Specialty Registrars’ Experience of Managing Head and Neck Cancer Patients

Objective The aim of this study was to collate and compare data on the training of Specialty Registrars in Restorative Dentistry (StRs) in the management of head and neck cancer (HANC) patients across different training units within the UK and Ireland. Methods Current trainees were invited to complete an online questionnaire by the Specialty Registrars in Restorative Dentistry Group (SRRDG). Participants were asked to rate their confidence and experience of assessing and planning treatment for HANC patients, attending theatre alone and manufacturing surgical obturators, and providing implants for appropriate cases. Respondents were also asked to appraise clinical and didactic teaching at their unit, and to rate their confidence of passing a future Intercollegiate Specialty Fellowship Examination (ISFE)-station assessing knowledge of head and neck cancer. Results Responses were obtained from 21 StRs (n=21) training within all five countries of the British Isles. Most respondents were based in England (76%), with one StR in each of Scotland, Wales, Northern Ireland and the Republic of Ireland. A third (33%) were in their 5th year of training. Almost half of the StRs indicated that they were confident of independently assessing (48%) new patients with HANC, with fewer numbers reporting confidence in treatment planning (38%). The majority (52%) of respondents indicated that they were not confident of attending theatre alone and manufacturing a surgical obturator. A third (33%) rated their experience of treating HANC patients with implants as ‘poor’ or ‘very poor’, including three StRs in their 5th year of training. Less than one third (<33%) rated didactic teaching in maxillofacial prosthodontics at their unit as ‘good’ or ‘excellent’, and only 7 StRs indicated that they were confident of passing an ISFE-station focused on HANC. Conclusion Experience and training regarding patients with head and neck cancer is inconsistent for StRs across the UK and Ireland with a number of trainees reporting a lack of clinical exposure.

Responding to mental health statutory drivers: experience of a low intensity cognitive behavioural therapy programme

Objectives Stress control (SC), a brief psycho-education course, was implemented to increase access to psychological therapies in line with Northern Irish mental health service statutory drivers. The first aim of this study was to gauge the efficacy of SC in a robust manner with clinical significance testing. The second aim was to assess whether demographics traditionally ‘hard-to-reach’ – males, younger adults and those from deprived areas – accessed SC. The third aim was to elucidate what prompted their access and the experiences of attendees at SC. Methods Attendees at SC were 170 adults over six iterations of the course. Pre- and post-questionnaires included the Depression Anxiety Stress Scales – 21, captured demographic details and qualitative feedback, which was subject to a mixed-methods analysis. Results SC attendees reported significant decreases on depression, anxiety and stress sub-scales post-intervention. Moreover, 38.71% ( n =36) of attendees who completed SC exhibited clinically significant improvement afterwards on one or more sub-scale. Attendance figures for males, younger adults and those classified as socioeconomically deprived were modest. Patterns within the data suggested prospective success for targeting these cohorts. Conclusions SC attracted people in need of mental healthcare input and affected quantifiable change within those people’s lives, while satisfying statutory demands for service delivery in an accessible community context. Recommendations to increase engagement with those traditionally ‘hard-to-reach’ for psychological services are provided, which, if implemented, have the potential to achieve further compliance with Northern Irish mental health statutory drivers.

The Promise of Peace:Revisiting the Northern Irish Model

The Northern Ireland peace process is often eulogized as a successful model of conflict transformation. Although the process exhibited many of the problems that beset other societies seeking to move from conflict to a negotiated peace (including disagreements over the functioning of institutions and the meanings of cultural symbols, unresolved issues relating to the effects of political violence on victims and survivors and society at large; and the residual presence of violent and political ‘spoiler’ groups), the resilience of political dialogue has proven remarkable.
This collection revisits the promise of ‘a truly historic opportunity for a new beginning’ a decade and a half on from the signing of the Belfast/Good Friday Agreement in 1998. The book will bring together academics from across a number of disciplines, including management and organizational behaviour, law, politics, sociology, archaeology and literature.

The different contributions aim to assess what impact it has made in the legal, policy, and institutional areas it specifically targeted: political reform, human rights and equality provision, working through legacies of the past (including police reform, prisoner release and victims' rights) and the building of new relationships within the island of Ireland and between Ireland and Britain. With the emergence of first-time voters who had no direct experience of the violence the book explores what the Agreement offers for future generations.

The book is the culmination of a 12-month research project sponsored by the British Academy and Leverhulme that addressed the following aspects of the peace process:
Peace walls: The euphemistically named peace walls remain one of the most visible reminders of Northern Ireland’s divisions and they are famously the only material manifestations of the conflict that have grown in number and extent since the 1998 Agreement. They were originally placed between antagonistic neighbouring communities – often at their request – at times of heightened tensions. Research under this theme explored the lack of ongoing engagement with their continuing presences, evolving meanings and impact on the communities that reside beside them needs to be overtly addressed.
Cultural division: Cultural differences have often been seen as lying at the heart of the ‘Irish problem’. Despite this, art and artists have increasingly been seen as having the potential to develop new discourses. Research explored the following questions: What role can the arts play in re-imagining the spaces opened up by the promises of the 1998 Agreement? What implication does the confrontation with the legacies of conflict have for artistic practices? What impact do the arts have on constructions of identity, on narratives of history, and on electoral politics?
Institutional transformation: This strand of research explored the significance of the process of organizational change which followed the establishment of the 1998 on political and other public policy institutions such as the police and prison services. It suggested that the experience and lessons learned from such periods of transition have much to contribute to how Northern Ireland begins to address political polarization in other areas of public service infrastructure, chiefly around the sectarian monoliths of education and housing.
Working through the past: ‘Legacy’ issues have gained increasing prominence since 1998: issues to do with public symbolism (particularly relating to the flying of flags and parading), defining victimhood, securing victims’ rights, recovery of the ‘disappeared’, reintegrating ex- prisoners back into society, and the possibilities for truth recovery and reconciliation have all acquired salient and emotive force. Although the 1998 Agreement promised to ‘honour the dead’ through a ‘new beginning’, it is increasingly unclear as to whether an agreed narrative about the past is possible – or even worthwhile pursuing. Research under this theme looked at the complex relationship between memory, commemoration and violence; how commemorative events are performed, organized, policed and represented. It also addressed the fraught issue of how to come to terms with Northern Ireland’s divided and bloodied past.

The editors are in the process of guiding contributors to adapt their papers, which were presented to a series of workshops on the above themes, to the purposes of the book. In particular, the contributors will be guided to focus on the related aims of assessing the extent of change that has occurred and providing an assessment of what remains to be done. To that end, contributors are asked to engage directly with the questions that close the ‘Introduction’, namely: To what extent has the ‘promise’ of the 1998 Agreement been fulfilled? To what extent has the 1998 Agreement given rise to forms of exclusion? To what extent has the 1998 Agreement shaped new forms of debate, dispute and engagement? In the absence of that guidance having been sent out yet, the outlines below are, for the time being, the abstracts of their original papers.

Portraits of Protestant Teens: A Report on Teenagers in Major U.S. Denominations

This report examines the religious beliefs and practices of American Protestant teenagers using new, nationally representative survey data from the National Study of Youth and Religion (NSYR). The NSYR is a major study of the religious and spiritual lives of contemporary American teens, which recently produced a book on its major findings entitled, Soul Searching: the Religious and Spiritual Lives of American Teenagers (by Christian Smith with Melinda Lundquist Denton, Oxford University Press, 2005). In addition to broadly describing the religious outlook of Protestant teenagers today — and as a more detailed, descriptive follow-up to that book — this report highlights several positive and negative experiences and evaluations of teenagers in different Protestant denominations and groupings of denominations. In brief, this report presents the following findings in these areas of interest: ♦ Religious Participation: Protestant teenagers are relatively active in religious organizations and activities, both within and beyond their churches. About one-half of all Protestant teens attend church weekly, participate in Sunday school or in a religious youth group, pray and attend a religious summer camp or retreat, though less than one-third read the Bible each week. This also means, however, that substantial numbers of Protestant teens are not actively participating in their religious traditions. Teens from conservative denominations such as Southern Baptist Convention and Assemblies of God are especially likely to regularly attend church and participate in other religious activities. ♦ Theological Beliefs: Protestant teenagers are likely to hold many traditional Christian religious beliefs. The majority of Protestant teens say they believe in God, the afterlife, angels, demons, miracles, judgment day and they view God as a personal being involved in the lives of people today. Sizable numbers of Protestant teens, on the other hand, do not hold these traditional Christian religious beliefs. Teens from conservative and black Protestant denominations are more likely than mainline Protestant teens to hold these religious beliefs. ♦ Importance of Faith: The majority of Protestant teenagers report that their religious faith is very important in their lives. Most of them also say that their families talk about religion together, that they have shared their faith with someone not of their faith and that they have had a powerful worship experience. A large minority of all Protestant teenagers, and in the case of some denominations a majority of teenagers, do not report that religious faith is very important in their lives. Teens from conservative and black Protestant denominations are particularly likely to report that faith is important in their lives. ♦ Evaluations of Churches: The majority of Protestant teenagers express relatively positive views of their churches and fellow church members. They typically report that they would continue to attend church if it were totally up to them, that they would attend a similar church if given the choice and that their current church is generally warm and welcoming. Protestant adolescents, however, do have some reservations about and problems with their churches and fellow church attendees, as spelled out in the following pages, particularly with other teenage attendees.

First Clinical Experience With Celt ACD(®) : A Femoral Arterial Puncture Closure Device

Introduction This prospective nonrandomized study compared the safety and efficacy of a novel arterial closure device (ACD) in common femoral artery procedures to that of the FDA submitted historical manual pressure control group, who underwent either a diagnostic angiogram (DA) or a percutaneous coronary intervention (PCI) procedure. Methods and Results A total of 55 patients were enrolled in this study of the novel ACD. Of the 55 patients, 39 were enrolled in the DA group and 16 were enrolled in the PCI group. Six patients were excluded. A device was deployed in 49 patients. Time to hemostasis (TTH), time to ambulation (TTA), device function, and device-related vascular complications were measured. In the device group, the TTH for the combined DA and PCI patients was 32 seconds (0.54 ± 0.93 minutes), significantly lower when compared with 16.0 ± 12.2 minutes (P < 0.0001) for the control group. Overall major vascular complication rate did not differ significantly, device group (1/49) and the historical control group (1/217). TTA in the combined PCI and DA device group was 226.4 ± 231.9 at the German site (site ambulation policy). In the Irish site, the average TTA in the PCI group was 187 minutes (n = 8) and 85 minutes (n = 14) in the DA group. Conclusion The Celt ACD® device is safe, effective, and significantly decreases the TTH compared to manual pressure and has a low vascular complications rate. The device may be effective in early ambulation and discharge of patients postcoronary intervention procedures.

Copy of Gov[erno]r Philips's additional instructions about settling some Palatine families in Nova Scotia: Copy Col. Dunbar's additional instruction about settling some Irish families in Nova Scotia : manuscript, [1730]

Copies of two documents, approved 20 Apr. 1730; instructions to Richard Philips state that a number of Protestant Irish and Palatine families have been granted land in Nova Scotia, to be surveyed by David Dunbar; and instructions to Dunbar to survey and lay out land for the families.

Lessons for African economies from Irish and East Asian industry policy

When comparisons in terms of industrial policy lessons to be learned have taken place, it has tended to be solely vis-a-vis the ‘development state’ East Asian experience. This paper broadens the analysis and considers lessons which African countries can learn from other so-called ‘tiger’ economies including Ireland and the East and South Asian countries. We recognise that the latter are indeed clearly significant as many African countries at the time of independence had economic structures and levels of income quite similar to East Asian countries, yet have grown at vastly different rates since then. Exploring why this has been the case can thus offer important insights into possibilities for industrial policy. Yet this comes with some health warnings over East Asian experience. We suggest that another important contribution can come by looking at the Irish example, given its emphasis on corporatism rather than simply relying on state direction in the operation of industrial policy. The Irish model is also more democratic in some senses and has protected workers’ rights during the development process in contrast to the often highly dirigisite East Asian model. Overall we suggest that some immediate actions are needed, notably with regard to the financial system in small African economies. Without such changes, a poorly functioning financial system will continue to keep investment at low levels. In relation to the small size of the African economies, the paper recommends regional integration and sufficient overseas development assistance (ODA) for infrastructural development. It is also critical to note that the various small African economies each face their own industrial and economic development challenges, and that a ‘one size fits all’ approach is not appropriate; rather the key is to tailor policies and systems to the unique opportunities and development challenges in each African country.

A critical reflection on Irish industrial policy:a strategic choice approach

Abstract: This paper offers a critical evaluation of recent Irish industrial policy (IP) experience. It argues that whilst Ireland managed to get some things “right” through its IP, substantial tensions arose through making foreign direct investment (FDI) attraction the centrepiece of policy, without at the same time adopting a more holistic approach in IP which inter alia also placed an emphasis on indigenous firms and entrepreneurship more generally. In particular, greater efforts should have been made much earlier in attempting to embed transnational corporation (TNC)-led activity better into the wider economy, in fostering domestic small firms and entrepreneurship, in promoting clusters, and more generally in evaluating IP more fully – notwithstanding the context which mitigated against such actions. As a result, Ireland as an economy remained vulnerable to strategic decisions made elsewhere by TNC decision makers, with IP effectively contributing to a situation that can be characterised as institutional and strategic failure. Overall, the paper suggests that wholesale emulation of the Irish IP approach is problematic.

Constructing literacy: Disadvantaged Irish mothers' attempts at developing literacy with their preschool children during storybook reading and jigsaw puzzle building

Early childhood research beginning in the 1960s has focused on the literacy experiences of preschool children in the home and the contribution of those experiences to later school success. Decades of research since then have investigated learning experiences of preschool children as they interacted with caregivers, siblings or peers prior to formal schooling (Durkin, 1966; Heath, 1983). ^ In this qualitative investigation into early literacy events that occur between disadvantaged Irish mothers and their children, four research questions were investigated. (1) How do disadvantaged Irish mothers engage their preschool children in literacy events such as storybook reading and jigsaw puzzle building? (2) How does the mother's previous school experience affect her role as the child's first teacher? (3) How does the culture of the neighborhood affect the child's developing literacy? (4) What risk factors inhibit literacy development in these Irish children? ^ This study examined the conversational exchanges between three disadvantaged Irish mothers and their preschool children living near Dublin, Ireland, as the mothers read a storybook to their children and assisted them in jigsaw puzzle building. Conversations were recorded, transcribed and analyzed into reading skill and teaching strategy categories for the purpose of determining the mothers' literacy intent during her turn. Journal notes, field notes and interviews with the mothers recorded other information and allowed for triangulation of data. ^ The results of this investigation indicated four findings. The first finding was that these disadvantaged mothers employed many of the same techniques that classroom teachers use during the reading lesson. They attempted high-level and low-level questions, teaching strategies, and other interactions that are so familiar in the classroom. The second finding was that jigsaw puzzle building produced a richer literacy interaction than storybook reading. The third finding was that the environment of the disadvantaged neighborhood posed many risks to children's literacy development. A final finding was that the mothers used thinking out loud behavior to vocalize their inner thoughts during literacy interactions. ^ Future research suggests studying mother/child dyads in other socio-economic environments and cultures to determine if other mothers practice the same skills and strategies as these mothers. ^

Frederick Douglass and Ireland, 1845: The "Vertiginous Twist[s]" of an Irish Encounter

Frederick Douglas was a reader of and writer on the nineteenth-century political and social texts and contexts of oppression, which he experienced at home and witnesed while in Ireland and Britain, 1845-47. This thesis is unique in its identification of several surprising lacunae in the research and critical evaluation of Frederick Douglass’ activities of reading and writing and the texts and contexts that supported these activities. This thesis takes Douglass’ relationship with Ireland and the Irish as its starting point, and offers several moments in the transnational space engendered by Douglass’ readerly and writerly experience of the transatlantic axes of Ireland, Britain and America. This thesis draws upon archival research to recover information regarding Douglass’ trip and subjects his reading and writing on Ireland and the Irish to the critical rigours of narratolgical, cultural and discourse analysis. One lacuna is Douglass’ favourite and neglected school primer, the Columbian Orator, which Douglass signified upon across his autobiographical project. The speech by the Irish patriot and exile, Arthur O’Connor, included in the Orator, is crucial to Douglass’ understanding and expression of justice and equality. Genette’s narratological analysis gives theoretical traction to the ways in which, in his autobiographical representations of his British trip, Douglass recalibrates his autobiographies to reflect his changing perspectives on his life and work. Contrary to popular assumptions, Douglass did, in two letters to Garrison address and comment on Irish poverty. This thesis interrogates the strategic anglophilia of these letters. While the World’s Temperance Convention (WTC) refused to discuss African- American slavery, analysis of Douglass’ speech in Covent Garden and of the paratextual apparatus of the published proceedings of the WTC demonstrates the impossibility of separating these closely interrelated reform causes. When a newly discovered poem from Waterford that admonished the city for its disregard for Douglass’ message is juxtaposed with an uncomfortable moment in Cork, we understand that Douglass became a pawn to bolster sectarian rivalries between nationalist and establishment factions. Though Douglass believed imperial politics was the best vehicle for modernity, he recognised that it had failed Ireland: consequently, in Thoughts and Recollections of a Trip to Ireland (1886), he advocates for Home Rule for Ireland.

The implementation of a literacy intervention 'Station Teaching' in infant classes in Irish primary schools

Background: I conducted my research in the context of The National Literacy Strategy (DES, 2011), which maintains that every young person should be literate and it outlines targets for improving literacy in schools from 2011 to 2020. There has been much debate on the teaching of literacy and in particular the teaching of reading. Clark (2014) outlines how learning to read should be a developmental language process and that the approaches in the early years of schooling will colour the children’s motivation and their perception of reading as a purposeful activity. The acquisition of literacy begins in the home but this study focuses on the implementation of a literacy intervention Station Teaching in the infant classes in primary school. Station Teaching occurs when a class is divided into four or five small groups of pupils and they receive intensive tuition at four or five different Stations with the help of Support teachers: New Reading, Familiar Reading, Phonics, Writing and Oral Language. Research Questions: These research questions frame my study: How is Station Teaching implemented? What is the experience of the intervention Station Teaching from the participants’ point of view: teachers, pupils, parents? What notion of literacy is Station Teaching facilitating? Methods: I chose a pragmatic parallel mixed methods design as suggested by Mertens (2010). I collected and analysed both the quantitative and qualitative data to answer the study’s research questions. In the study the quantitative data were collected from a questionnaire issued to 21 schools in Ireland. I used Excel as a data management package and thematic analysis to analyse and present the data in themes. I collected qualitative data from a case study in a school. This data included observations of two classes over a period of a year; interviews with teachers, pupils and parents; children’s drawings, photographs, teachers’ diaries and video evidence. I analysed and presented the evidence from the qualitative data in themes. Main Findings: There are many skills and strategies that are essential to effective literacy teaching in the early years including phonological awareness, phonics, vocabulary, fluency, comprehension and writing. These skills can be taught during Station Teaching. Early intervention in the early years is essential to pupils’ acquisition of literacy. The expertise of the teacher is key to improving the literacy achievement of pupils Teachers and pupils enjoy participating in ST. Pupils are motivated to read and engage in meaningful activities during ST. Staff collaboration is vital for ST to succeed ST facilitates small group work and teachers can differentiate accordingly while including all pupils in the groups. Pupils’ learning is extended in ST but extension activities need to be addressed in the Writing Station. More training should be provided for teachers on the implementation of ST and more funding for resources should be available to schools Significant contribution of the work: The main significance of the study includes: insights into the classroom implementation of Station Teaching in infant classes and extensive research into characteristics of an effective teacher of literacy.

County Cork: the experience of members of the establishment whose houses were burned in the IRA arson campaign, 1920-23

Between May 1920 and March 1923, there were seventy-three houses belonging to the County Cork establishment burnt down by IRA and anti-treaty forces. More houses were destroyed by this method in Cork than in any other Irish county in the same timeframe. The establishment were targeted by the IRA for their political, military and social persuasions that were essentially in opposition to the nationalist movement. The motivations behind these burnings is examined, the main reasons being reprisals for actions taken by Crown forces, military reasons, loyalty of house owners to the British government and agrarianism. The geographical distribution of these burnings is also provided to reveal how active individual IRA brigades were that operated within the county. Though there were few areas of the county left unaffected by the occurrence of arson attacks, there were higher concentrations of burnings in some areas. The house burnings in County Cork did not conform to the national pattern of house burnings and the reasons for this are explored. This study argues that the presence of Crown forces in Cork and their implementation of an official reprisal policy in January 1921 escalated military conflict, and arson attacks became a key tactic utilised by IRA forces in response to this policy. The aftermath of house burnings for members of the establishment is revealed through the various compensation committees that were formed after both the War of Independence and Civil War. Key sources for this study included personal papers of both the establishment and military figures, IRA witness statements, local and national newspapers, the 1901 and 1911 Irish Censuses, Colonial Office Papers, compensation claims filed with the British government and Irish Free State, and others from archives throughout Ireland and the United Kingdom.

Child care proceedings in non-specialist courts: the experience in Ireland

It is widely accepted that court proceedings concerning child protection are a particularly sensitive type of court proceedings that warrant a different approach to other types of proceedings. Consequently, the use of specialized family or children’s judges or courts is commonplace across Europe and in common law jurisdictions. By contrast, in Ireland, proceedings under the Child Care Act 1991 are heard in the general courts system by judges who mostly do not specialize in child or family law. In principle, the Act itself and the associated case law accept that the vulnerability of the parties and the sensitivity of the issues involved are such that they need to be singled out for a different approach to other court proceedings. However, it is questionable whether this aspiration has been realized in a system where child care proceedings are mostly heard in a general District Court, using the same judges and the same physical facilities used for proceedings such as minor crime and traffic offences. This article draws on the first major qualitative analysis of professional perspectives on child care proceedings in the Irish District Court. It examines evidence from judges, lawyers, social workers, and guardians ad litem and asks whether non-specialist courts are an appropriate venue for proceedings on an issue as complex and sensitive as child protection, or whether the establishment of specialist family courts with dedicated staff and facilities provides a better solution.

Renaissance Humanism and Ethnicity before Race:The Irish and the English in the Seventeenth Century

Inspired both by debates about the origins of the modern ideology of race and also by controversy over the place of Ireland and the Irish in theories of empire in the early modern Atlantic world, Renaissance Humanism and Ethnicity before Race argues that ethnic discourse among the elite in early modern Ireland was grounded firmly in the Renaissance Humanism and Aristotelianism which dominated all the European universities before the Enlightenment. Irish and English, Catholic and Protestant, all employed theories of human society based on Aristotle’s Politics and the natural law of the medieval universities to construct or dismantle the categories of civility and barbarism. The elites operating in Ireland also shared common resources, taught in the universities, for arguing about the human body and its ability to transmit hereditary characteristics. Both in Ireland and elsewhere in Europe, these theories of human society and the human body underwent violent changes in the late seventeenth century under the impact of the early Enlightenment. These changes were vital to the development of race as we know it.