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In this paper the authors report on a qualitative investigation into service mathematics carried out in Irish universities against a backdrop of major concerns nationally and internationally embodied in the so-called "Mathematics problem". The enquiry involved a close inspection of how service mathematics is perceived, planned, delivered, evaluated, assessed and experienced by both lecturers and students in selected service mathematics courses in all seven Irish universities. Murphy (2002) used Brousseau?s concept of didactical contract to uncover the implicit contract present in Irish second level classrooms. The authors emulated this work to discover the hidden learning contract in university service mathematics lectures in Ireland. Major outcomes of the study include insight into the nature of the didactical contract at work in the service mathematics courses surveyed, and the development of a preliminary characterisation of service mathematics in Irish universities. Service mathematics is also an issue for adult mathematics education and impacts on it.

Island studies have rarely focused on the role of small schools on offshore islands. Island schools are often impacted by the decisions of national, regional and local educational authorities, particularly in today's world where diseconomic and disbenefit arguments highlight the non-viability of small schools. Such schools are seen as unable to provide an adequate curriculum, socially disadvantageous and generally inefficient. This raises an important question: How does a small island school promote the participation and engagement of families and the community? This paper reports a bounded case to illustrate the characteristics intrinsic to a single small rural school as a communal hub on one of Ireland's Atlantic islands. A narrative about the school in past and present times, along with vulnerability mapping, is used to explore the social dynamics of the island school within its community. The findings show how the modern diaspora is different from that of earlier generations. The case also illustrates the differences in vulnerabilities between a perceived attractive environment, supported by a viable school potentially driving in-migration, and communities where the absence of a primary school or the risk of its closure would diminish the attractiveness of an island as a place for young families.

In a time when mathematical under-preparedness is widespread and learning support is most urgently needed, this investigation seeks to evaluate the effectiveness of the mathematics learning centre (MLC) in the University of Limerick. Qualitative and quantitative data on the impact of the MLC on the students' mathematics education and students' attitudes towards mathematics were collected through the use of student questionnaires. Analysis of this data provides significant evidence that the MLC is making a valuable contribution to the mathematical experience of the students who are availing of its services. The results of this study strongly support the belief that MLCs have the potential to provide students with both the affective and cognitive support that is so critical to many of the students entering third-level education presently.

Recovering additional historical weather observations from known archival sources will improve the understanding of how the climate is changing and enable detailed examination of unusual events within the historical record. The UK National Meteorological Archive recently scanned more than 66,000 paper sheets containing 5.28 million hand‐written monthly rainfall observations taken across the UK and Ireland between 1677 and 1960. Only a small fraction of these observations were previously digitally available for climate scientists to analyse. More than 16,000 volunteer citizen scientists completed the transcription of these sheets of observations during early 2020 using the RainfallRescue.org website, built using the Zooniverse platform. A total of 3.34 million observations from more than 6000 locations have so far been quality controlled and made openly available. This has increased the total number of monthly rainfall observations that are available for this time period and region by a factor of six. The newly rescued observations will enable longer and much improved reconstructions of past variations in rainfall across the British and Irish Isles, including for periods of significant flooding and drought. Specifically, this data should allow the official gridded monthly rainfall reconstructions for the UK to be extended back to 1836, and even earlier for some regions. [ABSTRACT FROM AUTHOR]

Peatlands store up to 2320 Mt of carbon (C) on only ~20% of the land area in Ireland; however, approximately 90% of this area has been drained and is emitting up to 10 Mt C per year. Gross primary productivity (GPP) is a one of the key components of the peatland carbon cycle, and detailed knowledge of the spatial and temporal extent of GPP under changing management practices is imperative to improve our predictions of peatland ecology and biogeochemistry. This research assesses the relationship between remote sensing and ground-based estimates of GPP for a near-natural peatland in Ireland using eddy covariance (EC) techniques and high-resolution Sen-tinel 2A satellite imagery. Hybrid models were developed using multiple linear regression along with six widely used conventional indices and a light use efficiency model. Estimates of GPP using NDVI, EVI, and NDWI2 hybrid models performed well using literature-based light use efficiency parameters and showed a significant correlation from 89 to 96% with EC-derived GPP. This study also reports additional site-specific light use efficiency parameters for dry and hydrologically normal years on the basis of light response curve methods (LRC). Overall, this research has demonstrated the potential of combining EC techniques with satellite-derived models to better understand and monitor key drivers and patterns of GPP for raised bog ecosystems under different climate scenarios and has also provided light use efficiency parameters values for dry and wetter conditions that can be used for the estimation of GPP using LUE models across various site and scales. [ABSTRACT FROM AUTHOR]

This article reports on the mathematical competency of students entering third-level education in the University of Limerick (UL). Data from diagnostic testing, gathered on 5,949 students between the years 1998 and 2008, are used to demonstrate the changes in competency levels of students entering UL. There has been a significant decline in the performance of students in the diagnostic test over time. The performance, on average, of students with the same leaving certificate mathematics grade on entry into university has not changed significantly over time. However, the profile of the entrants has changed considerably and this is contributing to the overall decline in mathematical competency.

Hunt and Lawson 1 displayed the evidence of decline in the mathematical standards of first-year students in Coventry University between 1991 and 1995. Gill 2 sought to investigate if this was also the case in the University of Limerick (UL). The results of diagnostic tests administered to first-year undergraduates in the science and technology groups (service mathematics courses) between 1997 and 2002 displayed the evidence that the mathematical standard of students entering the university of Limerick service mathematics courses had declined over the 6 years studied. In this article, the authors revisit the university of Limerick database, which currently holds data for over 6200 students, to investigate current mathematical entry standards of students in service mathematics courses. The university of Limerick responses to the "Mathematics Problem" are also described. Ireland presents a unique situation in terms of the mathematical homogeneity of its third-level students; most students enter via the same route, i.e. the Leaving Certificate, on completion of 13 years of formal mathematics education. However, while research results and coping mechanisms in terms of learning support are not generalizable, they are portable. It is hoped that mathematics educators worldwide can learn from the Irish situation. (Contains 5 tables and 8 figures.)

Lough Gur is a shallow groundwater fed eutrophic lake situated within a small agricultural catchment containing volcanic and karst rock features in mid‐west Ireland. Seasonally active conduits linking two spring discharge locations from the lake under high flow conditions were revealed using dye tracing and a terrestrial geophysical survey, highlighting the architecture of the conduit flow path from Lough Gur to its discharge spring. A radon survey combined with a lake geophysical survey identified the locations of in‐lake discharge springs and thickness of the lakebed sediments. Falling head hydraulic characterization experiments illustrated the heterogenous nature of lakebed sediments and hydrograph analysis coupled with stable isotopes of water (δ18O and δ2H) revealed significant surface water ‐ groundwater interaction during high flow periods. Significantly, δ18O and δ2H signatures plot above the global meteoric water line and local meteoric water line indicating hydration of silicate minerals and direct isotope exchange of δ18O between water and rock minerals. Groundwater δ18O and δ2H signatures during low flow periods indicate that recharge sources are influenced by enriched surface waters and precipitation while a wider range of signatures during high flow periods indicates a greater variation of sources. D‐excess signatures illustrate rapid rainfall infiltration under high flow conditions, thereby demonstrating the vulnerability of the groundwater, while lake water signatures confirm widespread surface water‐groundwater interaction/mixing. Hydrochemical analyses confirm both silicate weathering and carbonate dissolution as primary geochemical processes with Mg/Ca ratios suggesting greater groundwater residence time during low flow periods. Correlations between δ13CDIC and dissolved organic carbon suggest a seasonal switch in the source of DIC to groundwaters between the oxidation of organic matter in summer and dissolution of carbonate minerals in winter. The SI saturation index for calcite (SIC) illustrates calcium carbonate precipitation along with CO2 evasion to be a perennial processes. Finally, the spatial variation for nitrate isotopic signatures (δ18ONO3‐ and δ15NNO3‐) suggests a number of nitrate sources to groundwaters including soil organic nitrogen, manure and/or domestic effluent with indications of denitrification processes under low flow conditions. [ABSTRACT FROM AUTHOR]

Sacred wells and springs are important cultural features in many societies. A recent study in Ireland may be the first detailed countrywide investigation of the hydrogeology and water chemistry of sacred wells. Key findings are discussed in relation to case studies elsewhere. A wide range of hydrogeological settings are represented. There is evidence of anthropogenic impacts at many sacred springs and wells. Communication of potential health impacts is necessary but challenging, because of the sensitivities surrounding these sacred water sources. [ABSTRACT FROM AUTHOR]

The current grid code in Ireland requires wind farms to deliver meteorological data to the two transmission system operators. The importance of accurate on‐site measured wind speed signals increases as a function of the installed wind capacity. Since wind farms have been installed with varying technologies over the past 20 years, the system does not have a single point of failure. The lack of uniformity has been found to be both a handling challenge and reliability strength. In order to investigate the future compatibility of the current quality of MET data and to verify, whether and which types of new technology may be an acceptable source of meteorological data to be delivered to the TSOs, a study has been carried out. The study verified whether the quality of meteorological data is sufficient and reliable enough for the 2030 penetration targets set by the Irish government. This paper will describe the methods used to verify the quality of meteorological data signals, along with the various types of meteorological measurements that were found to be acceptable under varying conditions. The authors will also present several recommendations based on the findings of the study, and discuss how these recommendations are being implemented by EirGrid. [ABSTRACT FROM AUTHOR]

Evaluating the impact of environmental changes on past societies is frequently confounded by the difficulty of establishing cause-and-effect at relevant scales of analysis. Commonly, paleoenvironmental records lack the temporal and spatial resolution to link them with historic events, yet there remains a tendency to correlate climate change and cultural transformations on the basis of their seeming synchronicity. Here, we challenge perceptions of societal vulnerability to past environmental change using an integrated paleoenvironmental and land-use history of a remote upland site in the north of Ireland. We present a high-resolution, multi-proxy record that illustrates extended occupation of this marginal locality throughout the climate oscillations of the last millennium. Importantly, historically-dated volcanic ash markers enable us to pinpoint precisely in our record the timing of major national demographic crises such as the Black Death and the European, Irish and Great (Potato) Famines. We find no evidence that climate downturns or demographic collapses had an enduring impact on the use of the uplands: either the community escaped the effects of these events, or population levels recovered rapidly enough (within a generation) to leave no appreciable mark on the palaeoenvironmental record. Our findings serve to illustrate the spatial complexity of human activity that can enable communities to withstand or quickly bounce back from largescale calamities. In neglecting to consider such local-scale variability in social and economic organization, generalized models of societal collapse risk overplaying the vulnerability of populations to long- and short-term ecological stressors to the detriment of identifying the social constraints that influence a population's response to change. [ABSTRACT FROM AUTHOR]

The article explores the impact of adverse childhood experiences (ACEs) on adults who are currently experiencing homelessness. It examines the prevalence of ACEs in a homeless population and their relationship with current health status. It is reported that the research was conducted in Ireland and focused on understanding the unique experiences of homeless individuals who have a history of trauma and adversity.

In karst limestone areas interactions between ground and surface waters can be frequent, particularly in low lying areas, linked to the unique hydrogeological dynamics of that bedrock aquifer. In extreme hydrological conditions, however, this can lead to wide‐spread, long‐duration flooding, resulting in significant cost and disruption. This study develops and compares a nonlinear time‐series analysis based nonlinear autoregressive model with exogenous variables (NARX), machine learning based near support vector regression as well as a linear time‐series ARX model in terms of their performance to predict groundwater flooding in a lowland karst area of Ireland. The models have been developed upon the results of several years of field data collected in the area, as well as the outputs of a highly calibrated semi‐distributed hydraulic/hydrological model of the karst network. The prediction of total flooding volume indicates that the performances of all the models are similarly accurate up to 10 days into the future. A NARX model taking inputs of the past 5 days' flood volume; rainfall data and tidal amplitude data across the past 4 days, showed the best flood forecasting performance up to 30 days into the future. Existing real‐time telemetric monitoring of water level data at two points in the catchment can be fed into the model to provide an early warning flood warning tool. The model also predicts freshwater discharge from the inter‐tidal spring into the Atlantic Ocean which hitherto had not been possible to monitor. Key Points: Early warning system for groundwater flooding in lowland karst developed using nonlinear modeling approachesNonlinear autoregressive model with exogenous variables showed the best flood forecasting performance up to 60 days into the futureReal‐time telemetric monitoring of water level in the catchment can be fed into the model to provide an early warning flood warning tool [ABSTRACT FROM AUTHOR]

Two wheat genotypes forming high and low biomass, exhibiting differential expression of an isoflavone reductase -like (IRL) gene, and resulting in contrasting grain yield under heat stress field conditions were analyzed in detail for their responses under controlled heat and elevated CO2 conditions. Significant differences in IRL expression between the two lines were hypothesized to be the basis of their differential performance under the tested conditions and their stress tolerance potential. By a holistic approach integrating advanced cell physiological phenotyping of the antioxidative and phytohormone system in spikes and leaves with measurements of ecophysiological and agronomic traits, the genetic differences of the genotypes in IRL expression were assessed. In response to heat and elevated CO2, the two genotypes showed opposite regulation of IRL expression, which was associated with cytokinin concentration, total flavonoid contents, activity of superoxide dismutase, antioxidant capacity and photosynthetic rate in leaves, and cytokinin concentration and ascorbate peroxidase activity in spikes. Our study showed that IRL expression is associated with wheat yield performance under heat stress at anthesis, mediated by diverse physiological mechanisms. Hence, based on our results, the IRL gene is a promising candidate for developing genetic markers for breeding heat-tolerant wheat. [ABSTRACT FROM AUTHOR]

A 28‐year hydrological record on four intermittent wetlands (turloughs) in a hydraulically linked karst area in the west of Ireland was used to assess ecohydrological metrics for different vegetation communities. A methodology using a combination of continuous water level monitoring and high resolution topographic surveying was used to develop a detailed hydrological model of the karst network, from which water levels at any point within the turloughs can be defined at any time during the 28‐year period (1989 to 2017). The flood conditions experienced across the spatial distributions for different vegetation communities (as mapped by a field survey) have then been collated and presented as statistical distributions for flood duration, flood depth, flood frequency and mean temperature/global radiation at the time of year in spring when the flood waters start to recede. Analysis of these four turloughs has revealed distinct differences between vegetation communities, from Eleocharis acicularis communities at the turlough base typically experiencing 6 to 7 months of inundation per year compared to the limestone pavement community at the top fringes of the turloughs only flooded from 1 to 2 months per year. An approach that used Sentinel‐2 satellite data to provide an assessment of whether there have been changes in the spatial distribution of the communities is also presented. Such metrics can be evaluated alongside other variables such as water quality (particularly nutrients), soil type and land‐use, in order to understand the habitat requirements for such plant communities and their associated ecological systems. [ABSTRACT FROM AUTHOR]

Monitoring wetlands is necessary in order to understand and protect their ecohydrological balance. In Ireland, traditionally wetland-monitoring is carried out by manual field visits which can be very time-consuming. To automate the process, this study extends the ability of remote sensing-based monitoring of wetlands by combining RGB image processing, machine learning algorithms, and satellite data analysis to create seasonal maps of vegetation communities within the wetlands. The methodology matches multispectral and broad coverage of open-source Sentinel-2 (S2) imagery with the high spatial granularity of Unmanned Aerial Vehicles (UAV) or drone images. Single sensor drone imagery was captured, colour corrected and classified using random forest (RF) classifier for a subset of the wetland. The classified imagery was upsampled to satellite imagery scale to create training data for vegetation-segmentation in the entire wetland. The process was repeated for multiple seasons, and an annual map was created utilising the majority voting. The proposed framework has been evaluated on various wetlands across Ireland, with results presented herein for an ombrotrophic peatland complex, Clara Bog. The accuracy of the maps was checked utilising a set of area-based performance metric. The application of this method thereby reduces the number of field surveys typically required to assess the long-term ecological change of such wetland habitats. The performance of the proposed method demonstrates that the technique is a robust, quick, and cost-effective way to map wetland habitats seasonally and to explore their ecohydrological synergies. [ABSTRACT FROM AUTHOR]

Lowland karst aquifers can generate unique wetland ecosystems which are caused by groundwater fluctuations that result in extensive groundwater–surface water interactions (i.e. flooding). However, the complex hydrogeological attributes of these systems, linked to extremely fast aquifer recharge processes and flow through well-connected conduit networks, often present difficulty in predicting how they will respond to changing climatological conditions. This study investigates the predicted impacts of climate change on a lowland karst catchment by using a semi-distributed pipe network model of the karst aquifer populated with output from the high spatial resolution (4 km) Consortium for Small-scale Modelling Climate Lokalmodell (COSMO-CLM) regional climate model simulations for Ireland. An ensemble of projections for the future Irish climate were generated by downscaling from five different global climate models (GCMs), each based on four Representative Concentration Pathways (RCPs; RCP2.6, RCP4.5, RCP6.0 and RCP8.5) to account for the uncertainty in the estimation of future global emissions of greenhouse gases. The one-dimensional hydraulic/hydrologic karst model incorporates urban drainage software to simulate open channel and pressurised flow within the conduits, with flooding on the land surface represented by storage nodes with the same stage volume properties of the physical turlough basins. The lowland karst limestone catchment is located on the west coast of Ireland and is characterised by a well-developed conduit-dominated karst aquifer which discharges to the sea via intertidal and submarine springs. Annual above ground flooding associated with this complex karst system has led to the development of unique wetland ecosystems in the form of ephemeral lakes known as turloughs; however, extreme flooding of these features causes widespread damage and disruption in the catchment. This analysis has shown that mean, 95th and 99th percentile flood levels are expected to increase by significant proportions for all future emission scenarios. The frequency of events currently considered to be extreme is predicted to increase, indicating that more significant groundwater flooding events seem likely to become far more common. The depth and duration of flooding is of extreme importance, both from an ecological perspective in terms of wetland species distribution and for extreme flooding in terms of the disruption to homes, transport links and agricultural land inundated by flood waters. The seasonality of annual flooding is also predicted to shift later in the flooding season, which could have consequences in terms of ecology and land use in the catchment. The investigation of increasing mean sea levels, however, showed that anticipated rises would have very little impact on groundwater flooding due to the marginal impact on ebb tide outflow volumes. Overall, this study highlights the relative vulnerability of lowland karst systems to future changing climate conditions, mainly due to the extremely fast recharge which can occur in such systems. The study presents a novel and highly effective methodology for studying the impact of climate change in lowland karst systems by coupling karst hydrogeological models with the output from high-resolution climate simulations. [ABSTRACT FROM AUTHOR]

Identifying the origin of faecal pollution in water is needed for effective water management decisions to protect both human health and aquatic ecosystems. Traditionally used indicators of faecal contamination, such as E. coli , only indicate pollution from warm-blooded animals and not the specific source of contamination; hence, more source specific tracers are required. The study has focussed on separating the two main sources of contaminants within rural catchments in Ireland, agriculture and on-site wastewater treatment systems (predominantly septic tanks). While human-specific effluent tracers may assist in identifying potential pathways from individual septic tanks to surface waters, it is difficult to quantify the cumulative impact of such systems at a catchment scale. This study has investigated faecal sterols as a method to quantify such an impact on four small catchments in areas of low subsoil permeability with high densities of septic tanks. The results demonstrate the usefulness of faecal sterols which provide a quantitative evaluation of the respective impact between agricultural pasture inputs and on-site effluent showing differences between the four catchments. The study also highlights the need to derive more specific local reference sterol profile databases for specific countries or regions, using local source material of animal faeces and effluent. Two intensive sampling campaigns on the four catchments then used faecal sterols in parallel to fluorescent whitening compounds (FWCs), caffeine, artificial sweeteners and selected pharmaceuticals to gain further insights and confirmation about contamination hotspots as well as providing comparison between the different parameters. The combination of sterols, FWCs, caffeine, acesulfame and cyclamate has proven suitable to provide an estimate of the extent of human contamination in these rural catchments and has yielded additional information about potential pollution pathways and proximity of contamination. Overall, this methodology can help to facilitate a targeted and effective water management in such catchments. [Display omitted] • Sterols were successfully applied as faecal source indicators in small catchments. • For a reliable application of sterols a local reference material database is needed. • A multi-metric approach with different chemical MST methods is recommended. • Tracers should be selected based on catchment characteristics & application purpose. • Here faecal sterols, FWCs, caffeine, acesulfame & cyclamate were suitable tracers. [ABSTRACT FROM AUTHOR]

Several different approaches have been developed to model the specific characteristics of karst aquifers, taking account of their inherent complex spatial and temporal heterogeneities. This paper sets out the development of a semidistributed modelling approach for applications in an Irish karst context using urban drainage software. The models have proven to be very useful for different studies, with examples given for the ecohydrology of ephemeral karst lakes, extreme groundwater-flood alleviation, karst network investigation, submarine groundwater discharge, and quantification of different recharge and flow components. The limitations of the approach are also highlighted, in particular not being able to simulate diffuse infiltration and flow paths explicitly across the groundwater catchment. Hence, a more distributed, finite-difference modelling approach using MODFLOW Unstructured Grid (USG) with the newly developed Connected Linear Network (CLN) process is then compared against the semidistributed approach on the same karst catchment. Whilst it has proven difficult to achieve the same levels of model performance in simulating the spring flows in the distributed model compared to the semidistributed model, the ability to interrogate the flow paths at any point on the three-dimensional aquifer is demonstrated, which can give new insights into flows (and potential contaminant transport) through such complex systems. The influence of the proximity of highly transmissive conduits on the flow dynamics through the much-lower transmissive matrix cells in which the network is embedded has been particularly investigated. [ABSTRACT FROM AUTHOR]

The HeadUp collar (previously known as the Sheffield Support Snood) provides support for neck weakness caused by amyotrophic lateral sclerosis (ALS) and has shown to be superior to alternative options in a small cohort of patients from one single center. Here we report the assessment of the HeadUp collar in a larger cohort of patients, exploring the use in other neurological conditions and expanding to other centers across the UK and Ireland. An interventional cross-sectional study design was implemented to investigate the usability and acceptability of the HeadUp collar. A total of 139 patients were recruited for the study, 117 patients had a diagnosis of ALS and 22 patients presented with neck weakness due to other neurological conditions. Participants were assessed at baseline, fitted a HeadUp collar and followed-up one month later. The performance of the HeadUp collar was rated favorably compared to previously worn collars in terms of the ability to eat, drink and swallow. Findings suggest that the collar also permitted a more acceptable range of head movements whilst maintaining a good level of support. We conclude that the HeadUp collar is a suitable option for patients with neck weakness due to ALS and other neurological conditions. [ABSTRACT FROM AUTHOR]

Karstified carbonate aquifers are highly heterogeneous systems characterized by multiple recharge, flow, and discharge components. The quantification of the relative contribution of these components, as well as their numerical representation, remains a challenge. This paper identifies three recharge components in the time and frequency domain. While the analysis in the time domain follows traditional approaches, the analysis of the power spectrum allows frequencies associated with specific spectral coefficients and noise types to be distinguished more objectively. The analysis follows the presented hypothesis that the different frequency‐noise components are the result of aquifer heterogeneity transforming the random rainfall input into a sequence of non‐Gaussian signals. The distinct signals are then numerically represented in the context of a semidistributed pipe network model in order to simulate recharge, flow, and discharge of an Irish karst catchment more realistically. By linking the power spectra of the modeled recharge components with the spectra of the spring discharge, the information usually gained by classical performance indicators is significantly widened. The modeled spring discharge is well matched in the time and frequency domain, yet the different recharge dynamics explain the signal of the aquifer outlet in different noise domains across the spectrum. This study demonstrates the conjunctive use of frequency analysis in conceptualization of a hydrological system together with modeling and evaluation. Key Points: Hydrograph analysis was coupled with frequency and noise analysis to identify recharge dynamics in a karst spring discharge time seriesRecharge, flow, and discharge were modeled in a semidistributed pipe network model considering aquifer heterogeneities and noise domainsA new model evaluation approach using noise analysis provided information on the individual contribution of the internal flows [ABSTRACT FROM AUTHOR]

The importance of characterizing the ecohydrological interactions in natural, damaged/drained, and restored bogs is underscored by the importance of peatlands to global climate change and the growing need for peatland restoration. An understudied aspect of peatland ecohydrology is how shallow lateral flow impacts local hydrological conditions and water balance, which are critical for peatland restoration success. A novel method is presented using microcosms installed in the field to understand the dynamics of shallow lateral flow. Analysis of the difference in water table fluctuation inside and outside the microcosm experimental areas allowed the water balance to be constrained and the calculation of lateral flow and evapotranspiration. As an initial demonstration of this method, a series of four microcosm experiments were set up in locations with differing ecological quality and land management histories, on a raised bog complex in the midlands of Ireland. The timing and magnitude of the lateral flow differed considerably between locations with differing ecological conditions, indicating that shallow lateral flow is an important determining factor in the ecohydrological trajectory of a recovering bog system. For locations where Sphagnum spp. moss layer was present, a slow continuous net lateral input of water from the upstream catchment area supported the water table during drought periods, which was not observed in locations lacking Sphagnum. Consistent with other studies, evapotranspiration was greater in locations with a Spaghnum moss layer than in locations with a surface of peat soil. [ABSTRACT FROM AUTHOR]

To describe the population of young people in Ireland diagnosed with narcolepsy with regards to vaccine exposure, symptomatology, investigation results and experience of medical treatment. Retrospective review of medical records at the single tertiary referral centre for young people with narcolepsy in Ireland. Sixty-seven patients were diagnosed with narcolepsy between July 2006 and July 2017. Sixty-one (91%) of these developed symptoms after receiving the Pandemrix vaccine. The population was largely homogeneous with low hypocretin (87.5%), HLA DQB1∗0602 positivity (95%) and unremarkable findings on MRI Brain (100%). 77.6% experienced cataplexy; we also measured high levels of obesity, school non-attendance and psychosocial complexity. Symptoms often continued despite treatment, with multiple medications prescribed in 76.1% of patients. Prescription of sodium oxybate was associated with a significant reduction in BMI standard deviation scores at 6 months, with improved IOTF obesity scores seen at 36 month follow-up. This paper describes the experience of narcolepsy in children and young people in Ireland from 2006 – 2017 at the national tertiary referral centre. Narcolepsy in children and young people in Ireland carries a significant burden of illness, with impact on participation in education as well as physical and mental health. Symptoms can be refractory to medical treatment. Referral to tertiary centres for prompt treatment and multidisciplinary input is essential. • This study describes the Irish national experience of narcolepsy in children and young people since 2009. • The population was largely homogeneous with low hypocretin, HLA DQBQ∗0602 positivity, and normal MRI Brain. • Pandemrix vaccine exposure preceded symptom onset in the majority of cases. • Symptoms of narcolepsy were resistant to treatment with single agents; medication side-effects were common. • High levels of obesity, school non-attendance and psychosocial complexity are described. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Applied Ecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hydrogeology Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Previous studies on the safety of peri-operative transoesophageal echocardiography seem to suggest a low rate of associated morbidity and mortality. That said, there has been a paucity of prospective multicentre studies in this important area of clinical practice. We carried out a one-year prospective study in 2017, co-ordinated by the Association of Cardiothoracic Anaesthesia and Critical Care, to determine the rate and severity of complications associated with peri-operative transoesophageal echocardiography in anaesthetised cardiology and cardiac surgical patients. With the help of clinicians from 28 centres across the UK and Ireland, we recorded the total number of examinations conducted in anaesthetised patients during the study period. All major complications at each centre were prospectively reported and recorded. Of the 22,314 examinations, there were 17 patients diagnosed with a major complication which caused either palatal injury or gastro-oesophageal disruption. This corresponds to an incidence of 0.08% (95%CI 0.05-0.13%) or approximately 1:1300 examinations. There were seven deaths reported during the study period which were directly attributed to these complications, corresponding to an incidence of 0.03% (95%CI 0.01-0.07%) or approximately 1:3000. These figures are higher than previously reported and suggest a high probability of death following the development of a complication (~40%). Most complications occurred in patients without known risk factors for transoesophageal echocardiography associated gastro-oesophageal injury. We suggest clinicians and departments review their procedural guidelines, especially in relation to probe insertion techniques, together with the information communicated to patients when the risks and benefits of such examinations are discussed. [ABSTRACT FROM AUTHOR]

Ireland has experienced significant recent changes as to how the nation's water and wastewater infrastructure is managed, as a result of a national water utility, Irish Water, being founded in 2013. The management of surface and foul water used to be governed by local authorities, with inherently local outlooks with respect to the prevention of both pollution and flooding. The introduction of Irish Water with a more national (and global) agenda into this traditionally locally focused service has introduced an additional layer of governance. This study has used this management structure overhaul opportunity to make a critical evaluation of current sustainable stormwater management practices and policies in Ireland, using Dublin as a case study. From a combination of structured interviews and literature review, the paper evaluates the conditions that help promote effective sustainable drainage policies and implementation against those aspects that cause such infrastructure to be merely an irrelevant add-on. The key barriers to the uptake of sustainable stormwater management practices in Ireland have been summarised as well as suggestions made as to how these can be overcome. This research has highlighted the need for the engineer to play a more visible role in such matters of public interest. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Patients undergoing prolonged pelvic surgery may develop compartment syndrome of one or both lower limbs in the absence of direct trauma or pre‐existing vascular disease (well leg compartment syndrome). This condition may have devastating consequences for postoperative recovery, including loss of life or limb, and irreversible disability. Methods: These guidelines represent the collaboration of a multidisciplinary group of colorectal, vascular and orthopaedic surgeons, acting on behalf of their specialty associations in the UK and Ireland. A systematic analysis of the available peer‐reviewed literature was undertaken to provide an evidence base from which these guidelines were developed. Results: These guidelines encompass the risk factors (both patient‐ and procedure‐related), diagnosis and management of the condition. Key recommendations for the adoption of perioperative strategies to facilitate prevention and effective treatment of well leg compartment syndrome are presented. Conclusion: All surgeons who carry out abdominopelvic surgical procedures should be aware of well leg compartment syndrome, and instigate policies within their own institution to reduce the risk of this potentially life‐changing complication. [ABSTRACT FROM AUTHOR]

The quantification of submarine and intertidal groundwater discharge (SiGD) or purely submarine groundwater discharge (SGD) from coastal karst aquifers presents a major challenge, as neither is directly measurable. In addition, the expected heterogeneity and intrinsic structure of such karst aquifers must be considered when quantifying SGD or SiGD. This study applies a set of methods for the coastal karst aquifer of Bell Harbour in western Ireland, using long-term onshore and offshore time series from a high-resolution monitoring network, to link catchment groundwater flow dynamics to groundwater discharge as SiGD. The SiGD is estimated using the “pollution flushing model”, i.e. a mass-balance approach, while catchment dynamics are quantified using borehole hydrograph analysis, single-borehole dilution tests, a water balance calculation, and cross-correlation analysis. The results of these analyses are then synthesised, describing a multi-level conduit-dominated coastal aquifer with a highly fluctuating overflow regime draining as SiGD, which is in part highly correlated with the overall piezometric level in the aquifer. This concept was simulated using a hydraulic pipe network model built in InfoWorks ICM [Integrated Catchment Modeling]® version 7.0 software (Innovyze). The model is capable of representing the overall highly variable discharge dynamics, predicting SiGD from the catchment to range from almost 0 to 4.3 m3/s. The study emphasises the need for long-term monitoring as the basis for any discharge studies of coastal karst aquifers. It further highlights the fact that multiple discharge locations may drain the aquifer, and therefore must be taken into consideration in the assessment of coastal karst aquifers. [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]

• Falling head (PT) vs constant head (K fs) hydraulic conductivities across Irish soils. • Reynolds (2008) solution should be used to determine K fs in Irish context. • PT vs K fs relationship for Irish soils matches more generic formulations closely. • Comparison of international standards for soil treatment units provided. • Irish threshold PT limits for on-site wastewater treatment converted to K fs values. The suitability of a location for an on-site wastewater treatment process (for areas which lack access to centralised wastewater treatment systems) requires an assessment of the permeability of the soil into which the effluent will be discharged. In many jurisdictions this is determined using some type of in-situ percolation test. Falling head percolation tests, which give a value of percolation time (PT) that is empirically related to the notion of hydraulic conductivity, are widely used as they are relatively simple to carry out, but the test does not have a sound theoretical framework and test methods are not standardised internationally. In comparison, the saturated hydraulic conductivity of a soil obtained from a constant head well permeameter test is independent of test conditions, and so is a more suitable metric for design. A database of over 900 falling head tests carried out across a range of different subsoil types in Ireland has been collated, all with the inherent limitations of the existing regulative framework regarding the percolation test and soil texture assessment. These tests were then modelled using Hydrus 2-D numerical modelling simulations to determine equivalent field saturated hydraulic conductivity (K fs) values and thereby provide a correlation with PT values across the range of subsoil conditions. In addition, falling head tests have been carried out in parallel to constant head permeameter tests in the field and compared against the relationship derived from the broad dataset of simulated results. This revealed an optimal solution by which to determine K fs from the field permeameter test (using parameters recommended for most structured soils from clays to loams). The trendline based on Irish data was also compared against more generic formulations of the relationship between PT, and K fs and shown to match closely, particularly the Reynolds (2016) 'unified' methodology. Finally, the Irish threshold PT limits for on-site wastewater treatment have been converted to K fs values and compared against other international standards. [Display omitted] [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. Background: Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period. Design: The research used a descriptive design. Methods: A total of 809 midwives and nurses completed an anonymous, online or hard copy survey. Designed by the research team, the survey listed 26 potential barriers to the provision of perinatal mental health care. Results: Participants identified organisational factors as presenting the greatest barriers. Organisational barriers included lack of perinatal mental health services, absence of care pathways, heavy workload, lack of time, lack of privacy and not seeing women regularly enough to build a relationship. Over 50% of participants identified practitioner‐related barriers, such as lack of knowledge on perinatal mental health and cultural issues; lack of skill, in particular, skills to respond to a disclosure of a mental health issue; and fears of causing women offence and distress. Findings also indicated that the context of care and education influenced the degree to which participants perceived certain items as barriers. Conclusions: Midwives and primary care nurses encounter many organisational‐ and practitioner‐related barriers that negatively impact on their ability to incorporate mental health care into their practice. Relevance to clinical practice: Midwifery and nursing services need to develop strategies to address system‐ and practitioner‐related barriers, including the development of services and care pathways, and the provision of culturally sensitive education on perinatal mental health in order to support practitioners to address issues with confidence and competence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore public health nurses’ engagement, competence and education needs in relation to perinatal mental health care in Ireland. Background: It is estimated that 15%–25% of women will experience a mental health problem during or postpregnancy, either as a new problem or a reoccurrence of a pre-existing problem. Public health nurses, or their equivalent, are ideally positioned to support women’s mental health and improve health outcomes for the woman and baby, yet little is known about their role and engagement with mental health issues, other than with postnatal depression. The objectives of the study were to identify public health nurses’ knowledge, skills and current practices in perinatal mental health and establish their education needs. Design: The research used a descriptive design. Method: A total of 186 public health nurses completed an anonymous, online survey, designed by the research team. Results: While public health nurses are positive about their role in supporting women’s mental health, they lack the knowledge and skills to address all aspects of mental health, including opening a discussion with women on more sensitive or complex issues, such as trauma and psychosis and providing information to women. Those who received education reported statistically significant higher knowledge and confidence scores than those without. Conclusion: Public health nurses lack the knowledge and skills required to provide comprehensive perinatal mental health care to women. Future education programmes need to move beyond postnatal depression and address the range of mental health problems that may impact on women in the perinatal period. Relevance to clinical practice: Without knowledge and skill among nurses in all aspects of perinatal mental health, women with significant mental health needs may be left to cope alone and lack the necessary prompt evidence-based interventions and supports. [ABSTRACT FROM AUTHOR]

The results of this questionnaire show that the opinion of pelvic and acetabular surgeons in the UK and Republic of Ireland vary as to the best method of fixation for APC II pelvic injuries. A single anterior plate and single sacroiliac joint (SIJ) screw was the most popular fixation method, chosen by 34%. 74% favour a single, opposed to two orthogonal anterior plates. Posterior fixation supplementing anterior plating is preferred by 63% of surgeons, 58% use a single versus 42% two SIJ screws. Case by case assessment and intraoperative screening to assess stability is essential when considering whether to stabilise the SIJ. [ABSTRACT FROM AUTHOR]

The complexity of groundwater flooding poses unique challenges to policy makers and flood risk management agencies. An understanding of the interactions among recharge, storage and transport mechanisms during flood conditions is a precursor to effective groundwater flood risk assessment, but is often absent due to a lack of adequate data. The example of the Gort Lowlands, a major lowland karst catchment in the Republic of Ireland, is used to elucidate key flood mechanisms which must be considered when characterising groundwater flood risk in a lowland karst setting. The combination of large quantities of allogenic recharge, a high-capacity conduit system and deep surface depressions renders the catchment susceptible to groundwater flooding. Observed flood mechanisms include backwater flooding of sinks, overland flow caused by the overtopping of sink depressions, high water levels in turlough basins and surface ponding in local epikarst watersheds. Flood hazard maps are developed for the region using data collected during a major flood event in the winter of 2009, representing a significant contribution in the assessment and management of groundwater flood risk in Ireland. Major challenges to groundwater flood management and forecasting remain, however, and are discussed in the context of the prevailing hydrogeological and ecohydrological setting. [ABSTRACT FROM AUTHOR]

An introduction is presented in which topics within the issue are discussed which includes Irish Republican Violence, Irish republicanism and terrorism.

Background: The aim of the present study was to investigate the association of fMRI blood oxygen--level dependent (BOLD) reactivity with the level of epigenetic methylation of SLC6A4 in blood DNA from a sample of healthy participants and patients with major depressive disorder (MDD). Methods: We investigated patients with MDD and healthy controls using fMRI and an emotional attention-shifting task. We assessed site-specific DNA methylation of a previously characterized SLC6A4 region in peripheral blood DNA using pyro-sequencing. Results: Our study involved 25 patients with MDD and 35 healthy controls. Activation in the anterior insula elicited by negative emotional content was significantly positively associated with the degree of SLC6A4 methylation. Significantly negative associations were observed between activation in the posterior insula and the degree of SLC6A4 methylation when judging the geometry of pictures after seeing negative in contrast to positive emotional stimuli. Healthy controls with a high degree of SLC6A4 methylation depicted significantly more activity elicited by positive stimuli in limbic regions and more activity elicited by negative stimuli in limbic as well as cognitive control regions than those with a low degree of SLC6A4 methylation. Limitations: It is impossible to measure methylation directly in the brain and thus we assessed peripheral methylation of SLC6A4. Since the association was cross-sectional, no conclusion about cause and effect can be drawn. Conclusion: Our study provides further support to the hypothesis that particular DNA methylation states that are associated with brain function during emotion processing are detectable in the periphery. [ABSTRACT FROM AUTHOR]

Quantifying the proportion of the river hydrograph derived from the different hydrological pathways is essential for understanding the behaviour of a catchment. This paper describes a new approach using the output from master recession curve analysis to inform a new algorithm based on the Lyne and Hollick 'one-parameter' signal analysis filtering algorithm. This approach was applied to six catchments (including two subcatchments of these) in Ireland. The conceptual model for each catchment consists of four main flow pathways: overland flow, interflow, shallow groundwater and deep groundwater. The results were compared with those of the master recession curve analysis, a recharge coefficient approach developed in Ireland and the semi-distributed, lumped and deterministic hydrological model Nedbør-Afstrømings-Model. The new algorithm removes the 'free variable' aspect that is typically associated with filtering algorithms and provides a means of estimating the contribution of each pathway that is consistent with the results of hydrograph separation in catchments that are dominated by quick response pathways. These types of catchments are underlain by poorly productive aquifers that are not capable of providing large baseflows in the river. Such aquifers underlie over 73% of Ireland, ensuring that this new algorithm is applicable in the majority of catchments in Ireland and potentially in those catchments internationally that are strongly influenced by the quick-responding hydrological pathways. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The impact of rapid climate change on contemporary human populations is of global concern. To contextualize our understanding of human responses to rapid climate change it is necessary to examine the archeological record during past climate transitions. One episode of abrupt climate change has been correlated with societal collapse at the end of the northwestern European Bronze Age. We apply new methods to interrogate archeological and paleoclimate data for this transition in Ireland at a higher level of precision than has previously been possible. We analyze archeological 14C dates to demonstrate dramatic population collapse and present high-precision proxy climate data, analyzed through Bayesian methods, to provide evidence for a rapid climatic transition at ca. 750 calibrated years B.C. Our results demonstrate that this climatic downturn did not initiate population collapse and highlight the nondeterministic nature of human responses to past climate change. [ABSTRACT FROM AUTHOR]

Based on the sampling of 262 private domestic wells in Ireland, mainly located inHigh/Extremevulnerability areas, a quantitative model was developed for prediction of gastrointestinal infection risk attributable to verotoxigenicE. coli(VTEC) contamination of private wells in Ireland. Models are based on maximum likelihoods and predict an overall crude incidence rate of 28.3/100,000 well users per annum; approximately 5-6 times higher than crude incidence rates reported within the Irish population and up to 40 times higher than the current EU mean. Predicted crude incidence rates (CIR) of 21.6/100,000 and 88.7/100,000 were associated with borehole and hand-dug wells users, respectively, with predicted annual probabilities of 0.1% and 0.17%, respectively. Predicted annual infection risks associated with both (untreated) well types exceed the USEPA acceptable target of <1 infection/10,000 consumers/year. Where treatment systems are employed, models predict that a relatively small pathogen log reduction is necessary to meet health targets. Sensitivity analyses indicate that pathogen loading and dose-response are the input variables with the greatest contribution to model outputs. Using a more conservative assumption for pathogen contribution ratio, models predict a lower annual CIR of 5.56/100,000. Due to limitations in inherent assumptions, model results, while useful, should be treated with caution. [ABSTRACT FROM AUTHOR]

One of the key threats to groundwater and surface water quality in Ireland is the impact of poorly designed, constructed or maintained on-site wastewater treatment systems. An extensive study was carried out to quantify the impact of existing sites on water quality. Six existing sites, consisting of a traditional septic tank and soakaway system, located in various ranges of subsoil permeabilities were identified and monitored to determine how well they function under varying subsoil and weather conditions. The preliminary results of the chemical and microbiological pollutant attenuation in the subsoil of the systems have been assessed and treatment performance evaluated, as well as impact on local surface water and groundwater quality. The source of any faecal contamination detected in groundwater, nearby surface water and effluent samples was confirmed by microbial source tracking. From this, it can be seen that the transport and treatment of percolate vary greatly depending on the permeability and composition of the subsoil. [ABSTRACT FROM AUTHOR]

Traditional on-site wastewater treatment systems have proven to be unsuitable in areas of low permeability subsoils, representing a risk to human health and the environment. With large areas being covered by low permeability tills, Ireland needs to consider alternative treatment and disposal options to be able to allow further development in these areas and to deal with polluting legacy sites. The paper describes the development and structure of a geographic information system (GIS)-based decision support toolset to evaluate possible alternative strategies for these sites. The programme takes as its initial input the location of an existing house located in an area of low permeability subsoils. Through a series of interconnected GIS geoprocesses the model outputs appropriate solutions for a site, ranking them in terms of environmental sustainability and cost. However, the final decisions are still dependent on on-site constraints so that each solution is accompanied by an alert message that provides additional information for the user to refine the output list according to the available local site-specific information. [ABSTRACT FROM AUTHOR]

Introduction: Interactive occupation and social engagement are important components of quality of life for residents with dementia in nursing homes. Communal living spaces should be evaluated on these qualities. Two Irish nursing homes were compared pre and post conversion from a traditional to a household model unit using the Assessment Tool for Occupation and Social Engagement. This assessment uses interactive occupation and social engagement as positive outcome measures. Method: Residents, staff, and relatives were observed pre and post renovation over a 6-week period using a snapshot observational method over 4 hours on 7 different weekdays. Findings: Changing from a traditional to a household model nursing home increased the interactive occupation and social engagement of residents, staff, and visitors within the communal living areas. The role of a homemaker in the household unit was critical for maintaining residents' participation and engagement, including engaging in familiar everyday domestic tasks. Conclusion: Interactive occupation and social engagement were significantly increased in the household model unit over the traditional model unit, particularly for residents. In the household model unit, more residents initiated and maintained their own interactions within the communal environment and did not require prompting from staff to do this. [ABSTRACT FROM AUTHOR]

Aim: This study examines the impact of changing nitrogen (N) fertilizer application rates, land use and climate on N fertilizer-derived direct nitrous oxide (NO) emissions in Irish grasslands. Methods: A set of N fertilizer application rates, land use and climate change scenarios were developed for the baseline year 2000 and then for the years 2020 and 2050. Direct NO emissions under the different scenarios were estimated using three different types of emission factors and a newly developed Irish grassland NO emissions empirical model. Results: There were large differences in the predicted NO emissions between the methodologies, however, all methods predicted that the overall NO emissions from Irish grasslands would decrease by 2050 (by 40-60 %) relative to the year 2000. Reduced N fertilizer application rate and land-use changes resulted in decreases of 19-34 % and 11-60 % in NO emission respectively, while climate change led to an increase of 5-80 % in NO emission by 2050. Conclusions: It was observed in the study that a reduction in N fertilizer and a reduction in the land used for agriculture could mitigate emissions of NO, however, future changes in climate may be responsible for increases in emissions causing the positive feedback of climate on emissions of NO. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Purpose: Environmental Control Systems (ECS) have many benefits; however studies of personal experience of ECS use are scarce. This qualitative study explored the insiders' experience of using an ECS. Method: An ECS starter-pack was compiled and trialled for an eight-week period with six persons with high spinal cord injuries (SCI) living in Ireland. Semi-structured interviews were subsequently completed with each person and analysed using Interpretative Phenomenological Analysis (IPA). Findings: Two major themes emerged: 'Taking back a little of what has been lost', and 'Getting used to ECS' which is the focus of the current paper. This theme captured a dynamic interplay between the experience of 'hassle' and 'engagement' for new users of ECS. 'Hassle' resulted from technological frustrations and the challenge of breaking familiar habits, while 'Engagement' resulted from feeling good, having fun and being surprised. Conclusions: The complex interweaving of hassle and engagement experienced by new ECS users reflects the clinical experience of rehabilitation providers. The importance of overcoming initial hassle needs to be understood by clinicians and users in order to maximise the potential benefit of ECS. Non-use must be considered one reasonable outcome if based on realistic ECS trials. [ABSTRACT FROM AUTHOR]