Moving to evidence-based practice in long-term care:the role of a Best Practise Resource Centre in two long-term care settings.

In this article, the authors provide an overview on the development of a Long-Term Care Best Practise Resource Centre. The results of both a feasibility study and the outcomes of a 1-year demonstration project are presented. The demonstration project involved a hospital as the information service provider and two demonstration sites, a home care service agency and a nursing home that used the services of the Centre. The goals of the Centre were threefold: provide access to literature for staff in long-term care (LTC) settings; improve the information management skills of health care providers; and support research and the integration of best practices in LTC organizations. The results of the pilot study contributed to the development of a collaborative information access system for LTC clinicians and managers that provides timely, up-to-date information contributing to improving the quality of care for adults receiving LTC. Based on this demonstration project, strategies for successful innovation in LTC are identified.

Parenting Programmes: The Best Available Evidence

Parenting programmes have been provided to a wide range of child and parent groups across a number of countries, but are they effective? This aim of this paper is to examine the findings from a number of systematic reviews that summarise the best available research evidence on the impact of these programmes on a range of parental and child outcomes. In addition to examining the findings from systematic reviews, the paper also takes a selective look at the uptake of parenting programmes in the United Kingdom, the evidence for effectiveness and the efficacy of adopting a population-based approach to parent education.

The findings from systematic reviews indicate that parenting programmes can have a positive impact on a range of outcomes, including improved child behaviour, increased maternal self-esteem and relationship adjustment, improved mother–child interaction and knowledge and decreased maternal depression and stress. While there is a need for greater evaluation of the long-term impact of these programmes, preliminary evidence indicates that these positive results are maintained over time, with group-based, behaviourally orientated programmes tending to be more effective.

While several recent trials indicate that that these programmes can be effective within the United Kingdom, high drop-out rates may mean that they only reach a minority of parents. However, multi-level parent education strategies such as the Australian Triple P Positive Parenting Strategy that incorporate an array of mediums aimed at different levels of need may provide an opportunity to reach a wider range of parents. This approach is currently being evaluated in order to ascertain whether it is effective in improving child outcomes in the general population.

While there is no coherent strategy for parent training across the United Kingdom, within the Northern Ireland context there is a move towards the development of a family support strategy. While uptake of parent education and training is currently unknown the best available evidence highlights the positive impact that parent training can have, suggesting the importance of including parent education as one aspect of this strategy

What is the best method for diagnosing glaucoma?

Glaucoma is characterized by a typical appearance of the optic disc and peripheral visual field loss. However, diagnosis may be challenging even for an experienced clinician due to wide variability among normal and glaucomatous eyes. Standard automated perimetry is routinely used to establish the diagnosis of glaucoma. However, there is evidence that substantial retinal ganglion cell damage may occur in glaucoma before visual field defects are seen. The introduction of newer imaging devices such as confocal scanning laser ophthalmoscopy, scanning laser polarimetry and optical coherence tomography for measuring structural changes in the optic nerve head and retinal nerve fiber layer seems promising for early detection of glaucoma. New functional tests may also help in the diagnosis. However, there is no evidence that a single measurement is superior to the others and a combination of tests may be needed for detecting early damage in glaucoma. © 2010 Expert Reviews Ltd.

House at Bogwest - Best House 2012 RIAI Architecture Awards:A House Loved into Existence

Full length critical peer review article about House at Bogwest, which was the winner of the 2012 RIAI Best House award, by architect Emmett Scanlon. Photographs by Alice Clancy. Photographs and plans describing House at Bogwest.

Energy: lessons from devolution

Geraint Ellis and Richard Cowell explain the findings of the ‘Delivering renewable energy under devolution’ project, including some reasons for Scotland’s lead.

The UK has seen massive increases in renewable energy since 1998, with installed capacity growing from 2,600 MW to 12,300 MW in 2011. This has coincided with devolution and it is within Northern Ireland, Scotland and Wales that the greatest increases have been seen.

As devolved administrations now host half of the UK’s renewable energy capacity, their policies are critical to achieving the broader UK targets. This also provides a fascinating insight into what sort of approach works best, and why. This has been the focus of a two-year study, funded by the Economic and Social Research Council, involving universities from across the UK, which indicates that Scotland is leading the way on renewable energy.

All devolved governments have offered significant support to renewable energy but have different degrees of powers in relation to energy. Scotland’s success seems to be based on the centrality of energy issues to current political aspirations, particularly the SNP, but also has cross-party support. The research suggests that the consensus on the importance of renewable energy amongst élite interests in Scotland helps to explain why Scottish governments have been empowered and enabled to make robust use of the powers available.

As it has achieved successful growth in the sector, this too helps cultivate credibility among key business interests and gives increased leverage to its position in policy discussions with the UK Government. Scotland has been more consistent over time in presenting the expansion of renewable energy as a national economic agenda, rather than just an environmental or rural development agenda. The availability of larger, windy, but relatively less contested sites for onshore wind in Scotland has meant that more projects went through central consenting procedures rather than local planning authorities. Its enhanced support for wave and tidal power technologies is also notable. These political conditions have been harder to find in the rest of the UK, making progress a little more uncertain.

Northern Ireland has used its powers (which are more extensive than Scotland’s) to facilitate small-scale renewables and bio-fuel processes, with its liberalised planning regime offering an initial boost to expanding capacity.

This has contrasted with the position in Wales, which has least control over energy but the Welsh Government has adopted a more innovative approach to strategic spatial zoning; this appears to have pulled in a larger volume of onshore wind development interest than could be expected in a comparable region of England. A downside of the Welsh approach appears to be the fact that the concentration of these wind projects in these zones has triggered public opposition and political conflict.

It therefore appears that the powers available to the devolved governments do not seem to determine which country has been able to make greatest headway, with broader political commitments being more significant. Despite this, the research does not conclude that the actions and activities undertaken by the devolved governments are necessarily the most important factors in shaping the development of renewable energy in the UK. This is because devolution is still a relatively new dimension of energy governance in the UK and decisions affecting key drivers for renewable energy investment are still made mainly in Westminster, with the Treasury exercising close budgetary control. In all areas of the UK, grid capacity expansion remains slow to achieve. The major growth in offshore wind to date has been driven mainly by Westminster and cross-UK bodies with the most significant capacity growth being in English territorial waters.

Leaded Strand Lamp:Selected for Inclusion for an Exhibition of the best of irish Design as part of the Vernacular Exhibition in London Design Festival 2013. Curated by Ann Mulrooney

Contemporary product made using traditional Northern irish metal craft skills