Now showing 1 - 10 of 19
  • Publication
    Enhancing older people’s activity and participation with socially assistive robots: a multicentre quasi-experimental study using the ICF framework
    (Taylor & Francis, 2018-10-14) ; ;
    Socially assistive robots (SARs) are seen as part of a pragmatic solution to addressing the increasing demands, shortage of care workers and to realizing the potential of optimum integrated care. Yet their effectiveness and impact on older people’s care, activities and participation are still unknown. A total of 67 people aged 65 and over participated in a 24-week-long, quasi-experimental study in five residential nursing homes in Japan. The personalized care plan and targets were created based on the framework of the WHO’s International Classification of Function, Disability and Health (ICF). Three types of socially assistive robots were used. The participants in the robot intervention groups showed greater improvements in their scores for targeted activities and participation than the control group. Statistically significant improvements were observed in communication, self care, and social life. SARs have great potential for improving older people’s quality of life. With further research, the use of these robots by older people could be considered as a serious option in the future. In addition, the ICF framework can be utilized further for measuring the effects of introducing SARs on older people’s quality of life.
      454Scopus© Citations 20
  • Publication
    Scottish Devolution: A Slippery Path towards Consensus Democracy?
    (International Center for Comparative Law and Politics, Graduate School of Law and Politics, University of Tokyo, 2002)
    The aim of this paper is to show how constitutional change has come to realisation in Britain by focusing on Scottish devolution and also to point out that, in spite of many changes occurring in the British party system and structures, as well as regional government framework, the British political system will not alter until consensus on majoritarian decision-making is further eroded. This paper is divided into three parts: the first part will discuss the merits and demerits of consensus democracy. The second part will examine the progress of Scottish devolution historically and critically review conventional hypotheses about devolution. The last part will highlight one of these hypotheses that focuses on social cleavage and party system change in Britain in order to elucidate the constitutional constraint the British political system has on a much stronger impact on reforms. In this paper, Scottish devolution is focused on because it sheds light on a process of how the majoritarian system operates and has led to a constitutional change, primarily by the active roles played by the two major parties. Scottish devolution and yet unaccomplished electoral reforms for parliament in Westminster are in sharp contrast. Both arguments for fairer representation and more direct democracy started to come to political fore in the 1960s and only the latter has been seriously taken up by the Labour party, since post-war consensus1 between Conservative and Labour party about constitutional frameworks and economic management was broken down in the late 1970s and only when the party got back to power in 1997, devolution scheme was eventually implemented. It has taken almost twenty years to fulfill this goal. However, this still does not automatically result in consolidating the way towards consensus democracy. In conclusion, Britain still constitutes the majoritarian model even today, although there is some scope for change.
  • Publication
    The attitudes and awareness of London based emergency department physicians towards the management of common dentofacial emergencies
    Background Dentofacial emergencies which are a common presentation to the emergency department (ED) and there is little data on how they are managed by non-dentally trained clinicians in the ED. Aims: To investigate the attitudes and awareness of ED physicians towards four common aspects of dentofacial emergencies and to explore potential barriers ED physicians may face in treating these emergencies. Methods A questionnaire survey involving 103 ED physicians largely from around the London region was employed. Results: The cohort included ED consultants (n=33), ED registrars (n=33) and ED juniors (n=37). 76.5% reported as not having any formal training in managing these emergencies. The study found that the percentage of participants who were confident in managing dental trauma was 20.4%, major facial trauma (40.6%), interpreting facial x-rays (69.3%) and facial suturing (86.3%). A subgroup of the cohort (n=58) were questioned on who they felt should manage maxillofacial and dental emergencies. 51.7% felt that dentists should manage dental emergencies and 67.2% thought that maxillofacial surgeons should manage maxillofacial emergencies in the ED. Only 12.1% and 22.4% felt that ED doctors should treat dental emergencies and maxillofacial emergencies respectively. When asked who they would like to be treated by in the event they presented to the ED with a traumatic dental injury (n=102) only 3.9% favoured ED as treating speciality compared to 23.5% treatment by a dentist and 72.5% by a maxillofacial surgeon. None of the participants opted treatment by an ENP. Discussion: Although based on a limited study sample the data suggests that ED doctors do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. Furthermore the confidence level reported may not reflect actual competence and there is a need for greater awareness, validated guidelines and training resources for ED clinicians to treat dentofacial emergencies as well more research in this field of emergency medicine.
      546Scopus© Citations 56
  • Publication
    Mission Completed? Changing Visibility of Women's Colleges in England and Japan and Their Roles in Promoting Gender Equality in Science
    The global community, from UNESCO to NGOs, is committed to promoting the status of women in science, engineering and technology, despite long-held prejudices and the lack of role models. Previously, when equality was not firmly established as a key issue on international or national agendas, women’s colleges played a great role in mentoring female scientists. However, now that a concerted effort has been made by governments, the academic community and the private sector to give women equal opportunities, the raison d’être of women’s universities seems to have become lost. This paper argues otherwise, by demonstrating that women’s universities in Japan became beneficiaries of government initiatives since the early 2000s to reverse the low ratio of women in scientific research. The paper underscores the importance of the reputation of women’s universities embedded in their institutional foundations, by explaining how female scientific communities take shape in different national contexts. England, as a primary example of a neoliberal welfare regime, with its strong emphasis on equality and diversity, promoted its gender equality policy under the auspices of the Department of Trade and Industry. By contrast, with a strong emphasis on family values and the male-breadwinner model, the Japanese government carefully treated the goal of supporting female scientists from the perspective of the equal participation of both men and women rather than that of equality. Following this trend, rather contradictorily, women’s universities, with their tradition of fostering a ‘good wife, wise mother image, began to be highlighted as potential gender-free institutions that provided role models and mentoring female scientists. By drawing on the cases of England and Japan, this paper demonstrates how the idea of equality can be framed differently, according to wider institutional contexts, and how this idea impacts on gender policies.
      946Scopus© Citations 12
  • Publication
    What are the mechanisms that enable the reciprocal involvement of seldom heard groups in health and social care research? A rapid realist review protocol
    Background: The University College Dublin (UCD) PPI Ignite Connect Network will fundamentally embed public and patient involvement (PPI) in health-related research, education and training, professional practice and administration in UCD’s institutional structures and procedures. A significant focus of the programme of work is on actively engaging and developing long-term reciprocal relationships with seldom heard groups, via our ten inaugural partners. Methods: This rapid realist review will explore what are the mechanisms that are important in actively engaging seldom heard groups in health and social care research. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions, and (5) disseminate findings. The reviewers will consult with expert and reference panels to focus the review, provide local contextual insights and develop a programme theory consisting of context–mechanism–outcome configurations. The expert panel will oversee the review process and agree, via consensus, the final programme theory. Review findings will follow the adopted RAMESES guideline and will be disseminated via a report, presentations and peer-reviewed publication. Discussion: The review will update and consolidate evidence on the mechanisms that enable the reciprocal engagement and participation of ‘seldom heard’ groups in health and social care research. Via the expert and reference process, we will draw from a sizeable body of published and unpublished research and grey literature. The local contextual insights provided will aid the development of our programme theories. This new evidence will inform the design and development of the UCD PPI Ignite program focused on ensuring sustained reciprocal partnerships.
  • Publication
    Non-Technical Skills (NTS) for enhancing patient safety: achievements and future directions
    (Japanese Society for Quality and Safety in Healthcare, 2012-11) ; ; ;
    Problems in team communication and decision making have been implicated in accidents in high risk industries such as aviation, off shore oil processing, nuclear power generation. Recognition of the role that breakdowns in communication and teamwork play in patient safety incidents has led to a plethora of studies in the area of what has come to be widely known as non-technical skills (NTS); a term initially used in European aviation (1). This has led to increasing interest in identifying, assessing, training and measuring non-technical skills. Nontechnical skills are defined as the cognitive and social skills that complement workers’ technical skills (1). Technical skills are the procedural and clinical skills that healthcare professionals apply when diagnosing, monitoring and treating patients. Non-technical skills refer to the general cognitive and social skills that allow them to, among other things, monitor the situation, make decisions, take a leadership role, communicate and co-ordinate their actions within a team, in order to achieve high levels of safety and efficiency.
  • Publication
    Adult Safeguarding Legislation and Policy Rapid Realist Literature Review
    The investigation of, and intervention into the alleged abuse of older people has become a dominant feature of social work in Ireland. The international definition of elder mistreatment adopted in most western countries including Ireland, is: ‘Elder abuse is a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm to an older person’ (WHO, 2008; WHO/INPEA, 2002). Operationalising this abstract definition is to describe types or categories of abuse that older people can be subjected to - physical, sexual, psychological, financial and neglect. Although valuable, the limitations of these narrow and mutually exclusive categories are increasingly recognised (Anand et al., 2013; O’Brien et al., 2011; Naughton et al., 2012). There is a major lack of understanding of the voice and experiences of older people in relation to abuse (Anand et al., 2013; Charpentier and Souliéres, 2013; WHO, 2002b). Irish research has demonstrated that older people conceptualise elder abuse as the loss of voice and agency, diminishing status in society, violation of rights and wider societal influences that undermine a sense of individualism and ‘personhood’ (O’Brien et al., 2011; Naughton et al., 2013).
  • Publication
    Professional practice following regulatory change: An evaluation using principles of “Better Regulation”
    (Elsevier, 2020-02) ;
    Background: The provisions in place internationally to regulate the practice of healthcare professionals have undergone significant change. However, this changing regulatory environment as experienced by healthcare professionals in the practice setting has not to date been widely researched. Objective: To describe the “lived experience” of pharmacists in community practice in Ireland of the model of regulation introduced by the Pharmacy Act 2007 and their perception of it as fulfilling the seven principles of “better regulation”: Necessity; Effectiveness/Targeted; Proportionality; Transparency; Accountability; Consistency and Agility. Method: 20 community pharmacists purposively selected, shared their lived experiences of the Act, as implemented in a semi-structured interview. A qualitative content analysis incorporating a framework analysis based on the seven principles of better regulation was used to analyze the data. Results: The Act and its implementation by the Pharmaceutical Society of Ireland (PSI) was not perceived by community pharmacists overall as fulfilling the principles of better regulation. While there was agreement that the Act was necessary, its implementation by the PSI was not viewed as being effective, targeted, proportional and consistent. The PSI was considered to act as a deterrence regulator that is not adequately transparent or accountable. The Act is not sufficiently agile to respond to changes in pharmacy practice. Conclusion: Community pharmacists acknowledge the need for the Pharmacy Act but perceive that the PSI needs to adopt a more responsive approach to implementation if the Act is to be considered a model of better regulation. The study findings are of interest as there is little published research on how regulation is experienced by healthcare professionals who are subject to its provisions. The principles of better regulation provide an effective qualitative methodology to examine models of professional regulation based on the “lived experience” of regulatees.
      202Scopus© Citations 5
  • Publication
    Home-care Professionals’ Ethical Perceptions of the Development and Use of Home-care Robots for Older Adults in Japan
    Because of the workforce shortage in Japan, the use of home-care robots, or carebots, is increasingly perceived as a realistic option. Developing and implementing these carebots requires careful consideration of the ethical implications for all types of users. Few studies, however, have addressed the ethical principles and concepts involved in carebot use, and consequently, the discussion regarding roboethics in the home-care environment has been inadequate. This questionnaire study explored the relationship between the willingness of home-care professionals to use carebots, their experiences with robots, and their ethical perceptions. The principal factors affecting home-care staff perceptions were perceived benefit, use of personal information, the protection of privacy, and perceptions of risk. While perceived benefit was the common predictor affecting home-care staff willingness to use a robot for the care of all user types, concerns regarding the use of personal information were more prominent for older people.
      696Scopus© Citations 19
  • Publication
    Learning from patient safety incidents in incident review meetings: Organisational factors and indicators of analytic process effectiveness
    Learning from patient safety incidents is difficult; information is often incomplete, and it is not clear which incidents are preventable or which intervention strategies are optimal. Effective group processes are vital for learning but few studies in healthcare have examined in depth the processes involved and whether they are effective. The aims of this study were to identify factors that facilitated and hindered the process of analysing incidents in teams and to develop and apply a framework of indicators of effective analytic processes. Incident review meetings in acute care and mental health care were observed. Full field notes were analysed thematically. A framework of process measures was developed and used to rate each meeting using the field notes. Reliability was analysed. Factors hindering analysis were lack of organisational support, high workload and a managerial, autocratic leadership style. Facilitating factors were participatory interactions and strong safety leadership. Process measures showed deficits in critiquing the causes of incidents, seeking further information, critiquing potential solutions and solving problems that crossed organisational boundaries, supporting observational data on the importance of effective leadership. Organisational legitimacy, administrative support, training, tools for incident analysis, effective well trained leaders who empower the team and sufficient resources to manage the high workload were all identified in this study as necessary changes to improve learning. Future studies could develop and validate the proposed framework of process indicators to provide a tool for teams to use as an aid to improve the analysis of incidents.
      374Scopus© Citations 28