“An Italian of the Vatican type” : The Roman formation of Cardinal Paul Cullen, Archbishop of Dublin

Peer reviewed

Lower extremity amputation in people with diabetes: Trends and determinants

Introduction: The prevalence of diabetes is rising rapidly. Assessing quality of diabetes care is difficult. Lower Extremity Amputation (LEA) is recognised as a marker of the quality of diabetes care. The focus of this thesis was first to describe the trends in LEA rates in people with and without diabetes in the Republic of Ireland (RoI) in recent years and then, to explore the determinants of LEA in people with diabetes. While clinical and socio-demographic determinants have been well-established, the role of service-related factors has been less well-explored. Methods: Using hospital discharge data, trends in LEA rates in people with and without diabetes were described and compared to other countries. Background work included concordance studies exploring the reliability of hospital discharge data for recording LEA and diabetes and estimation of diabetes prevalence rates in the RoI from a nationally representative study (SLAN 2007). To explore determinants, a systematic review and meta-analysis assessed the effect of contact with a podiatrist on the outcome of LEA in people with diabetes. Finally, a case-control study using hospital discharge data explored determinants of LEA in people with diabetes with a particular focus on the timing of access to secondary healthcare services as a risk factor. Results: There are high levels of agreement between hospital discharge data and medical records for LEA and diabetes. Thus, hospital discharge data was deemed sufficiently reliable for use in this PhD thesis. A decrease in major diabetes-related LEA rates in people with diabetes was observed in the RoI from 2005-2012. In 2012, the relative risk of a person with diabetes undergoing a major LEA was 6.2 times (95% CI 4.8-8.1) that of a person without diabetes. Based on the systematic review and meta-analysis, contact with a podiatrist did not significantly affect the relative risk (RR) of LEA in people with diabetes. Results from the case-control study identified being single, documented CKD and documented hypertension as significant risk factors for LEA in people with diabetes whilst documented retinopathy was protective. Within the seven year time window included in the study, no association was detected between LEA in patients with diabetes and timing of patient access to secondary healthcare for diabetes management. Discussion: Many countries have reported reduced major LEA rates in people with diabetes coinciding with improved organisation of healthcare systems. Reassuringly, these first national estimates in people with diabetes in the RoI from 2005 to 2012 demonstrated reducing trends in major LEA rates. This may be attributable to changes in diabetes care and also, secular trends in smoking, dyslipidaemia and hypertension. Consistent with international practice, LEA trends data in Ireland can be used to monitor quality of care. Quantifying this improvement precisely, though, is problematic without robust denominator data on the prevalence of diabetes. However, a reduction in major diabetes-related LEA rates suggests improved quality of diabetes care. Much controversy exists around the reliability of hospital discharge data in the RoI. This thesis includes the first multi-site study to explore this issue and found hospital discharge data reliable for the reporting of the procedure of LEA and diagnosis of diabetes. This project did not detect protective effects of access to services including podiatry and secondary healthcare for LEA in people with diabetes. A major limitation of the systematic review and meta-analysis was the design and quality of the included studies. The data available in the area of effect of contact with a podiatrist on LEA risk are too sparse to say anything definitive about the efficacy of podiatry on LEA. Limitations of the case-control study include lack of a diabetes register in Ireland, restricted information from secondary healthcare and lack of data available from primary healthcare. Due to these issues, duration of disease could not be accounted for in the study which limits the conclusions that can be drawn from the results. The model of diabetes care in the RoI is currently undergoing a re-configuration with plans to introduce integrated care. In the future, trends in LEA rates should be continuously monitored to evaluate the effectiveness of changes to the healthcare system. Efforts are already underway to improve the availability of routine data from primary healthcare with the recent development of the iPCRN (Irish Primary Care Research Network). Linkage of primary and secondary healthcare records with a unique patient identifier should be the goal for the future.

Sean O'Sullivan fonds

Sean O’Sullivan was born in Hamilton, Ontario, in 1952. At an early age, he demonstrated an interest in politics. A chance meeting with John Diefenbaker in 1963, when Sean was just 11 years old, marked the beginning of his involvement with the Progressive Conservative Party. Diefenbaker became a mentor to him, and the two exchanged correspondence for many years. Sean became an active member of the Party, and his political career took off quickly. In 1965, he was elected to the executive of the Hamilton Area Young Progressive Conservatives, in 1968 was elected President, and also served as Youth Director for Diefenbaker’s re-election campaign. In 1970 he was elected President of the Ontario Young Progressive Conservatives, and in 1971 became Youth Adviser to Premier William Davis. Later that year, Diefenbaker chose Sean to be his Executive Assistant. In addition to his political activities, Sean enrolled at Brock University in 1969 to study political science. In 1972, he resigned as Diefenbaker’s assistant in order to run as a candidate for Hamilton-Wentworth in the federal election that year. At just 20 years of age, Sean was the youngest MP elected to the House of Commons. While working as an MP, Sean continued his studies at Brock University part-time, graduating with distinction. After being re-elected in 1974, he rose to greater prominence when he succeeded in having a private member’s bill passed making the beaver one of Canada’s national symbols. In 1977, he resigned as MP in order to pursue religious studies and become a Catholic priest. After completing four years of studies at the Irish College of Rome’s Gregorian University, Sean was ordained a priest in Toronto in 1981. In July, 1982, he was appointed Director of Vocations (full-time recruiter) for the archdiocese of Toronto. In this capacity, he implemented a controversial and widely publicized campaign to recruit priests. The recruitment succeeded in generating interest in the priesthood, doubling the number of students in the archdiocese. He was one of the founding members of Serra House, a residence for students considering the priesthood. After his term as Vocations Director ended in 1985, O’Sullivan became publisher of The Catholic Register, a weekly church newspaper. That same year, he was awarded an honorary doctorate from Brock University. In January 1987, he was appointed a Member of the Order of Canada. Later that year, he submitted a report to the Attorney General of Ontario, titled You’ve got a Friend, after conducting an independent review of Advocacy for Vulnerable Adults in Ontario at the request of the government. In 1983, O’Sullivan was diagnosed with leukemia. The disease went into remission after treatment, but was incurable. In 1989, he had a bone marrow transplant at Princess Margaret Hospital in Toronto, but died shortly afterwards. He was 37 years old. A memorial fund was established in his name, and included contributions from prominent business, church and political leaders such as Prime Minister Brian Mulroney, Toronto Sun Chairman Doug Crieghton and His Eminence G. Emmett Carter. The O’Sullivan family requested that Brock University be the beneficiary of the proceeds of the campaign.

An Irish apostle: articulating and actualising apostolicity in the early Irish church

This thesis examines the earliest extant Latin Lives of Brigit and Patrick; Cogitosus’s Vita Brigidae and Muirchú’s Vita Patricii as evidence for a seventh-century debate on Irish apostolicity. While often dismissed as mere propaganda, this thesis shows they are highly sophisticated demonstrations of the continuing connection that Kildare and Armagh had to their patron saints and their authority. It examines the importance of this connection for concepts of ecclesiastical organisation, teaching authority and episcopal succession against the backdrop of the seventh-century Easter question in the Insular Church. This will show that apostolicity was considered to be intrinsically linked with orthodoxy and universality. A textual focus brings forth general patristic themes and ideas that Irish hagiographers evoked through specific words and phrases. The thesis contextualises hagiographical material using evidence from Hiberno-Latin and early Insular exegetical commentaries, referring to major patristic exegetes such as Origen, Jerome, Augustine, and Gregory the Great as support. The introduction discusses the importance of apostolic ideology for the seventh-century Irish Church, and outlines a methodology for examining such abstract themes. The first chapter looks at how developments in apostolic ideology led to ideas of apostolic primacy seen in the Insular material. Chapters two, three, and four examine metaphors of food and feeding, the fountain and the stream, and the head and the body, as significant articulations of apostolicity. Chapter five examines how corporeal relics were understood as the visible proof of this continuity and preserved a saint’s authority for their episcopal heirs. Chapter six looks at how Muirchú engaged with Patrick’s connection to the universal Church and his self-professed lack of disciplina to reconcile his apostolicity with seventh-century norms. Chapter seven places the issues considered thus far in a thoroughly Insular context by examining how the earliest English sources present the Irish legacy in Northumbria after the synod of Whitby. Chapter eight looks at how the text of Patrick’s Confessio in the Book of Armagh relates to a wider seventh-century campaign by Armagh to rehabilitate Patrick’s apostolicity. The conclusion briefly summarizes the thesis, and suggests further avenues for researching this topic in the Insular material

Nineteenth century Boston College : Irish or American? /

Title from cover.

Ireland in the seventeenth century; or, The Irish massacres of 1641-2, their causes and results. Illustrated by extracts from the unpublished state papers, the unpublished mss. in the Bodleian library, Lambeth library, and the library of the Royal Dublin society, relating to the plantations of 1610-39; a selection from the unpublished depositions relating to the massacres ... and the reports of the trials in the High court of justice in 1652-4, from the unpublished mss. in Trinity college, Dublin.

Mode of access: Internet.

An epoch in Irish history; Trinity college, Dublin, its foundation and early fortunes, 1591-1660:

Mode of access: Internet.

The history of Andrew Dunn, An Irish Catholic : in which some pretensions of the Church of Rome are examined by the light of Holy Scripture.

Mode of access: Internet.

A primer of the Irish language, with copious reading lessons; for the use of the students in the College of St. Columba.

Mode of access: Internet.

Breaking ranks: the emergence of representative associations in the Irish armed forces 1989-1992

This study contexualises the relationship between the armed forces and the civil authority in Ireland using and revising the theoretical framework advanced by Huntington. It tracks the evolution of the idea of a representive body for soldiers in the late 1980s, to the setting up of statutory associations under the Defence Amendment Act 1990. The study considers Irish soldiers political agitation and their use of peaceful democratic activities to achieve their aims. It highlights the fundamental policy arguments that were made against the idea of representation for the army and positions those arguments in the study of civil-military relations. Utilising unique access to secret Department of Defence files, it reveals in-depth ideological arguments advanced by the military authories in Ireland against independent representation. This thesis provides an academic study of the establishment of PDFORRA. It answers key questions regarding the change in the position of Irish government who were categorically opposed to the idea of representation in the army. It illustrates the involvement of other agencies such as the European Organisation of Military Associations (Euromil) reveals reciprocal support by the Irish associations to other emerging groups in Spain. Accessing as yet unpublished Department of Defence files, study analyses tension between the military authorities and the government. It highlights for the first time the role of enlisted personnel in the shaping of new state structures and successfully dismmisses Huntingtons theoretical contention that enlisted personnel are of no consequence in the study of civil-military relations. It fills a gap in our understanding, identified by Finer, as to how politicisation of soldiers takes place. This thesis brings a new dimension to the discipline of civil-military relations and creates new knowledge that will enhance our understanding of an area not covered previously.

Revisiting Irish poetic modernisms

This thesis discusses Irish Modernist poetry written between 1905 and 1970, specifically the poetry of Joseph Campbell (1879-1944), Thomas MacGreevy (1893-1967), Denis Devlin (1908-1959) and Brian Coffey (1905-1995). All four poets have been largely neglected in criticism until a growth of interest encouraged by Michael Smith and Trevor Joyce’s New Writers’ Press during the 1970s. J.C.C. Mays, Stan Smith, Susan Schreibman, Terence Brown, Patricia Coughlan and Alex Davis published subsequent critical support during the ‘80s and ‘90s. My research aims to highlight poetry previously omitted from the canon of Irish literature, those with connections to British or continental European literary movements as well as poetry by women writers and writers from the North. Part of this exploration of Irish Poetic Modernisms involves an investigation of intersections between poetic modernisms and Irish war poetry and of depictions of Irish masculinity in the poetry of Devlin and Coffey. My discussion of Campbell’s poetry focuses on links between the early regional modernism of his poetry and later Irish modernist poetry, including his participation in the Ulster Literary Theatre, with the Literary Revival community in Dublin and his association with the proto-Imagist movement in London. My examination of connections between Irish war poetry and Irish modernism allows me to discuss the writing of several underrecognized Irish poets who are contemporaries and near contemporaries of the main subjects of my thesis. Thomas MacGreevy’s poetry is the most clear case study of the links between Irish modernist poetry and poetry about Ireland’s participation in the Great War. MacGreevy’s writing reveals his multiple allegiances: he both elegizes and challenges the increasing cultural inhibitions of Free State Ireland. Denis Devlin’s poetic portrayals of Ireland reveal his rejection both of the Literary Revival’s fascination with Celticism and of Dublin’s literary community while upholding tradition poetic gender roles. My research explores representations of masculinity and Irish politics, including heroic masculine imagery, in the long poems of Devlin and Coffey. My discussion of Brian Coffey considers the importance of the figure of the “poet as maker” to his writing and his relationship with Ireland during his long writing career. I also consider his role as the editor and executor of Devlin’s literary estate and the impact that had on both the latter’s posthumous reputation and Coffey’s later writing.

The broad-scale distribution and abundance of Scyphomedusae in Irish waters

Scyphomedusae are receiving increasing recognition as key components of marine ecosystems. However, information on their distribution and abundance beyond coastal waters is generally lacking. Organising access to such data is critical to effectively transpose findings from laboratory, mesocosm and small scale studies to the scale of ecological processes. These data are also required to identify the risks of detrimental impacts of jellyfish blooms on human activities. In Ireland, such risks raise concerns among the public, but foremost amongst the professionals of the aquaculture and fishing sectors. The present work looked at the opportunity to get access to new information on the distribution of jellyfish around Ireland mostly by using existing infrastructures and programmes. The analysis of bycatch data collected during the Irish groundfish surveys provided new insights into the distribution of Pelagia noctiluca over an area >160 000 km2, a scale never reached before in a region of the Northeast Atlantic (140 sampling stations). Similarly, 4 years of data collected during the Irish Sea juvenile gadoid fish survey provided the first spatially, explicit, information on the abundance of Aurelia aurita and Cyanea spp. (Cyanea capillata and Cyanea lamarckii) throughout the Irish Sea (> 200 sampling events). In addition, the use of ships of opportunity allowed repeated samplings (N = 37) of an >100 km long transect between Dublin (Ireland) and Holyhead (Wales, UK), therefore providing two years of seasonal monitoring of the occurrence of scyphomedusae in that region. Finally, in order to inform the movements of C. capillata in an area where many negative interactions with bathers occur, the horizontal and vertical movements of 5 individual C. capillata were investigated through acoustic tracking.

Irish Times coverage of Irish relief and development nongovernmental organisations, legitimacy and accountability, 1994-2009: analysis and implications for the role of nongovernmental organisations

The overall aim of this study was to investigate the extent to which and ways in which Irish relief and development nongovernmental organisations (NGOs) were linked with the concepts of legitimacy and accountability in Irish Times newspaper coverage between 1994 and 2009. This research was based on a quantitative content analysis of 215 Irish Times articles and the results were analysed using statistical methods. Key findings of the research included that NGO accountability received significantly more coverage than NGO legitimacy, "principal-agent" approaches to NGO accountability received significantly more coverage than "stakeholder" approaches to NGO accountability, and questioning of NGOs based on either their accountability or legitimacy was very limited. It is suggested that these findings may indicate both a failure by Irish NGOs to promote "development literacy" and global solidarity among the Irish public, and a limited degree of "development literacy" and global solidarity among the Irish public.