Case Of Ireland Research Articles

Medical indemnity knowledge and awareness among international medical graduates in Ireland.

Medical indemnity (MI) has become an important topic in the era of increasing number of medico-legal cases in Ireland. However, there is a sensible difference in understanding and usage of medical indemnity between Irish and international medical graduates. This study aimed to investigate the knowledge and awareness of medical indemnity among international medical graduates in Ireland. This was a descriptive study with an anonymous online survey including 19 questions about various aspects of MI. Analysis of the data was done using Microsoft Excel statistical analysis pack. One hundred eighty-six doctors participated in the study, 34 (18.2%) consultants, 74 (39.8%) registrars, 72 (38.7%) Senior House Officers (SHOs) and 6 (3.2%) General Practitioners (GPs). Their knowledge and insurance coverage were deficient before working in Ireland. The majority did not have any educational session about clinical indemnity insurance when starting work in Ireland. While most consultants (88.2%) had supplemental MI (SMI) at the time of the study, only 41.9% of registrars and 38.9% of SHOs had SMI. In addition, there was a difference between consultants and Non-consultant Hospital Doctors (NCHDs) involvement in medico-legal cases. 32.2% of consultants were involved in medico-legal cases compared to 19% of registrars and 18% of SHOs. There is a need to address clinical indemnity and supplemental clinical indemnity topics on induction days for international medical graduates working in Ireland, including clear information about professional protection arrangements with refresher meetings every six months especially during rotational placements.

Challenges of the public health response to a rare case of non-autochthonous Mycobacterium leprae, Ireland, 2024.

This case report details the public health response to a multibacillary leprosy case in Ireland. The case presented with hypopigmented skin lesions and neurological symptoms. Challenges included delayed recognition in the clinical setting, contact tracing within a congregate setting and lack of specific Irish guidelines. Comprehensive contact tracing, chemoprophylaxis and follow-up care were implemented, guided by international protocols. This case underscores the need for tailored guidelines and stigma mitigation strategies for this neglected tropical disease in non-endemic regions.

Reduced urgency, fewer options? How the EU influences kin-state politics in contemporary Europe

ABSTRACT Despite centuries of shifting borders, European nations and states still do not perfectly align. Where they do not align, how the kin-state can aid ethnic kin in neighbouring countries may become a fraught issue in party competition. However, we know little about how the EU influences party uses of these kin-state appeals, despite their persistence over time and after EU accession. Using qualitative process tracing for the most different cases of Ireland and Hungary, I find that a country’s deeper relationship with the EU reduces the saliency and intensity of kin-state appeals, although this is contingent on the relevant neighbouring countries also being EU members. This is because proximity to EU membership reduces voter demand for urgent ‘solutions’ to the ethnic kin issue and policy discretion in implementing these solutions.

Private equity involvement in primary care: the case of Ireland.

Private equity (PE) firms play an increasingly important role in healthcare. Yet, existing research remains uneven, mostly focused on the United States and on certain sectors such as nursing homes. Some geographical areas and health specialties remain under-explored. This brief paper outlines a research agenda focusing on three key issues: (1) PE's significance and (2) business strategies in healthcare, and (3) PE's impacts on health and healthcare. The paper uses primary care in Ireland as an example. The proposed research agenda should improve our understanding of the nature of PE in healthcare and serve as a basis for policy-makers to explore appropriate and effective regulation of PE to reduce its negative impacts if and when they exist.

Contesting Power-Sharing? LGBTQ+ Activism and the Sexual Citizenship of Consociationalism

Notwithstanding valuable contributions, the relationship between power-sharing and sexuality remains undertheorized. This paper asks if consociationalism can be seen as a form of sexual citizenship, whereby rights are granted or denied based on sexuality. The question is applied to the case of Northern Ireland, through a review of the extant scholarship, analysis of the consociational institutions, and semi-structured interviews with LGBTQ+ activists and other relevant actors. The paper argues that power-sharing is not only exclusionary of LGBTQ+ rights, but fundamentally produces sexual citizenship, a system that demarcates the boundaries of inclusion into the state in terms of sexual orientation. Furthermore, its findings demonstrate creative, but also calculated agency by activists to navigate this ethnicized context in pursuit of rights.

A source and a destination country for migrant healthcare workers: the case of Ireland

Abstract Background Ireland has a long tradition of emigration, particularly to countries such as the United Kingdom and the USA. Since 2000, Ireland has become increasingly reliant upon migrant healthcare workers. At present, 43% of nurses and 45% of physicians registered in Ireland, trained internationally. Methods This study draws on literature and available data (migration and registration data) to illustrate recent patterns of healthcare worker migration into and out of Ireland. Results The data show that Ireland depends heavily on migrant healthcare workers to staff its health system. In 2021-22, internationally trained healthcare workers comprised 71% of new entrants to the medical register and 69% of new entrants to the nursing register. In terms of outward migration, the data also indicate a consistent pattern of outward migration of physicians to countries such as Australia, the United Kingdom, Canada, and New Zealand. Conclusions A heavy (and growing) reliance on migrant healthcare workers to staff the Irish health system implies a failure to train or retain sufficient healthcare workers locally and indicates weak healthcare workforce planning capacity. It also highlights a disconnect between Irish healthcare workforce planning and the WHO global code on the international recruitment of health personnel. This study will consider some of the risks associated with high rates of inward and outward healthcare worker migration in the Irish context.

A COVID question: the impact on our nursing home residents

COVID-19, a novel coronavirus which targets the respiratory system, has had a significant impact on Irish nursing homes. The virus was declared a global pandemic in March 2020, and as of 14th June the Health Protection Surveillance Centre has reported 258 clusters of cases in nursing homes, comprising 21% of all cases in Ireland and associated with 943 deaths. This pandemic is a source of many ethical dilemmas — an example being the ethical issues arising from enforced social isolation imposed on residents during lock-down. The cocooning of residents in nursing homes raises a question with no simple answer — does the risk this isolation poses to the wellbeing of elderly residents outweigh the benefits of such strict measures to protect them from COVID-19? The adverse effects of isolation, although relevant in any infectious outbreak, are compounded in this instance by the unprecedented scale of the coronavirus pandemic and the immense pressure on the healthcare system as it faces this new threat to health. Even in the chaos of a global pandemic, the ethical principles at the root of all healthcare decisions, namely non-maleficence, beneficence, autonomy, and justice remain pertinent.

Covid-19 as a lens to investigate local approaches to business and human rights: the case of Northern Ireland

Covid-19 as a lens to investigate local approaches to business and human rights: the case of Northern Ireland

The Europeanization of Wage Policy and Its Consequences for Labor Politics: The Case of Ireland

This article investigates the transnational labor politics associated with the Europeanization of wage policy, based on process tracing of Irish minimum wage regulation reforms over the past two decades. The policy struggle in Ireland started as an employer-led domestic challenge to market-embedding regulation and was then affected by two EU interventions on wage policy: one with a de-regulatory orientation (during EU-IMF conditionality) and one with a re-regulatory one (with the approval of the EU minimum wage directive). Findings show that differences in collective action undertaken by employers and trade unions to influence wage policy at the national level can be explained by the intersection of each actor’s preferences toward market-constraining or liberalizing labor regulation and their access to supranational (EU-level) institutions and support. This analysis contributes to debates on how transnational opportunity structures can alter labor’s and employers’ local power resources and strategies.

Clinical presentation, outcome and prognostic factors in dogs with immune-mediated haemolytic anaemia: a retrospective single-centre study of 104 cases in Ireland (2002–2020)

BackgroundImmune-mediated haemolytic anaemia (IMHA) has a high mortality rate within the first weeks to months of diagnosis. Identifying dogs at increased risk of death may help guide decision-making for owners and veterinarians. Prior studies have identified several but inconsistent prognostic factors. The objectives of the study were to describe the clinical presentation and outcome of canine immune-mediated haemolytic anaemia in Ireland and to assess for independent factors associated with survival including long-term survival. Medical records from a single centre were reviewed between 2002 and 2020 to identify dogs with immune-mediated haemolytic anaemia using the American College of Veterinary Internal Medicine (ACVIM) consensus statement algorithm. Survival analysis was performed using univariable Cox proportional hazards regression models with Breslow method for ties to identify prognostic factors.ResultsOne hundred and four cases were included. The diagnosis of immune-mediated haemolytic anaemia was classified as definitive, supportive and suspicious in 42 (40%), 50 (48%), and 12 dogs (12%) respectively. Twenty-two dogs (21%) were diagnosed with associative IMHA and 82 dogs were diagnosed with non-associative IMHA (79%). 65% of the cases received more than one immunosuppressive medication during the course of treatment. The mortality rate at one and three months was 16% (95% confidence interval [CI] 9–26) and 31% (95% CI 21–43) respectively. Excluding dogs that died within three months, the median survival time was 2664 days. The relapse rate during the follow-up period was 7%. Survival did not improve over the course of the study period. Thrombocytopenia and hyperbilirubinaemia were identified as negative prognostic indicators (Hazard ratio 2.2 and 2.5, 95% CI 1.1–4.1 and 1.1–5.6, respectively).ConclusionsExcluding dogs that died within three months, the outcome was good in dogs with non-associative immune-mediated haemolytic anaemia in Ireland. The relapse rate was low regardless of the presence of associative causes. Thrombocytopenia and hyperbilirubinaemia were the only independent negative prognostic factors. The one-month and three-month mortality rates were similar compared to prior studies and survival did not improve over time during the study period: the mortality rate of canine immune-mediated haemolytic anaemia remains high in the acute phase.

Trichophyton indotineae: first case in Ireland and response to topical griseofulvin.

To our knowledge, we report the first case of Trichophyton indotineae in Ireland, highlighting the pathogen’s resistance to conventional antifungal treatments and the necessity for advanced diagnostic techniques. Notably, the infection in our patient began to resolve when griseofulvin liquid was unintentionally used topically, suggesting an alternative treatment approach for this resistant dermatophyte.

Breaking the ‘culture of silence’: exploring therapist perspectives of culturally sensitive systemic psychotherapy in contested sociopolitical contexts – a Northern Ireland case study

Breaking the ‘culture of silence’: exploring therapist perspectives of culturally sensitive systemic psychotherapy in contested sociopolitical contexts – a Northern Ireland case study

How supply and demand affect national house prices: The case of Ireland

While many western economies experienced substantial fluctuations in house prices since the turning of the century, the Irish residential market stands out as a particular case. Irish house prices experienced profound increases in the period leading up to the global financial crisis (GFC); thereafter the concomitant downturn in both the real Irish economy and financial sector precipitated a dramatic decline in prices between 2007 and 2012. However, since 2012 prices have increased in a sustained and persistent manner. A number of possible reasons are commonly cited for the recovery. In this paper we avail of a new housing and financial sector model, which are part of a broader macro-econometric model, COSMO, of the Irish economy to characterise the determinants of Irish house prices over the period 1995–2019 and in particular to examine the reasons for the post 2012 recovery. The suite of models are used to examine the contribution of developments in both monetary policy and financial stability as well as the performance of the real economy. The role played by the sluggish response of the supply-side of the Irish residential sector is also assessed. The supply-side of the Irish market was especially impacted by the GFC and has struggled to respond to the surge in housing demand which has accompanied the general economic recovery since 2012. Our results have interesting implications for the growing literature examining the intersection of monetary policy and financial stability on house prices.

Harnessing Curtailed Wind-Generated Electricity via Electrical Water Heating Aggregation to Alleviate Energy Poverty: A Use Case in Ireland

Ireland experiences high energy poverty rates alongside surplus wind energy resources. With 77% of Irish households equipped with electrical immersion heaters for domestic hot water (DHW) generation, this study proposes an Electrical Water Heating Aggregation (EWHA) scheme. The scheme allocates surplus wind-generated electricity to provide DHW to fuel-poor households, thereby alleviating energy poverty through harnessing curtailed wind energy. Through a developed wind-generated electricity allocation model and half-hourly data analysis for a weather year, this research assesses the feasibility and economic viability of the EWHA scheme, focusing on the householder as the primary benefactor from the scheme (as opposed to ancillary grid service provision). The results suggest an optimal aggregation size where maximum curtailment and carbon offset coincide with maximum benefits for participants. The findings indicate that fuel-poor households in Ireland could receive a full DHW tank every three weeks using surplus wind energy, harnessing 89% of overnight curtailed wind energy and offsetting 33 MkgCO2 annually. Moreover, the scheme could potentially save the Irish state approximately EUR 4 million by 2030, increasing to EUR 11 million by 2050, in carbon costs. Overall, this research demonstrates the potential of EWHA schemes to alleviate energy poverty, optimise wind energy utilisation, and contribute significantly to carbon emission reduction targets.

Challenges of balanced development of regions in the context of centralisation, the case of Ireland

Challenges of balanced development of regions in the context of centralisation, the case of Ireland

Housing prices, costs, and policy: The housing supply equation in Ireland since 1970

AbstractThis article examines the responsiveness of new housing supply to prices and costs, using the case of Ireland at quarterly frequency from the 1970s, as well as a county‐level panel from the 1990s. Across four error‐correction specifications, and supported by an instrumental variables approach, we find the estimated elasticity of new housing supply to prices of +0.9 in the baseline, while that of costs is larger in magnitude (−1.9). We present evidence that responsiveness to prices rose after the 1980s, then fell in the 2000s, before rising again and also that elasticities vary at the county level.

Women Playwrights at the Crossroads: A Comparative Study of Ireland and Korea in the Mid-Twentieth Century

This paper examines plays by Irish and Korean women playwrights whose work is often neglected in their national canons and in the male-dominated theatre scene of the mid-twentieth century. The cases of Ireland and Korea overlap in compelling ways with discussions of modernity that are being reconstructed from the perspectives of colonial subjugation (under Britain and Japan) and wartime experience (in the Irish Civil War of 1922-23 and Korean War of 1950-53). There is a close relationship between these women writers’ marginalised place in their respective countries’ literary and theatrical scene and the process of Irish and Korean modernisation. The paper conducts a comparative analysis of works by Teresa Deevy, Kim Ja-rim, Maura Laverty and Jeon Ok-joo, highlighting the various thematic, political and formal strategies that these playwrights adopted at a time when their nations were ‘at the crossroads’. Against the grand narratives of ‘the nation’, women playwrights focused on depicting the aesthetics of daily life, emphasising aspects that had been neglected or marginalised in the discourse of modernity/coloniality. They dismantled clichés of dutiful wives and pacifist mothers, choosing instead to create complex and authentic depictions of femininity, endowing their female characters with a potent political voice in the public sphere. By reassessing their plays from a transnational feminist perspective, the paper seeks to expand feminist discourses in both Irish and Korean theatre history.

A geographical analysis of social enterprises: the case of Ireland

PurposeThis study aims to conduct a geographical analysis of the distribution and type of activities developed by social enterprises in rural and urban areas of Ireland.Design/methodology/approachThe study analyses data of more than 4,000 social enterprises against a six-tier rural/urban typology, using descriptive statistics and non-parametric tests to test six hypotheses.FindingsThe study shows a geographical rural–urban pattern in the distribution of social enterprises in Ireland, with a positive association between the remoteness of an area and the ratio of social enterprises, and a lack of capital-city effect related to the density of social enterprises. The analysis also shows a statistically significant geographical rural–urban pattern for the types of activities developed by social enterprises. The authors observe a positive association between the remoteness of the areas and the presence of social enterprises operating in the community and local development sector whereas the association is not significant for social enterprises developing welfare services.Research limitations/implicationsThe paper shows the potential of using recently developed rural–urban typologies and tools such as geographical information systems for conducting geographical research on social enterprises. The findings also have implications for informing spatially sensitive policymaking on social enterprises.Originality/valueThe merging of a large national data set of social enterprises with geographical tools and data at subregional level contributes to the methodological advancement of the field of social enterprises, providing tools and frameworks for a nuanced and spatially sensitive analysis of these organisations.

Defining a ‘Paris Test’ of national contribution to global climate mitigation: the Irish exemplar

Abstract It is commonplace to see political assertions that this or that national climate mitigation plan is “aligned” with the Paris Agreement. It is much less common to see this supported by transparent quantitative analysis, grounded in explicit provision for global climate justice. One interesting exception is the case of Ireland. In this Perspective, we briefly describe, and also critique, this exemplar case of a transparent national “Paris Test” of domestic mitigation ambition. We also comment on the opportunity for generalisation to other Paris Agreement Parties and consider critically what follows. We urge all good faith parties to the Agreement to adopt the genuinely emergency scale responses that are now so manifestly required to meet its laudable - but so far largely aspirational - objectives.


Multi-level governance and policy contestation: Ambiguity and conflict in the implementation of peatland conservation in Ireland

Biodiversity represents one of the most controversial areas of environmental governance. Objectives: Compliance with the EU regulatory framework is contained in the Habitats Directive (92/43/EEC) and in the designation of special areas of conservation which has prompted contestation in relationships between public authorities, farmers, and local landholders across all levels of governance. Methodology: Using Matland’s ambiguity-conflict model as a lens to view the implementation experience, the discussion uses official documentation and literature sources to explore Ireland’s compliance with EU biodiversity regulation with reference to peatlands. Results: This article uses the case of Ireland to explore inadequate implementation which led to prolonged legal proceedings culminating in an unfavourable judgement against the Irish state on 29th June 2023. In Case C-444/21 the Court of Justice of the European Union (CJEU) ruled that Ireland failed to fulfil its obligations under the directive, namely the appropriate designation of a Natura 2000 network of sites for important habitat and a protection regime for them. Central to Irish debates on the habitats directive is the protection of raised bogs which has resulted in considerable conflict, politicisation, and prolonged negotiations between peat-cutters and public authorities at national and local levels. Conclusions: The discussion highlights the difficulties in changing ingrained attitudes and practices for managing nature conservation in privately owned land and in securing collaborative engagement with stakeholders.