Consideration of coastal risk in the Irish spatial planning process

The vulnerability of coastal areas to associated hazards is increasing due to population growth, development pressure and climate change. It is incumbent on coastal governance regimes to address the vulnerability of coastal inhabitants to these hazards. This is especially so at the local level where development planning and control has a direct impact on the vulnerability of coastal communities. To reduce the vulnerability of coastal populations, risk mitigation and adaptation strategies need to be built into local spatial planning processes. Local government, however, operates within a complex hierarchal governance framework which may promote or limit particular actions. It is important, therefore, to understand how local coastal planning practices are shaped by national and supranational entities. Local governments also have to respond to the demands of local populations. Consequently, it is important to understand local populations’ perceptions of coastal risk and its management. Adopting an in-depth study of coastal planning in County Mayo, Ireland, this paper evaluates: (a) how European and national policies and legislation shape coastal risk management at local level; (b) the incorporation of risk management strategies into local plans; and (c) local perception of coastal risks and risk management. Despite a strong steer from supranational and national legislation and policy, statutory local plans are found to be lacking in appropriate risk mitigation or adaptation strategies. Local residents appear to be lulled into a sense of complacency towards these risks because of the low level of attention afforded to them by the local planning authorities. To avoid potentially disastrous consequences for local residents and businesses, it is imperative that this situation is redressed urgently. Based on our analysis, we recommend: the development and implementation of a national ICZM strategy, supported by detailed local ICZM plans; and obliging local government to address known risks in their plans rather than defer them to project level decision making.

Rent: Prostitution and the Irish apartment block

In 1974, pursuing his interest in the infra-ordinary – ‘the banal, the quotidian, the obvious, the common, the ordinary, the back-ground noise, the habitual’ – Georges Perec wrote about an idea for a novel:

‘I imagine a Parisian apartment building whose façade has been removed … so that all the rooms in the front, from the ground floor up to the attics, are instantly and simultaneously visible’.

In Life A User’s Manual (1978) the consummation of this precis, patterns of existence are measured within architectural space with an archaeological sensibility that sifts through narrative and décor, structure and history, services and emotion, the personal and the system, ascribing commensurate value to each. Borrowing methods from Perec, to move somewhere between conjecture, analysis and other documentation and tracing relationships between form, structure, materiality, technology, organisation, tenure and narrative use, this paper interrogates the late twentieth-century speculative apartment block in Britain and Ireland arguing that its speculative and commodified purpose often allows a series of lives that are less than ordinary to inhabit its spaces.

Retinal Vascular Caliber, Iris Color, and Age-Related Macular Degeneration in the Irish Nun Eye Study

Pupose. To evaluate the relationship between retinal vascular caliber (RVC), iris color and age-related macular degeneration (AMD) in elderly Irish nuns. Methods. Data from 1233 participants in the cross-sectional observational Irish Nun Eye Study were assessed from digital photographs with a standardized protocol using computer-assisted software. Macular images were graded according to the modified Wisconsin age-related maculopathy grading system. Regression models were used to assess associations, adjusting for age, mean arterial blood pressure, body mass index, refraction and fellow RVC. Results. In total, 1122 (91%) participants had gradable retinal images of sufficient quality for vessel assessment (mean age: 76.3 years [range: 56-100 years]). In an unadjusted analysis, we found some support for a previous finding that individuals with blue iris color had narrower retinal venules compared to those with brown iris color (P<0.05) but this was no longer significant after adjustment. AMD status was categorized as no AMD, any AMD and late AMD only. Individuals with any AMD (early or late AMD) had significantly narrower arterioles and venules compared to those with no AMD in an unadjusted analysis but this was no longer significant after adjustment. A non-significant reduced risk of any AMD or late AMD only was observed in association with brown compared to blue iris color, in both unadjusted and adjusted analyses. Conclusions. RVC was not significantly associated with iris color or early/late AMD after adjustment for confounders. A lower but non-significant AMD risk was observed in those with brown compared to blue iris color.

Fit for Purpose?:Challenges for Irish Public Administration and Priorities for Public Service Reform

The depth of the current economic and fiscal crisis has raised concerns about the Irish political and administrative system, and prompted calls for fundamental reform of our structures of public governance. Both the state and its financial system are reliant on international support. This crisis requires a coherent response from our public administration. There is recognition that this change cannot simply be a repeat or extension of the public service reform programmes of the past. It will need to be more radical than this. Over the coming years, the numbers employed in the public service will continue to fall and expenditure will need to be restrained, targeted and prioritised. The Public Service Agreement 2010-2014 (the Croke Park Agreement) sets out a framework for change. But there is a need to look beyond the agreement to consider more fundamentally the future role of public administration in the context of the new economic and social dispensation in Ireland. Our public services need to adapt to this new environment if they are to continue to be fit for purpose.

In this paper we set out the main challenges facing public administration and where we see reform as vital. We note what changes have taken place to date, including experience with previous reform efforts, and outline what should happen next. Where appropriate, we draw on national and international practice to provide exemplars of change.

The Business of Building Peace: Private Sector Cooperation across the Irish Border

The sustainability of cross-border peacebuilding initiatives is increasingly pertinent in a context of reduced public funding (national and European), yet the potential contribution to be made to this from private sector cooperation remains under-explored. This paper brings together quantitative data on cross-border trade with qualitative evidence from business leaders in the Irish border region in order to examine the nature of cross-border cooperation within the private sector and its possible connections to peacebuilding. This evidence is analysed in the light of three theses: spillover, contact and business-based peacebuilding. The first part of this paper assesses the conditions for cross-border business cooperation in Ireland, including funding support for economic development, European integration, and (post-Agreement) institutional change. The second part examines the particular contributions made by the private sector to peace, centring upon consciously non-political motivations (such as pragmatism and profit), networking and leadership.

Minimal intervention dentistry and older patients part 2: minimally invasive operative interventions

As described in the first paper of this two part series, the expansion of our older population and the concomitant reduction in levels of edentulism will result in an increase in the number of patients presenting in general practice with complex restorative challenges. The application of the concepts of minimal intervention dentistry and minimally invasive operative techniques may offer a powerful armamentarium to the general dentist to provide ethical and conservative treatment to older patients.

Clinical Relevance: When it is unavoidable, operative intervention should be as minimally invasive as practicable in older patients to preserve the longevity of their natural dentition.

Subjective impact of minimally invasive dentistry in the oral health of older patients

OBJECTIVES: The aim of this study was to investigate if a minimally invasive oral health package with the use of atraumatic restorative treatment (ART) or a conventional restorative technique (CT) would result in any perceived benefit from the patients' perspective and if there would be any difference between the two treatment groups.

MATERIALS AND METHODS: In this randomised clinical trial, 99 independently living older adults (65-90 years) with carious lesions were randomly allocated to receive either ART or conventional restorations using minimally invasive/intervention dentistry (MID) principles. Patients completed an Oral Health Impact Profile (OHIP)-14 questionnaire before and 2 months after treatment. They were also asked to complete a global transition question about their oral health after treatment.

RESULTS: At baseline, the mean OHIP-14 scores recorded were 7.34 (ART) and 7.44 (CT). Two months after treatment intervention, 90 patients answered the OHIP-14 and the mean scores were 7.23 (not significant (n.s.)) and 10.38 (n.s.) for the ART and CT groups, respectively. Overall, 75.5 % of patients stated that their oral health was better compared to the beginning of treatment.

CONCLUSIONS: Although not shown by the OHIP-14, patients perceived an improvement in their overall oral status after treatment, as demonstrated by the global transition ratings in both groups.

CLINICAL RELEVANCE: Dental treatment using minimally invasive techniques might be a good alternative to treat older individuals, and it can improve their oral health both objectively and subjectively.

Minimal intervention dentistry and older patients Part 1: Risk assessment and caries prevention

Ten million people in the UK today are aged over 65. The latest projections estimate that there will be 5 1/2 million more people aged 65 and older in the next 20 years. This projected pattern of population ageing will have profound consequences for dentistry. Minimal intervention dentistry (MID) is a modern evidence-based approach to caries management in dentate patients that uses the 'medical model' whereby disease is controlled by the 'oral physician'. This approach offers considerable benefits over conventional dentistry for older patients. It encourages patients to be responsible for their oral health through the provision of both knowledge and motivation. MID encompasses risk assessment for dental disease, early detection and control of disease processes, and minimally invasive treatment. 

Clinical Relevance: Risk assessment tools can aid the general dental practitioner and the patient to develop a suitable caries prevention programme for that individual and reduce the need for future operative intervention.

Gerodontology--how big is the challenge in Ireland?

Population trends suggest that the Irish population is ageing, and that this population will have substantial treatment needs. These patients will be better informed than previous generations, and will demand treatment aimed at preserving a natural dentition. This will impact upon delivery of oral healthcare and manpower planning needs to consider how to address the increased demand for dental care. Poor oral health is associated with systemic health problems, including cardiovascular disease, respiratory disease and diabetes mellitus. It also has a negative impact upon quality of life, and the World Health Organisation has encouraged public healthcare administrators and decision makers to design effective and affordable strategies for better oral health and quality of life of older adults, which, in turn, are integrated into general health management programmes. Treatment concepts such as minimally invasive dentistry and the shortened dental arch concept are discussed in the context of these demographic changes and recommendations.