Management In Ireland Research Articles

109 Optimising Community-Based Physical Activity for Chronic Condition Management in Ireland: A Comprehensive Systems Analysis guided by RE-AIM

109 Optimising Community-Based Physical Activity for Chronic Condition Management in Ireland: A Comprehensive Systems Analysis guided by RE-AIM

Factors Influencing the Perceived Economic Benefits of Innovative Agri-Environmental Contracts

Continued innovation in contract design may enhance the delivery of agri-environmental climate public goods (AECPG), but barriers to adoption arise in terms of how farmers perceive the economic benefits. Therefore, this paper examines survey data from Ireland and the Netherlands to analyse whether land managers agree that results-based, collective action, value chain and land tenure contracts for the delivery of AECPG are understandable, applicable to their farm and economically beneficial. Using Probit models, we also identify groups of land managers who perceive the different contract types as being economically beneficial, and these findings can inform policymakers of farmer groups who need adequate consideration during the design of agri-environmental contracts. For example, greater incentives could encourage older farmers to enrol in results-based contracts in Ireland and value chain contracts in the Netherlands. We also find a link between contract duration and the perceived economic benefits of collective action contracts in both countries, with land managers in Ireland desiring a longer duration. We highlight that policymakers and land managers in Ireland could apply lessons from the design of agri-environmental contracts in the Netherlands, where they are more common and varied. Greater knowledge exchange between users and non-users of such contracts would also help bridge the gap between theory and practice in both countries.

The role of interpersonal conflict as a cause of work-related stress in construction managers in Ireland

Purpose The purpose of this study is to provide evidence to support an emerging theory that interpersonal conflict is the primary cause of workplace stress among a self-selected sample of Irish construction managers. Design/methodology/approach Eighteen construction managers working in Ireland were recruited for this study. Using semi-structured interviews and interpretative phenomenological analysis as the research methodology, the causes of their workplace stress were investigated. Findings Participants reported that the principal cause of their workplace stress was high levels of interpersonal conflict between colleagues. The effects of this interpersonal conflict included avoidance behaviour, ill health, absences from the workplace and loss of productivity issues. Deadlines, penalty clauses, lack of appreciation, cliques, costs, communication, temporary contracts and delays were also reported stressors. Research limitations/implications A limitation of the study is the small sample of 18 construction managers and the limited geographical area. Social implications The social implications of this study could be to clearly identify that interpersonal conflict may be under reported in the construction industry, and there is a possibility that it is being misclassified as other workplace behaviours such as bullying, harassment and workplace violence. If this is so, this could aid future researchers in addressing this challenging workplace behaviour. Originality/value The current consensus in the literature is that the three main causes of workplace stress are bullying, harassment and violence. However, the role and importance of interpersonal conflict as reported in this study, with the exception of North America and China, is not reflected in the wider health and safety research literature. In addition, interpersonal conflict and its reluctance to be reported is largely absent from construction safety research. The findings of this study may be explained if the workplace stress research community is currently misclassifying interpersonal conflict as a manifestation of bullying, harassment or violence. If this is the case, interpersonal conflict needs further research. This is to establish if this cause of construction-related workplace stress needs to be reconsidered as a standalone phenomenon in the wider family of challenging workplace behaviours.

A process perspective of conceptual innovation: Integrating equity in applications of the ecosystem services concept in Ireland

The ecosystem services (ES) concept emerged as a metaphor to demonstrate humanity’s dependence on the natural environment and is increasingly applied to frame human-nature relationships in conservation science, policy and practice. This paper aims to enhance understanding of how the ES concept is applied for ecosystem management and biodiversity conservation in the Irish context, with further applicability to international contexts. Semi-structured interviews were conducted with stakeholders involved in ES research, policy and practice to understand and reflect a variety of perspectives. Three contexts of ecosystem management in Ireland are examined as focal points for the ES framing: natural capital and ES research; Agri-Environment schemes as types of Payments for ES; and collaborative forms of governance for peatland conservation. Specifically, we examine the idea of conceptual innovation as a process where concepts evolve in time and space as they are applied by different societal actors. The contexts examined demonstrate a variety of perceptions and show the scope for agency in how concepts are applied when they meet local realities. The research also demonstrates how alternative concepts and ideas are continuously emerging in societal discourse, and suggests the need to develop ‘networks of concepts’ that can work together to manage the politics, power relations and inequities inherent in the application of any concept. Fostering transparency and reflection on values, language and how knowledge is produced helps make visible power dynamics underlying the ES concept and encourages the development of ES approaches that are effective, inclusive and actionable. Developing concepts from a process perspective has implications for changing the course of a concept as its future unfolds. Following from this, we suggest the need to map an emancipatory future agenda for ES research that centres the voices of those researching, participating and acting ‘from the margins’.

A survey of physiotherapist managers in Ireland and their views on the role of Advanced Practice Physiotherapists.

Within the current context of implementation of an Advanced Practice Grade, the Irish Society of Chartered Physiotherapists commissioned a survey of physiotherapy manager opinions regarding the role of Advanced Practice Physiotherapists. The aim of this survey was to explore the views of physiotherapist managers in relation to the characteristics, role, competencies and management of Advanced Practice Physiotherapists (APPs) in Ireland. Physiotherapist managers based in primary and secondary care settings in Ireland were invited to participate in a survey on Advanced Practice. Quantitative data from a custom designed online survey was analysed with descriptive statistics and qualitative data from open-ended survey questions were analysed using thematic analysis. The response rate to the survey was 32% (24/75). On average, respondents thought that 54% (range: 15%-80%) of an APPs time should be spent in clinical practice and between 17% and 20% variously on managerial and leadership, teaching and education and research and development duties. Four themes were identified from the surveys' open-ended questions related to the description of APP: 'Extended scope 'Advanced clinical training, knowledge, and decision-making', 'Autonomy, independence and responsibility', and 'Wider roles'. Irish physiotherapist managers recognised the extended scope of practice, expertise and multiple roles characteristic of APPs. They indicated the need for legislative changes and clarity around governance.

The use of innovative contracts to provide agri-environmental public goods: Comparing attitudes between Ireland and other European countries

Results-based, collective action, value chain, and land tenure contracts are means to improve the management of agri-environmental public goods. The objective of this paper is to assess the understandability, applicability, and perceived economic benefit of each of these contract types by land managers and stakeholders in twelve European countries, with a special emphasis on Ireland. Using survey data, we find that most land managers agree that results-based contracts are understandable, applicable to their farm, and economically beneficial. A lower portion of land managers in Ireland than other European countries agree that value chain and land tenure contracts are understandable or applicable to their farms. The results suggest that greater efforts are required to promote collective action contracts across Europe as they are paramount to the management of public goods. To increase the adoption of innovative contracts, providing financial certainty and autonomy should be prioritized by policymakers, particularly in Ireland.

THU250 Therapeutic Inertia In Primary Care With Poor Information Transfer To Specialist Care - A Rural Irish Experience

Abstract Disclosure: C.T. Coughlan: None. T.M. O'Sullivan: None. M.C. O'Donovan: None. M.J. Hannon: None. The burden of diabetes management in Ireland is shared between primary care physicans and specialists in secondary care, using current international management guidelines (1). However, long waiting lists and resource constraints limit the ability of secondary care to respond rapidly to all referrals. This study was designed to identify missed opportunities for early intervention in the management of diabetes in primary care. Written referrals of diabetes patients from primary care physicians to a specialist endocrinology service in a rural Irish hospital were audited to assess both the appropriateness of the referrals and to identify any missed opportunities for starting adjunctive treatments in primary care. We analysed all 74 referrals - mean age 58, 45% female – that were on the hospital diabetes clinic waiting list at the time of data collection. 61/74 (82%) had type 2 diabetes. The average time between date of referral and date of data collection was 231 days. Only 43/74 (58%) included a HbA1c value in the referral document. Of the type 2 diabetes referrals, only 12/61 (20%) included a BMI value. Mean HbA1c in the type 2 diabetes cohort was 71 mmol/mol (8.6%), and mean BMI was 30.6 kg/m2. Despite this, 19/61 (40%) were on monotherapy at time of referral, only 15/61 (25%) were on a GLP1 analog, and only 17/61 (28%) were on an SGLT2 inhibitor. Of the type 2 patients with documented BMI > 30 kg/m2, only 2/5 (40%) were on a GLP1 analog and only 2/5 (40%) were on an SGLT2 inhibitor. Lipid values were included in the referrals of 26/74 patients (35%), and blood pressure values in 25/74 (34%). Despite this, 44/74 (59%) were on a statin and 40/74 (54%) were on an ACE inhibitor or ARB. The renal function (serum creatinine or eGFR) was provided in 22/74 (30%), and information regarding microalbuminuria was provided in only 12/74 (16%). Foot examination was documented in 13/74 referrals (18%), and retinal screening status was documented in 17/74 (23%). Given the exponential increase in the numbers of patients with obesity and diabetes and increasing evidence on the importance of early multifactorial risk reduction, it is essential that cardiovascular risk factors and diabetes complications are documented and appropriate initial management commenced while patients await secondary care evaluation. Our study shows that referrals lack critical information which makes appropriate prioritization difficult. Also, the major classes of oral hypoglycaemic agents are under utilized in primary care, which exposes patients to damaging hyperglycaemia for an unnecessarily long time prior to secondary care evaluation. 1. Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65(12):1925-66. Presentation: Thursday, June 15, 2023

Investigating bottlenecks hampering the adoption of water quality-enhancing practices for sustainable land management in Ireland

The scaling of adopted measures on farms is often proposed however, the factors that inform non-adoption of advised measures are typically overlooked. Better understanding of these factors could offer important insights for overcoming these bottlenecks and therefore offer important potential with respect to addressing agri-environmental challenges. We investigated the factors hampering the adoption of sustainable land management practices advised by the main agricultural extension of Ireland. A large qualitative dataset (N = 760) containing farmers’ reasons for rejection of advised practices was analysed to identify bottlenecks for adoption. Our research showed that rejection can be explained by different underlying reasons. While subsidies exist for the implementation of sustainable land management practices, incentives to implement are insufficient and costs remain the main barrier for the adoption of the sustainable land management practices. Additionally, land ownership challenges and the aging farming population hamper the adoption of sustainable land management practices. Next to an analysis of the reasons for rejection of all advised practices, we investigated three often advised sustainable land management practices in-depth: implementation of riparian buffer zones, preventing cattle access to watercourses and implementation of a nutrient management plan. The differences in barriers for adoption between these practices showed the need for nuanced communication in order to enhance uptake. In order to reach water quality targets through enhanced uptake of sustainable land management practice, advice should be framed and tailored to farmer objectives.

Addressing child and adolescent obesity management in Ireland: identifying facilitators and barriers in clinical practice.

Ireland's Model of Care for the Management of Overweight and Obesity outlines a plan for treating adolescent and child obesity (CO). However, engagement with key stakeholders is required to support its implementation and improve health services. This study aims to map the perceived barriers and facilitators related to CO management across healthcare settings, professional disciplines, and regions in the Republic of Ireland (ROI). An online cross-sectional survey of registered healthcare professionals (HPs), designed to adhere to the Consolidated Framework for Implementation Research (CFIR), was co-developed by a project team consisting of researchers, healthcare professionals, and patient advocates. The survey was pilot tested with project stakeholders and distributed online to professional groups and via a social media campaign, between September 2021 and May 2022, using "SurveyMonkey." Data were summarised using descriptive statistics and thematic analyses. Themes were mapped to the CFIR framework to identify the type of implementation gaps that exist for treating obesity within the current health and social care system. A total of 184 HPs completed the survey including nurses (18%), physicians (14%), health and social care professionals (60%), and other HPs (8%). The majority were female (91%), among which 54% reported conducting growth monitoring with a third (32.6%) giving a diagnosis of paediatric/adolescent obesity as part of their clinical practice. Nearly half (49%) of the HPs reported having the resources needed for clinical assessment. However, 31.5% of the HPs reported having enough "time," and almost 10% of the HPs reported having no/limited access to suitable anthropometric measurement tools. Most HPs did not conduct obesity-related clinical assessments beyond growth assessment, and 61% reported having no paediatric obesity training. CFIR mapping identified several facilitators and barriers including time for clinical encounters, suitable materials and equipment, adequate training, perceived professional competency and self-efficacy, human equality and child-centredness, relative priorities, local attitudes, referral protocols, and long waiting times. The findings provide actionable information to guide the implementation of the Model of Care for the Management of Overweight and Obesity in Ireland. Survey findings will now inform a qualitative study to explore implementation barriers and facilitators and prioritise actions to improve child and adolescent obesity management.

Understanding Pressures to Archaeological Heritage in the Face of Climate Change: An Integrated Approach to Coastal-Zone Assessments in Ireland

Coastal heritage and archaeological sites are part of a complex system of socioenvironmental processes whose conditions are placed at risk from increasing climate-change pressures and impacts. Cultural-heritage managers are working to increase understanding of these pressures and create ways to assess, mitigate, and/or adapt to change. Coastal-zone assessments (CZA) are a recognized methodology in several national management plans to gather detailed data in order to provide an informed assessment of current resources and any associated hazards and risks. A collaborative and innovative partnership is seeking to expand on current CZA models by integrating social, historical, and geomorphological criteria into archaeological site assessment, with aims toward the development of a resource-priority index for coastal-heritage managers in Ireland.

Melanoma-related costs by disease stage and phase of management in Ireland.

Management options for the treatment of melanoma have expanded in recent years. In an era of promising, but expensive novel pharmacological treatments, robust stage-specific melanoma-related cost estimates are necessary to support budgetary planning, evaluation of cost-effectiveness and to contribute to the investment case for prevention. A detailed decision model, describing the melanoma care pathway (by disease stage) from diagnosis, through treatment and follow-up was developed over a 5-year time frame from the perspective of the Irish healthcare system. The model was populated with real-world data from the National Cancer Registry Ireland. Uncertainty was explored using one-way and probabilistic sensitivity analysis. The cost of managing a case of melanoma diagnosed at Stage IV (€122985) was more than 25 times more expensive than managing a case diagnosed at Stage IA (€4269). Total costs were sensitive to the choice of immunotherapeutic and targeted drug, duration of treatment and proportion of patients receiving immunotherapy agents. The rising incidence of melanoma and high cost of new novel therapies presents an immediate challenge to cancer control and public health globally. This study highlights the cost differential between early and late detection and the potential return on investment for prevention versus high-cost treatment.

The Role of Volunteers and Citizen Scientists in Addressing Declining Water Quality in Irish River Catchments

Integrated Catchment Management (ICM) frames water management in Ireland to account for the complex hydrological, biophysical, and environmental interactions along with the political, socio-economic and cultural influences inherent in the management of river catchments. Despite a range of European Union (EU) Directives, national laws, policies, and incentives, the quality of water and biological diversity in Irish rivers is declining. In response, there has been an increased effort to involve local communities in ICM through a bottom-up, nature-based citizen science approach to activate local cooperation and environmental stewardship. This paper assembles 157 examples of citizen science water-based projects (48 in Ireland as of 2021) to appraise the position of community-led water monitoring in ICM. Notable differences found between the Irish and international programmes found a greater emphasis on habitat internationally, while a taxonomy focus was evident in Ireland despite a lower number of skilled volunteer activity-based citizen science projects. The continuing decline in water quality in Ireland, even with appropriate regulations, commendable governance changes, and expansion of citizen science, suggests more work is necessary before there will be successful ICM and improvements to river water quality.

Reviews: City and county management in Ireland, 1929–2020

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Historical droughts in Irish catchments 1767–2016

AbstractRecent prolonged dry periods in summer 2018 and spring 2020 have reawakened interest in drought in Ireland, prompting questions regarding historical drought occurrence and potential long‐term risks. Employing 250 years of monthly precipitation and flow reconstructions, we investigate historical drought in Irish catchments evaluating the characteristics (number of events, duration, and deficits) of moderate, severe, and extreme droughts as well as the propagation of meteorological to hydrological drought. Using standardized indices, we identify three distinct catchment types. Cluster 1 catchments, located in the wetter northwest are characterized by small areas, low groundwater storage, and the highest frequency of hydrological drought relative to other catchments. Cluster 3 catchments, located in the drier east and southeast have larger areas, greater groundwater storage, the highest frequency of meteorological drought but the least hydrological droughts. However, once established, droughts in Cluster 3 tend to be more persistent with large accumulated deficits. Cluster 2 catchments, located in the southwest and west, are intermediate to Clusters 1 and 3, with hydrological droughts typically of shorter durations, reduced accumulated deficits but greater mean deficits. The most extreme droughts based on accumulated deficits across all catchments occurred in 1803–1806, 1854–1859, 1933–1935, 1944–1945, 1953–1954, and 1975–1977. Although not as severe, droughts in 1887–1888, 1891–1894, and 1971–1974 also appear as significant extremes. Changes in drought characteristics reveal a complex picture with the direction, magnitude, and significance of trends dependent on the accumulation period used to define drought, the period of record analysed, and the reference period used to standardize indices. Of particular note is a tendency towards shorter, more intense meteorological and hydrological droughts. Our findings offer important insight for drought and water management in Ireland given the paucity of extreme droughts in short observed river flow records.

‘We’re Meant to Be Crossing Over … but the Bridge Is broken’: 2020 University Graduates’ Experiences of the Pandemic in Ireland

We interviewed university graduates of 2020 in Ireland to understand how the coronavirus pandemic had affected them. Demonstrating a keen awareness of their mental health, participants had adopted self-care practices such as mindfulness. They recounted positive experiences of life in their ‘lockdown homes’ with supportive families. Some were embarking on normative adult pathways sooner than anticipated while others opted for postgraduate study to bide time. Participants reported heightened worry/anxiety and had limited their media use in response. Their plans did not extend beyond the immediate future, reflecting a degree of resignation. The participants accepted the strict constraints associated with pandemic management in Ireland. They did not view themselves as members of a group that was likely to experience the long-term costs of the pandemic but rather were attempting to negotiate their own pathway through labour market uncertainty while also demonstrating high levels of solidarity towards vulnerable groups in society.

A first acoustic density estimate for sperm whales in Irish offshore waters

Previous studies off western Ireland have suggested that substantial numbers of, mainly male, sperm whales may be found in these habitats. Whaling vessels operating from shore stations in Ireland in the early 20th century frequently caught sperm whales in oceanic waters. It is likely that this North Atlantic region contains important foraging habitats for this species, and that mature males must also migrate through this area moving between breeding grounds to the south and other feeding areas further north. Increasingly, these offshore waters are being utilised and potentially impacted by human industrial activities. For example, as inshore resources are depleted and technology improves, both the commercial fishing and the oil and gas industry are becoming more active in deeper waters beyond the continental margin. It is important therefore to better understand the biology and ecology of sperm whales in these more remote areas. However, their offshore location and deep diving habits, together with weather constraints in the exposed Atlantic, make research difficult. New sperm whale density estimates are reported using data from six seasonal passiveacoustic surveys carried out in two successive years (2015 and 2016). These covered a corridor approximately 110km wide which bounded a major portion of Ireland’s continental shelf break. Towed hydrophone line-transect methodologies were used, which have proven to be highly effective for surveying sperm whales in offshore waters and in poor weather conditions. Target motion analysis was applied to calculate the ranges of vocalising whales from the survey tracklines and the effective strip half-width calculated across all surveys was 7,958m. The study area was surveyedin three blocks and animal densities within these blocks varied between 1 and 4.6 individuals per 1,000km2 (CV 0.34 and 0.21 respectively) with an overall mean density in waters deeper than 300m of 3.2 individuals per 1,000km2(CV 0.04). These robust density estimates are the first of their kind for Irish waters and are similar to those reported in other Atlantic areas considered significant for this species. These results emphasise the significance of this region as sperm whale habitat. The results of this study should be used to inform the future sustainable development and management of Ireland’s offshore Atlantic.

An examination of the level of local authority sustainable planning for event management: a case study of Ireland

The growth of the events industry will continue to place increasing demands on the environmental and social resource base upon which events depend. Although Local Authorities have a long-running commitment to achieving sustainable development, there exist many gaps in relation to its application within the context of planning for events management. In the current event environment there is a fundamental need for a sustainable approach to planning for events by Local Authorities, given their often statutory responsibility to license events and to facilitate and regulate the process of planning for large-scale outdoor public events. This research employed a multi-methodological approach utilising a content analysis of Local Authority event management plans and interviews with Local Authority event personnel. The findings report significantly low levels of Local Authority sustainable planning for event management in Ireland and point to the need for a consistent, transparent and state-wide sustainable approach to planning for events in Ireland. The lessons learned from this study may have implications for event destinations at international level. This study suggests a possible solution for Local Authorities to effectively lay the foundation for a transition towards greater levels of sustainable planning for events management going forward.

The Afterlives of Global Capital

ABSTRACT Decay and decomposition have long been important to the histories of capitalist development but what are the particular forms that characterize the relationship between “waste” and value in post-2008 financialization? I argue that financialization is characterized by the organized conversion of distress into forms of financial value. To make this argument I lay particular emphasis on the rehabilitation of “toxic” assets through the practices of asset management in Ireland's National Asset Management Agency. I extend this argument by foregrounding political interventions staged around post-crisis housing, a critical strategy which seeks a certain point of confrontation between the abstract and the visceral. This strategy identifies the “afterlives of global capital” as sites that could incubate imaginative work designed to challenge finance in key ways. This provokes questions about financialized value: do we now locate value in forms of financial integrity or in decay, decomposition and detritus?

Tinnitus management in Ireland: a pilot study of general practitioners.

Tinnitus is a phenomenon that affects approximately 15% of the adult population. A minority of patients will experience chronic bothersome tinnitus that has a detrimental effect on their quality of life. Management of such tinnitus is challenging for healthcare practitioners. Primary care services are the first point at which patients seek expert medical advice about their condition and General Practitioners (GPs) must be equipped with the knowledge to appropriately triage and guide patients. To date, there has been little research surrounding tinnitus management in Ireland. The aim of this study is to determine how GPs assess and manage tinnitus patients in Ireland. This is a quantitative study in the form of an online survey. The 15-item questionnaire was made available through SurveyMonkey and was distributed by email to GPs in Cork, Kerry and South Dublin. The survey obtained 43 responses. Sixty-three percent of GPs do not follow any routine criteria for onward referral. Forty percent feel that tinnitus has sufficient impact on their practice to warrant further training. GPs expressed a need for clearer guidance on tinnitus management and better access to resources such as ENT (ear nose throat), MRI (magnetic resonance imaging) and audiology. This study demonstrates there is wide variation in how tinnitus is evaluated and managed by GPs, which represents a gap in clinical care. We recommend further research, implementation of a service model for tinnitus, national clinical guidelines, training pathways for primary care staff and establishment of regional direct-access tinnitus clinics throughout Ireland.

The case for mainstreaming nature-based solutions into integrated catchment management in Ireland

The case for mainstreaming nature-based solutions into integrated catchment management in Ireland