Welcome to Research Repository UCD
Research Repository UCD is a digital collection of open access scholarly research publications from University College Dublin. Research Repository UCD collects, preserves and makes freely available publications including peer-reviewed articles, working papers and conference papers created by UCD researchers. Where material has already been published it is made available subject to the open-access policies of the original publishers. This service is maintained by UCD Library.
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- PublicationThe economic and social impact of higher education(Irish Universities Association, 2006)
47488 - PublicationCorporate governance, accountability and mechanisms of accountability : an overview(Emerald, 2008)Purpose – This paper reviews traditional corporate governance and accountability research, to suggest opportunities for future research in this field. The first part adopts an analytical frame of reference based on theory, accountability mechanisms, methodology, business sector/context, globalisation and time horizon. The second part of the paper locates the seven papers in the special issue in a framework of analysis showing how each one contributes to the field. The paper presents a frame of reference which may be used as a 'roadmap' for researchers to navigate their way through the prior literature and to position their work on the frontiers of corporate governance research. Design/methodology/approach – The paper employs an analytical framework, and is primarily discursive and conceptual. Findings – The paper encourages broader approaches to corporate governance and accountability research beyond the traditional and primarily quantitative approaches of prior research. Broader theoretical perspectives, methodological approaches, accountability mechanism, sectors/contexts, globalisation and time horizons are identified. Research limitations/implications – Greater use of qualitative research methods are suggested, which present challenges particularly of access to the “black box” of corporate boardrooms. Originality/value – Drawing on the analytical framework, and the papers in the special issue, the paper identifies opportunities for further research of accountability and corporate governance.
34132Scopus© Citations 313 - PublicationElderly care in Ireland - provisions and providers(University College Dublin. School of Social Justice, 2010-04)
32392 - PublicationEquality in education : an equality of condition perspective(Sage Publications, 2005)Transforming schools into truly egalitarian institutions requires a holistic and integrated approach. Using a robust conception of 'equality of condition', we examine key dimensions of equality that are central to both the purposes and processes of education: equality in educational and related resources; equality of respect and recognition; equality of power; and equality of love, care and solidarity. We indicate in each case some of the major changes that need to occur if we are to promote equality of condition. Starting with inequalities of resources, and in particular with inequalities tied to social class, we argue for abandoning rigid grouping policies, challenging the power of parents in relation to both selection and grouping, and changing curricula and assessment systems to make them more inclusive of the wide range of human intelligences. In relation to respect and recognition, we call for much more inclusive processes for respecting differences, not only in schools' organizational cultures, but also in their curriculum, pedagogy and assessment systems. Regarding inequalities of power, we call for democratization of both teacher-student relationships and school and college organization. For promoting equality of love, care and solidarity, we argue that schools need to develop an appreciation of the intrinsic role that emotions play in the process of teaching and learning, to provide a space for students and teachers to talk about their feelings and concerns, and to devise educational experiences that will enable students to develop their emotional skills or personal intelligences as a discrete area of human capability.
23972Scopus© Citations 146 - PublicationDiscretionary disclosure strategies in corporate narratives : incremental information or impression management?(University of Florida. Fisher School of Accounting, 2007)The purpose of this paper is to review and synthesize the literature on discretionary narrative disclosures. We explore why, how, and whether preparers of corporate narrative reports use discretionary disclosures in corporate narrative documents and why, how, and whether users react thereto. To facilitate the review, we provide three taxonomies based on: the motivation for discretionary narrative disclosures (opportunistic behavior, i.e. impression management, versus provision of useful incremental information); the research perspective (preparer versus user); and seven discretionary disclosure strategies. We also examine the whole range of theoretical frameworks utilized by prior research, and we put forward some suggestions for future research.
22996 - PublicationFrom asset based welfare to welfare housing? The changing function of social housing in Ireland(Routledge, 2011)This article examines a distinctive and significant aspect of social housing in Ireland – its change in function from an asset-based role in welfare support to a more standard model of welfare housing. It outlines the nationalist and agrarian drivers which expanded the initial role of social housing beyond the goal of improving housing conditions for the poor towards the goal of extending home ownership and assesses whether this focus made it more similar to the ‘asset based welfare’ approach to housing found in south-east Asia than to social housing in western Europe. From the mid-1980s, the role of Irish social housing changed as the sector contracted and evolved towards the model of welfare housing now found in many other western countries. Policy makers have struggled to address the implications of this transition and vestiges of social housing’s traditional function are still evident, consequently the boundaries between social housing, private renting and home ownership in Ireland have grown increasingly nebulous.
Scopus© Citations 29 22605 - PublicationUsing Twitter to recommend real-time topical news(ACM, 2009-10)Recommending news stories to users, based on their preferences,has long been a favourite domain for recommender systems research. In this paper, we describe a novel approach to news recommendation that harnesses real-time micro-blogging activity, from a service such as Twitter, as the basis for promoting news stories from a user's favourite RSS feeds. A preliminary evaluation is carried out on an implementation of this technique that shows promising results.
21473Scopus© Citations 340 - PublicationConstructive approaches towards water treatment works sludge management : an international review of beneficial re-uses(Taylor & Francis, 2007-03)Till date, virtually all known drinking water processing systems generate an enormous amount of residual sludge, and what else to do with this rapidly increasing 'waste' stream in an economic and environmentally sustainable manner remains a significant environmental issue. Perhaps, the realization of this fact has led to series of concerted efforts aimed at beneficial re-uses in an effort to close the loop between efficient water treatment and sustainable sludge management. This paper therefore presents a comprehensive review of available literature on attempts at beneficial reuses of water treatment plant sludge, in an effort to provide a compendium of recent and past developments, and update our current state of knowledge. Four broad categories of uses, which included over eleven possible ways in which waterworks sludges can be reused were identified and examined. Obvious advantages of such reuse options were highlighted and knowledge gaps identified. Future issues that will assist in the development of sustainable waterworks sludge management options with a multi-prong approach were equally discussed.
20062Scopus© Citations 400 - PublicationExpansive cements and soundless chemical demolition agents : state of technology review(2009-10)Expansive cements and soundless chemical demolition agents (SCDAs) were first introduced in the early 1970s but failed to gain widespread adoption for selective removal of rock and concrete due to their proprietary nature and a lack of usage guidelines. Nearly 40 years later, the patents have expired, and a large number of competitive products have entered the market. These factors coupled with a heightened interest in their potential environmental benefits have greatly expanded their usage. Specifically, these chemicals can be introduced into a pattern of small, drilled holes in concrete and/or rock. After a specific period (usually less than 24 hours), the in-situ material will crack sufficiently that it can be removed without the use of traditional explosives or further percussive efforts. The products generate substantially less noise and vibration than usually associated with the removal of rock and concrete. This paper provides a state-of-the-technology review of five available products. The focus is on the proposed applicability of various products under specific conditions. Special attention is paid to the viability of such agents under varying temperatures and with materials of particular strengths.
18730 - PublicationCurriculum Design in Higher Education: Theory to Practice(University College Dublin. Teaching and Learning, 2015-09)This eBook emphasises the theory to practice of curriculum design in higher education. The book focuses on programme (not module) level of design; incorporates face-to-face, blended and online curricula; attempts to link theory to practice by giving some practical resources and/or exercises; draws the author's experiences of working and researching into curriculum design in the Irish higher education sector; is aimed at all staff involved in curriculum design, including academic staff (faculty), institutional managers, educational developers and technologists, support staff, library staff and curriculum researchers; is primarily drawn from literature and experiences in the higher education sector, however those in adult and further education may also find it useful. The structure of this book is based on a curriculum design process that the author has developed as part of her experience and research on curriculum design.
17832 - PublicationClustering with the multivariate normal inverse Gaussian distribution(Elsevier, 2016-01)Many model-based clustering methods are based on a finite Gaussian mixture model. The Gaussian mixture model implies that the data scatter within each group is elliptically shaped. Hence non-elliptical groups are often modeled by more than one component, resulting in model over-fitting. An alternative is to use a mean–variance mixture of multivariate normal distributions with an inverse Gaussian mixing distribution (MNIG) in place of the Gaussian distribution, to yield a more flexible family of distributions. Under this model the component distributions may be skewed and have fatter tails than the Gaussian distribution. The MNIG based approach is extended to include a broad range of eigendecomposed covariance structures. Furthermore, MNIG models where the other distributional parameters are constrained is considered. The Bayesian Information Criterion is used to identify the optimal model and number of mixture components. The method is demonstrated on three sample data sets and a novel variation on the univariate Kolmogorov–Smirnov test is used to assess goodness of fit.
17795Scopus© Citations 67 - PublicationInequality and crime(MIT Press, 2000-11)This paper considers the relationship between inequality and crime using data from urban counties. The behavior of property and violent crime are quite different. Inequality has no effect on property crime but a strong and robust impact on violent crime, with an elasticity above 0.5. By contrast, poverty and police activity have significant effects on property crime, but little on violent crime. Property crime is well explained by the economic theory of crime, while violent crime is better explained by strain and social disorganization theories.
17794Scopus© Citations 455 - PublicationAgent-based coordination for the sensor web(ACM, 2010-03-26)The approach described advocates the use of a multi-agent system, and specifically the use of multi-agent distributed constraint optimisation algorithms. Developing software for low powered sensing devices introduces several problems to be addressed; the most obvious being the limited computational resources available. In this paper we discuss an implementation of ADOPT, a pre-existing algorithm for distributed constraint optimisation, and describe how it has been integrated with a reflective agent platform developed for resource constrained devices, namely Agent Factory Micro Edition (AFME). The usefulness of this work is illustrated through the canonical multi-agent coordination problem, namely graph colouring.
16100Scopus© Citations 2 - PublicationMichael White's narrative therapy(Springer Verlag, 1998)A systematized description of a number of practices central to Michael Whites' narrative approach to therapy is given. These include collaborative positioning of the therapist, externalizing the problem, excavating unique outcomes, thickening the new plot, and linking the new plot to the past and the future. The practices of remembering and incorporation, using literary means to achieve therapeutic ends, and facilitating taking-it-back practices are also described. A number of questions are given which may be useful for those concerned with narrative therapy to address.
15735Scopus© Citations 110 - PublicationVisualization in sporting contexts : the team scenario(SciTePress, 2011-01-29)Wearable sensor systems require an interactive and communicative interface for the user to interpret data in a meaningful way. The development of adaptive personalization features in a visualization tool for such systems can convey a more meaningful picture to the user of the system. In this paper, a visualization tool called Visualization in Team Scenarios (VTS), which can be used by a coach to monitor an athlete’s physiological parameters, is presented. The VTS has been implemented with a wearable sensor system that can monitor players’ performance in a game in a seamless and transparent manner. Using the VTS, a coach is able to analyze the physiological data of athletes generated using select wearable sensors, and subsequently analyse the results to personalize training schedules thus improving the performance of the players.
15438 - PublicationProvision of childcare services in Ireland(University College Dublin. School of Social Justice, 2008-03)External report commissioned by and presented to the EU Directorate-General Employment and Social Affairs, Unit G1 'Equality between women and men'
15329 - PublicationFinancial statement fraud : some lessons from US and European case studies(Wiley-Blackwell, 2007-07)This paper studies 14 companies which were subject to an official investigation arising from the publication of fraudulent financial statements. The research found senior management to be responsible for most fraud. Recording false sales was the most common method of financial statement fraud. Meeting external forecasts emerged as the primary motivation. Management discovered most fraud, although the discovery was split between incumbent and new management.
15184Scopus© Citations 40 - PublicationThe effectiveness of family therapy and systemic interventions for child-focused problems(Wiley, 2009-02)This review updates a similar paper published in the Journal of Family Therapy in 2001. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with various difficulties. In this context, systemic interventions include both family therapy and other family-based approaches such as parent training. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; child abuse and neglect; conduct problems (including childhood behavioural difficulties, ADHD, delinquency and drug abuse); emotional problems (including anxiety, depression, grief, bipolar disorder and suicidality); eating disorders (including anorexia, bulimia and obesity); and somatic problems (including enuresis, encopresis, recurrent abdominal pain, and poorly controlled asthma and diabetes).
15107Scopus© Citations 162 - PublicationFocus groups versus individual interviews with children : A comparison of data(Routledge (Taylor & Francis), 2006)In recent years there has been an increase in the use of qualitative data collection techniques in research with children. Among the most common of these methods are focus groups and individual interviews. While many authors claim that focus groups have advantages over individual interviews, these claims have not been tested empirically with children. The present study reports on the use of focus groups and interviews to collect qualitative data from 116 children in three age groups, with mean ages of 8.4, 11.5 and 14.3 years. The children were randomly allocated to participate in either focus groups or individual interviews where they were presented with identical material and questions relating to their beliefs about peers with psychological disorders. In line with previous research, the interviews produced significantly more relevant and unique ideas about the causes of these disorders than the focus groups, but the latter gave rise to greater elaboration of ideas. The participating children showed no significant difference in their preference for one method over the other. Thus, whether to choose individual interviews or focus groups is likely to depend on the nature of the research question in any given study.
14633Scopus© Citations 45
Recent Submissions
- PublicationReduced Fetal Movements during Pregnancy: an audit of pregnancy characteristics(2022-01-21)Maternal perception of RFM in pregnancy is a common reason for self-referral to maternity services. Preventing and reducing adverse outcomes can only be achieved through better detection and management of women with RFM, however the pregnancy characteristics of women who present with RFM in pregnancy vary.
- PublicationCompetence Framework for Breastfeeding Support(The University of Dublin, Trinity College Dublin, 2015-07)The Global Strategy for Infant and Young Child Feeding (WHO, 2003) emphasises that women need education and support from knowledgeable health workers, in order to establish and maintain breastfeeding. However, evidence-based knowledge, skills, and attitudes are lacking among health workers in many disciplines and settings (Renfrew et al 2012). It is recognised that training and continued education are associated with improved breastfeeding outcomes for clients (Thulier and Mercer 2009), meaning that methods to assess competency of health workers related to breastfeeding, are required. The National Breastfeeding Strategy Action Plan (Department of Health & Children, 2005) set an objective to ensure that ‘Health workers have the knowledge and skills necessary to protect, promote and support breastfeeding’ (Objective 2.2, pg 35). A study was undertaken by the Education & Training sub-committee and their report recommended that further work was undertaken to establish the expected standards/competencies of the various levels of health workers related to assisting breastfeeding towards providing appropriate education and training for all the levels (Becker, Mumford, Cahill, 2010) and a means of measuring this important objective. The purpose of this project was to develop a competency framework for health workers in the hospital and community settings who provide support and care to pregnant women, babies and their mothers who are breastfeeding. The framework is intended to list core competences in breastfeeding assistance and protection whilst recognising that competences for individual health disciplines may also exist through other regulatory and educational mechanisms. It is envisioned that the framework will benchmark expected work practices, assist in workforce planning and skill mix, inform academic curricula and professional development programs, and so will enhance the care of breastfeeding children and their mothers and promote inter-professional collaboration. The framework for competencies in supporting breastfeeding was commissioned by ALCI (The association of Lactation Consultants in Ireland) and developed in consultation with the Education and Training subgroup of the National Breastfeeding Strategy Implementation Committee.
- PublicationWomen's Experiences and Understandings of Menopause(Women's Health Council, 2008-10-07)The aim of this study was to describe and analyse a sample of women’s experiences and understandings of the menopause, in order to provide information on how women in Ireland experience this time in their lives and help identify the types of supports and services women would like. Thirty-nine women between the ages of 42 and 63 from a range of socio-economic backgrounds and with representation from both rural and urban areas participated in the study. Data were collected by 36 individual interviews and one group interview. Data were analysed using a qualitative strategy called thematic networks analysis.
2 - PublicationConstructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis(Wiley, 2022-03)Aims: To explore how Advanced Nurse Practitioners (ANP) are positioned within current nursing and health system structures in Ireland by making explicit the discourses that construct ANPs’ identities and how they both enable and constrain their roles. Background: Ambiguity and confusion characterize debates about the ANP role having a profound impact on ANP identity and how they realize their roles. Without clear definitions, boundaries are difficult to ascertain, the full potential of the ANP is not realized and, consequently, ANPs are underutilized. Although this study is relevant outside Ireland's borders, it is of particular concern in the Irish setting as current policy aims to increase ANP numbers. Design: A qualitative discourse analysis using Gee's Tools of Inquiry. Method: Data were collected between April 2019 and January 2020 through seven in-depth interviews and four focus groups and analysed using Gee's Tools of Inquiry. Participants included ANPs, nurses, doctors and allied healthcare professionals. Findings: Five key discourses emerged. Language-in-use established, first, that ANPs add value to the healthcare system and, second, highlighted the centrality of nursing to ANPs’ identity. The third discourse builds an educated and skilled identity for ANPs, one that, however, lacked the expertise and influence of their medical colleagues. The fourth discourse constructs an identity for ANPs as medical substitutes, lesser roles, yet innovative additions to the system and a threat to existing structures. The final discourse constructs tensions between independence and autonomy, on the one hand, and control, on the other. Conclusion: This study alerts healthcare professionals to ways in which discourses influence opinion and frame ANPs’ identity. Healthcare professionals should challenge Conversations and Discourses that disparage the ANP role. ANPs need to clearly articulate their role, the value that it adds to the healthcare system and demonstrate how it aligns with and complements other healthcare professionals’ roles. Impact: By identifying and critiquing extant Discourses and Conversations, healthcare professionals, and health system leaders and managers will gain a better understanding of the issues that both enable and constrain the ANP role.
2Scopus© Citations 10 - PublicationA quality framework for health services developed through an inclusive approach(Sciedu Press, 2015-03-18)Objective: This study set out to explore and define the concept of “quality” from the perspective of health service managers and health professionals in Ireland, and to develop a theory to inform the development of a quality framework for the Irish health system. Methods: Design: The study design was based on Strauss and Corbin’s (1990) grounded theory approach. This provided a method of social inquiry with the purpose of developing a theory through a systematic and rigorous approach to examine and advance emerging concepts. Setting and participants: Fifty health service managers and professionals employed by the Health Service Executive (HSE) in Ireland participated in this study. Interventions: In-depth interviews were used to explore with participants their experiences of quality in Irish health services, definitions of quality and the elements necessary for a quality framework. Main outcomes: This study produced a substantive theory that identified the need for a holistic approach to quality across three domains (the patient, workforce and organisation). Results: The quality framework comprises an integrated set of domains, values, approaches, processes and enablers. Across the domains, the approaches and processes provide the mechanisms to achieve quality. These are supported by values (that promote quality) and a set of enablers (which underpin the elements, providing the platform for change). Conclusions: The emergent theory provides the basis for a quality framework for health services for Ireland in the 21st Century. Unlike most extant quality frameworks, the framework was derived empirically through an inclusive approach with key care providers, supporting the relevance and potential utility of the framework.
5 - PublicationDeveloping a university-accredited Lean Six Sigma curriculum to overcome system blindness(Oxford University Press, 2019-12-22)This paper discusses the development of a Lean Six Sigma (LSS) postgraduate education programme that has enabled the delivery of over 90 quality improvement projects led by its graduates across 50 healthcare organizations in Ireland. A key success factor in embedding and sustaining LSS in these organizations was the accreditation by a major, national, research-intensive university of the LSS education programme from which the students graduated. To ensure the programme's approval by the university it was necessary to contextualize LSS within established conceptual frameworks. This helped counter misconceptions that what was proposed was technical training in tools and techniques to provide quick fixes for routine healthcare process issues. Two related conceptual frameworks were selected to frame the curriculum: Senge's Fifth Discipline and Deming's System of Profound Knowledge. This paper focuses on how a central element of both frameworks, systems thinking or appreciation for a system, was enacted in the curriculum using Oshry's work on system blindness. Showing how systems thinking was conceptualized in the curriculum established the legitimacy and credibility of the programme within academia. This led to the approval of the first university-accredited graduate programme in LSS for healthcare in Ireland.
2Scopus© Citations 12 - PublicationPrevalence of mental health disorders in children and adolescents in the Republic of Ireland: a systematic review(Cambridge University Press, 2023)Referrals to Child and Adolescent Mental Health Services (CAMHS) have increased in recent years. Services are already under-resourced and the adverse psychological impact of Covid-19 is likely to increase demand. Accordingly, an understanding of prevalence of mental health (MH) disorders among youth is imperative to help inform and plan services. Aim: To establish prevalence of MH disorders among youth (under 18) in Ireland. Method: A systematic review using pre-defined search terms in PubMed, PsycInfo, Embase and CINAHL was conducted. Empirical studies conducted in Ireland, in youth and focusing on MH disorders were included. Results: From a total of 830 papers identified, 38 papers met inclusion criteria. Significant variation in rates of MH disorders was evident based on study methodology. Screening questionnaires for general psychopathology reported rates of 4.8–17.8% scoring above clinical cut-offs, with higher rates for ADHD (7.3%). Studies examining depression ranged from 4% to 20.8%, while rates for ‘current’ MH disorder, determined by semi-structured interview, were 15.5%, while ‘lifetime’ rates varied from 19.9% to 31.2%. Fewer than half (44%) of those identified as ‘in need’ of specialist MH services were accessing CAMHS. Conclusion: Data on MH disorders among Irish youth is limited, and studies showed significant variance in rates, making service planning difficult. There is an urgent need for serial epidemiological surveys, with clear operational criteria for clinically impairing MH difficulties. Such studies are essential to understand potential demand and service planning. This is most urgent given the expected increased demand post Covid-19.
4Scopus© Citations 7 - PublicationDevelopment of a factorial survey for use in an international study examining clinicians’ likelihood to support the decision to initiate invasive long-term ventilation for a child (the TechChild study)(Springer, 2022-07-21)Background: The decision to initiate invasive long-term ventilation for a child with complex medical needs can be extremely challenging. TechChild is a research programme that aims to explore the liminal space between initial consideration of such technology dependence and the final decision. This paper presents a best practice example of the development of a unique use of the factorial survey method to identify the main influencing factors in this critical juncture in a child’s care. Methods: We developed a within-subjects design factorial survey. In phase 1 (design) we defined the survey goal (dependent variable, mode and sample). We defined and constructed the factors and factor levels (independent variables) using previous qualitative research and existing scientific literature. We further refined these factors based on expert feedback from expert clinicians and a statistician. In phase two (pretesting), we subjected the survey tool to several iterations (cognitive interviewing, face validity testing, statistical review, usability testing). In phase three (piloting) testing focused on feasibility testing with members of the target population (n = 18). Ethical approval was obtained from the then host institution’s Health Sciences Ethics Committee. Results: Initial refinement of factors was guided by literature and interviews with clinicians and grouped into four broad categories: Clinical, Child and Family, Organisational, and Professional characteristics. Extensive iterative consultations with clinical and statistical experts, including analysis of cognitive interviews, identified best practice in terms of appropriate: inclusion and order of clinical content; cognitive load and number of factors; as well as language used to suit an international audience. The pilot study confirmed feasibility of the survey. The final survey comprised a 43-item online tool including two age-based sets of clinical vignettes, eight of which were randomly presented to each participant from a total vignette population of 480. Conclusions: This paper clearly explains the processes involved in the development of a factorial survey for the online environment that is internationally appropriate, relevant, and useful to research an increasingly important subject in modern healthcare. This paper provides a framework for researchers to apply a factorial survey approach in wider health research, making this underutilised approach more accessible to a wider audience.
3Scopus© Citations 2 - PublicationExpert survey on coverage and characteristics of pediatric palliative care in Europe – a focus on home care(Springer, 2022-10-17)Background: For children with life-limiting conditions home care is a key component of pediatric palliative care. However, poor information is available on service coverage and in particular on country-specific pediatric palliative home care characteristics. The aim of the study was therefore to describe the association between pediatric palliative care coverage and national activities and obtain detailed information on the pediatric palliative home care structure in different European countries. Methods: Online survey with in-country experts from N = 33 European countries. Results: Pediatric palliative home care (65.6%) represented the most pediatric palliative care units (15.6%) and the least common services. National documents constituted the most widespread national pediatric palliative care activity (59.4%) and were associated with available services. Pediatric palliative home care could be mostly accessed as a service free of charge to families (95.2%) from the time of a child's diagnosis (85.7%). In most countries, oncological and non-oncological patients were cared for in pediatric palliative home care. Only a minority of home care teams covered home-ventilated children. Pediatric palliative home care usually comprised medical care (81.0%), care coordination (71.4%), nursing care (75.0%) and social support (57.1%). Most countries had at least two professional groups working in home care teams (81.0%), mostly physicians and nurses. In many countries, pediatric palliative home care was not available in all regions and did not offer a 24 h-outreach service. Conclusions: Pediatric palliative care provision in Europe is heterogeneous. Further work on country-specific structures is needed.
Scopus© Citations 4 - PublicationAssessing how the policy of free GP care for children aged under 6 has impacted unscheduled paediatric healthcare in Ireland(PublicPolicy.ie, UCD Geary Institute for Public Policy, 2022-04-29)The term “unscheduled” healthcare refers to care that is generally provided with less than 24- hour notice, with general practitioners (GPs) the most common first point of contact for this type of unplanned care (O'Cathain et al., 2007). The most significant change to paediatric unscheduled healthcare in Ireland in recent years has been the extension of free GP care to all children aged under 6 from July 2015. This policy provided access to daytime and out-of-hours (OOH) GP care at no charge to the 70% of children aged under 6 who were not existing holders of a medical or GP visit cardi, with GPs receiving an annual capitation fee per registered patient. While the removal of the barrier of cost might reasonably be expected to increase utilisation in the short-term, the longer-term impact on utilisation and possible health benefits needs to be better understood in order to inform future policy development. Using data from eight practices and an OOH service in North Dublin, O’Callaghan et al. (2018) found attendance at daytime GP increased by 29% and by 26% at the OOH service in the year following the introduction of this policy, while Nolan and Layte (2017) using longitudinal data from Growing Up in Ireland, estimated an increase in attendance of 25%. Using data from 16 GP practices located across 12 of the 26 counties of the Republic of Ireland and a large OOH GP service operating in the South-East of Ireland, the CUPID Project assessed that this policy led to an increase in attendance at daytime GP of 20% - 21% in the three years following its introduction (McDonnell et al., 2022). A larger effect was identified at the OOH service (21% - 29%). Across each of these studies, the increase in attendance was significant and, as shown by McDonnell et al. (2022), persistent.
5 - PublicationThe Meaning Given to Bioethics as a Source of Support by Physicians Who Care for Children Who Require Long-Term Ventilation(SAGE, 2022-03-29)The role and potential of bioethics input when a child requires the initiation of technology dependence to sustain life is relatively unknown. In particular, little is understood about the meaning physicians give to bioethics as a source of support during the care of children in pediatric intensive care who require long-term ventilation (LTV). We used a hermeneutic phenomenological approach to underpin the collection and analysis of data. Unstructured interviews of 40 physicians in four countries took place during 2020. We found that elements of trust, communication and acceptance informed the physicians’ perceptions of the relationship with bioethics. These ranged from satisfaction to disappointment with their input into critical decisions. Bioethics services have potential to help physicians gain clarity over distressing and complex care decisions, yet physicians perceive the service inconsistently as a means of support. This research provides a sound basis to guide more beneficial interactions between clinicians and bioethics services.
2Scopus© Citations 8 - PublicationQuality care metrics (QC-M) in nursing and midwifery care processes: a rapid realist review (RRR) protocol(Health Research Board, 2021-01-28)Background: In 2018, the Office of the Nursing and Midwifery Services Director (ONMSD) completed phase one of work which culminated in the development and launch of seven research reports with defined suites of quality care process metrics (QC-Ms) and respective indicators for the practice areas - acute care, midwifery, children's, public health nursing, older persons, mental health and intellectual disability nursing in Ireland. This paper presents a rapid realist review protocol that will systematically review the literature that examines QC-M in practice; what worked, or did not work for whom, in what contexts, to what extent, how and why? Methods: The review will explore if there are benefits of using the QC-Ms and what are the contexts in which these mechanisms are triggered. The essence of this rapid realist review is to ascertain how a change in context generates a particular mechanism that produces specific outcomes. A number of steps will occur including locating existing theories on implementation of quality care metrics, searching the evidence, selecting relevant documents, data extraction, validation of findings, synthesising and refining programme theory. This strategy may help to describe potential consequences resulting from changes in context and their interactions with mechanisms. Initial theories will be refined throughout the process by the local reference panel, comprised of eight key intervention stakeholders, knowledge users such as healthcare professionals and an expert panel. Ethical approval is not required for this rapid realist review. Conclusion: It is anticipated that the final programme theory will help to explain how QC-Ms work in practice; for whom, why and in what circumstances. Findings of this review could help to give insights into realism as a framework and how nursing and midwifery QC-Ms have been implemented previously.
15 - PublicationPolicy of free GP care for children under 6 years: the impact on Emergency Department attendance(Elsevier, 2021-06)Universal health coverage (UHC) aims to improve child health. Ireland, the only country in the European Union without universal access to primary care, introduced general practitioner (GP) care at no charge for children aged under six in 2015. This paper aims to evaluate the impact of this policy on attendance at the emergency department (ED). A difference-in-difference (DiD) analysis was applied to visit records of 367,000 paediatric patients at five hospitals over a period of five years, with treatment and control differentiated by age. DiD was also used to assess if GP referrals and the severity of presentations altered as a consequence of this policy. While existing research estimates that this policy increased attendance by children aged under six at general practice by over 25%, this policy did not lead to a reduction in ED attendance. Hospital level effects on attendance varied from no impact to increased attendance by children aged under six of 28.9%. While increased GP referrals, particularly for injury and medical reasons, indicated more patients presented to their GP prior to ED attendance, walk-ins without referral did not decrease. Attendance increased at both regional hospitals, which also had the highest proportion of GP referred visits. While the marginal probability of a visit being GP referred increased at four of the five hospitals in this study, only in two of these can the entire effect be attributed to the introduction of this policy (effects 1.4 and 1.8 percentage points). Previous unmet need, capacity constraints in general practice, regional variability in the GP to population ratio, restricted hours of access to GPs, coupled with faster access to diagnostics in the ED setting, may explain variability in the effect and why the expected reduction in ED attendances did not occur.
8Scopus© Citations 5 - PublicationInterpersonal and communication skills development in nursing preceptorship education and training programmes: a scoping review protocol(Health Research Board, 2021-03-11)The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.
19 - PublicationSafety culture in health care teams: A narrative review of the literature(Wiley, 2019-07-08)Aim: Explore the recent literature to examine the factors that affect safety culture within health care teams. Background: Health care organisations must understand and improve their safety culture. However, safety culture is a complex phenomenon which interacts with a myriad of factors, making it difficult to define, measure and improve. Evaluation: A comprehensive search strategy was used to search four major databases. Peer-reviewed which were published in English between 2006 and 2017 and presented research studies related to safety culture in health care teams were included. A narrative analysis was undertaken. Key issues: Issues relevant to the definition, measurement and improvement of safety culture, the impact of teamwork and communication on safety culture, the role of leaders and accountability are explored. Conclusion: The above themes inform our understanding of developing, measuring and sustaining safety culture in health care teams. However, further research is warranted to accurately understand how to measure and improve safety culture. Implications for nursing management: To support a safety culture, initiatives to facilitate effective communication between nurse practitioners and other health care professionals must be introduced. Nurse managers should adopt leadership strategies that will support nurses’ psychological safety and create a just culture.
Scopus© Citations 35 10 - PublicationThe importance of nurturing trusting relationships to embed shared decision-making during pregnancy and childbirth(Elsevier, 2021-07)Objective: To generate greater awareness of the contextual and relational factors that influence women's capacity to participate in shared decision-making during childbirth. Methods: A three-phase participatory action research approach involving in-depth interviews and co-operative inquiry meetings. Setting: Dublin, Ireland in a large maternity hospital. Participants: Five postnatal women who gave birth to live healthy babies, and attended obstetric or midwifery-led care and 13 practising midwives. Findings: This paper presents the findings from the third phase of a three-phase action research study exploring the action's women consider necessary to embed informed choice, into practice. The findings reveal that multiple organisational and relational factors influence how women can participate in shared decision-making including the model of care they attended, continuity of carer, power dynamics, hospital policies and trust in self and others. Women's relationships with maternity care professionals reveals that exercising choice is not only defined by but contingent on the degree of trust in their relationships with maternity care professionals.
10Scopus© Citations 40 - PublicationNarratives of a Pandemic: An Innovation in Facilitating CTG Workshop in the Virtual Space(2021-03-11)The Covid-19 pandemic propelled midwifery education into the virtual space, providing a unique opportunity to explore and create innovative solutions for virtual teaching.
8 - PublicationFirst Postnatal visit: views of Irish mothers and public health nurses of quality of care provided(2016-09-20)The role of public health nurses (PHNs) supporting parents and infants is acknowledged nationally and internationally. The first postnatal visit is recognised as the most important contact a PHN has with a mother and baby. The purpose of this visit is the promotion of optimal social, physical and emotional health and wellbeing including; neonatal care needs of the baby, postnatal care needs of the mother and establishment of a foundation for ongoing relationship building. International evidence suggests a lack of consensus for this visit as priorities for mothers and nurses may differ; it is important to explore quality of care provided amongst services users and nurses.
8 - PublicationDoing qualitative research on dementia with family caregivers in Kenya: A reflection on fieldwork experiences(International Institute on Ageing, 2020-11-11)In this paper, I present reflections on a self-funded study that explored the experiences of caring for people with dementia (PWD) in Kenya. I use an autoethnographic approach to examine and discuss some key issues that emerged during the planning and fieldwork phases of the study. This approach entails auto- reflection and the analysis of each part of the research experience. This paper does not report on the study's findings but provides an understanding of the difficulties encountered while researching in Kenya on a topic which is little understood. The paper begins with a background to the study, followed by the motivation of conducting the research. I then discuss the critical issues encountered during the various phases of the project. These included i) difficulties securing funding for the project, ii) challenges recruiting participants and iii) the lack of emotional support for the researcher during this process. The paper also offers suggestions on strategies that could benefit researchers seeking to study a similar problem in this context.
9 - PublicationA meta-synthesis of the perspectives and experiences of healthcare professionals on the humanisation of childbirth using a meta-ethnographic approach(Centre for Reviews and Dissemination, University of York, 2020-04-01)Problem: The humanisation of childbirth has been identified as a practice of care focusing on the physical, psychological, and emotional wellbeing of women. Healthcare professionals (HCPs) are expected to understand and embed humanised practice when supporting women in childbirth. Aim: The aim of this paper is to present a meta-synthesis of the experiences and perspectives of HCPs regarding the humanisation of childbirth. Methods: A systematic search of the electronic databases CINAHL, Medline, PsychINFO, and SocINDEX were conducted in July 2020. Qualitative studies exploring HCPs’ experiences of humanisation in childbirth were eligible. Studies were synthesised using a meta-ethnographic approach. Findings: Fourteen studies involving 197 participants were included. Two third order interpretations were developed: ‘Women at the centre’ and ‘Professional Dissonance’. Two line of argument synthesis were identified: ‘invisible boundaries’ and ‘unconscious undermining’. Discussion: HCPs recognised that women required positive interactions which met both their emotional and physical needs. Human touch supported bonding between HCPs and women. HCPs understood humanisation as the reduction of unnecessary intervention and/or technology but had difficulties enacting this and often used disempowering language when discussing women’s choices. The management of pain and the presence of a companion were considered important by HCPs. Conclusion: This synthesis revealed that HCPs do understand the humanisation of childbirth but have difficulties in enacting it in practice. Women classified as high risk were identified as having specific needs such as increased emotional support. Further research is required for women classified as high risk who may require technology and/or interventions to maintain a safe birth.
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