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.

Frequency of cytokine gene promoter polymorphisms in the Northern Ireland Cystic Fibrosis population

It has been postulated that cytokine allele frequencies are gender and perhaps geographically-specific. Cytokine release is crucial in the regulation of the type and magnitude of the immune response. This study observed no differences in the frequency of cytokine promoter polymorphisms associated with variant levels of expression in patients with CIF and a non-CF population of Northern Ireland. (c) 2007 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Northern Ireland: The Politics of Constraint

The article surveys the interrupted experience of devolution in Northern Ireland since 1999 and draws a number of comparisons between the first devolved Assembly and Executive and their successors elected in 2007. It underlines the significance of the changed political, electoral and paramilitary context in the period leading up to the 2007 Assembly election which, together with a number of procedural changes effected by the 2006 St Andrews Agreement, enabled the restoration of power-sharing devolution to occur. Against the background of its legislative and policy record and the wider altered state of Northern Ireland, it concludes that the contrived consociational model of governance can work, up to a point, but perhaps as much because of the politics of constraint than consociationalism's much vaunted promise to reflect and engender the politics of accommodation.

In Pursuit of School Ethos

The purpose of this paper is to examine the linkages and relationships between the officially prescribed school ethos and that which emerges from social interaction. Qualitative data drawn from one Grant-Maintained-Integrated and one Catholic primary school in Northern Ireland show how school ethos, defined as the observed practices and interactions of school members, often departs considerably from school ethos defined as those values and beliefs which the school officially supports. On the basis of the data it is argued that much of what we understand of school ethos is superficial and contradictory. With this in mind the paper concludes by presenting a new angle on ethos which, when taken in conjunction with the other perspectives, further enhances our understanding of how schools work.

Overcoming Customer Dependency - A Case Study of Small Consumer Food Producers in Northern Ireland

Dependency on a small number of customer puts intense pressure on suppliers' profit margin and, in slow growing markets, limits their ability to grow. using stragtegic benchmarking information, a group of Northern Ireland consumer food producer are shown, depsite slow market growth and higher than averge customer dependency, to have increased market share while maintaining aboe vergate proitability. examination of the business strategic and develoment activites of the consumer food firms,and comparble information for other small food prodcuers in Ireland, suggests and emphasiss on cost-reduction and new prodcut development. A comparision of the productivity and prodcut range of the consuer food firms provides evidence of the success of these strategic. This suggests that even a relatively weak market situations, charactrised by dependency on a small number of customers, can be over come by effective and appropriate business strategy.

Rethinking prenatal care within a social model of health: an exploratory study in Northern Ireland

Implementation of maternity reform agendas remains limited by the dominance of a medical rather than social model of health. This article considers group prenatal care as a complex health intervention and explores its potential in the socially divided, postconflict communities of Northern Ireland. Using qualitative inquiry strategies, we sought key informants’ views on existing prenatal care provision and on an innovative group care model (CenteringPregnancy®) as a social health initiative. We argue that taking account of the locally specific context is critical to introducing maternity care interventions to improve the health of women and their families and to contribute to community development.

User perspective on palliative care services: experiences of middle-aged partners bereaved through cancer known to social work services in Northern Ireland

This qualitative research study explores experiences of partners bereaved through cancer, who were resident in an urban area of Northern Ireland and who had been service users of the social work services. Data were collected in 2004 from 10 individuals who participated in semi-structured interviews. Emergent themes were identified using thematic content analysis and findings analysed under four categories: cancer journey; impact of bereavement; process of adjustment and change; and experience of support services. Opportunities to facilitate communication were not always maximised, often resulting in poor bereavement outcomes. Although hospices undertook bereavement risk assessment, participants were unaware of its use and queried its accuracy without service user involvement. The most cited informal support was family and friends, although such help was time-limited. Service user feedback regarding social workers was generally positive; however, there was a lack of knowledge about their role in palliative care. Post-bereavement adjustment was influenced by the quality of social networks, the responsibilities of lone parenthood, and challenges to life values and core beliefs. A framework for palliative care social work has been recommended based on research findings.

Residential segregation in Northern Ireland in 2001: assessing the value of exploring spatial variations

Segregation measures have been applied in the study of many societies, and traditionally such measures have been used to assess the degree of division between social and cultural groups across urban areas, wider regions, or perhaps national areas. The degree of segregation can vary substantially from place to place even within very small areas. In this paper the substantive concern is with religious/political segregation in Northern Ireland—particularly the proportion of Protestants (often taken as an indicator of those who wish to retain the union with Britain) to Catholics (often taken as an indicator of those who favour union with the Republic of Ireland). Traditionally, segregation is measured globally—that is, across all units in a given area. A recent trend in spatial data analysis generally, and in segregation analysis specifically, is to assess local features of spatial datasets. The rationale behind such approaches is that global methods may obscure important spatial variations in the property of interest, and thus prevent full use of the data. In this paper the utility of local measures of residential segregation is assessed with reference to the religious/political composition of Northern Ireland. The paper demonstrates marked spatial variations in the degree and nature of residential segregation across Northern Ireland. It is argued that local measures provide highly useful information in addition to that provided in maps of the raw variables and in standard global segregation measures.

Monitoring and population estimation of the European badger (Meles meles) in Northern Ireland

The estimation of animal abundance has a central role in wildlife management and research, including the role of badgers Meles meles in bovine tuberculosis transmission to cattle. This is the first study to examine temporal change in the badger population of Northern Ireland over amedium- to long-term time frame of 14-18 years by repeating a national survey first conducted during 1990-1993. A total of 212 1-km2 squares were surveyed during 2007-2008 and the number, type and activity of setts therein recorded. Badgers were widespread with 75% of squares containing at least one sett. The mean density of activemain setts,which was equivalent to badger social group density, was 0.56 (95%CI: 0.46-0.67) active main setts per km2 during 2007-2008. Social group density varied significantly among landclass groups and counties. The total number of social groups was estimated at 7,600 (95%CI: 6,200-9,000) and, not withstanding probable sources of error in estimating social group size, the total abundance of badgers was estimated to be 34,100 (95% CI: 26,200-42,000). There was no significant change in the badger population from that recorded during 1990-1993. A resource selection model provided a relative probability of sett construction at a spatial scale of 25m. Sett locations were negatively associated with elevation and positively associated with slope, aspect, soil sand content, the presence of cover, and the area of improved grassland and arable agriculture within 300 m.

Folklore’s Timeless Past, Ireland’s Present Past, and the Perception of Rural Houses in Early Historic Ireland

This study examines how the archaeology of historic Ireland has been interpreted. Two approaches to the history and archaeology of Ireland are identified. The first, the timeless past, has its roots in a neo-Lamarckian view of the past. This perspective was particularly developed in the work of geographer and ethnographer, Estyn Evans. The second view, associated in particular with a nationalist approach to Ireland’s past, looked to the west of the country where it was believed the culture had been preserved largely unchanged and in its purest form. The continuing impact of these frameworks upon the interpretation of rural settlement in the period 1200– 1700 is examined. It is argued that historians and archaeologists alike have underestimated the quality of buildings.