The Barretstown experience

The thesis was prompted by a simple clinical observation. Seriously ill children returning from Barretstown Holiday Camp appeared changed. Barretstown ‘magic’ confuses the issue but indicates real and clinically evident transformations. The project sought to understand the experience and place it in a recognisable framework. The data was collected by interviews, observations as camp Paediatrician, memberships of the Child Advisory Committee and the Association’s criteria assessment team, participation in volunteer training and visits to international camps. The research presents evidence that the concepts of rite of passage, graceful mimesis and salutogenesis clarify operative social processes. The passage stages of separation, transition and reaggregation can be identified. Passage rites reorder personal and social upsets to fresh arrangements that facilitate change. Interviews confirm the reordering impact of achievements in play activities. These are challenging experiences closely guided by their Masters of Ceremonies – the Caras. The Cara/camper relationship is crucial and compatible with Girard’s theory of external mimesis. Visits to four camps confirm an inspirational process in contrast to a reported camp with a predetermined formative influence. Charismatic Caras/Councillors inspire playful mimesis and salutogenic transformations. Health is more than correction of pathogenic deficits and restoration of homeostasis. Salutogenic health promotes heterostasis – a desire for optimal experiences underpinned by a sense of coherence and adequate resources. Some evidence is presented that children have an improved sense of coherence after camp, which enables them to cope better with the demands of ill health. The camps enable sick children to up regulate risk taking towards more heterostatic experiences rather than down regulate their expectations. The heterostatic impulse can explain the disability paradox of good quality of life in the presence of severe disability. The salutogenic power of Barretstown can trump the pathogenic effects of childhood cancer and other serious illnesses.

Work experience in transition year: a mixed methods study of subject and career choices

Transition Year (TY) has been a feature of the Irish Education landscape for 39 years. Work experience (WE) has become a key component of TY. WE is defined as a module of between five and fifteen days duration where students engage in a work placement in the broader community. It places a major emphasis on building relationships between schools and their external communities and concomitantly between students and their potential future employers. Yet, the idea that participation in a TY work experience programme could facilitate an increased awareness of potential careers has drawn little attention from the research community. This research examines the influence WE has on the subsequent subjects choices made by students along with the effects of that experience on the students’ identities and emerging vocational identities. Socio-cultural Learning Theory and Occupational Choice Theory frame the overall study. A mixed methods approach to data collection was adopted through the administration of 323 quantitative questionnaires and 32 individual semi-structured interviews in three secondary schools. The analysis of the data was conducted using a grounded theory approach. The findings from the research show that WE makes a significant contribution to the students’ sense of agency in their own lives. It facilitates the otherwise complex process of subject choice, motivates students to work harder in their senior cycle, introduces them to the concepts of active, experience-based and self-directed learning, while boosting their self-confidence and nurturing the emergence of their personal and vocational identities. This research is a gateway to further study in this field. It also has wide reaching implications for students, teachers, school authorities, parents and policy makers regarding teaching and learning in our schools and the value of learning beyond the walls of the classroom.

The quality of diabetes care in the community: practice, policy and culture

Aim: Diabetes is an important barometer of health system performance. This chronic condition is a source of significant morbidity, premature mortality and a major contributor to health care costs. There is an increasing focus internationally, and more recently nationally, on system, practice and professional-level initiatives to promote the quality of care. The aim of this thesis was to investigate the ‘quality chasm’ around the organisation and delivery of diabetes care in general practice, to explore GPs’ attitudes to engaging in quality improvement activities and to examine efforts to improve the quality of diabetes care in Ireland from practice to policy. Methods: Quantitative and qualitative methods were used. As part of a mixed methods sequential design, a postal survey of 600 GPs was conducted to assess the organization of care. This was followed by an in-depth qualitative study using semi-structured interviews with a purposive sample of 31 GPs from urban and rural areas. The qualitative methodology was also used to examine GPs’ attitudes to engaging in quality improvement. Data were analysed using a Framework approach. A 2nd observation study was used to assess the quality of care in 63 practices with a special interest in diabetes. Data on 3010 adults with Type 2 diabetes from 3 primary care initiatives were analysed and the results were benchmarked against national guidelines and standards of care in the UK. The final study was an instrumental case study of policy formulation. Semi-structured interviews were conducted with 15 members of the Expert Advisory Group (EAG) for Diabetes. Thematic analysis was applied to the data using 3 theories of the policy process as analytical tools. Results: The survey response rate was 44% (n=262). Results suggested care delivery was largely unstructured; 45% of GPs had a diabetes register (n=157), 53% reported using guidelines (n=140), 30% had formal call recall system (n=78) and 24% had none of these organizational features (n=62). Only 10% of GPs had a formal shared protocol with the local hospital specialist diabetes team (n=26). The lack of coordination between settings was identified as a major barrier to providing optimal care leading to waiting times, overburdened hospitals and avoidable duplication. The lack of remuneration for chronic disease management had a ripple effect also creating costs for patients and apathy among GPs. There was also a sense of inertia around quality improvement activities particularly at a national level. This attitude was strongly influenced by previous experiences of change in the health system. In contrast GP’s spoke positively about change at a local level which was facilitated by a practice ethos, leadership and special interest in diabetes. The 2nd quantitative study found that practices with a special interest in diabetes achieved a standard of care comparable to the UK in terms of the recording of clinical processes of care and the achievement of clinical targets; 35% of patients reached the HbA1c target of <6.5% compared to 26% in England and Wales. With regard to diabetes policy formulation, the evolving process of action and inaction was best described by the Multiple Streams Theory. Within the EAG, the formulation of recommendations was facilitated by overarching agreement on the “obvious” priorities while the details of proposals were influenced by personal preferences and local capacity. In contrast the national decision-making process was protracted and ambiguous. The lack of impetus from senior management coupled with the lack of power conferred on the EAG impeded progress. Conclusions: The findings highlight the inconsistency of diabetes care in Ireland. The main barriers to optimal diabetes management center on the organization and coordination of care at the systems level with consequences for practice, providers and patients. Quality improvement initiatives need to stimulate a sense of ownership and interest among frontline service providers to address the local sense of inertia to national change. To date quality improvement in diabetes care has been largely dependent the “special interest” of professionals. The challenge for the Irish health system is to embed this activity as part of routine practice, professional responsibility and the underlying health care culture.

Reflections on the transformation of my meaning making to support the organic growth of a firm

The objective of my Portfolio is to explore the working hypothesis that the organic growth of a firm is governed by the perspectives of individuals and such perspectives are governed by their meaning-making. The Portfolio presents explorations of the transformation of my meaning making and in adopting new practices to support the organic growth of a firm. I use the work of other theorists to transition my understanding of how the world works. This transition process is an essential tool to engage with and understand the perspectives of others and develop a mental capacity to “train one’s imagination to go visiting” (Arendt, 1982; p.43). The Portfolio, therefore, is primarily located in reflective research. Using Kegan’s (1994) approach to Adult Mental Development, and Sowell’s (2007) understanding of the visions which silently shape our thoughts I organise the developments of my meaning making around three transformation pillars of change. In pillar one I seek to transform an unthinking respect for authority and break down a blind pervasiveness of thought within my reasoning process arising from an instinct for attachment and support from others whom I trust. In pillar two I seek to discontinue using autocratic leadership and learn to use the thoughts and contributions of a wider team to make improved choices about uncertain future events. In pillar three I explore the use of a more reflective thinking framework to test the accuracy of my perceptions and apply a high level of integrity in my reasoning process. The transformation of my meaning making has changed my perspectives and in turn my preferred practices to support the organic growth of a firm. I identify from practice that a transformative form of leadership is far more effective that a transactional form of leadership to stimulate the trust and teamwork required to sustain the growth a firm. Creating an environment where one feels free to share thoughts and feelings with others is an essential tool to build a team to critique the thoughts of one other. Furthermore, the entrepreneurial wisdom to grow a firm must come from a wider team, located both inside and outside the boundaries of a firm. No individual or small team has the mental capacity to provide the entrepreneurship required to drive the organic growth of a firm. I address my Portfolio to leaders in organisations who have no considered framework on the best practices required to lead a social organisation. These individuals may have no sense of what they implicitly believe drives social causation and they may have no understanding if their meaning making supports or curtails the practices required to grow a firm. They may have a very limited capacity to think in a logical manner, with the result they are using guesses from their ‘gut’ to make poor judgements in the management of a firm.

The political and economic context of Keynes’s 1933 Finlay lecture: transforming a business practitioner’s ways of knowing

This thesis is structured in the format of a three part Portfolio of Exploration to facilitate transformation in my ways of knowing to enhance an experienced business practitioner’s capabilities and effectiveness. A key factor in my ways of knowing, as opposed to what I know, is my exploration of context and assumptions. By interacting with my cultural, intellectual, economic, and social history, I seek to become critically aware of the biographical, historical, and cultural context of my beliefs and feelings about myself. This Portfolio is not exclusively for historians of economics or historians of ideas but also for those interested in becoming more aware of how these culturally assimilated frames of reference and bundles of assumptions that influence the way they perceive, think, decide, feel and interpret their experiences in order to operate more effectively in their professional and organisational lives. In the first part of my Portfolio, I outline and reflect upon my Portfolio’s overarching theory of adult development; the writings of Harvard’s Robert Kegan and Columbia University’s Jack Mezirow. The second part delves further into how meaning-making, the activity of how one organises and makes sense of the world and how meaning-making evolves to different levels of complexity. I explore how past experience and our interpretations of history influences our understandings since all perception is inevitably tinged with bias and entrenched ‘theory-laden’ assumptions. In my third part, I explore the 1933 inaugural University College Dublin Finlay Lecture delivered by economist John Maynard Keynes. My findings provide a new perspective and understanding of Keynes’s 1933 lecture by not solely reading or relying upon the text of the three contextualised essay versions of his lecture. The purpose and context of Keynes’s original longer lecture version was quite different to the three shorter essay versions published for the American, British and German audiences.

Parents' experiences of child growth and development concerns: an interpretative phenomenological analysis

Background: Assessing child growth and development is complex. Delayed identification of growth or developmental problems until school entry has health, educational and social consequences for children and families. Health care professionals (HCPs), including Public Health Nurses work with parents to elicit and attend to their growth and development concerns. It is known that parents have concerns about their children’s growth and development which are not expressed in a timely manner. Measuring parental concern has not been fully effective to date and little is known about parents’ experiences of expressing concerns. Aim: To understand how parents make sense of child growth or development concerns. Method: The study was qualitative using Interpretative Phenomenological Analysis (IPA). A purposeful sample of 15 parents of pre-school children referred by their PHN to second tier services was used. Data were collected by semi-structured interviews. NVivo version 10 was used for data management purposes and IPA for analysis. Findings: Findings yielded two contextual themes which captured how parents described The Concern – ‘telling it as it is’ and their experiences of being Referred on. Four superordinate themes were found which encapsulated the Uncertainty – ‘a little bit not sure’ of parents as they made sense of the child’s growth and development problems. They were influenced by Parental Knowledge – ‘being and getting in the know’ which aided their sense-making before being prompted by Triggers to action. Parents then described Getting the child’s problem checked out as they went to express their concerns to HCPs. Conclusion and Implications: Parental expression of concerns about their child is a complex process that may not be readily understood by HCPs. A key implication of findings is to reappraise how parental concern is elicited and attended to in order to promote early referral and intervention of children who may have growth and development problems.

Moral shielding: A grounded theory of integrity maintenance in multidisciplinary teams

Using a classic grounded theory methodology (CGT), this study explores the phenomenon of moral shielding within mental health multidisciplinary teams (MDTS). The study was located within three catchment areas engaged in acute mental health service practice. The main concern identified was the maintenance of a sense of personal integrity during situational binds. Through theoretical sampling thirty two practitioners, including; doctors, nurses, social workers, occupational therapists, counsellors and psychologists, where interviewed face to face. In addition, emergent concepts were identified through observation of MDTs in clinical and research practice. Following a classic grounded theory methodology, data collection and analysis occurred simultaneously. A constant comparative approach was adopted and resulted in the immergence of three sub- core categories; moral abdication, moral hinting and pseudo-compliance. Moral abdication seeks to re-position within an event in order to avoid or deflect the initial obligation to act, it is a strategy used to remove or reduce moral ownership. Moral gauging represents the monitoring of an event with the goal of judging the congruence of personal principles and commitments with that of other practitioners. This strategy is enacted in a bid to seek allies for the support of a given moral position. Pseudo-compliance represents behaviour that hides desired principles and commitments in order to shield them from challenge. This strategy portrays agreement with the dominant position within the MDT, whilst holding a contrary position. It seeks to preserve a reservoir of emotional energy required to maintain a sense of personal integrity. Practitioners who were successful in enacting moral shielding were found to not experience significant emotional distress associated with the phenomenon of moral distress; suggesting that these practitioners had found mechanisms to manage situational binds that threatened their sense of personal integrity.

The political philosophy of Miki Kiyoshi: A close reading of the philosophical foundations of cooperative communitarianism

The thesis is a historical and philological study of the mature political theory of Miki Kiyoshi (1897-1945) focused on Philosophical Foundations of Cooperative Communitarianism (1939), a full translation of which is included. As the name suggests, it was a methodological and normative communitarianism, which critically built on liberalism, Marxism and Confucianism to realise a regional political community. Some of Miki’s Western readers have wrongly considered him a fascist ideologue, while he has been considered a humanist Marxist in Japan. A closer reading cannot support either view. The thesis argues that the Anglophone study of Japanese philosophy is a degenerating research programme ripe for revolution in the sense of returning full circle to an original point. That means returning to the texts, reading them contextually and philologically, in principle as early modern European political theory is read by intellectual historians, such as the representatives of Cambridge School history of political thought. The resulting reading builds critically on the Japanese scholarship and relates it to contemporary Western and postcolonial political theory and the East Asian tradition, particularly neo-Confucianism. The thesis argues for a Cambridge School perspective radicalised by the critical addendum of geo-cultural context, supplemented by Geertzian intercultural hermeneutics and a Saidian ‘return to philology’. As against those who have seen radical reorientations in Miki’s political thought, the thesis finds gradual progression and continuity between his neo-Kantian, existentialist, Marxian anthropology, Hegelian and finally communitarian phases. The theoretical underpinnings are his philosophical anthropology, a structurationist social theory of praxis, and a critique of liberalism, Marxism, nationalism and idealism emphasising concrete as opposed to abstract theory and the need to build on existing cultural traditions to modernise rather than westernise East Asia. This post-Western fusion was imagined to be the beginning of a true and pluralistic universalism.

Community workers' understandings and practices of resistance

This research is focused on Community Workers located in Southern Ireland, and their understandings and practices of resistance. It is an attempt to explore the ways in which community workers’ understandings and practices of resistance are formed and, in turn, inform their sense of identity and their responses to the wider context of community development work in Ireland today. This study is specifically located but also has wider application and relevance because of the extended international reach of neo-liberal and managerial rationalities, and their implications for politics, policy and practice. The study considers resistance in a number of inter-related ways: as a collective oppositional position (with negative and positive dimensions); a personal and/or professional value (associated with the ‘expansion of contention’); a strategy for negotiating unequal power relations (in a range of levels and spaces of power); an identity (in relation to the sustaining of ‘reflexive subjectivities’); a set of practices, (which take into account the interplay between economic, political and cultural influences); and an educational process through which practitioners assess and enact personal and professional agency. Critical theorisations of community development and of the Irish state over time, trace the ways in which neo-liberalism and managerialism has inflected community development practice and the positions of community workers and communities in that process. The study draws on James C. Scott, Gramsci, Barnes and Prior, among others, which enabled the interrogation of resistance in relation to everyday practices through engaging with ‘hidden transcripts’ and spaces. The method chosen was focus group discussions with three groups of community workers located in different counties in Southern Ireland. This method facilitated a deep discourse analysis of practitioners’ encounters with resistance in the field of community work. Key findings relate to the various interpretations of the role of resistance, practices of resistance (including current restrictions), the value of resistance work and the conditions that may be conducive to practising resistance.

Public evaluations of novel food technologies: a qualitative citizen-scientist deliberative discourse approach

This qualitative research expands understanding of how information about a range of Novel Food Technologies (NFTs) is used and assimilated, and the implications of this on the evolution of attitudes and acceptance. This work enhances theoretical and applied understanding of citizens’ evaluative processes around these technologies. The approach applied involved observations of interactive exchanges between citizens and information providers (i.e. food scientists), during which they discussed a specific technology. This flexible, yet structured, approach revealed how individuals construct meaning around information about specific NFTs. A rich dataset of 42 ‘deliberate discourse’ and 42 postdiscourse transcripts was collected. Data analysis encompassed three stages: an initial descriptive account of the complete dataset based on the top-down bottom-up (TDBU) model of attitude formation, followed by inductive and deductive thematic analysis across the selected technology groups. The hybrid thematic analysis undertaken identified a Conceptual Model, which represents a holistic perspective on the influences and associated features directing ‘sense-making’ and ultimate evaluations around the technology clusters. How individuals make sense of these technologies is shaped by: their beliefs, values and personal characteristics; their perceptions of power and control over the application of the technology; and, the assumed relevance of the technology and its applications within different contexts. These influences form the frame for the creation of sense-making around the technologies. Internal negotiations between these influences are evident and evaluations are based on the relative importance of each influence to the individual, which tend to contribute to attitude ambivalence and instability. The findings indicate the processes of forming and changing attitudes towards these technologies are: complex; dependent on characteristics of the individual, technology, application and product; and, impacted by the nature and forms of information provided. Challenges are faced in engaging with the public about these technologies, as levels of knowledge, understanding and interest vary.

A river of memory: landscape, narrative and identity in the Lee Valley, Co. Cork, Ireland

In moments of rapid social changes, as has been witnessed in Ireland in the last decade, the conditions through which people engage with their localities though memory, individually and collectively, remains an important cultural issue with key implications for questions of heritage, preservation and civic identity. In recent decades, cultural geographers have argued that landscape is more than just a view or a static text of something symbolic. The emphasis seems to be on landscape as a dynamic cultural process – an ever-evolving process being constructed and re-constructed. Hence, landscape seems to be a highly complex term that carries many different meanings. Material, form, relationships or actions have different meanings in different settings. Drawing upon recent and continuing scholarly debates in cultural landscapes and collective memory, this thesis sets out to examine the generation of collective memory and how it is employed as a cultural tool in the production of memory in the landscape. More specifically, the research considers the relationships between landscape and memory, investigating the ways in which places are produced, appropriated, experienced, sensed, acknowledged, imagined, yearned for, appropriated, re-appropriated, contested and identified with. A polyvocal-bricoleur approach aims to get below the surface of a cultural landscape, inject historical research and temporal depth into cultural landscape studies and instil a genuine sense of inclusivity of a wide variety of voices (role of monuments and rituals and voices of people) from the past and present. The polyvocal-bricoleur approach inspires a mixed method methodology approach to fieldsites through archival research, fieldwork and filmed interviews. Using a mixture of mini-vignettes of place narratives in the River Lee valley in the south of Ireland, the thesis explores a number of questions on the fluid nature of narrative in representing the story and role of the landscape in memory-making. The case studies in the Lee Valley are harnessed to investigate the role of the above questions/ themes/ debates in the act of memory making at sites ranging from an Irish War of Independence memorial to the River Lee’s hydroelectric scheme to the valley’s key religious pilgrimage site. The thesis investigates the idea that that the process of landscape extends not only across space but also across time – that the concept of historical continuity and the individual and collective human engagement and experience of this continuity are central to the processes of remembering on the landscape. In addition the thesis debates the idea that the production of landscape is conditioned by several social frames of memory – that individuals remember according to several social frames that give emphasis to different aspects of the reality of human experience. The thesis also reflects on how the process of landscape is represented by those who re-produce its narratives in various media.

"I have nothing to say, only to show": appropriation in the poetries of Trevor Joyce, Alan Halsey, and Susan Howe

This thesis studies contemporary poetry’s innovations in textual borrowing and the range and scope of its appropriative practices. The restrictions of the inherited definitions of appropriation include a limited capacity for expression and meaningfulness, a partial concept of appropriation’s critical capacity, and an inadequate sense of the poet’s individual and unique practice of appropriation. This thesis resolves the problematic constraints limiting contemporary definitions of appropriation by tracing the history of the practice to reveal an enduring relation between appropriation and poetic expression. Close readings of Trevor Joyce’s, Alan Halsey’s, and Susan Howe’s poetry serve as evidence of contemporary poetry’s development of appropriation beyond the current ascriptions and offer some direction on how the critical understanding of appropriation might be extended and redefined. Here, appropriation is recognized as another source of lyric expression, critical innovation, and conceptual development in contemporary poetry. This thesis encourages a new perspective on the purpose and processes of poetic appropriation and the consequences of its declarative potential for both poet and poem.

Echoes of existentialism in the works of Carlos Fuentes

In this thesis I have set out to trace the echoes of existentialism in the work of the Mexican novelist, Carlos Fuentes scrutinizing, in particular, La región más transparente, La muerte de Artemio Cruz and Cambio de piel. In the opening segment of the thesis I outline the essential tenets of existentialist thought and how it became the predominant philosophical and literary movement of the early part of the twentieth-century. Stemming from the work of Sören Kierkegaard in Denmark towards the end of the nineteenth-century, it challenged the arid philosophies of previous generations and provided a new way of looking at man and the human condition. In this opening chapter, I study the works of the more important philosophers in this regard such as Heidegger, Sartre, Jaspers, Marcel, Unamuno, and Ortega y Gasset and show how each in his own way contributed to the further development of the new philosophy. Chapter 2 is concerned with the spread of existentialism to the Latin American continent. In the early part of the twentieth-century, Mexico was emerging from a turbulent revolutionary period and seeking a solution to the fractured nature of its society. The Spanish philosopher, Ortega y Gasset, and the many Spanish intellectuals who sought refuge from Franco’s dictatorship in Mexico, helped to popularise the new philosophy and these lively debates about existentialism served to underpin ideas around mexicanidad or Mexican national identity. Carlos Fuentes was deeply immersed in the debate of his time, positioned as he was as a prominent public intellectual. In La muerte de Artemio Cruz he shows us how great wealth and power are a poor recompense for the loss of love and compassion and lead only to alienation and selfishness. In his other best known novel, La región más transparente, he explores the rise of modern Mexico and its society – an inauthentic society that is corrupted by a scramble for wealth and self-aggrandizement. The final chapter is devoted to the study of Cambio de piel which is concerned with violence and alienation as central pillars of existence. The violence depicted here precipitates a crisis in the human condition and an accompanying sense of alienation. The thesis seeks to establish that existentialism is central not only to Fuentes’s literary concerns but also forms a part of his ethics as an artist.

Remembrance of the ancestors in contemporary paganism: Lineage, identity, and cultural belonging in the Irish context

This article explores some of the ways of remembering and honouring the ancestors in contemporary Pagan religious traditions, with a focus on the Irish context. An overview is provided of how the "ancestors" are conceptualised within Paganism, as well as where they are believed to be located in the afterlife or Otherworld. Veneration of ancestral peoples is a significant part of many Pagan rituals. Some methods of honouring the dead, and contacting the dead, through ritual practices are described. Remembering and honouring the dead, whether distant forebears or more recent relatives, is particularly important during the Pagan celebration of the festival of Samhain, feast of the dead, on October 31. Issues around ancestors, lineages and ethnicity are significant in many Pagan traditions, and attention is paid to these factors in terms of the Irish Pagan community's sense of cultural belonging as well as their sense of place in a physical respect in relation to the landscape, proximity of sacred sites, and other features of their geographical location.

Keeping their heads down: Shame and pride in the stories of Protestants in the Irish Republic

This study draws on a number of in-depth interviews to explore the ethnic aspect of Protestantism in the Republic of Ireland. We explore themes of shame and pride around issues of identity, together with a sense of loss of a minority rapidly losing cultural distinctiveness. Following Ireland‘s division, the ordinary Protestants of the south, comprising a range of religious denominations bound by history, intermarriage and culture, found themselves in a society in which their story was rarely told. The dominant narrative was one of a Catholic people, long oppressed by a wealthy Protestant minority. The story of ordinary Protestants, including those in rural and urban poverty, went largely unheard. Today, ordinary Protestants – small farmers, shop keepers, housewives – tell the story of Ireland as seen through their family‘s narratives. Themes of pride and shame, often intertwined, form a thread that binds their testimony, drawing on family, personal and local history, folklore and statements of identity.