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The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

This paper provides an update of a previous review ' Red Meat in the Diet' published in the Nutrition Bulletin in 2005. An update on red meat consumption levels in the UK and other countries is provided, and a summary of the nutritional content of red meat in the diet is given. Current evidence on dietary and lifestyle factors associated with red meat consumption and the effects of red meat intake on health and chronic disease outcomes are discussed. As there is now continued debate about the environmental impact of different aspects of our diet, sustainability issues regarding red meat were also discussed. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

The practice of deliberately concealing garments within the structure of buildings is described. These finds provide a means of exploring how space was conceived and experienced in the past, and how these deliberately hidden garments mediated, and continue to mediate, the relationship between people and the spaces they occupied, and may continue to occupy. The Deliberately Concealed Garments Project was set up in 1998 to locate, document and analyze garments found hidden within buildings. Concealments have preserved many textiles in the UK, mainland Europe, Australia and North America. The significance of these caches rests not only in the finds themselves, as rare items of dress, but also because of what they reveal about perceptions of built space. The concealments are believed to serve a protective function, not against the weather or immodesty, but against incoming malevolent forces. As apotropaic (evil-averting) agents they protect from within rather than as outer coverings or internal divisions. The paper discusses how garments concealed within buildings transform space through the work of metaphor. [ABSTRACT FROM AUTHOR]

This article continues from an earlier paper that examined Australian laws regulating the use of preimplantation genetic diagnosis (PGD) for the purpose of what the author has tentatively termed 'negative enhancement' to develop that analysis to include an examination of similar laws in the UK and Europe. The term 'negative enhancement' is used to describe those instances where individuals seek to use PGD to achieve outcomes that, commonly, are socially not preferred. In a recent survey by the Genetics and Public Policy Centre, it was found that 3% of IVF-PGD clinics in the United States reported having provided PGD to couples who seek to select an embryo for the presence of a particular disease or disability, such as deafness, in order that the child share the characteristic with the parents. The idea of 'negative enhancement' is, therefore, both a paradox and a useful means to describe the hidden assumptions behind claims that enhancement technologies can only lead us in one direction -- towards a race of blond, blue-eyed, able-bodied, intellectually magnificent and athletically superior beings. In Australia there does appear to be a legal (if not ethical) consensus that PGD should only be used to select against serious disability. In the UK under the Human Fertilization and Embryology Act (1990) to test using PGD, there must be a significant risk of a serious physical/mental disability/illness/medical condition implying that choosing in favour of a disability would not be acceptable. The proposed amendments to the Human Fertilisation and EmbryologyAct currently before the House of Lords contain an explicit prohibition on the use of PGD to select in favour of a disability. In Europe, the Charter of Fundamental Rights of the European Union, 2000 O.J. (C 364) 1 (December 7, 2000) explicitly prohibits eugenic practices in Article 3(2) but there is uncertainty with respect to how that will be interpreted in relation to disability. Specific regulation of PGD exists in a number of European countries but prohibitions and limits vary across the states. This paper will map out these differences and address the question of whether selection in favour of a disability using PGD is allowed in these jurisdictions. [ABSTRACT FROM AUTHOR]