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The religious dimensions of ethnic identities have been under-theorized. In contemporary industrial societies there is a tendency to characterize religiously demarcated groups as ‘really’ ethnic.This article suggests that the religious content of ethnic boundaries may be more important than might initially be assumed. A religious identification may have specific religious content and assumptions that may cause it to operate in different ways from other identities. Even if identities do not seem primarily religious per se, they may have latent religious dimensions that can become reactivated. Whilst identity conflicts and other social struggles may stimulate the return of the religious, once reactivated, the religious dimensions of identity may take on a logic of their own.Therefore, the article argues that in many contexts there is a two-way relationship between religion and ethnicity. Each can stimulate the other, rather than religion simply playing a supporting role to the ethnic centrepiece.

This paper challenges the fixed boundaries that ethnographers have often constructed between religious insiders and outsiders. Drawing on Neitz's observations, it argues that the main task of reflexive fieldwork is locating the self in relation to ambiguous and shifting boundaries. We offer a comparative analysis of the experiences of two differently socially located researchers to illustrate how religious identity emerges as a continuum, on which one's place is negotiated with one's research participants. We also examine the importance of intersecting multiple identities. Finally, the paper questions whether social identity categories are the primary way that we relate with our respondents. It explores the spiritual and emotional dimensions of research relationships and argues that these may transform, reinforce and generally interact with social identities. Comparing our experiences, we outline the consequences of these reflections for data gathering and analysis.

It is a common misconception that religion in Northern Ireland is merely a marker of ethnicity. Particularly for Catholics, religion is thought to represent, but not play a part in constructing, social differences. This paper urges re-examination of how the relationships between religion and politics are conceived, and argues that analysis must extend beyond linkages between theological beliefs and political preferences. Other dimensions of religion, such as its role in the construction of community and identity as well as its institutional influence, are much more useful in understanding the social significance of Catholicism. The paper concludes that when these dimensions of religion are examined, we find that Catholicism is much more than an ethno-national marker, and has in fact been enormously important in the politics of conflict, and in the continuing construction of communal identity, in Northern Ireland.

It has long been asserted that strong evangelical religious beliefs underpin strong unionist and loyalist political attitudes in Northern Ireland. Although recent literature has argued for a wide diversity of political attitudes amongst evangelicals, this has not been quantified. Based on analysis of the 1991 Northern Irish Social Attitudes Survey and the 1998 Northern Ireland Life and Times Survey, this article argues that evangelicals are attitudinally different to other Protestants in Northern Ireland. However, their distinctiveness arises from their conservative moral attitudes and not, as widely claimed, from stronger unionist political values. Indeed, in terms of party identification, in 1991 evangelicals were less likely than other Protestants to support the Democratic Unionist Party (DUP). And although there has been a small shift towards the DUP over the course of the 1990s, it is not due to any strengthening of the unionism of evangelicals, but rather the increasing importance of moral conservatism in predicting voters' party choice in Northern Ireland.

This article places Northern Ireland within the unfolding sociological debate on religion in modern Britain. It measures secularization along Casanova’s three dimensions (1994): religious differentiation, decline and privatization. It finds that Northern Ireland has, in common with Britain, high levels of religious differentiation, grey areas of religious belief and little convinced secularism. However, Northern Ireland differs in that it has higher levels of religious affiliation and practice, and religion plays more roles in civil society than it does in other parts of Britain. The article explores the role of conflict in forming these religious trends, asking if they represent a persistence of the sacred, or simply mask deeper ethnic divisions. It concludes that the social dimensions of religion are just as important as the supernatural, and that they often inform each other. Finally, it suggests that the dynamics of religious change are comparable across regions and, as such, Northern Ireland might be a useful case study for British policy makers, particularly as it becomes increasingly multicultural and religiously plural.

This article analyses the use of equality as a concept central to the implementation of the 1998 Good Friday Agreement in Northern Ireland. The authors argue that, although equality legislation is succeeding in redressing previous discrimination in society, the discourses that have emerged around it have exacerbated competition and polarization between communities for two main reasons. Firstly, in " selling' the Agreement to their supporters, political elites have appropriated community-specific definitions of the concept, thus reinforcing rather than weakening group differences. Secondly, the practice of equality legislation involves the definitive categorization of individuals as members of particular groups. This article examines these processes and their effects through the analysis of the discourse of nationalist and Unionist Party elites and of individual Catholics and Protestants. This is done in order to capture the dynamics of change in political communication and identification rather than simpl...

Catholic history in Northern Ireland has often been couched in terms of victimhood. This narrative has been used to identify, locate and evaluate the community vis-a-vis Protestants through recent conflict. However, in the wake of recent political change, many Catholics are presenting themselves not as victims, but as equals, fully expectant that there will be no going back to the unionist hegemony of the past. Based on analysis of in-depth interviews with a variety of Catholics in the year 2000, this article examines the discursive change from victims to equals. It explores how far Protestants are trusted by Catholics not to victimise, and whether there may be some that do not feel they have benefited from political change in Northern Ireland and may still see themselves as victims. It concludes that whilst equality, like victimhood, is a morally laden concept, it is easier to accommodate politically. This is one of the most important developments of the peace process in recent years, because just as pol...

This article demonstrates the responsiveness of national and religious identifications to political change among Protestants in Northern Ireland. It begins by theorizing identification as a process of working out our ideas of self, others and place. Subsequently, it proceeds to outline how the recent Good Friday Agreement (1998) changes the political landscape from the perspective of a variety of Protestants. Then, based on a narrative analysis of interview data collected in 2000, it maps the main directions of change. Three responses are highlighted, as people come to accept, reject or ignore political developments after the Agreement, and their differing relationships with British national and Protestant religious identifications are discussed. The article concludes by highlighting the underlying dynamics of identification with a view to maximizing the acceptance of political change in Northern Ireland.

Do summer laboratory research apprenticeships during high school have an impact on entry to MD/PhD programs? This quantitative study (n= 236,432) examines the connection between laboratory research apprenticeship experience at the high school level and matriculation into one of the more rigorous educational programs for scientific research training., Do summer laboratory research apprenticeships during high school have an impact on entry into MD/PhD programs? Apart from the nearly decade-long span of time between high school and matriculation into an MD/PhD program, young people have many life-shaping experiences that presumably impact their education and career trajectories. This quantitative study (n = 236,432) examines the connection between early laboratory research apprenticeship experiences at the high school level and matriculation into one of the more rigorous educational programs for scientific research training. The span of time covered by this analysis reaches across more than a decade, examining the potential importance of research experiences during the precollege years in the educational trajectory of young people. Intertwined with this question on research experiences is a second major concern regarding diversity in the life sciences research corps. Diversity in this wide-ranging discipline refers specifically to the underrepresentation of Blacks/African Americans, Hispanics/Latino/as, and American Indians/Alaska Natives among the ranks of research scientists. Thus, this study includes analyses that specifically focus on research apprenticeships of Blacks/African Americans and Hispanics/Latino/as and their entrance into MD/PhD programs.

Interruptions occur throughout clinical practice. They occur during ward rounds, procedures, discussions with relatives or specialists, while checking drugs or equipment, when prescribing and writing in notes. They can take the form of face-to-face interaction, telephone calls or text messages, pagers, alarms on monitors or equipment. They may be for mundane reasons, low priority or urgent. They may be for relaying information, to refer patients, to discuss plans, to arrange treatment or investigations. Some are unnecessary and potentially unsafe, but others are essential re-directions to more urgent clinical situations. It may be that educational interventions could be used to reduce the detrimental effects of ill-timed interruptions and to promote effective re-directional interruptions.

Purpose: To explore the acceptability of using ReaDySpeech, an online speech therapy programme for people with dysarthria after stroke, within usual clinical practice. This early clinical testing underpins future research evaluation of ReaDySpeech.Methods: A prospective, observational design involving interviews with speech and language therapists with experience of using ReaDySpeech. This included the usability of ReaDySpeech, therapists’ training/support needs, ease of recruitment of therapist and patient participants, ReaDySpeech technical issues and therapy content. Therapists also provided feedback from the patient participants.Results: Six therapists working in hospital and community-based settings used ReaDySpeech with five patients (12-28 weeks post-stroke, four female, mean age 71 years). Therapists found it was easy to use, training/support was sufficient and they reported positive feedback from participants. Areas to address involved patients’ access to Wi-Fi, ease of navigation, content improvements and difficulties recruiting people more than 12 weeks post-stroke as most patients had already been discharged.Conclusions: ReaDySpeech was acceptable and generally feasible to use in clinical practice. This early phase research testing has been essential to improve navigation within the therapy software and content. ReaDySpeech can now be further evaluated with a phase two feasibility trial with earlier recruitment following stroke.

The aut dedere aut judicare, or “extradite or prosecute” clause is shorthand for a range of clauses that are almost compulsory in international treaties criminalizing conduct, obliging a State to either extradite or prosecute one accused of the crime the subject of the treaty. The obligation has become increasingly central in the emerging legal regime against impunity and has a role in States’ armoury of international criminal enforcement mechanisms. Yet there has been little academic consideration of the sources of the principle, including whether it exists at customary international law, and the scope and operation of the obligation. While the topic is currently being considered by the International Law Commission, this paper seeks to provide some of the empirical research that has to date been missing and to identify the sources and scope of the obligation to extradite or prosecute. The views reflected in this paper are personal and do not necessarily reflect those of the United Nations.

BACKGROUND: Cediranib (RECENTIN™) is an oral, highly potent VEGF inhibitor. This study evaluated the effect of food on the pharmacokinetics of cediranib and compared the administration of continual cediranib via two dosing strategies using this as a platform to investigate pharmacodynamic imaging biomarkers. METHODS: Sixty patients were randomised to receive two single doses of cediranib in either fed/fasted or fasted/fed state (Part A). In continual dosage phase (Part B), patients were randomised to a fixed-dose or dose-escalation arm. Exploratory pharmacodynamic assessments were performed using DCE-MRI and CT enhancing fraction (EnF). RESULTS: In part A, plasma AUC and C (max) of cediranib were lower in the presence of food by a mean of 24 and 33%, respectively (94% CI: AUC, 12-34% and C (max), 20-43%), indicating food reduces cediranib plasma exposure. In part B, cediranib 30 mg/day appeared to be the most sustainable for chronic dosing. Continuous cediranib therapy was associated with sustained antivascular effects up to 16 weeks, with significant reductions in DCE-MRI parameters and CT EnF. CONCLUSIONS: It is recommended that cediranib be administered at least 1 h before or 2 h after food. Evidence of antitumour activity was observed, with significant sustained effects upon imaging vascular parameters.

Background: Patients with recurrent ovarian cancer often achieve partial response following chemotherapy, resulting in persistent small volume disease. After completion of treatment, the dilemma of when to initiate subsequent chemotherapy arises. Identification of biomarkers that could be used to predict when subsequent treatment is needed would be of significant benefit. Design: Twenty-three patients with advanced ovarian cancer and residual asymptomatic disease following chemotherapy underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) at study entry, 4, 8, 12, 18 and 26 weeks or disease progression. A subgroup of patients provided plasma samples within which a panel of angiogenic biomarkers was quantified. Results: By 4 weeks, significant differences in whole tumour volume, enhancing fraction and Ca125 were observed between patients whose disease progressed by 26 weeks and those who remained stable. Significant correlations between plasma soluble vascular endothelial growth factor recptor-1 (sVEGFR-1) and sVEGFR-2 concentrations, and blood volume and tumour endothelial permeability surface area product measured by DCE-MRI were observed. Conclusions: Imaging markers have a potential role in early prediction of disease progression in patients with residual ovarian cancer and may supplement current measures of progression. The correlation of DCE-MRI and serological biomarkers suggests that tumour angiogenesis affects these markers through common biological means and warrants further investigation.

Purpose: Little is known concerning the onset, duration, and magnitude of direct therapeutic effects of anti–vascular endothelial growth factor (VEGF) therapies. Such knowledge would help guide the rational development of targeted therapeutics from bench to bedside and optimize use of imaging technologies that quantify tumor function in early-phase clinical trials. Experimental Design: Preclinical studies were done using ex vivo microcomputed tomography and in vivo ultrasound imaging to characterize tumor vasculature in a human HM-7 colorectal xenograft model treated with the anti-VEGF antibody G6-31. Clinical evaluation was by quantitative magnetic resonance imaging in 10 patients with metastatic colorectal cancer treated with bevacizumab. Results: Microcomputed tomography experiments showed reduction in perfused vessels within 24 to 48 h of G6-31 drug administration (P ≤ 0.005). Ultrasound imaging confirmed reduced tumor blood volume within the same time frame (P = 0.048). Consistent with the preclinical results, reductions in enhancing fraction and fractional plasma volume were detected in patient colorectal cancer metastases within 48 h after a single dose of bevacizumab that persisted throughout one cycle of therapy. These effects were followed by resolution of edema (P = 0.0023) and tumor shrinkage in 9 of 26 tumors at day 12. Conclusion: These data suggest that VEGF-specific inhibition induces rapid structural and functional effects with downstream significant antitumor activity within one cycle of therapy. This finding has important implications for the design of early-phase clinical trials that incorporate physiologic imaging. The study shows how animal data help interpret clinical imaging data, an important step toward the validation of image biomarkers of tumor structure and function. (Clin Cancer Res 2009;15(21):6674–82)

PURPOSE: There is considerable interest in developing non-invasive methods of mapping tumor hypoxia. Changes in tissue oxygen concentration produce proportional changes in the magnetic resonance imaging (MRI) longitudinal relaxation rate (R(1)). This technique has been used previously to evaluate oxygen delivery to healthy tissues and is distinct from blood oxygenation level-dependent (BOLD) imaging. Here we report application of this method to detect alteration in tumor oxygenation status. METHODS AND MATERIALS: Ten patients with advanced cancer of the abdomen and pelvis underwent serial measurement of tumor R(1) while breathing medical air (21% oxygen) followed by 100% oxygen (oxygen-enhanced MRI). Gadolinium-based dynamic contrast-enhanced MRI was then performed to compare the spatial distribution of perfusion with that of oxygen-induced DeltaR(1). RESULTS: DeltaR(1) showed significant increases of 0.021 to 0.058 s(-1) in eight patients with either locally recurrent tumor from cervical and hepatocellular carcinomas or metastases from ovarian and colorectal carcinomas. In general, there was congruency between perfusion and oxygen concentration. However, regional mismatch was observed in some tumor cores. Here, moderate gadolinium uptake (consistent with moderate perfusion) was associated with low area under the DeltaR(1) curve (consistent with minimal increase in oxygen concentration). CONCLUSIONS: These results provide evidence that oxygen-enhanced longitudinal relaxation can monitor changes in tumor oxygen concentration. The technique shows promise in identifying hypoxic regions within tumors and may enable spatial mapping of change in tumor oxygen concentration.

Validated assays of circulating biomarkers of angiogenesis to predict and determine the efficacy of vascular-targeted anticancer drugs would facilitate successful drug development. Multiple biomarker candidates exist and a multiplex approach was sought to minimise the requisite patient blood volume and to aid selection of those biomarkers with greatest potential clinical utility. Validation of the SearchLight multiplex ELISA platform comprising two multiplex assays of nine potential angiogenesis biomarkers was conducted (plex 1; VEGF R1 and R2, IL-8, KGF, PlGF; plex 2; PDGFbb, HGF, FGFb and VEGF). The study focused on instrument qualification, analyte specificity within the multiplex format, assay precision and reproducibility. No evidence was found within the multiplex that signals output from one analyte impinged on another or that antibody cross-reactivity occurred. Spike recovery for 5 between-experiment repeats was within +/-15% of input values for 7 of the 9 multiplexed analytes, with a coefficient of variation (CV) of

Admissions for exacerbations of chronic obstructive pulmonary disease (COPD) present a significant proportion of patients in the acute medical take. The British Thoracic Society (BTS) provides guidelines for time specific interventions, that should be delivered to those with an acute exacerbation of COPD through the admission care bundle. These include correct diagnosis, correct assessment of oxygenation, early administration of treatment, recognition of respiratory failure, and specialist review. Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) chose improvement in acute COPD care to be a local Commissioning for Quality and Innovation (CQUIN) scheme, which enables commissioners to reward excellence by linking a proportion of English healthcare providers' income to the achievement of local quality improvement goals. The effects of initiatives put in place by senior clinicians had waned, and further improvements were required to meet the CQUIN target. The aim of the scheme was to improve compliance with the BTS guidelines and CQUIN scheme for patients admitted with an exacerbation of COPD. Specific bundle paperwork to be used for all patients admitted to the Trust with an exacerbation of COPD was introduced to the Trust in June 2014, with training and education of medical staff at that time. This had improved compliance rates from 10% to 63% by September 2014. Compliance with each intervention was audited through the examination of notes of patients admitted with an exacerbation of COPD. Compliance rates had plateaued over the last three months, and so a focus group involving junior medical staff met in September 2014 to try to increase awareness further, in order to drive greater improvements in care, and meet the CQUIN requirements. Their strategies were implemented, and then compliance with the CQUIN requirements was reaudited as described above. The December 2014 audit results showed a further improvement in overall COPD care, with 73% of patients receiving all elements of the COPD admission care bundle, versus 63% in September 2014. Appropriate blood gas analysis, nebuliser administration, and respiratory review also improved. Prescription of steroids and antibiotics remained static, with 96% of patients receiving these treatments within four hours in the emergency department (ED). The only criteria which showed a decline was appropriate oxygen prescription, which dipped from 97% to 87%. After the effect of initial strategies plateaued, this quality improvement project facilitated a further increase in compliance with the CQUIN targets, both improving patient care, and safeguarding continued CQUIN funding. There is further work to be done to maintain and support further improvement in standards, and to encourage use of the COPD admission bundle paperwork for documentation purposes.

To examine the anatomic relationships of retinal blood vessels to the nerve fiber layer.Retinal flat preparations from monkey and cat were stained with methylene blue dye and examined by light microscopy.A focal transition in nerve fiber bundle patterns occurs just above major retinal blood vessels. Bundles abandon a compact form and splay open just as they reach a major blood vessel. Maximum separation of axon fascicles occurs immediately above the blood vessel and the bundles reform after the crossing of the blood vessel is complete. In so doing, nerve fiber bundles temporarily thin and broaden, assuming the shape of an inverted hull. In contrast, at the retinal periphery, minor blood vessels and axon fascicles have no special relationship to each other.At major blood vessel crossings, a focal alteration in nerve fiber bundle anatomy takes place under which local deformability may be enhanced. This adaptation probably lessens the risk of injury to ganglion cell axons from vascular compression. In addition, deflection of the nerve fiber pathway obviates the need for major blood vessels to bend or kink to achieve a crossing, thus avoiding turbulent flow.

Background. Fanconi anaemia (FA) is an autosomal recessive, genetically heterogeneous disorder, characterised by interstrand crosslink-induced chromosome breaks, congenital abnormalities and predisposition to malignancies. It has a prevalence of about 1/40 000 in black South Africans (SAs). A founder mutation in the FANCG gene occurs in the homozygous state in 77.5% of southern African blacks. Objective. To locate additional pathogenic mutations in the FANCG gene of black FA patients who were heterozygous for the founder mutation. Methods. Further mutation analysis of the FANCG gene was undertaken in 7 patients clinically suspected of having FA. The parents of two of the patients were tested for the presence of the founder mutation to determine true heterozygosity in the patients. To clarify whether or not previously unreported variants were pathogenic, 58 random black SA individuals were screened. Results. Three novel single base pair deletions, resulting in frameshift mutations (c.247delA, c.179delT and c.899delT) were identified in 3/7 patients. A fourth patient was found to have a single base substitution resulting in a splice site mutation (c.1636+1G>A). The remaining three patients were not found to harbour any pathogenic mutations. Two non-pathogenic variants were also identified among the seven patients. Conclusion. The results of this small sample suggest that a second common mutation in the FANCG gene is unlikely in this population. However, FANCG sequencing should be performed on patients heterozygous for the common founder mutation to attempt to confirm their diagnosis.

3546 Background: Addition of bevacizumab to FOLFOX-4 prolongs progression free and overall survival in patients with metastatic CRC. Bevacizumab reduces tumor blood flow, so may impair delivery of subsequent cytotoxic chemotherapy. We present the first data that describe in detail the temporal anti-angiogenic and anti-vascular effects of bevacizumab. Methods: DCE-MRI and volumetrics were used to evaluate tumor pharmacodynamics and growth inhibition in ten patients with newly diagnosed CRC liver metastases. Patients were imaged at baseline (twice), 4 hours after single agent 10mg/kg bevacizumab, and at days 3, 8, and 12. An extended Tofts model was applied to allow calculation of plasma volume (vp) and Ktrans. Results: 34 tumors were identified. Significant reductions in Ktrans and vp were detected within 4 hours, were maximal at day 3 and persisted until day 8 (all p

14533 Background: Cediranib (AZD2171) is an oral, highly potent and selective inhibitor of vascular endothelial growth factor (VEGF) signaling, with activity against VEGFR-1, -2 and -3. The effect ...

Reducing religion to a mere ethnic marker has stifled the debate about its social and political significance in Northern Ireland. This article puts forward a constructivist argument, which understands religion as a dynamic of personal and group identification, as the key to illuminating its social significance. Drawing on analysis of in-depth interviews it finds four main ways in which religion informs processes of social identification and community construction in Northern Ireland: where it acts as an identity marker; where religious rituals play a practical role, or religious ideas play a symbolic role, in the construction of community; and, where doctrine can legitimize oppositional social identifications. In fact, specifically religious structures and religious ideas remain socially significant beyond the confines of the most devout. Thus, rather than just marking out ethnic identities, this article argues that religion generally provides some substantive content to processes of categorization and social comparison in Northern Ireland.