Group Trauma-Focused Cognitive-Behavioural Therapy with Former Child Soldiers and other War-affected Boys in the DR Congo: A Randomised Controlled Trial.

Background: The Democratic Republic of Congo (DRC) has been home to the world’s deadliest con?ict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers.

Method: A randomised controlled trial involving 50 boys, aged 13–17, including former child soldiers (n = 39) and other war-affected boys (n = 11). They were randomly assigned to an intervention group, or wait-list control group. The intervention group received a 15-session, group-based, culturally adapted Trauma-Focused Cognitive–Behavioural Therapy (TF-CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3-month follow-up (intervention group).

Results: Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait-list control group, the TF-CBT intervention group had highly signi?cant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety-like symptoms, conduct problems and a signi?cant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier scores were separated for sub-analysis. Three-month follow-up of the intervention group found that treatment gains were maintained.

Conclusions: A culturally modi?ed, group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war-affected boys.

A Review of the Research on Offender Supervision in the Republic of Ireland and Northern Ireland

This paper reviews existing research on offender supervision in the Republic of Ireland and Northern Ireland. Three distinct areas are considered: practising offender supervision, experiencing supervision and decision-making in this sphere. The material presented draws on findings from a European-wide research action under the Cooperation in Science and Technology (COST) initiative. The review highlights some of the gaps in knowledge and the need to focus research attention in this area. This need is underlined by the expansion in probation’s role, both North and South. In common with other countries there has been a growth in referrals to probation and in the numbers of people subject to supervision, whether on a community sentence or under post-custodial licence conditions. This review highlights some of the relevant factors including the increased emphasis placed on public protection and attempts to reduce the prison population. The circulation of people through systems and the experiences, processes and decision-making involved are all areas that we argue are worthy of further research attention.

Appealing to the Republic of Letters: An Autopsy of Anti-venereal Trials in Eighteenth-century Mexico

This study analyses the narrative elements of a little-known report into anti-venereal trials written by an Irish military physician-surgeon, Daniel O'Sullivan (1760–c.1797). It explores the way in which O'Sullivan as the narrator of the Historico-critical report creates medical heroes and anti-heroes as a means to criticise procedures initiated by staff in the Hospital General de San Andrés, Mexico City. The resulting work depicts a much less positive picture of medical trials and hospital authorities in this period than has been recorded to date, and provides a critical and complicated assessment of one of Spain's leading physicians of the nineteenth century, Francisco Javier Balmis (1753–1819).

Endodontic 'Solutions'. Part 2:An audit comparing current practice in Belfast with UK and Republic of Ireland Dental Schools

Endodontic lubricants, irrigating solutions and medicaments help reduce the microbial load within root canals. Primary and secondary cases involve different microbes. Each'solution'or combinations thereof could play a significant role but no detailed guidelines exist on their use. An audit was undertaken to compare current practice in Belfast Dental School to the others across the UK and Republic of Ireland (ROI). This audit highlighted three main differences between Belfast and other dental schools. Many other institutions utilized other irrigants besides sodium hypochlorite (NaOCl), different intracanal medicaments, including calcium hydroxide, and higher concentrations of NaOCl. Having gathered this information, we ask, 'Is there sufficient evidence to change the endodontic regime currently used at Belfast Dental School?'. Using the findings from the literature review (Part 1), we introduce new evidence-based protocols for primary and secondary cases for use in Belfast Dental School. Clinical Relevance: In the absence of detailed clinical guidelines on the use of endodontic lubricants, irrigants and medicaments in primary and secondary cases, it is important to be aware of current practice in UK and ROI dental schools where dentists and specialists are trained.

Invisible from View: Leaving and Aftercare Provision in the Republic Of Ireland

The adequacy of provisions for young people leaving care and in aftercare in the Republic of Ireland have been the subject of recent policy attention. A landmark report, the Ryan Report (2009), into historic abuse in state institutions recommended strengthening provisions in this area. However, the legislative basis for aftercare remains relatively weak and services for young people leaving care remain ad hoc and regionally variable. This article outlines the current context of leaving and aftercare provision in the Republic of Ireland and traces some of the recent policy debates and recommendations in this area. A genealogical analysis of leaving care and aftercare provision highlights that this issue has historically only emerged as a concern in the context in which young people leaving the care system are perceived as a ‘threat’ to social order. It is argued that the failure to adequately reform leaving and aftercare provision is reflective of wider social inequality and of a context in which young people in care are largely invisible from view.

Protecting the most vulnerable in an economic crisis: a participatory study of civil society organisations in the Republic of Ireland

This paper advances knowledge of how civil society organisations (CSOs) negotiate the shift from boom-time public expenditure to governmental austerity. The study focuses on the Republic of Ireland, where CSOs occupied an important role in providing a voice for ‘vulnerable’citizens in corporatism for over a decade. The global financial crisis and subsequent austerity measures caused the country’s model of corporatist-style ‘social partnership’ to collapse. The article connects CSOs’ adaptation to austerity measures when protecting the ‘people behind the cuts’ to broader questions about co-optation of civil society through state-led policymaking
institutions.

The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys

Objectives: Multimorbidity is common in the older population, but the impact of combinations of chronic conditions on disability and quality of life (QoL) is not well known. This analysis explores the effect of specific combinations of chronic diseases on disability, QoL and self-rated health (SRH).

Design: We used data from two population representative cross-sectional studies, the Northern Ireland Health and Social Wellbeing Survey (NIHSWS) 2005 and the Survey of Lifestyle, Attitudes and Nutrition (SLAN) 2007 (conducted in the Republic of Ireland).

Setting: Randomly selected community-living participants were interviewed at home.

Participants: A total of 6159 participants aged 50 years and older were included in the analysis.

Outcome measures: Chronic conditions were classified as cardiovascular disease, chronic pain,diabetes or respiratory disease. Interaction terms estimated by logistic regression were used to examine the effects of multiple chronic conditions on disability, SRH and QoL.

Results: Each chronic condition group was correlated with each of the others after adjusting for sociodemographic factors. Those from Northern Ireland were more likely to report a limitation in daily activities (45%) compared to those from the Republic of Ireland (21%). Each condition had an independent effect on disability, SRH and QoL, and those with multiple chronic conditions reported the worst outcomes. However, there were no statistically significant positive interactions between chronic condition groups with respect to any outcome.

Conclusions: Chronic conditions affect individuals largely independent of each other with respect to their effect on disability, SRH and QoL. However, a significant proportion of the population aged 50 years and over across the island of Ireland lives with multimorbidity,and this group is at the highest risk of disability, poor SRH and poor QoL.

Bicameralism in the Republic of Ireland: The Seanad Abolition Referendum

Whether or not a legislature is uni- or bi-cameral has been found to have important consequences. Ireland's 1937 constitution provided for a directly elected lower chamber (Dáil Éireann) and an indirectly elected upper chamber (Seanad Éireann). With the appointment to government in 2011 of two political parties with a common electoral commitment to abolish bicameralism, the subsequent coalition agreement included a promise to hold a referendum offering voters the option to move to a unicameral parliamentary system. On 4 October 2013, the electorate voted to retain the upper chamber, albeit by a narrow majority of 51.7 per cent, on a turnout of 39.17 per cent. The outcome was arguably surprising, given that opinion polls signalled a plurality of voters favoured abolition, and there was a general public antipathy towards political institutions in the midst of a major economic crisis. Public opinion research suggests that a combination of factors explained voting behaviour, including a lack of interest amongst those who did not vote. A cost savings argument was a significant factor for those favouring abolition, while concerns over government control of the legislative process appear to have been most prominent in the minds of those who voted to retain the upper chamber.