965 resultados para D901 Europe (General)


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This paper provides an exposition of Michel Foucault's 'history of the present' in order to make the case for its relevance to the study of social work history. It sets out the general principles underpinning this practice and considers its application to a particular research question relating to history of child welfare and protection social work in the Republic of Ireland. The paper seeks to highlight the challenges involved in its use and illuminate its potential value as an approach for researching the history of social work. It is concluded that this exposition offers one appropriate approach that could be employed within the growing field of social work history research across Europe.

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European integration remains a 'non-cleavage' in relation to the Lipset-Rokkan model, as it has not produced significant restructurings of national party systems. Yet, while not effecting the terms of interparty competition, Europe has nevertheless come to occupy an increasingly large place in national political debates. Since the early 1990s, Euroscepticisms have taken root, to varying degrees, across the entire continent. This article analyses the rise of these Eurosceptic tendencies, examining the phenomenon in terms of both the Europeanisation of national political life and the wider emergence of forms of protest politics. The analysis demonstrates how European questions have been absorbed into established party structures, while at the same time pointing towards a renewed research agenda which pays greater attention both to the discursive dimension of political life and to the roles played by national parties as European actors.

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Background: The aim of the SPHERE study is to design, implement and evaluate tailored practice and personal care plans to improve the process of care and objective clinical outcomes for patients with established coronary heart disease (CHD) in general practice across two different health systems on the island of Ireland.CHD is a common cause of death and a significant cause of morbidity in Ireland. Secondary prevention has been recommended as a key strategy for reducing levels of CHD mortality and general practice has been highlighted as an ideal setting for secondary prevention initiatives. Current indications suggest that there is considerable room for improvement in the provision of secondary prevention for patients with established heart disease on the island of Ireland. The review literature recommends structured programmes with continued support and follow-up of patients; the provision of training, tailored to practice needs of access to evidence of effectiveness of secondary prevention; structured recall programmes that also take account of individual practice needs; and patient-centred consultations accompanied by attention to disease management guidelines.

Methods: SPHERE is a cluster randomised controlled trial, with practice-level randomisation to intervention and control groups, recruiting 960 patients from 48 practices in three study centres (Belfast, Dublin and Galway). Primary outcomes are blood pressure, total cholesterol, physical and mental health status (SF-12) and hospital re-admissions. The intervention takes place over two years and data is collected at baseline, one-year and two-year follow-up. Data is obtained from medical charts, consultations with practitioners, and patient postal questionnaires. The SPHERE intervention involves the implementation of a structured systematic programme of care for patients with CHD attending general practice. It is a multi-faceted intervention that has been developed to respond to barriers and solutions to optimal secondary prevention identified in preliminary qualitative research with practitioners and patients. General practitioners and practice nurses attend training sessions in facilitating behaviour change and medication prescribing guidelines for secondary prevention of CHD. Patients are invited to attend regular four-monthly consultations over two years, during which targets and goals for secondary prevention are set and reviewed. The analysis will be strengthened by economic, policy and qualitative components.