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Background Executive skills refer to a set of cognitive skills that allow individuals to engage in goal directed behavior. They encompass planning, initiation, inhibition, monitoring and flexibility in approach to tasks, and are necessary for functional competence. Executive skills are vulnerable to disruption with damage to the brain, as occurs with dementia. Methods Participants were recruited from a tertiary memory assessment and support Service. The Assessment of Motor & Process Skills (AMPS), a standardised observational assessment of occupational performance (1Fischer, 2003) was administered by trained Occupational Therapists. In addition, the EXIT-25, a pen & paper based assessment of executive skills (2Royall et al, 1992) was administered. Process scores from the AMPS, and overall score from the EXIT 25 were utilised for correlation analysis. Results 22 participants, 12 male and 10 females, age range 60-91 (mean 75.5 years), was analysed using Spearman's Rho correlation (-.2). Results did not identify a strong correlation Conclusion Dementia is commonly regarded as a disorder of memory. However, diagnosis is dependent on functional decline related to cognitive decline. The AMPS provides a formal assessment of functional skills, in terms of motor & process skills with cut off scores regarding safe independent living. The results of this study indicate that the AMPS is not associated with executive scores on formal cognitive assessments, highlighting the value of an extensive multi-component MDT approach (also incorporating history taking, imaging, bio marker testing etc.) in assessing and diagnosing a dementia. [ABSTRACT FROM AUTHOR]

Presents an analysis of the depreciation of Irish pound in 1803-4. Price of gold in 1808-10; Bullion Report of 1810 and Currency Report of 1804; Co-integration techniques; Economic analysis of exchange rate; Statistical basis of the Irish Currency Report; Over-issuing of bank notes.

In the late Elizabethan period Ireland became a critical focus of the Tudor regime as the Nine Years War (c.1593-1603) threatened English rule in the second Tudor kingdom and the country became a theatre of the Anglo-Spanish War (1585-1604). As a result of this military emergency officials in Ireland began composing a deluge of policy papers from the mid-1590s onwards. Over two hundred of these treatises are extant. This paper provides the first systematic overview of this war-time discourse on Ireland. In doing so it sheds light on these writings and their significance for the history of late Elizabethan Ireland. [ABSTRACT FROM AUTHOR]

Background Developing age-friendly communities is a significant global policy issue. The WHO (2007) age-friendly cities and communities initiative has had a significant influence on the development of Ireland's Age-Friendly Programme. With research on such programmes still at an early stage, this paper critically examines the utilisation of the WHO age-friendly planning framework in an Irish context. It explores older adults' experience of living in two towns in an 'age-friendly' county and, in parallel, examines stakeholders' perspectives on the development of the county's age-friendly programme. This multi-perspectival approach facilitates an assessment of how the age-friendly county programme addresses older residents' needs, and illustrates how the WHO conceptual and planning framework has worked in an Irish context. Methods The paper reports on a study which employed a mixed-method, qualitative case-study research design, using a constructivist grounded theory approach to explore the lived experience of older adults, and a case-study framework for the stakeholder perspective. Results The research identifies salient social and cultural dimensions of the day-to-day lived experience of older people which, although they impact on the age-friendliness of the places in which they live, are neglected in the WHO framework. It also identifies a unique combination of economic, political, cultural, and organisational factors which have impacted on age-friendly programme development in Ireland. Conclusion In critically analysing use of the WHO age-friendly model, the paper suggests ways in which the model can be modified to better accommodate the diverse experience of older adults not only in Ireland, but also in other geographic and cultural contexts. [ABSTRACT FROM AUTHOR]

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

What can community development learn from frontline community resistance to extractivism and the fossil fuel industry? In the global North, environmental governance often operates within the dominant mode of neoliberal 'environmentality' (Luke. 1999. Environmentality as green governmentality, in E. Darier ed, Discourses of the Environment , Blackwell, Oxford), conceptualizing environmental action in individualized and depoliticized ways. This is compounded by the discursive hegemony of the educated middle-classes, which frames environmental issues in ways that render invisible the concerns of marginalized communities and workers. In this paper, I present an activist ethnography and case study of Love Leitrim, a community group that played a crucial role in the successful Irish movement to resist fracking. I suggest that local environmental justice struggles point to the possibility of a 'liberation environmentality' (Fletcher. Environmentality unbound: multiple governmentalities in environmental politics, Geoforum , 2017;85, 311–315); which challenges capitalist modes of environmental governance that facilitate the exploitation of the environment for capital accumulation. The paper identifies how a combination of (i) relational local organizing; (ii) trans-local networking with other frontline communities and (iii) creative political engagement enabled campaigners to organize collectively around the environment, navigate power asymmetries and secure political change across spatial scales. I conclude by suggesting that Love Leitrim's frontline community struggle offers important insights for community development workers who wish to address the environment as a political issue and play a role in bringing about a just transition for marginalized communities and workers. [ABSTRACT FROM AUTHOR]

The Protected Disclosures Act 2014 is Ireland's main workplace whistleblowing legislation. It will be amended by the Protected Disclosures (Amendment) Act 2022 on 1 January 2023 on foot of Ireland's obligation to transpose into national law Directive 2019/1937/EU of the European Parliament and the Council of 23 October 2019 on the protection of persons who report breaches of Union law. This paper addresses the question of whether, in amending the 2014 Act, there were lessons that could have been learnt from the experience in the UK in the operation of its whistleblowing legislation. In answering this question, the findings of an analysis of the case law under the 2014 Act between 15 July 2014 and 15 July 2020 are presented and discussed. In conducting the case law analysis, specific issues were assessed, including, procedural issues concerning the forum for the taking of a claim, costs, fees, processing times, and time limits for presenting penalisation claims and substantive issues regarding the type of claim and the success rate. The research established that there are deficiencies in the 2014 Act, and in some of its amendments under the 2022 Act. It also established that there is an inequity in the treatment under the legislation of 'employees' and workers other than employees. The author concludes that to address these procedural and substantive deficiencies and inequities, Ireland should have gone beyond the minimum standards of the Directive and looked to the UK for guidance. [ABSTRACT FROM AUTHOR]

The rise of exclusionary populism is widely regarded as one of the most significant phenomena in today's political world. Despite this, the relationship between populism and security remains under-explored in the literature, including the affective power of populist security narratives. Against this background, this paper conducts a comparative analysis of radical right populist discourse in response to two recent shocking crimes in France and Ireland. The different expression given to security concerns in the two countries, such as a much less antagonistic 'flaunting of the low' in France, is suggestive of a more contingent and institutionally mediated relationship between security and populism than the existing literature would suggest. [ABSTRACT FROM AUTHOR]

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

Background The transition of older persons between care settings is recognised as a particularly critical and vulnerable period (Renom-Guiteras et al. 2014). Appropriate documentation and processes are key in assisting the provision of quality, safe, person-centred care when transferring older persons from residential to acute care settings. This paper reports on the design phase of a national transfer document for older persons. The objective was to inform the development of a draft national transfer document. Methods Development consisted of two phases 1) an integrative review and 2) focus group interviews with stakeholders. The review was guided by Whittemore and Knafl's (2005) integrative review framework. Data from studies using both quantitative and qualitative methodologies were extracted and thematically analysed. Using a qualitative descriptive approach, focus group interviews (n=8) were conducted with a convenience sample of key stakeholders (n=68) to establish their perspectives regarding transfer documents. Data were analysed using content analysis. Results from both phases were integrated to guide the development of the draft document. A multidisciplinary panel of experts in older persons care, reviewed and provided feedback on the draft transfer document. Results Within the review, thirty identified papers focused on transfer documentation between residential and acute care. Results indicated that using a standardised document can potentiate the delivery and acceptance of relevant person-centred information between all parties when transferring an older person between residential and acute care settings. Qualitative interview findings highlighted important aspects for consideration regarding the layout, content and format of future transfer documentation. Following collaboration with the expert panel the transfer document was developed for piloting. Conclusion Consistency and clarity of information is key for a successful transfer of older persons from residential to acute settings. Information needs to be evidence-based, current, and subject to response and change in accordance with best available international practice. [ABSTRACT FROM AUTHOR]

Background The Acute Medical Ambulatory Centre (AMAC) was established with the goals of facilitating early discharge and preventing avoidable medical admissions. 12 months post its introduction, the service was inefficient and operating under capacity. A project aimed to improve the AMAC referral processes and increase the centre's overall efficiency was undertaken. Methods Western Australia Department of Health Clinical Service Redesign methodology (a blend of Lean and Six Sigma methodologies) was used to complete the project. This involved process mapping, root cause analysis and solutions sessions with stakeholders, as well as a semi-structured phone interview with patients. Results Transition from a paper-based to an electronic referral system. Creation of an 'AMAC Quick Reference Guide' for doctors. Production of an AMAC contact card to be given to patients on discharge if they   have AMAC follow up. Letters detailing the patient review are forwarded on the day of the appointment facilitating timely feedback to GPs. An AMAC information flyer for GPs is now available on the hospital website. Conclusion Redesigning the referral process to the AMAC has improved workflow and efficiency with significant improvements in staff satisfaction. The institution is aiming to become paperless and this redesign project has led to the elimination of another paper form. The success of the project is testament to the engagement of the staff involved and demonstrates the need for doctors to not only engage their medical colleagues, but also nursing and clerical staff. The redesign project has helped refocus hospital priorities and should hopefully see further support for the centre; developing the ambulatory model of care as an integral part of the service provided. Other centres can learn valuable lessons from our experience and develop similar strategies to cope with the ever-increasing demands on the public healthcare system. [ABSTRACT FROM AUTHOR]

Child-protection social work is a stressful occupation that results in workforce concerns about poor levels of staff retention and high levels of inexperience. This paper presents results from a cross-sectional survey and reports findings from a sample of 162 Northern Irish social workers. The sample were measured for 'resilience' (acceptance of self and life and individual competence, RS14 Resilience Scale), 'burnout' (emotional exhaustion EE, depersonalisation DP, personal accomplishment PA, Maslach Burnout Inventory) and organisational subscales (work-load, community, values, equity and control, Area of Work Life Scale (AWLS)). Pearson zero-order correlations showed that higher resilience was associated with lower EE and higher PA. Hierarchical linear regression analysis was used to identify unique demographic and work-specific predictors of resilience in addition to the AWLS subscales of control and values. The final model significantly accounted for 27 per cent of the variance in resilience scores, providing increased knowledge about resilience enhancing factors. As resilience is not an apolitical concept, the wider debates and politics of resilience are acknowledged. Specifically, contextual concerns are addressed that relate to the organisational factors that impact on social workers. The paper concludes by calling for organisational interventions to support resilience in social workers and maintain expertise in child-protection services. [ABSTRACT FROM AUTHOR]

This paper investigates the occurrence and nature of barriers to social inclusion in distinct geographical settings. Utilising a unique administrative dataset from Ireland's dominant social inclusion programme, this study examines how location impacts the occurrence of these barriersat a small-area level. Ireland's high growth rates have raised concerns about uneven effects, making it an interesting case study for 'left behind' places. The findings reveal that barriers associated with social inclusion, related to economic participation, are more prevalent in ' independent urban towns ' compared to both more urban and more rural areas, over and above area-level deprivation. This implies that existing policies, which traditionally employs a simplistic urban/rural dichotomy, lacks effective targeting, and would benefit from adopting a more precise spatial perspective. [ABSTRACT FROM AUTHOR]

This paper presents a novel system of annual Population Estimates Compiled from Administrative Data Only (PECADO) for Ireland in the absence of a Central Population Register. The system is entirely based on data originated from administrative sources, so that population estimates can be produced even without purposely designed coverage surveys or a periodic census to recalibrate estimates. It requires several extensions to the traditional Dual System Estimation (DSE) methodology, including a restatement of the underlying assumptions, a trimmed DSE method for dealing with erroneous enumerations in the administrative register, and a test for heterogeneous capture probabilities to facilitate the choice of blocking in applications. The PECADO estimates for years 2011–2016 are compared to the Census counts in 2011 and 2016. We demonstrate how the system can be used to investigate the Census 2016 under-count in Ireland, in place of the traditional approach of deploying additional population coverage surveys. [ABSTRACT FROM AUTHOR]

This paper discusses the development of a Lean Six Sigma (LSS) postgraduate education programme that has enabled the delivery of over 90 quality improvement projects led by its graduates across 50 healthcare organizations in Ireland. A key success factor in embedding and sustaining LSS in these organizations was the accreditation by a major, national, research-intensive university of the LSS education programme from which the students graduated. To ensure the programme's approval by the university it was necessary to contextualize LSS within established conceptual frameworks. This helped counter misconceptions that what was proposed was technical training in tools and techniques to provide quick fixes for routine healthcare process issues. Two related conceptual frameworks were selected to frame the curriculum: Senge's Fifth Discipline and Deming's System of Profound Knowledge. This paper focuses on how a central element of both frameworks, systems thinking or appreciation for a system, was enacted in the curriculum using Oshry's work on system blindness. Showing how systems thinking was conceptualized in the curriculum established the legitimacy and credibility of the programme within academia. This led to the approval of the first university-accredited graduate programme in LSS for healthcare in Ireland. [ABSTRACT FROM AUTHOR]

This policy review deals with the current context for community development practice in the Republic of Ireland. It details social partnership as the new model of governance, which requires broad societal participation in decision‐making, and it reflects on some of the practical operational problems encountered with the partnership approach. The White Paper, ‘A Framework for Supporting Voluntary Activity and for Developing the Relationship between the State and the Community and Voluntary Sector’, that was published in 2000 is considered with respect to the objectives of community development agencies. [ABSTRACT FROM PUBLISHER]

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]

This paper discusses the results of a two-year research project on the sources of success in regional clusters of entrepreneurship and innovation like Silicon Valley. Our project has studied a number of locations, most of which have shown spectacular rates of growth of information and communications technology-related activities during the 1990s. Our case studies comprise some emerging regions, notably in Ireland, India, Israel and Taiwan, along with more advanced areas like Northern Virginia in the US, Cambridge, UK, the Scandinavian countries and the Silicon Valley 40 years ago by way of the memory of one of its 'father founders', Gordon Moore. Through visits, interviews and other materials, we uncovered some regularities about the determinants of success of these entrepreneurial-led models of economic growth. We find that the economic factors that give rise to the start of a cluster can be very different from those that keep it going. Agglomeration economies, external effects and 'social increasing returns' of any sort arise almost naturally after a cluster has taken off But the most difficult and risky part is to get the new clusters started. At that stage, 'old economy' factors like firm-building capabilities, managerial skills, a substantial supply of skilled labor and connection to markets were crucial for the take off of these 'new economy' clusters (including Silicon Valley 40 years ago). [ABSTRACT FROM AUTHOR]

Background: Patients and family members make complaints about their hospital care in order to express their dissatisfaction with the care received and prompt quality improvement. Increasingly, it is being understood that these complaints could serve as important data on how to improve care if analysed using a standardized tool. The use of the Healthcare Complaints Analysis Tool (HCAT) for this purpose has emerged internationally for quality and safety improvement. Previous work has identified hot spots (areas in care where harm occurs frequently) and blind spots (areas in care that are difficult for staff members to observe) from complaints analysis. This study aimed to (i) apply the HCAT to a sample of complaints about hospital care in the Republic of Ireland (RoI) to identify hot spots and blind spots in care and (ii) compare the findings of this analysis to a previously published study on hospital complaints in the UK.Methods: A sample of complaints was taken from 16 hospitals in the RoI in Quarter 4 of 2019 (n = 641). These complaints were coded using the HCAT to classify complaints by domain, category, severity, stage of care and harm. Chi-squared tests were used to identify hot spots, and logistic regression was used to identify blind spots. The findings of this study were compared to a previously published UK study that used HCAT to identify hot spots and blind spots.Results: Hot spots were identified in Irish hospital complaints while patients were receiving care on the ward, during initial examination and diagnosis, and while they were undergoing operations or procedures. This aligned with hot spots identified in the UK study. Blind spots were found for systemic problems, where patients experience multiple issues across their care.Conclusions: Hot spots and blind spots for patient harm can be identified in hospital care using the HCAT analysis. These in turn could be used to inform improvement interventions, and direct stakeholders to areas that require urgent attention. This study also highlights the promise of the HCAT for use across different healthcare systems, with similar results emerging from the RoI and the UK. [ABSTRACT FROM AUTHOR]

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

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

The author provides a brief clarification of his original article which was mis-anticipated by Paul Michael Garrett. He explores the insights which whiteness studies, potentially offer into the ways that race operates outside situations that are seen as characteristic difference along with consideration of number of problems related to whiteness including a tendency to reproduce a black/white binary opposition, simplistic accounts of the processes through which racialisation occurs and a limiting focus on racism as an aspect of internal values. Further justification of his criticism by Garrett icluding small number of texts regarding whiteness in social work education, warrants more detailling consideration and unexploration of class is also presented.

This paper reports on a qualitative study of outcomes for permanence and stability for children in long-term care in Ireland. The aim of this research was to inform social work practitioners on how to enhance stability and permanence for children and to inform decision making and report writing for children in care. The research was designed and delivered in partnership with social work practitioners in the relevant areas. Drawing from the significant literature on this area the main factors impacting on permanence and stability are summarised and presented in terms of intrinsic and extrinsic factors. Biographical narrative interviews were conducted with twenty-seven participants (children and young people, parents and foster parents). This paper reports how, amongst a complex array of findings, three themes most linked to affect permanence and stability were found to be Relationships, Communication and Social Support. Underpinning these, the importance of Continuity was significant. Based on these findings, recommendations and practice guidance for social workers were developed in partnership with the Irish statutory Child and Family Agency and are summarised in the Conclusion. [ABSTRACT FROM AUTHOR]

This paper considers the relationship between the economic concept of time preference and relevant concepts from psychology and biology. Using novel data from a time diary study conducted in Ireland that combined detailed psychometric testing with medical testing and real-time bio-tracking, we examine the extent to which individual differences in financial discounting are related to underlying biological and psychological differences. The paper finds that financial discounting is related to a range of psychological variables including consideration of future consequences, self-control, conscientiousness, extraversion, and experiential avoidance, as well as being predicted by heart rate variability and blood pressure. [ABSTRACT FROM AUTHOR]

Limited attention has been paid to the realization of the right to interpretation in the police station. What has been done often focuses on the police or the interpreter experience. We seek to address this lacuna by focusing on the extent to which the right to interpretation is realized in Ireland. We start by outlining the nature of the right at international and European levels, and exploring the reasons why the right is so important. We consider how this has been implemented in Ireland, and note how even on paper there are significant, fundamental concerns as to how the effectiveness of the right is achieved. We then present findings from semi-structured interviews with over 40 criminal defence solicitors in Ireland, with experience of attending police interviews. The findings show that solicitors have concerns about the process of securing interpreters, the quality of the work, their independence, their understanding of their role, the overall impact on the process and the urgent need for training. It is abundantly clear that the right cannot be effectively realized under the current system in Ireland, despite the Directive on Interpretation being in effect there. Further, we note that solicitors are often uncertain and unclear on the extent of the right and what they can ask for. This means that those who are defending the rights of the detainee are unlikely to challenge breaches as they occur. The right to interpretation is clearly deeply neglected and ineffective in Ireland. [ABSTRACT FROM AUTHOR]

Large-scale reform of statutory child protective services in the Republic of Ireland is underway, prompted by adoption of the national strengths-based and safety-organised practice approach, known as 'Signs of Safety' (SoS). Despite the radical change it impels, critical commentary from the academy on the conventions of SoS remains conspicuous by its absence. One reading of the ecological systems approach is that to appreciate implications of SoS for children and families at risk, we must surpass a sequestered concern with child protection and welfare alone. To substantiate this, and embed a reconceived Signs of Safety, human scale development theory is critically deployed through an augmented, rather than exclusive focus, on the axis of protection needs within the typology of fundamental human needs. To aid this, critical application of theory is partially reworked and appropriated through a life course perspective, to better account for lifespan positioning. Overall, the sustaining proposition of the paper is that academic interrogation of SoS is both a practical and ethical imperative, and a necessary complement to large-scale organisational change underway. [ABSTRACT FROM AUTHOR]

Established towards the end of the Great War, the Irish Recruiting Council was responsible for one of the largest military recruitment campaigns ever waged on Irish soil. Tasked with raising 50,000 volunteers, it produced a wide array of promotional material which included posters, newspaper advertisements and a fortnightly magazine entitled The Irish Soldier. Its work has attracted a measure of scholarly attention, but little is known about its origins, its dealings with authorities in Westminster and Dublin Castle, and the operational difficulties it encountered when attempting to mobilise the public. Even less is known about its newspaper campaign and the reasons behind the continuation of the body in peacetime, when the need for recruits had apparently subsided. This paper addresses these shortcomings by examining the IRC in more detail than has hitherto been achieved in the historiography. In so doing, it calls for a revision of existing understandings of the Council, suggesting that it was not just a recruiting body per se , but a major propaganda agency which portrayed enlistment as a means of uniting a divided country and encouraged Irishmen to mobilise to help resolve long-standing tensions between nationalists and unionists. [ABSTRACT FROM AUTHOR]

This article constitutes the first large-scale examination of the Cork anti-Methodist riots of 1749–50. Methodist hagiographers have described the rioters as disengaged foot soldiers for Cork's corporation and Anglican clergy. By exploring these disturbances in their religious, political and social context, this paper suggests that the predominantly Catholic rioters were fuelled by their own politico-theological grievances, thereby illuminating the persistence of religious violence in eighteenth-century Ireland. Furthermore, by exploring tensions between Cork Methodists and Baptists, it highlights both the ways in which Methodists sometimes fuelled opposition and the fact that they were not always the sole victims of anti-Methodist violence. [ABSTRACT FROM AUTHOR]

Invertebrate forest pests and pathogens can cause considerable economic losses and modern patterns of trade have facilitated the international movement of pest species on an unprecedented level. This upsurge in trade has increased the pathways available to high risk species, facilitating entry and potential establishment in nations where they were previously absent. To support policy and pest prioritization, pest risk analyses are conducted to decide 'if' and 'how' pests should be regulated in order to prevent entry or establishment; however, they cannot be carried out for every potential pest. This paper utilizes a hierarchical clustering (HC) approach to analyse distribution data for pests of Sitka spruce (Picea sitchensis (Bong.) Carr.) in order to identify species of high risk to Ireland, as well as potential source regions of these pests. The presence and absence of almost a 1000 pests across 386 regions globally are clustered based on their similarity of pest assemblages, to provide an objective examination of the highest risk pests to Irish forestry. Regional clusters were produced for each taxon analysed including the Coleoptera, Diptera, Hemiptera, Hymenoptera, Nematoda, Lepidoptera and the Fungi. The results produced by the HC analysis were interpreted with regard to biological realism and climate. Biologically meaningful clusters were produced for each of the groups, except for the Diptera and Nematoda, and each of the species analysed were ranked within their group by a quantitative risk index specific to the island of Ireland. The impact of uncertainty in the distribution data is also examined, in order to assess its influence over the final groupings produced. The outputs from this analysis suggest that the highest risk pests for Ireland's Sitka spruce plantations will originate from within Europe. Ultimately, Ireland could benefit from seeking regulation for some of the higher ranking pests identified in this analysis. This analysis provides the first of its type for Sitka spruce, as well as its application in Ireland. It also serves to highlight the potential utility of HC as a 'first approach' to assessing the risk posed by alien species to hitherto novel regions. [ABSTRACT FROM AUTHOR]

Barrett's esophagus (BE) is the main pathological precursor of esophageal adenocarcinoma (EAC). Progression to high-grade dysplasia (HGD) or EAC from nondysplastic BE (NDBE), low-grade dysplasia (LGD) and indefinite for dysplasia (IND) varies widely between population-based studies and specialized centers for many reasons, principally the rigor of the biopsy protocol and the accuracy of pathologic definition. In the Republic of Ireland, a multicenter prospective registry and bioresource (RIBBON) was established in 2011 involving six academic medical centers, and this paper represents the first report from this network. A detailed clinical, endoscopic and pathologic database registered 3,557 patients. BE was defined strictly by both endoscopic evidence of Barrett's epithelium and the presence of specialized intestinal metaplasia (SIM). A prospective web-based database was used to gather information with initial and follow-up data abstracted by a data manager at each site. A total of 2,244 patients, 1,925 with no dysplasia, were included with complete follow-up. The median age at diagnosis was 60.5 with a 2.1:1 male to female ratio and a median follow-up time of 2.7 years (IQR 1.19–4.04), and 6609.25 person years. In this time period, 125 (5.57%) progressed to HGD/EAC, with 74 (3.3%) after 1 year of follow-up and 38 (1.69%) developed EAC, with 20 (0.89%) beyond 1 year. The overall incidence of HGD/EAC was 1.89% per year; 1.16% if the first year is excluded. The risk of progression to EAC alone overall was 0.57% per year, 0.31% excluding the first year, and 0.21% in the 1,925 patients who had SIM alone at diagnosis. Low-grade dysplasia (LGD) progressed to HGD/EAC in 31% of patients, a progression rate of 12.96% per year, 6.71% with the first year excluded. In a national collaboration of academic centers in Ireland, the progression rate for NDBE was similar to recent population studies. Almost one in two who progressed was evident within 1 year. Crucially, LGD diagnosed and confirmed by specialist gastrointestinal pathologists represents truly high-risk disease, highlighting the importance of expertise in diagnosis and management, and providing indirect support for ablative therapies in this context. [ABSTRACT FROM AUTHOR]

Using microsimulation tools, we explore the social policy responses to the Great Recession and the COVID-19 crisis, and their impact on preserving living standards in Ireland. During the Great Recession, the focus was on cost reduction. By contrast, during the COVID-19 crisis, the focus was on mitigating the impact on household incomes. In addition, an innovation in joint public and private responses emerged through social partnership. We find a stronger policy response during the COVID-19 crisis than the Great Recession. The COVID-19 crisis was more rapid, leaving more individuals out of work, thus family support was weaker. This was compensated by stronger private support through social partnership. Consequently, those with lower incomes had larger disposable incomes at the onset of the crisis; an effect that reduced with policy learning. We find increasing trust in public institutions during the COVID-19 crisis as opposed to a decline during the Great Recession. [ABSTRACT FROM AUTHOR]

Background Preventing transmission of COVID-19 within prisons is both important and challenging. The confined conditions in prisons can encourage person-to-person spread with the potential for outbreaks occurring. Contact tracing is an important contributor to the longer-term management strategy for COVID-19 in prisons as well as in the community but is highly resource-intensive. This paper describes the approach to contact tracing taken by the Irish Prison Service (IPS). Methods The IPS National Infection Control Team, in collaboration with the National Quality Improvement (QI) team and Health Service Executive (HSE) in Ireland, implemented a programme to develop and train in-prison contact tracing teams (CTTs). CTTs were run by prison staff with experience of working with detainees, prison IT systems and CCTV. Protocols for undertaking contact tracing for both detainee and staff cases of COVID-19 were established. Results All prisons, and two support agencies, within the IPS now have fully functional in-prison CTTs. Every CTT has responded to at least one case COVID-19, undertaken contact tracing and instigated quarantine of contacts. Conclusions A partnership approach with development of prison-led CTTs can provide an effective mechanism for contact tracing of COVID-19 cases within the prison setting. [ABSTRACT FROM AUTHOR]

Objective To estimate the budget impact from the perspective of the Irish health-care system attributable to a reconfiguration in the diagnostic care pathway for patients with suspected RA by adopting an early identification and referral model (EIM). Methods The budget impact model evaluated the total health-care use and costs attributable to an EIM to diagnose patients with suspected RA relative to the reference scenario of current practice. The modelling also assessed a primary outcome of effect, which examined how many patients can be diagnosed by a rheumatologist within 3 months of symptom onset. The budget impact analysis model was estimated over a 5-year time frame. Results The EIM generated a cost saving for the Irish health-care system of €237 547 over the time frame relative to current practice. The cost savings were realized owing to a reduction in the number of general practitioner (GP) visits of 18 790 and a reduction in diagnostic tests carried out by GPs. The results showed that 1027 (510%) more patients were diagnosed within 3 months of symptom onset in the EIM compared with current practice. Conclusion This paper has presented an alternative rheumatologist-led service design that can be used in diagnosing patients with suspected RA. The rheumatologist-led service provision detailed in this study has the potential simultaneously to reduce demand for primary care services and to improve the health outcomes of patients. The use of an EIM sees rheumatologist activity incorporate patient demand. [ABSTRACT FROM AUTHOR]

Consumer trust in the modern food system is essential given its complexity. Contexts vary across countries with regard to food incidents, regulation and systems. It is therefore of interest to compare how key actors in different countries might approach (re)building consumer trust in the food system; and particularly relevant to understanding how food systems in different regions might learn from one another. The purpose of this paper is to explore differences between strategies for (re)building trust in food systems, as identified in two separate empirical studies, one conducted in Australia, New Zealand and the UK (Study 1) and another on the Island of Ireland (Study 2). Interviews were conducted with media, food industry and food regulatory actors across the two studies (n  = 105 Study 1; n  = 50 Study 2). Data were coded into strategy statements, strategies describing actions to (re)build consumer trust. Strategy statements were compared between Studies 1 and 2 and similarities and differences were noted. The strategy statements identified in Study 1 to (re)build consumer trust in the food system were shown to be applicable in Study 2, however, there were notable differences in the contextual factors that shaped the means by which strategies were implemented. As such, the transfer of such approaches across regions is not an appropriate means to addressing breaches in consumer trust. Notwithstanding, our data suggest that there is still capacity to learn between countries when considering strategies for (re)building trust in the food system but caution must be exercised in the transfer of approaches. [ABSTRACT FROM AUTHOR]

This paper considers structural change in post-Famine Ireland through an examination of changes in the allocation of the labour force across three broad production sectors: primary, secondary and tertiary. To do so, it makes extensive use of the Irish Census of Population from 1821 to 1911 as a source of occupational information. While there are a number of concerns with these returns, outlined and explored here, the Irish census remains the most complete source of information available on male and female labour force activity and occupations in Ireland during this period. The outcome of this exercise is a picture of Irish primary, secondary and tertiary sector employment during the latter half of the nineteenth century that is consistent with that of an economy undergoing a development transition: modernising albeit slowly. While Ireland was the poorest region of the UK economy, it was one of the richer European economies in terms of GDP per head and undergoing a development transition similar to a number of European economies during this period. [ABSTRACT FROM AUTHOR]

Examines the history of the tory and liberal Irish nationalists relevant to the politics of patronage in Ireland during the period 1880 to 1914. Practice of the parliamentary representatives in Ireland; Use of their political influence to secure low-level public sector jobs for constituents in return for electoral advantage; Indications of political history and practice.

Comparative welfare state research has developed an interest in the role of the family in welfare regimes and in agrarian social classes as influences on the formation of welfare states. This paper seeks to bring together and extend these perspectives by exploring the role of state support for family‐based economic production, especially family farming, in the evolution of welfare regimes. Family employment is a de‐commodified alternative to wage labour. As such, it received extensive support in many of today's advanced welfare states at various points over the past century, giving rise to a form of social protection which differed from that offered by welfare provisions in the usual sense. The paper illustrates this contention by reference to Ireland from around 1870 until the Second World War, where massive state intervention in social and economic life designed to promote small‐scale family farming was a core element of ‘social policy’ broadly defined. The paper also points to other emerging welfare states where broadly similar processes could be found. Though the details and outcomes of those processes varied widely, they point to ways in which both the familial and agrarian dimensions of social policy have a greater significance in welfare regimes than has yet been adequately recognized. [ABSTRACT FROM PUBLISHER]

Context/problem: Comparative analysis of relative and absolute mortality differentials between socioeconomic groups are now available. These show consistently increasing relative increases in mortality differentials but complex trends in absolute mortality differentials. Objective: This paper provides an analysis of relative and absolute trends in mortality by cause of death and socioeconomic group (SEG) from 1984 to 2008 among men and active women aged 30-64 years in Ireland and compares these results with recent European and US studies to give an overview of trends. Methods: This paper uses mortality data from the Irish Central Statistics Office from 1984 to 2008 to calculate standardized death rates by age, sex, socioeconomic status and cause of death showing trends in SEG inequalities in mortality in Ireland. These show which specific causes of death are driving all-cause mortality trends. Results: SEG differentials in all-cause mortality among men and women have been increasing since the 1980s. Some of this increase reflects larger falls in cardiovascular causes among advantaged groups, but the trend is largely accounted for by increasing inequalities in mortality in digestive, neoplasm and external causes of deaths. Conclusions: These findings are in line with international findings that show that socioeconomic differentials in digestive, neoplasm and external cause deaths are driving general socioeconomic differentials in all-cause mortality. External cause deaths may have been influenced by levels of economic activity, particularly in construction, during the economic boom among manual workers. Furthermore, deaths from digestive diseases during the 1990s and 2000s may well be the result of increases in liver disease associated with excessive alcohol consumption. [ABSTRACT FROM AUTHOR]

Background Aimed to compare the prevalence, characteristics, and associated mortality risk of frailty in Northern Ireland (NI) and the Republic of Ireland (ROI). Methods Secondary analysis of the first wave of two nationally representative cohorts, the Northern Ireland Cohort for the Longitudinal Study of Ageing or NICOLA study (N  = 8504) and the Irish Longitudinal Study on Ageing or TILDA study (N  = 8504). Frailty was assessed using a harmonized accumulation deficits frailty index (FI) containing 30 items. FI scores classified individuals as non-frail (<0.10), pre-frail (0.10–0.24) and frail (≥0.25). Linkage to respective administrative data sources provided mortality information with a follow-up time of 8 years. Results The prevalence of frailty was considerably higher in NI compared with the ROI (29.0% compared with 15.0%), though pre-frailty was slightly lower (35.8% and 37.3%, respectively). Age, female sex, and lower socio-economic status were consistently associated with a higher likelihood of both pre-frailty and frailty. In the pooled analysis, both frailty and pre-frailty were higher in NI (RR = 2.68, 95% CIs 2.45, 2.94 and RR = 1.30, 95% CIs 1.21, 1.40, respectively). Frailty was associated with an increased mortality risk in both cohorts, even after full adjustment for all other characteristics, being marginally higher in TILDA than in NICOLA (HR = 2.43, 95% CIs 2.03, 2.91 vs. HR = 2.31, 95% CIs 1.90, 2.79). Conclusions Frailty is a major public health concern for both jurisdictions. Further research and monitoring are required to elucidate why there is a higher prevalence in NI and to identify factors in early life that may be driving these differences. [ABSTRACT FROM AUTHOR]

Background Pendlebury and Rothwell's recent paper reports the incidence of cognitive impairment and dementia post stroke as 5% for TIA, 8% for minor stroke and 34% for severe stroke. 1We wanted to explore if these trends were reproducible in an Irish cohort. Methods We conducted a retrospective review of a random sample of 100 discharges from a dedicated stroke rehabilitation unit between 2017 and 2018. Diagnosis of cognitive impairment or dementia was extracted from MDT discharge documentation, along with results of cognitive assessments. This cohort required inpatient rehabilitation post stroke, so we can infer that these were severe strokes. As a surrogate marker of disability, the average Barthel Index of this sample on admission to rehabilitation was 13, indicating moderate functional dependency. Results Complete information was available for 94/100 patients. The average age was 67 years (age range 33-95 years) 37 of 94 (39%) were judged to have cognitive impairment on discharge. Demonstration of functional impairment was central to this assessment. 30 (81%) of these diagnoses were supported by abnormal cognitive tests. 3 of those judged to have cognitive impairment, were unable to complete cognitive assessment. 2 of those judged to have cognitive impairment had cognitive scores which were within the normal range. None of the discharge letters mentioned a diagnosis of post stroke or vascular dementia. Conclusion This study replicates Pendlebury and Rothwell's findings that over a third of people suffering from severe strokes will develop cognitive impairment. This is of critical importance to stroke clinicians as it should prompt frank discussions with stroke patients and their families about prognosis, recovery and future planning. [ABSTRACT FROM AUTHOR]

Background Frailty is a common, multi-factorial, age-related syndrome commonly observed in people with diabetes. Although older diabetics are prone to adverse healthcare outcomes and diabetes increases the risk of developing frailty, little is known about the effects of frailty on diabetes. This paper examines the association between diabetes, frailty, and mortality in Europeans aged ≥50 years. Methods Data were included from The Survey of Health, Ageing and Retirement in Europe (SHARE) waves one and six. A participant's first interview was taken as the baseline and subsequent waves were used for mortality follow-up (time and cause). Frailty and pre-frailty were measured using established cut-offs using the Physical Phenotype (SHARE-FI) and a 55-item Frailty Index (FI-55). Kaplan-Meier survival analysis was used to assess the relationship between frailty and mortality in people with diabetes and significance tested using log-rank test. Cox regression was used to adjust for potential confounders (age, sex, education, income, employment, alcohol use, smoking, hypertension, hypercholesterolaemia, myocardial infarction, stroke, metastatic cancer, chronic lung disease, polypharmacy, self-perceived health and depression). Results Data from 8,954 diabetics aged 50-99 years were included with 1,598 deaths (17.8%). According to the SHARE-FI, 1,971 (22.0%) were frail, 4,183 (46.7%) pre-frail and 2,800 (31.3%) robust. According to the Kaplan-Meier log-rank test survival varied significantly across frailty strata according to both indexes (p<0.001). At 10-year follow-up, adjusting for confounders SHARE-FI frailty and pre-frailty were significantly associated with mortality, adjusted Hazard Ratio (HR) 2.19, (95% CI:1.66-2.89), and 1.38 (95% CI:1.09-1.74), respectively. Results were similar using the FI-55, HR for frailty 1.66 (95% CI:1.09-2.54). Causes of mortality were significantly different according to frailty status (p<0.05). Conclusion Frailty and pre-frailty are independent risk factors for mortality in diabetics. The identification of frailty is important for the risk-stratification and management of middle aged and older patients with diabetes and should be included in the routine assessment of these high-risk individuals. [ABSTRACT FROM AUTHOR]

Background Frailty is an important marker of adverse outcomes for older people accessing the Emergency Department (ED). Older patients with frailty have a higher attendance rate to the ED, spend longer in the ED and have a higher rate of admission (HSE, 2017). Frailty Intervention Therapy Teams (FITT) are designed to screen and assess this population in the ED setting, with the aim of early assessment to help decrease length of stay or avoid admission. Two different FIT Teams have recently been formed within the Cork-Kerry region. The aim of this study was to evaluate staff's experience of these teams. Methods This was a mixed methods study. Structured surveys were developed to collect qualitative and quantitative data. The surveys were constructed using themes listed by Proctor et al. (2011) around implementation and service outcomes. Ward and ED staff were provided with paper surveys within the hospital setting and community staff were surveyed via post. Quantitative survey data was analysed using descriptive statistics and qualitative data was analysed with thematic content analysis. Results Data from 117 surveys was included for analysis (response rate 49%). Results showed that the majority of staff (89%) reported ED was a suitable setting for the FITT, with 85% reporting the information collected by the FITT impacted their involvement. Other themes emerging from staff's experience included timeliness, safety and comprehensive assessment. Conclusion Overall, staff reported the FITT provided a timely service that assisted with decision making and planning. This involved earlier comprehensive assessment, prompt identification of issues which lead to decreased workload for ward staff. It also created an increased volume of referrals to community and ward staff received in a timelier manner. [ABSTRACT FROM AUTHOR]

Background Wearable technology is a fast developing area. Often, the focus of research is on accuracy, while the practicalities of using the device may be overlooked, despite the fact that this greatly influences utility. This scoping review therefore explored the design and usability preferences of people for wearable technology for health monitoring. Methods A scoping review was conducted of literature evaluating user preferences for the design of wearable technology systems, for people aged >50 years, with good health, or chronic diseases. Results A search of relevant databases yielded 628 potential studies (after duplicates removed). Following title/abstract and then full text screening, 17 papers were included. The most commonly reported theme related to design and user interface (13 studies). Users wanted a small, unobtrusive and light device which doesn't snag on clothing or affect activities of daily living, but yet has a readable and easy-to-use interface, which may prove challenging for designers! Users were most happy to wear a device on the wrist and/or hip region, being considered the least obtrusive / most discrete. Users were open to the technology aspects of the device, but wanted specific training, or clear and readable instructions. Less commonly reported parameters included issues with privacy and ownership of data (two studies); cost (two studies); reliability and accuracy (three studies), including being accurate overnight and in the shower, etc.; and clinical usefulness, i.e. the data being effectively linked with other healthcare data. Where considered, participants didn't want to wear a device by night (two studies). Safety of wearable devices was not a theme in any study. Conclusion Overall, user needs seem to be rarely considered in the design of wearable technology for health monitoring. However, the limited studies do highlight important user concerns, which should be considered by the technology designers and prescribers. [ABSTRACT FROM AUTHOR]

Background There is an increasing number of older persons experiencing transfer episodes between residential and acute care facilities (Griffiths et al. 2014). Current transfer documentation is diverse; often only containing basic information and very little person centred patient information. The objective of this HSE National Clinical Programme for Older People funded study was to develop a national person centred transfer tool, for use during patient transfer between residential and acute services. Following an extensive literature review, focus group interviews with stakeholders and input from an expert panel, a pilot transfer document was developed. This paper reports on the pilot study of this document. Methods Researchers, in consultation with the expert panel, developed questionnaires. Questionnaires were quantitative, with three open-ended questions. Of the 28 residential settings and 3 acute settings that were contacted, 26 residential and 3 acute settings (93%) participated in the study. The pre-pilot questionnaire asked staff in residential settings their perceptions on current transfer documentation (n=875). The post-pilot questionnaire asked staff in residential and acute care settings their thoughts on the new transfer document which was used for the pilot (n=1085). Results Findings suggest that staff agree that the new transfer tool is person centred, contains relevant patient information and could help communication between healthcare professionals in these settings. Findings also indicate that the length of time to complete the document is of concern, particularly in an emergency and there were suggestions from staff in residential care services that some sections could be prepopulated. Conclusion In order to have a transfer document that is efficient, and person centred, there is a need for it to be available electronically and easy for staff to fully complete particularly in an emergency transfer. [ABSTRACT FROM AUTHOR]

Background Day care is an important service for some people with dementia and their carers. In Ireland, day care services for people with dementia are delivered by a mix of dementia specific day-care centres and generic centres that cater for people with dementia to various degrees. In this paper we map the geographic variation in the supply of day care services for people with dementia relative to potential need. Methods Using a national HSE survey of day care centres, we estimate the current supply of day care services for people with dementia in both generic and dementia specific centres by combining a number of qualitative and quantitative measures. To identify the variation in supply, we map day care provision at local and regional levels to the number of people with dementia in the area. To consider geographic accessibility, we map and analyse the population living outside the catchment area of the day care centres. Results There is significant variation across the country in the existing capacity of day care centres to cater for people with dementia. The number of places per 100 persons with dementia varies from 9 to 16 across the Community Health Organisation areas. We show that 20 per cent of people with dementia are not living within a 15km radius of a day care centre that caters for people with dementia. Conclusion Day care has a place in the menu of service for people with dementia living in the community. As the number of people with dementia grows, investment in day care centres needs to be targeted to areas of greatest need. In many parts of the country, the current day care centres have limited capacity to provide a service for people with dementia that live in their catchment area. There is considerable geographical inequity in day care provision for people with dementia across the country. [ABSTRACT FROM AUTHOR]

Background Developed by Blackhall et al. (2011), the Validation, Emotion, Reassure, Activity (VERA) communication framework seeks to provide student nurses with a guide to provide person-centred care to people living with dementia. The framework aims to enable the caregiver to communicate with the person living with dementia in a respectful manner, and accept that there is both value and meaning to the person's speech and behaviour. This paper presents the findings from a small pilot control pre-post study which aimed to explore the impact of the VERA framework to promote person-centred communication between student nurses and older people with dementia in long term care. Methods A control group of six students, received standard communication training and ten students received additional communication training using the VERA framework. Data was collected using the non-participant observational tool Quality of Interactions Schedule (QUIS) and three self-assessment questionnaires to assess student nurses' confidence, dementia knowledge and communication skills. Results The results of this study found that those students who received the additional VERA communication training were observed to have a significantly (Mann-Whitney U test; p = <0.05) reduced number of negative interactions with people with dementia than those students who had received standard communication training alone. In addition, student nurses trained in the VERA framework showed a significant increase (Mann-Whitney U test; p = <0.05) in their confidence to care for people with dementia than those who had received standard communication skills training. Conclusion The study finding need to be interpreted with caution given the small sample size and the pilot nature of the study. Nevertheless, these findings indicate that the VERA framework has the potential to improve (1) person-centred communication between student nurses and older people with dementia and (2) students' confidence to care for people with dementia. [ABSTRACT FROM AUTHOR]

Background The continuing evolution of adult safeguarding legislation, policy and practice in relation to the abuse of vulnerable adults reflects a growing awareness of the nature and extent of such abuse in Ireland. The Adult Safeguarding Bill, 2017 represents a progressive step in safeguarding older people and vulnerable adults. The intention of the Bill is to put in place additional protections for adults, in particular, for those who may be unable to protect themselves, such as older people or those lacking capacity. Part 3 provides for mandatory reporting by specified/named persons/professionals. This paper sets out to critically analyse the concept of mandatory reporting within adult safeguarding using international comparators as case studies. Methods A rapid realist review of adult safeguarding reporting typologies and systems in five key jurisdictions: Australia, Canada, England, Northern Ireland and Scotland, were explored to answer the question: ' what works, for whom and in what circumstances ?' [1] Results Jurisdictions differ as to who the mandated reporters are, the scope and powers of mandatory reporting, and the types of abuse subject to reporting. Of significance is that the debate on mandatory reporting has increasingly focused on institutional settings, rather than more broadly across services. Key concepts identified are those of protection, empowerment and proportionality. Adult safeguarding legislation must therefore ensure that interventionist and compulsory measures to protect do not excessively restrict the rights of the individual. Conclusion Mandatory reporting may offer professionals increased powers to prevent and reduce the abuse of adults and older people, but this could also change the dynamic of relationships within families, and between families and professionals. Ultimately, the success of any legal approach will rest with professional judgment in balancing autonomy with protection. [ABSTRACT FROM AUTHOR]

Background Family carers provide thousands of hours of unpaid work every year, a third of whom are men, however this group are generally under-represented in research. Comparative studies have shown that male carers experience their caring role differently to female counterparts. Social concepts related to masculinity can help to explain help-seeking behaviours of male carers, as well as their attitudes to accessing outside support. Compared to women carers, men have lower rates of uptake of formal support services. This aim of this review, therefore, was to examine accounts of male carers' experiences and perceptions of receiving formal support. Methods The study followed a meta-ethnography process starting with a systematic literature search of five electronic databases. The methodological quality of the included studies was evaluated using the McMaster checklist. Using NVivo 12 software, primary qualitative data was analysed and key themes were identified. Results were synthesised using Noblit and Hare's (1988) process of meta-ethnography, retaining direct quotes from the studies. Results Eighteen studies were included in the final paper. Three main themes were identified: 1) asserting control over the caring role 2) desire to excel in caring role and 3) coping without formal support. Conclusion For the most part, male carers expressed a desire to be competent in their caring role. Perceived loss of control within the caring relationship was a key factor when men had low trust and dissatisfaction with services. Support services that were collaborative, education-based and gender-sensitive were favoured by the men. To engage more male carers, service providers should acknowledge men's experience and capabilities as well as their wish to stay involved in decision-making around care for their family member. For men over the age of 85 male family carers outnumber females in Ireland (CSO 2016). It is important to understand male carers' experience to develop more inclusive supports and consequently increase service uptake. [ABSTRACT FROM AUTHOR]

Background 10% of people over 65 years have frailty, rising to between a quarter and a half of those over 85. Comprehensive Geriatric Assessment (CGA) is the gold standard for the management of frailty in older people; it's a process that involves a holistic, interdisciplinary assessment of the older person. Evidence shows that CGA is effective in improving outcomes for older people. The National Clinical Programme for the Older Person outlines the role of the occupational therapist in CGA. A clinical audit was completed to investigate whether the occupational therapists in the Medicine for the Older Person service are adhering to guidelines for CGA. Methods Following a literature review, a retrospective audit of occupational therapy (OT) initial assessments was completed using paper count method. Data pertinent to CGA OT assessment was collected. Audit results were presented to the OT team alongside a CGA education session. A re-audit was completed, using above methods. Results 10 inpatient initial assessment forms reviewed pre and post audit. Activities of Daily Living Assessment: Pre result: 60%  Post Result: 90% Home Environment: Pre: 80% Post: 100% Performance Components Assessment: Vision: Pre:  90%  Post: 100% Hearing: Pre: 80% Post: 100% Upper Limb: Pre: 70% Post: 100% Mood: Pre: 60% Post: 80% Cognition: Pre: 90% Post: 100% Sleep: Pre: 70% Post: 80% Social Assessment: Pre: 60% Post:90% Falls Assessment: Pre: 60% Post: 90% Drving: Pre: 60% Post: 90% Conclusion This audit identified that the occupational therapists in the medicine for the older person service were not CGA compliant. CGA training now forms an important part of our OT induction programme. We are now "playing our part" in CGA with improvements in all domains. CGA is now commonplace practice within our team, in line with international and national best practice guidance for management of frailty. [ABSTRACT FROM AUTHOR]

Background Currently, 1 in 10 people diagnosed with dementia in Ireland are aged under 65, this is termed "Younger Onset Dementia" (YOD). Though small in numbers these figures (4000 people) are increasing, and important differences exist between people diagnosed with (PwYOD) and those diagnosed with later onset dementia (LOD). As dementia is normally associated with advancing age, clinicians are not always on the alert for its diagnosis in younger people. Diagnosing YOD can be especially challenging since presentation may be atypical and there is a lack of clinical ownership in this area. Methods A structured literature review was conducted to identify optimum models of diagnostic processes and pathways for PwYOD. Two research questions were addressed: (i) what models for the diagnosis of PwYOD exist nationally and internationally, and what evidence supports these and (ii) what are the differences between diagnostic processes and pathways for PwYOD compared with PwLOD. A systematic search strategy was devised to identify all relevant scientific papers. Key databases were used, supplemented by grey literature searches. A narrative synthesis approach was undertaken to assess the literature identified. Results Pathways and processes to the diagnosis of YOD are unclear and complex and compared with LOD, diagnosis takes more time. PwYOD are more likely to have multiple referrals to different specialists, have their memory and cognitive complaints misattributed to other factors such as depression and experience longer delays in obtaining a diagnosis. Conclusion Few evidence-based best-practice models or guidelines for the diagnosis of YOD exist internationally. Increased awareness of the signs and symptoms of YOD among all healthcare professionals is necessary. There is a need for improved linkages to be developed between Geriatric Medicine, Neurology, Psychiatry, and Primary Care services and in certain instances for suspected cases of YOD to be referred to neurology-led memory clinics. [ABSTRACT FROM AUTHOR]