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Little is known about the relationship between treatment organization characteristics and client outcomes or drug-related harms in community opiate substitution therapy. In the absence of sufficient scientific evidence, the organizational configuration of addiction treatment services is often decided on an ad hoc and sometimes politically motivated basis as the evaluation of the impact of policies or practices on clients at the organizational level is limited. The objective of this multi-site cross-sectional study was to identify and understand how client characteristics and staff perceptions of organizational functioning related to client engagement in community-based opiate substitution therapy services in Ireland. This paper reports on a cross-sectional survey of clients (n = 262) and staff (n = 132) questionnaires across 12 discrete community-based prescribing service providers (organizations) in Ireland. Measures of client engagement in treatment were shown to be higher in organizations with more positive staff ratings of organizational functioning. In particular, in organizations where staff reported having greater job autonomy, clients reported better overall engagement. Specifically, greater staff autonomy in organizations related to greater levels of treatment participation (p = 0.034), treatment satisfaction (p < 0.001), and better rapport with staff (p < 0.001). Clients who were the longest in treatment expressed significantly poorer rapport with staff (p = 0.44) and were less likely to seek out support from peers (p = 0.023), while those in stable accommodation reported greater participation in treatment (p = 0.009). Levels of peer support were not related to organizational characteristics, but clients with lower levels of education (p = 0.002) and those in early treatment (p = 0.017) were more likely to seek support from peers. The findings establish the importance of assessing organizational and client attributes as part of an overall strategy for enhancing the quality of treatment. This paper provides valuable information for policymakers and provides an ample basis for further exploration of how treatment organizations work, and not just that they work. Policymakers and planners need to consider introducing specific interventions for clients or staff in the context of a 'whole systems' approach. From an organizational and planning perspective, this should involve further consideration of measures that relate to increasing staff's sense of autonomy. This paper provides further evidence that the success of policy-making or planning relating to treatment organizations can be successfully measured at the client and organizational levels. [ABSTRACT FROM AUTHOR]

There is an increased need for accessible psychosocial interventions that support both people with dementia and their spouses. Recent research demonstrates the benefits of music therapy and caregiver-delivered music therapy for this population. This paper contributes to the emerging evidence base on telehealth music therapy for people with dementia outside of a COVID-19 era when in-person services were available. This exploratory phenomenological study explores the experiences of two couples who attended a six-week telehealth music therapy programme via two detailed case examples. Online semi-structured interviews with each couple were conducted pre and post intervention and analysed using Interpretative Phenomenological Analysis. Three shared themes emerged from the data analysis including (1) social isolation and lack of confidence linked to dementia diagnosis is worsened in rural locations, (2) song singing and song writing enables us to revisit happy memories, and (3) telehealth delivery increases access due to geographical location. The findings are presented in a narrative case study format to provide rich detailed descriptions of the music therapy programme and to illuminate the experiences of the participants. In both examples, telehealth delivery expanded access to music therapy (which was otherwise unavailable) and stimulated reminiscence which in turn encouraged meaningful engagement between the couple. The delivery of music therapy via telehealth, alongside in-person delivery, has the potential to expand access to music therapy to those who may not have access to or are no longer able to attend community support services due to geographical location, increased cognitive decline or reduced mobility. The successful delivery of telehealth music therapy is dependent on several factors including digital literacy, access to appropriate technological devices, caregiver support and level of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: There is limited research examining the views of general practice pharmacists (GPPs) on their role and their impact in general practice. The aim of this study was to explore GPPs' views regarding this role and its potential impact within general practice in Northern Ireland (NI). Methods: A paper-based self-administered questionnaire was mailed to 319 general practices in NI in 2022, directed to the GPP who spent most time at the practice. A variety of closed and open questions were included in six sections. Responses to closed questions were analysed descriptively whilst open question responses were analysed using content analysis. To ascertain associations between variables (e.g. GPP prescribing status, working arrangements and aspects of collaboration with GPPs), Fisher's exact test was employed with an a priori significance level of p < 0.05. Results: 155 responses were received equating to a response rate of 48.5%. Most participants (72.3%) were female, independent prescribers (71%), and 64.5% were currently using their independent prescriber qualification. Services that were provided by most GPPs were medication reconciliation (99.4%) and medication reviews (97.4%). The most common method of communication between GPPs and general practitioners (GPs) was face-to-face (89.0%). Telephone was the most common method of communication between GPPs, community pharmacists (97.4%) and patients (98.7%). Most GPPs (> 80%) showed positive attitudes towards collaboration with GPs and those who worked in multiple practices were more likely to agree with the Attitudes Towards Collaboration Instrument for pharmacists (ATCI-P) statements compared to those who worked in a single practice (p < 0.05). Less than 40% (36.8%) of GPPs agreed that patients were aware of the role they provided. The majority of GPPs (80.6%) expressed positive views on their impact on primary care. Analysis of the free-text comments revealed the need for more GPP patient-facing activities, GPP-specific training, and promotion of the GPP role. Conclusion: The findings indicated that GPPs had largely positive views about their role and their impact on primary care. The results may be helpful for practices and service commissioners. Further research is necessary to explore the perspectives of patients regarding the role of the GPP and to enhance patients' awareness of the GPP. [ABSTRACT FROM AUTHOR]

Objective: Although Ireland has one of the highest levels of well‐being in Europe, having a health condition has been found to have a direct negative impact. The aim of this study is to evaluate the current situation and the experiences of patients with epidermolysis bullosa (EB), a rare genetic skin disease, and their relatives living in Ireland, with a focus on burdens and helpful practices. Methods and Measures: In a mixed‐methods design, a series of standardised questionnaires were combined with open‐ended questions. Via an online survey, data from n = 59 EB patients and relatives of EB patients living in Ireland were collected. Results: EB affects both the patients and their relatives. Burdens were found in relation to the visibility of EB, the degree of severity, the current health status, reduced mobility, the financial impact of EB, the psychosocial impact and personal and social resources. The paper also analyses existing resources and highlights opportunities for support and needs of improvement. Conclusion: Quality of life with EB is influenced by somatic symptoms and the psychosocial burden. Individual helpful practices in dealing with this rare disease can be considered as mediators, but they need to be supported by structural and healthcare improvements. Patient or Public Contribution: The perspective of EB patients, their relatives and EB experts were taken into account in the development of the study design via two feedback loops with the EB patient organisations DEBRA Ireland and DEBRA Austria. The design was adapted accordingly. Additionally, by including open‐ended questions, patients and relatives could contribute their individual perspectives and add insights into their lives with EB that might not have been captured with the structured online survey alone. [ABSTRACT FROM AUTHOR]

Background: The clitoris has long been ignored in medical literature and teaching, with the first paper describing its anatomy only published in 1993. It is essential that those working in women's health understand the anatomy of this important female sexual organ. Aims: The aim of this study was to assess the level of knowledge of the anatomy of the clitoris across five cohorts in a busy teaching maternity hospital in Ireland. Materials and Methods: A questionnaire was devised, asking ten consultants, ten non‐consultant hospital doctors (NCHDs), ten midwives, ten midwifery students and ten medical students to name the anatomical parts of a 3D model of the clitoris. Results: None of the 50 respondents could name all five labelled parts of the clitoris, and 38 of respondents could not correctly name one anatomical part. Conclusions: It is evident that there is a lack of knowledge of the anatomical parts of the clitoris among the medical staff included in this study. This reflects a lack of adequate teaching in this area in both past and recent years. Despite this, we acknowledge that women's health and sexual health awareness is improving all of the time, and we hope that this study can highlight the need for reformed teaching in this area. [ABSTRACT FROM AUTHOR]

This paper sought to determine risk factors of occupational injury in the Irish dairy farming sector and to estimate the roles of both dairying expansion and the discipline of agricultural extension in influencing reducing injury occurrence. Data for this study was obtained via the Irish National Farm Survey (NFS). In total, 260 farm (83.6% of NFS dairy farm sample) workplace injury survey questionnaires were completed by NFS recorders by interviewing principal farm operators for year 2017. Injury survey data was analysed for 48 variables in conjunction with NFS core farm socio-economic, physical and financial data. Additionally, core data from 2010 for 78.5% of farms surveyed in 2017 was included in the study. Data were analysed using a three-step statistical testing process which met all Binary Logistic Regression assumptions. The study found that dairy farms had a higher farm workplace occupational injury level compared to a previous study. The study data indicates occurrence of elevated injury levels on farms which expanded and which were intensively managed from a milk production perspective. Farm expansion was associated with increased labor units used and increased investment per hectare. The study also found that use of extension services and farm discussion group participation were not associated with injury occurrence. This study demonstrates how a retrospective farm workplace occupational injury survey of Irish dairy farms, analysed in combination with farm business data can be used to identify injury risk factors, including those associated with production expansion. Irish dairy farms have a heightened farm workplace occupation injury level while dairy production expansion increased injury levels. Extension engagement did not influence on injury levels. Approaches to improve farm safety on dairy farms are outlined. [ABSTRACT FROM AUTHOR]

Background: This paper aims to explore the impact of recovery education on recovery knowledge, attitudes and the quality of life of students undertaking recovery education, contributing to the evidence base in relation to the impact of recovery education. It also explores the experiences of all stakeholders involved in the co‐facilitation, delivery and participation in recovery education. Setting and Participants: This study evaluates the experiences of stakeholders involved in the co‐facilitation, delivery and participation in recovery education across four recovery colleges in Ireland. Participants included students undertaking recovery education, peer educators, education facilitators, recovery college coordinators and practitioner/service providers. Discussion: Findings from the quantitative survey when compared with extant literature suggest that students had a good understanding of recovery education. The social aspect of empowerment for growth and wellbeing was identified through themes relating to co‐production and facilitating student learning. Support for equitable access to recovery education, including co‐production for both the public and staff, was identified as a challenge for the future. Conclusion: The findings from both the qualitative and quantitative components of the study show the positive impact of recovery education on stakeholders while acknowledging the need for ongoing support for people working in recovery education and the development of services. In particular, there was a high level of recovery knowledge found in students undertaking recovery education. Patient or Public Contribution: This study utilised a co‐created study design. From inception a steering group comprising stakeholders (peer educators, recovery education facilitators including past recovery college students and nonpeer staff involved in the co‐production of recovery education) directed the conduct of the evaluation. This steering group participated in an iterative process of information sharing, suggestions for evaluation process and language. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present commentary on adult safeguarding designated officers' (nominated senior staff members in the Health Service Executive and its funded services) in Ireland readiness for online learning and their perception of the blended approach used in their training and considers the implications of this for practice. Design/methodology/approach: In total, 233 designated officers were surveyed. A self-administered online survey comprising of two instruments was used. The questionnaire combines two previously validated tools measuring readiness for online learning and perceptions of blended learning. Minor modifications were made to account for local circumstance and language. Demographic questions relevant to the survey population were added. The response rate was 49%. Findings: Designated officers regarded specified competencies for online learning as important to very important with highest importance placed in time management. Designated officers expressed they were confident to very confident in their ability to accomplish all competencies in online learning. The highest confidence was in the technical competencies. Designated officers are demonstrating high readiness for online learning. Designated officers reported positively on online contributions and on blended learning workload. The scores indicate positive perceptions of the blended learning experience. Responses to an open-ended question were largely positive with some suggestions for improvement made. Practical implications: Findings have helped inform planning and development of the Health Service Executive's adult safeguarding training for designated officers with changes made since this survey was undertaken. Originality/value: To the best of the author's knowledge, this is the first time a survey was undertaken of designated officers in Ireland with a view to improving safeguarding training. Recommendations for adaptions to the blended designated officer programme were proposed and subsequently accepted and implemented. [ABSTRACT FROM AUTHOR]

Background: As the life expectancy of people with intellectual disability increases, they may now outlive their parents or their parents' ability to continue to care. Siblings of adults with intellectual disability often succeed their parents as primary carers. Little is known about the health and well‐being of this important cohort of carers who will be both caring for and ageing alongside their brother or sister with intellectual disability. The Carer's Study within The Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA) provides a unique insight into the health and well‐being of family carers of older adults with intellectual disability including sibling carers in Ireland. This article reports on the findings from waves 1, 2, 3 and 4 of the IDS‐TILDA Carer's Study. Methods: The IDS‐TILDA Carer's Study surveys family carers of older people (aged 40 years and older) with intellectual disability on a 3‐yearly cycle. The family carers complete a self‐administered, mixed‐methods questionnaire. The qualitative data are analysed thematically, and a descriptive analysis of the quantitative data is conducted using SPSS. Findings: In each wave, sibling carers comprised a significant proportion of the Carer's Study participants: W1 58%; W2: 61.4%; W3: 76.7%; and W4: 45.8%. The siblings were predominantly female, not in paid employment and were caring without the support of a spouse or partner. Across the four waves, siblings reported good general health. However, a high prevalence of particular conditions including back pain, aching joints and stress was also reported, and in each wave, siblings reported feeling completely overwhelmed by their care responsibilities. Although sibling carers reported that they have considered the future, only a minority have progressed to action in this regard. Conclusions: There is evidence of the strong relational and emotional commitment by the siblings to their brother or sister with intellectual disability. However, through the four waves of data, there was also evidence of physical, mental and financial toll. An urgent need exists to identify and engage with siblings to protect their well‐being as they provide care for an increasingly ageing sibling. Accessible Summaries: When the parents of people with intellectual die or can no longer provide care and support, brothers and/or sisters may take over the role.Little is known about the lives of these brothers and sisters and whether they need support.Our study asks brothers and sisters about their lives, their health and the good and more difficult things about being a carer.This paper reports on the results of four surveys over 9 years.Most brothers and sisters felt that their health was good but because many reported health problems, more support should be available to brothers and sisters who are carers. [ABSTRACT FROM AUTHOR]

Background: Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far‐reaching dissemination of current evidence and best‐practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. Aims: To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. Methods & Procedures: A mixed‐methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. Outcomes & Results: A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. Conclusions & Implications: Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian‐based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS: What is already known on the subject: Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge: This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work?: Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in‐depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia. [ABSTRACT FROM AUTHOR]

This paper documents co‐participatory research with children in six primary schools in Ireland during the COVID‐19 pandemic. It explores the use of what we term digital dialogues with diverse groups of children aged 9–10 years as members of Child Research Advisory Groups. The paper conceptualises the digital dialogues as sites of resistance as well as constraint, empowering children to articulate their voices in relation to schooling and the pandemic, whilst mediated by power dynamics—between adults and children, and between children, in the articulation of those voices. [ABSTRACT FROM AUTHOR]

Background: People with post‐stroke aphasia (PWA) are more likely to experience serious mood disorders compared with those without. Emotional regulation may be important for influencing life participation after stroke. Understanding emotional regulation in the context of aphasia is important for promoting personally defined recovery, psychological well‐being and life participation. Aims: To explore how individuals experience and regulate negative emotional responses to aphasia as part of re‐engaging with life. Methods & Procedures: In‐depth semi‐structured qualitative interviews with 14 PWA were conducted. The focus and design were developed with public and patient involvement contributors. Reflexive thematic analysis was applied. Outcomes & Results: Analysis generated three themes, which captured inherent diversity across participants in terms of emotional experiences, responses and regulation strategies: (1) emotional upheaval at all stages of recovery; (2) regulating emotional upheaval; and (3) discerning possibilities for life participation. Emotional regulation occurred both within and without the context of formal support services. Conclusions & Implications: Individuals may be differently (en)abled in responding positively, with implications for aphasia psychological support and self‐management interventions. The findings may inform future interventions to optimize well‐being and personally meaningful outcomes for PWA. WHAT THIS PAPER ADDS: What is already known on the subject: PWA experience significant psychosocial upheaval and are at risk of mood disorders. Emotional regulation may be important for influencing one's emotional state, social participation and relationships after stroke. There is a need to better understand the ways in which PWA experience and regulate their emotions to develop better support for personally defined recovery. What this paper adds to existing knowledge: PWA may experience significant and pervasive mood disorders in the long term after stroke. This may be compounded by worries for their children's well‐being. Some, but not all, regulate emotions by drawing on positivity, determination, gratitude or stoicism. Having (supportive) opportunities to experience the impact of aphasia is important for discerning helpful strategies and participation opportunities. What are the potential or actual clinical implications of this work?: Confronting altered abilities requires supportive, responsive opportunities sensitive to emotional responses. Opportunities for peer support and/or meaningful emotional support and compassion from family and friends are important therapeutic targets. Therapeutic input should pay attention to any familial and parenting concerns that may be compounding low mood. Although emotional regulation and recovery may occur without formal support, mental health services must be organized in such a way that PWA can access as needed. [ABSTRACT FROM AUTHOR]

Background: Assessing and measuring the experience and quality of care provided is central to the improvement of care delivery of all healthcare systems. This paper reports on the development of a survey instrument to capture the experiences of care at end of life from the perspective of bereaved relatives in the Republic of Ireland. Methods: A multi-method, multi-stakeholder, sequential approach was adopted for this study. Items for inclusion in the survey instrument bank were identified through (1) a feasibility study and scoping literature review, (2) expert panel programme board review, (3) focus groups and (4) gap analysis. The following steps were undertaken to prioritise the items for inclusion in the final survey instrument: (1) a Delphi study (2) technical expert panel review (3) cognitive interviews with bereaved relatives and an (4) expert panel programme board review. Results: Following an iterative process with key stakeholders, a survey instrument was developed with sections focusing on the provision of care at home, in the last nursing home / residential care facility, hospice and hospital, as well as care experience in the last 2 days of life, the relative's experiences of care and support, the circumstances of care surrounding death and demographic information. In total, a bank of 123 questions were prioritised to be included in the National End of Life Survey instrument. Conclusion: The survey will provide a standardised national approach to capturing the experience of care of those who have died, from the perspective of bereaved relatives in the Republic of Ireland. This will allow health service providers, policy makers and regulators to gather important insights into the experiences of care at end of life and will help fulfil the requirement of healthcare services to ensure they are providing high-quality care. [ABSTRACT FROM AUTHOR]

Background: An increasing number of children in the UK and Ireland are growing up speaking more than one language. The many advantages of bilingualism are acknowledged; however, this increased linguistic diversity presents particular challenges for speech and language therapists (SLTs). The case is often more complex with speakers of minority languages such as Welsh and Irish, which are acquired almost exclusively in bilingual contexts. Lack of appropriate standardized assessments for bilinguals is a key issue for SLTs internationally; however, little is known about the practices, personal perspectives or wider challenges faced by SLTs in assessing minority language skills. We focus on SLTs working with English–Irish bilinguals across Northern Ireland (NI) and the Republic of Ireland (ROI) where status, use and exposure to Irish differ significantly. Aims: To investigate the perceptions and practices of SLTs in NI and the ROI in the assessment of bilingual English–Irish‐speaking children. Methods & Procedures: A 33‐item online survey was distributed to SLTs working with children in community settings in NI and the ROI. Outcomes & Results: A total of 181 SLTs completed the survey. The majority of respondents had bilingual English–Irish‐speaking children on their caseloads; however, less than one‐quarter had assessed Irish language skills. Responses indicate confusion as to whether best‐practice guidelines applied in this particular context where the majority of speakers have English as their first language and limited domains of exposure to Irish outside of the education system. Resources available to assess Irish language skills were found to be limited. Informal analysis of language samples emerged as the most popular assessment tool. SLTs in the ROI had a significantly higher level of competence in the Irish language than SLTs in NI. This reduced the challenge of assessment. Many SLTs reported scoring assessments standardized on monolingual populations when assessing English language skills in bilingual English–Irish‐speaking children. Conclusions & Implications: Our findings highlight the challenges faced by SLTs in meeting best‐practice guidelines in the assessment of speakers of minority languages such as Irish. Further work is needed to ensure clinicians and other professionals have access to information and enhanced training on bilingual language acquisition in minority language contexts and implications for assessment and diagnosis. This study underlines the need for further research on the acquisition of minority languages as well as the development of alternative assessment tools to assist SLTs in meeting the needs of this population. What this paper adds: What is already known on the subject: Existing research indicates that SLTs face challenges in assessing bilingual clients. Lack of assessment resources is a global issue, particularly with respect to minority languages. Emerging research indicates that SLTs and other professionals are dissatisfied with current resources for assessing Irish‐speaking bilinguals and are struggling to meet best‐practice guidelines. What this paper adds to existing knowledge: The status of the Irish language differs significantly between NI and the ROI, while English is the dominant language in both areas. This study provides the first exploration of current assessment practices for bilingual English–Irish‐speaking children as reported by SLTs across both regions. The challenges of assessing bilingual clients in many other countries are mirrored by SLTs in NI and the ROI. The majority of children acquiring Irish are doing so in a specific context: the immersion education setting. This raises uncertainty for SLTs about whether the definition of bilingualism actually applies. Despite clinicians and clients sharing the same majority language, the complexity of minority language assessment remains. What are the potential or actual clinical implications of this work?: SLTs require specific support and resources to help them meet the assessment needs of bilingual English–Irish‐speaking children. Ongoing education and training are required for clinicians and other professionals to facilitate understanding of the complexities surrounding bilingual speakers of minority languages and the application of best‐practice guidelines. A greater understanding of the context in which children are acquiring Irish and the impact this may have on their acquisition of English would further support clinicians in identifying speech, language and communication needs in this population. [ABSTRACT FROM AUTHOR]

This paper explores parents' experiences of breaking news and communicating to the child with cancer and their siblings, and identifies the supports parents request to help them in this role. This paper represents one component of a wider action research study which employed mixed methods to explore supports needed by parents of children with a cancer diagnosis in the Republic of Ireland. This paper reports on the survey phase of the study, which involved the distribution of a postal survey to 550 families of children in cancer treatment and remission. This survey included four open-ended questions exploring parents' experiences of breaking news and communicating about the illness to the ill child and his/her siblings. Descriptive statistics on the profile of the parents were generated with computer software package SPSS and qualitative responses were analyzed using the survey questions as the initial framework. Parents identified four interventions that helped ease the distress of these difficult conversations: coaching, resources, team engagement, and play therapy. Parents expressed concern for siblings, describing them as "suffering" and "forgotten". Parents requested four sibling-specific interventions: the creation of resources for siblings, therapeutic support, coaching for parent-sibling conversations, standardize a family meeting with the multi-disciplinary team that includes siblings. This paper demonstrates how the practical supports requested by parents which are consistent with the principles embedded within the internationally defined psychosocial standards of care could be translated into practice when supporting parents to communicate with children in the context of pediatric cancer. [ABSTRACT FROM AUTHOR]

Cognitive cognitive load theory (CLT) has been conceived for improving instructional design practices. Although researched for many years, one open problem is a clear definition of its cognitive load types and their aggregation towards an index of overall cognitive load. In Ergonomics, the situation is different with plenty of research devoted to the development of robust constructs of mental workload (MWL). By drawing a parallel between CLT and MWL, as well as by integrating relevant theories and measurement techniques from these two fields, this paper is aimed at investigating the reliability, validity and sensitivity of three existing self-reporting mental workload measures when applied to long learning sessions, namely, the NASA Task Load index, the Workload Profile and the Rating Scale Mental Effort, in a typical university classroom. These measures were aimed at serving for the evaluation of two instructional conditions. Evidence suggests these selected measures are reliable and their moderate validity is in line with results obtained within Ergonomics. Additionally, an analysis of their sensitivity by employing the descriptive Harrell-Davis estimator suggests that the Workload Profile is more sensitive than the Nasa Task Load Index and the Rating Scale Mental Effort for long learning sessions. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well‐being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia‐related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development. Aims: To establish the current practices of SLTs managing dementia‐related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered. Methods & Procedures: An anonymous, cross‐sectional web‐based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open‐ended questions were analysed using conventional content analysis. Outcomes & Results: A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self‐rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources. Conclusions & Implications: The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well‐being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper addsWhat is already known on the subjectResearch indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice.What this paper adds to existing knowledgeThis paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints.What are the potential or actual clinical implications of this work?These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia‐related dysphagia and mealtime difficulties effectively. [ABSTRACT FROM AUTHOR]

This paper explores the well-being ['well-being' and 'wellbeing' are used interchangeably in the literature. Well-being is used in this paper (except in the reference list where exact wording is maintained)] benefits of participation in a workplace choir for health service staff. A mixed method study, this project combines quantitative measures of work engagement, perceived stress, resilience levels and work absences with qualitative interviews with choir participants. It is the first study of workplace choirs in Ireland and one of very few studies internationally that research health service staff choirs. There is some preliminary evidence of benefits that choir attendance may increase positive perception of workers' mental health as well as effect depression rates. However, evidence is limited quantitatively and difficulties in measuring the health benefits of arts interventions are noted. Qualitative data, however, confirms previous study findings, namely that a workplace choir can promote social connectedness, enjoyment at work and staff engagement. Work place choir was also noted to appeal mainly to a limited demographic of work place staff and people with relatively positive health and well-being. Efforts must be made to engage staff from lower socio-economic backgrounds, diverse cultural backgrounds and male staff in work place health promotion activities, as these groups were found less likely to join a work place choir. Given the low cost and low risk of this activity, and the qualitative benefits reported, it is recommended to continue to develop and evaluate health service workplace choirs. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Patient and public involvement (PPI) is recognized as an increasingly important feature of healthcare research, education and public policy.In mental health, PPI is increasingly seen as evidence of the further democratization of services, which started with de‐institutionalization in the 1960s and the recovery movement in the 1990s.While much is known about learning enablers and learning gains on generic community‐based training programmes, less is known about PPI‐specific programmes in mental health. What this paper adds to existing knowledge?: Participants at a national training programme to support the engagement of service users, their families and carers in mental health services identified training topics of greatest importance to them and reported on what they learnt and what helped their learning.Patient and public involvement training initiatives aimed at supporting the engagement of service users, their families and carers should emphasize individual needs and local contexts.Training programmes should not make artificial or actual distinctions between the programme participants who are health professionals and those who are non‐professionals, such as service users.To our knowledge, this PPI initiative is the first time a national health service provider has sought to develop an engagement structure in mental health on a state‐wide basis. What are the implications for practice?: Participants in training programmes designed to support patient and public involvement believe that such programmes should include understanding how conflict is resolved, how committees work effectively and how to develop interpersonal and facilitation skills.Training programmes in mental health involving both professional and non‐professional participants requires all the participants to work together in particular at commissioning and design stages to achieve their desired outcome.The evaluation of the training programme to support the roll‐out of this initiative offers lessons to others who may wish to pursue similar structures in other jurisdictions. Introduction: The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. Aim: We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. Methods: We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open‐ended questions. Results: A total of 54 participants returned the completed questionnaire, yielding a response rate of 60%. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1–5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co‐produce the training. Discussion: All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health should work together to achieve their desired outcome. This requires co‐production in the design, delivery and evaluation of the training initiative, and co‐production can impact at both individual and local levels. Implications for Practice: PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co‐production, is a necessary prerequisite at the co‐commissioning, co‐design, co‐planning, co‐delivery and co‐assessment stages of programme development, as is the need to avoid artificial or actual distinctions between health professionals and those who are non‐professionals, such as service users. Relevance statement: Mental health engagement and PPI are key principles underpinning modern mental health services and may increasingly impact on wider health service provision including policy and research imperatives. This paper discusses the evaluation of a PPI training programme and offers practical insights as to how such initiatives can be improved. [ABSTRACT FROM AUTHOR]

Based on the rich extant research in the field of mental health in acculturation, it is calling to identify religion as one of the meditative variables of the relationship between acculturation and mental health. In addition, little knowledge exists about the detailed religious experience of Chinese migrants in Ireland. This research adopted classic grounded theory to guide data collection and analysis. The findings show that Christian faith plays a significant role as a mediator in the cross-cultural adaptation of the participants with two aspects of the mental impacts: helping to cope with mental stress and providing spiritual satisfaction. The results in this paper are part of the findings from an investigation of the religious experience of the participants during their cross-cultural adaptation in Ireland. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to outline a knowledge translation (KT) case study undertaken as part of a multi-component research programme aimed at evaluating new parenting supports in the earliest years. The study aimed to: explore the influencing factors relating to research use in an early years context; and to use the findings, at least in part, to execute an integrated KT plan – to promote stakeholder engagement, greater research visibility and to enhance the understanding of findings emerging from the research programme. Design/methodology/approach: A mixed-methods study was embedded within a large-scale, longitudinal research programme. In the present study, a national survey (n = 162) was administered to stakeholders working with children and families throughout Ireland. A series of one-to-one interviews were also undertaken (n = 37) to amplify the survey findings. Also, one focus group was carried out with parents (n = 8) and one with members of the research team (n = 3). Several dissemination strategies were concurrently developed, executed and evaluated, based partly on survey and interview findings and guided by the knowledge translation planning template (Barwick, 2008; 2013; 2019). Findings: The main factors influencing the dissemination of evidence, as identified by the stakeholders – were: a lack of resources; an under-developed understanding of research use and dissemination; insufficient collaboration and communication; and conflicting stakeholder priorities. Despite these challenges, the research programme was found to benefit from a multi-component KT plan to achieve the outlined dissemination goals. Practical implications: The KT planning process allowed the research team to be more accountable, introspective and to work more efficiently. This helped increase the likelihood of more targeted and successful dissemination of the research findings, delivering a better return on research investment. Originality/value: This is the first study of its kind (to our knowledge) to provide important insights for stakeholders in Ireland and elsewhere about how to improve the dissemination process. Effective KT planning can ultimately help to bridge the research-policy-practice gap and enable the effective translation of high-quality evidence in the early years' sector to enhance outcomes for families in the shorter and longer-term. [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]

This paper presents the findings from an analysis of survey data which was collected from public health nurses (N = 136) as part of a larger study with more than 4000 nurses and midwives in Ireland. The purpose of the study was to examine the prevalence of burnout using the Oldenburg Burnout Inventory and to compare relationships between burnout, demographic and work characteristics across this group of nurses. Younger PHNs were most likely to report feeling burnout (68%) compared with those aged 51 or over (47%) who reported the lowest levels. PHNs whose highest level of qualification was a primary degree were least likely to report feeling burnout (31%) compared with those who held a Masters / Doctoral degree (54.5%). PHNs who reported working on a fixed-term full-time contract were most likely to report feeling burnout (70%) compared with those who were on a permanent part-time contract (49%). Quantitative analysis, using both descriptive and inferential statistics, was carried out and the findings show that PHNs reported moderate levels of burnout. The findings also show that burnout among PHNs is strongly correlated with the physical demands placed on individuals during work, having constant time pressures, too much being expected of individuals, the work environment being too demanding and dissatisfaction with the physical conditions. [ABSTRACT FROM AUTHOR]

Aim: To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses. Background: Seasonal influenza causes significant mortality and morbidity among older people and high‐risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low. Design: An explanatory sequential mixed methods study design. Data Sources: Qualified nurses attending mandatory training in two large acute hospitals in Ireland. Methods: A paper‐based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 – February 2018. A self‐selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 – October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process. Results: Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure. Conclusion: Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi‐faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence‐based knowledge, accessibility, and external cues to action. Impact: Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Self-harm is a relatively common occurrence in adolescents; however, there remains a lack of understanding about the motivations behind adolescent self-harm, and this poor understanding can have a negative impact on how mental health professionals respond to young people who self-harm., What does this paper add to existing knowledge? This paper identifies the reasons for self-harm in a community sample of young people and finds that the functions of self-harm differ for different people and that there may be multiple reasons for self-harm., Findings provide support for the affect-regulation model of self-harm which states that young people self-harm to regulate how they are feeling, but provides little support for the interpersonal influence model which proposes that self-harm is an attempt to influence how other people respond to them. , What are the implications for practice? Self-harm for most young people serves at least one specific function and is an indication of distress., There is a requirement for a non-pathologizing response towards young people who self-harm; self-harm should be understood as a meaningful behaviour rather than a symptom of an illness., Mental health nurses need to understand the multiple functions of self-harm. A better understanding of the individualized meaning behind self-harm can positively impact on attitudes towards young people who self-harm and provide for improved mental health service provision., Abstract Introduction Although self-harm is a relatively common occurrence in adolescents, there is a lack of understanding about the motivations behind it. A poor understanding of self-harm contributes to negative perceptions about those who self-harm and a poor healthcare experience. Aim & Methods This study identifies motivations behind self-harm in school-based adolescents using a cross-sectional survey. Motivations behind self-harm were elicited using a scale and open-ended responses. Results Of the 856 adolescents who completed the survey across 11 postprimary schools, 103 reported a history of self-harm. The most commonly endorsed reason for self-harm was to 'get relief from a terrible state of mind' (79%). Open-ended responses were consistent with scale responses with most reporting that they self-harmed to relieve distressing emotions. Discussion Findings provide support for the affect-regulation model of self-harm with support also demonstrated for the self-punishment and antidissociation models. There was little support for the interpersonal influence model suggesting that the commonly held belief that self-harm is attention-seeking is one attributed by others to young people, and not widely reported by young people themselves. Implications for practice Mental health services need to be responsive to the needs of young people who self-harm which requires eliciting and understanding the individual and multiple meanings behind self-harm to best inform treatment options. [ABSTRACT FROM AUTHOR]

Aims and objectives: To report the development, testing and validation of an instrument to assess the stressors experienced by student nurses during their older adult clinical placements. Background: The world's population of older adults is accelerating rapidly, with associated increased healthcare demands and a growing need for skilled nursing staff. However, this sector fails to attract adequate numbers of nursing graduates which is leading to a significant gap between nursing supply and demand. Older adult care is considered to be less attractive than other specialties and accompanied by more sources of stress. Design: A quantitative design was used. Methods: Data were collected from a cohort of Irish student nurses (n = 242) completing older adult clinical placements as part of their undergraduate degree. Exploratory and confirmatory factor analysis examined the instrument's underlying latent structure. Discriminant validity was investigated using a confirmatory factor analysis model with covariates. STROBE guidelines for cross‐sectional studies informed reporting of this paper's research. Results: Factor analyses identified two factors relating to "Knowledge and Workload" and "Resources," which were assessed by nine and six items, respectively. Discriminant validity analyses found a significant relationship between age and the workload and knowledge factor, and between year of programme and the resources factor. The new instrument was labelled the Student Nurse Stressor‐15 (SNS‐15) Scale. Conclusions: The SNS‐15 contained some overlap with stressors from extant general student nurse stress instruments and a number of unique stressors encountered in older adult care. Future research directions are discussed. Relevance to clinical practice: The SNS‐15 may assist stakeholders in nurse education and practice with the development of undergraduate degree programmes and clinical placements, and ultimately, in improving patient care and student retention. [ABSTRACT FROM AUTHOR]

As one of the Celtic languages, Irish is among the few languages in the world that employ word initial mutations (IMs) in order to express grammatical functions. IMs express grammatical information by a way of systematic alternation of minimal phonological contrasts, which closely links segmental phonology to grammatical morphology (Irish also employs final consonant palatalization as a grammatical marker, but this will not be the focus of our paper). The overwhelming majority of Irish speakers are bilingual (with English), and virtually all Irish-speaking children grow up with varying degrees of exposure to and use of English in the home. Irish is undergoing rapid language change at present, and the system of IM is affected by this process of shift such that many fluent Irish speakers show inconsistent use of IM in their spoken language. Given inconsistency in the use of a grammatical system in the adult language, the question arises whether it will be possible to identify developmental norms for the use of IM in child language. This in turn has clinical implications, in terms of the presence (or absence) of clinical markers of language delay or disorder. The data we report on consist of narrative samples from typically developing children (aged between 3 and 6) and a group of parents, who completed the same task (telling a story from a wordless picture book). We plot consistency and accuracy IM use in the language of children and parents. A key finding is that inconsistent IM use by parents is mirrored by inconsistent use by children. We discuss clinical implications for language sampling for diagnostic purposes, and the importance of individualized assessment. [ABSTRACT FROM AUTHOR]

Aim Clinical handover at the point of discharge is critically important. It generally occurs through a written document, usually in the form of a discharge summary. Hospital discharge summaries contribute to continuity of care for patients who leave hospital and who may require care in the community provided by their GP. They must be accurate, valid, reliable, timely, legible and complete. The aim of this study was to investigate GPs' perceptions of the content of discharge summaries generated by emergency advanced nurse practitioners (EANPs). Method A cross-sectional descriptive survey design was used and a questionnaire was distributed to 120 GPs. Raw statistical data were analysed using SPSS v22 while the qualitative data from the open-ended questions were manually analysed. Findings Most GPs were satisfied with the EANPs' discharge summary letters. However, this study supports previous papers that identified deficits in communication between secondary care and GPs. Conclusion There is a need to refine discharge summaries to create an enhanced structured discharge summary template that can be used by all disciplines. [ABSTRACT FROM AUTHOR]

This paper explores the experience of post-separation fathering, in the context of a prior history of domestic abuse from the perspectives of mothers, fathers, children and professionals participating in a three-year doctoral research project. A mixed methodological research design conducted over two phases involved both the completion of survey questionnaires by 219 mothers and the participation in focus groups and individual interviews by children and young people, mothers, fathers and professionals. The findings highlight clear evidence of post-separation contact facilitating the continued abuse of women and children. The findings also highlight a lack of attention to the parenting of abusive men who were identified as struggling to realise their fathering aspirations and take responsibility for the impact of their abusive behaviour on their children and ex-partners. Particular constructions of family life are found to sustain the often unmonitored presence of abusive men in post-separation family life. This paper concludes by asserting the need to prioritise the construction of fathers as 'risk' in the context of post-separation father-child contact. Doing so does not mean excluding fathers from children's lives; rather, what is critical is to find ways to ensure that abusive men can be 'good enough' fathers. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Separation is not a 'vaccine against domestic violence', with women and children at risk of continued abuse in the post-separation period., Abusive men need to be held responsible for their abusive behaviour before the potential for safe contact can be considered., All of the key players - mothers, children and fathers - may need support from the impact that domestic violence has on parenting capacity and family life. [ABSTRACT FROM AUTHOR]

Background: User-centred design (UCD) is a process whereby the end-user is placed at the centre of the design process. The WIISEL (Wireless Insole for Independent and Safe Elderly Living) system is designed to monitor fall risk and to detect falls, and consists of a pair of instrumented insoles and a smartphone app. The system was designed using a three-phase UCD process carried out in Ireland, which incorporated the input of Irish end-users and multidisciplinary experts throughout.Objective: In this paper we report the results of a usability and user experience (UX) assessment of the WIISEL system in multiple countries and thus establish whether the UCD process carried out in Ireland produced positive usability and UX results outside of Ireland.Methods: 15 older adults across three centres (Ireland, Italy and Israel) were recruited for a three-day trial of the system in their home. Usability and UX data were captured using observations, interviews and usability questionnaires.Results: The system was satisfactory in terms of the usability and UX feedback from the participants in all three countries. There was no statistically significant difference in the usability scores for the three countries tested, with the exception of comfort.Conclusions: A connected health system designed using a UCD process in a single country resulted in positive usability and UX for users in other European countries. [ABSTRACT FROM AUTHOR]

This article reports on the outcomes of a research study on the early implementation of a strengths-based family-centred model of practice in Ireland known as the Meitheal model. The paper aims to translate the key messages from this research to practice with families involved in the child welfare system. This is done by highlighting the process by which intervention focused on support and prevention using a strengths perspective has begun to occur in practice. Using data collected from stakeholders involved in the implementation of the practice model, the research provides insight into the opportunities and challenges involved at macro and micro-levels of practice. The discussion links this development in Ireland to the wider international context, using three broad frameworks informed by the ecological model; a framework for determining thresholds in children’s services and the continuum of intervention between support and protection to inform system change aimed at enhancing family support and better outcomes for children and families. Underpinning this is an emphasis on how Meitheal as a strengths-based approach can influence the achievement of the principles of early intervention, prevention and family support in the child welfare system in Ireland. [ABSTRACT FROM PUBLISHER]

It is predicted that significant and ongoing investment in M-Commerce platforms and application development by commercial entities will fundamentally change consumers' shopping and web browsing behaviours. However, the evolving behaviour of Smart Phone users is somewhat tempered by concerns over M-Payments. If Smart Phones are to reach their full M-Commerce potential, the ability of consumers to transact and pay for products/services through these devices in an easy, safe and reliable manner must be addressed. In response, this paper contributes a theoretical model and empirically tests the model to explore Irish consumers' perceptions of using Smart Phones to make M-Payments for products/services. The findings present conclusive evidence that trust is the most powerful factor influencing consumers' willingness to use Smart Phones to make M-Payments. While perceived usefulness and perceived ease of use influence the payment decision, their impact is much lower. Mobile self-efficacy and personal innovativeness have almost no direct impact. The paper concludes that irrespective of individuals' high levels of personal innovativeness or mobile self-efficacy and irrespective of whether Smart Mobile Media Services are perceived as useful and easy to use, consumers will not make M-Payments, until they are convinced that Smart Phone M-Payment systems are safe and reliable. [ABSTRACT FROM PUBLISHER]

This paper draws on three studies conducted in Australia, Canada and Ireland which explore the factors influencing research utilisation in the child protection sector in each country. The paper recognises that research uptake is complicated by a number of factors. It also acknowledges critiques which cite the equally significant influence of ideologies, context, unpredictability, time constraints and political expediency. However, all three studies recognised the increasing importance of evidence-based practice. The methods used in the three studies were not identical but the frameworks used were sufficiently similar to enable the classification of both common and dissimilar barriers and facilitators to research use. Those which they identified were categorised into four types: individual, organisational, environmental and characteristics relating to the nature of research material. Implications were identified for policy makers, service providers and research producers. The point was made that we now live in a period where unprecedented means of knowledge transfer and exchange provide unique opportunities to improve the lives of children and families. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Avail of opportunities to attend learning events., Draw on research findings when conducting assessments, writing reports, devising intervention plans, evaluating programmes and tendering for funding., Establish links with research centres., Become involved in the conduct of research., Support colleagues (champions) who display particular interest and motivation in the use of research evidence by recognising and/or rewarding effort., Avail of opportunities to undertake further study that includes a research component. [ABSTRACT FROM AUTHOR]

Do all newly qualified primary-level teachers report the same experience of child protection practices in their schools? Drawing on findings from a recent Irish study, this paper will consider the operation of official child protection guidelines in schools based on the reported awareness and knowledge of a sample of newly qualified teachers. Their knowledge of child protection guidelines pertains to experience of induction into child protection practices upon taking up employment in the school and their awareness of a designated liaison person, school child protection policy and the procedures for reporting a suspected child protection issue within the school. The findings of this research indicate that schools' compliance with national guidelines on child protection is certainly inconsistent and such an ad hoc approach can be seen to impact on the perceived confidence levels of newly qualified teachers in dealing with child protection issues in the school. Given the crucial role teachers play in the safeguarding of children and the potential for strengthening this role, this paper argues for the standardisation of the operation of child protection procedures across all schools and the provision of training for all school staff. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message There is a clear need for enhanced, standardised pre-service and in-school child protection training., New entrants to the teaching profession should automatically be inducted into the school child protection policy., Schools should have clearly articulated child protection policies and action plans which are consistently communicated to staff on a regular basis., The potential for teachers to promote child welfare and protection should be acknowledged and realised. [ABSTRACT FROM AUTHOR]

Background: Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients' experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods: This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland's Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results: We identified three overarching themes relevant to the purpose of this paper: (1) patients' experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions: Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored. [ABSTRACT FROM AUTHOR]

The recent economic crisis along with changing demographic trends has stimulated an increased interest in the value obtained from social care expenditure so as to ensure the sustainability of systems in the future. In Ireland, the Department of Health, further to a recent review of its disability services, commited to a new approach that will reshape and redesign its service provision. It specifically outlined a reorganisation of financing services, from a model of prospective block grant funding to a system of individualised budgeting based on an assessment of need. This paper examines the relationship between need, service utilisation and cost for high-cost users of adult intellectual disability residential services in an Irish county under the current model of block grant financing. The analysis reported is based on primary data collected from 68 high-cost users of adult intellectual disability residential services in an Irish county in 2013. Statistical analysis was performed to identify the relationship between need and cost, and also to examine the variations in the cost of support between the service provider organisations. Our analysis determined an association between need and cost, with poorer levels of psychological well-being related to higher costs. However, the study found no evident relationship between staff/client ratios, the numbers of staff engaged at the residential units and need. An examination of cost variations between the service provider organisations revealed that agency status; service unit size; client and staff characteristics all contributed to variations in the cost of care. This study supports the development of a national resource allocation framework as being fundamental to the equitable and transparent distribution of scarce resources, as recommended by the Department of Health in Ireland. [ABSTRACT FROM AUTHOR]

Introduction: This article presents some of the results of a year-long project in the Republic of Ireland to review the quality of the hospital inpatient enquiry data for its use in activity-based funding (ABF). This is the first of two papers regarding best practice in the management of clinical coding services. Methods: Four methods were used to address this aspect of the project, namely a literature review, a workshop, an assessment of the coding services in 12 Irish hospitals by structured interviews of the clinical coding managers, and a medical record audit of the clinical codes in 10 hospitals. Results: The results included here are those relating to the quality of the medical records, coding work allocation and supervision processes, data quality control measures, communication with clinicians, and the visibility of clinical coders, their managers, and the coding service. Conclusion: The project found instances of best practice in the study hospitals but also found several areas needing improvement. These included improving the structure and content of the medical record, clinician engagement with the clinical coding teams and the ABF process, and the use of data quality control measures. [ABSTRACT FROM AUTHOR]

Alister Hardy’s initiative in starting a programme of empirical research into religious experience in the UK employing the methods of the social sciences continues through the work of the Religious Experience Research Centres. John Greer initiated a similar research tradition through his questionnaire surveys of the incidence and nature of religious experience among children and young people in Northern Ireland. Leslie Francis and Tania ap Siôn replicated Greer’s classic surveys, with ap Siôn extending Greer’s analysis into nine categories of religious experience (Guidance and help, Exam concerns, God’s presence, Answered prayer, Death, Sickness, Conversion, Difficulty of description, and Miscellaneous), while also noting their setting and frequency. This paper develops the Greer tradition further, drawing on more recent data from pupils in the Republic of Ireland, and arguing for a modified analytical process in order to provide a more nuanced understanding of reports of religious experience. [ABSTRACT FROM PUBLISHER]

Background: The use of complementary therapy has become increasingly integrated into specialist palliative care units (SPCUs). Objective: To evaluate patients' interest in and experience of complementary therapies during their inpatient stay in a SPCU. Method: All 179 patients admitted to the SPCU over a 3-month period were assessed on admission. Those deemed suitable to participate by the researcher/clinical nurse specialist were invited to participate in this research. A standardised paper questionnaire was completed by the participating patients. Results: 71 patients (40%) completed the study. Those excluded had cognitive impairment, fatigue, communication difficulties or were imminently dying. Some declined to participate. A variety of age groups and diagnoses were represented. Only 27% of participants had a previous experience of using complementary therapies in the past 12 months. The majority (52%) were 'very interested' in receiving complementary therapy, while 13% reported having 'no interest'. Massage and reflexology were identified as the most popular forms of complementary therapy. The primary anticipated benefits associated with complementary therapy were relaxation and improvement in general wellbeing. Conclusion: This research has indicated a high level of interest in complementary therapies in the study population, across a wide age range regardless of diagnosis or level of disease. [ABSTRACT FROM AUTHOR]

This paper reports on some outcomes of a research study evaluating a new assessment framework of clinical competence used in undergraduate nursing programmes in the Mid West Region of Ireland. First, this paper presents both the strengths and weaknesses of the present model, as articulated by student nurses. Second, it generates a broader critical debate around the concept of competency assessment. The model of competence in question was developed by the Irish Nursing Board then elaborated on by the University of Limerick in partnership with local health service providers in 2002. Methodology involved a triangulated approach, comprising a series of focus group interviews with students (n=13) and preceptors (n=16) followed by a survey of students (n=232) and preceptors (n=837). Findings from the student focus groups are reported here. Themes identified using Burnard's (1991) framework for analysis are preparation for competency assessment, competency documentation, supporting assessment in practice, organisational and resource factors and the competency assessment structure and process. Results from this research have implications for refinement and revision of the present competency assessment framework, for student and staff preparation and for collaboration between stakeholders. [ABSTRACT FROM AUTHOR]

Accessible summary • This paper describes the role of the psychiatric nurse working in a high secure psychiatric facility in Ireland. • Since this study in 2006, this role has transformed moving from a custodial to a recovery model of care. • The United Kingdom Central Council framework for this study provided a useful method to establish a baseline for this role and as part of strategy to develop nursing practice. The Central Mental Hospital is one of the oldest high secure mental health services in Europe dating back to 1845 but has been one of the last to introduce (forensic) psychiatric nurses. This paper describes the role of psychiatric nurses working in this high secure psychiatric facility in Ireland. The United Kingdom Central Council competency framework was considered to be a prudent starting point for beginning to understand this role in an Irish context. The study received a response rate of 74% and found that the Irish Forensic Mental Health Nurse experiences many of the same challenges as their international colleagues. A high proportion of nursing practice is focused on assessment, communication and creating a therapeutic environment based very much in keeping with the mainstream role in mental health nursing. Skills in specialist assessments and addressing offending behaviour were considered important but deficient at that time. The importance of recovery and human rights were considered paramount but challenged by the need for risk management and security. [ABSTRACT FROM AUTHOR]

A nurse prescribing scheme has recently been implemented within the Republic of Ireland. This paper reports on the views of community mental health nurses on nurse prescribing just prior to the implementation of the scheme. Data were gathered through a 13-item questionnaire administered to 103 members of the Association of Community Mental Health Nurses in Ireland. Results indicated a distinct difference of view between male and female community mental health nurses, with female nurses having greater reservations towards the desirability of nurse prescribing in relation to educational preparation and impact on professional relationships. Overall, only 17% of respondents favoured being supervised in their prescribing practice by their consultant psychiatrist. The paper concludes that there is ambivalence towards prescribing in this important group of nurses which may need to be taken into account if nurse prescribing is to be successfully implemented within the Irish mental health service context. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

Aims: The aim of this paper is to propose a methodology for classifying prisons into distinct drug-use risk categories based on prisoners’ use of specified prescription and illegal drugs. The categories of prisons thus defined have particular relevance for the planning of drug-related interventions, education and services in Irish prisons. The methodology may be transferable to, and of value in, prison systems elsewhere.Methods: From the 14 prisons in Ireland, 824 randomly selected prisoners completed a self-administered questionnaire on lifetime, last year and last month use of specified prescription and non-prescription drugs. Questions were derived from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and other sources. Oral fluid samples were collected for verification of recent drug use. The EMCDDA definition of “recent problematic drug use” was used inpost hochierarchical cluster analysis to define categories of prisons with similar drug-use patterns.Findings: Four categories of prisons, designated “low”, “medium”, “high” and “very high” drug use, were identified. While the prisons comprising each category were known, drug use patterns in individual prisons were not disclosed because of concerns about prisoner confidentiality in a small jurisdiction. The clusters identified were used to contextualise subsequent analyses of drug use, the availability and use of harm-reduction services and differential service requirements by prison category.Conclusions: The methodology described allows for identification of prison categories by drug-use patterns. With restrictions on disclosure of information by individual prison, it provides more valuable information than would derive from data on all prisons combined. [ABSTRACT FROM PUBLISHER]

Accessible summary People with intellectual disability live within their community and will require services to support them at end of life., Often people with intellectual disability are denied access to essential services., This paper identifies the experiences of community nurses caring for persons with an intellectual disability and palliative/end-of-life care needs., Summary Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of palliative care services and integration of people with intellectual disability into their communities has resulted in an increased demand and greater diversity in the population groups accessing palliative care services. This study aims to describe the provision of community nursing support for persons with an intellectual disability and palliative/end-of-life care needs from the perspective of community nurses. A quantitative descriptive cross-sectional survey was employed. On receipt of ethical approval, data were collected through self-reporting questionnaires and descriptive analysis was conducted to describe frequencies and to identify patterns of the respondents using spss version 18. Only 85 people with an intellectual disability were referred to palliative/end-of-life care services over a 3-year period. Those delivering care expressed challenges including, understanding communication styles, late referrals, lack of time, knowledge and skills. Highlighted within the study were the benefits of liaison between family and professional and nonprofessional carers. Findings provide insight into the importance of teamwork, advance planning, knowing the person and best practice in providing palliative/end-of-life care for people with intellectual disability through collaboration. [ABSTRACT FROM AUTHOR]

Primary objective: This paper reports on a client-driven therapy group designed to help clients actively process changes and equip them with the psychological skills necessary to facilitate rehabilitation. Research design: This is an exploratory mixed methods research design based in clinical practice. Methods and procedures: This study documents results from five therapy groups, each group consisting of 2-hour sessions over an average of 6 weeks with a review session 6 weeks later. Forty-five clients (13 female, 32 male, average age = 40.54, SD = 11.87) with brain injury attended the group with Headway psychological services, Cork. Clients’ pre- and post-measures of functioning were gathered to assess the potential therapeutic benefits. Thematic analysis was used to evaluate the qualitative data. Main outcomes and results: Results illustrate a number of benefits to the participants, including normalizing effects, helping with acceptance, finding a new identity and positive mental health changes. Conclusions: Findings are encouraging and help to validate the effectiveness of group therapy as an intervention tool. [ABSTRACT FROM AUTHOR]

Aim To explain a strategy to improve response rates from healthcare professionals to a postal survey in the Republic of Ireland. Background Response rates to surveys conducted among healthcare professionals have been declining steadily. This paper is based on the development of a response rate strategy to address this challenge. Data sources A study in Ireland using a survey instrument that relied on the voluntary participation of managers and healthcare professionals. Review methods Database and manual literature searches were undertaken across the literature related to methodology to increase response rates from healthcare professionals. The databases Cinahl, Medline, PsyclNFO, Wiley Online Library and Scopus-V.4 were searched using 'response rates' and the terms: 'response rate theory', 'survey response rates', 'increase', 'improve health professionals', 'primary care research', 'health care teams', 'health service research' and 'research participation'. Only English-language publications were reviewed. Discussion Researchers must be aware of factors that influence healthcare professionals they seek to engage and so they can create research environments that do not preclude or dissuade practitioners from participating. Conclusion The potential impact of poor response rates is a concern for healthcare researchers. Research-based practice is central to improving the quality of health care. Response-rate strategies can enhance research. Implications for research/practice Nurse researchers as part of the broader health research community need to consider potential response rates at the research design stage. Response rate strategies should be developed and outlined as part of their overall research proposal and study reports. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the reported predictors of the practice of restricting a child for a clinical procedure in hospital. Background Previous work in this area is dominated by discussion papers and suggestions for addressing the issue of restriction. This is the first study to explore reported predictors of this practice with a view to implementing change based on research findings. Design A factorial survey was developed, which incorporated the use of vignettes with various scenarios. The factorial design enabled exploration of the interaction of multiple factors on the practice of restriction. Methods One hundred and sixty-six nurses caring for children were each sent 10 vignettes and asked to rate their likelihood to restrict a child based on the vignettes. A total of 105 nurses responded to the survey, representing a response rate of 63%. Hierarchical linear regression was used to identify reported predictors of restriction. Results Nurses were more likely to restrict a child if they had prior instruction on safe holding, if there was no play therapist available, if the nurse was a registered general nurse with no other registration qualification, if the child required cannulation or if the child was less than five years of age. Conclusion This study identified predictors of restriction from the perspective of practicing nurses; the evidence needs to be used in developing clinical guidelines and in multidisciplinary education. Relevance to clinical practice There is a need to move from any presumption of restriction towards more critical consideration of the individual requirements of the child. There is a need to increase the numbers of nurses receiving specialist training on the care of a child in hospital. The importance of a well-resourced play therapy service is supported, and there is a need for multidisciplinary work to explore alternatives to restriction. [ABSTRACT FROM AUTHOR]

Background: Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to 'engage' and 'empower' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the 'engagement' of the clinical teams who participate and vice-versa. Objective: This paper explores and examines the impact of a large-scale QI programme, the Productive Ward, on the 'work engagement' of the nurses and ward teams involved. Design/methods: Using the Utrecht Work Engagement Scale (UWES), we surveyed, measured and analysed work engagement in a representative test group of hospital-based ward teams who had recently commenced the latest phase of the national 'Productive Ward' initiative in Ireland and compared them to a control group of similar size and matched (as far as ispossible) on variables such as ward size, employment grade and clinical specialty area. Results: 338 individual datasets were recorded, n = 180 (53.6%) from the Productive Ward group, and n = 158 (46.4%) from the control group; the overall response rate was 67%, and did not differ significantly between the Productive Ward and control groups. The work engagement mean score (±standard deviation) in the Productive group was 4.33 (±0.88), and 4.07 (± 1.06) in the control group, representing a modest but statistically significant between-group difference (p = 0.013, independent samples t-test). Similarly modest differences were observed in all three dimensions of the work engagement construct. Employment grade and the clinical specialty area were also significantly related to the work engagement score (p < 0.001, general linear model) and (for the most part), to its components, with both clerical and nurse manager grades, and the elderly specialist areas, exhibiting substantially higher scores. Conclusions: The findings demonstrate how QI activities, like those integral to the Productive Ward programme, appear to positively impact on the work engagement (the vigour, absorption and dedication) of ward-based teams. The use and suitability of the UWES as an appropriate measure of 'engagement' in QI interventions was confirmed. The engagement of nurses and front-line clinical teams is a major component of creating, developing and sustaining a culture of improvement. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports the findings of two studies that examined factors predicting infertility distress in male partners within couples with an infertility diagnosis and where the couple was receiving fertility treatment. Design: A cross-sectional design was implemented using a questionnaire battery (The questionnaire battery comprised an inventory of four different standardised questionnaires compiled together into one booklet) compiled from earlier theory-building qualitative research conducted by the authors. Methods: Infertility related distress was examined in relation to a number of psychosocial variables including relationship dynamics, self-esteem, current mental health and attitudes towards idealised masculinity. The questionnaire battery was completed by 167 men undergoing or consulting for fertility treatment. Participants were recruited through Irish fertility clinics (Study 1, n = 111) and through an online survey (Study 2, n = 55). Results: Regression analyses identified four variables that predicted variance in infertility distress in both studies: 'Attitude towards idealised masculinity', 'Mental health', 'Relationship satisfaction' and 'Self-esteem'. This finding was found to be robust having controlled for age, time since diagnosis, number of attempts at treatment and diagnostic category (male factor, female factor or mixed factor infertility). Conclusion: Recommendations for fertility clinics and mental health professionals should be made in relation to managing infertility distress and supporting couples during fertility treatment. [ABSTRACT FROM AUTHOR]