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Developmental dysplasia of the hip (DDH) represents a spectrum of anatomic abnormalities in which the femoral head and the acetabulum are aligned improperly or grow abnormally. It is generally acknowledged that the rationale behind screening for DDH is that earlier diagnosis will lead to simpler treatments resulting in better outcomes and minimising the need for open surgery. Additionally, the condition and subsequent treatment for DDH poses significant challenges for parents and impacts on many aspects of parent, child and family lives. To date, there are no national guidelines or algorithms in relation to the screening or management of DDH. The aim of this research was to explore the detection and care of infants with developmental dysplasia of the hip. A mixed methods sequential explanatory design was utilised over three phases. Data collection involved a retrospective chart review (n=372), a survey (n=100), and semi-structured interviews involving parents (n=11) and health care professionals (n=8). Data analysis used the Statistical Package for Social Sciences (SPSS) and semi-structured interviews were subjected to thematic analysis. The study revealed that despite a high late referral and diagnosis rate of DDH in the region, treatment in a specialist consultant led DDH clinic provided successful outcomes. A further significant finding of the study was the general lack of awareness regarding the condition DDH and the lack of hip health related information given to parents. Findings also identified that more formal training is needed by health care professionals to facilitate the development of their knowledge and skills in relation to the examination and screening of DDH. Recommendations include the need for a National Integrated Care Pathway in relation to DDH while also supporting collaboration between Primary and Secondary Care. Consequently, this will promote a family centred approach to how health care professionals practically and psychologically support families through the diagnosis and treatment of DDH. Keywords: Developmental dysplasia of the hip; consultant; parents; health care professionals; late referral; screening; treatment.

Table S1. Fitted main effect general linear models for the relationship of symptom scores to demographic/clinical variables. The findings from the multivariable linear models for the eight symptoms that demonstrated statistical significance based on bivariate results are summarized in Table 5. More detailed information (model coefficients, confidence intervals for these coefficients, and r-squared values for each model), is displayed in Table S1. (DOCX 30 kb)

Midwives are specialists in normal pregnancy and midwifery led care (MLC) is recommended as being the most appropriate type of care for low risk pregnant women. MLC offers a choice for birth at home or in hospital with total care provided by midwives. MLC provides continuity of care, choice, and develops trusting relationships. A pregnancy is considered ‘low risk’ if the woman is without pre-existing medical conditions or pregnancy complications. In Ireland, maternity services continue to utilise the medical led model of care which limits choice for women. This presents challenges for midwives in developing MLC and consequently women may not be aware of alternative choices and accessibility of these schemes. Whilst MLC initiatives have been established in some parts of Ireland, developments are slow in comparison to other countries. The aim of this research was to explore the perceptions of women and their care providers of the provision of antenatal care. This was achieved through a 3 Phase mixed methods design. Data collection involved a descriptive survey (n=394) and 12 focus groups involving pregnant women and multidisciplinary professionals. Data analysis used Predictive Analytics Software (PASW) and the focus groups were subjected to a content analysis framework. The study identified a lack of awareness and understanding of the concept of a ‘low risk’ pregnancy. Consequently, a lack of information and available options of care were identified by women and care providers. This lack of information led to feelings of disempowerment in relation to choice, communication and decision-making processes. Findings also demonstrated excessive waiting times and congested antenatal clinics. Further collaboration and communication is required between general practitioners and antenatal clinics to streamline future services for women. Recommendations include the development of group antenatal care to enhance access to MLC and decision-making processes that will offer more choice for women. Keywords: Antenatal care services; low risk pregnant women; provision of information; access to care; decision making.

The purpose of this study is to investigate how indigenous software companies are pricing and licensing their product and service offerings. Nearly a decade ago, almost all software product companies sold software by offering perpetual licences and the software companies performed local installations on their clients’ premises. Today the Software-as-a-Service (SaaS) model is having a profound influence on the way software is currently charged and licensed. In place of an upfront payment in the form of a licence fee the cost of the service, upgrades, backups and support are all included in a specific fee (subscription). The Ireland-Newfoundland Partnership (INP) fund supported this research project. The research focused on Irish and Newfoundland indigenous software companies and with the help of the INP fund, the researcher collected part of the primary data in Newfoundland, Canada. Conducting the study in two jurisdictions enabled the researcher to identify similarities and differences amongst the indigenous software vendors in the two regions. Mixed-methods surveys are pursued to achieve the research objectives. The primary data used in this study was gathered through a questionnaire administered to 220 indigenous Irish software companies, with a response rate of 29% and a series of six semi-structured interviews. The interviews were conducted with owners and managers in Ireland and Newfoundland. This mixed-method survey enabled the researcher to establish information as regards the industry sector, gain an in-depth understanding of how software companies are pricing and licensing their software offerings and understand exportation of software. The findings that emerged from this research show that pricing was dependent on a vendor’s software business model. The outcome of this study shows that there appears to be a mixture of software licensing methods used by software vendors surveyed. Some vendors are using the traditional software licensing methods while others are using contemporary methods such as usage-based methods. A second finding that surfaced from this study relates to the pricing methods used by software vendors surveyed. In general, vendors’ pricing methods are categorised as cost-based, competition-based or customer-based. It emerged that despite the software owners indicating that they use customer-based methods, a cost-based approach dominated both the questionnaire and interview findings. It was also discovered that software vendors were no longer offering pure product or pure services to their customers and that SaaS was increasing in popularity as a pricing model amongst the Irish and Newfoundland software vendors. The outcome of this study offers a software-pricing template attached as Appendix F, which would help practitioners to learn from their experience and induct staff assuming responsibility in this area.