A Census-based longitudinal study of variations in survival amongst residents of nursing and residential homes in Northern Ireland

Background: despite the intensive services provided to residents of care homes, information on death rates is not routinely available for this population in the UK. Objective: to quantify mortality rates across the care home population of Northern Ireland, and assess variation by type of care home and resident characteristics. Design: a prospective, Census-based cohort study, with 5-year follow-up. Participants: all 9,072 residents of care homes for people aged 65 and over at the time of the 2001 census with a special emphasis on the 2,112 residents admitted during the year preceding census day. Measurements: age, sex, self-reported health, marital status, residence (not in care home, residential home, dual registered home, nursing home), elderly mentally infirm care provision. Results: the median survival among nursing home residents was 2.33 years (95% CI 2.25–2.59), for dual registered homes 2.75 (95% CI 2.42–3.17) and for residential homes 4.51 (95% CI 3.92–4.92) years. Age, sex and self-reported health showed weaker associations in the sicker populations in nursing homes compared to those in residential care or among the non-institutionalised. Conclusions: the high mortality in care homes indicates that places in care homes are reserved for the most severely ill and dependent. Death rates may not be an appropriate care quality measure for this population, but may serve as a useful adjunct for clinical staff and the planning of care home provision.

The push and pull between religion and ethnicity: The case of loyalists in Northern Ireland

This paper uses a case study of a largely religiously non-practising group, working class loyalists in Northern Ireland, to explore the relationship between religion and ethnicity in divided societies. It finds that loyalists often turn to religion habitually in times of insecurity to provide justification for conflict. But religion does not just prop up deeper ethnic identities. Religion has meaning and content itself that is sometimes tension with oppositional ethnic identities and, in some cases, can transform them totally. This produces a complex set of relationships in which religion and ethnicity push and pull against one another in the lives of individuals, neither dominating fully over the other.

Disaggregating conservative Protestant groups in Northern Ireland: Overlapping categories and the importance of a born-again self-identification

Rather than treating conservative Protestantism as a homogenous phenomenon, recent literature has underlined the importance of disaggregating this group to illuminate important attitudinal and behavioral differences between conservative Protestants. However, the methods used to empirically operationalize conservative Protestantism have not always been able to capture variations within the groupings. Based on analysis of the 2004 Northern Ireland Life and Times Survey, we argue that religious self-identification is a more useful way of analyzing conservative Protestant subgroups than denomination or religious belief. We show that many of these identifications are overlapping, rather than stand-alone, religious group identifications. Moreover, the identification category of born-again has seldom been included in surveys. We find having a born-again identification to be a better predictor than the more frequently asked fundamentalist and evangelical categories of the religious and social beliefs that are seen as indicative of conservative Protestantism.

Reflections on Practice Learning in Northern Ireland and the Republic of Ireland: Lessons from Student Experiences

Practice learning is viewed as one of the most important components of social work education wherever in the world social work is practised. Northern Ireland and the Republic of Ireland provide an interesting case example of the educational impact on students resulting from their experience of different models of practice learning. Although sharing a common historical legacy, recent developments in policy in both jurisdictions have tended to engender greater divergences in how programmes organise and deliver social work education and practice learning. Drawing on findings from a joint-research project with students in Queen’s University, Belfast and Trinity College, Dublin, the authors highlight significant cross-border similarities as well as differences in the way practice learning is conceptualised, organised and delivered. Through comparing and contrasting student experiences, the authors reflect on how the findings might help to inform the future development of practice learning standards in both jurisdictions.

Escaping the Cage of Ethno-National Conflict in Northern Ireland: The Importance of Transnational Networks

co-author; Cathal McCall