code during refactoring

"Negotiating Resettlement": some Concluding Thoughts

In this article, I take the opportunity to discuss some recent work on the history of population displacement, including the valuable work represented in this HSR Special Issue, with a particular focus on the situation of displaced persons and refugees in Europe in the aftermath of the Second World War. Here, I concentrate on the interaction of multiple actors in the post-war international refugee regime and then turn to some specific issues in relation to the confidential case files of the UNHCR compiled between 1951 and 1975. This allows me a few final reflections on the extent to which digital methods can support research and dissemination as well as the wealth of material at the disposal of any historian who wishes to study the mainsprings of mass population displacement, the management practices and policies of the state, the dynamics of the international refugee regime, the role of activists and relief workers, and not least the responses of refugees who navigated the dangerous waters of displacement, who were caught up in the myriad processes of categorisation, and who encountered officials who had the power to determine their prospects

NANOPHYTOPLANKTON PHYSIOLOGY AND THE CARBON CYCLE

Laboratory experiments on the physiological response of members of the nanophytoplankton to temperature and light limitation and nutrient saturation were conducted in order to investigate if nanophytoplankton conforms to Plankton Functional Types (PFTs) for modelling purposes. This thesis concluded that nanophytoplankton does not follow all of the assumed physiological traits. The Q10 estimates for members of the nanophytoplankton are considerably lower than Eppley, and since nanophytoplankton does not follow the Eppley curve at warmer temperatures, the results suggest that the Eppley assumptions cannot be used to describe nanophytoplankton. μmax0 is used as a temperature physiological modelling parameter (as well as Q10) which are components of the exponential and linear fits. However, nanophytoplankton best fits to an optimum function which uses μopt, Topt and dT as model parameters. These results are in contrast to the Eppley assumptions. Using a dynamic photosynthesis model five phytophysiological parameters were derived including the maximum photosynthesis rate

Diet Induced Alterations and Distribution of Indices of Lysine Catabolism

Lysine is thought to be oxidized primarily by lysine alpha-ketoglutarate reductase (LKR) and saccharopine dehydrogenase (SDH), which are restricted to the mitochondrial matrix. Lysine is presumably transported through the plasma membrane by isoforms(s) of a cationic amino acid transporter (CAT). Although the mechanism(s) of lysine transport through the inner mitochondrial membrane is not known, it is presumptively transported by one or both mitochondrial ornithine transporters (ORC-1/ORC-2). Tissue distribution of LKR and the mechanism(s) responsible for alterations in hepatic lysine catabolism in swine are unclear. Also, the roles of the alternative pathways of lysine degradation, the L-amino acid oxidase-dependent (LAAO), in poultry, and the lysyl oxidase-dependent pathway (LO), in mammals and poultry, have not been established. Genetic effects on lysine degradation were evaluated throughout the production-cycle in 2 strains of commercial turkey. Hepatic LKR activity (P\u3c0.05), LKR mRNA (P\u3c0.01), SDH activity (P\u3c0.05), lysine oxidation (LOX, P\u3c0.0001), LAAO activity (P\u3c0.05), LO activity (P\u3c0.01) L-amino acid oxidase (P\u3c0.0001), and CAT1 mRNA abundance (P\u3c0.05) differed throughout the production cycle. Differences in indices of lysine catabolism due to strain in these 2 commercial lines of turkey were not detected. The LAAO and LO activities represented only 0.21 and 0.03% of the activity of enzymes involved in the saccharopine-dependent pathway. These data support that the saccharopine-dependent pathway is the predominant pathway of lysine degradation in turkey liver and that indices of hepatic lysine catabolism vary throughout the production cycle. Next, studies were conducted in swine to characterize the tissue distribution and evaluate possible mechanisms of alterations in lysine degradation. In growing pigs, LKR activity (P\u3c0.001) was highest in liver, intestine and kidney samples and SDH activity (P\u3c0.0001) and LKR (P\u3c0.0001) and SDH mRNA (P\u3c0.0001) were highest in liver. Interestingly, tissue distribution of LKR activity was correlated with ORC-1 and ORC-2 mRNA (r2=0.32, P\u3c0.05 and r2=0.41, P\u3c0.05, respectively). Average LO activity across tissues represented only 0.5% of the activity of enzymes involved in the saccharopine-dependent pathway. These data indicate that extra-hepatic tissues play a role in whole-body lysine degradation, ORC transporters may play a role in the transport of lysine into the mitochondrial matrix for its catabolism, and the saccharopine-dependent pathway is the predominant pathway of lysine degradation in pig tissues. To further investigate the role of ORC in lysine catabolism and to discern the mechanisms responsible for alterations of lysine catabolism, weanling pigs (n=35) were fed either a control (C), high protein (HP), low protein (LP), high lysine (HL) or low lysine (LL) diet. Liver LKR activity (P\u3c0.05) and AASS protein expression (P\u3c0.01) were reduced in pigs consuming the LL diet compared to C. Liver SDH mRNA expression was reduced (P\u3c0.08) with the consumption of the LL diet compared to C, and AASS mRNA was reduced (P\u3c0.05) with the consumption of the LL diet compared to the HP and HL diets. No significant dietary alterations in lysine catabolism were detected in heart or kidney. There was an increase (P\u3c0.05) in liver ORC-1 mRNA expression with the consumption of the HL diet and a dramatic decrease in ORC-1 expression when treated with the LL diet. From these data it can be concluded that diet-induced alterations in lysine catabolism do occur in pig liver and the response of the ORC-1 mRNA to low lysine diets implicates that transporter as an important molecular basis of lysine conservation

Machine vision based teleoperation aid

When teleoperating a robot using video from a remote camera, it is difficult for the operator to gauge depth and orientation from a single view. In addition, there are situations where a camera mounted for viewing by the teleoperator during a teleoperation task may not be able to see the tool tip, or the viewing angle may not be intuitive (requiring extensive training to reduce the risk of incorrect or dangerous moves by the teleoperator). A machine vision based teleoperator aid is presented which uses the operator's camera view to compute an object's pose (position and orientation), and then overlays onto the operator's screen information on the object's current and desired positions. The operator can choose to display orientation and translation information as graphics and/or text. This aid provides easily assimilated depth and relative orientation information to the teleoperator. The camera may be mounted at any known orientation relative to the tool tip. A preliminary experiment with human operators was conducted and showed that task accuracies were significantly greater with than without this aid

The sacrificial embrace:exploring contemporary English parish clergy lives

Describing clergy experiences ‘in their own words’, this paper reflects on the findings of a qualitative study (by the authors) on the lives of contemporary Church of England parish clergy.1 From the data, themes of obedience, sacrifice and intimacy emerge to provide an explanatory framework for clergy lives. In applying theological, social science and occupational management perspectives, the research counters the literature about clergy failures. While acknowledging a range of clergy views about the nature of faith and commitment, it nevertheless reveals an enduring and authentic vocational steadfastness among priests across the years