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The provisions of the Pension (Amendment) Bill 2001 announced by the Irish government in July 2001 are explained. The reforms of the national pensions system and the effects of Personal Retirement Savings Accounts are explored.

All pregnant women in the United Kingdom are offered and encouraged to take up screening for human immunodeficiency virus (HIV), hepatitis B and syphilis, with excellent uptake rates and engagement in care resulting in very few infants being infected with HIV in the United Kingdom. However, in that small number of women who decline testing, there remains an opportunity to offer further support to test and engage them and their baby in care, even if this happens in labour or immediately after birth. In addition, these women may be at increased risk of HIV. Our hospital is in an extremely high prevalence area for HIV, and most untested individuals are of childbearing age. We embarked on a quality improvement project to engage all women delivering at our unit in HIV testing or to test their babies via cord blood at birth. We sought to do this in a constructive and inclusive way, led by the HIV specialist midwife with the support of the HIV antenatal and the hospital senior management teams. Following an initial evaluation, the approach was modified and an innovative approach together with a trusted advocate was used to engage a particularly hard-to-reach group. We have achieved 100% uptake of HIV testing and made two HIV diagnoses that would not otherwise have been made; both in women who reported themselves not to be at risk and both engaged in care and delivered HIV-negative infants.

An estimated 33.9 million people are living with dementia worldwide. The overall estimated median survival time from onset of dementia to death is 4.1 years for men and 4.6 years for women, with longer survival times in those with early-onset dementia. Much has been discussed about the needs of this vulnerable group of people particularly in terms of their health-care and end-of-life care (EoLC) needs. However, the literature suggests that people with end-stage dementia are still not receiving adequate or appropriate EoLC. Difficulty diagnosing dementia, a stigma surrounding the disease, lack of education of the dementia disease process and the ability to identify complications encountered at end-stage dementia by health-care providers, families and carers are some of the factors preventing those with dementia receiving effective EoLC. Great strides have been made to improve dementia palliative care; however, this cohort of patients still receive fewer referrals to appropriate palliative care services than other terminally ill patients.

Many governments across Europe and America set maintaining the quality of life (QoL) of older people living in long-term care as a key policy objective; however, much of the evidence reveals that life in many care environments is still routinized and institutionalized. QoL is a term that is widely used but poorly defined and understood. The focus of this Review is on identifying the components of QoL and reviewing strategies for improving QoL in long-term care. Six components of QoL were consistently identified across studies: autonomy, environment, connectedness, meaningful activity, independence and sense of self. A review of strategies for improving QoL revealed that the evidence of effectiveness across studies remains inconclusive. The judgment of quality was often hampered by inadequate details on the study design and the use of nonspecific and wide-ranging QoL tools. Furthermore, high-quality studies are required to determine effectiveness.

The aim of the PRINCE study was to determine the effectiveness of a structured education pulmonary rehabilitation programme for those living with COPD in primary care in Ireland. This qualitative element of the larger PRINCE trial aims to describe the constituents of ‘usual care’ for patients allocated to the control arm of the study.A descriptive qualitative study was used to explore the constituents of usual care. A convenience sample of participants (n=20) allocated to the usual care group were interviewed.Three main themes arose from the study: experiences of having and managing COPD, lifestyle advice, and factors that helped or hindered self-management.Usual care left many people grappling in the dark trying to manage their COPD. It was found that usual care was not at its optimum for people with COPD in the control arm of the PRINCE study.

This article describes the development of a Structured Education Pulmonary Rehabilitation Programme (SEPRP), for the PRINCE (Pulmonary Rehabilitation In Nurse-led Community Environments) study. This process involved a literature review of existing PR programmes, a content analysis of national and international PR programmes and a concept analysis of empowerment. Secondly, two small descriptive qualitative studies were undertaken to further inform programme content exploring the views of health professionals and clients on programme content, as well as their perceptions of living with COPD. The findings of these two stages led to the development of the eight-week PRINCE SEPRP, based on a philosophy of empowerment and the SEPRP was underpinned by the Transtheoretical model (TTM) of behaviour change. Programme content included managing medications and managing breathlessness, knowing and managing symptoms, recognizing and managing acute exacerbations as well as an individualized exercise programme. Participants' experiences of self management following participation in the SEPRP were also examined. The findings indicate that nurses working in primary care have an important role in informing the development of SEPRP as well as having a key role in their delivery. They have the potential to work in empowering ways with COPD clients and the PRINCE SEPRP is just one example of how this can be put into practice.

ABSTRACT: The teaching of professionalism has become a prominent topic among academic and clinical faculty members who teach future speech-language pathologists and audiologists. This article grew from a series of conferences and discussions generated by the Midwest Clinic Directors Group and a collaborative teaching initiative conducted by the authors. Results included an interdisciplinary program and methods to measure professional development among students in Communication Sciences and Disorders (CSD) programs. This article describes the process that led to both of these outcomes and poses questions for clinical and academic faculty members in CSD programs to focus on teaching professionalism throughout the curriculum.

Of the estimated 10000 people annually who have a stroke in Ireland, about 7?500 will continue to live with some residual disability. This study explored older people’s perceptions of health, level of independence as well as the factors that enhanced or diminished ability to maintain quality of life after stroke. A grounded theory approach was used and 20 stroke survivors were interviewed. Analysis of the data revealed three main themes: concepts of health and independence, sense of loss, and environmental factors. Despite their disability most participants continued to have a positive concept of health. Participants overall adopted a functional approach toward independence and those with severe disabilities felt less independent. Many reported a profound sense of loss in terms of identity and role function. Environmental factors including availability of transport and social connections had a significant impact on quality of life. Most participants appeared to be struggling to adapt to their disability and subsequent experiences in a rather unsupportive environment.

Antagonism of the bradykinin B1 receptor represents a potential treatment for chronic pain and inflammation. Novel antagonists were designed that display low-nanomolar affinity for the human bradykinin B1 receptor and good bioavailability in the rat.

Background. Excessive pulmonary blood flow increases ventricular volume work in the face of inadequate systemic cardiac output, low diastolic blood pressure, and inadequate coronary perfusion. Using the smallest available 3-mm polytetrafluoroethylene shunts have been successful, although catastrophic shunt thrombosis has occasionally been observed. To avoid thrombosis with a smaller conduit, saphenous vein homografts (SVG) were used to construct the modified Blalock–Taussig (BT) shunts.

Ethical frameworks are the foundation for any research with humans or nonhuman animals. Human research is guided by overarching international ethical principles, such as those defined in the Helsinki Declaration by the World Medical Association. However, for nonhuman animal research, because there are several sets of ethical principles and national frameworks, it is commonly thought that there is substantial variability in animal research approaches internationally and a lack of an animal research ‘Helsinki Declaration’, or the basis for one. We first overview several prominent sets of ethical principles, including the 3Rs, 3Ss, 3Vs, 4Fs and 6Ps. Then using the 3Rs principles, originally proposed by Russell & Burch, we critically assess them, asking if they can be Replaced, Reducedor Refined. We find that the 3Rs principles have survived several replacement challenges, and the different sets of principles (3Ss, 3Vs, 4Fs and 6Ps) are complementary, a natural refinement of the 3Rs and are ripe for integration into a unified set of principles, as proposed here. We also overview international frameworks and documents, many of which incorporate the 3Rs, including the Basel Declaration on animal research. Finally, we propose that the available animal research guidance documents across countries can be consolidated, to provide a similar structure as seen in the Helsinki Declaration, potentially as part of an amended Basel Declaration on animal research. In summary, we observe substantially greater agreement on and the possibility for unification of the sets of ethical principles and documents that can guide animal research internationally.

Background. Direct cavopulmonary connection using an extracardiac conduit has a number of theoretical advantages in the staged management of children with single ventricular congenital heart defects. With appropriate planning, completion Fontan using an extracardiac connection may be accomplished without the use of cardiopulmonary bypass.

ABSTRACTThe Tax transactivator protein of human T-cell leukemia virus type 1 (HTLV-1) plays a central role in the activation of viral gene expression. In addition, Tax is capable of activating the expression of specific cellular genes and is involved in the transformation of T-lymphocytes resulting in the development of adult T-cell leukemia. Tax is a phosphoprotein that colocalizes in nuclear bodies with RNA polymerase II, splicing complexes, and specific transcription factors including members of the ATF/CREB and NF-?B families. In this study, we identified adjacent serine residues at positions 300 and 301 in the carboxy terminus of Tax as the major sites for phosphorylation. Phosphorylation of at least one of these serine residues is required for Tax localization in nuclear bodies and for Tax-mediated activation of gene expression via both the ATF/CREB and NF-?B pathways. Introduction of amino acid substitutions which are phosphoserine mimetics at positions 300 and 301 restored the ability of a phosphorylation-defective Tax mutant to form nuclear bodies and to activate gene expression. These studies define sites for regulatory phosphorylation events in Tax which are critical for its ability to activate gene transcription.

The article discusses issues concerning the involvement of women in financial management as of October 2014. Topics covered include a study conducted by financial services firm Fidelity Investments on the views of women on the role of their husbands or male partners in managing family finances, the lack of confidence in women's capability in making decisions regarding investments, and the demand for financial planning among career-focused women.

The article focuses on Kari Cashen, a firefighter. Recently she has combined her passion for art and firefighting to create colorful, humorous posters to help her fire orders and watch out situations required for all firefighters. For Cashen, every 10-mile run or uphill training hike was an opportunity to draw mental pictures. Although the mental art was helpful and fun, seeing the images on posterboard really helped Cashen focus on the essential firefighting safety messages. She shared the artwork with crew members, who especially liked the cartoon characters that showed them and the fires that they had battled.

This article presents guidelines for those who want to learn how to ski or snowboard in Vermont.

An introduction to the January 2011 issue of "Ski Vermont" is presented in which the author discusses the experience of living local and celebrating winter in Vermont, how the spirit of fellowship and cooperation permeates the Vermont experience, and the significance of sharing life experiences in Vermont with guests and friends.

The article reports on activities planned for Learn a Snow Sports Month in Vermont in 2010. From January 4 to 10, several Vermont alpine and Nordic resorts will offer free rental equipment, lift tickets for beginners and one lesson for both adults and children. The Winter Trails event on January 9 offers opportunities for snowshoeing and Nordic skiing amid wooded trails.

The article focuses on various topics discussed within the issue, including deals to make skiing and riding in Vermont more affordable, local foods and beverages recommended to visitors and the experiences of several Vermont residents.

A personal narrative is presented which explores the author's experience of achieving her goal to be a successful umpire trainer with disability.

The article provides answers to a question of what readers' most memorable Valentine's Day gifts were in school.