Transition from Children’s to Adult Services forYoung People with Life-limiting Conditions: Findings from a Questionnaire Survey in Northern Ireland

Research aims: 
To describe service provision for the transition from children’s to adult services for young people with life-limiting conditions in Northern Ireland, and to identify organisational factors that promote or inhibit effective transition. 
Study population: 
Health, social, educational and charitable organisations providing transition services to young people with life-limiting conditions in Northern Ireland. 
Study design and methods: 
A questionnaire has been developed by the research team drawing on examples from the literature and the advice of an expert advisory group. The questionnaire was piloted with clinicians,academics and researchers in June 2013. The questionnaire focuses on components of practice which may promote continuity in the transition from child to adult care for young people with a life-limiting condition. The survey will be distributed throughout Northern Ireland to an estimated 75 organisations, following the Dillman total design survey method. Numerical data will be analysed using PASW Statistical software to generate descriptive statistics along with a thematic analysis of data generated by open-ended questions. 
Results and interpretations: 
The survey will provide a description of services, transition policies, approaches to managing transition, categories of service users, the ages at which transition starts and completes, experiences with minority ethnic groups, the input of service users to the process, organisational factors promoting or hindering effective transition, links between services, and service providers’ recommendations for improvements in services.The outcomes will be an overview of the transition services currently provided in Northern Ireland identifying models of good practice and the key factors influencing the quality, safety and continuity of care. Survey results are due early in 2014.

Social Services of General Interest: The EU Competence Regime and a Constitution of Social Governance

In discussing the potential role of the EU, the Member States, their composite parts and civil society organisations in establishing social services of general interest at sub-national, national, transnational and EU wide levels, this chapter explores the EU competence regime for social services of general interest. Its analysis contradicts a tendency in academic writing to demand protection of national prerogatives for shaping welfare states against EU intervention at all costs, because this would be counterproductive for the progress of the EU project. It submits that an EU constitution of social governance should create mixed responsibilities so that the EU, states and civil society actors support each other in creating preconditions for social integration in the EU. It uses the field of social services of general interests as an example of applying this general theoretical concept.

The Impact of EU Privacy Legislation on Biometric System Deployment: Protecting citizens but constraining applications

Biometric systems provide a valuable service in helping to identify individuals from their stored personal details. Unfortunately, with the rapidly increasing use of such systems, there is a growing concern about the possible misuse of that information. To counteract the threat, the European Union (EU) has introduced comprehensive legislation that seeks to regulate data collection and help strengthen an individual’s right to privacy. This article looks at the implications of the legislation for biometric system deployment. After an initial consideration of current privacy concerns, it examines what is meant by ‘personal data’ and its protection, in legislation terms. Also covered are issues around the storage of biometric data, including its accuracy, its security, and justification for what is collected. Finally, the privacy issues are illustrated through three biometric use cases: border security, online bank access control and customer profiling in stores.

Domestic fridge-freezer load aggregation to support ancillary services

Grid operators and electricity retailers in Ireland manage peak demand, power system balancing and grid congestion by offering relevant incentives to consumers to reduce or shift their load. The need for active consumers in the home using smart appliances has never been greater, due to increased variable renewable generation and grid constraints. In this paper an aggregated model of a single compressor fridge-freezer population is developed. A price control strategy is examined to quantify and value demand response savings during a representative winter and summer week for Ireland in 2020. The results show an average reduction in fridge-freezer operating cost of 8.2% during winter and significantly lower during summer in Ireland. A peak reduction of at least 68% of the average winter refrigeration load is achieved consistently during the week analysed using a staggering control mode. An analysis of the current ancillary service payments confirms that these are insufficient to ensure widespread uptake by the small consumer, and new mechanisms need to be developed to make becoming an active consumer attractive. Demand response is proposed as a new ancillary service called ramping capability, as the need for this service will increase with more renewable energy penetration on the power system.

Applying the recovery approach to the interface between mental health and child protection services

There are a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and inquiry reports, as complex and problematic. This paper proposes that more positive, integrated approaches to service user engagement, risk assessment and management may lead to better outcomes in working with families experiencing parental mental health problems and child protection concerns. It is proposed that the recovery approach, increasingly used in mental health services, can inform the processes of engagement, assessment and intervention at the mental health and child protection interface. The article provides a critical overview of the recovery approach and compares it with approaches typifying interventions in child protection work to date. Relevant research and inquiries are also examined as a context for how to more effectively respond to cases where there are issues around parental mental health problems and child protection. The article concludes with case material to illustrate the potential application of the recovery approach to the interface between mental health and child protection services.

Predictors of place of death for those in receipt of home-based palliative care services in Ontario, Canada

Many cancer patients die in institutional settings despite their preference to die at home. A longitudinal, prospective cohort study was conducted to comprehensively assess the determinants of home death for patients receiving home-based palliative care. Data collected from biweekly telephone interviews with caregivers (n=302) and program databases were entered into a multivariate logistic model. Patients with high nursing costs (odds ratio [OR]: 4.3; confidence interval [CI]: 1.8-10.2) and patients with high personal support worker costs (OR: 2.3; CI: 1.1-4.5) were more likely to die at home than those with low costs. Patients who lived alone were less likely to die at home than those who cohabitated (OR: 0.4; CI: 0.2-0.8), and those with a high propensity for a home-death preference were more likely to die at home than those with a low propensity (OR: 5.8; CI: 1.1-31.3). An understanding of the predictors of place of death may contribute to the development of effective interventions that support home death.