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Currently in the UK and Ireland, after a hip fracture most patients do not receive bone protection medication to reduce the risk of refracture. Yet randomised controlled trial data specifically examining patients with hip fracture have shown that intravenous zoledronate reduces refracture risk by a third. Despite this evidence, use of intravenous zoledronate is highly variable following a hip fracture; many hospitals are providing this treatment, whilst most are currently not. A range of clinical uncertainties, doubts over the evidence base and practical concerns are cited as reasons. This paper discusses these concerns and provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital, in order to reduce costly re-fractures in this frail population. [ABSTRACT FROM AUTHOR]

The article reports on the significance of the Act of Union between Great Britain and Ireland. The Act of Union between the two countries which come into force on January 1, 1800 was the outcome of immediate military necessity. It was also the outcome of decades of spasmodic thought by politicians on both sides of the Irish Sea concerning the relationship between the two islands. But while the overall intention was undoubtedly an integrative one, a failure to understand the nature of Irish politics and society together with the pressing imperatives of war with France generated a casual and shallow attitude towards administrative detail and undermined those master plans.

Background: Within the European Union (EU), substantial efforts are being made to achieve economic and social cohesion, and the reduction of health inequalities between EU regions is integral to this process. This paper is the first to examine how self-reported conditions and non-communicable diseases (NCDs) vary spatially between and within countries. Methods: Using 2014 European Social Survey (ESS) data from 20 countries, this paper examines how regional inequalities in self-reported conditions and NCDs vary for men and women in 174 regions (levels 1 and 2 Nomenclature of Statistical Territorial Units, 'NUTS'). We document absolute and relative inequalities across Europe in the prevalence of eight conditions: general health, overweight/obesity, mental health, heart or circulation problems, high blood pressure, back, neck, muscular or joint pain, diabetes and cancer. Results: There is considerable inequality in self-reported conditions and NCDs between the regions of Europe, with rates highest in the regions of continental Europe, some Scandinavian regions and parts of the UK and lowest around regions bordering the Alps, in Ireland and France. However, for mental health and cancer, rates are highest in regions of Eastern European and lowest in some Nordic regions, Ireland and isolated regions in continental Europe. There are also widespread and consistent absolute and relative regional inequalities in all conditions within countries. These are largest in France, Germany and the UK, and smallest in Denmark, Sweden and Norway. There were higher inequalities amongst women. Conclusion: Using newly available harmonized morbidity data from across Europe, this paper shows that there are considerable regional inequalities within and between European countries in the distribution of self-reported conditions and NCDs. [ABSTRACT FROM AUTHOR]

Although the presentation of original research to learned societies is valuable, the target should be publication in a peer-reviewed journal. Therefore, the strength of a meeting may be assessed by the rate of the subsequent publication of papers from the presented abstracts. We conducted an analysis of abstracts presented at consecutive annual meetings of the Society for Cardiothoracic Surgery (SCTS) in Great Britain and Ireland over a 15-year period. Abstract books and other documentation from the 1993–2007 meetings were reviewed; abstracts from other major Cardiothoracic Surgery meetings held in 2007 were also reviewed. Medline was searched to identify the peer-reviewed publications arising from each work presented. For abstracts presented at SCTS in 2003–07, the factors potentially associated with publication were analysed by logistic regression. If no publications were identified, authors were contacted through a standardized email questionnaire to ascertain its status and reasons for non-publication. Over the 15-year period, 909 abstracts were presented at the SCTS meetings. The rate of publication rose from ∼30% in the mid-1990s to consistently >60% from recent meetings, with a high of 81.3% from 2006. However, in comparison with other Cardiothoracic Surgery meetings in 2007, the chance of subsequent publication from SCTS (66.7%) was lower than from the European Association for Cardio-Thoracic Surgery (75.0%), the American Association for Thoracic Surgery (83.9%) and The Society of Thoracic Surgeons (72.5%) meetings. For abstracts presented at the last five SCTS meetings, publication was most commonly in a speciality journal (56.3%) and the median time for publication was 15 months (range −24 to 63 months) with 14 papers published prior to presentation at the meeting. On regression analysis, the only factor associated with publication was the study design comparing randomized trials and systematic reviews with other types of study (P < 0.01). Of the 90 unpublished abstracts, 48 (53.3%) authors replied to an email questionnaire revealing that 41 (85.4%) were never submitted for publication. The most common reasons given were low priority (29.6%) and low likelihood of acceptance (24.1%). In recent years, the annual meeting of the Society has become a forum for the presentation of high-quality research that usually withstands peer-review, most commonly in a speciality journal. The rate of publication has increased to consistently >60%, although those that remain unpublished are generally never submitted. This compares favourably with national meetings of other surgical societies, although it is lower than other major cardiothoracic meetings which have an affiliated journal. At a time when it has been suggested that medical research in the UK is in decline, cardiothoracic surgery appears to be thriving. [ABSTRACT FROM PUBLISHER]

Direct payments have brought new opportunities for self-determination and independent living to disabled people in the UK, featuring prominently in government strategy and the 2006 White Paper, 'Our Health, Our Care, Our Say'. However, ten years after direct payments legislation, take-up remains low and implementation varies greatly. Rates of take-up in England remain more than double those in other parts of the UK, raising questions about devolution and equity. This paper presents data from a national study to examine some of the mechanisms underlying uneven outcomes for disabled people in different parts of the United Kingdom, with particular reference to the politics of devolved governance. The analysis focuses on scope for interpretations of policy; resources for information and training; the impact of mandatory duties and targets; extensions to new user groups; and the role of support organizations and disability activism. The evidence suggests that local variations have been produced not only by 'local' factors, but also by different opportunity structures for policy development in England, Scotland, Wales and Northern Ireland. This raises questions about the impact of devolution on equity and opportunity for disabled people in the UK. [ABSTRACT FROM AUTHOR]

The impact of British rule casts a long shadow over Irish history. While nationalist historians tended to blame Union with Britain for all the economic ills of the 19th century (O’Brien, 1921), recent re-evaluations of both historical and recent Irish economic performance have been cause for a reappraisal of the economic relations between Ireland and Britain (Cullen, 1969; Kennedy and Johnson, 1996). The extent to which economic factors were important in Ireland’s withdrawal from the United Kingdom will be examined in this paper. A secondary aim is to assess the economic consequences of independence in the interwar period. There were many economic reasons up to 1913 as to why Ireland should separate. UK policy was determined by majority voting and policies were suited to the needs of industrial workers in Britain, rather than agricultural workers in Ireland. This led to increased spending beyond the means of Ireland which caused transition difficulties on independence. Finally the consequences of separation in the north and south of Ireland are examined. Evidence suggests that separation led to short term economic difficulty. In the longer run the south benefited from independence due to weakness in British institutions and the incentive structures created during the interwar period. [ABSTRACT FROM PUBLISHER]

Over the last two decades, Ireland has emerged as a paradigmatic case of partnership governance. Underpinned by state-facilitated national agreements that sought to maximize economic and social development, 'partnership' was also held to include the development of progressive social policies. The 'community and voluntary sector' has been both the site and purported vehicle for these progressive policies. In this context, community development emerged as a discourse of social action that was both popular with what Donnelly-Cox and Jaffro (1999) have in the Irish context called 'second generation community development', i.e. the emergence of self-activated local community groups informed by a social justice ethos, and to the Irish state as a route to social inclusion for an array of marginalized social groups. Since the early 1990s, these groups have been the recipients of significantly increased state funding. This resource has had a dramatic effect on the structure and nature of community development. In this paper, we outline and assess the model of community development that has emerged in Ireland during this period. Based on empirical data arising from a nationwide survey of community workers, we profile the extent of state funding; the consequent employment profile of community development workers and the impact on volunteerism; and the nature and consequence of community development's emerging relationship with the Irish state. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

This article considers the implications of Brexit for UK–Irish relations. It examines how Brexit has altered the terms of the British–Irish relationship by considering the impact on bilateral and cross-border economic and trade patterns. The article focuses on two primary economic effects. First, the short-term impact of Brexit and the Ireland/Northern Ireland Protocol on the Northern Ireland economy, and on trade relations between Great Britain and Ireland and across the Irish border; and second, how Brexit has spurred a discussion about the (economic) appropriateness of partition on the island of Ireland in the post-Brexit period, the extent to which it has led to increased calls for a border poll, and how any future unification process might be economically managed. This includes some provisional evaluation of the economic costs and challenges in relation to future constitutional change for the island of Ireland and the UK. The discussion here connects with wider British constitutional issues including calls for Scottish independence and the possible break-up of the UK. [ABSTRACT FROM AUTHOR]

The author consider the transnational, or interconnected aspects, of Catholicism, Protestantism, and Christianity in Great Britain and Ireland with Europe for the period circa 1689 to 1800. The author considers how British civilization during the period considered "Christendom;" notions of Protestant unity among European Protestants; and how Irish and English Catholics found support among their European brethren to face anti-Catholic British laws. The article also considers ongoing hostilities between Europe and the Ottoman Empire throughout the period, as well as the impact of the French Revolution upon British and Irish religious thought.

Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under 'mitigation' to modelled events under 'no mitigation' to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. [ABSTRACT FROM AUTHOR]

Lists books on Great Britain and Ireland. Titles of books; Names of authors and publishers; Number of pages; Prices; 'Clockmaking in Oxfordshire, 1400-1850,' by C.F.C. Beeson; 'English Books and Readers,' by H.S. Bennett; 'British Coalminers in the Nineteenth Century,' by John Benson.

There has been a recent explosion in development of image recognition technology and its application to automated plant identification, so it is timely to consider its potential for field botany. Nine free apps or websites for automated plant identification and suitable for use on mobile phones or tablet computers in the field were tested on a disparate set of 38 images of plants or parts of plants chosen from the higher plant flora of Britain and Ireland. There were large differences in performance with the best apps identifying >50 % of samples tested to genus or better. Although the accuracy is good for some of the top-rated apps, for any quantitative biodiversity study or for ecological surveys, there remains a need for validation by experts or against conventional floras. Nevertheless, the better-performing apps should be of great value to beginners and amateurs and may usefully stimulate interest in plant identification and nature. Potential uses of automated image recognition plant identification apps are discussed and recommendations made for their future use. [ABSTRACT FROM AUTHOR]

Brexit will have profound implications for health and health policy yet, while much attention has focused on health professionals, medicines and health protection, the risk of food insecurity, and thus health, has received less attention. We identify five major threats to the availability and affordability of food supplies. These are a lack of regulatory alignment restricting ability to import foods from the EU and beyond, a shortage of agricultural labour in the UK, increased prices of imported foods due to tariffs, damage to supply chains, for example, due to customs delays and loss of interoperability of transportation, and damage to agricultural production and food flows in Ireland. [ABSTRACT FROM AUTHOR]

Background Worldwide, the Irish diaspora experience health inequalities persisting across generations. The present study sought to establish the prevalence of psychological morbidity in the children of migrant parents from Ireland, and reasons for differences. Methods Data from two British birth cohorts were used for analysis. Each surveyed 17 000 babies born in one week in 1958 and 1970 and followed up through childhood. Validated scales assessed psychological health. Results Relative to the rest of the cohort, second-generation Irish children grew up in material hardship and showed greater psychological problems at ages 7, 11 (1958 cohort) and 16 (both cohorts). Adjusting for material adversity and maternal psychological distress markedly reduced differences. Relative to non-Irish parents, Irish-born parents were more likely to report chronic health problems (odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.08–1.54), and Irish-born mothers were more likely to be psychologically distressed (OR: 1.44; 95% CI: 1.13–1.84, when child was 10). Effect sizes diminished once material adversity was taken into account. Conclusions Second-generation Irish children experienced high levels of psychological morbidity, but this was accounted for through adverse material circumstances in childhood and psychological distress in parents. Public health initiatives focusing on settlement experiences may reduce health inequalities in migrant children. [ABSTRACT FROM PUBLISHER]

Background: the workforce is ageing. The contribution of older workers is considerable. Their occupational health profiles differ from those of younger workers.Objective: we wished to establish whether consideration has been given by regulatory and professional bodies of the impact of ageing-related conditions such as dementia on professional practice.Methods: We e-mailed a questionnaire to 22 regulatory and professional bodies in the UK and the Republic of Ireland. We asked whether there are supports for their practitioners should they develop age-related diseases, (particularly cognitive disorders),whether the body considered that the practitioner was responsible for their own health, and whether the body has resources to arrange for medical review for their professionals if concerns arose regarding competence. Where bodies did not respond, information relating to the questions was extracted from their on-line resources.Results: thirteen bodies responded. None of these had specific supports to assist older workers. Some knew of other supports (occupational health, employee assistance supports, benevolent funds or counselling services). All of the bodies who responded either have or are developing structures to deal with concerns regarding their practitioners.Conclusion: The absence of specific policies for age-related diseases, (particularly dementia), among professional and regulatory bodies is a challenge for an ageing workforce in the liberal professions. Closer working between geriatric medicine, old age psychiatry, occupational health and professional bodies is recommended to develop age-attuned policies and systems which protect the public while supporting the professionals in both work and timely transition from work. [ABSTRACT FROM AUTHOR]

The UK has long experienced a shortage of social workers and has recruited internationally to meet demand. There have been few specific data quantifying the scale of social work mobility to the UK through which such experiences can be set in context. The analysis reported in this article uses data from October 2008, relating to registered social workers working in England. As part of a wider study of migrant social care workers in England, the article reports analysis of data records of over 7,000 non-UK social workers registered to work in England and compares their characteristics to UK-qualified social workers. These analyses are supplemented by analysis of more recent application and registration data from the General Social Care Council pertaining to social workers qualified within and outside the European Union during 2008 and 2009. The findings highlight several important observations in terms of non-UK-qualified social workers' profile as well as some possible trends in migration and variations in rates of qualification verification. Over half of all international social workers in England were trained in four countries: Australia, South Africa, India and the USA. Findings are contextualised with qualitative data obtained from the wider study and policy debates. [ABSTRACT FROM PUBLISHER]

Climate policy is driving an extensive deployment of wind generation in the Irish electricity market. This study evaluates the cost of increasing wind generation both to the system as a whole and to consumers for 2020. We consider different scenarios on fuel and carbon-dioxide permit prices and the extent of electricity interconnection with Great Britain. For a small and isolated electricity system such as Ireland, a high penetration of wind is economically sound only with increased interconnection to Great Britain, since wind generation would otherwise be curtailed. Not surprisingly, for low fuel prices the least-cost scenario contains low levels of wind generation whereas the opposite is true for high fuel prices. The findings highlight the importance of interconnection and its operation and governance. [ABSTRACT FROM PUBLISHER]

Commission of the European Communities v. lreland is important for it clarifies the division of areas of competences between the European Community (EC) and its Member States in the mixed agreements, such as the United Nations Convention on the Law of the Sea (LOS Convention). According to the Court of Justice of the European Communities, a finding that there has been a transfer to the Community of areas of shared competence is contingent on the existence of Community rules within the areas covered by the mixed agreement provisions in issue, even though these rules establish only minimum standards. Thus, when dealing with the LOS Convention disputes involving EC Member States, the court or tribunal needs to establish that the shared competence in question has not been transferred to the Community. Otherwise, it should decline jurisdiction on the basis that the parties or party lack(s) locus standi. [ABSTRACT FROM AUTHOR]

The article assesses the nature of warfare in Ireland during the 1640s and 1650s relative to the codes of conduct and atrocity of war. The conduct of war became increasingly violent in Ireland due to a potent mix of religious and ethnic tensions between Catholic Irish natives and Protestant English administrators during the mid sixteenth century. The declaration of martial law and the imposition of summary justice following the suspension of the normal legal process were used by the English administrators against the Catholic Irish natives.

Harry Ferguson (2001), referring largely to Britain and Ireland, maintains that social work should be committed to a 'new way of thinking' which is rooted in 'life politics'. This idea, uncritically grounded in the ideas of Anthony Giddens and Ulrich Beck, fails to convince because: the assertion that we are now living in a 'post traditional order' is undermined by the resilience of key historical forms of regulation and control which continue, for example, to limit women's choice in the sphere of reproductive rights; identified changes in the texture of family relations are not evidenced by research; the 'life politics' perspective places too great an emphasis on human agency, choice and volition and not enough on structural constraint; the structural location of the 'life politics' proponents is not interrogated; the analysis is too stridently dismissive of the idea that 'emancipatory politics' should be social work's primary orientation. [ABSTRACT FROM AUTHOR]

The author reflects on the development of Advanced Nurse Practitioner role to provide sole resident cover for level three patients and its impact on the cost, outcomes and work patterns in cardiac surgery programme in Great Britain and Ireland. She explores the national benchmarking survey on the future policy for workforce development in the Society of Cardiothoracic Surgery (SCTS). She says that practitioners should have knowledge, experience and decision-making skills to provide expert care.

Discusses anaesthetic management of the older patients. Guidelines on perioperative care of the elderly issued by the Association of Anesthetists of Great Britain and Ireland; Factors that increased the profile of the older patients in the field of anaesthesia and intensive care; Statistics of aged persons who would use anaesthesia; Effect of aging on the response to physiological and pharmacological stress.