GEOGRAPHIC PROFILE OF HEALTHCARE NEEDS AND NON-ACUTE HEALTHCARE SUPPLY IN IRELAND. ESRI RESEARCH SERIES NUMBER 90 JULY 2019

This report provides evidence on the supply of and need for non-acute primary, community and long-term care across geographic areas in Ireland in 2014. This is the first report to be published from the Health Research Board-funded project ‘An inter-sectoral analysis by geographic area of the need for and the supply and utilisation of health services in Ireland’. This report provides the most comprehensive evidence on the geographic distribution of primary, community and long-term care supply to have been published for Ireland to date. Overall, the report finds significant inequalities in the supply of primary, community and longterm care services across counties in Ireland.1 The findings have important implications for future planning of the Irish health system. The overall objective of the project is to provide evidence to inform policymakers about the shift of care, where appropriate, from the acute hospital setting to nonacute care settings. This project is undertaken in the context of significant system reforms in recent years that aimed to, among other things, achieve greater integration in the Irish healthcare system via shifting care, where appropriate, from acute to non-acute settings and building capacity in primary, community and longterm care. The project sets out to provide detailed evidence on supply of services in the non-acute sector, compares supply across regions to identify where nonacute care supply is particularly scarce, and provides evidence on how acute and non-acute services interact, and substitute, within the Irish health and social care system. Evidence generated from this project is of particular relevance in the context of the current Sláintecare strategy (Houses of the Oireachtas Committee on the Future of Healthcare, 2017), a cross-party plan aimed at delivering sustainable and equitable health and social care services in Ireland

AN ANALYSIS OF THE EFFECTS ON IRISH HOSPITAL CARE OF THE SUPPLY OF CARE INSIDE AND OUTSIDE THE HOSPITAL. ESRI RESEARCH SERIES NUMBER 91 SEPTEMBER 2019

This report provides new evidence on key factors that affect patients’ length of stay (LOS) in Irish public acute hospitals. Overall, the report finds that greater supply of home care and long-term residential care (LTRC) could reduce patients’ LOS and thereby reduce delayed discharges, particularly for older people, in Irish hospitals. This is the second report published from the Health Research Board-funded project, An inter-sectoral analysis by geographic area of the need for and the supply and utilisation of health services in Ireland. Findings in this report build on comprehensive evidence from Smith et al. (2019) on the geographic distribution of long-term care and community care in Ireland in 2014. The overall objective of the project is to provide evidence to inform policymakers about the scope to move care from acute hospitals to other care settings in the community or LTRC (whether for longer stays or shorter-term rehabilitation or convalescence). This project is undertaken in the context of the Sláintecare (Houses of the Oireachtas Committee on the Future of Healthcare, 2017) reforms that seek to achieve greater integration in the Irish healthcare system and move delivery of care into the community where appropriate. The aim of this report is to contribute new evidence on key factors that affect patients’ LOS and the extent of delayed discharges in public hospitals

Demand for the Statutory Home Care Scheme. ESRI Research Series 122 March 2021.

A statutory scheme for the financing and regulation of home support services is a key Sláintecare reform proposal. An Economic and Social Research Institute report entitled “Demand for the Statutory Home Support Scheme” is the first of three research projects funded by the Department of Health to inform the development of a home support scheme

Accessibility and dimensionality: enhanced real time creative independence for digital musicians with quadriplegic cerebral palsy

Inclusive music activities for people with physical disabilities commonly emphasise facilitated processes, based both on constrained gestural capabilities, and on the simplicity of the available interfaces. Inclusive music processes employ consumer controllers, computer access tools and/or specialized digital musical instruments (DMIs). The first category reveals a design ethos identified by the authors as artefact multiplication -- many sliders, buttons, dials and menu layers; the latter types offer ergonomic accessibility through artefact magnification. We present a prototype DMI that eschews artefact multiplication in pursuit of enhanced real time creative independence. We reconceptualise the universal click-drag interaction model via a single sensor type, which affords both binary and continuous performance control. Accessibility is optimized via a familiar interaction model and through customized ergonomics, but it is the mapping strategy that emphasizes transparency and sophistication in the hierarchical correspondences between the available gesture dimensions and expressive musical cues. Through a participatory and progressive methodology we identify an ostensibly simple targeting gesture rich in dynamic and reliable features: (1) contact location; (2) contact duration; (3) momentary force; (4) continuous force, and; (5) dyad orientation. These features are mapped onto dynamic musical cues, most notably via new mappings for vibrato and arpeggio execution

High-current inductors for high-power automotive DC-DC converters

This thesis is focused on the investigation of magnetic materials for high-power dcdc converters in hybrid and fuel cell vehicles and the development of an optimized high-power inductor for a multi-phase converter. The thesis introduces the power system architectures for hybrid and fuel cell vehicles. The requirements for power electronic converters are established and the dc-dc converter topologies of interest are introduced. A compact and efficient inductor is critical to reduce the overall cost, weight and volume of the dc-dc converter and optimize vehicle driving range and traction power. Firstly, materials suitable for a gapped CC-core inductor are analyzed and investigated. A novel inductor-design algorithm is developed and automated in order to compare and contrast the various magnetic materials over a range of frequencies and ripple ratios. The algorithm is developed for foil-wound inductors with gapped CC-cores in the low (10 kHz) to medium (30 kHz) frequency range and investigates the materials in a natural-convection-cooled environment. The practical effects of frequency, ripple, air-gap fringing, and thermal configuration are investigated next for the iron-based amorphous metal and 6.5 % silicon steel materials. A 2.5 kW converter is built to verify the optimum material selection and thermal configuration over the frequency range and ripple ratios of interest. Inductor size can increase in both of these laminated materials due to increased airgap fringing losses. Distributing the airgap is demonstrated to reduce the inductor losses and size but has practical limitations for iron-based amorphous metal cores. The effects of the manufacturing process are shown to degrade the iron-based amorphous metal multi-cut core loss. The experimental results also suggest that gap loss is not a significant consideration in these experiments. The predicted losses by the equation developed by Reuben Lee and cited by Colonel McLyman are significantly higher than the experimental results suggest. Iron-based amorphous metal has better preformance than 6.5 % silicon steel when a single cut core and natural-convection-cooling are used. Conduction cooling, rather than natural convection, can result in the highest power density inductor. The cooling for these laminated materials is very dependent on the direction of the lamination and the component mounting. Experimental results are produced showing the effects of lamination direction on the cooling path. A significant temperature reduction is demonstrated for conduction cooling versus natural-convection cooling. Iron-based amorphous metal and 6.5% silicon steel are competitive materials when conduction cooled. A novel inductor design algorithm is developed for foil-wound inductors with gapped CC-cores for conduction cooling of core and copper. Again, conduction cooling, rather than natural convection, is shown to reduce the size and weight of the inductor. The weight of the 6.5 % silicon steel inductor is reduced by around a factor of ten compared to natural-convection cooling due to the high thermal conductivity of the material. The conduction cooling algorithm is used to develop high-power custom inductors for use in a high power multi-phase boost converter. Finally, a high power digitally-controlled multi-phase boost converter system is designed and constructed to test the high-power inductors. The performance of the inductors is compared to the predictions used in the design process and very good correlation is achieved. The thesis results have been documented at IEEE APEC, PESC and IAS conferences in 2007 and at the IEEE EPE conference in 2008

COVID-19 and emergency department attendances in Irish public hospitals. ESRI QEC Special Article May 2020.

New ESRI research published today, 22 May, shows that emergency department (ED) attendances in Ireland fell sharply at the onset of COVID-19 outbreak in Ireland. The average number of daily emergency department attendances at the end of March 2020 was approximately half what it was at the beginning of March. Similar reductions were seen across each region of the country. The reductions were substantial across all age groups, with particularly high reductions amongst younger age groups. There was even a decline in the number of attendances classified as very urgent/immediate. The fall in these more serious cases was 27%, compared to a 32% decline in less urgent attendances

The Future of Qualitative Research in Psychology: Accentuating the Positive.

In this paper we reflect on current trends and anticipate future prospects regarding qualitative research in Psychology. We highlight various institutional and disciplinary obstacles to qualitative research diversity, complexity and quality. At the same time, we note some causes for optimism, including publication breakthroughs and vitality within the field. The paper is structured into three main sections which consider: 1) the positioning of qualitative research within Psychology; 2) celebrating the different kinds of knowledge produced by qualitative research; and 3) implementing high quality qualitative research. In general we accentuate the positive, recognising and illustrating innovative qualitative research practices which generate new insights and propel the field forward. We conclude by emphasising the importance of research training: for qualitative research to flourish within Psychology (and beyond), students and early career researchers require more sophisticated, in-depth instruction than is currently offered

Nonprimate hepaciviruses in domestic horses, United kingdom

Although the origin of hepatitis C virus infections in humans remains undetermined, a close homolog of this virus, termed canine hepacivirus (CHV) and found in respiratory secretions of dogs, provides evidence for a wider distribution of hepaciviruses in mammals. We determined frequencies of active infection among dogs and other mammals in the United Kingdom. Samples from dogs (46 respiratory, 99 plasma, 45 autopsy samples) were CHV negative by PCR. Screening of 362 samples from cats, horses, donkeys, rodents, and pigs identified 3 (2%) positive samples from 142 horses. These samples were genetically divergent from CHV and nonprimate hepaciviruses that horses were infected with during 2012 in New York state, USA. Investigation of infected horses demonstrated nonprimate hepacivirus persistence, high viral loads in plasma (105–107 RNA copies/mL), and liver function test results usually within reference ranges, although several values ranged from high normal to mildly elevated. Disease associations and host range of nonprimate hepaciviruses warrant further investigation

APCR, factor V gene known and novel SNPs and adverse pregnancy outcomes in an Irish cohort of pregnant women

<p>Abstract</p> <p>Background</p> <p>Activated Protein C Resistance (APCR), a poor anticoagulant response of APC in haemostasis, is the commonest heritable thrombophilia. Adverse outcomes during pregnancy have been linked to APCR. This study determined the frequency of APCR, factor V gene known and novel SNPs and adverse outcomes in a group of pregnant women.</p> <p>Methods</p> <p>Blood samples collected from 907 pregnant women were tested using the Coatest^®Classic and Modified functional haematological tests to establish the frequency of APCR. PCR-Restriction Enzyme Analysis (PCR-REA), PCR-DNA probe hybridisation analysis and DNA sequencing were used for molecular screening of known mutations in the factor V gene in subjects determined to have APCR based on the Coatest^®Classic and/or Modified functional haematological tests. Glycosylase Mediated Polymorphism Detection (GMPD), a SNP screening technique and DNA sequencing, were used to identify SNPs in the factor V gene of 5 APCR subjects.</p> <p>Results</p> <p>Sixteen percent of the study group had an APCR phenotype. Factor V Leiden (FVL), FV Cambridge, and haplotype (H) R2 alleles were identified in this group. Thirty-three SNPs; 9 silent SNPs and 24 missense SNPs, of which 20 SNPs were novel, were identified in the 5 APCR subjects. Adverse pregnancy outcomes were found at a frequency of 35% in the group with APCR based on Classic Coatest^®test only and at 45% in the group with APCR based on the Modified Coatest^®test. Forty-eight percent of subjects with FVL had adverse outcomes while in the group of subjects with no FVL, adverse outcomes occurred at a frequency of 37%.</p> <p>Conclusions</p> <p>Known mutations and novel SNPs in the factor V gene were identified in the study cohort determined to have APCR in pregnancy. Further studies are required to investigate the contribution of these novel SNPs to the APCR phenotype. Adverse outcomes including early pregnancy loss (EPL), preeclampsia (PET) and intrauterine growth restriction (IGUR) were not significantly more frequent in subjects with APCR compared to normal pregnant women however Pregnancy induced hypertension (PIH) was found to be associated with FVL in our study group.</p