An Examination of the Use of Coercion by Assertive Outreach and Community Mental Health Teams in Northern Ireland.

In mental health services over recent decades, the positive move away from hospital-based care to community-based services has entailed that people with higher levels of need are being supported by community mental health services. This paper begins by reviewing the literature on coercion in the field of community-based mental health care and treatment. It is argued that the lack of a critical understanding of the concept and how it is used by practitioners and agencies can have serious repercussions for the rights of service users. Using a quasi-experimental, longitudinal design, the authors then seek to test some of the ideas about coercion by comparing the activities of assertive outreach and community mental health teams in Northern Ireland, particularly the key ideas of perceived coercion, workers’ strategies and engagement with services. Key findings were that assertive outreach appeared to be more successful at reducing perceived coercion, minimizing the need for coercive strategies, engaging high-risk clients and reducing inpatient bed use. These findings are compared with other studies in this area. The authors also argue that there is a need for greater transparency in the way that practitioners use coercive measures and more explicit guidance is required in this crucial area of mental health practice.

Vegetation history at the multi-period prehistoric complex at Ballynahatty, Co. Down, Northern Ireland.

Palaeoecological methods can provide an environmental context for archaeological sites, enabling the nature of past human activity to be explored from an indirect but alternative perspective. Through a palynological study of a small fen wetland located within the catchment of a multi-period prehistoric complex at Ballynahatty, Co. Down, Northern Ireland, we reconstruct the vegetation history of the area during the early prehistoric period. The pollen record reveals tentative evidence for Mesolithic activity in the area at 6410-6220 cal. BC, with woodland disturbance identified during the Mesolithic-Neolithic transitional period ca. 4430-3890 cal. BC. A more significant impact on the landscape is observed in the Early Neolithic from 3944-3702 cal. BC, with an opening up of the forests and the establishment of a mixed agricultural economy. This activity precedes and continues to be evident during the Mid-Neolithic during which megalithic tombs and related burial sites were constructed at Ballynahatty. Due to chronological uncertainties and a possible hiatus in peat accumulation in the fen, the contemporary environment of the Ballynahatty timber circle complex (constructed and used ca. 3080-2490 cal. BC) and henge (dating to the third millennium cal. BC) cannot certainly be established. Nevertheless, the pollen record suggests that the landscape remained open through to the Bronze Age, implying a long continuity of human activity in the area. These findings support the idea that the Ballynahatty prehistoric complex was the product of a gradual and repeated restructuring of the ritual and ceremonial landscape whose significance continued to be recognised throughout the early prehistoric period.

Exposure to the “Troubles” in Northern Ireland influences the clinical presentation of schizophrenia

Introduction: This study investigates the effect of exposure to "The Troubles" (the period of civil unrest from 1968 onwards) in Northern Ireland on symptomatology in people with schizophrenia.

Method: Eighty-two participants were assessed on a number of psychiatric rating scales and on measures of trauma, including an instrument designed to assess exposure to "Troubles"-related trauma.

Results: People with schizophrenia and a history of exposure to "The Troubles" had significantly higher levels of anxiety, depression, dissociative symptoms and number of admissions compared to those patients with no such exposure.

Discussion: "Troubles"-related trauma has a direct effect on the presentation of schizophrenia in Northern Ireland. Specific therapeutic intervention may be required in order to help patients come to terms with their experiences. © 2008 Elsevier B.V. All rights reserved.

‘The “PB” and the aestheticization of violence in Northern Ireland’

In this short article I feature examples of the creative appropriation and transformation of a protest vehicle such as the petrol bomb. I show that the human imagination can create an aesthetics out of even the street protest, and can creatively carnivalise, play and translocate such practices and violent stances into the dance studio, the theatre, and even the everyday.

Minimum Wage Regulation under Devolution in Northern Ireland

This paper assesses the development and functioning of regional minimum wage regulation in Northern Ireland in the interwar period under a federal form of devolution. Unlike current devolution arrangements in Scotland and Wales, this gave the Stormont Parliament powers over employment and minimum wage regulation. Northern Ireland Trade Boards were set up by the Ulster Unionist Government under the Trade Boards (Northern Ireland) Act 1923 and functioned along the same lines as those in Great Britain. Uniquely in the UK in this period, employer opposition resulted in the main Trade Board in the Irish Linen Industry being replaced by voluntary collective bargaining machinery. About one-quarter of employees were covered by minimum wage regulation, including two-thirds of females in Belfast, keeping a protective floor under low pay.

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.

Towards Educational Inclusion in a Transforming Society: Some Lessons from Community Relations and Special Needs Education in Northern Ireland

This paper takes an original approach to an important aspect of educational research and its role in transforming societies, namely that of educational inclusion. It brings together what some might consider two rather strange bedfellows i.e. community relations and special needs education. It also draws upon new tools for theorising educational inclusion, which give a central role to the discursive nature of human conduct and which take a view of human behaviour as socially embedded and meaningful.

Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

Objectives: To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI).

Methods: Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993–2005 and prostate cancer deaths 1979–2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression.

Results: Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = -1.5% in RoI, -1.3% in NI) at a time when PSA testing was not widespread.

Conclusions: Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.

The growing visibility of creationism in Northern Ireland: are new science teachers equipped to deal with the issues?

The growing visibility of various forms of creationism in Northern Ireland raises issues for science education. Attempts have been made at political levels to have such “alternatives” to evolution taught in the science classroom, and the issue has received coverage in local press and media. A sample of 112 pre-service science teachers answered a survey on attitudes toward evolution. Preliminary analysis revealed many of these new teachers held views contrary to scientific consensus—over one fifth doubt the evidence for human evolution, and over one quarter dispute the common ancestry of life. Over two thirds indicated a preference for teaching a “range of theories” regarding these issues in science. In addition, 49 pre-service biology teachers viewed a DVD resource promoting “intelligent design” and completed an evaluation of it. The biology teachers also took part in either focus groups or additional questionnaires. A majority took the resource at face value and made positive comments regarding its utility. Many articulated views contrary to the stated positions of science academies, professional associations, and the UK government teaching directives regarding creationism. Most indicated a perception that intelligent design is legitimate science and that there is a scientific “controversy” regarding the legitimacy of evolution. Concern is raised over the ability of these new teachers to distinguish between scientific and non-scientific theories. The suggestion is made that the issue should be addressed directly with pre-service science teachers to make clear the status of such “alternatives.” The paper raises implications for science education and questions for further research.

Dissonances in self-reported health and mortality across denominational groups in Northern Ireland

Measures of self-reported health status are increasingly used in research and health policy. However, the inherent subjectivity of the responses gives rise to lingering concerns about their utility, especially across national and cultural boundaries. In this study we use religious denomination as a proxy for Scottish ancestry within Northern Ireland and demonstrate significant differences in levels of self-reported ill-health that are not fully reflected in mortality risks. These findings mirror the differences between Scotland and Northern Ireland previously shown in ecological studies and provide more definitive evidence that even within the United Kingdom factors other than morbidity levels influence the perception and reporting of health status. Possible explanations for the dissonance between morbidity and mortality levels are discussed and the reasons for a preference for socio-economic rather than cultural factors are described. (C) 2010 Elsevier Ltd. All rights reserved.

Devolution in Northern Ireland/Ulster/the North/Six counties: Delete as appropriate

The aim of the Agreement and devolution in Northern Ireland is to draw together atavistic political groups in order to promote a consociational accord which upholds minority rights and cultural demands. However, it is important to understand that disagreements between the pro-British and pro-Irish populations remain and that devolution has a multiplicity of political and cultural meanings. Indeed, determining the incapacity of Northern Irish society to shift towards pluralist and less culturally subjective categorizations of belonging and political devotion remains crucially importance. This article argues that devolution is a first, although as yet unclear, step toward a range of future constitutional changes.

Bioaccessibility of trace elements in soils in Northern Ireland

Assessment of elevated concentrations of potentially toxic elements (PTE) in soils and the association with specific soil parent material have been the focus of research for a number of years. Risk-based assessment of potential exposure scenarios to identified elevated PTE concentrations has led to the derivation of site- and contaminant-specific soil guideline values (SGVs), which represent generic assessment criteria (GACs) to identify exceeded levels that may reflect an unacceptable risk to human health. A better understanding of the ‘bioavailable’ or ‘bioaccessible’ contaminant concentrations offers an opportunity to better refine contaminant exposure assessments. Utilizing a comprehensive soil geochemical dataset for Northern Ireland provided by the Tellus Survey (GSNI) in conjunction with supplementary bioaccessibility testing of selected soil samples following the Unified BARGE Method, this paper uses exploratory data analysis and geostatistical analysis to investigate the spatial variability of pseudo-total and bioaccessible concentrations of As, Cd, Co, Cr. Cu, Ni, Pb, U, V and Zn. The paper investigates variations in individual element concentrations as well as cross-element correlations and observed lithological/pedological associations. The analysis of PTE concentrations highlighted exceeded levels of GAC values for V and Cr and exceeded SGV/GAC values for Cd, Cu, Ni, Pb, and Zn. UBM testing showed that for some soil parent materials associated with elevated PTE concentrations e.g. the Antrim Lava Group with high Ni concentrations, the measured oral bioaccessible fraction was relatively low. For other soil parent materials with relatively moderate PTE concentrations, measured oral bioaccessible fraction was relatively high (e.g. the Gala Sandstone Group of the Southern Uplands-Down Longford Terrain). These findings have implications for regional human health risk assessments for specific PTEs.