Dual diagnosis: a community perspective

This report presents a community inquiry project concerned with addressing Dual Diagnosis needs in the urban communities of Finglas and Cabra, North Dublin. The study was funded by the Social Inclusion/ Addiction Service, CH09, Health Service Executive and Finglas/Cabra Local Drug & Alcohol Task Force. This Participatory Action Research study involved a process in which the research participants were in partnership with the research team for the duration of the study. This project had two research cycles over a nine-month period. In the first month of the study, the community research group (CRG) was established to oversee, support and participate in the research process. This group included members of the community such as service users, their family members and service providers. Throughout this inquiry, central to all activities, was the importance of ensuring that there was a shared community conversation about the local Dual Diagnosis needs. This study achieved this using Participatory Action Research methods. The first cycle comprised of an Open Dialogue Community Forum and three focus groups. Participants included local residents, service users, community representatives, local health, and social care professionals. During this cycle, participants shared personal experiences of Dual Diagnosis and the difficulties in accessing appropriate treatment and care, which often lacks compassion for individuals seeking help. Family members spoke about the effect Dual Diagnosis has had on their own and on their relatives’ lives. Professionals shared their experiences of working and supporting clients with Dual Diagnosis. Findings in this cycle mirrored those from the international literature. For example, no joined up policy, restricted and inappropriate service access, limited family support, a lack of intra agency collaboration, organisational struggles for professionals to liaise across services and agencies in relation to collaborative care. Cycle two focused on how the communities and local organisations can provide effective care for people with Dual Diagnosis and their families, along with required government directives. A second Open Dialogue Forum identified the required actions at community, organisational and governmental level. The findings are summarised across three main domains: Community response; Organisational requirements; Governmental responsibility. This research provides a community insight into the impact of Dual Diagnosis. It highlights ways to address Dual Diagnosis through a series of interconnecting actions supported by governmental and policy change. Additionally, the findings have implications for the two communities and national policy makers. Notably, this work contributes to the dialogue surrounding the unmet needs of those who experience Dual Diagnosis. Of particular relevance to this research is the process by which the community was galvanised and the representative stakeholders brought together in dialogue. Crucially, this process was deemed a significant outcome of this research in that it facilitated the emergence of mutually agreed findings. The community stakeholders can now establish a process towards enacting the required changes to develop provision for people with Dual Diagnosis and their families. This research demonstrates that the community experience of Dual Diagnosis is complex and impactful. Importantly, it appears that there are systemic issues effecting the two communities’ ability to respond to Dual Diagnosis. It is rare for research to present the shared voices of service users, their families and those they seek help from about the impact of a challenging condition like Dual Diagnosis. This collective voice needs acknowledgment as it is grounded in the shared desire to address the needs of those with Dual Diagnosis from a community and local organisational level while signposting both policy and operational changes to drive and facilitate this

Cryptic Disc Structures Resembling Ediacaran Discoidal Fossils from the Lower Silurian Hellefjord Schist, Arctic Norway

The Hellefjord Schist, a volcaniclastic psammite-pelite formation in the Caledonides of Arctic Norway contains discoidal impressions and apparent tube casts that share morphological and taphonomic similarities to Neoproterozoic stem-holdfast forms. U-Pb zircon geochronology on the host metasediment indicates it was deposited between 437 ± 2 and 439 ± 3 Ma, but also indicates that an inferred basal conglomerate to this formation must be part of an older stratigraphic element, as it is cross-cut by a 546 ± 4 Ma pegmatite. These results confirm that the Hellefjord Schist is separated from underlying older Proterozoic rocks by a thrust. It has previously been argued that the Cambrian Substrate Revolution destroyed the ecological niches that the Neoproterozoic frond-holdfasts organisms occupied. However, the discovery of these fossils in Silurian rocks demonstrates that the environment and substrate must have been similar enough to Neoproterozoic settings that frond-holdfast bodyplans were still ecologically viable some hundred million years later

Irish nurses’ and midwives’ understanding and experiences of empowerment

Aim This study explored conceptualisations of empowerment amongst Irish nurses and midwives. Background Current literature on the meaning of empowerment in the literature lacks consensus. As a result there is a likelihood that empowerment will be conceptualised differently between managers and sub-ordinates. Method In order to get a sense of how Irish practitioners viewed empowerment, ten focus groups were held in locations throughout Ireland (n = 93). A national distribution of participants was obtained. Results Twenty-one different responses emerged representing what nurses and midwives understood by the term empowerment. In relation to experiences of empowerment, six themes were found to impact on empowerment experiences. Three themes emerged as central to empowerment. One theme (education for practice) was identified as an antecedent to empowerment. Conclusion Empowerment is a complex concept and its meaning is contextually determined. Managers play a key role in impacting on the empowerment perceptions of Irish nurses and midwives

Finding Columba in the Book of Kells

Saint Columba’s association with the Book of Kells has a long history. The earliest evidence may date to 1007 when we read about ‘the Great Gospel of Colum Cille.’ Past interpretations suggest this book (probably Kells) was written by the saint. Scholars now agree this is impossible and support instead the notion that this eighth/ninth-century Gospel book was created to honour Columba around 200 years after his death (d.597). The paper investigates the possibility that several sources of evidence in Kells link it with Columba. The first considers the iconography of ff. 2v-3r in Kells’ Canon Tables, which reference relics traditionally associated with the saint (his white robe, flabellum, stylus, and a shrine). The second examines the possibility that the manuscript known as the Cathach influenced Kells. While the most prominent feature is an unusual decorative motif from the older book, attention is also drawn to several other correspondences between the two manuscripts. A prolific scribe, Columba, was traditionally believed to have written the Cathach, which, unlike Kells, may be contemporary with him. The evidence presented here strengthens the links between Kells and the saint, suggesting it rightly deserves to be called ‘the Great Gospel of Colum Cille.

Continuity and transition in the poetry of James Tevlin (1798-1873)

The notable folk-poet, James Tevlin, from Billywood, Moynalty, was born in 1798 and died in 1873. Tevlin's poems had a wide circulation in Meath, Cavan, Louth and Westmeath, according to the Irish scholar Henry Morris, writing in 1933. Tevlin is one of the group of poets in north Meath who were known personally by the prolific scribe, Peter Gallegan, who recorded their work in his numerous manuscripts. As well as Tevlin, there was Peter Daly of Carnaross, Matthew Monaghan of Mullagh, Peter Coalrake and Michael Clarke, both of Nobber, HughMcDonnell of Drunconrath and Fr. Paul O'Brien of Cormeen, who became the first professor of Irish in Maynooth College. These poets wrote in Irish and in English, or sometimes in macaronic verse, where the two languages are combined in the same poem. Hence their work, like that of Tevlin, marks them as part of the transition from Irish to English, a change which accelerated rapidily in Meath throughout the nineteenth century

Sustaining community heritage: the case for political action

The following is the gist of an oral presentation made to the Joint Dail-Senad Committee on Heritage and the Irish Language, Leinster House, 2 November 1999, at the invitation of the Committee. The presentation was made on behalf of The O'Carolan Harp and Cultural Festival, Nobber, The Meath Harp School and Meath Archaeological and Historical Society. The proceedings were televised on TG4. Traditional arts are the result of consensus in a community. Song, music, dance, verse and folklore express the personality and identity of a community over time. Song and verse - for instance the great folk songs"Donall Og" and "An Droighnean Donn" - give the permanence of art to the intimate experiences of the people. People's memories and emotions, their joys and sorrows, are caught in the sensuous sound-web of this richly verbal art and made resonant in the imagination. Snatched from the encroaching darkness of oblivion, their joys and sorrows live in the illumination of the poet's song, and serve to light the way on the uncertain journey from yesterday to tomorrow. The community knows itself and reflects upon itself through art-lamenting its losses or celebrating notable feats or accomplishments. This is particcccularly true of an oral culture. I think for instance, of a song in the aisling or vision mode or tradition, "Ur-Chill an Chreagain", from my own part of the country, which was known as the national anthem of south Ulster, so frequently was it sung

Book Review: From Prehistory to the Present: Kilskyre-Ballinlough through the ages.

The parish of Kilskyre and Ballinlough celebrated in 2004 the 150th anniversary of the building of the beautiful Church of St. Alphonsus Liguori. To mark the occasion, the members of the Historical Society, together with Fr. Andy Doyle, P.P., produced a splendid history of the parish, a marvellous compendium of life in the area from earliest times to the present day. The volume richly deserves the warm words of welcome prefaced by Bishop Michael Smith, and by Uachtaran na hEireann, Mary McAleese, who launched the volume when she attended the festivities

Sustaining community heritage: the case for political action

The following is the gist of an oral presentation made to the Joint Dail-Senad Committee on Heritage and the Irish Language, Leinster House, 2 November 1999, at the invitation of the Committee. The presentation was made on behalf of The O'Carolan Harp and Cultural Festival, Nobber, The Meath Harp School and Meath Archaeological and Historical Society. The proceedings were televised on TG4. Traditional arts are the result of consensus in a community. Song, music, dance, verse and folklore express the personality and identity of a community over time. Song and verse - for instance the great folk songs"Donall Og" and "An Droighnean Donn" - give the permanence of art to the intimate experiences of the people. People's memories and emotions, their joys and sorrows, are caught in the sensuous sound-web of this richly verbal art and made resonant in the imagination. Snatched from the encroaching darkness of oblivion, their joys and sorrows live in the illumination of the poet's song, and serve to light the way on the uncertain journey from yesterday to tomorrow. The community knows itself and reflects upon itself through art-lamenting its losses or celebrating notable feats or accomplishments. This is particcccularly true of an oral culture. I think for instance, of a song in the aisling or vision mode or tradition, "Ur-Chill an Chreagain", from my own part of the country, which was known as the national anthem of south Ulster, so frequently was it sung