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Background: People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim: To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods: Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results: The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including 'geographical inequity', 'discriminatory practices', and 'public and private system deficits'. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions: These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution: The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper. [ABSTRACT FROM AUTHOR]

This paper examines the role of privacy in the health context by investigating the influence of privacy concerns and perceived benefits on individuals' acceptance of health technologies used by healthcare providers and their own adoption of mobile health technologies. The study adopts a two‐stage sequential mixed‐methods design. The first stage is a quantitative survey of 447 citizens from two countries. The second stage involves 50 qualitative interviews which further untangle the roles of privacy concern and benefits. The integrated findings provide evidence that a privacy paradox exists. While individuals continue to express a high desire for privacy, their consideration of the benefits and privacy concerns prior to adoption is largely skewed toward the benefits, due to a lack of privacy knowledge, emphasis on immediate gratification, overestimation of the benefits, and underestimation of the risks. The study further extends the privacy calculus theory to the health context and acknowledges the factors impacting this comparison of benefits and privacy concerns prior to and postadoption of a new technology. The study provides actionable insights for practice, highlighting the importance of privacy education to foster awareness and control mechanisms to negate the potential negative effects of privacy concern. [ABSTRACT FROM AUTHOR]

Background: Modifiable factors such as substance use, lack of attendance at antenatal care, overweight or obesity and sleeping position are associated with a higher risk of stillbirth. This qualitative study aimed to explore women's experiences of modifiable factors during pregnancy and their awareness of stillbirth. Methods: Purposive sampling was implemented by hospital staff in a large tertiary maternity hospital in Ireland between November 2020 and March 2021. Women were approached during their stay in the hospital and were invited to participate in a semistructured interview 3–5 months later. Eligible women were primiparous, >18 years of age and had an uncomplicated pregnancy and delivery. Eighteen women who consented to be followed up were interviewed at 3–5 months postpartum. Thematic analysis was used to analyse the data. Results: Four themes were identified: attitudes towards behaviour change, awareness regarding stillbirth and risk factors, the silence around stillbirth and risks, and attitudes towards receiving information about stillbirth. Women spoke about behaviour change in terms of outcomes, and most changes (e.g., ceasing alcohol consumption) were perceived as easy to manage. Awareness of stillbirth was limited among the women interviewed, and the association between risk behaviours and stillbirth was not known by any woman. Results suggest that there is a silence around stillbirth, including in antenatal care, which hinders information provision. However, most women highlighted the value of receiving information and extra education about modifiable risk factors and stillbirth. Conclusion: There is a general lack of understanding of the link between behavioural risk factors and potential pregnancy outcomes such as stillbirth. Providing further information to women about stillbirth and providing additional support with behaviour change might contribute to enhancing preventive efforts. Patient or Public Contribution: Patients were involved in this study by providing their experiences of antenatal care which were used as primary data. [ABSTRACT FROM AUTHOR]

Crisis pregnancy counselling (CPC) is a specific form of crisis counselling, whereby the pregnancy represents a personal crisis for the woman involved. While much research has been undertaken into understanding the antecedents and outcomes of crisis pregnancy, few studies have examined the experience of CPC from the perspective of counsellors. In addition, no studies to date have examined the changes in the experience of CPC following substantial changes in abortion legislation. The current study therefore aimed to describe the experiences of providing CPC within the context of recent legislative changes pertaining to the provision of abortion in Ireland. Seven semi‐structured, in‐depth individual interviews were conducted with counsellors and therapists who had provided CPC in the Irish context. Interviews were recorded, transcribed and analysed using interpretative phenomenological analysis (IPA). Four superordinate themes emerged from the data analysis: (1) tension created by legislative conditions, (2) the impact of societal views and stigma, (3) a new sense of freedom, and (4) finding meaning and motivation in supporting women's choices. Overall, the study highlights that CPC is a complex experience, which differs in important ways from providing counselling in other contexts, including other forms of crisis counselling. Implications for policy and practice are identified. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the general population's awareness of stillbirth.Design: A cross-sectional telephone population survey.Setting: A nationally representative sample of the Irish adult population.Sample: In all, 999 members of the Irish population were selected by random digit dialling.Methods: Data were analysed using descriptive and inferential statistics. Binary logistic regression was used to assess the odds of identifying risk factors for stillbirth.Main Outcome Measures: Public knowledge of incidence, risk factors, causes and social awareness about stillbirth.Results: Only a minority, 17%, of respondents correctly identified the incidence of stillbirth. Men and those aged over 45 years were more likely to say they did not know when a stillbirth occurs. Over half, 56% of respondents were unable to identify any stillbirth risk factors. Half of respondents, 53%, believed that the cause of stillbirth was due to a problem with the baby, 39% a problem with the mother, while 31% believed stillbirth occurred as a result of the care provided to the mother. The majority, 79%, believed that all stillbirths should be medically investigated, although women were more likely to suggest this (82% versus 76.4%; P = 0.043). Stillbirth had been represented in traditional and online media for 75% of respondents and 54% said they personally knew someone who had a stillbirth.Conclusions: There is a lack of public knowledge concerning the incidence, risk factors and causes of stillbirth. Improved public health initiatives and antenatal education are warranted to increase awareness of stillbirth risk factors and to improve care and monitoring during pregnancy.Funding: No funding was granted for this study.Tweetable Abstract: Irish population study shows low public awareness of stillbirth incidence, risk factors and causes.Plain Language Summary: This study aimed to find out what the general public know about the risk factors associated with stillbirth and whether stillbirth can be prevented. Many stillbirth risk factors can be identified and when they are, healthcare professionals can monitor pregnancy and hopefully reduce the possibility of a baby dying before birth. A sample of 999 people from the Irish population was surveyed by a professional telephone polling company for this study. The results of this study found that most people did not know how common stillbirth was and also believed that only a minority could be prevented. Most people were not able to identify any risk factors that can lead to stillbirth. Most people knew someone who had had a stillbirth and likewise most people believed that all stillbirths should be investigated to find a cause. It is possible that some people do not know the difference between stillbirth and miscarriage and this question was not asked in this study. Six people did not complete the interview as the topic of stillbirth was too sensitive. It is possible that these people had experienced a stillbirth themselves and so their results are not included. This study highlights the importance of increasing public awareness about stillbirth by providing clear information to women and their partners that there are risk factors associated with stillbirth that can be identified and monitored. The results of this study suggest that these risk factors could be highlighted in antenatal preparation classes and public health campaigns. [ABSTRACT FROM AUTHOR]

Very little is known about the experiences of lesbian, gay, bisexual, and transgender ( LGBT) people in relation to mental health services. Therefore, the overall aim of the current research was to explore LGBT people's experiences of mental health service provision in Ireland. The objectives were to identify barriers and opportunities, to highlight service gaps, and to identify good practice in addressing the mental health and well-being of LGBT people. A mixed methods research design using quantitative and qualitative approaches was deployed. A multipronged sampling strategy was used and 125 respondents responded to the questionnaire. A subset of phase 1 ( n = 20) were interviewed in the qualitative phase. Quantitative data was analyzed using descriptive statistics. Qualitative data were analyzed thematically. The sample consisted of LGBT people ( n = 125) over 18 years of age living in Ireland. Over three-quarters (77%) had received a psychiatric diagnosis. Findings include that whilst 63% of respondents were able to be 'out' to practitioners, 64% felt that mental health professionals lacked knowledge about LGBT issues and 43% felt practitioners were unresponsive to their needs. Finally, respondent recommendations about how mental health services may be more responsive to LGBT people's needs are presented. [ABSTRACT FROM AUTHOR]

Lindsay K.L., Gibney E.R. & McAuliffe F.M. (2012) Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries. J Hum Nutr Diet. Abstract Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted. [ABSTRACT FROM AUTHOR]

Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients 'at risk' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored. An education programme, incorporating 'Malnutrition Universal Screening Tool (MUST)' training, was implemented in eight of 10 eligible primary care practices (14 general practitioners and nine practice nurses attended), in seven private nursing homes (20 staff nurses attended) and two health centres (53 community nurses attended) in conjunction with a community dietetics service for patients at risk of malnutrition. Nutritional knowledge was assessed before, immediately after, and 6 months after the intervention using self-administered, multiple-choice questionnaires. Reported changes in practice and the acceptability of the education programme were considered using self-administered questionnaires 6 months after the intervention. A significant increase in nutritional knowledge 6 months after the intervention was observed ( P < 0.001). The management of malnutrition was reported to be improved, with 69% (38/55) of healthcare professionals reporting to weigh patients 'more frequently', whereas 80% (43/54) reported giving dietary advice to prevent or treat malnutrition. Eighty-percent (44/55) of healthcare professionals stated that 'MUST' was an acceptable nutrition screening tool. An education programme supported by a community dietetics service for patients 'at risk' of malnutrition increased the nutritional knowledge and improved the reported management of malnourished patients in the community by healthcare professionals. [ABSTRACT FROM AUTHOR]