Search

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

In Northern Ireland, social work-specific legislation is planned for safe staffing across the governmental sector. As part of a broader research project to inform this development, we conducted a scoping review seeking examples of safe staffing definitions, safe staffing-related legislation, policy and practice in social work and associated professions from the UK and internationally. We searched English language databases in 2023 websites and reference lists as well as grey literature. Finding no international examples of social work-specific safe staffing definitions, legislation, or policy outside of Children's Services, we offer a tentative definition to the current debate. Our scoping review found examples of individual social workers and local teams developing caseload management practices to promote 'safer' working, which may be useful for policymakers and regulators to consider. However, these need greater conceptual clarity, consensus over definitions and outcomes, and evaluation for cost-effectiveness. Given the limited evidence in this area, recommendations include the need for further research to ascertain what 'safe staffing' does, can and should mean in social work and what can work in different contexts and at different levels of policy and practice to inform service user and social worker safety in social work. [ABSTRACT FROM AUTHOR]

The effects of psycholinguistic variables are critical to the evaluation of theories about the cognitive reading system. However, reading research has tended to focus on the impact of key variables on average performance. We report the first investigation examining variation in psycholinguistic effects across the life span, from childhood into old age. We analyzed the performance of a sample of 535 readers, aged 8-83 years in lexical decision and pronunciation tasks. Our findings show that the effects on reading of two key variables, frequency and AoA, decrease in size with increasing age over the life span. We observed the systematic modulation by age and reading ability of these and other psycholinguistic effects alongside a global U-shaped effect of age. Diffusion model analyses suggest that developmental speed-up in decision responses can be attributed to the increasing quality of evidence accumulation in reaction to words, while the ageing-related slowing can be attributed to decreasing efficiency of stimulus encoding or response execution processes. An analysis of spoken response durations furnishes a consistent picture in which the slowing of pronunciation responses with age can be attributed to slowing articulatory processes. We think our findings can be explained by theoretical accounts that incorporate learning as the basis for the development of structure in the reading system. However, an adequate theory shall have to include assumptions about both developmental learning and later ageing. Our results warrant a life span theory of reading.

Background: Data from clinical trials of lumacaftor-ivacaftor (LUM-IVA) demonstrate improvements in lung clearance index (LCI) but not in FEV1 in children with Cystic Fibrosis (CF) aged 6–11 years and homozygous for the Phe508del mutation. It is not known whether LUM/IVA use in children can impact the progression of structural lung disease. We sought to determine the real-world impact of LUM/IVA on lung structure and function in children aged 6–11 years. Methods: This real-world observational cohort study was conducted across four paediatric sites in Ireland over 24-months using spirometry-controlled CT scores and LCI as primary outcome measures. Children commencing LUM-/IVA as part of routine care were included. CT scans were manually scored with the PRAGMA CF scoring system and analysed using the automated bronchus-artery (BA) method. Secondary outcome measures included rate of change of ppFEV1, nutritional indices and exacerbations requiring hospitalisation. Results: Seventy-one participants were recruited to the study, 31 of whom had spirometry-controlled CT performed at baseline, and after one year and two years of LUM/IVA treatment. At two years there was a reduction from baseline in trapped air scores (0.13 to 0.07, p = 0.016), but an increase from baseline in the % bronchiectasis score (0.84 to 1.23, p = 0.007). There was no change in overall % disease score (2.78 to 2.25, p = 0.138). Airway lumen to pulmonary artery ratios (AlumenA ratio) were abnormal at baseline and worsened over the course of the study. In 28 participants, the mean annual change from baseline LCI2.5 (-0.055 (-0.61 to 0.50), p = 0.85) measurements over two years were not significant. Improvements from baseline in weight (0.10 (0.06 to 0.15, p < 0.0001), height (0.05 (0.02 to 0.09), p = 0.002) and BMI (0.09 (0.03 to 0.15) p = 0.005) z-scores were seen with LUM/IVA treatment. The mean annual change from baseline ppFEV1 (-2.45 (-4.44 to 2.54), p = 0.66) measurements over two years were not significant. Conclusion: In a real-world setting, the use of LUM/IVA over two years in children with CF aged 6–11 resulted in improvements in air trapping on CT but worsening in bronchiectasis scores. Our results suggest that LUM/IVA use in this age group improves air trapping but does not prevent progression of bronchiectasis over two years of treatment. [ABSTRACT FROM AUTHOR]

The term value‐based healthcare (VBHC) describes an approach to the organization and delivery of care that emphasizes reducing the cost of care while improving outcomes. This involves increased investment earlier in the care pathway e.g., in the prevention, timely diagnosis, and screening for complications in order to maximize the overall impact of care. Key elements of VBHC include the collection and interpretation of relevant data to drive quality improvement and appropriateness of care, a focus on a continuum of care from prevention through to complications, an awareness of the financial drivers of the cost of care and a recognition that meaningful outcomes of care are those that are important to patients. Although VBHC has its origins in North America and has mostly been applied to private health systems, the principles can also be applied to national health services. In publicly funded health systems, where resources are finite, VBHC initiatives aim to eliminate ineffective care that has no beneficial impact or added value for patients and to optimize patient outcomes by delivering care that meets the changing healthcare needs of a population over time. The National Health Service in Wales has established a VBHC Office and has begun to realize the benefits of adopting VBHC approaches. The Irish Health Service Executive (HSE) can learn from the approaches used in Wales. In this paper we explore some of the principles of VBHC through case studies from Ireland and Wales highlighting how national health services are using VBHC to achieve improvement in outcomes for people living with diabetes. [ABSTRACT FROM AUTHOR]

Marinas are known to act as species reservoirs, facilitating the persistence and spread of non-native species. Monitoring of marinas for non-native species is therefore an essential element of any integrated monitoring programme. Baseline and updated survey data are needed to understand the abundance, distribution and rate of spread of non-native species within marinas over time in order to support management strategies, develop applicable biosecurity measures and inform rapid response plans. Rapid assessment surveys (RAS) were employed to survey floating pontoons, as well as opportunistically survey intertidal structures, for non-native biofouling species in 22 marinas across the Republic of Ireland. A total of 25 nonnative species were recorded: 19 invertebrates and 6 macroalgae, with ascidians being the most represented group. Four non-native species not previously reported in published literature from the Republic of Ireland were recorded: devil's tongue weed, Grateloupia turuturu Yamada, 1941, the compass sea squirt, Asterocarpa humilis (Heller, 1878), the San Diego sea squirt, Botrylloides diegensis Ritter & Forsyth, 1917 and the branching bryozoan, Bugulina simplex (Hincks, 1886). Other species identified as part of this study and previously reported from Ireland were shown to have increased their range. [ABSTRACT FROM AUTHOR]

Background: Variation in genes involved in ethanol metabolism has been shown to influence risk for alcohol dependence (AD) including protective loss of function alleles in ethanol metabolizing genes. We therefore hypothesized that people with severe AD would exhibit different patterns of rare functional variation in genes with strong prior evidence for influencing ethanol metabolism and response when compared to genes not meeting these criteria. Objective: Leverage a novel case only design and Whole Exome Sequencing (WES) of severe AD cases from the island of Ireland to quantify differences in functional variation between genes associated with ethanol metabolism and/or response and their matched control genes. Methods: First, three sets of ethanol related genes were identified including those a) involved in alcohol metabolism in humans b) showing altered expression in mouse brain after alcohol exposure, and altering ethanol behavioral responses in invertebrate models. These genes of interest (GOI) sets were matched to control gene sets using multivariate hierarchical clustering of gene-level summary features from gnomAD. Using WES data from 190 individuals with severe AD, GOI were compared to matched control genes using logistic regression to detect aggregate differences in abundance of loss of function, missense, and synonymous variants, respectively. Results: Three non-independent sets of 10, 117, and 359 genes were queried against control gene sets of 139, 1522, and 3360 matched genes, respectively. Significant differences were not detected in the number of functional variants in the primary set of ethanol-metabolizing genes. In both the mouse expression and invertebrate sets, we observed an increased number of synonymous variants in GOI over matched control genes. Post-hoc simulations showed the estimated effects sizes observed are unlikely to be under-estimated. Conclusion: The proposed method demonstrates a computationally viable and statistically appropriate approach for genetic analysis of case-only data for hypothesized gene sets supported by empirical evidence. [ABSTRACT FROM AUTHOR]

This article empirically applies Knut Laaser's integrated conceptual framework, combining Sayer's moral economy (ME) theory with labour process theory (LPT), to examine how two rival Irish unions engaged with an uneven moral economy and consciously sought to build collective worker solidarity during a dispute over competitive tendering and marketization. Using qualitative data from a case study of BusCo in Ireland's public transport sector, the article enriches sociological understanding of trade union solidarity, and how it is engendered, contested and experienced. [ABSTRACT FROM AUTHOR]

Teaching and learning anatomy by using human cadaveric specimens has been a foundation of medical and biomedical teaching for hundreds of years. Therefore, the majority of institutions that teach topographical anatomy rely on body donation programmes to provide specimens for both undergraduate and postgraduate teaching of gross anatomy. The COVID‐19 pandemic has posed an unprecedented challenge to anatomy teaching because of the suspension of donor acceptance at most institutions. This was largely due to concerns about the potential transmissibility of the SARS‐CoV‐2 virus and the absence of data about the ability of embalming solutions to neutralise the virus. Twenty embalming solutions commonly used in institutions in the United Kingdom and Ireland were tested for their ability to neutralise SARS‐CoV‐2, using an established cytotoxicity assay. All embalming solutions tested neutralised SARS‐CoV‐2, with the majority of solutions being effective at high‐working dilutions. These results suggest that successful embalming with the tested solutions can neutralise the SARS‐CoV‐2 virus, thereby facilitating the safe resumption of body donation programmes and cadaveric anatomy teaching. [ABSTRACT FROM AUTHOR]

In recent years, there has been a move toward a more human rights-based approach to the issue of supported and assisted decision-making (ADM) with legislative changes strengthening the formal right for older people to participate in care planning and decision-making. Ireland's Assisted Decision-Making (Capacity) Act, 2015 breaks from traditional views of capacity to consider the uniqueness of each decision in relation to topic, time and place for those with impaired or fluctuating capacity. This study set out to explore experiences of assisted decision making (ADM) in acute care hospitals in Ireland and to identify the barriers and enablers to ADM for older people and people with dementia from the perspective of different Health and Social Care Professionals (HSCPs) involved in their care. We carried out 26 semi-structured audio-recorded interviews with a convenience sample of HSCPs working in two acute hospitals and subsequently confirmed the results. HSCPs identified several barriers to, and enablers of, ADM in acute hospitals that were categorized into three key themes: Building meaningful engagement with older people and their family carers; barriers and enablers associated with interprofessional collaboration and barriers and enablers associated with the environment. Our findings suggest that despite concrete policy and legislative underpinnings to ADM, this was not always evident in practice and suggests the need for specialized education and training on ADM in practice settings. [ABSTRACT FROM AUTHOR]

Atlantic bluefin tuna (ABT, Thunnus thynnus ; Linneaus, 1758) is an ecologically important apex-predator with high commercial value. They were once common off the coast of the United Kingdom (UK), before disappearing in the 1960s. In regions lacking commercial fisheries for ABT, such as the UK and Ireland, spatial data can be scarce. In these cases, sightings and bycatch databases can offset information shortfalls. Here, we document the reappearance of ABT into territorial waters of the UK from 2014 onwards, and increased occurrence off Ireland. We analyse a novel, multi-source dataset comprising occurrence data (2008–2019; 989 sightings and 114 tonnes of bycatch) compiled from a range of sources (scientific surveys, ecotours and fisheries). We show an increasing trend in effort-corrected ABT occurrence in (i) the pelagic ecosystem survey in the western English Channel and Celtic Sea (PELTIC), (ii) an ecotour operator, and (iii) the Irish albacore fishery in on-shelf and off-shelf waters. Sightings of ABT by the PELTIC correlated with modelled abundance estimates of ABT and the Atlantic multidecadal oscillation. These data demonstrate that sightings of ABT have increased off the UK and Ireland since 2014, following the same increasing trend (2010 onwards) as the eastern ABT population. [ABSTRACT FROM AUTHOR]

The IPCC emphasises the need to centre climate change adaptation in climate actions due to a lack of progress on meaningful climate change mitigation. This requires the expansion of adaptive capacity across many sectors, including education. Research asserts the key role formal education plays in increasing the learning and cognitive aspects of adaptive capacity and associated capabilities, but further work is required to understand the impacts of attempts to enact such changes, specifically in relation to climate change adaptation planning. Drawing on impact data collected from an experimental place-based digital educational resource – Climate Smart – that includes a serious online role play game, designed with and for second level students aged 15–17 in Ireland, this paper outlines the challenges of, and opportunities for, engaging young people in learning about climate change adaptation planning. We conclude that while such educational innovations are impactful in the short-term and essential for developing foundational knowledge and skills, as well as shaping individual and social norms, they will be insufficient alone to optimise capabilities for long term adaptive capacity for climate change adaptation. Wider complementary structural changes across multiple systems which support people to enact their learning and functionalise their capabilities are required. Finally, a prospective agenda for progressing adaptive capacity for climate adaptation planning with education at its core is outlined. [ABSTRACT FROM AUTHOR]

Background The true frequency of hospital outbreaks of invasive group B streptococcal (iGBS; Streptococcus agalactiae) disease in infants is unknown. We used whole genome sequencing (WGS) of iGBS isolates collected during a period of enhanced surveillance of infant iGBS disease in the UK and Ireland to determine the number of clustered cases. Methods Potentially linked iGBS cases from infants with early (<7 days of life) or late-onset (7–89 days) disease were identified from WGS data (HiSeq 2500 platform, Illumina) from clinical sterile site isolates collected between 04/2014 and 04/2015. We assessed time and place of cases to determine a single-nucleotide polymorphism (SNP) difference threshold for clustered cases. Case details were augmented through linkage to national hospital admission data and hospital record review by local microbiologists. Results Analysis of sequences indicated a cutoff of ≤5 SNP differences to define iGBS clusters. Among 410 infant iGBS isolates, we identified 7 clusters (4 genetically identical pairs with 0 SNP differences, 1 pair with 3 SNP differences, 1 cluster of 4 cases with ≤1 SNP differences) of which 4 clusters were uncovered for the first time. The clusters comprised 16 cases, of which 15 were late-onset (of 192 late-onset cases with sequenced isolates) and 1 an early-onset index case. Serial intervals between cases ranged from 0 to 59 (median 12) days. Conclusions Approximately 1 in 12 late-onset infant iGBS cases were part of a hospital cluster. Over half of the clusters were previously undetected, emphasizing the importance of routine submission of iGBS isolates to reference laboratories for cluster identification and genomic confirmation. [ABSTRACT FROM AUTHOR]

The visibility of young people in climate change debates has risen significantly since the inception of the Fridays for Future movement, but little is known about the diversity of positions, perspectives and experiences of young people in Ireland, especially with respect to climate change adaptation planning. To close this knowledge gap, this article first interrogates key emergent spaces of public participation within the arena of climate action in Ireland in order to identify the extent of young people's participation and whether any specific consideration is given to disadvantaged groups. It then tests the impacts of workshops specifically designed to support disadvantaged young people's engagement with climate change adaptation which were rolled out with a designated Delivering Equality of Opportunity in Schools (DEIS) school in inner-city Dublin, Ireland. We found limited attention to public participation in climate change adaptation planning generally, with even less consideration given to engaging young people from disadvantaged communities. However, positive impacts with respect to enhanced knowledge of climate change science and policy processes emerged following participation in the workshops, providing the bedrock for a greater sense of self-efficacy around future engagement with climate action amongst the young people involved. We conclude that what is needed to help ensure procedural justice around climate action in Ireland are specific, relevant and interactive educational interventions on the issue of climate change adaptation; interventions which are sensitive to matters of place and difference. [ABSTRACT FROM AUTHOR]

Much of the cooperation on criminal justice matters between the United Kingdom and the Republic of Ireland is based on EU level instruments. While there has been consideration of the broader impact of Brexit on the Good Friday Agreement and consensus on the need to avoid a return to a hard border between Ireland and Northern Ireland, more detailed consideration has not been given to the effect that Brexit may have on continued criminal justice cooperation across the border. This article highlights the combined risks that Brexit presents for Northern Ireland in the form of increased criminality at a time when the loss of EU police cooperation mechanisms may result in a reduction of operational capacity and the removal of the legal architecture underpinning informal cooperation. Part 1 seeks to highlight the historical context of UK-Irish cooperation in policing matters. Part 2 explores the risk that post Brexit the Irish border may become a focus for criminal activity. The risks relating to increased immigration crime, smuggling of commodities and potential rise in terrorist activities are explored. Part 3 considers how the risks of increased criminal threats are exacerbated by the loss of EU criminal justice cooperation mechanisms and how this will affect UK-Irish cooperation specifically. Consideration is particularly given to the loss of information sharing systems. Part 4 considers how loss of EU level cooperation mechanisms could be mitigated. The viability of bilateral agreements between the UK and Ireland is considered alongside ways which police cooperation can be formalised to compensate for the potential loss of EU criminal justice information sharing systems. Nordic police cooperation is considered as a potential blueprint for the UK and Ireland. [ABSTRACT FROM AUTHOR]

The Republic of Ireland and the United Kingdom have a long, close and difficult history. The most recent phase of which dates from 1998 and the conclusion of the Good Friday Agreement. Since 1921, however, there has been unique practice between Ireland and the UK as regards the transfer of accused and convicted persons from one to the other. Indeed, there has been a special and close relationship between the two in that regard; albeit one not without difficulties. In recent times EU Justice and Home Affairs measures and the Good Friday Agreement have supplemented and strengthened the relationship. These include, since January 2004, the European Arrest Warrant (EAW). The EAW has been particularly important in streamlining the extradition process between the Ireland and the UK. This phase of history and co-operation is coming to an end. The UK's membership of the EU has now ceased, and a transition period during which the UK remains part of the EAW will end on 31st December 2020. The extradition relationship between the two is therefore facing a considerable challenge. There are several options open to Ireland, the UK and the EU as a replacement. Time, political will and the interests of third states, however, may well stand in the way of the conclusion of an agreement that optimally serves the interests of all parties and criminal justice. This paper considers the origins of extradition between the UK and Ireland and the alternative methods of extradition open to the UK and Ireland after Brexit. Consideration is given to the likely operation of a Norway-Iceland style agreement and whether such an agreement will be in place by the end of the transition and, if it was, whether its terms are likely to be sufficient for the needs of Ireland and the UK. The possibility of a bilateral arrangement on extradition between Ireland and the UK is also explored. Underlying the discussion is the critical point that the future extradition relationship must retain its 'special' characteristics, and therefore maintain the trust and good will that has developed over the years and given rise to an effective extradition relationship between the two countries. In other words, the lessons of history must be remembered. [ABSTRACT FROM AUTHOR]

"The Forgotten Cemetery: Excavations at Ranelagh, Co Roscommon" is a comprehensive and detailed study of an early-medieval settlement and cemetery complex discovered during road construction in NW Ireland. The site, which dates back to the 4th century AD, was initially a settlement-cemetery enclosure that later became a center for various activities such as livestock rearing, textile manufacturing, and tool production. The book explores the development of the site, burial practices, daily life, diet, and the bioarchaeological analysis of the 557 human burials. It provides valuable insights into medieval Ireland and is freely available online. [Extracted from the article]

This book review discusses "Botany and gardens in early modern Ireland," edited by Elizabethanne Boran, E. Charles Nelson, and Emer Lawlor. The book explores the limited sources of information on native and naturalized plants in Ireland before 1800, as well as the gardens of the seventeenth and eighteenth centuries. It is divided into four sections, covering topics such as seventeenth-century sources, the pioneering flora of Reverend Dr Caleb Threlkeld, Dublin book collections, and wider aspects of early modern Irish gardening. The book is praised for its informative and readable content, and includes contemporary and modern illustrations. [Extracted from the article]

This is a summary of the history of the Association of Coloproctology of Great Britain and Ireland from its inception in the late 1980s to the present day. [ABSTRACT FROM AUTHOR]

Most research on anadromous fishes has been invested in their freshwater life‐phases, resulting in a relatively sparse understanding of their spatial ecology during marine life‐phases. However, understanding the marine dispersal of anadromous fishes is essential to identify threats and to implement conservation measures that fully encompass their lifecycle.The twaite shad Alosa fallax is an anadromous fish increasingly imperilled across its range due to pollution, harvesting, and impediments to freshwater migration, but little is known about its distribution and movements during its marine life‐phase. Here, the application of acoustic telemetry provided novel insights into the coastal dispersal of twaite shad in the UK and Ireland during 2018–2019, and the freshwater entry of individuals during the 2019 spawning season.Of 73 twaite shad acoustic‐tagged during their upstream migration in the River Severn in May 2018, 58 emigrated from the river. Twelve were subsequently detected 200 km to the south‐west at the Taw–Torridge Estuary between July 2018 and April 2019, where estuarine movements up to 5.8 km inland occurred in summer, winter, and spring. One was subsequently detected in the Munster Blackwater Estuary (Ireland) and then in the River Severn, indicating a minimum movement distance of 950 km. Thirty‐four (59%) of the emigrating individuals from 2018 re‐entered fresh water in the rivers Severn (n = 33) and Wye (n = 2) in April and May 2019.These results suggest year‐round use of estuarine and nearshore habitats by at least a subset of the twaite shad population during their marine phase, providing evidence of potential range overlap between populations that spawn in different areas in the UK and Ireland, which may be facilitated by substantial dispersal. The results also highlight the potential of telemetry for estimating freshwater and marine mortality, and the benefits of sharing detection data across networks. [ABSTRACT FROM AUTHOR]

The UK and Ireland have many native pony breeds with historical and cultural importance as well as being a source of uncharacterized genetic diversity. However, there is a lack of comprehensive research investigating their genetic diversity and phylogenetic interrelationships. Many studies contain a limited number of pony breeds or small sample sizes for these breeds. This may result in erroneous grouping of pony breeds that otherwise have intricate interrelationships with each other and are not evaluated correctly when placed as a token subset of a larger dataset. This is the first study that specifically investigates the genetic diversity within and between British and Irish native pony breeds using large sample numbers from locations of their native origin. This study used a panel of microsatellite markers and sequence analysis of the mitochondrial control region to analyze the genetic diversity within and between 11 pony breeds from Britain and Ireland. A large dataset was collected (a total of 485 animals were used for mtDNA analysis and 450 for microsatellite analysis), and previously published data were used to place the British and Irish ponies in a global context. The native ponies of Britain and Ireland were found to have had a complex history, and the interrelationships between the breeds were revealed. Overall, high levels of genetic diversity were maintained in native breeds, although some reduction was evident in small or isolated populations (Shetland, Carneddau, and Section C). Unusual mitochondrial diversity distribution patterns were apparent for the Carneddau and Dartmoor, although among breeds and global haplogroups there was a high degree of haplotype sharing evident, well‐represented within British and Irish ponies. Ancestral maternal diversity was maintained by most populations, particularly the Fells and Welsh ponies, which exhibited rare and ancient lineages. The maternal and paternal histories of the breeds are distinct, with male‐biased crossings between native breeds, and other shared influences, likely Arabs and Thoroughbreds, are apparent. The data generated herein provide valuable information to guide and implement the conservation of increasingly rare native genetic resources. [ABSTRACT FROM AUTHOR]

Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) establishes a right to legal capacity for all people, including those with support needs. People with disabilities have a legal right to be given the appropriate supports to make informed decisions in all aspects of their lives, including health. In Ireland, the Assisted Decision-Making (Capacity) Act (2015) ratifies the Convention and has established a legal framework for Assisted Decision Making (ADM). The main provisions of the Act are not yet implemented. Codes of Practice to guide health and social care professionals are currently being developed. Internationally, concerns are expressed that ADM implementation is poorly understood. Using realist synthesis, this study aims to identify Programme Theory (PT) that will inform ADM implementation in healthcare.Methods: A Rapid Realist Review using collaborative methods was chosen to appraise relevant literature and engage knowledge users from Irish health and social care. The review was led by an expert panel of relevant stakeholders that developed the research question which asks, 'what mechanisms enable healthcare professionals to adopt ADM into practice?' To ensure the PT was inclusive of local contextual influences, five reference panels were conducted with healthcare professionals, family carers and people with dementia. PT was refined and tested iteratively through knowledge synthesis informed by forty-seven primary studies, reference panel discussions and expert panel refinement and consensus.Results: The review has developed an explanatory PT on ADM implementation in healthcare practice. The review identified four implementation domains as significant. These are Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring and Education, Training & Enablement. Each domain is presented as an explanatory PT statement using realist convention that identifies context, mechanism and outcome configurations.Conclusions: This realist review makes a unique contribution to this field. The PT can be applied by policymakers to inform intervention development and implementation strategy. It informs the imminent policy and practice developments in Ireland and has relevance for other worldwide healthcare systems dealing with similar legislative changes in line with UNCRPD. [ABSTRACT FROM AUTHOR]

Aims To identify factors that influence lack of engagement of young adults with Type 1 diabetes (aged 13-21 years) with structured diabetes education ( SDE) to inform and broaden the reach of future SDE. Methods A quantitative, cross-sectional survey was undertaken of 227 young people with Type 1 diabetes drawn from 11 health trusts across Northern Ireland and England, deemed to be representative of the wider population. Participants were asked to complete a questionnaire exploring non-attendance, along with the Diabetes Care Profile, the Diabetes Empowerment Scale (Short Form), the Diabetes Knowledge Test and the 12-item General Health Questionnaire. Demographic, health and diabetes-specific variables including HbA1c were also collected. Results The five most commonly cited reasons for non-attendance were 'Had other things to do' (68.3%), 'No time' (62.2%), 'Could not get time off school/college or work' (60.8%), 'Learnt about diabetes from other sources' (55.5%) and 'Feel able to cope on own' (52.9%). Conclusions Greater emphasis is required on communication with young people about the benefits of SDE. In addition, efforts need to be directed to making diabetes education more accessible without losing the quality of structured programmes. [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]

Background In Ireland, the Assisted Decision-Making (ADM) (Capacity) Act and emerging Codes of Practice provide a legal framework for Healthcare Professionals (HCPs) to enable ADM for patients with impaired capacity. ADM ensures that a person's will and preference is at the centre of all decisions related to their care. This study conducted a realist evaluation and developed a Programme Theory (PT) to highlight how ADM for older people can be operationalised within an Acute Care (AC) context. Methods Key informants with interest in ADM informed this evaluation. Interviews were conducted in two Acute Care (AC) sites with multidisciplinary HCPs working within older person services (n=20). Interviews with informants that recently received care within an AC setting involved older people (n=3) people with dementia (n=4) and family carers (n=5). Ethnographic observations from AC multidisciplinary team meetings also informed the review. The framework that guided the qualitative analysis was from a PT informed by literature on ADM implementation in healthcare (O'Donnell, Ní Shé, Davies et al.2018). Results The refined PT is supported by credible evidence that is informed by authentic experiences of decision making support in the AC setting. Validation groups (n=4) with the key informants verified the PT. Three mechanisms were identified as a positive climate and receptive environment for the adoption of formal ADM. These are: AC settings that adopt inter-professional accountability and shared responsibility for patient care that is guided by a clear policy process. Acute care and practice that is informed by a shared commitment to person-centred care and shared decision making. HCPs that operate within an AC setting where organisational learning informs practice through inter-professional training, mentorship and peer support. Conclusion Involving stakeholders in PT development enhances the utility, feasibility and applicability of the results. This PT provides a framework for those planning ADM implementation within the AC settings. [ABSTRACT FROM AUTHOR]

Background Ireland's Assisted Decision-Making (Capacity) Act 2015 breaks from traditional views of capacity to consider the uniqueness of each decision with relation to topic, time and place for those with impaired or fluctuating capacity. It has yet to be commenced, however codes of practice and educational strategies are in development to support health and social care professionals (HSCPs) to practice in accordance with the Act. This study set out to examine barriers and enablers to the adoption of assisted decision making (ADM) involving older people in acute hospitals from multiple perspectives. It describes a pre-implementation formative evaluation informed by the perspectives of relevant stakeholders in ADM practice. Methods In total, 12 key informant interviews and two validation groups were conducted with family carers and older people with and without a diagnosis of dementia in two acute hospitals. In addition, 20 interviews and two validation groups were conducted with HSCPs. Interviews focused on contextual characteristics as well as barriers and enablers of ADM. Results Barriers and enablers included supporting capacity through adopting a functional approach, the physical environment where decision-making takes place, meeting information and support needs, methods of communication, upholding will and preferences, relationships and trust. Time and timing were consistently identified as a critical factor. HSCPs also highlighted the need for specialised education and training on ADM practice. Conclusion The issues identified around ADM will inform the development of a serious discussion game on acute care scenarios, which will be deployed for awareness raising and educational purposes. Findings will also help focus attention on how those working within complex health systems and organisations can practically implement changes to practice in line with ADM legislation. [ABSTRACT FROM AUTHOR]

Aim Although socioeconomic background is known to impact on the incidence and progression of chronic kidney disease, its influence of on the presentation and outcome for acute kidney injury is not known and is the subject of this study. Design The Welsh National electronic AKI reporting system was used to identify all cases of AKI in patients >18 years of age between March 2015 and November 2017. Methods Socioeconomic classification of patients was derived from the Welsh Index Multiple Deprivation score (WIMD). Patients were grouped according to the WIMD score by their postcode, and the ranked data were categorized into percentiles and correlated with incidence and measures of AKI severity and outcome. Results Date was collected on a total of 57 654 patients. Increased deprivation was associated with higher AKI incidence rates, more episodes of AKI per patient and more severe AKI at presentation. In contrast 90-day mortality was highest in the most affluent areas. Mortality in affluent areas was driven by increased patient age. Corrected for age 90-day mortality was higher in areas of increased deprivation. Conclusion This study highlights that AKI incidence presentation and outcomes are adversely affected by social deprivation. Further studies are required to understand the extent to which these differences reflect patient related factors or regional differences in provision and access to care. [ABSTRACT FROM AUTHOR]

The mid-Palaeozoic was a significant interval in the evolution of plants, during which their biogeomorphic influence on terrestrial landscapes increased dramatically. The products of plant-sediment interactions are well known from Carboniferous strata, but earlier evidence dating to the initial rise of arborescent trees in the Devonian is less common. We present new evidence for early plant-sediment interactions from the Late Devonian (Famennian) Harrylock Formation (County Wexford, Ireland), which hosts standing trees that represent Ireland's earliest known fossil forest. The formation records deposition in fluvial and lacustrine environments, the former of which is here shown to have hosted Earth's earliest known log jam as well as early examples of vegetation-induced sedimentary structures (VISS) and a vegetation-stabilized chute channel. Fossilized driftwood preserved in the lacustrine facies contains the earliest evidence for arthropod(?) borings in large vascular plant debris. Together these early examples show that plant-sediment and plant-animal interactions, frequently recorded in Carboniferous strata, were already in existence by the Devonian and may have been previously underreported in other successions of the same age. The sparse Devonian record of plant-related sedimentary phenomena could be explained by a lesser abundance and/or longevity of such features in landscapes prior to subsequent evolutionary innovations in large vascular plants. • The earliest reported evidence for a log jam-induced channel avulsion. • The earliest known animal borings in vascular plant material. • Devonian vegetation-induced sedimentary structures. • Devonian record of a chute channel, stabilized by vegetation. [ABSTRACT FROM AUTHOR]

The role played by fever in the outcome of critical illness in children is unclear. This survey of medical and nursing staff in 35 paediatric intensive care units and transport teams in the United Kingdom and Ireland established attitudes towards the management of children with fever. Four hundred sixty-two medical and nursing staff responded to a web-based survey request. Respondents answered eight questions regarding thresholds for temperature control in usual clinical practice, indications for paracetamol use, and readiness to participate in a clinical trial of permissive temperature control. The median reported threshold for treating fever in clinical practice was 38 °C (IQR 38-38.5 °C). Paracetamol was reported to be used as an analgesic and antipyretic but also for non-specific comfort indications. There was a widespread support for a clinical trial of a permissive versus a conservative approach to fever in paediatric intensive care units. Within a trial, 58% of the respondents considered a temperature of 39 °C acceptable without treatment.Conclusions: Staff on paediatric intensive care units in the United Kingdom and Ireland tends to treat temperatures within the febrile range. There was a willingness to conduct a randomized controlled trial of treatment of fever. What is known: • The effect of fever on the outcome in paediatric critical illness is unknown. • Paediatricians have traditionally been reluctant to allow fever in sick children. What is new: • Paediatric intensive care staff report a tendency towards treating fever, with a median reported treatment threshold of 38 °C. • There is widespread support amongst PICU staff in the UK for a randomized controlled trial of temperature in critically ill children. • Within a trial setting, PICU staff attitudes to fever are more permissive than in clinical practice. [ABSTRACT FROM AUTHOR]

Sea trout are parasitized by two species of caligid copepod sea lice, Lepeophtheirus salmonis and Caligus elongatus. Generally, levels of lice infestation are lowand fewadverse effects on the host have been reported. However, with the advent of marine salmon farming since the 1980s, there have been many published accounts of L. salmonis sea lice epizootics on salmonids in aquaculture areas. Fewlarge-scale studies are available on levels of sea lice infestation of sea trout in areas without salmon farms or before their development. Understanding natural background lice levels on sea trout is important to interpret lice levels on trout in aquaculture areas. The Celtic Sea Trout Project, an INTERREG IVA Ireland Wales EU funded project, examined the status, distribution, genetics, and ecology of sea trout around the Irish Sea and provided an opportunity to assess levels of lice on sea trout spatially and temporally in an area without marine salmon farming. The prevalence of L. salmonis remained constant over the 3 years (63- 69%), whereas the prevalence of C. elongatus was lower (20-40%). The mean abundance of L. salmonis ranged from 3.6 to 3.8 and that of C. elongatus ranged from 0.6 to 4.3 (n = 850). Therewas a significant variation in L. salmonis abundance between marine areas. However, the relative stability in the prevalence and mean intensity of both lice species observed and the low mean abundances and very small proportion of juvenile life stages of L. salmonis reported here are similar to those reported from other studies in areas without salmon farming and likely represent natural background salmon lice levels on sea trout. This 3-year study, conducted over a wide geographic area, represents one of the largest studies of sea lice infestation patterns on sea trout in an area distant from finfish aquaculture influences. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this project was to develop an educational package for undergraduate student nurses that would provide them with the theoretical knowledge and clinical judgement skills to care for a patient with a wound. Background. Internationally there is concern over the adequacy of preparation of undergraduate nurses for the clinical skill of wound care. Deficits have also been identified in the underpinning biological sciences needed for this skill. Expectations associated with wound management have altered significantly in the last two decades with decision making around wound care coming under the scope of practice of nurses. The treatment and care options for patients with wounds must be based on a sound knowledge of how wounds are formed and healed. If nurses do not have the evidence-based knowledge, it can affect wound healing adversely leading to increased patient suffering, pain and delayed healing. From an organisational perspective, delayed healing will increase the cost of care. Design. This project used constructivism learning theory to provide a framework for the development of a wound care educational package for undergraduate Irish nurses in their penultimate year of training. Methods. Collaboration was formed with key stake holders. Pertinent curriculum content was mapped. Learning strategies to suit the incoming student learning styles were incorporated into newly developed theoretical content and practical skill sessions. Conclusion. The developed educational programme will assist student nurses in their care of patients with wounds. Relevance to clinical practice. This study provides a model that can be followed to develop small units of the study to keep abreast of changes in health care delivery and the changing scope of practice of nurses. It also contributes to the debate on the teaching and learning of biosciences as it highlights the depth of biological knowledge required as a basis for good evidence-based nursing care. [ABSTRACT FROM AUTHOR]

Gaelic Football and Hurling are two sporting codes within the Gaelic Athletic Association. The purpose of this study was to report the body composition phenotype of inter-county Gaelic athletic association players, comparing groups by code and field position. 190 senior, male, outfield inter-county players (144 hurlers and 46 Gaelic footballers) were recruited. Stature and body mass was measured, estimates of three components of body composition, i.e. lean mass, fat mass and bone mineral content was obtained by dual energy X-ray absorptiometry (DXA), and normative data for Gaelic athletic association athletes by code and position was compared. Other than in the midfield, there was limited difference in body composition between codes or playing position. Stature-corrected indices nullified any existing group differences between midfielders for both codes. Further comparisons with a non-athletic control group (n = 431) showed no difference for body mass index (BMI); however, the athletic group has a lower fat mass index, with a greater lean mass in accounting for the matched BMI between groups. In addition to providing previously unknown normative data for the Gaelic athletic association athlete, a proportional and independent tissue evaluation of body composition is given. [ABSTRACT FROM AUTHOR]

Charcot-Marie-Tooth disease (CMT) is the most common inherited neuropathy with heterogeneous clinical presentation and genetic background. The axonal form (CMT2) is characterised by decreased action potentials indicating primary axonal damage. The underlying pathology involves axonal degeneration which is supposed to be related to axonal protein dysfunction caused by various gene mutations. The overlapping clinical manifestation of CMT2 with distal hereditary motor neuropathy (dHMN) and intermediate CMT causes further diagnostic difficulties. Aminoacyl-tRNA synthetases have been implicated in the pathomechanism of CMT2. They have an essential role in protein translation by attaching amino acids to their cognate tRNAs. To date six families have been reported worldwide with dominant missense alanyl-tRNA synthetase ( AARS) mutations leading to clinically heterogeneous axonal neuropathies. The pathomechanism of some variants could be explained by impaired amino acylation activity while other variants implicating an editing defect need to be further investigated. Here, we report a cohort of six additional families originating from the United Kingdom and Ireland with dominant AARS-related neuropathies. The phenotypic manifestation was distal lower limb predominant sensorimotor neuropathy but upper limb impairment with split hand deformity occasionally associated. Nerve conduction studies revealed significant demyelination accompanying the axonal lesion in motor and sensory nerves. Five families have the c.986G>A, p.(Arg329His) variant, further supporting that this is a recurrent loss of function variant. The sixth family, of Irish origin, had a novel missense variant, c.2063A>G, p.(Glu688Gly). We discuss our findings and the associated phenotypic heterogeneity in these families, which expands the clinical spectrum of AARS-related neuropathies. [ABSTRACT FROM AUTHOR]

The notion of role clarity, and its impact on clinical governance, has not been previously considered within academic literature. The purpose of this research article was to add to theoretical knowledge surrounding the clinical governance and the effect that role clarity has on governance operationally. The context of Irish health care and Irish hospital boards is used to explore this phenomenon. A mixed-methods approach was used to appreciate the central phenomenon. The doctoral dissertation this article was drawn from identified that the adoption of similar or consistent structures and processes between Irish acute care hospitals would aid efficiencies, both human and cost, on multiple levels. Ultimately, the article concludes that role clarity is a significant component in the determination of effective health care. Hospital boards and their individual members should be cognizant of the implications of role clarity and its impact on effective and efficient clinical governance. [ABSTRACT FROM AUTHOR]

Abstract: Current attempts to encourage sustainable consumption are failing to make significant advancements and consumption by households in daily practices continues to grow. Interventions in this area are often based on simplistic behavioural assumptions, which overlook the embeddedness of daily consumption practices and fail to challenge escalating consumption demands and expectations. Against this background there is a need to consider more radical socio-cultural, technological and organisational innovations that may fulfil the goals of daily practices more sustainably in the future. Taking the case of home heating, the most energy intensive practice in Irish households, this paper reports on a participatory backcasting study that developed future scenarios and action plans for sustainable heating. In contrast to conventional behavioural change models and forecasting techniques, this study adopted a social practice orientation. This paper focuses on the operationalisation of the social practice approach with special reference to the iterative processes around scenario development and the resultant backcasting outputs. Participant evaluations of the procedure are presented which indicate that despite significant operational complexity, the process was strongly valued and provided significant opportunity for learning amongst stakeholders involved. Whether such approaches can be integrated into governing systems, however will depend on a willingness amongst stakeholders to embrace a radical reconceptualisation of behaviour. [Copyright &y& Elsevier]

These guidelines update previous guidance published in 2005. They have been revised by a group who are members of the UK and Ireland Neuroendocrine Tumour Society with endorsement from the clinical committees of the British Society of Gastroenterology, the Society for Endocrinology, the Association of Surgeons of Great Britain and Ireland (and its Surgical Specialty Associations), the British Society of Gastrointestinal and Abdominal Radiology and others. The authorship represents leaders of the various groups in the UK and Ireland Neuroendocrine Tumour Society, but a large amount of work has been carried out by other specialists, many of whom attended a guidelines conference in May 2009. We have attempted to represent this work in the acknowledgements section. Over the past few years, there have been advances in the management of neuroendocrine tumours, which have included clearer characterisation, more specific and therapeutically relevant diagnosis, and improved treatments. However, there remain few randomised trials in the field and the disease is uncommon, hence all evidence must be considered weak in comparison with other more common cancers. [ABSTRACT FROM AUTHOR]

In recent years, the concept of sustainable consumption (SC) has received increased attention. Overconsumption in industrialized countries still presents major challenges to achieving sustainable development goals despite the global economic crisis. This paper offers an in-depth analysis of national influences on consumption patterns in the Republic of Ireland, focusing in particular on the role of governance in the design of policy instruments for sustainable consumption. It is argued that country-specific political conditions and policy frameworks fundamentally shape everyday household consumption. After an initial discussion of the effectiveness of three key types of policy instruments-legislative, economic, communicative-the paper compares SC policy making and implementation in Ireland with examples of good practice from Europe. An agenda to progress Ireland's sustainable consumption policy framework is proposed in the concluding part of the paper. [ABSTRACT FROM AUTHOR]

Contemporary consumption represents an archetypal 'wicked problem', being linked to climate change, biodiversity loss and resource depletion, while also functioning as a cultural signifier and a driver of economic growth and innovation. The Janus-faced nature of consumption is an important indicator of the complexity facing those who aspire to encouraging more sustainable consumption patterns. This paper argues that there are outstanding, and related, areas of contention that need further research in order to generate a more comprehensive and coherent picture of consumption and how it may be made more sustainable. In essence attention needs to be paid to the practices of consumption, its governance and also how practices and governance interact. This paper examines everyday practices and their regulation in two key areas of consumption in Ireland - how we get around (transport) and how we live in our homes (heating/cooling, lighting, cleaning and eating) - to identify current gaps in social science research. In conclusion a multi-pronged research framework for approaching these lacunae is outlined. [ABSTRACT FROM AUTHOR]

Background: Individual medical schools currently decide on the content and delivery of their undergraduate psychiatry curriculum, so there is probably significant variation in the students’ experience of the speciality during the medical course and in the extent to which they develop the appropriate skills and knowledge base. Aim: To ascertain how the teaching of undergraduate psychiatry differs across UK and Irish medical schools. Methods: The educational lead for psychiatry at each medical school in the United Kingdom and Ireland completed a questionnaire providing factual information on the teaching structure, contents and assessment methods in their current psychiatry curriculum. Results: Some aspects of the curriculum were consistent across the medical schools with other areas showing great variability. The course content was broadly similar but the assessment, length of experience and course structure differed. Conclusion: There are significant differences in how psychiatry is taught to undergraduate students in the United Kingdom and Ireland and although all the curricula are evaluated by the General Medical Council, further study is required to see if this has any effect on the levels of competency achieved. [ABSTRACT FROM AUTHOR]

Environmentally focused social economy activities have been identified as archetypal examples of sustainable development: what might be called grassroots sustainability enterprises. The economic, social and environmental benefits that they can offer have been alluded to, but little empirical evaluation has been conducted examining the governing conditions under which they emerge or the impacts they engender. In response this paper investigates the experiences of one arena of grassroots sustainability enterprise in Ireland, community based recycling organizations (CBROs). The research found that the tripartite focus of CBROs on economic development, environmental enhancement and social capacity building can be problematic rather than bringing enhanced status. Building on an analysis of national planning documents it is proposed that such problems emerge as dominant governing conditions are pursuing ecological modernization and social partnership as distinct rather than integrated pathways of development. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

Abstract: A task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) was convened to produce some up-to-date, evidence-based, practical, clinical guidelines on the management of cancer-related breakthrough pain in adults. On the basis of a review of the literature, the task group was unable to make recommendations about any individual interventions, but was able to make a series of 12 recommendations about certain generic strategies. However, most of the aforementioned recommendations are based on limited evidence (i.e., case series, expert opinion). The task group also proposed a definition of breakthrough pain, and some diagnostic criteria for breakthrough pain. [Copyright &y& Elsevier]

Irish waste collectors were advised by the Department of Environment, Heritage and Local Government to adopt pay-by-use (PBU) domestic waste charges from 1 January 2005. The measure was taken to combat the rising volumes of waste produced nationally and to apply the 'polluter pays' principle to waste charging, in line with EU principles. The implementation of PBU domestic waste charges in Ireland and the impact of these charges nationally, in terms of waste to landfill, recycling and illegal waste diversion, were examined using a combination of postal surveys and telephone interviews with local authorities. The research revealed that PBU has had the desired effect of reducing waste to landfill. However, as currently applied in Ireland, PBU is not reaching its full potential. The use of a variety of PBU charging systems across the country, with one system used widely in Ireland considered internationally as the least effective PBU system available, and the absence of universal curbside recycling services, may have contributed to the relatively small decreases in waste to landfill on a nationwide level when compared to reductions reported internationally. [ABSTRACT FROM AUTHOR]

The question of how best to govern waste is a challenging issue across the globe. As a result, new policy instruments, such as voluntary agreements, eco-labelling and market based instruments, frequently identified as being emblematic of a shift from government to governance are being developed and implemented in an attempt to improve waste management. In particular, the introduction of pay-by-use (PBU) mechanisms, where charges are based on the weight or volume of waste presented for collection, have been cited as a key means to promote the polluter pays principle (PPP) in the waste field. However, most analyses of waste charges have attempted to quantify PBU impacts in terms of tonnes of waste diverted from landfill, recycled or dumped illegally, and less consideration has been given to their development and implementation from a governing perspective. In response, this paper reports on a nationwide survey of PBU in Ireland that revealed a general increase in recycling and diversion from landfill since it was introduced in 2005. The paper concludes that although such metrics seem to support the introduction of PBU they must be read within a dynamic policy context characterized by limited information, increasingly privatized waste services and neoliberal statecraft. [ABSTRACT FROM AUTHOR]

This 3-day conference, with a focus on formulation, is part of a series of conferences organized by Meetings Management on different aspects of vaccine adjuvants. The previous Modern Vaccine/Adjuvants Formulation took place in Prague in 2004 and it was interesting to observe what has changed and what since then remains the same. [ABSTRACT FROM AUTHOR]