Northern Ireland Regional Research Articles

A qualitative study of adult protection procedures: threshold screening of new referrals by designated adult safeguarding practitioners

Purpose This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process. Design/methodology/approach Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software. Findings This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process. Originality/value This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.

Improved imaging of ground deformation and brine seepage around abandoned flooded salt mines by joint inversion of multiphysics data

Centuries of bad mine-flooding practice have left a legacy of underground salt mine collapse and contaminated discharges, the scale of which is only slowly being revealed now that ground processes have caused instability over decades to >100 years. Geophysical methods are used for mapping ground subsidence and groundwater contamination at such sites but suffer individually from non-uniqueness and with the underlying mechanism and processes not being well understood. Here, to reduce uncertainty and maximize accuracy we recover subsurface models with structural similarity enforced via crossgradients joint inversion of seismic refraction and dc resistivity data for the top 40 m at former mining areas in Carrickfergus region of Northern Ireland. The models in combination with multispectral image fusion, enable us to identify hitherto unknown mechanism of deformation and compositional changes consistent with the Chebotarev geochemical evolution of groundwater. We found evidence of concealed gravitational slump structures interpreted as being caused by water ingress weakening the gypsum-bearing marl bedrock (via gypsum dissolution and increased fluid pressures within marl) and leading to gravitational gliding deformation, expressed as curved subsidence bands and stepped thrusts coincident with surface zones of brine-mud seepage and sinkhole collapse. Our results have wide-ranging implications for best-practice assessment and management of abandoned flooded salt mines and the hazards they pose to ground stability and water resources world-wide.

Assessment tools used in adult safeguarding practice within the UK and Ireland: results from a small-scale qualitative study

PurposeAcross the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep themselves safe from potential harm or abuse. The ways in which the statutory and voluntary sectors have chosen to safeguard these adults varies. Different models of intervention and the utilisation of a range of assessment tools, frameworks and approaches have evolved, often in response to policy and practice wisdom. Empirical research in this area is limited. The primary research purpose of the project on which this paper is based is to gather information on the range of tools and frameworks that are used in adult safeguarding practice across the UK and Ireland. In so doing, this paper seeks to contribute and inform the future development of an evidence based adult safeguarding assessment framework.Design/methodology/approachA team of academics from England, Scotland, Northern Ireland and Ireland wanted to explore the possibility of adapting a pre-existing assessment framework currently in use in family and childcare social work to consider its utility in assessing carers involved in adult safeguarding referrals. This paper reports on a small pilot study which sought to inform the adaptation of this framework for use in adult safeguarding. This paper is based on a qualitative study involving 11 semi-structured telephone interviews with adult safeguarding social work managers and experienced practitioners. Two to four professionals from each region of England, Scotland, Northern Ireland and Ireland were interviewed to elicit their perceptions and experiences of engaging in adult safeguarding assessment processes and their views about models of assessment.FindingsThis study identified considerable variation in and between the nations under review, in terms of the assessment frameworks and tools used in adult safeguarding practice. To a large extent, the assessment frameworks and tools in use were not evidence based or accredited. Participants acknowledged the value of using assessment frameworks and tools whilst also identifying barriers in undertaking effective assessments.Originality/valueThere is limited evidence available in the literature regarding the utility of assessment frameworks and tools in adult safeguarding practice. This primary research identifies four themes derived from professional’s experiences of using such frameworks and identifies broader recommendations for policy and practice in this area.

P-P58 The role of PET-CT in the management of pancreatic cancer. A Northern Ireland experience

BackgroundDiagnosis and staging has proven to be difficult in 10-20% of patients with pancreatic cancer. The PET-PANC study found that PET-CT significantly influenced the staging and management of pancreatic cancer and therefore the NICE guidelines now advise PET-CT in all patients who have localised potentially resectable disease. This study aimed to investigate the impact of PET-CT on the management of pancreatic cancer patients in a single tertiary referral centre.MethodsThere were 288 patients with pancreatic cancer discussed at the Northern Ireland Regional Hepatobiliary MDM from January 2020 to March 2021. Of these patients, 176 were deemed to have inoperable disease based on initial CT, 5 had borderline resectable disease, 1 had holding chemotherapy due to COVID restrictions and 57 were excluded from surgical resection for a variety of reasons. These included the patient being unfit for surgery, the patient declining operative intervention and an alternative treatment offered as result of COVID-19 pandemic. Therefore, there were 49 patients with pancreatic adenocarcinoma which the MDT concluded should be considered for surgical resection.ResultsA total of 27 patients who were due to undergo a curative resection had a pre-operative PET-CT scan (55.1%). This demonstrated metastatic disease in 9 cases (33.3%). Four patients who did not have a preoperative PET-CT were found to have metastatic disease at operation (9.7%). This equated to a total metastatic incidence of 26.5% in those who had been initially deemed resectable based on CT scan alone. The time interval from MDM decision to surgery averaged 25.4 days in those who did not have a PET/CT compared to 40.43 days in those who did. This was an average delay of 15.07 days until treatment.ConclusionsThis study demonstrates the important role the PET-CT has in the management of patients with pancreatic cancer. A significant number of patients avoided an unnecessary operation which would have delayed the commencement of chemotherapy. However, there are limitations to PET-CT, demonstrated in the patient with an inconclusive result, who was found to have liver metastases at surgery. The introduction of PET-CT in the staging process does undoubtedly cause delays to surgical resection and a more streamlined pathway needs to be developed to limit the delay to curative treatment.

Safety Evaluation of an Expedited Omalizumab Home Self-Administration Pathway.

IntroductionThe Northern Ireland Regional Immunology Service (NIRIS) has developed an expedited omalizumab home self-administration pathway to reduce face-to-face clinic attendance during the coronavirus disease 2019 (COVID-19) pandemic. This audit evaluates the safety of this pathway with a particular focus on anaphylaxis.ObjectivesThis study aimed to retrospectively audit the records of 39 patients undertaking expedited home self-administration at NIRIS for complications, particularly emergency department attendance for anaphylaxis. The target was for 100% of patients to complete a six-month course without experiencing anaphylaxis related to omalizumab administration.Materials and methodsA total of 39 records of patients who underwent expedited omalizumab self-administration were audited by a single reviewer. They were prospectively collected between March 2020 and August 2021. Clinical data were collected from the Northern Ireland Electronic Care Record (NIECR).ResultsHundred percent of patients were in the process of completing or had completed a six-dose course without anaphylaxis. During the course of omalizumab, 7.6% of patients attended the emergency department. Zero percent of patients have experienced anaphylaxis triggered by omalizumab. The target of 100% patients completing the expedited pathway without omalizumab-related anaphylaxis was met.ConclusionHome self-administration of omalizumab is preferred by patients and clinicians for reducing expense, travel, and unnecessary clinical contact during the COVID-19 pandemic. An expedited omalizumab home self-administration training pathway appears to be safe in a population of Northern Irish patients with chronic spontaneous urticaria (CSU). More research is needed to determine whether the expedited pathway should become the standard of care post-pandemic

Enhancing the social networks of adults with ASD: a low level community intervention

PurposeThis paper aims to design and evaluate an innovative community-based service for adults with autism in a rural region of Northern Ireland. The goal was to reduce their social isolation through gaining social skills and building social networks.Design/methodology/approachOver three years, 54 persons with a median age of 21 years received 12 months of one-to-one, personalised support and opportunities to participate in peer groups and social activities which are detailed in the paper. Quantitative and qualitative information about the impact of the service was obtained from its users, their relatives, as well as service personnel.FindingsService users rated themselves to have changed in more ways than did their relatives and staff although there was a consensus that the changes were most marked in terms of spending more time out of the house, engaging in more community activities, being more independent and increased confidence. The main benefits they perceived from participation in the project were socialising, new experiences and learning new things.Research limitations/implicationsAs with many service projects, a longer term follow-up of service users was not possible due to resource constraints.Practical implicationsThe service could be replicated with suitable staff although current constraints on social care budgets have limited its expansion to more users and extension to other areas in Northern Ireland.Social implicationsReducing the social isolation of adult persons with autism spectrum disorders needs to be personalised to the person, their living circumstances and the community in which they live. Family carers also stand to gain from community support services.Originality/valueThis low level, low cost service was implemented in a predominantly rural area with a majority of users from socially deprived areas.

Investigation of the Effect of Slurry, Combined with Inorganic N Rate and Timing, on the Yield of Spring Barley Post Cover Crop of Stubble Turnips

Integration of cover crops into arable rotations over winter results in difficulty in determining the nitrogen (N) requirement for the following commercial crop. The region of Northern Ireland (NI) has had no previous field research on cover crops and how they may affect N supply to the following commercial crop. Stubble turnips (Brassica rapa oleifera L.) were sown as a cover crop, after the harvest of winter barley (Hordeum vulgare L.) and retained over winter. Prior to planting the stubble turnips, pig slurry was applied to maximise cover crop growth. The stubble turnips accumulated 111 and 150 kg N/ha in their biomass. This equates to 79 and 107% of the N requirement of a 5 t/ha spring barley crop, if this N is released sufficiently. In this experiment, the cover crop of stubble turnips was over-sown with spring barley and supplemented with different rates of organic manures (either applied at 50 m3/ha of pig slurry or not applied), and inorganic N fertiliser (0, 70 and 140 kg N/ha), at two different timings (early or late). In the two experimental years, additional N supplied in the form of inorganic N or organic manures, did not significantly enhance spring barley yields. No control area of fallow was included in this trial. However, this study demonstrates that in this region there may be a greater rate of N release from the cover crop of stubble turnips than estimated due to agronomic management practices applied and conducive climatic conditions. This means that in this study location, a reduced N rate programme supplemented to the spring barley is possible, which lead to considerable financial savings.

Social workers’ perceptions of restorative approaches with families in cases of elder abuse: a qualitative study

PurposeThe purpose of this paper is to explore professional perspectives on restorative approaches with families in elder abuse cases.Design/methodology/approachData were gathered from 37 social workers in statutory and voluntary organisations through nine focus group sessions in one region of Northern Ireland. A thematic analysis was undertaken and themes were derived from the data using NVivo software.FindingsThis paper reports main findings under the themes of engaging families and service users; managing risk in working with families in adult safeguarding; and challenges for professionals in practice. A key finding was that professionals felt challenged personally and professionally in managing the risks and working with families in these highly complex cases.Originality/valueInvestigative approaches have their limitations in relation to adult abuse situations. This study adds to the existing knowledge base, identifies potential practice developments and discusses the challenges in adopting restorative approaches with families in elder abuse cases. The study highlights the need for further specialist training. Managers should consider the creation of specialist teams with a focus on alternative or restorative approaches with families.

P453 An eight-year retrospective audit of clinical psychology referrals within the Northern Ireland Regional Adult Cystic Fibrosis Centre

P453 An eight-year retrospective audit of clinical psychology referrals within the Northern Ireland Regional Adult Cystic Fibrosis Centre

Outlook on UK-EU Brexit negotiations and possible economic risks

The UK parliament on 29 January endorsed by 317 to 301 votes a government-backed amendment proposing to renegotiate the Brexit deal with the European Union, specifically demanding major changes to the so-called backstop on future border management between the UK region of Northern Ireland and the Republic of Ireland. EU negotiators, as well as leaders from the remaining 27 EU member states, have repeatedly stated that they reject such a move. While still failing to approve viable alternative routes, the UK parliament also confirmed in a nonbinding vote with a majority of 318 to 310 that it is opposed to leaving the EU without a deal. The easiest route is for the UK to secure an orderly Brexit on 29 March would require major EU concessions to the backstop, such as agreeing to a time limit or providing a unilateral exit clause for the UK. But, the EU continues to rule out a renegotiation, suggesting May could struggle to win some concessions to win over support from hardline Brexiteers. Should the EC refuse to budge on the backstop agreement, parliament could demand a legally binding vote to remove a “no deal” option from the table, increasing the likelihood of the UK edging closer to a softer Brexit instead. This could entail the establishment of a permanent UK-EU customs union, which could attract sufficient number of votes from the opposition as well as an array of pro-EU MPs from the governing Conservative Party. However, May has so far refrained from offering such an option as it would significantly increase the risk of splitting her party. Without either EU concessions or a cross-party alliance supporting a softer Brexit, the risk of exiting without a deal on 29 March increases. At this point in time (4 February), IHS Markit's assessment that the risk of a “no-deal” Brexit is more elevated, and sits uncomfortably around a 25–30% probability range. Even before we examine the impact of a “no deal” outcome on the UK economy, the continued Brexit uncertainty represents a significant hit on business sentiment, with many firms bemoaning the continued lack of clarity and expressing deep shock that the no-deal option remains on the table. Business groups continue to highlight the lack of contingency planning for a disorderly Brexit. Specifically, London Chamber of Commerce and Industry chief executive Colin Stanbridge reports, “75 per cent of London businesses that we surveyed still haven't made any provisions in preparation for Brexit. Furthermore, the survey also reveals that 86% of businesses in London employing under 10 people have made no preparations at all due to lack of resources and time.” More encouragingly, some have welcomed the fact that parliament has indicated that it is against leaving the EU without a deal, although it is not legally binding. Indeed, Huw Evans, the director-general of the Association of British Insurers, noted that it was “encouraging to see Parliament saying it won't support a no-deal outcome”. Overall, parliament's indecisive vote on the Brexit path signifies that there has been no progress towards how the UK will leave the EU, with many UK firms angry that the point of departure is getting ever close. They highlight that the continued uncertainty is damaging business sentiment and economic activity. Indeed, the latest survey data suggest that the UK economy was close to stagnation in the final month of 2018 and point to limited growth in the first half of 2019. At this stage, we continue to advocate a cautious near-term growth outlook, with the UK economy set to expand by 1.1% (the January consensus is 1.4%) in 2019 and 1.3% (consensus at 1.6%) in 2020 from an estimated 1.3% gain in 2018.

Everyday narratives, personalized memories and the remaking of national boundaries

In this article I explore some of the interrelations of individual reflexivity, personalized memory and national boundaries through an empirical and inductive analysis of the ways ordinary citizens remember their personal national past. I show how these personalized narratives stretch the conventional boundaries of nation and group. Of a sample of over 220 ordinary citizens in each part of Ireland, over half, and two-thirds in the still conflict-ridden region of Northern Ireland, narrated memories that could not be brought under conventional oppositional categories, and that produced in the respondents further reflection and rethinking. What is significant is how many of them did so. Since identities and traditions are said to be persistent and long-lasting in each part of Ireland, and in particular in Northern Ireland, the findings are unexpected. The article concludes that there is everyday potential for quite radical revision of conventional constructions of the nation.

Tu1808 - Early Life Events and Risk of Inflammatory Bowel Disease and a Population-Based Study From a Region of Northern Ireland

Tu1808 - Early Life Events and Risk of Inflammatory Bowel Disease and a Population-Based Study From a Region of Northern Ireland

Criminal Justice in Transition: The Northern Ireland ContextA.‐M. McAlinden and C. Dwyer (Eds.). Oxford: Hart (2015) 386pp. £49.50hb ISBN 978–1849465779

Criminal Justice in Transition: The Northern Ireland ContextA.‐M. McAlinden and C. Dwyer (Eds.). Oxford: Hart (2015) 386pp. £49.50hb ISBN 978–1849465779

Implications of attachment theory for practice: A workshop to inform development of clinical practice guidance

This paper reports on a day workshop held with the Northern Ireland Regional Faculty on 12 October 2015 at the Muckamore facility, to inform the development of clinical practice guidelines on Attachment and Intellectual Disabilities. Group work was undertaken to identify possible issues that might arise for clinical psychologists in their work, firstly in assessment, and then in intervention. In terms of intervention, themes were ordered according to the proposed guidance structure through which psychologists might apply attachment theory: psychological therapy; positive behaviour support; supervision; consultation; promoting user involvement; and cultural issues. A key over-arching theme of the day was that each client and each problem that presents to psychologists requires detailed and individualised formulation.

Pine marten (Martes martes) abundance in an insular mountainous region using non-invasive techniques

Despite their often high conservation status and international obligations to undertake regular population surveillance, the status of pine marten (Martes martes) in many countries remains poorly understood. We conducted a non-invasive survey to determine the abundance of pine marten in forested habitat located within a 360 km2 mountainous region of Northern Ireland. We deployed 126 hair tubes between June and November during which 4 sampling sessions occurred, each lasting approximately 10 days. Hair samples were collected and analysed using genetic techniques to confirm species identity, sex and provide individual identity profiles. Genotyping success rates increased with the number of hairs in a sample and were significantly greater with sample sizes of ≥10 hairs (χ2 = 15.1, df 1, P < 0.005). Abundance estimates for the adult breeding population were 23 individuals (95 % CI 15–31). Sex ratio data were 61 % male and 39 % female, suggesting that 14 males and 9 females were present in the breeding population. The total population abundance of pine marten, including breeding adults and annual juvenile recruitment, was estimated at 32 (95 % CI 31–35). Mean pine marten density was 0.53 per km2 of forest habitat and was within the range of densities found for the species in Europe. A breeding population in the low 20’s was considered small, and further research is needed on factors that may impact on the population including habitat management, connectivity and mortality. Non-invasive surveys provided conservation relevant data within a relatively short temporal period.

Familial hypercholesterolaemia (FH) in Wales is genetically heterogeneous

Familial hypercholesterolaemia (FH) in Wales is genetically heterogeneous

Managing Soil Erosion in Northern Ireland: A Review of Past and Present Approaches

In recent decades, the off-site transport of sediment and nutrients from agricultural land into the neighbouring natural and built environment has become a more pressing environmental sustainability issue than the on-site threats of soil erosion in many of the world’s temperate regions. In the temperate region of Northern Ireland, recent studies have highlighted the off-site issue of soil erosion by water in the present day, and projected that the problem may become more widespread and serious in a changing climate. This review paper examines how this problem is being managed in the present day, and draws on examples of policy in other countries to consider how the role of policy needs to be modified for more effective management. Farmers are generally not adhering to present-day policy and “keeping their land in good agricultural and environmental condition”. A range of suggested changes in policy and practice is offered, ranging from educating farmers on erosion mitigation and remediation to developing specific policies aimed at targeting soil erosion and conservation as their sole objective. An increase in the evidence base from measured erosion rates in the field is postulated to be the most likely route to achieving policy changes.

Congregation and social structure: An investigation into four Northern Irish memberships

The relationship between organised religion and the wider society has been of fundamental concern within the sociology of religion. The author addresses the issue in terms of how material forms of social structure relate to individual congregational memberships. Four contrasting congregations were chosen for study (Baha’i, Roman Catholic, Anglican and Independent Evangelical), all in the author’s home region of Northern Ireland. A range of interviewing methods and tools were used, including tables of indices of dissimilarity, narrative analysis and Multidimensional Scaling. Each congregation was found to be delineated according to a specific set of demographic variables, each forming the profile of a wider community beyond that generated by itself. Additional investigations revealed how the congregations operated at the micro, meso and macro levels of social integration and differentiation.

Brian Friel’s Transformation from Short Fiction Writer to Dramatist

In 1965, Irish playwright Brian Friel emphatically told Graham Morrison, don't concentrate on the theatre at all. I live on short stories. This is where my living comes from. As for play-writing, it began as a sort of and then eventually I got caught up more and more in it. But the short story is the basis of all the work I do. (1) By 1968, however, Friel had virtually stopped writing stories. To date, no critic has sufficiently explained why Friel moved from writing short fiction and drama solely to writing drama by the end of the 1960s, although one critic, citing Friel's statement about playwriting as self-indulgence has recently wrongly argued that Faber and Faber's inability to secure publishing rights to Friel's short fiction and its publication instead by smaller firms in the 1960s and 1970s have altered not only the Irish 'canon' but even the actual generic choices of a writer. (2) The more accepted narrative to emerge in criticism of Friel's work, however, suggests that not only did Friel find the formulaic requirements for short fiction in the New Yorker, which published many of his stories, stifling, but also that he realized that his short fiction was too imitative of the two Irish masters at the time, Sean O'Faolain and Frank O'Connor. (3) But there are several equally important reasons for Friel's commitment to drama and rejection of short fiction. They include Friel's experimentation with other genres such as radio drama and journalism, which may have helped him realize that he was better suited for a more fluid, experimental genre than short fiction, and his realization--expressed in his major essays on theater--that only drama, with its ability to enchant audiences, would allow him to depict his consistent theme of flux while also appealing to a potential community within the theater. Finally, Friel's interest in politics almost ineluctably kept him in the dramatic arena as the conflict in Northern Ireland lengthened and deepened through the 1970s and 1980s. This essay thus concludes with an assessment of the role of the Field Day Theatre Company, which enabled Friel to offer an exciting, fluid alternative on the stage to the hidebound, binary politics of Northern Ireland that provided both a model of communal interrogation and tentative articulation of deep-seated political, religious, and cultural problems that might augur a less divided society in the future. For a time, Friel seems to have wondered if radio drama would be the subgenre most suited to his desire to community through exploring the intellectual, social, spiritual, geographic, and political milieu of his region of Northern Ireland. As I have argued elsewhere, Nobel Laureate Seamus Heaney, also raised in Northern Ireland, used the platform of BBC Northern Ireland to create sonically an imagined regional community of the sort described by Benedict Anderson [in Imagined Communities], a new province, where the contributions of both Catholics and Protestants would be honoured. (4) While more reticent about his aim in this regard than Heaney has been, Friel has nonetheless long been interested in drawing together disparate members of the community in Northern Ireland. He realized early in his career that radio exercised a special hold on the minds of the Irish and had the sort of mesmerizing effect upon which he would later base his ritualized theory of theater, a theory metadramatically explored in his masterpiece, Faith Healer (1979). Heaney has recalled the intensity with which he and family members listened to the radio in the 1940s and 1950s: If an angel had passed or a mighty wind had arisen or tongues of flames descended, the occasion could not have been more prepared for or more expectant. (5) Even when became more popular in the 1960s, Rex Cathcart has shown that Northern Irish audiences remained loyal to the older medium in part because television long lacked any significant local component whereas radio continued to supply a regional service. …

Educational effectiveness of an intervention programme for social-emotional learning

AbstractThe article presents a critical reflection of the use of mixed and blended methods in the first 2 years of a 3-year longitudinal randomised evaluation of PATHS (NI), a social and emotional intervention programme introduced in schools in a region of Northern Ireland (NI) traditionally characterised by religious and cultural diversity. As described by Durlak and Weissburg (2010), social-emotional learning (SEL) is the process through which children and adolescents acquire the attitudes and skills to: (a) recognise and manage emotions, (b) set and achieve positive goals, (c) demonstrate care and concern for others, (d) establish and maintain positive relationships, (e) make responsible decisions, and (f ) handle interpersonal relationships effectively. Implementation of the PATHS (NI) programme began in six schools for children aged 4–11 in September 2008 as a pilot phase of the programme’s development. The article reports how the analyses of data obtained from mixed and blended methods produced comp...