Service Execution Research Articles

Tracing Service Request Processing in Cloud

ABSTRACTNowadays, more and more IT services are being hosted on cloud systems, which render cloud systems to grow into a huge complex with millions of physical servers, multi‐layer software stacks and the processing of cloud service requests across many servers and software layers. It is highly demanded for cloud service providers to have the capability of getting the knowledge on cloud service behaviour directly from the service execution instead of from people's expertise. This paper studies the problem of tracing cloud service's processing of requests across components in cloud environments and proposes cloud tracing mechanisms for this purpose. We also developed model‐based studies of our proposed mechanisms for analysing certain designs of the mechanisms. The implementation of the proposed cloud tracing is deployed onto the environments of OpenStack, Kubernetes and Hadoop, and the experiments on these environments demonstrate that our mechanisms effectively trace cloud service behaviour and generate a single complete request execution path, while without our mechanisms the cloud tracing either fails to work or results in thousands of path segments. Our mechanisms have a low performance overhead (2.3%) in the experiments.

Addressing Age-Related Complexity in Intellectual Disability (AARC-ID): an economic analysis of different support models. Study protocol.

People with intellectual disability are living longer. While this is a positive development, it may mean living with age-related morbidities which require specialist care to meet needs. While most people with intellectual disability would prefer to remain living in their current homes, if extra supports are not available, they may experience a need to move into residential type settings such as nursing homes. This is usually related to current funding systems not being responsive to developing age-related needs of people with intellectual disability. For example, if a person had been living independently but they are developing mobility issues, there is often no extra budget for staff to assist them. This can result in the person having to move to a different setting to have their needs met. However, such a move may impact on quality of life, wellbeing and personal dignity. This study will build a picture of the future needs of people who are ageing with intellectual disability, what extra supports they require, and the costs of those supports. This will be completed using two secondary data sources– the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) and the National Ability Support System (NASS), as well as collecting primary qualitative data to understand perspectives and experiences. The overall aim of the study is to provide economic evidence on the needs, resources and outcomes associated with supporting people aged ≥40 with intellectual disability to age in place. Data from 15 years of IDS-TILDA, the NASS and Health Service Executive costing calculations are available. Using a variety of analytical methods, levels of support will be defined alongside potential economic and policy scenarios. This research will provide evidence to inform policy such that more people with intellectual disability can continue to age at home rather than enter nursing homes.

Eating disorders: clinical update.

Variation exists in our attitude and behaviour towards food and exercise, resulting in different degrees of health and ill health. Cultural and economic factors contribute to this, alongside personal choices, leading to a spectrum from normative eating, through disordered eating to the extremes of eating disorders (EDs). Understanding the intricate interplay between biological, psychological, and sociocultural factors to eating, exercise and body image is paramount to understand the current state regarding EDs and to deliver/develop multifaceted and individualised treatments. Significant service developments have occurred following the launch of the Irish Health Service Executive Model of Care for EDs in 2018. However, incomplete roll out and surge in EDs referrals post Covid-19 require generic child and adolescent mental health services (CAMHS) to be competent in assessment of EDs, and to keep abreast of clinical updates in order to offer effective treatment.This review provides an evidenced based update on eating related difficulties, outlines a useful assessment framework, offers information on appropriate clinical management, and highlights exciting clinically relevant research developments.

Informing Implementation of a National Integrated Clinical Pathway for Low Back Pain in Ireland: A Pre-Implementation Qualitative Study With General Practitioners.

Ireland's Health Service Executive is developing a new national integrated low back pain (LBP) pathway spanning primary and secondary care to improve LBP healthcare. Clinical pathways are frequently employed to optimise clinical outcomes and resource use but are challenging to implement. Context-specific implementation planning, leveraging implementation science and its conceptual frameworks, should inform successful implementation. To explore General Practitioner (GP) perceptions of the new LBP pathway, using their on-the-ground knowledge to assess barriers and facilitators to implementation with the goal of developing tailored implementation strategies. Qualitative data will be collected through semi-structured one-to-one interviews with a purposive sample of GPs. Data analysis will be guided by Framework Analysis with initial open coding followed by mapping to the domains and constructs of the Consolidated Framework for Implementation Science and Proctor's implementation outcomes of acceptability, appropriateness and feasibility. Potential implementation strategies will be devised from the identified determinants of implementation. System-wide changes and improvements in healthcare are difficult to accomplish. The rationale and design of a pre-implementation study with key stakeholders is outlined with the view of informing optimal implementation of Ireland's new national integrated LBP pathway in primary care settings.

Effectiveness of the Public Relations Role of the Palu Pratama Tax Service Office (KPP) in Increasing Public Awareness of Paying Taxes

The aim of this research is to describe the strategy of the Public Relations Role of the Palu Pratama Tax Service Office (KPP) in increasing public awareness of paying taxes. To describe the effectiveness of the Public Relations Role of the Palu Pratama Tax Service Office (KPP) in increasing public awareness of paying taxes. This type of research is descriptive qualitative, the subjects of this research are seven people consisting of two public relations officers in the executive service section, five taxpayers from the general public. The research method for collecting data is through observation, interviews and documentation. The analysis was carried out using 3 stages, namely data reduction, data presentation, and conclusions. The results of the research show that the strategies carried out by the Public Relations of the Pratama Palu Tax Service Office (KPP) in increasing public awareness of paying taxes are: 1) Operational strategy, carried out by the public relations of the Pratama Palu KPP, namely tax corners in four strategic locations in the city of Palu. 2.) Persuasive and educational strategy, namely the use of the sipabeta application to make it easier to manage property taxes. 3.) Collaboration strategy, KPP Pratama Palu public relations collaborates with the Regional Financial and Asset Processing Agency (BPKAD) of Palu city in socializing taxation. The effectiveness of the public relations role of KPP Pratama Palu in increasing public awareness of paying taxes: 1) As a communicator, conducting outreach with the public about the importance of paying taxes. 2) as an image maker, socialize the sipabeta system to make it easier for people to pay property taxes. 3) as a Conceptor, conveying information and educational activities to the community. 4) As a Problem Solver, plays a role in resolving problems in public communication, tax service complaints.

The Australian clinical trial landscape: Perceptions of rural, regional and remote health service capacity and capability

BackgroundAccess to clinical trials is limited for rural, regional and remote Australians, adding to the current health inequity between rural and metropolitan populations. The Australasian Teletrial Model was developed to bring clinical trials “closer to home”. In 2020, the Australian Teletrial Program was funded to expand and support the uptake of the model across six Australian states and territories. The aim of this study was to explore and describe the clinical trial landscape in Australia prior to the implementation of the Australian Teletrial Program with a particular focus on rural, regional and remote health services.MethodsThis qualitative study provides a descriptive exploration of the clinical trial landscape across rural, regional and remote Australia. Data were obtained from semi-structured interviews (n = 33) and one focus group (n = 5) involving clinical trial stakeholders between August 2022 and May 2023. Deductive then inductive thematic analysis used the broad topic areas of the interview schedule as a framework, as follows: education and training, workforce, equipment and services, clinical trial sites, participant recruitment and clinical trial approval process.ResultsThis study identified barriers that are generalizable to the Australian clinical trial landscape and those specific to the rural, regional and remote health service context. The main barriers to conducting clinical trials in rural, regional and remote areas were lack of investment and engagement on the part of health service executives, workforce limitations, inconsistent training, lack of physical infrastructure and competing clinical priorities. Despite these challenges, clinicians reported enthusiasm for conducting clinical trials, and opportunities were reported for these health services to partner with larger metropolitan/regional health services, regional universities and communities to support the growth of clinical trial capability and capacity.ConclusionsThe clinical trial landscape in Australian health services varies in terms of quality and availability of training, workforce capacity, executive support, site capability and approval processes. The Australian Teletrial Program has an immense opportunity to overcome some of the reported challenges by supporting capacity and capability building. Ultimately, however, sustainable reform to bring trials closer to home requires a collaborative approach that considers implementation strategies across all levels of the health service and government, alongside other initiatives.

Characteristics of participants in the first fully online National Diabetes Prevention Programme: A quantitative survey

Background Diabetes prevention programmes (DPPs) are being implemented around the world to tackle the rise in type 2 diabetes. In 2021/22, the Health Service Executive(HSE) in Ireland piloted a fully online national diabetes prevention programme(NDPP). Characteristics and factors affecting participation may be different among people attending online DPPs compared to face-to-face programmes. The aim of this study was to describe the demographic, psychosocial and health characteristics of participants in the pilot of the online NDPP in Ireland. Methods A survey from the evaluation of the English NDPP was adapted for the Irish context with Patient and Public Involvement (PPI) input. The survey was sent (between April and June 2022) to all individuals who attended the initial assessment of the pilot NDPP (n=73). It contained questions on health status, co-morbidities, motivation to improve health, quality of life, self-efficacy, beliefs about the risk of diabetes, participation(e.g. recollection and understanding of invite, number of sessions attended), as well as demographic information. Results Response rate was 30.5% (n=22). Mean age of responders was 62 years (range 36–82 years) and over half were men (57.1%, n=12). The majority (81%, n=17) had attended 6 or more of the 14 sessions. Most (90.5% n=19) reported having family members or acquaintances with diabetes, had positive views of their current health status and high quality of life scores (71.4%, n= 15). Mental health scores were slightly higher than the national average. Over half (57.2%, n=12) were confident or very confident about participating in an online DPP. Almost all (95.2%, n=20) believed it was important to manage their risk of type 2 diabetes. Conclusions Participants in the online pilot NDPP had positive views of their general health and positive psychosocial characteristics affecting their decision to participate. These beliefs may be modifiable intervention targets to encourage participation among non-attenders in future programmes.

The discretionary powers of the court regarding the application of judicial control over the execution of court decisions in civil cases

It was established that the concept of discretionary powers of the court regarding the application of judicial control over the execution of court decisions in civil cases should be understood as such powers when, within the limits defined by law, the court that issued a decision in a civil case that is subject to execution has the opportunity independently (on own discretion) to choose one of several options for a specific lawful decision regarding the activities of the public or private executor to whom such execution is entrusted, regarding his actions or inaction, on the basis of a complaint filed by a party to the enforcement proceedings. In turn, the parties to enforcement proceedings have the right to appeal to the court with a complaint if they believe that their rights or freedoms have been violated by the decision, action or inaction of the state executive or private executive during the execution of the court decision. This provides an opportunity to intervene at one’s own discretion (judicial discretion) within the limits of the powers of the state executor or private executor. The complaint is considered within a ten-day period in a court session with the participation of the debt collector, the debtor and the state executor or other official of the state executive service body or private executor whose decision, action or inaction is contested. However, when applying judicial discretion when applying this or that rule of law during judicial control, the judge must focus on achieving the goals and objectives of civil proceedings, as well as executive proceedings. Discretionary powers should not be used arbitrarily, and the court should control the decisions made on the basis of the exercise of discretionary powers as effectively as possible. At the same time, the powers of a judge must fulfill both the tasks set before a specific court (judge) during the administration of justice (correct and timely consideration and resolution of cases, fair judicial consideration of cases by an independent and impartial court), and the tasks set by the domestic legislator before the entire judiciary by the authorities (execution of justice), as well as tasks of the international level (guaranteeing and implementing the principle of access to justice and the principle of fair trial.

ВИКРИВАЧІ ЯК ІНСТРУМЕНТ ПРОТИДІЇ КАТУВАННЯМ У ПЕНІТЕНЦІАРНІЙ СИСТЕМІ: АНАЛІЗ ПРАВОВИХ МЕХАНІЗМІВ І ВИКЛИКІВ

The article analyzes the legal mechanisms which regulate the possibility of introducing the institution of whistleblowers in the field of combating torture and other ill-treatment into the national penitentiary system. The author’s defines the institution of “whistleblower” as a natural person with legal capacity who, having proper, reliable information, on the basis of confidentiality, has reported the facts of torture, cruel, inhuman or degrading treatment or punishment, or other criminal offenses against health, committed by another person, if such information became known to him/her in connection with his/her economic, public, scientific, professional or labor activity in the law enforcement sphere, service or training, or his/her direct participation in the procedures provided for by law that are mandatory for the commencement of such activity, service or training. The author’s identifies the current challenges that lead to the introduction of the institution of whistleblowers in the penitentiary system in the field of combating torture and other types of ill-treatment, namely Inadequate conditions of detention of prisoners and convicts held in pre-trial detention centers and penitentiary institutions of the State Criminal Executive Service of Ukraine; failure to provide timely and adequate medical care to prisoners and convicts held in pre-trial detention centers and penal institutions of the State Criminal Executive Service of Ukraine; the existence of facts of “mutual responsibility” or silence regarding torture and other types of ill-treatment in the penitentiary system; insufficient effectiveness of the existing system of counteracting torture and other ill-treatment in the penitentiary system; insufficient effectiveness of investigations and mechanisms for documenting the facts of torture and other ill-treatment in the penitentiary system, avoidance of responsibility by officials and obstruction of fair justice; lack of reliable data on the facts of torture and other ill-treatment in the penitentiary system, the latency of this group of criminal offenses, which leads to silence of this problem in society and failure to take measures for its successful prompt resolution; lack of an effective dual (internal and external) system of regular penitentiary inspections and monitoring; lack of real compensation for victims of torture and other ill-treatment in the penitentiary system. Keywords: whistleblower, counteraction, torture, cruel, inhuman or degrading treatment, punishment, legislation, Ministry of Justice of Ukraine, convict, prisoner, staff, penitentiary system, penal authority, penal institution, State Criminal Executive Service of Ukraine.

Digital twin-driven cloud manufacturing system: an implementation framework, operating mechanism and key technologies

ABSTRACT Cloud manufacturing (CMfg), as a manufacturing mode to realize resource collaboration and service sharing, can help enterprises reduce costs, increase efficiency and enhance competitiveness. Existing CMfg relies on historical service evaluation results as the basis for task matching and thus lacks effective methods for the precise assessment of the adaptability to current tasks and the sustainability for future endeavors; throughout the service process, deficiencies occur including a lack of real-time assessment, prediction, and optimization capabilities for service execution outcomes. Motivated by the shortcomings of existing CMfg, this article focuses on how to enhance the dynamism and timeliness of the CMfg service process. A novel digital twin (DT)-driven CMfg service model is proposed. Specifically, a framework and an operation mechanism of DT-driven CMfg service are proposed; three key technologies related to DT in CMfg service are proposed, including model migration based matching modeling technology, multi-agent reinforcement learning based CMfg service composition optimization, and DT data-driven CMfg service performance prediction, which provide a theory and method for the DT and CMfg integration construction. The experiment demonstrates that the proposed methods have good performance for the production of cast aluminum engine fan bracket and provide a holistic understanding of DT in CMfg service.

The Employee Performance Management of the Regional Technical Implementation Unit (UPTD) of the Animal Health and Veterinary Public Health Center of Seruyan Regency in Improving Public Services.

This research aims to analyze the quality of animal health service management at the Regional Technical Implementation Unit (UPTD) Animal Health Center of Seruyan Regency using the POAC (Planning, Organizing, Actuating, Controlling) management approach. Conducted from June 1 to September 1, 2024, this study employs a qualitative method with descriptive analysis. Data were collected through literature reviews, direct observations, and interviews with staff and management involved in the service delivery process. The findings reveal that the service planning at the UPTD Animal Health Center and Veterinary Public Health has not effectively engaged farmers, which has resulted in a disconnect between the programs offered and the actual needs of the farming community. Although the internal organization of the center is assessed as practical, the accessibility of services for farmers residing in remote areas remains a significant concern that requires attention. The execution of veterinary health services showcases the competence and skills of health workers. However, there are notable deficiencies in communication and the availability of information that hinder effective service delivery. Furthermore, the existing control system does not adequately accommodate user feedback, highlighting an urgent need for enhanced communication channels. Overall, this research aims to provide actionable recommendations to improve the quality of veterinary health services in Seruyan Regency, ultimately fostering a more responsive and user-centered service environment. The insights gained from this study will contribute to the ongoing efforts to align veterinary health services with the community's needs, ensuring better health outcomes for livestock and the farming population.

НАВЧАЛЬНА ДИСЦИПЛІНА «ЗАГАЛЬНЕ І СПЕЦІАЛЬНЕ ДІЛОВОДСТВО» У ПРОФЕСІЙНІЙ ПІДГОТОВЦІ МАЙБУТНІХ ФАХІВЦІВ-ПЕНІТЕНЦІАРІЇВ

The article characterizes the peculiarities of teaching the educational discipline “General and special office management” in the context of professional training of future penitentiary specialists in higher education institutions. It is substantiated that the academic discipline “General and special office management” plays an important role in the professional training of future specialists of the State Criminal Executive Service of Ukraine, because it involves the formation of a system of theoretical knowledge, practical skills and skills to work with documents specific to each of the management functions, as well as for certain fields of activity, in particular, familiarization with the theoretical and practical issues of documentation and the rules of organization of record keeping in institutions of the criminal executive service. As a result of mastering this educational discipline, students (cadets) should develop skills and abilities related to compiling, proofreading, accounting (registration), sorting, storing, searching, processing information stored in documents, as well as copying, information transfer, document transportation inside and outside the management apparatus of an institution or organization. It has been proven that the effectiveness of mastering an educational discipline depends on the teacher’s selection of educational material, the planning and implementation of independent work by students of higher education, as well as their preparation for practical classes. The content of the lecture course is characterized, the relationships between lectures and practical classes are determined. The conditions for successful mastering by future penitentiary specialists of the educational course “General and special office management” are substantiated, in particular, the need for systematic, consistent work throughout the entire academic semester, the formation of analytical skills for working with literature, and thorough preparation for the semester exam are substantiated. It has been proven that the effectiveness of the performance of the criminal-executive service specialists in the future of their official duties, the pace of their career growth, and the intensity of professional and personal development depend in some places on the development of the skills of working with documentation. Key words: academic discipline, professional training, higher education students, lecture, independent work, future specialists, criminal-executive service.

Problems of enforcement of court decisions during martial law

The article examines the introduction of martial law in Ukraine, which significantly changed the situation, in particular, in the system of forced execution of court orders, decisions, resolutions, etc. It has been analyzed that enforcement of executive letters, orders, court decisions and resolutions, notary inscriptions is carried out by bodies of the State Executive Service of Ukraine and private executors. It is noted that during the period of martial law, two main legislative acts were adopted, which changed the procedure for introducing executive proceedings. For example, the Law of Ukraine «On Amendments to Chapter XIII «Final and Transitional Provisions» of the Law of Ukraine «On Enforcement Proceedings» dated March 15, 2022 No. 2129-IX and the Law of Ukraine «On Amendments to Certain Laws of Ukraine Regarding Enforcement Activities court decisions, decisions of other bodies and officials during the period of martial law» dated 04/11/2023. It was found that the system of enforcement of court decisions of state bodies, legal entities, and individuals is important for ensuring the implementation of state functions related to the restoration and protection of violated rights. Also, the fact that there are many problematic situations that need to be resolved, for example: technical problems and shortcomings of the system or registers, a more favorable position of debtors than collectors, narrowing of the actions of public and private executors and their remuneration. The enforcement institution underwent changes, but they were temporary and helped to keep our country afloat during martial law. During the period of martial law, court decisions, orders, decrees, orders and resolutions must be implemented and their implementation must be ensured by public and private executors. For the high-quality and effective exercise of their powers, persons and bodies that carry out the enforcement of decisions have administrative powers, in turn, they provide for the possibility of subordinating certain subjects and comply with mandatory prescriptions or orders.

NARA: Network-Aware Resource Allocation mechanism for minimizing quality-of-service impact while dealing with energy consumption in volunteer networks

A large-scale volunteer computing system is a type of distributed system in which contributors volunteer their computing resources, such as personal computers or mobile devices, to contribute to a larger computing effort. Volunteer resources are connected over the Internet and together form a powerful computing system capable of providing a service without depending on a service provider. Volunteer network resource allocation is the process of assigning computing tasks or services to a network of volunteer resources. The allocation process includes identifying the needed resources, selecting appropriate volunteers, and assigning tasks or services based on their capabilities. Volunteer computing systems consist of a large number of heterogeneous resources - in terms of processing power, storage, and availability - belonging to different authorities - users or organizations - and exhibiting uncertain behavior in terms of connection, disconnection, capacity, and failure. All of this makes resource allocation a challenging task in terms of ensuring a minimum quality of service, requiring complex algorithms and optimization techniques to ensure that services are efficiently allocated while respecting the constraints of the available resource. This paper introduces the Network-Aware Resource Allocation mechanism, which leverages the location, connectivity, and network latency of volunteer nodes to minimize the time a service runs with degraded quality of service and aims to deal with the energy consumption resulting from data replication requirements. This resource allocation mechanism applies to both the initial deployment of the service in the network and to the reallocation of nodes in the event that one of the allocated nodes fails or becomes unavailable. Our method has been validated in a simulation environment of a realistic volunteer system. The analysis of the results shows how our mechanism meets the quality requirements of users while minimizing the synchronization and replication times of service data replicas, as well as the time that services run with degraded quality of service, reducing the times by more than 70% in the service deployment phase and by more than 60% in the service execution phase. It also helps to reduce overall energy consumption.

Investigating dietary intakes of pregnant women in an outpatient department using the FIGO Nutrition Checklist and assessing the acceptability of the checklist for use in routine antenatal care

Many adverse outcomes for both mother and baby can result from suboptimal maternal nutrition during pregnancy(1). Pregnancy is seen as an opportunity to encourage beneficial lifestyle changes(2). The Health Service Executive published nutritional guidelines for pregnancy in Ireland(3), however there is no standardised approach for assessment in antenatal care. The FIGO Nutrition Checklist is a tool which asks “yes/no” questions about dietary intakes in pregnant women with the goal of identifying deficits compared to recommendations. A “no” answer to one or more questions indicates a possible nutrition risk in the diet. Implementation of the Nutrition Checklist during pregnancy would benefit both mother and baby. The aim of this study is to assess the nutritional intakes of pregnant women attending the public outpatient clinic in the National Maternity Hospital, Dublin using the FIGO Nutrition Checklist, and assess the acceptability of the tool for use as part of routine antenatal care.This observational cross-sectional study used two self-administered questionnaires to (i) assess women’s nutritional intakes to identify those at nutritional risk, and (ii) assess the acceptability of the Nutrition Checklist as part of routine antenatal care. Recruitment took place from December 2023 to February 2024. All English-speaking women of any gestation or parity attending the public outpatient department of NMH were eligible to take part. Baseline characteristics were obtained through their hospital records on the electronic chart system. Statistical analysis was completed using IBM SPSS.A total of 102 pregnant women were recruited during routine antenatal clinics in the public outpatients department in the NMH, Dublin, Ireland. Most (88.7%) declined following a special diet. The majority (85.7%) answered “No” to at least one diet quality question, highlighting potential nutritional risk. Only 43.9% reported eating at least one portion of fish per week and 20.4% reported consuming <1 serving of wholegrains per day. Current folic acid intakes were high among the cohort, however 16.3% answered “No” to currently taking folic acid. The acceptability of the checklist was excellent. Most (70.6%) women strongly agreed that the checklist was easy to complete, with 80% recommending using it in practice and most (81.4%) of the women who took part in the survey agreed that the checklist contained useful information, with only 1% disagreeing.The FIGO Nutrition Checklist identified numerous nutritional concerns and the acceptability of the checklist was excellent. This suggests that using the tool as part of routine antenatal care should be considered.

Under the microscope - A review of the testing of Foods for Specific Groups products available on the Irish market

Foods for Specific Groups (FSGs) are a category of products for vulnerable groups including “processed cereal-based foods and baby foods” (PCFBF); “food for special medical purposes” (FSMPs); “infant formula” (IF) and “follow-on-formula” (FOF) as per Regulation (EU) No 609/2013(1). Specific labelling and compositional requirements are set out in the legislation for each of these categories of foods. The Food Safety Authority of Ireland (FSAI) ensures the enforcement of these regulations through service contracts with official agencies including the Health Service Executive (HSE) and the Department of Agriculture, Food and the Marine (DAFM)(2). The aims of this study were to: (1) Identify the categories and quantities of FSGs tested by official agencies in 2022 and (2) Investigate the compositional compliance of products tested.FSG products were analysed by Official Laboratories (OLs) using accredited methods for potassium, selenium, iodine, zinc, manganese, magnesium, molybdenum, phosphorus, calcium, folic acid, sodium, iron, chromium, vitamin B2 and vitamin B1. Both the measure of uncertainty (MoU) and limit of quantification (LOQ) values were reported. Data was extracted from FSAI’s National Food Safety Surveillance database. Samples were categorised as IF, FOF, PCFBF or FSMPs as per the legislation. FSG products not available for sale in Ireland were excluded. Nutrient concentrations were assessed against the limits permitted in legislation.Of the total FSG products tested (n92) in 2022, nearly two-thirds (n64) were produced for the Irish market, with the remainder (n28) produced for export. The majority (n51) of Irish products were sampled by the HSE including IF (n10), FOF (n8) PCFBF (n7) and FSMPs (n26). The remaining Irish products (n13) were sampled by DAFM - IF (n6), FOF (n6), and FSMPs (n1). The majority of PCFBF (n6), IF (n14), FOF (n13) tested were deemed compliant, while only 44% (n12) of FSMPs sampled were compliant with the legislation. Possible non-compliance of FSMPs was due to high levels of selenium, chromium, and molybdenum. Possible non-compliance of FOF and IF was due to high levels of selenium. PCFBF possible non-compliance was due to high levels of potassium. However, the analytical MoU values for the nutrients ranged from 0.04 % to 44% which makes judgement of compliance difficult in some instances.This study gives an overview of FSG products tested by official agencies including their compliance with compositional regulations. Overall, compositional compliance across FSG products is high. However, possible non- compliances were identified due to the wide range of MoUs and their overlap with some permitted limits for certain nutrients. Another issue identified is that some LOQs were higher than the maximum permitted level in legislation. Future work for the FSAI will involve working with the OLs to accredit more sensitive methods, thus facilitating better official controls.

The Impact of the COVID-19 Pandemic on the Sex Ratio at Birth in Ireland.

The sex ratio at birth (SRB), calculated as male divided by total live births, is an important indicator of population health. Typically, male live births slightly outnumber female live births. Population events, including pandemics, can alter the SRB, with effects sometimes evident 9 months post-event, potentially due to changes in sexual behavior and/or stress levels. This study investigates the impact of the COVID-19 pandemic on the SRB in the Republic of Ireland. Publicly available monthly live birth data for Ireland were obtained from the Central Statistics Office for the period 2015 to 2021. Time series analysis predicted the SRB for 2020 using data from 2015 to 2019, with comparisons made between observed and predicted values. In December 2020, 9 months after the March 2020 COVID-19 declaration, the observed SRB sharply fell to 49.44% (97.80 males for every 100 females), below the 95% prediction interval of 50.31% to 52.15%, significantly deviating from the expected male predominance. December 2020 also recorded the lowest average daily number of births (n = 145) in the study period. The sharp decline in the SRB in December 2020, alongside the lowest birth count, suggests reduced sexual intercourse at the population level, particularly in March 2020, aligning with recommendations from Ireland's Health Service Executive (HSE). The HSE advocated precautionary measures such as limiting partnered sex in March 2020 to mitigate the spread of COVID-19. These findings highlight the pandemic's potential impact on population dynamics and stress the importance of SRB monitoring as a low-cost and readily available health indicator, especially during national crises.

Is there a maximum transfer time for safe planned home births? Building evidence to

Abstract Evidence-based assessment of suitability for planned home birth (PHB) is a critical component of safe, effective home birth services. This study aimed to build an evidence base to inform transfer time recommendations for the Health Service Executive (HSE) Home Birth Service in Ireland. Transfer rates, time and distance were described for women who began labour at home with the HSE Home Birth Service between 2012 and 2021. Binary logistic regression was used to identify factors associated with intrapartum transfer and to examine the relationship between transfer time and outcomes. A survey on home birth policy and practice was issued to informants in countries offering comparable services to the HSE. Of 2,000 women initiating labour at home, 376 (18.9%) required intrapartum transfer, with transfer rates of 48.2% and 10.1% for primiparous and multiparous women, respectively. Primiparity (aOR: 8.95, 95% CI 6.89-11.7, p < 0.001) and maternal body mass index ≥30 (aOR: 1.93, 95% CI 1.14-3.20, p = 0.013) significantly increased the odds of intrapartum transfer. Serious adverse outcomes were rare in those requiring intrapartum transfer. No statistically significant increase in poor outcomes was detected with increasing transfer time; however, statistical power to detect small but important effects was limited. In other home birth services, transfer time is explicitly considered when assessing suitability; information provided to women includes details on transfer rates and times. While this study did not find a threshold time associated with increased risk of adverse outcomes for PHB, it has highlighted the significance of transfer time in shared decision-making on birthplace. Women considering PHB should receive parity-specific information on outcomes including transfer rates. This work highlights the pivotal role of Public Health in ensuring that evidence is combined with expert judgement and womens’ preferences to provide high quality, accessible, person-centred services. Key messages • Transfer time plays a key role in supporting shared decision-making for women considering a home birth. • This study identified opportunities to extend the comprehensiveness of assessment of suitability for planned home births using local and international evidence.

Large scale public health system transformation: Ireland

Abstract Ireland has coped comparatively well with the COVID-19 pandemic when considering excess mortality. The reasons are likely complex and multifaceted, but it may be, in part, attributable to a comparatively young population and progress on indicators related to premature mortality and preventable mortality on chronic diseases and lifestyle risk factors. “Healthy Ireland” is a national framework in place since 2013 and utilizes a settings based approach to promote health and wellbeing in communities. It aims to improve collaboration between government, institutions, local communities, and individuals. Sláintecare is an all’party long-term health reform initiative developed in 2017 aimed at delivering the right care, at the right time, in the right place by the right team. In addition, in 2018 Ireland embarked on an ambitious public health reform programme with the implementation of the recommendations of the Crowe Horwath review of Public Health. While challenges exist, including access to services and waiting times, the governments has put in place initiatives to address these and is committed to, amongst other things, promo ting the continued integration of services across a variety of domains including primary to quaternary prevention. As Ireland began to emerge from the COVID-19 pandemic it established “The Public Health Reform Expert Advisory Group” to identify learnings from the public health components of the response, with a view towards strengthening public health and health protection generally and, specifically, future public health pandemic preparedness. The group, made up of national and international public health experts, submitted its final report in September 2023 which outlined a series of recommendations focused on potential improvements to public health policy, structures and governance. The WHO analysis of the Essential Public Health Functions provided complementary results. More work is now ahead to consider and implement these recommendations and foster institutional reforms including at the Health Services Executive, the Department of Health, and at the Health Protection Surveillance Centre.

Public and professional attitudes to the digitisation of health and social care in Ireland

Abstract Background The European Commission has set targets for all EU citizens to have access to electronic medical records by 2030. In Ireland the Sláintecare health reform programme has set goals around the use of digital technologies in health and social care. The Health Information and Quality Authority (an independent authority established to drive high-quality and safe care for people using health and social care services in Ireland) in partnership with the Health Service Executive (public healthcare provider) and the Department of Health (Ministry) conducted a National Engagement on Digital Health and Social Care. The aim of this engagement was to understand the opinion, attitudes and comfort levels of the public and professionals working in health and social care around digitisation of health and social care. Methods The National Engagement on Digital Health and Social Care used a mixed-method approach to data collection. There were two surveys, a national telephone survey with a representative sample of the public (n = 2009) and an online survey with professionals working in health and social care (n = 1020). There were separate focus groups with professionals and with the public, including representatives of minority groups. Results Preliminary results indicate that the public and professionals have positive attitudes to digital health and social care. Of the public surveyed 73% said that they are likely to access their online health record. Professionals feel that when the public have access to information via an online health record they will be better informed about their health (88%). Both the professionals and public feel that it is important to ensure patient choice around the format and delivery of care. Conclusions The research provides valuable insights and gives the public and professionals a platform to voice their opinions and have a meaningful impact on how digital health and social care is developed and implemented in Ireland. Key messages • This research provides unique insights and a deeper understanding into the attitudes of Irish public and professionals working in health and social care towards digital health. • Research findings will inform national policy, legislation and recommendations on the use of digital health tools in Ireland.