Now showing 1 - 10 of 17
  • Publication
    Use of Power Flow Controllers to Enhance Transmission Network Utilisation on the Irish Transmission Network
    The Ireland and Northern Ireland power system is in a period of rapid transition from conventional generation to renewable generation and has seen a rapid increase in large demand sites requiring connection into the backbone transmission system. The role of EirGrid and SONI as Transmission System Operator in Ireland and Northern Ireland is to operate, maintain and develop the electricity transmission network. EirGrid ensure that new transmission projects are developed in a way that balances technical, economic, community and other stakeholder considerations. This has resulted in much more detailed evaluation of planning options to maximize utilisation of the existing network which may include but are not limited to uprating the capacity of the existing transmission system mainly through the thermal or voltage uprate of existing circuits. Another method to increase network utilisation is to strategically deploy Power Flow Control devices to relieve system overloads and maximise network transfer capacities. EirGrid has developed a new grid development strategy which places particular emphasis on identifying technologies to help resolve network issues. This paper presents the study findings for application of power flow controller (PFC) to relieve system issues.
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  • Publication
    Written information on bipolar affective disorder: the patients' perspective
    Aims and method: The mental health information available to people with bipolar affective disorder is variable in quality. We conducted a qualitative survey in an urban out-patient department to elicit the opinions of people with bipolar affective disorder on the written information provided by three health information providers.Results: Participants’ responses were generally positive for each leaflet. The two leaflets rated highest by participants used quality assurance tools. However, 20-30% had difficulty understanding the leaflets. Medical jargon and verbosity were common criticisms. Clinical implications: Professional bodies such as the Royal College of Psychiatrists play an important role in providing patients with written information. Quality assurance standards should be used in the production of patient information. A tool measuring individuals’ appraisal of information may ensure information is appropriate to their requirements.
      298Scopus© Citations 1
  • Publication
    The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study
    (D. Steinkopff-Verlag (Springer), 2008-04) ; ; ;
    Background: Suicidal ideation is believed to be part of a constellation of suicidal behaviours that culminates in suicide. There is little information on the cross-national prevalence of all suicidal ideation or of serious suicidal ideation in spite of its likely public health importance. Methods: A two-stage screening approach of over 12,000 adults from the general population were evaluated by face to face interview to identify those meeting ICD-10 criteria for depressive disorders at eight sites in five European countries. This study is a cross-sectional analysis of item 9 (suicidal ideation) of the Beck depression inventory from the total screened sample. Results: The standardised period prevalence for all suicidal ideation varied from 1.1 to 19.8% while for serious suicidal ideation there was much less variation. Examining the inter-relationships between all suicide ideation, serious suicide ideation, depressive disorders and suicide failed to support a seamless transition from suicide ideation through depression and serious ideation to suicide. Conclusions: Strategies to prevent suicide should be tailored to take account of site specific differences in its aetiology and understanding the path from suicidal ideation through depression to suicide is crucial to this.
      748Scopus© Citations 72
  • Publication
    National survey of psychiatrists' responses to implementation of the Mental Health Act 2001 in Ireland
    (Springer for the Royal Academy of Medicine in Ireland, 2010-06) ; ;
    Background: Ireland’s Mental Health Act 2001 resulted in substantial changes to mental health services and the process of involuntary admission. Aims: To determine the views of Irish psychiatrists regarding the new legislation, 1 year after full implementation. Methods: We sent questionnaires to all 735 members of the Royal College of Psychiatrists in Ireland. Results: The response rate was 43.7%. As much as 84% of respondents reported satisfaction with training; 69.1% reported increased workloads; 26.8% reported decreased time with service-users; 40.7% reported changes in relationships with service-users (e.g. increased empathy, but more legalistic, conflicted relationships). Almost one in three (27.4%) stated that it was not feasible to implement the Mental Health Act. Negative comments highlighted the adversarial nature of mental health tribunals, effects on therapeutic relationships and issues related to children. Conclusions: The implementation of the Mental Health Act 2001 has resulted in increased workloads, more conflicted relationships with service-users and adversarial mental health tribunals.
      563Scopus© Citations 22
  • Publication
    Impact of severity of personality disorder on the outcome of depression
    The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n = 121), group sessions on depression prevention (n = 106) or treatment as usual (n = 183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r = 0.21; p < 0.001), 6 months (r = 0.14; p = 0.02) and 12 months (r = 0.21; p = 0.001). On multi-variable analysis, BDI at baseline (p < 0.001) and type of treatment offered (individual therapy, group therapy, treatment as usual) (p = 0.01) were significant independent predictors of BDI at 6 months. BDI at baseline was the sole significant independent predictor of BDI at 12 months (p < 0.001). There was no interaction between personality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.
      430Scopus© Citations 16
  • Publication
    Applications for fees waivers on medical and psychiatric grounds at an Irish third-level college
    (Springer for the Royal Academy of Medicine in Ireland, 2009-12) ; ;
    Background: Physical and mental illness present substantial challenges to college students and authorities. Aims: (1) To characterize medical and psychiatric reasons underlying requests for fees waivers at an Irish third-level college; (2) to identify information included in applications; and (3) to develop proposals for standardizing applications. Methods: We examined all applications for exemption from fees for medical or psychiatric reasons over two academic years at an Irish third-level college. Results: Two hundred and twenty-two students applied for exemptions; 91% were successful. Psychiatric problems were more common than physical illness (64.1 vs. 27.9%). There was wide variation in details provided in applications with few providing details on likely ongoing duration of illness (5.0%). Conclusions: We recommend that (a) a structured medical application form be completed by medical practitioners supporting applications; (b) a medical practitioner review applications; and (c) there should be annual re-audit of this process.
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  • Publication
    Distinguishing between adjustment disorder and depressive episode in clinical practice: The role of personality disorder
    Background: There is significant symptomatic overlap between diagnostic criteria for adjustment disorder and depressive episode, commonly leading to diagnostic difficulty. Our aim was to clarify the role of personality in making this distinction. Methods: We performed detailed assessments of features of personality disorder, depressive symptoms, social function, social support, life-threatening experiences and diagnosis in individuals with clinical diagnoses of adjustment disorder (n=173) or depressive episode (n=175) presenting at consultation-liaison psychiatry services across 3 sites in Dublin, Ireland. Results: Fifty six per cent of participants with adjustment disorder had likely personality disorder compared with 65% of participants with depressive episode. Compared to participants with depressive episode, those with adjustment disorder had fewer depressive symptoms; fewer problems with social contacts or stress with spare time; and more life events. On multi-variable testing, a clinical diagnosis of adjustment disorder (as opposed to depressive episode) was associated with lower scores for personality disorder and depressive symptoms, and higher scores for life-threatening experiences. Limitations: We used clinical diagnosis as the main diagnostic classification and generalisability may be limited to consultation-liaison psychiatry settings. Conclusions: Despite a substantial rate of likely personality disorder in adjustment disorder, the rate was even higher in depressive episode. Moreover, features of likely personality disorder are more strongly associated with depressive episode than adjustment disorder, even when other distinguishing features (severity of depressive symptoms, life-threatening experiences) are taken into account.
      1206Scopus© Citations 13
  • Publication
    What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service
    (Springer for the Royal Academy of Medicine in Ireland, 2011-03) ; ; ;
    Aim: This study aimed to measure patient satisfaction with the care they were receiving; examine patients' knowledge of the psychiatric services in general; and identify variables associated with satisfaction. Methods: Patients attending the Mater Misericordiae University Hospital psychiatric outpatient clinics over a 13-week period, and the Mater Misericordiae University Hospital clozapine clinic over a 4-week period and were invited to complete the Barker Scale of Patients' Views Towards Care Received From Psychiatrists. Results: One-hundred and ninety-two patients were invited to participate and there was a response rate of 94%. Eighty-six percent of respondents were satisfied with their care; 92% stated psychiatrists were caring towards them; 85% that psychiatrists know what they are doing; 84% that their illness was explained by their psychiatrist; and 65% that psychiatric care is improving; but 65% stated that psychiatric services are still not good enough. Eighty-six percent were, or had been, in receipt of a psychological treatment. On multi-variable analysis, satisfaction was associated with the view that doctors explained treatment clearly, the view that doctors do not rely excessively on medication, and having been visited by a community mental health nurse. Conclusion: Patients attending psychiatry outpatient services reported a high degree of satisfaction with the treatment they were receiving, although there were discrepancies between satisfaction with their own specific service and with psychiatric services in general.
      266Scopus© Citations 10
  • Publication
    Social capital and suicide in 11 European countries: an ecological analysis
    Background: 'Social capital' refers to the existence of voluntary community networks and relationships based on trust, and the use of these networks and relationships to enable positive social action. Social capital is positively associated with selected indices of mental health. Methods: We performed an ecological investigation of the relationship between social trust (as one component of social capital) and national suicide rates in 11 European countries (n=22,227). Results: There was an inverse relationship between social trust and national suicide rates (i.e. the higher the social trust, the lower was the suicide rate), after controlling for gender, age, marriage rates, standardised income and reported sadness. Conclusions: Social capital may have a protective effect against suicide at the national level. Multi-level analysis, taking into account both group-level and individual-level variables, would help clarify this relationship further and guide appropriate interventions at both the group and individual levels.
      697Scopus© Citations 66
  • Publication
    Mental health professionals and information sharing: carer perspectives
    (Springer for Royal Academy of Medicine in Ireland, 2015) ; ; ;
    Background: The important role played by carers of those with mental health problems is frequently undervalued among healthcare professionals. Aims: To identify the difficulties encountered by carers in relation to obtaining information from mental health teams. Methods: Participants in the study included carers or family members of persons with mental illness who were affiliated with a support group in Ireland. Information was gathered using an 18-item self-report questionnaire. This is an amended version of the Carer Well-Being and Support Questionnaire for carers of people with a mental health problem or dementia. Results: One-hundred and fifty-nine carers complete the questionnaire. On average respondents stated that they have been in the role of a carer for someone with a mental health problem for 14.4 years, spending a median of 20-h caring each week. Despite most carers maintaining that they are generally satisfied with the support offered to them from medical and/or care staff, the majority (56.3 %) of respondents stated that they have specifically encountered difficulties accessing information from the treating mental health team. The main reasons given to them by the mental health team for withholding information include: lack of patient consent (46.2 %) and unavailability of a team member (46.2 %). From a carer perspective, respondents stated that the main reason they feel there is difficulty in accessing information is a lack of concern for their role as a carer in the patient's management (60.5 %). More than 75 % of all respondents are afraid of negative consequences for them or for the person in their care as a result of information being withheld by the treating team. Conclusions: Carer involvement is essential for the complete and effective management of individuals with mental illness. Confidentiality should not be used as a reason for completely excluding carers.
      759Scopus© Citations 8