The impact of organisational factors and government policy on psychiatric nurses family focused practice with parents who have mental illness, their dependent children and families in Ireland

Government policy and organizational factors influence family focused practice in adult mental health services. However, how these aspects shape psychiatric nurses’ practice with parents who have mental illness, their dependent children and families is less well understood. Drawing on the findings of a qualitative study, this article explores the way in which Irish policy and organizational factors might influence psychiatric nurses’ family focused practice, and whether (and how) family focused practice might be further promoted. A purposive sample of 14 psychiatric nurses from eight mental health services completed semi-structured interviews in 2013. The analysis was inductive and presented as thematic networks. Both groups described how policies and organizational culture enabled and/or hindered family focused practice, with differences between community and acute participants seen. The need to develop national and international policies along with practices to embed information and support regarding parenting into ongoing care is implicated in this study.

The role of operations management in public sector policy and practice alignment: a local government analysis

In responding to the demand for change and improvement, local government has applied a plethora of operations management-based methods, tools and techniques. This article explores how these methods, specifically in the form of performance management models, are used to improve alignment between central government policy and local government practice, an area which has thus far been neglected in the literature. Using multiple case studies from Environmental Waste Management Services, this research reports that models derived in the private sector are often directly ‘implanted’ into the public sector. This has challenged the efficacy of all performance management models. However, those organisations which used models most effectively did so by embedding (contextualisation) and extending (reconceptualisation) them beyond their original scope. Moreover, success with these models created a cumulative effect whereby other operations management approaches were probed, adapted and used.

Improving allied health professionals' research implementation behaviours for children with cerebral palsy: protocol for a before-after study

BACKGROUND: Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, vision and hearing, intellectual difficulties and epilepsy. Health and therapy services are frequently required throughout life, and this care should be effective and evidence informed; however, accessing and adopting new research findings into day-to-day clinical practice is often delayed.

METHODS/DESIGN: This 3-year study employs a before and after design to evaluate if a multi-strategy intervention can improve research implementation among allied health professionals (AHPs) who work with children and young people with cerebral palsy and to establish if children's health outcomes can be improved by routine clinical assessment. The intervention comprises (1) knowledge brokering with AHPs, (2) access to an online research evidence library, (3) provision of negotiated evidence-based training and education, and (4) routine use of evidence-based measures with children and young people aged 3-18 years with cerebral palsy. The study is being implemented in four organisations, with a fifth organisation acting as a comparison site, across four Australian states. Effectiveness will be assessed using questionnaires completed by AHPs at baseline, 6, 12 and 24 months, and by monitoring the extent of use of evidence-based measures. Children's health outcomes will be evaluated by longitudinal analyses.

DISCUSSION: Government, policy makers and service providers all seek evidence-based information to support decision-making about how to distribute scarce resources, and families are seeking information to support intervention choices. This study will provide knowledge about what constitutes an efficient, evidence-informed service and which allied health interventions are implemented for children with cerebral palsy.

TRIAL REGISTRATION: Trial is not a controlled healthcare intervention and is not registered.

Chronic child abuse and domestic violence: Children and families with long-term and complex needs

It is estimated that up to one million children may have been exposed to domestic violence in the UK, with significant consequences for their social and emotional development in childhood and later life. At a time when the central and devolved administrations in the UK have developed strategies to tackle domestic violence, this paper reports the findings from a study conducted on children in the child protection system with long-term and complex needs as a result of experiencing domestic violence. The research identifies the characteristics of the children and their families and tracks their careers through the child protection system. The findings indicate that professionals have an awareness of domestic violence, and that younger children with younger parents are most likely to experience prolonged periods in the child protection system. Domestic violence in this context typically co-exists in families experiencing other difficulties such as substance misuse and socio-economic deprivation. In conclusion, the paper argues that Government policy and professional practice should primarily be concerned with assessing the risk that men present, rather than the risk that children are at. By reframing professional interventions, men are more likely to be challenged to accept responsibility for their behaviour and the consequences for their families.

‘The “English Disease” is to Look for a “Solution of the Irish Problem”’: British Constitutional Policy in Northern Ireland after Sunningdale 1974–1976

This article reconstructs British constitutional policy in Northern Ireland after power-sharing collapsed in May 1974. Over the following two years, the British government publicly emphasised that Northern Ireland would decide its own future, but ministers secretly considered a range of options including withdrawal, integration and Dominion status. These discussions have been fundamentally misunderstood by previous authors, and this article shows that Harold Wilson did not seriously advocate withdrawal nor was policy as inconsistent as argued elsewhere. An historical approach, drawing from recently released archival material, shows that consociationalists such as Brendan O'Leary and Michael Kerr have neglected the proper context of government policy because of their commitment to a particular form of government, failing to recognise the constraints under which ministers operated. The British government remained committed to an internal devolved settlement including both communities but was unable to impose one.

From survey to policy: community relations in Northern Ireland

Public policy is expected to be both responsive to societal views and accountable to all citizens. As such, policy is informed, but not governed, by public opinion. Therefore, understanding the attitudes of the public is important, both to help shape and to evaluate policy priorities. In this way, surveys play a potentially important role in the policy making process.

The aim of this paper is to explore the role of survey research in policy making in Northern Ireland, with particular reference to community relations (better known internationally as good relations). In a region which is emerging from 40 years of conflict, community relations is a key policy area.

For more than 20 years, public attitudes to community relations have been recorded and monitored using two key surveys: the Northern Ireland Social Attitudes Survey (1989 to 1996) and the Northern Ireland Life and Times Survey (1998 to present). This paper will illustrate how these important time series datasets have been used to both inform and evaluate government policy in relation to community relations. By using four examples, we will highlight how these survey data have provided key government indicators of community relations, as well as how they have been used by other groups (such as NGOs) within policy consultation debates. Thus, the paper will provide a worked example of the integral, and bi-directional relationship between attitude measurement and policy making.

Evaluation of an Older Persons’ Assessment Educational Workbook with second year nursing students in the UK.

Background: As a first step to successfully meet the complex health and social needs of older people, patient assessment has become a central feature of government policy and practice in order to ensure that care planning is person-centred. A core component of nurse education is clinical practice in order to support the development of clinical skills and competence; therefore it is important to help students and their practice-based mentors to develop and apply older person assessment skills. Therefore, an educational workbook was developed to help 2nd year nursing students to learn a structured, systematic and individualised older person assessment process with the support of their mentor.

Aim: A pilot study to evaluate the impact of an Older Persons’ Assessment Educational Workbook and explore second year nursing students’ competence and their opinions and use of an older person’s assessment skills workbook.

Research Methodology: A pre-experimental design (pre and post-test with no comparison group) was undertaken with n=6 2nd year students in 2014. The outcome measure was the Nursing Competence Questionnaire and results were analysed using the Wilcoxin Signed Rank Test in SPSS version 21. Content analysis of completed workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Key Findings- No pre-post-test difference was found in the Nursing Competence Questionnaire with p=0.058 for the total scale. However, as this was a pilot, the study was under-powered and all students’ scores improved. Content analysis of the workbook found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (Std dev 281.8). Through the survey students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The workbook showed potential as an intervention to help support development of nursing students’ assessment skills in practice.

Risk in Private Finance Initiative Projects::A Public Sector Perspective

The management of public sector risk is increasingly seen as a priority area of UK government policy. This has been highlighted recently by the Prime Minister Gordon Brown who stated that “the issue of public risk is one of the most challenging areas of policy-making for any government” (Strategic Risk, 2008). In response to these challenges, the UK Prime Minister has appointed a new body - the Risk and Regulation Advisory Council (RRAC) which is tasked with improving the way risk to the public is understood and managed. One area of particular concern with regard to the governance of public sector risks involves projects procured via the Private Finance Initiative (PFI). These projects involve long-term contracts, complex multi-party interactions and thus create various risks to public sector clients. Today, most PFI actors acknowledge the potentially adverse effects of these risks and make an effort to prevent or mitigate undesirable results. As a consequence, issues of risk allocation, risk transfer and risk management have become central to the PFI procurement process. This paper provides an overview of the risk categories and risk types which are relevant to the public sector in PFI projects. It analyses risk as a feature of uncertain future project-related events and examines potential pitfalls which can be associated with PFI risk management on the basis of a case study of a high-profile PFI hospital in Scotland. The paper concludes that, despite the trend towards diminished risk profiles during the operational phase, the public sector continues to be exposed to significant risks when engaging in PFI-based procurement.

Lay Catholicism and Religious Policy in Cromwellian Ireland

The conquest of Ireland between 1649 and 1653 created almost as many problems as it solved for the English government of the country. Not least of these was how, if at all, the majority Catholic population was to be won over to Protestantism. This article reassesses Cromwellian religious policy towards the Catholic laity and traces its evolution up to the end of the decade, taking account also of Catholic responses to official measures. It argues that the supposed leniency of government policy has been overstated and that Catholics who refused to conform to Protestantism in fact risked heavy penalties.

The Mixed Fortunes of Irish Unions: Living with the Paradoxes of Social Partnership

We assess the fortunes of Irish unions since 1980 and, in particular, focus on the period of national social partnership since 1987. We argue that, structurally, unions have been weakened by a sharp decline in union density levels. In addition, labor law reform has not been as permissive as unions desired. However, on the other hand, we highlight that union membership in Ireland has never been higher and unions exert a strong influence over many areas of government policy. In conclusion, we argue that continuing with social partnership is the most viable option for Irish unions, though significant gains in union power are unlikely to happen.

The impact of adversity in childhood on outcomes in adulthood: research lessons and limitations

Summary: Current UK Government policy is concerned with the possible connections between childhood adversity, social exclusion and negative outcomes in adulthood. Understanding the impact of adverse childhood experiences on outcomes in adulthood is therefore key to informing effective policy and practice. In this article, the research on the impact of childhood adversity on outcomes in adulthood is reviewed in the broad categories of: mental health and social functioning; physical health; offending; service use; and economic impact. The literature on resilience that focuses on those who experience adversity, but do not have associated negative outcomes is also briefly considered. The strengths and limitations of the range of research methods used are then examined. Findings: Previous studies have tended to focus on specific forms of adversity, predominantly abuse and neglect, and either: specific populations and specific outcomes; specific populations and general outcomes; or general populations and specific outcomes. This means there may be incomplete understanding of the inputs (the range of adverse experiences in childhood), the processes (how these may affect people) and the outcomes (across domains in adulthood). Applications: It is concluded that it is important for social work researchers to engage in the current debate about how to prevent harmful childhood adversity and there is an important gap in the research for more interdisciplinary large-scale general population studies that consider the full range of childhood adversity and associated impacts across time and the possible processes involved.

Research intensity and knowledge transfer activity in UK universities

As the innovation process has become more open and networked, Government policy in the UK has sought to promote both research excellence in the university sector and the translation of this into economic benefit through university–business engagement. However, this policy approach has tended to be applied uniformly with little account for organisational differences within the sector. In this paper we consider if differences between universities in their research performance is reflected in their knowledge transfer activity. Specifically, as universities develop a commercialization agenda are the strategic priorities for knowledge transfer, the organisational supports in place to facilitate knowledge transfer and the scale and scope of knowledge transfer activity different for high research intensive (HRI) and low research intensive (LRI) universities? The findings demonstrate that universities’ approach to knowledge transfer is shaped by institutional and organisational resources, in particular their ethos and research quality, rather than the capability to undertake knowledge transfer through a Technology Transfer Office (TTO). Strategic priorities for knowledge transfer are reflected in activity, in terms of the dominance of specific knowledge transfer channels, the partners with which universities engage and the geography of business engagement.

Property rights and competing for the affections of Demos: The Impact of the 1867 Reform Act on stock prices

The 1867 Reform Act in Britain extended the electoral franchise to the skilled but propertyless urban working classes. Using stock market data and exploiting the fact that foreign and domestic equities traded simultaneously on the London market, this paper finds that investors in British firms reacted negatively to the passage of this Act. We suggest that this finding is consistent with investors foreseeing future alterations of property rights arising from the pressure that the large newly enfranchised group would bring to bear on government policy. We also suggest that our findings appear to be more consistent with the Tory political competition explanation for the Act rather than the Whig threat-of-revolution explanation.