Search

‘Lovely Leitrim, where the Shannon waters flow’ is renowned for its scenic combination of waterways and uplands, for its rural borderland location, and for its small population. While it shares many challenges and opportunities with neighbouring western counties, some of its recent experiences are unique to the county and reflect its geographical location and its population decline, as well as efforts to address both issues. Attempts to drive economic growth in Leitrim have had a number of unintended outcomes for the county, as the following discussion will demonstrate. As the least populous county in Ireland, there are few Leitrim-dwellers who are not acutely aware of the vulnerable position in which this places them. While Leitrim might be a ‘hidden gem’, it could also be characterised as a forgotten county, which can struggle to have its voice heard on a national stage. This chapter explores some of the recent pressures facing Leitrim’s landscape and society, including housing oversupply, fracking and afforestation.

This chapter presents a concise overview of the evolution and development of Irish suburbia from the nineteenth century to the present. As well as charting the changing nature, form, function and meaning of the Irish suburb, the chapter also recognises key phases in its development that reflect social, political and economic change. It reveals that while the growth and development of Irish suburbia largely mirrors the American and British experience, Irish suburbia has its own particular character and unique cultures.

Background: \ud Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes.\ud \ud Methods: \ud In this multicentre, open-label, randomised controlled trial, we recruited women aged 18–40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy. Participants were pregnant (≤13 weeks and 6 days' gestation) or planning pregnancy from 31 hospitals in Canada, England, Scotland, Spain, Italy, Ireland, and the USA. We ran two trials in parallel for pregnant participants and for participants planning pregnancy. In both trials, participants were randomly assigned to either CGM in addition to capillary glucose monitoring or capillary glucose monitoring alone. Randomisation was stratified by insulin delivery (pump or injections) and baseline glycated haemoglobin (HbA1c). The primary outcome was change in HbA1c from randomisation to 34 weeks' gestation in pregnant women and to 24 weeks or conception in women planning pregnancy, and was assessed in all randomised participants with baseline assessments. Secondary outcomes included obstetric and neonatal health outcomes, assessed with all available data without imputation. This trial is registered with ClinicalTrials.gov, number NCT01788527.\ud \ud Findings: \ud Between March 25, 2013, and March 22, 2016, we randomly assigned 325 women (215 pregnant, 110 planning pregnancy) to capillary glucose monitoring with CGM (108 pregnant and 53 planning pregnancy) or without (107 pregnant and 57 planning pregnancy). We found a small difference in HbA1c in pregnant women using CGM (mean difference −0·19%; 95% CI −0·34 to −0·03; p=0·0207). Pregnant CGM users spent more time in target (68% vs 61%; p=0·0034) and less time hyperglycaemic (27% vs 32%; p=0·0279) than did pregnant control participants, with comparable severe hypoglycaemia episodes (18 CGM and 21 control) and time spent hypoglycaemic (3% vs 4%; p=0·10). Neonatal health outcomes were significantly improved, with lower incidence of large for gestational age (odds ratio 0·51, 95% CI 0·28 to 0·90; p=0·0210), fewer neonatal intensive care admissions lasting more than 24 h (0·48; 0·26 to 0·86; p=0·0157), fewer incidences of neonatal hypoglycaemia (0·45; 0·22 to 0·89; p=0·0250), and 1-day shorter length of hospital stay (p=0·0091). We found no apparent benefit of CGM in women planning pregnancy. Adverse events occurred in 51 (48%) of CGM participants and 43 (40%) of control participants in the pregnancy trial, and in 12 (27%) of CGM participants and 21 (37%) of control participants in the planning pregnancy trial. Serious adverse events occurred in 13 (6%) participants in the pregnancy trial (eight [7%] CGM, five [5%] control) and in three (3%) participants in the planning pregnancy trial (two [4%] CGM and one [2%] control). The most common adverse events were skin reactions occurring in 49 (48%) of 103 CGM participants and eight (8%) of 104 control participants during pregnancy and in 23 (44%) of 52 CGM participants and five (9%) of 57 control participants in the planning pregnancy trial. The most common serious adverse events were gastrointestinal (nausea and vomiting in four participants during pregnancy and three participants planning pregnancy).\ud \ud Interpretation: \ud Use of CGM during pregnancy in patients with type 1 diabetes is associated with improved neonatal outcomes, which are likely to be attributed to reduced exposure to maternal hyperglycaemia. CGM should be offered to all pregnant women with type 1 diabetes using intensive insulin therapy. This study is the first to indicate potential for improvements in non-glycaemic health outcomes from CGM use.\ud \ud Funding: \ud Juvenile Diabetes Research Foundation, Canadian Clinical Trials Network, and National Institute for Health Research.

Background Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. Methods/design A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (

The study of population is at the forefront of many different aspects of geography. Following an overview of the key demographic variables and their significance, this paper examines the role which an understanding of population plays in relation to the outcomes of humanitarian crises, particularly natural disasters. The concept of vulnerable populations is considered, with specific reference to gender differences and to the likely future impact of climate change.

Laurence O’Neill, described on the occasion of his election to a fifth successive term of office as a ‘popular, useful, independent and energetic Lord Mayor’, was the last person to hold the office under the British regime and the first to hold it under the Free State administration. His term, then, straddled a very turbulent period in Ireland’s political and social history. It began in the midst of the First World War and continued through the ‘troubles’ of the early 1920s, coming to an end – perhaps- with the abolition of Dublin Corporation in 1924. The word ‘perhaps’ is apposite, because O’Neill did not vacate the Mansion House until 1925 and as late as 1926 a court case failed to conclude that he was no longer lord mayor, with the judge suggesting that ‘probably’ he remained lord mayor. In any case, it was O’Neill who was the proposer, in 1930, of the next elected lord mayor of the city, that well-known and charismatic leader Alfie Byrne, discussed in the following chapter.

Cet article explore comment la collaboration entre les départements de géographie des universités peut renforcer les compétences pratiques, les compétences de reflection et les approches innovantes des futurs enseignants dans les domaines de l'interculturalisme, la mondialisation et le civisme, et également faciliter la déconstruction des stéréotypes négatifs à l'égard des personnes, des lieux, des paysages et des enjeux. Ceci a été facilité par un module de géographie américano-européen commun qui a eu lieu en 2012-13 entre la University of Northern Colorado (UNCO), et SPD-Dublin City University. Ils ont collaboré sur de cours basé sur Moodle pour les étudiants facilitées par le AAG (Association des géographes américains) - Centre for Global Geography Education. Le module d'identité nationale CGGE examine les caractéristiques géographiques de l'identité nationale et de l'interaction de la culture, la politique, et le lieu. Étudiants UNC et SPD-DCU ont été rejoints dans la dernière partie de ce projet pilote par les étudiants grecs de l'Université de la mer Egée. La méthodologie utilisée dans ce cours pilote est facilement transférable. Dans ce document, les points de vue des étudiants irlandais au module sont analysés. This paper explores how collaboration between Geography Departments in universities can enhance the practical competencies, skills and innovative approaches of future teachers in the areas of inter-culturalism, globalization, and good citizenship, and also facilitate the deconstruction of negative stereotyping in relation to people, places, landscapes and issues. This was facilitated by a shared US-European Geography module that took place in 2012-13 between the University of Northern Colorado, and SPD-Dublin City University. They collaborated on a Moodle-based course for students facilitated by the AAG’s (Association of American Geographers) Centre for Global Geography Education. The CGGE National Identity module examines geographic characteristics of national identity and interplay of culture, politics, and place. UNCO and SPD-DCU students were joined in the latter part of this pilot project by Greek students from the University of the Aegean. The methodology used in this pilot course is easily transferable. In this paper the viewpoints of the Irish students to the module are analysed.