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Background Ireland introduced comprehensive smoke-free workplace legislation in 2004. This study evaluates the economic impact of the workplace smoking ban on the value of sales in bars Methods Data on the value of bar sales were derived from a large, nationally representative, annual business-level survey from 1999 to 2007. The economic impact of the smoking ban was evaluated according to geographical region and bar size. Analysis was based on an econometric model which controlled for background changes in population income and wealth and for investments made by the bars during this period. Results The overall impact of the Irish smoking ban on bar sales appears to be very small. The ban was associated with an increase in sales among medium to large bars in the Border-Midland-West (more rural) region of Ireland, and a small reduction in sales among large bars in the more urban, South-East region. We failed to find any evidence of a change in bar sales in the remaining categories studied. Conclusions The results indicate that although some bars saw positive effects and some negative, the overall impact of the smoking ban on the value of sales in bars was negligible. These findings provide further supporting evidence that comprehensive smoke-free workplace legislation does not harm hospitality businesses while having positive health effects. [ABSTRACT FROM AUTHOR]

The adult-centric concept of 'age-appropriateness' is an arbitrary signifier and yet it commands a powerful common-sense appeal in governing the shape of sexuality education. The visibility of LGBTQ+ lives in primary schools is deeply impacted by the cis-heteronormative ways in which age-appropriateness is commonly understood and mobilised; very often resulting in silence and delay. The concept of age-appropriateness also becomes entangled with moral panics about 'promoting' LGBTQ+ lives, or children being somehow 'recruited' to identify as LGBTQ+. This paper draws on findings from a study with the parents of eleven trans and gender diverse children (then aged between 5 and 13) conducted in 2017, as well as a follow-up study conducted with seven participants from the same group of parents and children in 2022. The paper explores how the politics of age and agency intersect and become intensified as trans and gender diverse children and their parents navigate and make decisions about their bodies, lives and everyday worlds in primary schools. These stories of trans and gender diverse children provide an arresting invitation to adults to attend closely to the rich stories of children themselves in (re)considering the potential of sexuality education across contexts. [ABSTRACT FROM AUTHOR]

Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [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]

Accessible Summary: What is known on the subject?: Nurses' observation of patients in seclusion is essential to ensure patient safety.Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy.Direct observation and video monitoring are widely used in observing patients in seclusion.Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients.Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness.Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized.Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion.Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs.A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision.Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients.Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness.More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations.Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room.When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. Introduction: A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim: The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method: A retrospective phenomenological approach, using semi‐structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results: Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion: The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice: Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion. [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]

Generation of reliable data underpins the effectiveness of Occupational Health and Safety (OHS) surveillance systems. Despite the importance of understanding OHS data systems, there are few papers that provide overviews of their structure and/or content. This paper introduces a basic framework for assessing OHS data systems that will be of use to researchers internationally. We applied this approach to assess the Irish OHS data system by undertaking a data mapping exercise. We developed a checklist based on recommendations of monitoring and measurement of OHS proposed by the National Academies of Sciences, Engineering, and Medicine (USA). An assessment of published reports that present systematic OHS surveillance data was undertaken to identify the institutions or organisations responsible for collecting and curating the data, their remit, and, associated with this, their respective case definitions. We then provide an overview of the variables collected and these are then mapped against the checklist. The assessment highlights that whilst the farm fatalities dataset provides complete coverage of all fatalities, regardless of age or employment status, the same is not true of the three non-fatal injuries datasets reviewed. There are important differences in the data collection methods and, associated with this, which populations are covered. The assessment approach provides valuable insights into the strengths and weaknesses of a critical element of OHS surveillance systems, namely the production of datasets. This knowledge is important for researchers as understanding the data that informs their research is fundamental to good science. It is critical for policy-makers and other stakeholders to understand the strengths and weaknesses on which OHS policy, strategies, or education and training interventions are developed. [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]

Introduction: Reminiscence therapy (RT), which engages individuals to evoke positive memories, has been shown to be effective in improving psychological well-being in older adults suffering from PTSD, depression, and anxiety. However, its impact on brain function has yet to be determined. This paper presents functional magnetic resonance imaging (fMRI) data to describe changes in autobiographical memory networks (AMN) in community-dwelling older adults. Methods: This pilot study used a within-subject design to measure changes in AMN activation in 11 older adults who underwent 6 weeks of RT. In the scanner, participants retrieved autobiographical memories which were either recent or remote, rehearsed or unrehearsed. Participants also underwent a clinical interview to assess changes in memory, quality of life, mental health, and affect. Findings: Compared to pretreatment, anxiety decreased (z = −2.014, p =.040) and activated significant areas within the AMN, including bilateral medial prefrontal cortex, left precuneus, right occipital cortex, and left anterior hippocampus. Conclusion: Although RT had subtle effects on psychological function in this sample with no evidence of impairments, including depression at baseline, the fMRI data support current thinking of the effect RT has on the AMN. Increased activation of right posterior hippocampus following RT is compatible with the Multiple Trace Theory Theory (Nadel & Moscovitch, 1997). [ABSTRACT FROM AUTHOR]

Background: Children with Down syndrome have speech and language difficulties that are disproportionate to their overall intellectual ability and relative strengths in the use of gesture. Shared book reading between parents and their children provides an effective context in which language development can be facilitated. However, children with Down syndrome often take a passive role in shared book reading and the use of key word signing (KWS) as a shared book reading technique has never been investigated. Aims: This study aimed to compare children with Down syndrome's participation and use of KWS across two methods of shared book reading – one in which a book had key‐word sign prompts embedded (signed condition) and the other in which a book was read as normal (unsigned condition). Measures of child and parent communicative behaviour were taken in each condition to establish if differences emerged. Methods & Procedures: A total of 36 children with Down syndrome (aged between 18 and 61 months) and their mothers took part in the study. Parent–child dyads were videoed at home reading two books, one in a signed and one in an unsigned condition. Child measures included total number of signs produced in each condition and levels of attention and initiation as measured by the Pivotal Behaviour Rating Scale. Parent measures included total number of utterances, mean length of utterance (MLU) in morphemes and vocabulary diversity (VOCD). Parental measures were transcribed using the Codes for Human Analysis Transcripts (CHAT) software and analysed by the Computerised Language Analysis software (CLAN). Contrasts in outcomes between the signed and unsigned conditions were estimated using Poisson and linear mixed‐effects models, determined by the type of data. Outcomes & Results: Results showed that children attempted to sign significantly more in the signed than unsigned condition, as well as showing significant increases in their levels of attention and initiation. There was also a significant increase in the total number of utterances used by parents in the signed versus unsigned condition and a decrease in MLU. VOCD was similar in both conditions. Conclusions & Implications: This study shows that the simple act of embedding key word signs into commercially available books, during shared book reading between parents and young children with Down syndrome, positively affects children's participation (initiation and attention) and use of KWS. The use of KWS as a core shared book reading technique may therefore be a fruitful avenue to facilitate growth in the language abilities of young children with Down syndrome. What this paper adds: What is already known on this subject: Most children with Down syndrome have significant speech and language difficulties, with relative strengths in the use of gesture. Shared book reading is an activity reported to positively affect language. However, children with Down syndrome are reported to take a passive role in shared book reading and are therefore more dependent on their parents to use techniques that facilitate their levels of participation, in order to maximise potential benefits. To the best of our knowledge, the communicative effects of embedding key word signing (KWS) in shared book reading have never been examined with children with Down syndrome. What this paper adds to existing knowledge: This is the first study to investigate the communicative impact of parents embedding KWS in a shared book reading activity with their young children with Down syndrome. Our findings show that this relatively simple manipulation resulted in Increase in children's sign attempts.Increase in children's overall participation in shared book reading (indicated by levels of attention and initiation).Increase in the number of utterances produced by parents (primarily as a result of repetitions).Decrease in parental mean length of utterance. These findings suggest that embedding KWS in shared book reading is likely to facilitate increased language abilities in this cohort. What are the potential or actual clinical implications of this work?: Shared book reading is part of the daily routine for many parents and their children with Down syndrome. Integrating KWS is a relatively simple adaptation to this activity which is likely to enhance children's language skills. Therapists can encourage parents to do this at home to support work carried out at school and in a clinical setting. [ABSTRACT FROM AUTHOR]

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

This paper reports on a study (commissioned by central government) of a specialist social work service provided by local government agencies (local authorities) in Ireland. The service originated in the 1960s, was designed to meet the accommodation related needs of Travellers, an indigenous, Irish, ethnic group, who have faced centuries of social exclusion and discrimination. The paper begins with an account of the economic and social problems faced by Travellers and then the few available Irish and UK publications. It then reports on qualitative findings drawn from interviews with social workers, Travellers and other key stakeholders. The idiom 'betwixt and between' is used to characterise the social work role. Respondents aspired to forms of social action and advocacy roles but were sometimes viewed with suspicion by Traveller activists. Local authority structures were overly focused on non-social work functions where social work expertise was rarely acknowledged or utilised. This partly explains why social workers faced challenges in upholding their professional values, regulatory obligations and continuous professional development. The authors conclude by arguing for a more clearly defined, human-rights based social work role, referencing lessons that can be drawn from the wider European literature. [ABSTRACT FROM AUTHOR]

Background: School is an important setting for creating healthy and sustainable food environments. Using participatory methods, this pilot study examined food and packaging waste and nutrition quality within the school food system. Methods: One secondary school in Ireland participated in a waste audit. Eleven male students (15–17 years) participated as citizen scientists. Students collected waste over 1 day and documented data on waste categories. Nutrition labels were photographed for analysis. Students created a video and participated in a focus group. Quantitative data were summarised using descriptive frequencies. A Nutrient Profile Model was applied to summarise nutrition quality. The focus group discussion was analysed using content analysis. Results: Highest weights of waste were organic waste (14.2 kg), paper and cardboard (5.0 kg), and hard plastics (4.1 kg). Materials banned by the European Union Single Use Plastics Directive were found. Recycling bins were contaminated with food waste. Nutrition labels from 132 food packages were analysed, of which 115 items (87%) were low‐nutrient, energy dense foods. Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups. Students were not surprised by the unhealthy food choices; however, they were shocked and saddened at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. Conclusions: The methodologies allowed successful engagement with students on this topic. The use of unnecessary plastics to serve food, poor waste separation practices, and the production of avoidable waste from low‐nutrient, energy‐dense products were key issues identified. Students proposed solutions that are achievable in the short‐term. Key highlights: Eleven 15–17‐year‐old secondary school students successfully participated as citizen scientists in a waste audit at their school that characterised the quantity, type and nutrition quality of waste associated with the food system.Organic waste, paper and cardboard, and hard plastics represented the most frequent waste. Recycling bins were contaminated with organic waste.Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups.The researchers conduced a focus group with students when they expressed shock and sadness at the waste practices. Their proposed solutions mapped across individual, community and organisational levels. [ABSTRACT FROM AUTHOR]

Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the prevalence of hate speech among children and adolescents and on hate speech definitions that guide prevalence assessments for this population; and b) the theoretical and empirical overlap of hate speech with related concepts. This review was guided by the Cochrane approach. To be included, publications were required to deal with real-life experiences of hate speech, to provide empirical data on prevalence for samples aged 5 to 21 years and they had to be published in academic formats. Included publications were full-text coded using two raters (κ =.80) and their quality was assessed. The string-guided electronic search (ERIC, SocInfo, Psycinfo, Psyndex) yielded 1,850 publications. Eighteen publications based on 10 studies met the inclusion criteria and their findings were systematized. Twelve publications were of medium quality due to minor deficiencies in their theoretical or methodological foundations. All studies used samples of adolescents and none of younger children. Nine out of 10 studies applied quantitative methodologies. Eighteen publications based on 10 studies were included. Results showed that frequencies for hate speech exposure were higher than those related to victimization and perpetration. Definitions of hate speech and assessment instruments were heterogeneous. Empirical evidence for an often theorized overlap between hate speech and bullying was found. The paper concludes by presenting a definition of hate speech, including implications for practice, policy, and research. [ABSTRACT FROM AUTHOR]

The products that we use in our living environment greatly assist us in maintaining health and independence as we age. Much research has been conducted on the physical ergonomic needs in product design for older people, overlooking an understanding of the 'softer' functionality that domestic products offer. Through an ethnographic case study of older peoples' cooking and heating product needs (N=40), this paper presents 1) a theoretical framework which supports the need for designers to consider social and emotional connections when designing domestic products for older people and 2) practical implications and requirements for future designers to consider when designing these products. In this paper, I encourage designers to consider the reflective and visceral connections domestic products hold and how products can both inhibit and increase social inclusion. [ABSTRACT FROM AUTHOR]

This paper uses a reflective method to gather findings with relation to a collaborative governance approach for the sociotechnical transition to a low carbon society in a regional context. As top-down and bottom-up approaches to sustainable transitions have proven insufficient in bringing about the necessary changes required to meet the demands of climate action, more collaborative approaches between local communities, national public bodies and research organisations are warranted. Within this, there is a need to understand the dynamics of collaborative governance for participants in the process. Through a process of reflective practice, this paper outlines the networks, personal capacities, organisational capacities, benefits and challenges of collaborative governance partnerships for sustainable transitions from the perspective of individuals within a collaborative committee working on a regional transition project on the Dingle Peninsula, Co Kerry, Ireland. Alongside this, some solutions to challenges outlined through reflection are highlighted. This research paper highlights the need for the incorporation of reflective practice within collaborative governance for the socio-technical transition to a low-carbon society. [ABSTRACT FROM AUTHOR]

This paper focuses on qualitative findings on how young people in long-term foster care in Ireland interpret permanence and stability. We focus principally on subjective and relational permanence, emphasising the significance of these concepts for social work, while extending some conceptual approaches to permanence. Importantly, findings from this study highlight conceptual gaps in how permanence and stability are conceptualised in research and we outline an approach which more fully embraces the multi-dimensionality of young people's life experiences and emotions. Recent studies underline that permanence encompasses several elements (e.g. ecological, legal). However, this paper extends current research in illustrating how Irish young people in foster care experience permanence and stability every day, and how these experiences embrace discursive, emotional and temporal dimensions. [ABSTRACT FROM AUTHOR]

In many contexts, there has been a rapid increase in the visibility of trans* lives in the public sphere. Much educational research has focused on how to make life better for trans* children and young people in schools. This paper moves sideways from this concern to explore how public discourses around trans* lives and the individual labour of bodies are changing the shape of gender in schools and society. Ireland offers an insightful site for this inquiry because, following the Gender Recognition Act (2015) and the Marriage Equality Act (2015), trans* lives have become more visible in the public sphere and there has been a heightened concern for trans* children and young people in schools. This paper draws on an analysis of how trans* people are represented in the media as well as in a selection of accounts from the primary school community of a trans* child. Framed by debates about gender intelligibility, normativity and transgression, the paper elucidates how, as trans* visibility increases, the disciplinary terms of gender are reproduced with ambivalent effects. It argues against individualised and simplistic approaches to trans* identities in schools and raises questions about new gender possibilities in schooling contexts. [ABSTRACT FROM AUTHOR]

Background: There is an increasing demand for mental health support in primary care, especially for young people. To improve mental health support for young people in general practice, the needs of young people must be considered.Aim: To explore the experiences of young people (aged 12-25 years) on receiving mental health care in primary care and identify the needs of young people who present with mental health concerns.Design and Setting: A systematic review and narrative synthesis.Method: This was a systematic review and narrative synthesis. Six databases were searched for literature relating to young people's experiences of receiving mental health care in primary care. Additional handsearching and manual internet searching were conducted. Narrative synthesis was employed.Results: Five papers and a further two reports from manual internet searching were found, resulting in the inclusion of 1823 young people from four different countries (UK, US, Ireland, and Canada) for synthesis. The synthesis generated four themes: the centrality of a trusting relationship; showing empathy and taking concerns seriously; being given time to talk; and barriers to accessing mental health support in primary care.Conclusion: Young people need a trusting relationship to discuss sensitive issues. To enable high-quality and effective mental health consultations with young people and the development of trust, GPs require unhurried consultations and the ability to maintain continuity of care. [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: 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]

Studies of children's consistency of word production allow identification of speech sound disorder. Inconsistent errors are reported for two groups of children: childhood apraxia of speech (CAS) due to difficulty with the motoric precision and consistency of speech movements; and inconsistent phonological disorder (IPD) attributed to impaired phonological planning. This paper describes the inconsistent productions of children with IPD in comparison to typically developing children. In two studies of suspected SSD (N = 135), 22 children pronounced ≥40% of 25 words inconsistently on three repeated trials. No participant had symptoms of CAS. They were monolingual and spoke Australian- or Irish-English. Assessment determined the proportions of words said consistently (i.e. the same across productions: all correct or with the same error) or inconsistently (i.e. differently across productions: at least one correct and one error or different errors in productions). Qualitative analyses examined error types and explored the effect of target words' characteristics on inconsistency. Children with IPD produced 52% of words with different errors. While 56% of all phoneme errors were developmental (age appropriate or delayed), atypical errors typified inconsistency: default sounds and word structure errors. Words with more phonemes, syllables and consonant clusters were vulnerable to inconsistency, but their frequency of occurrence had no effect. TD children and those with IPD had different quantitative and qualitative error profiles, confirming IPD as a diagnostic category of SSD. Qualitative analyses supported the hypothesised deficit in phonological planning of words' production for children with IPD. [ABSTRACT FROM AUTHOR]

Young people's voices detailing how they experienced engagement with the criminal justice system following child sexual abuse, what was helpful or unhelpful and how services can be improved to minimise secondary victimisation and maximise the potential for healing are largely absent from the research literature. This paper draws on semi‐structured interviews with a culturally diverse sample (n = 47) of young people aged 14 to 25 across Ireland and Canada about their experiences of disclosure and engagement with systems. Data were collected pertaining to experiences engaging with law enforcement personnel using thematic analysis with a trauma‐informed lens. The research identified three key themes: the importance of feeling safe through kindness, transparency and being believed; the importance of having a say; and the importance of timely court processes. The study builds on the small body of qualitative research illustrating young people's lived experiences of engaging with the criminal justice system and provides empirical support for promoting a trauma‐informed approach in how police engage with young people. Guidance is offered for police professionals on how to engage with adolescents following sexual abuse. [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]

Occupational fatality rates are useful in communicating key safety challenges associated with different industries or affecting different populations within those industries. Though seemingly intuitive, the calculation and use of fatality rates associated with farming needs to be carefully considered. This paper highlights difficulties and variability in Farm Fatality Rate (FFR) measures, proposes a series of rates appropriate for assessments of farm safety, and demonstrates their usage through an analysis of farm workplace deaths in Ireland between 2008 and 2016. Six FFRs are calculated including: the Farm Household Rate (FHR); Farm Operator Rate (FOR); Family Worker Rate (FWR), Worker Rate (WR), Seasonal Fatality Rate (SFR) and, Enterprise Fatality Rate (EFR). To assess trends over time we calculate the rate using appropriate numerators and denominators in three sub-periods. FFRs vary considerably depending on which numerator and denominator are deployed. Over the period, the FHR, FOR, and FWR increased due to growth in the number of fatalities and a slight decrease in the denominator populations. The WR has declined substantially over the full period. The QFR increased substantially for Q2–Q4 whilst the EFR highlights workers on dairy or beef enterprises being particularly at risk. The characteristics of farm workforces present many challenges to the calculation of occupational fatality rates. We propose six alternatives that provide insights into the risks faced by farm households, farm operators, farm workers, seasonally and by type of farm enterprise. We recommend that, regardless of the rate used, the limitations associated with all fatality rates are clearly explained, particularly when engaging with media and occupational health and safety stakeholders. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychosocial interventions (PSI) are recognized and recommended internationally as they primarily focus on improving a client's mental health and preventing relapse.Limited qualitative studies focus on the similarities and differences on offering PSI in practice across many countries. What this paper adds to existing knowledge?: This manuscript provides readers with qualitative findings of mental health nurses' (MHNs) experiences of using PSI in practice and the need for regular clinical supervision to increase MHNs confidence and enhance the offering of PSI.MHNs want PSI guidelines for the offering of these skills to their client groups across practice settings.MHNs require work release from practice to attend supplementary training on PSI so that they can do their job adequately. What are the implications for practice?: This study sheds light on the similarities and differences on PSI in Irish mental health services. It also highlights what MHNs recognize as important for PSI to be implemented. Clinical supervision and the development of PSI guidelines are necessary so that MHNs feel confident delivering these skills. They also need ongoing work release from practice to attend supplementary PSI training to provide best evidence to enhancing client experiences and positive PSI recovery outcomes. Description: The paper will report on the interview data of trained MHNs' experiences of using PSI within the Irish context. This observational data will be reported elsewhere (Smyth et al. 2020—under review). Introduction: This research is conducted when the current reform of Irish mental health governance demands clarification of key psychosocial skills (PSI) required for mental health nurses (MHNs) to embrace recovery‐orientated ways of working. There is limited evidence about this important topic in Ireland and across countries. Aim: To explore PSI‐trained MHNs' experiences of using PSI within Ireland. Method: A multiple case study methodology was used and situated within an interpretive paradigm. Data were gathered using semi‐structured interviews with 40 PSI‐trained MHNs. Findings: Three overarching themes developed from the analysis. These included (a) PSI‐trained MHNs' understanding and use of PSI; (b) facilitating factors supporting the use of PSI by PSI‐trained MHNs; and (c) obstacles limiting the use of PSI by PSI‐trained MHNs. Discussion: MHNs recognize that regular clinical supervision is required to increase their confidence, along with PSI guidelines for the offering of these skills across practice settings. MHNs also need work release to attend supplementary training on PSI so that they can do their job adequately. Implications for practice: This study suggests that MHNs are often stuck between a rock and a hard place when delivering PSI in practice. MHNs need to be aware that this can affect client outcomes. Relevance statement: This research identified a gap in knowledge within the Irish context but also across the world on this important topic. MHNs need access to regular clinical supervision, PSI guidelines and ongoing PSI training to feel confident in order to keep abreast of the changes happening in mental health practice and research. [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]

The recent attention focused on child sexual abuse (CSA) disclosure pathways has highlighted complex psychological processes that influence disclosure both for children and adults. Some authors have suggested that such processes may differ between children and adults yet few studies have examined distinct samples within the same study. This paper addresses this gap by exploring adolescent (n = 20) and adult (n = 10) experiences of disclosure of childhood sexual abuse. Interviews were conducted with both samples, using the same interview schedule and a comparative analysis was conducted of the key themes identified from a grounded theory analysis. Those themes that were found to be common to both samples included pressure cooker effect, telling would make it worse, and self-blame. Themes that were found to be more prevalent in the adolescent sample included police/court involvement, concern for other children, being asked, and peer influence. It is suggested that such potential differences reflect the changing social context over the past few decades which is characterised by increased awareness of sexual abuse as a crime and the risks of recidivism of offenders. [ABSTRACT FROM AUTHOR]

Personal assistance (PA) has long been a key support for Irish people with physical and sensory disabilities, but evidence shows that Ireland lacks national standards for allocation, provision and data collection. Addressing a particular gap in understanding the experiences of disabled people, this paper draws on a large-scale mixed-method study with PA service users which was conducted in summer 2021. Overall, the evidence shows satisfaction among many service users, but suggests that systemic shortfalls have a clearly detrimental effect on the functionings and capabilities valued by the participants in relation to their ability to participate in social and economic activities that many people take for granted. The findings of this study provide valuable insights into what good personal assistance means for disabled people's everyday lives and what Irish PA service users want to see change in the system. The findings are grounded in the Irish context, but they are useful to an international audience in clearly showing the value of PA and the importance of meaningfully including disabled people in its design and regulation. [ABSTRACT FROM AUTHOR]

Background: Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support final year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods: This study aimed to evaluate a simulation-based education initiative from the perspectives of final year undergraduate nursing and midwifery students (N = 95). An online survey, using the validated Simulation Effectiveness Tool – Modified (SET-M), was distributed to final year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results: The results of the study highlight final year nursing and midwifery students' perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confidence and gain experience in preparation for real-life practice. Students reported feeling more confident in their assessment skills, in providing care and interventions in responding to changes in a person's health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefing and debriefing sessions were highlighted as important aspects of the simulation which helped to increase student confidence and cultivate meaningful learning. Conclusion: Simulation-based education is a valuable teaching and learning modality, particularly for final year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional. [ABSTRACT FROM AUTHOR]

Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus‐based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross‐sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information, (2) caseload information, (3) service provision and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed‐ended survey responses and content analysis of open‐ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for ≤ 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities. What this paper addsWhat is already known on the subjectThe published multidisciplinary literature has identified that SLTs have a role in PPC. However, there has been no targeted research investigating the professional characteristics of clinicians in this context, nor any detailed information regarding associated clinician beliefs or management approaches.What this paper adds to existing knowledgeThis study is a snapshot of attributes, practice patterns and beliefs of SLTs who work with a PPC population. It highlights SLT perspectives of education and training, as well as meta‐perceptions of themselves within the multidisciplinary team.What are the potential or actual clinical implications of this work?Data presented in this paper will help to enable SLTs, organizations and associations to augment service provision and determine future professional development priorities within the field of PPC. [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]

Background & Objective: Epidermolysis bullosa (EB) is the term used for a group of genetic skin fragility disorders. For those living with EB, pain represents a constant challenge, with blistering and tasks such as changing dressings, adding to the distress. This paper focuses on describing and exploring the health‐care needs of children, adults and families who are affected by EB. The specific aim of the paper is to identify the needs of the EB population with a view towards informing the development of a community liaison service to support adults living with EB and the parents/carers of children living with EB. Setting and Participants: Interviews with six adults and the parents of eight children with EB were conducted. The data were analysed thematically. All participants were resident on the island of Ireland and are therefore reflecting on services in this geographic region. Results: Participants' needs were grouped into five themes: support managing physical health‐care issues; access to community/home‐based services; EB‐specific information and psychosocial support; effective interaction with health‐care professionals; and advice regarding benefits and entitlements. Discussion and Conclusions: This article represents the health‐care needs and preferences of a broad spectrum of those with EB, highlighting the need for a comprehensive service regardless of the severity of the condition. [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]

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers' conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family's situation in terms of the range of issues identified and candidate 'causes'. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies' involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning. [ABSTRACT FROM AUTHOR]

If teacher education is to be taken seriously, it must be research-based with teacher educators as active researchers and perceived as 'public intellectuals'. This re-positioning of teacher education to be 'research driven' comes with pressure on teacher educators to focus on securing research funding and increase publication output. This expectation for research productivity competes with increasing calls for more relevant and imaginative teacher preparation programmes. To present the challenging contexts in which Irish teacher educators operate with respect to fulfilling both a teaching and research remit, this paper maps the changing higher education landscape, the regulation of teacher education along with a myriad of curricular reforms at primary and post-primary level. The paper then explores current teacher educators' positioning in the Irish context as active users and producers of research through in-depth interviews with ten experienced teacher educators. [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]

Introduction: Internationally mental distress is more prominent in the LGBTI community than the general population. The LGBTIreland study was set up to take stock of this in the Republic of Ireland. This paper reports on the analysis of the transgender group with reference to minority stress theory and cognitive dissonance theory. Method: An online survey was conducted addressing several aspects of mental health and distress that received responses from all groupings (n = 2,264) among which 12.3% (n = 279) identified as transgender. The survey consisted of several validated tools to measure depression, anxiety, stress (DASS-21), coping (CSES), self-esteem (RSES), alcohol and drugs misuse (AUDIT) and a variety of questions addressing demographics, experiential aspects, coping and self-related factors. Data analysis focused on predicting mental distress using DASS-general (composite of depression, anxiety and stress). Results: Transgender participants reported higher levels of mental distress, self-harm, suicidal ideation and attempts, and lower levels of self-esteem in comparison with the LGB groups, as well as the general population. Hierarchical multiple regression showed that 53% of variance in mental distress could be predicted from reduced self-esteem, the experience of harassment and not belonging in school. Furthermore, mental distress was highest among younger participants, those who were 'not out', those who had self-harmed and used avoidant coping. There was no significant difference in distress levels among those who had sought mental health support and those who had not. Conclusions: To understand mental distress in transgender people, the minority stress model is useful when taking into account both adverse external (environmental) and internal (cognitive/emotional) factors. The cognitive dissonance mechanism is essential in outlining the mechanism whereby gender incongruence is associated with psychological discomfort, low self-esteem and high mental distress. [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]

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]

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]

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]

Purpose: Assistive technologies have deep and personal meanings for people with disabilities. This study sought to provide an in-depth exploration of the subjective meaning of Environmental Control System (ECS) use for people with high cervical spinal cord injury. Materials and method: Interpretative Phenomenological Analysis (IPA) was used to explore the personal meaning of ECS. In-depth interviews with five participants were analyzed according to recommended IPA guidelines to produce a rich phenomenological account of lived experience. Results: This study identified two overarching themes, one of which was the subject of an earlier publication. This paper focuses on the second theme “taking back a little of what you have lost” and its two main components “reclaiming a little doing” and “feeling enabled”. Doing everyday things, being less dependent on others and feeling safer and less needy all contributed to participants experience of regaining something important of what had been lost. Conclusions: A nuanced range of meanings, demonstrating how “a little can mean a lot” emerged from this study. For those with high cervical spinal cord injury, “reclaiming a little doing” resulted in subtle, but subjectively significant, improvements in identity, relationships and well-being, while “feeling enabled” was both enjoyable and empowering and led to an increased sense of safety and reduced neediness. The potentially powerful impact on individuals with life-altering injuries of reclaiming a little of what they had lost, supports the value of more widespread access to and provision of ECS. Implications for rehabilitation: While ECS use produces only a “little” objective change in activity levels, it subjectively means “a lot” to people with high level injuries. ECS enable people to “do” everyday things as well help in supporting them to “feel” less dependent and needy. Using ECS facilitates much more than functional tasks and a sense of security. It helps promote positive self-perception and continuity of being. It is important for those with high cervical spinal cord injuries to have access to ECS to ensure they can enjoy both psychological and physical benefits. [ABSTRACT FROM AUTHOR]

Major transitions in older people's lives can give rise to multifaceted forms of social exclusion, with subsequent impacts for later life health and well‐being. With place now a central concept within policy on ageing and community care, there is the potential that it may offer new pathways to support older people undergoing these critical life transitions (CLTs). However, how policy and practice stakeholders working with and on behalf of these population groups understand, conceptualise and capitalise on the involvement of place in CLTs has not been investigated. This paper aims to address this deficit and explores the perspectives of key national and local actors on three CLTs—dementia, bereavement and forced migration—and their relationship with place and exclusion. The analysis involved 18 semi‐structured interviews with stakeholders from policy, practice and advocacy spheres related to the CLTs and ageing in general. Interviews highlighted the differences across stakeholders in perceived exclusionary impacts, and the different degrees to which place is conceptualised in relation to these transitions. Findings illustrate the lack of a holistic policy approach to the needs of older people experiencing CLTs that impedes our capacity to truly harness place in supporting older people. The article concludes by arguing for a more nuanced reconstruction of place and its meanings in the context of CLTs. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is an increasing recognition that sleep is an important aspect of health and well‐being, and this is particularly the case in infancy and early childhood where sleep behaviours and patterns can result in substantial problems. Methods: This paper draws on Wave 1, 2, and 3 data from Growing Up in Ireland, the national longitudinal study of children in Ireland to provide an overview of sleep patterns in a population of children aged 9 months (n = 11,112), 3 years (n = 9,790), and 5 years (n = 8,996). The anonymised data made available through the Irish Social Science Data Archive were analysed using descriptive statistics. Results: Findings from the analysis show that about two thirds of infants (66.9%; n = 7,433) and just under 3 quarters of children aged 3 years (72.8%; n = 7,127) go to sleep between 7:00 p.m. and 9:00 p.m. and about 3 quarters (78.6%; n = 7,070) of 5‐year‐old children are in bed by 9:00 p.m. Just under half of infants (48.5%; n = 5,000) wake up between 7:00 a.m. and 8:00 a.m. and 13.5% (n = 1,500) wake up between 6:00 a.m. and 7:00 a.m. More than 80% (n = 8,889) of mothers report their 9‐month‐old infant wakes up at least occasionally and 13.8% report it happens every night. Almost all infants nap during the daytime, with the majority (56.0%; n = 6,222) doing so for between 1 and 2 hours. About one third (65.4%; n = 6,402) of 3‐year‐olds take daytime naps, but only 5.0% (n = 449) of 5‐year‐olds do so. Substantial proportions of mothers report children's sleep patterns are at least a small problem for them (ranging from about 30% (n = 3,333) in infancy to 22% (n = 2,444) at 3 years and 12% (n = 1,079) at 5 years). Conclusions: These findings highlight a substantial unmet need, and it is suggested that public health nurses and health visitors have a key role to play in supporting positive sleep patterns in early childhood. [ABSTRACT FROM AUTHOR]

This paper examines the influence of the Troika on the retrenchment and reform of social security in Ireland during its bailout between 2010 and 2013. To do this, it draws on data from in-depth interviews with senior civil servants and civil society organisation staff who met with the Troika as part of their quarterly missions to Ireland during this period. The key themes which emerged from these interviews include the largely domestic origins of social security retrenchment and reform; the surprising, and distinctive, positions adopted by the European Commission and the International Monetary Fund (IMF); the extent of the Irish government's room for manoeuvre in this area, and the ways in which the Irish government defended social security against proposals for additional cuts put forward by the Troika. The paper concludes by arguing that the scope for domestic decision-making was heavily constrained, yet non-trivial, and that the Troika's influence comprised not only ‘powering’ but also ‘persuasion’. [ABSTRACT FROM PUBLISHER]

Introduction: Individuals with multimorbidity in deprived areas experience worse health outcomes and fragmented care. Research suggests that primary care-based link workers providing social prescribing have potential to improve health and well-being. This paper reports the results of a pilot study conducted in preparation for a randomised controlled trial (RCT) that aims to test the effectiveness of primary care-based link workers providing social prescribing in improving health outcomes for people with multimorbidity who attend general practices in deprived areas in Ireland. Methods: An uncontrolled pilot study of an intervention based on the Glasgow Deep End links worker programme, in a single general practice, tested the feasibility and acceptability of planned processes for a RCT. Outcomes were recruitment and retention rates and acceptability of the trial processes and intervention to patients, general practitioners (GPs) and the link worker. Structured interviews were conducted with six patients, the link worker and two GPs within the practice and analysed using descriptive qualitative analysis. Feedback from a Public Patient Involvement group and an Implementation Advisory Group of key stakeholders was incorporated into the evaluation process. Results: Twelve out of 14 patients completed the intervention. Selection and recruitment processes were lengthier than expected. GPs recommended including psychosocial need in the selection process. Interviewed patients, the GPs and the link worker were positive about the intervention. Conclusion: A range of adaptations were identified for the main trial, mainly considering psychosocial need in the selection process to reflect normal referral pathways. This has resulted in a pragmatic RCT design. [ABSTRACT FROM AUTHOR]

Purpose – Child participation is increasingly a global phenomenon as stated by Article 12 of the United Nations Convention on Children's Rights. This supports the first principle, Democracy, of the Health Promoting School movement. The purpose of this paper is to facilitate a three-phase participatory research process (PRP) to document the views of children about participation in school. Design/methodology/approach – A total of 248 primary school pupils aged nine to 13 years participated: the first group of pupils answered two questions on individual coloured paper; the second group categorised these data separately, by question, assigning labels for each of the categories; and the third group used the categories to develop schema. The analysis was inductive. Findings – The most common categories for what made pupils feel a part of their school were school uniforms, sports, friends, teachers and their school/classroom environment. Increase in the number of school activities, encouraging friendship and equal participation were key indicators of how pupils would ensure that everybody felt a part of the school. The findings indicate that interpersonal relationships and belonging are in the opinion of children important for taking part in school life. Originality/value – The paper illustrates children's understanding of what taking part in school means to them. The PRP encouraged pupils to have control of the three-phase research process, and demonstrated the ability of children to work together in groups while having fun at the same time. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper describes the steps used in developing and piloting a structured education programme - the Structured Education Reminiscence-based Programme for Staff ( SERPS). The programme aimed to prepare nurses and care assistants to use reminiscence when caring for people with dementia living in long-term care. Reminiscence involves facilitating people to talk or think about their past. Background Structured education programmes are used widely as interventions in randomised controlled trials. However, the process of developing a structured education programme has received little attention relative to that given to evaluating the effectiveness of such programmes. This paper makes explicit the steps followed to develop the SERPS, thereby making a contribution to the methodology of designing and implementing effective structured education programmes. Design The approach to designing the SERPS was informed by the Van Meijel et al. (2004) model ( Journal of Advanced Nursing 48, 84): (1) problem definition, (2) accumulation of building blocks for intervention design, (3) intervention design and (4) intervention validation. Methods Grounded theory was used (1) to generate data to shape the 'building blocks' for the SERPS and (2) to explore residents, family and staff's experience of using/receiving reminiscence. Results Analysis of the pilot data indicated that the programme met its objective of preparing staff to use reminiscence with residents with dementia. Staff were positive both about the SERPS and the use of reminiscence with residents with dementia. Conclusions This paper outlines a systematic approach to developing and validating a structured education programme. Participation in a structured education programme is more positive for staff if they are expected to actively implement what they have learnt. Ongoing support during the delivery of the programme is important for successful implementation. Relevance to clinical practice The incorporation of client and professional experience in the design phase is a key strength of this approach to programme design. [ABSTRACT FROM AUTHOR]

The Irish General Practitioner Training (GP) Programme is currently moving to Competency-Based Medical Education (CBME), facilitated by Programmatic Assessment (PA) and Entrustable Professional Activities (EPAs). These new assessment and feedback mechanisms may provide a rich and much sought-after dataset. However, given the possible number of feedback and assessment events, and the variety of modalities used, aggregating and interpreting these can be costly and difficult. Dashboard implementations (DI) have been purposed as a solution to bridge the gap between the large datasets and the training community at all levels. To explore the Irish GP training community's perceptions on how an EPAs DI could facilitate the delivery of GP training in Ireland. A qualitative approach was taken, using a focus group representative of different groups in the training community. Concurrently, an EPAs DI was developed. Focus group transcripts were analysed in an iterative fashion using Template Analysis to generate themes and subthemes. Numerous advantages were seen in relation to the implementation of an EPAs DI around entrustment decisions, constructive alignment and summative decision-making. These advantages, however, need to be tempered with the realisation that the EPAs DI is not and should not be misinterpreted as being the learning analytic panacea for GP training. This paper outlines the perceptions from a postgraduate medical education training community on an EPAs DI, which would be applicable to other training communities considering introducing similar mechanisms. [ABSTRACT FROM AUTHOR]