Electronic aids to daily living: be able to do what you want

Purpose. This study explores the experiences of Irish people with high cervical spinal cord injuries living with electronic aids to daily living (EADL) and the meaning attributed to such systems in the context of participation in everyday life. Method. Qualitative methodology using a phenomenological approach was used to explore the phenomenon of living with EADL. Data were collected using four focus groups of users and nonusers of EADL (n = 15). All participants had high cervical spinal cord injuries (C3-5). Groups were video recorded, transcribed verbatim and analysed using descriptive phenomenological analysis. Findings. Findings revealed key elements of the meaning of living with EADL. Two key themes, time alone and changed relationships are described. These contribute to the super ordinate theme of autonomy. Findings suggest that participants perceived improvements in both anticipated and actual lived experiences with EADL. Themes are interrelated and together represent a summary of the experience of living with environmental controls. The themes described are similar to those found in other spinal injury studies relating to quality of life. Conclusions. Findings highlight differences in life experiences for those with and without EADL and provides motivation to address this difference. Such insights are valuable for both users and providers of EADL.

Experiences and desires of people with tetraplegia living with and without electronic aids to daily living: an Irish focus group study

This qualitative descriptive study explores the lived experience for persons with a high cervical spinal cord injury who have Electronic Aids to Daily Living (EADLs), and for persons who have no EADLs. Fifteen people with cervical spinal cord injuries attended four focus groups. Data analysis uncovered a novel framework of several themes that were organised into three categories: experiences, desires and meanings of living with EADL. Users’ and non users’ groups revealed homogenous themes. Experiences and desires are explored further in this paper. Themes within the category of experiences included: EADL devices, supply support and training, abandonment, mouthsticks and powered wheelchairs. Desires included: simple stuff, reliability, aesthetics and voice activation. Findings offer valuable personal insights about life with EADL to be considered by all involved with EADL.

The GrEAT pack: generic electronic assistive technology environmental control system - information booklet

This is a user manual for your electronic assistive technology environmental control system trial pack or in simple words – a few bits of technology that can let you control some household appliances. This information is intended for you, your family and carers.

Irish occupational therapists' views of electronic assistive technology

Introduction: Electronic assistive technology (EAT) includes computers, environmental control systems and information technology systems and is widely considered to be an important part of present-day life. Method: Fifty-six Irish community occupational therapists completed a questionnaire on EAT. All surveyed were able to identify the benefits of EAT. Results: While respondents reported that they should be able to assess for and prescribe EATs, only a third (19) were able to do so, and half (28) had not been able to do so in the past. Community occupational therapists identified themselves as havinga role in a multidisciplinary team to assess for and prescribe EAT. Conclusion: Results suggest that it is important for occupational therapists to have up-to-date knowledge and training in assistive and computer technologies in order to respond to the occupational needs of clients.

An investigation of the utilisation of health impact assessments (HIAs) in Irish public policy making

It is the aim of this thesis to investigate Health Impact Assessment (HIA) use in public policy formulation in Northern Ireland and in the Republic of Ireland. The influences affecting the use of HIAs will be examined in this study. Four case studies, where HIA has been conducted, will be used for research analysis. This includes HIAs conducted on traffic and transport in Dublin, Traveller accommodation in Donegal, a draft air quality action plan in Belfast and on a social housing regeneration project in Derry. HIA aims to identify possible intended and unintended consequences that a project, policy or programme will have on the affected population’s health. Although it has been acknowledged as a worthwhile tool to inform decision-makers, the extent to which it is used in policy in Ireland is subject to scrutiny. A theoretical framework, drawing from institutionalist, impact assessment and knowledge utilisation theories and schools of literature, underpin this study. The investigation involves an examination of the unit of analysis which consists of the HIA steering groups. These are made up of local authority decision makers, statutory health practitioners and community representatives. The overarching structure and underlying values which are hypothesized as present in each HIA case are investigated in this research. Chapters 2 and 3 outline the main literature in the area which includes theories from the public health and health promotion paradigm, the policy sciences and impact assessment techniques. Chapter 4 describes the methodology in this research which is a multiple case study design. This is followed by an analysis of the cases and then concludes with practical recommendations for HIA in Ireland and theoretical conclusions of the research.

Phase estimation receiver for full-field detection: a novel receiver structure for electronic dispersion compensation of metropolitan area networks

The development of ultra high speed (~20 Gsamples/s) analogue to digital converters (ADCs), and the delayed deployment of 40 Gbit/s transmission due to the economic downturn, has stimulated the investigation of digital signal processing (DSP) techniques for compensation of optical transmission impairments. In the future, DSP will offer an entire suite of tools to compensate for optical impairments and facilitate the use of advanced modulation formats. Chromatic dispersion is a very significant impairment for high speed optical transmission. This thesis investigates a novel electronic method of dispersion compensation which allows for cost-effective accurate detection of the amplitude and phase of the optical field into the radio frequency domain. The first electronic dispersion compensation (EDC) schemes accessed only the amplitude information using square law detection and achieved an increase in transmission distances. This thesis presents a method by using a frequency sensitive filter to estimate the phase of the received optical field and, in conjunction with the amplitude information, the entire field can be digitised using ADCs. This allows DSP technologies to take the next step in optical communications without requiring complex coherent detection. This is of particular of interest in metropolitan area networks. The full-field receiver investigated requires only an additional asymmetrical Mach-Zehnder interferometer and balanced photodiode to achieve a 50% increase in EDC reach compared to amplitude only detection.

An empirical examination of risk equalisation in a regulated community rated health insurance market

Despite universal access entitlements to the public healthcare system in Ireland, over half the population is covered by voluntary private health insurance. The market operates on the basis of community rating, open enrolment and lifetime cover. A set of minimum benefits also exists, and two risk equalisation schemes have been put in place but neither was implemented. These schemes have proved highly controversial. To date, the debate has primarily consisted of qualitative arguments. This study adds a quantitative element by analysing a number of pertinent issues. A model of a community rated insurance market is developed, which shows that community rating can only be maintained in a competitive market if all insurers in the market have the same risk profile as the market overall. This has relevance to the Irish market in the aftermath of a Supreme Court decision to set aside risk equalisation. Two reasons why insurers’ risk profiles might differ are adverse selection and risk selection. Evidence is found of the existence of both forms of selection in the Irish market. A move from single rate community rating to lifetime community rating in Australia had significant consequences for take-up rates and the age profile of the insured population. A similar move has been proposed in Ireland. It is found that, although this might improve the stability of community rating in the short term, it would not negate the need for risk equalisation. If community rating were to collapse then risk rating might result. A comparison of the Irish, Australian and UK health insurance markets suggests that community rating encourages higher take-up among older consumers than risk rating. Analysis of Irish hospital discharge figures suggests that this yields significant savings for the Irish public healthcare system. This thesis has implications for government policy towards private health insurance in Ireland.

Electronic spectroscopy of thiones

The phosphorescence excitation spectra of two thiones, 4-H-1-xanthione (XT) and 4-H-1-pyrane-4-thione (PT), cooled in a supersonic jet were investigated. The vibronic lineshape of the T1z origin of PT measured by cavity ring-down spectroscopy is considered and the excited state rotational constants are calculated. For XT the 3A2(nπ* ) → X1A1 phosphorescence excitation spectrum was investigated in the region 14900-17600 cm-1. The structure observed is shown to be due to the T1← S0 absorption and an assignment in terms of the vibronic structure of the band is proposed. A previous assignment of the S1 ← S0 origin is considered and the transition involved is shown to be most probably due to the absorption of a vibronic tiplet state T1z,v7. An alternative but tentative assignment of the S1,0 ←S0,0 transition is suggested. In the case of PT the phosphorescence excitation spectrum was investigated in the region of the 1A2(ππ*) ← X1A1 absorption band between 27300 and 28800 cm-1. The spectrum exhibits complex features which are typical for the strong vibronic coupling case of two adjacent electronic states. The observed intermediate level structure was attributed to the coupling with a lower lying dark electronic state 1B1(nπ*2), whose origin was estimated to be ~ 825 - 1025 cm-1 below the origin of 1A2(ππ*)0. Consequences of the vibronic coupling on the decay dynamics of 1A2(ππ*) as well as tentative assignments of vibronic transitions 1A2(ππ*)v ← X1A1 are also discussed. In the T1z ← S0 cavity ring-down absorption spectrum of PT, the vibronic lineshape of the T1z origin is analysed. As the T1z line is separated from the T1x,1y lines by a large zero-field splitting it is possible to use an Asyrot-like program to calculate the vibrational-rotational parameters determining the lineshape. It is shown that PT is non-planar in the first excited triplet state and the lineshape is composed of a mixture of A-type and C-type bandshapes. The non-planarity of PT is discussed.

The utility of survey and administrative data to generate information for research and outcomes-based oral health services development

The aim of this research, which focused on the Irish adult population, was to generate information for policymakers by applying statistical analyses and current technologies to oral health administrative and survey databases. Objectives included identifying socio-demographic influences on oral health and utilisation of dental services, comparing epidemiologically-estimated dental treatment need with treatment provided, and investigating the potential of a dental administrative database to provide information on utilisation of services and the volume and types of treatment provided over time. Information was extracted from the claims databases for the Dental Treatment Benefit Scheme (DTBS) for employed adults and the Dental Treatment Services Scheme (DTSS) for less-well-off adults, the National Surveys of Adult Oral Health, and the 2007 Survey of Lifestyle Attitudes and Nutrition in Ireland. Factors associated with utilisation and retention of natural teeth were analysed using count data models and logistic regression. The chi-square test and the student’s t-test were used to compare epidemiologically-estimated need in a representative sample of adults with treatment provided. Differences were found in dental care utilisation and tooth retention by Socio-Economic Status. An analysis of the five-year utilisation behaviour of a 2003 cohort of DTBS dental attendees revealed that age and being female were positively associated with visiting annually and number of treatments. Number of adults using the DTBS increased, and mean number of treatments per patient decreased, between 1997 and 2008. As a percentage of overall treatments, restorations, dentures, and extractions decreased, while prophylaxis increased. Differences were found between epidemiologically-estimated treatment need and treatment provided for those using the DTBS and DTSS. This research confirms the utility of survey and administrative data to generate knowledge for policymakers. Public administrative databases have not been designed for research purposes, but they have the potential to provide a wealth of knowledge on treatments provided and utilisation patterns.