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This article investigates the position of environmental education in the primary school curriculum over the past 150 years in the Republic of Ireland. The extent of how wider social, political, and cultural developments influence the way in which teachers and learners experience environmental education can be seen through the curricular changes. To achieve this, the five primary school curricula from 1872 to the present day were reviewed with respect to the amount of environmental education included in them. This review demonstrates a dramatic change in socio-environmental relations in contemporary Irish society during the 19th and 20th centuries, as reflected through primary school curricula. Environmental education is included, in some form, in all five Irish primary curricula over the 150-year period studied, though it does appear on the margins of some curricula as a subject, or part of a subject, that can be taught at the discretion of the teacher. Such a peripheral situation of environmental education is not unique to Ireland's curricula, and this investigation provides a greater understanding of the broader influences on the status of environmental education overall in Irish education.

Before the COVID-19 pandemic, the world struggled to address growing educational inequalities and fulfil the commitment to Sustainable Development Goal 4, which seeks to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The pandemic has exacerbated these inequalities and changed how education functions, moving to online and hybrid methods. The challenges in global education highlighted and worsened by the pandemic make it necessary to re-evaluate education systems and the policies in place to support access, quality and equal opportunity. This article focuses on analysing education policies at a national level. It tests a pilot policy analysis tool, the International Education Index (IEI), developed as a starting point to begin this reconsideration and create an accessible and comprehensive way to evaluate national education systems to inform decision-making and policies in the new context. This research uses Ireland and Northern Ireland to test the IEI pilot tool. The IEI consists of 54 questions across nine indicators, including institutional frameworks, education strategies, digital skills and infrastructure, twenty-first century skills, access to basic social services, adherence to international standards, legal frameworks, data gathering and availability and international partnerships. Countries can score 108 points to be categorised as having developed, emerging or nascent national education systems. Ireland scored 94 and Northern Ireland 81, indicating that they have developed national education systems.

Background: Childhood obesity affects around 7-8% of children in Ireland and is associated with increased risks of health complications. Data on healthcare resource use and the related costs for children with obesity are important for research, future service-planning, efforts to reduce the burden on families, and care pathways. However, there is little or no data available to describe these in Ireland. Methods: We undertook a retrospective chart review for 322 children attending a national paediatric weight management service to assess their hospital service utilisation, and the associated costs, over a four-year period. We used a micro-costing approach and estimated unit costs for different types of hospital services. Multivariable negative binomial regression analyses and Cragg hurdle models were used to assess characteristics associated with type, frequency and costs of hospital care. Results: Eighty-two percent of children had severe obesity, and thirty-eight percent had a co-morbid condition. Over the four-year period, children had a mean of 27 (median 24, IQR 16-33) episodes of care at a mean cost of €2590 per child (median €1659, IQR 1026--3103). The presence of a co-morbid condition was associated with more frequent visits. Neither severity of obesity nor socioeconomic status were associated with overall service utilisation. The Cragg hurdle model did not identify statistically significant differences in hospital costs according to participant characteristics. Conclusion: Children with obesity frequently visit a variety of paediatric services and children with co-morbid conditions have greater levels of hospital utilisation. Further research is needed with larger sample sizes to explore variation in healthcare utilisation in this population, and the relationship between common co-morbidities and weight status. This would facilitate assessment of the implications for care pathways and examination of associations between patient outcomes and related healthcare costs and cost-effectiveness.

In this paper, we consider the changes to mathematics learning support (MLS) at Maynooth University due to the COVID-19 pandemic, including the provision of novel online study groups aimed at increasing student engagement and interaction. We briefly outline the local, national and international impact of COVID-19 on MLS and then focus on the results of a student survey. Respondents who regularly used online MLS were broadly positive about their experiences. They cited, in particular, the influence of tutors and the scheduled study groups, which provided structure and motivation as well as the opportunity to work with others and ask questions in less intimidating small groups. However, some respondents highlighted factors that impacted negatively on their engagement. These included low attendance or interaction from peers, timetabling issues or busy schedules, lack of awareness of the details of the services and increased feelings of discomfort and anxiety in an online environment. We consider how this student feedback may influence our future online and in-person supports.

Mathematics Support Centres are available in the majority of Higher Education Institutions in Ireland and the UK. Whilst the online presence of these centres appears to be increasing, there is little research to date which considers its breadth or effectiveness. In this paper we consider the results of a survey on the online presence of support centres in Ireland and the UK. We discuss the opportunities that arise from such a presence, the challenges that exist and what the results of the survey mean for individual practitioners and the wider mathematics support community.

Medical students increasingly utilize social media platforms to supplement their preclinical learning; however, the prevalence of social media use for physiology learning in medical education remains unclear. The aim of the present study was to determine how first-year medical students from both direct entry medicine and graduate entry medicine interacted with social media as a learning tool by assessing its prevalence, perceived benefits, favored platforms, and reason(s) for its use. Seventy-one percent of surveyed students (out of 139 participants) stated that they interacted with social media in general more than 12 times per week. However, 98% had previously used internet platforms to source physiology information, with 89.2% doing so at least once per week during term. YouTube was the primary source of learning for 76% of students. Significantly, 94% of students indicated that they would first search for answers online if they did not understand something in physiology rather than contacting their instructor in person or by e-mail. However, only 31% of students "fact-checked" physiology information obtained from online sources, by using textbooks, papers, and/or instructors. Our study has revealed that most preclinical medical students utilize social media extensively to study physiology. However, the absence of academic and ethical oversight, paired with students' lack of critical appraisal of possibly inaccurate information, does raise concerns about the overall utility of social media as part of physiology education.

High‐risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re‐traumatisation of young people and deteriorating therapeutic relationships. Trauma‐informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma‐informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma‐informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma‐informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma‐informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma‐informed practice is crucial to recovery‐focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people. [ABSTRACT FROM AUTHOR]

Purpose: Falls are a major issue for people with neurological conditions, and the evaluation of falls prevention interventions is of high priority. To date, the views of patient groups regarding outcomes of importance have been largely overlooked. The purpose of this study was to explore outcomes of interest among people with Multiple Sclerosis (MS), Parkinson's disease (PD) and stroke upon completion of falls prevention interventions to inform the development of a core outcome set (COS). Materials and methods: Five online focus groups and one semi-structured interview were conducted among people with PD (n = 10), MS (n = 7), and post-stroke (n = 3), one of whom also had PD. Transcripts were analysed using reflexive thematic analysis. Results: Four themes were developed; (1) Fall events are not homogeneous, (2) Exercise-based programmes are beneficial but falls services are not meeting user needs, (3) Programme success beyond the reduction in falls, and (4) Acquisition of skills to self-manage falls beyond the life of the programme. Conclusions: This study presents new perspectives across patient groups regarding important outcomes upon completion of falls prevention interventions. Taken together with the findings of a literature review, this data will inform the development of a COS. People with multiple sclerosis, Parkinson's disease and stroke consider the success of a falls prevention intervention to be dependent on improvements across a wide range of outcomes. The design and implementation of falls prevention interventions should align with patient preferences. Clinicians and researchers should consider the use of multidomain interventions to facilitate improvements in the desired outcomes of patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Falls have a detrimental effect on Ireland's ageing population and result in a significant personal and healthcare cost burden. Evidence-based falls prevention programmes reduce the harmful effects of falls. The Covid-19 pandemic disrupted in-person programme delivery and necessitated a shift to telerehabilitation. The feasibility and acceptability of falls prevention telerehabilitation needs further investigation. OBJECTIVE: The objective of this study was to explore the opinions of participants and physiotherapists about a falls prevention telerehabilitation programme, and identify key barriers and facilitators to improve the quality of future similar programmes. METHODS: A qualitative study design was used, 13 semi-structured one-to-one telephone interviews (n = 11 participants, n = 2 physiotherapists) were performed. Data were coded and thematic analysed. RESULTS: Four inter-related themes were identified: technical considerations for change in mode of programme delivery to online and blended; facilitators and barriers for effective delivery of the online and blended programmes; factors promoting programme engagement and progress; significance of supportive interpersonal relationships. CONCLUSIONS: Participants and physiotherapists reported improvements in strength, balance and confidence, and willingness to continue the exercises long-term. Telerehabilitation had some advantages over in-person including flexibility and convenience; however, these gains must be considered against the drawbacks of less social interaction and group cohesion. Key insights identified regarding satisfaction with the technology, format and delivery can be used to improve the quality of future online and blended programmes. [ABSTRACT FROM AUTHOR]

There is a dearth of research on the experience of motherhood within the Irish prison system. This paper considers the specific issue of facilitating contact between incarcerated mothers and their children. It is based on a study which explores the views of practitioners working directly with mothers in prison on how the mother-child relationship is accommodated and supported. Data presented are based on eight one-to-one interviews with participants from within the prison system and with participants working in an external support agency. The research findings highlight examples of good practice within the prison system with a sense that participants endeavour to support this relationship whenever possible. Suggestions for improved practice and the associated resource needs are also discussed. Internationally there are many exemplars of supportive initiatives promoting relationships between incarcerated mothers and their children. Such models and the relevant research and literature are considered in this paper. The paper concludes with reflections on the findings of this study with reference to this literature.

The positive deviance approach seeks to identify and learn from those that perform exceptionally well. Positive deviance as an approach to quality improvement is gaining traction in general practice. This study aimed to explore and compare stakeholders' perceptions of the factors that support the delivery of exceptional care in general practice and to refine a previously developed theoretical framework of factors associated with positively deviant care in general practice: the Identifying and Disseminating the Exceptional to Achieve Learning (IDEAL) framework. Semi-structured interviews were conducted with 33 purposively sampled patients, general practitioners, practice nurses, and practice managers in Irish general practice. Subsequently, a directed content analysis approach was employed to deductively analyse interview data using the IDEAL framework, and newly emerging factors were inductively analysed and abstracted into the framework. Several distinct strategies (e.g. patient activation and team collaboration), structures (e.g. facilities and staffing), and contextual factors (e.g. communication and rapport, and culture) were found to support the delivery of exceptional care, and differences in perceptions, values, and expectations emerged between patients and practice staff. Interview data largely supported the pre-determined factors posited by the IDEAL framework, and new factors were abstracted into the framework (e.g. facilities and infrastructure). Stakeholder engagement regarding the factors supporting exceptional care in general practice supported and extended the IDEAL framework, contributing to a more comprehensive understanding of how exceptional care is delivered in general practice. The refined framework will support researchers, policymakers, and teams looking to support, measure, and achieve exceptionally good patient care in general practice. [ABSTRACT FROM AUTHOR]

Introduction: This small-scale study explored the feasibility of the Global TALES protocol in eliciting personal narratives in typically developing monolingual Irish children, using the online Zoom platform. We investigated children's performance on measures of productivity (total number of utterances; total number of words) and syntactic complexity (MLU in words). We also documented the topics children talked about in response to the six emotion-based prompts contained in the Global TALES protocol. Methods: Nineteen typically developing children (6 male, 13 female), aged between 10.0 and 10.11 years produced personal narratives in response to the Global TALES protocol. Given COVID-19 pandemic-related public health restrictions, the language samples were elicited using Zoom. All stories were transcribed and analysed using Systematic Analysis of Language Transcripts software. Qualitative content analysis was used to code the topics of the children's stories. Results: Sixteen participants responded to all prompts. One participant only responded to three of the six prompts. The prompt that was least successful in eliciting a response was the "problem" prompt; 15.7% (n = 3) of the children did not provide a response to this prompt. On average, children produced 40 utterances, although individual variability was high. On average, MLU was 8.7, ranging from 6 to 11. Children's topics closely resembled those reported in the Global TALES feasibility study despite the fact, the current study took place during the COVID-19 pandemic. The most frequent topics were related to family (events, illnesses, relationships, siblings) and finding or fixing something. Conclusion: The Global TALES protocol was successful in eliciting personal narratives from 10-year-old Irish English-speaking children. Future larger scale studies are now needed to investigate if the results generalise to the wider Irish population with a view to create local benchmarks of personal narrative performance. [ABSTRACT FROM AUTHOR]

Maternity care in Ireland has been described as a "testament to the strength and influence of the medical profession" (Mc Kee 1986: 192). A review of maternity and gynaecology services in the Dublin area in 2004 revealed that "no participant...thought that the maternity services were women centred at the time" (Women's Health Council, 2007, "Review of the gynaecology and maternity services in the greater Dublin area"). Meanwhile, current Department of Health policy aims to deliver "woman centred" maternity care as a means to ensuring the well being of Irish women (Department of Justice, Equality and Law Reform 2007, "National women's strategy 2007-2016." Dublin: Stationery Office). This paper deploys Frame Analysis in order to show how maternity policy is articulated in the face-to-face interaction of a midwives' ante-natal clinic. Drawing on the interactive notion of frames and knowledge schemas (Goffman 1967, "Interaction ritual: Essays on face to face behaviour." New York: Pantheon; 1981, Tannen and Wallat 1993), the analysis shows how current maternity policy is articulated linguistically in the context of a midwives' ante-natal clinic. Several frames are intertwined in the talk: examination frame, reporting frame, socio-relational frame. The frames can be identified with reference to question- answer- comment/next question exchange structures, and a conversational register. Frame switches are accomplished by both the women and the midwives. The medical model of pregnancy and birth prevails in the interactions. The analysis also shows how women attempt to articulate their perspectives on pregnancy and birth through the alignments they take up in the talk that occurs and through their ability to frame switch gracefully.Resistance to current policy occurs occasionally and fleetingly, instigated by women's introduction of a birth plan or by recommendations of the midwife. Resistance is a delicate undertaking and ultimately the medical perspective that prevails in the face-to-face interaction while alternative perspectives are heard as whispers that are easily silenced. Close analysis of how policy is enacted and resisted in face-to-face interaction in this health care context is important for enabling change to take place.

Little research to date explores parental experiences of early intervention. This study uses action research over a six-month period to explore the expectations and experiences of parents whose children attended an early-intervention group for speech/language impairments. This intervention programme was facilitated by a speech and language therapist and a psychologist and took place in the West of Ireland. Two focus groups were conducted with the parents of these children: one pre-intervention and one post-intervention. The focus groups were facilitated by two of the authors who were unfamiliar to the participants. Following each focus group, a summary of themes that emerged from the discussion was discussed with the clinical staff. Two changes were subsequently implemented: the timing of the group and clarification of parents' roles. Thematic network analysis was conducted in accordance with the processes outlined by Attride-Stirling (2001). Three global themes of progress, uncertainty and dissatisfaction emerged from the analysis pre- and post-intervention. In addition the global theme of certainty emerged pre-therapy and the global theme of satisfaction emerged post-therapy. The findings of this study highlight the importance of both service users and clinical staff co-constructing a shared frame of reference so that they can engage more fully in the therapy process. (Contains 2 tables and 1 figure.)

Background: While much commentary exists in relation to the portrayal of disabled people in the media, very little research examines the talk itself in any detail. This paper examines the how people with communication disabilities and disabled people are dealt with in the talk of a radio programme about disability. Aims: To show how the voices of disabled people, and in particular people with communication difficulties, are dealt with on a radio programme titled "For and About People with Disability" (http://www.rte.ie). Methods & Procedures: Analysis of 15 episodes of an Irish radio programme for and about people with disability called "Outside the Box" to identify frames governing the discourse. Outcomes & Results: Three frames are identified: radio programme frame; presenter frame; and interview frame. Communication disability never appears as a topic in the radio programme frame. In the presenter and interview frames the presenter foregrounds medical aspects of experiences, asks questions that only seek factual information, and fails to respond to subjective aspects of disabled people's experiences. Analysis of the interviewees' responses show how they hold the floor and introduce subjective accounts of living with disability. Conclusions: Frame analysis reveals how disability (including communication disability) is dealt with in the talk of a radio programme for and about people with disability. There is an overemphasis on medical aspects of disability and a view of disability as a primarily physical phenomenon is broadcast. In spite of mainly medical/factual questions, interviewees manage to include rich accounts of their experience. People with communication disability are not included, possibly due to issues of intelligibility or lack of awareness. Speech and language therapists have a valuable role to play in terms of "learning to listen" and "helping to tell." (Contains 2 tables.)

Quantitative and qualitative data from two Irish-speaking communities in Ireland (F, a core community within the heartland of Irish-speaking Galway and B, a peripheral community on the edge of Galway city) are examined in order to investigate the role of location in language contact. The analysis of the observed linguistic outcomes based on interviews conducted in these two communities showed that English nouns were more frequently borrowed in the F community furthest away from the community of English speakers and English discourse markers were very common and statistically significant in terms of differentiating F and B. In a sample of 20,400 words from F speakers only 559 words were English words. Almost 30% of the English words that appear in the data were nouns and over 66% were discourse markers. In the qualitative analysis, F speakers were shown to use English discourse markers in the construction of informal style. B speakers were shown to engage with the two languages in contact in a very different way by codeswitching for metalinguistic purposes. Overall the paper argues that sociolinguistic context as location determines the choices of bilingual speakers living in environments where both Irish and English are available for use.

There are disparities in health outcomes between youth from higher and lower socioeconomic backgrounds, and girls are especially vulnerable to changes in health‐related behaviours as they develop. Therefore, this study explored how girls from disadvantaged communities in Dublin, Ireland, make sense of 'being healthy.' A phenomenological qualitative design was implemented. Three focus groups were conducted (n = 22, 10–12 years) and data were analysed using thematic analysis. Food and physical appearance featured prominently within the girls' definitions of health. Girls and their families from low‐SES backgrounds may experience more difficulties with time scarcity as well as environmental barriers to a healthy lifestyle. [ABSTRACT FROM AUTHOR]

This article contains a short update on the work of the sigma Accessibility Special Interest Group. We announce the release of resources to assist mathematics tutors and coordinators with the support of mature students and those with dyslexia, dyscalculia and dyspraxia. We provide a brief background to the development of these resources and describe their pilot in two institutions, one in England and the other in Ireland. We close with a description of the next stages of work for the special interest group and a call for additional people to get involved. [ABSTRACT FROM AUTHOR]

The political year started and ended with surges in Covid‐19 cases dominating the political world, business and citizens' lives. Caution at the end of the year was probably determined by what had happened at the start of 2021, with a surge in deaths from Covid‐19 damaging the government's reputation and its parties' support. Other more normal issues also started to return to politics, which made 2021 a more typical year of government versus opposition, with the main opposition party gaining support. [ABSTRACT FROM AUTHOR]

Background: This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiology, assessment, and treatment of obesity. Summary: It shifts the focus of obesity management toward improving patient-centred health outcomes, functional outcomes, and social and economic participation, rather than weight loss alone. It gives recommendations for care that are underpinned by evidence-based principles of chronic disease management; validate patients' lived experiences; move beyond simplistic approaches of "eat less, move more" and address the root drivers of obesity. Key Messages: People living with obesity face substantial bias and stigma, which contribute to increased morbidity and mortality independent of body weight. Education is needed for all healthcare professionals in Ireland to address the gap in skills, increase knowledge of evidence-based practice, and eliminate bias and stigma in healthcare settings. We call for people living with obesity in Ireland to have access to evidence-informed care, including medical, medical nutrition therapy, physical activity and physical rehabilitation interventions, psychological interventions, pharmacotherapy, and bariatric surgery. This can be best achieved by resourcing and fully implementing the Model of Care for the Management of Adult Overweight and Obesity. To address health inequalities, we also call for the inclusion of obesity in the Structured Chronic Disease Management Programme and for pharmacotherapy reimbursement, to ensure equal access to treatment based on health-need rather than ability to pay. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Physiotherapists in Irish hospitals with critical care units deliver physiotherapy services 24 hours a day, seven days a week. There is a perceived lack of consistency in the level of clinical competence, required skills and content of training between hospitals, compounded by the absence of a national policy, procedure or clinical framework for physiotherapists working in critical care. The study aimed to identify the minimum standards of clinical practice expected of physiotherapists working in critical care settings in Ireland. METHODS: A modified Delphi technique was used to survey a panel of senior and clinical specialist physiotherapists working in critical care units in Ireland to obtain consensus of items. The questionnaire of 214 items was completed over three rounds. Items were determined 'Essential/Not Essential/Unsure' by participants. Items that did not reach consensus were included in the subsequent round with additional items suggested by participants. RESULTS: 25/46(54%) physiotherapists completed the first round, with 17 and 13 completing round 2 and round 3 respectively. A total of 220 items were included, 120 of which were deemed essential for a minimum standards of independent clinical practice in Irish critical care units. Fifty-six items were considered not essential while consensus was not reached on 44 items. CONCLUSIONS: This study identified 120 items of knowledge and clinical skills considered essential as a minimum standard by physiotherapists working in Irish critical care units. Further discussion is required to determine how these results can be applied to guide clinical practice for physiotherapists working in critical care in Ireland. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death globally. Most cases are diagnosed late. Primary healthcare professionals are often the first point of contact for symptoms of concern. This study explored primary healthcare professionals' experience of referring individuals with signs and symptoms suggestive of lung cancer along the appropriate healthcare pathway and explored strategies to help primary healthcare professionals detect lung cancer early. Focus groups and individual interviews were conducted with 36 general practitioners, community pharmacists, practice nurses, and public health nurses. Data were analysed thematically. Participants identified typical lung cancer signs and symptoms such as cough and coughing up blood (i.e. haemoptysis) as triggers for referral. Atypical/non-specific signs and symptoms such as back pain, pallor, and abnormal blood tests were perceived as difficult to interpret. Participants often refrained from using the word 'cancer' during conversations with patients. Ireland's Rapid Access Lung Clinics were perceived as underused, with some general practitioners referring patients to these clinics only when clear and definitive lung cancer signs and symptoms are noted. Lack of communication and the resulting disruption in continuity of care for patients with suspected lung cancer were highlighted as healthcare system flaws. Education on early referral can be in the form of communications from professional organizations, webinars, interdisciplinary meetings, education by lung specialists, and patient testimonials. Lung cancer referral checklists and algorithms should be simple, clear, and visually appealing, either developed as standalone tools or embedded into existing primary care software/programmes. [ABSTRACT FROM AUTHOR]

The aims of the study were to explore what personal narratives in Irish broadsheet and tabloid newspapers reveal about the lived experience of people with dementia. The sample included twenty narratives collected from five Irish newspapers between 2011 and 2017 inclusively. The relative absence of narratives of people with dementia in Irish newspapers is shown as only twelve of the twenty narratives contained the voice of the person with dementia themselves. Inductive analysis and thematic analysis generated four main themes with a total of thirteen subthemes. The main themes are: (1) Dementia as a personal journey, (2) stereotypes and stigma, (3) barriers and (4) awareness. This study highlights the under-representation of personal narratives of people with dementia in Irish newspapers which is seen as a contributing factor in the lack of understanding and awareness of dementia in society in general. Exploring mediated representations of the lived experience of people with dementia through personal narratives provides insight into the naturalised discourses of dementia which impact on people's lived experiences. (172) [ABSTRACT FROM AUTHOR]

The multiracial family and the existence of mixed race children have come to be a regular feature of Irish familial life. Yet, nation-building discourses have promulgated notions of ethnic and religious homogeneity with Irish identity being racialised exclusively as white. Moreover, to date, there has been a dearth of academic scholarship related to racial mixedness in the Irish context. Through in-depth interviews, this paper sets out, therefore, to provide empirical insight into the lives of fifteen black (African) – white (Irish) mixed race young people (aged 4 to 18) with a particular focus on their experiences of racialised exclusion. Indeed, findings suggest that, as in other majority white national contexts, the black-white mixed race young people are racialised as black in the Irish public domain and as such, are positioned as 'racialised outsiders'. In fact, their narrative accounts shed light on everyday encounters saturated by 'us-them' racial constructs based on phenotype. Thus, these young people, who are not fully recognised as mixed race Irish citizens, are effectively deprived of a space in which to articulate their belonging within the existing statist (i.e. inside/outside) framework. [ABSTRACT FROM AUTHOR]

Research on physical activity programming for children with autism spectrum disorder (ASD) is scant. The aim of this study was to assess the nature of physical activity programming conducted in ASD units in Irish primary schools, in addition to assessing the perceived benefits and challenges among teachers. An online questionnaire was sent to every primary school with an ASD unit in Ireland (n = 380). Questions pertained to the amount and type of physical activity being conducted, in addition to questions on physical activity facilities, training, and the teachers' perceived challenges and benefits. Data were gathered on 69 ASD units. In the majority of units (74.24%), physical education classes were held daily, with the most frequent duration (45.45%) being 10-20 minutes. The most common types of activities performed included walking (92.42%), running (81.82%), and jogging (60.61%). This study gives an insight into the nature of physical activity for children in ASD units in Irish primary schools. [ABSTRACT FROM AUTHOR]

Feedback is the key ingredient from which we grow. This paper contributes to the literature on student feedback in higher education, specifically within work-based learning. It provides an overview of the usability, utility and impact of a freely available feedback tool, the 5 min feedback form (5MFF). The 5MFF was constructed for use within physiotherapy and is being utilised across clinical placement sites in Ireland. The generalisability of its structure allows for transferability across healthcare professions and other work-based disciplines. A multi-site cross-sectional study utilising convenience sampling across a diverse range of placement settings was conducted. Physiotherapy students, practice educators and practice tutors were surveyed on their experience and perceptions of the 5MFF. Findings indicate strong agreement in relation to ease of use, speed of completion and the form's ability to structure and provide timely feedback. Results support its capacity to encourage feedback prioritisation, identify strengths and weaknesses, direct learning, modify behaviours and facilitate the achievement of goals and objectives. Through facilitating collaborative dialogue the 5MFF supports the feedback conversation through raising awareness of student challenges or practice educator and tutor concerns. Utilisation of the 5MFF during physiotherapy clinical education supports effective feedback delivery and enables a positive feedback process. [ABSTRACT FROM AUTHOR]

Background A series of changes in maternity care provision were implemented internationally in response to the COVID-19 pandemic. This study aimed to assess the impact of COVID-19 on maternal clinical outcomes, resulting from these changes to care provision. Methods A before and during comparative study of maternal pregnancy, childbirth, and postpartum clinical outcomes was conducted at a maternity hospital in Ireland. Inferential statistics were used to compare datasets with significance set at P<0.05. Results Overall, no difference in caesarean section rates between the two study periods was observed, although more caesarean sections were observed in multiparous women during the pandemic (30% vs 35%, P=0.01). The rate of elective compared to emergency caesarean section was also higher during the pandemic, from a proportionate difference of 3.6% pre-pandemic to 13.6% during the pandemic. Rates of induction of labour for post-dates (post-maturity induction) were also increased during the pandemic. Conclusions The changes to maternity care because of the COVID-19 pandemic appear to have affected some maternal clinical outcomes, and thus, potentially, women's overall intrapartum and postnatal health and wellbeing. [ABSTRACT FROM AUTHOR]

Disabled children experience many barriers to inclusion in society. Such barriers include public attitudes, knowledge, and perceptions towards disability. There is a specific gap in the literature examining the representation of disabled children in mass media, especially within an Irish context. Previous research primarily focuses on representations of disabled adults. Eighty-nine Irish broadsheet newspaper articles from a 12-month period were analysed using qualitative content analysis and critical discourse analysis. Although disabled children featured within the discourse, the child's voice was predominantly absent. Reports regarding the lived experience predominantly came from the third person, providing a non-authentic voice of disability in childhood. Articles highlighted some of the challenges faced by children e.g. difficulty in accessing educational placement. Opportunities for disabled children to share their experiences using their preferred communication means offer valuable insights into their lives. Media professionals should be supported in facilitating children to have their voice heard. Two methods were used to examine how disabled children were represented in three Irish newspapers and what types of words were used to represent them Although disabled children are featured within Irish newspaper articles, parents and people who work with disabled children tended to speak on their behalf Sometimes disabled children were labelled using impairment first terminology Irish newspapers highlight some of the challenges faced by disabled children e.g. accessing appropriate schools and social outlets Healthcare professionals have a role in advocating for and supporting disabled children to actively participate and have their voices and stories heard in the media Healthcare professionals have a role in educating media professionals to support communication with disabled children so as to deliver a first-person account of living with a disability [ABSTRACT FROM AUTHOR]

In recent years, the mixed race family constellation has emerged as a persistent feature of Irish societal life. An increase in interracial partnering invariably leads to the presence of white women who are parenting children who are ascribed to another race. Yet, nationalist discourses and the incorporation of jus sanguinis principles in constitutional law have constructed a version of Irishness that 'others' and excludes the mixed race person. This paper focuses on the white Irish mother and her mixed race (i.e. black African/white Irish) child (ren), as the majority of mixed race families in the State. In fact, this article sets out to provide a novel perspective vis-à-vis the location of the mixed race family in the context of the exclusionary politics of Irish citizenship and how, through their mothering practices, these white women negotiate and challenge dominant ideologies of belonging on behalf of their children. More specifically, this paper examines the mothers' attempts to establish their children as equal claimants of rights in the Irish public sphere. By drawing on in-depth interviews with twelve white Irish mothers, this paper reveals that the women's efforts to publicly articulate their mixed race children as legitimate Irish citizens have been largely denied or even, de-politicized. Rather, at the level of citizenship, the racialized insider-outsider dynamic gets reproduced as the political autonomy of such citizens is constrained by notions of phenotype (and bloodline criteria). I further draw attention to the governmental production of these mixed race subjects as 'failed' citizens, who must live out their difference silently in the interstitial spaces of the national framework. [ABSTRACT FROM AUTHOR]

In this paper we report on a pilot of resources to support students with dyslexia conducted at a university in Ireland. We give brief background to the development of these resources and describe the steps taken to pilot them in a mathematics support centre. We outline the feedback received from tutors and students, and close with observations on how the pilot outcomes may influence the future implementation of these and other similar resources. [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]

Deliberative democracy is for many the most significant development in democratic theory in the last 50 years and it has been used in some places to solve real-world policy problems. However, measuring the impact of deliberative methods is not clearly achievable because several independent variables are manipulated simultaneously. One of the main goals of deliberation is opinion change and thus it is important to understand why opinions change. This paper utilises comparison groups in order to isolate the impact of deliberation from information in the deliberative process. We outline the results of a quasi-experiment in which deliberation took place in a citizens' assembly (CA) in Ireland. As part of this we measured the impact using pre- and post-test controls, including a group given the information the CA participants received, but without the deliberation. The results of the analysis provide evidence of a separate deliberation effect. [ABSTRACT FROM AUTHOR]

Background This longitudinal study examined the profile and pregnancy-related behaviours of women who reported smoking in two successive pregnancies when they presented for prenatal care in a large maternity hospital. Methods Using the hospital electronic medical records, women who delivered two successive singleton pregnancies during the years 2011–15 were analyzed. Standardized data were computerized by a midwife at the first prenatal visit, following delivery and before discharge. Results Over the 5 years, 6647 women delivered twice. Overall 5754 (86.6%) were persistent non-smokers in both pregnancies, 609 (9.2%) were persistent smokers in both pregnancies and between pregnancies 202 (3.0%) quit and 82 (1.2%) started smoking. Compared with persistent non-smokers, persistent smokers had higher rates of reported illicit drug use, alcohol consumption and psychological problems and lower rates of planned pregnancy, folic acid supplementation and breastfeeding in both pregnancies (all P < 0.001). In persistent smokers, folic acid supplementation practices deteriorated and illicit drug use increased in the subsequent pregnancy. Conclusions We found that approximately one in 10 women smoked in two consecutive pregnancies. Furthermore, compared with non-smokers, persistent smokers were more likely to report other health behaviours associated with adverse pregnancy outcomes and may require additional multidisciplinary support. [ABSTRACT FROM AUTHOR]

Examines the extent to which a national policy on paid educational leave might help to overcome problems in manpower, labor, and education, using examples from four countries and comparing their positions regarding the formulation of coordinated policies and coordination with manpower, training, labor, and education policies. (Author/CT)

Consumer research has offered a multitude of understandings of space. While these insights have contributed both to absolute and relativistic appreciations, the discourse has tended more often towards absolute representations. Through an examination of Irish road bowling, built from a four-year ethnography, we position Henri Lefebvre's triadic model of social space as a heuristic device that may be used to further relativistic representations of space. In doing so we expose how Irish road bowlers produce space on public roads. We find that such space and the actions of road bowlers within it are deeply influenced by both historic and contemporary socio-cultural discourses. In this way, we highlight how Lefebvre can be used to get at the context of context and offer an alternative understanding of normative and existential communitas. [ABSTRACT FROM AUTHOR]

Background Benign Paroxysmal Positional Vertigo (BPPV) and other vestibular disorders are very common and often missed in older populations and are a significant risk factor and cause of falls. Vestibular rehabilitation is increasingly recognised as an effective intervention for the management of vestibular dysfunction in all age groups. This review aimed to explore the prevalence of vestibular disorders in the cohort attending an integrated day hospital falls assessment service and the feasibility of delivering vestibular rehabilitation interventions as part of this service. Methods We retrospectively reviewed the charts of all the patients who attended a new ambulatory day hospital between Nov 2018 and April 2019. Inclusion criteria included a recent history of falls and aged over 75. All patients had received a comprehensive geriatric assessment which included screening for vestibular symptoms and on-site assessment (if indicated) by a physiotherapist with expertise in vestibular rehabilitation. Results 40 patients (33 women, 7 men) with a mean age of 82 were seen in this period. All had suffered recent falls with 10 having suffered a fracture. 5 patients (12%) tested positive for Benign Paroxysmal Positional Vertigo and 2 others (5%) had evidence of both peripheral and central vestibular impairment. Vestibular rehabilitation interventions, including particle repositioning manoeuvres were delivered within the day hospital setting with review appointments offered to all patients. Conclusion This review highlights the high prevalence of vestibular disorders, especially BPPV (12%) in older fallers. It supports the feasibility of delivering vestibular assessments and rehabilitation as a component of the physiotherapy input within a day hospital falls service. [ABSTRACT FROM AUTHOR]

Background The National Stroke Audit 2015 showed that Ireland had made great advances in stroke care but one notable area of deficiency was in access to early swallow screening (within 4 hours). An early swallow screen is recommended by the Royal College of Physicians Stroke Guidelines (2016) to minimise the risk of aspiration pneumonia. The National Guideline for Swallow Screening in Stroke was released in May 2017 and outlines the need to have staff who are trained in swallow screening available 24/7. This audit aimed to evaluate the percentage of stroke patients in our hospital who received a documented swallow screen within 4 hours of admission. Methods Data relating to swallow screens/assessments and the time in which they were performed was extracted from our hospital's HIPE database. The sample size included all confirmed strokes seen by the stroke service in our hospital in the first 6 months of 2018 (1/1/2018- 30/06/2018 inclusive). This amounted to 78 patients. Results In our hospital >90% of patients diagnosed with stroke get admitted to our stroke unit. Of the 78 patients, 38 (48.1%) had a documented swallow screen/assessment during admission, 27 did not have a documented swallow screen/assessment (34.2%) and for 14 patients (17.7%) it was unclear whether they had one during admission. Of the 38 patients who had documented swallow screens/assessments during admission 5 (13.2%) of these occurred within 4 hours of admission. Conclusion In summary while our hospital is succeeding in getting the vast majority of diagnosed strokes into our stroke unit we are not currently meeting the UK target for early swallow screening. We aim to roll out an education and training programme targeting nurses and doctors in our stroke unit regarding early swallow screening and re-audit this in 6-12 month's time. [ABSTRACT FROM AUTHOR]

Background To progress with integrated care, for older persons, it was proposed to establish a Day Hospital in a Primary Care Centre. Population data for Co Mayo shows the percentage of those over 65 years, (17.6%), to be significantly higher than the national average In 2018 there were 39,092 attendances to the Emergency Department and approximately 500, per month, were over 75 years. The aim was to develop a pathway from the Emergency Department to the Day Hospital for those 75 years and over who had experienced a fall. Additionally, this included an Early Supported Discharge for hip fracture patients. Methods The Day Hospital was operational 1 day per week with an allocation of funding for a Consultant, Occupational Therapist and assigned Project Manager. Holter and Blood pressure monitoring equipment was purchased. The Home First Team were reassigned to the front door of the hospital and worked with a cANP and a Medical Registrar. A weekly multi-disciplinary forum, inclusive of all stakeholders, developed working relationships, built a shared vision and standardised the approach for the patient cohort. Frailty training was provided specifically to Emergency Department staff. Results The Home First Team saw 541 patients (Jan-Apr 2019) and in collaboration with the Geriatrician streamed those suitable for management to primary care. The Integrated Day Hospital, 1 day per week (Jan-Apr 2019) delivered 55 new assessments plus follow-up appointments. Patient feedback is very positive and specifically highlights ease of access in primary care. Conclusion Establishing a Day Hospital in a Primary Care Centre is an innovative approach and shifts the focus of intervention from acute to primary care. The location is ideal due to a range of disciplines on site, PHN, Dietetics, Psychiatry This is the initial phase, with some pathways in place, and the overall aim is to provide GP access to rapid assessment in Primary Care and thus ensure hospital avoidance where possible. [ABSTRACT FROM AUTHOR]

In the days leading up to the Republic of Ireland's 2018 abortion referendum, activists from an organization called Sligo for Life erected a 100-metre-tall 'NO' sign made of plastic sheeting high on Ben Bulben in the Dartry Mountains. Over a 24-hour period, reactions played out in the temporary performance space of social media as a spontaneous, improvised performance of satirical images and comments, circulated predominantly on Twitter and Instagram. In this ecofeminist scramble through the limestone and mudstone slopes of Ben Bulben, I propose that at a crucial moment during high-stakes campaigning the performativity of the protest and its aftermath came to stand in for a material and metaphorical peak in what was subsequently widely pronounced as a 'landslide' victory for the 'yes' campaign when the referendum outcome was announced on 26 May. The initial performance on the mountain and its mediatized extension signalled an affective juncture in campaigning that belonged on but also went far beyond Ben Bulben's actual summit, contesting the gendered mountain space in the process. By reasserting Ben Bulben's apparently immovable historical, cultural and ecological significance, the responding community ultimately temporarily communicated the mountainside as an unstable and precipitous -- if not entirely feminist - space. [ABSTRACT FROM AUTHOR]

The article analyzes the depiction of Irish abortion travel in the theatrical productions "Thorny Island" written by Sarah Binchy and "My Name Is Saoirse" written by Eva O'Connor. It explores women's experiences traveling for abortion and reviews how this concept has been explored in Irish theater. The implications of abortion travel on women's rights and reproductive rights are discussed, as well as the representation of the ferry used by women to travel to Great Britain to have an abortion.

Background and Purpose: A tourniquet may potentiate rare and devastating arterial complications after total knee replacement (TKR) in patients with peripheral vascular disease (PVD). Most prior studies that evaluated peripheral arterial blood flow primarily used the ankle-brachial index (ABI). Methods: We assessed the prevalence and risk factors for PVD in a cohort undergoing TKR. Clinical and radiological evaluations, including duplex ultrasonography, were performed one week prior to, and six weeks post-TKR performed under tourniquet control. Forty patients were analysed (20 male, 20 female; mean age 67 yrs, range: 53-80 yrs). Main Findings: Hypertension (50%) and hypercholesterolaemia (50%) were the most common co-morbidities. Distal pulses were present in all patients preoperatively. Six patients (15%) had arterial calcification on their preoperative knee X-rays. Three patients (7.5%) had moderate PVD. There was no change in blood flow postoperatively in patients with or without PVD (p > 0.05). Vascular stenosis was less than 50% in all patients preoperatively and postoperatively. No postoperative vascular complications occurred. Conclusions: Severe PVD is not common in patients undergoing TKR. Performing total knee replacement under tourniquet control does not adversely affect the vasculature in patients with less than 50% vascular occlusion. [ABSTRACT FROM AUTHOR]

Team-based neuromuscular training programs for injury prevention have been tested primarily in female and adolescent athletes in soccer, handball, and basketball with limited research in adult male field sports. This study explored whether the GAA 15, a multifaceted 8-week neuromuscular training program developed by the Gaelic Athletic Association (GAA), could improve risk factors for lower limb injury in male Gaelic footballers and hurlers. Four Gaelic sports collegiate teams were randomized into intervention or control groups. Two teams (n = 41), one football and one hurling, were allocated to the intervention, undertaking a 15 minutes program of neuromuscular training exercises at the start of team training sessions, twice weekly for 8 weeks. Two matched teams (n = 37) acted as controls, participating in usual team training. Lower extremity stability (Y-Balance test [YBT]) and jump-landing technique using the Landing Error Scoring System (LESS) were assessed preintervention and postintervention. There were moderate effect sizes in favor of the intervention for right (d = 0.59) and left (d = 0.69) composite YBT scores, with adjusted mean differences between intervention and control of 3.85 ± 0.91% and 4.34 ± 0.92% for right and left legs, respectively (p, 0.001). There was a greater reduction in the mean LESS score in favor of the intervention group after exercise training (Cohen's d = 0.72, adjusted mean difference 2.49 ± 0.54, p, 0.001). [ABSTRACT FROM AUTHOR]

The article discusses the Irish historical violence and Ennui's amnesiac aesthetics in the 19th history. Topics include writer Maria Edgeworth's national politics, Ireland's history of violence and dispossession, and the relationship between Irish history and contemporary political power through a striking thought experiment.

Relevance and importance for healthcare communication research: Obesity is rapidly rising complex public health issue affecting over 20% of children and adolescents. Stigma and anti-weight bias are frequently reported by people living with obesity and engaging with healthcare. Good communication skills between PHPs and patients form the foundation of quality medical care. It is imperative that where possible we encourage positive empowering communication for children and adolescents living with obesity to reduce unintended harm. Our work aims to co-create communication learning tools for primary health care professionals (PHPs) grounded in an empathy-based theoretical framework which prioritises the experiences of children and adolescents who live with obesity - and their carers. Innovative in healthcare communication research, teaching or policy/practice: Co-creation of learning materials by collaborating with patients and caregivers allows educators to develop an in-depth understanding of the patient experience. The empathy-based approach uses patients' values, preferences, and needs to incorporate patient lived experience into scenarios and role play that facilitates experiential learning opportunities for PHPs. The aim of this project is to create training tools for PHPs that will enhance patient-PHP communication and contribute to more meaningful interactions and obesity de-stigmatisation. Additionally, this research may offer a template for training that could be used in other stigmatised health areas. We are collaborating with constituents who have lived experience of paediatric obesity and healthcare to generate role play videos and interactive pathways that show a spectrum of communication interactions ranging from positive to negative. Learners will be evaluated through self-reflection as well as curated assessment criteria. It is expected that PHPs will gain a greater awareness of the immediate and long-term effects of a negative healthcare communication experience and PHPs will also gain the tools to change their practice and enhance the patient experience. [ABSTRACT FROM AUTHOR]

Mindful of Benedict Anderson’s emphasis onImagined Communitieson the power of print culture – and print-capitalism – to shape and share national ideas and identities, this article offers a comparative analysis of the commemorations of 1798 and 1916 by looking at commemorative ephemera: kitschy memorabilia, themed merchandise, newspaper cuttings and advertisements, handbills and inventively branded commodities, as important cultural texts which purveyed ideological values and meanings at the time of their production. It suggests that the consumer sphere allows us to shed light on the commemorative discourses these ephemeral objects produce, retelling and retailing the risings in question. Texts often regarded as throwaway or lowbrow vied for their share in the ideological marketplace to form part of the heritage of 1798 and 1916, the centenary of the one feeding into the ferment of the other. The reception and representation of the pivotal figures of Wolfe Tone and James Connolly is discussed through the prism of Thomas Richards’ conception of commodity culture, and attention is paid to counter-commemorative strands as well as positive rhetorics of remembrance. [ABSTRACT FROM PUBLISHER]