From Shirts to Arpilleras – Derry's Textile Heritage Continues

The other contemporary textile programme closely linked to Derry city comes in the form of the International Conflict Textiles collection curated by Roberta Bacic. From Shirts to Arpilleras - Derry's Textile Heritage Continues Since then, Conflict Textiles has continued to use the process of I arpillera i workshops, seeding the creation of I arpilleras i and textiles exhibitions as a means of encouraging people to reflect on and process the difficult past in Northern Ireland and beyond. [Extracted from the article] Copyright of Textile: The Journal of Cloth & Culture is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

ICU without walls = ICU without Data? the Covid-19 deficit

Introduction: Northern Ireland (NI) has 5.5 ICU beds/100 000 population,1 amongst the lowest in Western Europe.2 Alongside ICU bed expansion the Covid-19 response required delivery of advanced Respiratory support (Continuous Positive Airway Pressure (CPAP) and High Flow Nasal Oxygen (HFNO)) outside ICU. ICNARC provides robust data for patients within ICU but this is unavailable for those receiving 'critical care' elsewhere. Objective(s): To evaluate delivery of CPAP/HFNO outside of ICU to Covid-19 patients - focusing on demographics and outcomes including ICU admission and mortality. Method(s): Ward-CPAP for acute hypoxaemic respiratory failure (AHRF) was not previously utilised.3 It was introduced for Covid-19 to Medical wards. Data was analysed using the NI Electronic Care Record, ward electronic note system (EDAMS) and ICU system (ICCA, Koninklijke Philips N.V.). Data was compared between Wave 1 (01/03/2020 - 12/12/2020) and Wave 2 (13/12/2020 - 01/04/2021). Result(s): 215 patients received CPAP/HFNO/Invasive Mechanical Ventilation (IMV) for Covid-19: 103 in Wave 1 and 112 in Wave 2. 75 Covid-19 patients were admitted to the ICU itself (comprising 44 of the study cohort, 11 direct from ED and 20 transferred from other Trusts). Table 1 shows demographics. Fewer patients were female as seen elsewhere,4 there were more young patients in Wave 2. The majority of patients would likely have been ICU candidates pre-pandemic,3 but a subset of 25% were deemed for a ward ceiling-of-care on admission by a Consultant and the proportion of elderly patients was higher than described by ICNARC.4 Comorbidities and obesity were common. Outcomes are shown in Table 2 and Figures 1-3. Close co-operation with ICU saw 61% of patients with a documented ICU review. Overall 20% of patients were admitted to ICU, and 15% received IMV. Mortality was 37%, but 22% if patients with an admission ward ceiling-of-care decision were excluded. Mortality correlated with frailty and age (fig 2&3). Outcomes were generally better in Wave 2. Conclusion(s): This Evaluation documents the huge contribution to the critical care Covid-19 response made by our Medical teams, not captured by ICNARC. Most patients avoided ICU admission and IMV and outcomes were likely at least comparable which undoubtedly freed up vital ICU beds. We thank the teams involved and believe it is vital to evaluate the outcome of all critically ill Covid-19 patients irrespective of their location.

Adapting Regulations Post-Brexit

The UK government is taking advantage of the new regulatory flexibility, afforded by Brexit, to boost the country's competitiveness in pharma On 1 Jan. 2021, the United Kingdom formally left the European Union to become a third country and no longer a member of the Union's single market and customs union. The UK has, for example, decided to draw up its own version of the EU chemicals legislation-called REACH (Registration, Evaluation, Authorization, and Restriction of Chemicals)-which sets technical standards for chemical ingredients for medicines (1). Because the UK is a separate legal entity-a third country-the UK's excipient producers and their raw material suppliers have started to be concerned about procedures like customs declarations and rules of origin. [...]by 18 Feb. 2021 the UK had vaccinated 26% of its population versus 8% in Denmark-the leading EU country for vaccines availability-6% in Germany, and 5% in France (6). NICE needs to change Industry believes that the National Institute for Health and Care Excellence (NICE), the government's health technology assessment (HTA) body, is being too restrictive with its evaluation of digitalization products, which ultimately sets the price paid by the government for them (9).

The introduction of novel bladder outlet therapies in a regional day-case unit in Northern Ireland

ContextNorthern Ireland has five health and social care trusts that provide a Urology service. COVID-19 resulted in the cessation of all but the most urgent elective urological cases. As a result there was an immediate need to enhance current facilities to improve care for our patients. Operations for bladder outlet obstruction, such as transurethral resection of the prostate (TURP), were largely on hold. Men with benign prostatic enlargement continued to suffer in terms of quality of life from symptoms and morbidity from their condition, with subsequent costly attendances through unscheduled care.Issue/ChallengeAs one trust, we had over 100 men active on a waiting list for TURP. We had over 100 patients awaiting a review to decide on surgical management. We had over 400 men awaiting routine assessment through our lower urinary tract symptom assessment clinic.Several surgical options now exist for bladder outlet obstruction. Until this project, TURP was the only option offered to men in Northern Ireland, which is out-with NICE guidance. A TURP has traditionally been an inpatient operation requiring a hospital stay of 2-3 days. During the pandemic and looking to the recovery of services, this was not a viable option.Assessment of issue and analysis of its causesA scoping exercise on where to best place any new service was performed. Key stakeholders included our clinical leaders, management colleagues in the trust and the Department of Health. With successful implementation of a traffic light system for COVID-19, a green pathway for elective surgery had been implemented with great success in our main inpatient Ulster Hospital site. Reflecting on what had been learned in this process, and with a clear need to advocate day-case as default for certain procedures, a regional centre out-with our main inpatient operating theatres was delivered – the Regional Day Procedure Centre (DPC), based at Lagan Valley Hospital.ImpactThe impact has been improved individual patient journeys and improved quality of life for men living with benign prostatic obstruction, with their treatment happening much more promptly, as well as increased staff satisfaction and a saving in theatre costs and bed days.InterventionWe learned and implemented novel bladder outlet techniques;namely Rezum steam ablation therapy to the prostate;green light laser treatment of the prostate (GLLP) and hoImium enucleation of the prostate (HoLEP). We arranged simulation-based training for our Consultant and Speciality Doctor team and mock theatre set up training with the theatre staff to include common pitfalls with equipment. We also arranged simulation-based training for postgraduate surgical trainees, enhancing training during the pandemic.Involvement of stakeholders, such as patients, carers or family members:We engaged and had the support of the clinical and managerial teams from the outset. We opened communication with the day-case unit pre-assessment and anaesthetic teams early. We introduced a new co-located outpatient prostate assessment clinic in conjunction with a nurse specialist.Key MessagesOver the last 6 months we have implemented an all options service for bladder outlet obstruction. We have performed more than 50 day-case Rezum cases, introduced day-case GLLP and inpatient HoLEP. All Rezum and GLLP cases have been day-case with the subsequent personal and institutional savings. We will report our clinical outcomes and reflect on lessons learned.Lessons learntThe introduction of novel bladder outlet therapies has led to improved quality of life for men living with bladder outlet obstruction. We have significantly reduced the waiting list and the waiting time for treatment. We have shown that service development and improvement for benign disease is possible even during a pandemic.Measurement of improvementWe are following up these men with validated symptoms and quality of life scores. We get objective measurement of improvement through repeat flow rate and measurement of post void residual urinary volumes. We have kept a database on key patien parameters and self-reported outcomes. Initial results are promising.Strategy for improvementAs an ongoing and ever evolving project, we use multiple PDSA cycles to improve our service. Weekly team briefs at the end of theatre lists allow feedback from all staff. In particular we have learned from our patients. We have introduced local anaesthetic treatment with Rezum in men unfit for other options. We have contacted other units to share their experience and there has been coverage of our work in our regional media.

Rehabilitation needs after critical illness: Referral outcomes from a ICU follow up clinic in Northern Ireland

Introduction: In 2019/20 a total of 171,900 people were admitted to adult general intensive care units (ICU) across England, Wales and Northern Ireland, with a survival rate of 79.6% at hospital discharge.1 Patients who survive critical illness and admission to ICU often experience ICU-related long-term physical and non-physical impairments and disability following hospital discharge.2 National guidance advocates multidisciplinary team (MDT) follow up to identify and manage the unmet health needs of this patient population.3-4 The UK has seen an increase in the number of follow up services available in the last 7 years.2 The Covid-19 pandemic further highlighted the need to provide this service, locally resulting in the establishment of the Belfast Health and Social Care Trust (BHSCT) ICU follow up clinic in July 2020. The follow up clinic is offered to patients aged = 18 years, an ICU length of stay of = 4 days, who have been discharged from an inpatient setting within the last 12 weeks and do not receive follow up from any other established care pathway. The clinic consists of an ICU Nurse, Doctor, Clinical Psychologist and Physiotherapist. Patients are offered either a virtual, face-to-face or telephone appointment. Objective(s): To identify unmet rehabilitation needs and onward referral requirements of patients presenting at an ICU follow-up clinic in Northern Ireland. Method(s): Data was gathered retrospectively using an excel database detailing patient demographics, appointment details and onward referrals generated from the clinic. Data was analysed for a set time period between the 01/12/2021 - 09/02/2022. The type of referral and the profession responsible were captured. Result(s): During the time period eight post ICU follow up clinics were completed. A total of 36 patient's attended (14 male and 22 female). Six appointments were attended virtually via MS Teams, 12 via telephone and 18 face-to-face. Twenty-three (64%) of the patients required at least one onward health referral. A total of 61 onward health referrals were generated from this population. Table 1 details the number of onwards referrals by speciality. Conclusion(s): Approximately 64% of patients who attended the post ICU follow up clinic, during a 10 week period, demonstrated unmet rehabilitation needs resulting in onward health referrals. This data supports the need for a post ICU follow up clinic at BHSCT to identify ongoing need, ensure transition of care to relevant services and optimise patient's physical and psychological outcomes. One limitation of this study is that not all recommended allied health professionals are commissioned for the clinic which may impact on the health needs identified. Future work should consider the impact of this and discussions regarding the need for a commissioned post ICU follow up clinic which is truly MDT for this patient population should be considered.

A six year experience of a national leadership fellowship in Northern Ireland: achieve, develop, explore programme for trainees (ADEPT)

ContextThe Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland (NI) with a collective leadership strategy. This is a Clinical Leadership Fellows programme available to specialist, general practice and dental trainees in NI as an out of programme experience year. It is recruited competitively through a scored application followed by a 3-part interview. The fellowship programme is coordinated with host organisations, who sponsor fellows to work with organisational leaders in an apprentice model and undertake a self-directed project. This leadership training was provided by the HSC Leadership Centre until 2020, which supported achievement of an Institute of Leadership and Management (ILM) level 7 Certificate. The current 2021-22 cohort have joined the Faculty of Medical Leadership and Management (FMLM) Fellow Scheme.Issue/ChallengeWith the ADEPT programme now in its sixth year and many of its graduates consultants or general practitioners (GPs), a need was identified to assess how the fellowship has shaped participant career performance, decision making and views on leadership training. This study aimed to determine the demographics of ADEPT Fellows and evaluate the impact of the fellowship as perceived by ADEPT alumni on career goals, choices, achievements, and development of leadership skills related to the NHS Healthcare Leadership Model.Assessment of issue and analysis of its causesDemographic data for all ADEPT fellows was held centrally through Northern Ireland Medical and Dental Training Agency (NIMDTA) and assessed anonymously. A mixed-methods questionnaire was composed using Smart Survey. Likert-scale questions were designed to determine the extent to which participants believed ADEPT supported their development of strong and exemplary elements of the nine dimensions of the NHS Healthcare Leadership Model. This questionnaire was split into 4 sections;demographics and project outline, self-assessment of leadership skills before and after ADEPT, career planning and progression and suggestions for programme improvement. The questionnaire was distributed electronically to all ADEPT alumni in November 2021 and remained open for 4 weeks.ImpactThis study validates the usefulness of the ADEPT clinical leadership programme both at an individual and organisational level.InterventionThere have been 46 ADEPT fellows to date (72% female;all fellows were white). ADEPT fellows were most commonly from Psychiatry (33%), Paediatrics (17%) and Obstetrics and Gynaecology (15%). There were 19 responses from the alumni cohort of 46 (41%). 75% of respondents reported that their project resulted in publication, presentation or award. Leadership skill development was identified as best in Evaluating Information and Engaging the Team, whereas skills in Sharing the Vision and Developing Capability saw less improvement. The majority felt that the fellowship had been useful in securing their position as a consultant or general practitioner and 50% went on to pursue senior leadership positions.Key MessagesThe ADEPT Clinical Leadership Fellowship delivers effective leadership training as measured by the nine domains of the NHS Healthcare Leadership Model. It provides value for host organisations through the projects undertaken and by developing doctors who are more likely to engage in future formal leadership roles. ADEPT alumni saw the value in their leadership experience and felt it should be embedded in standard postgraduate training schemes to reach a wider audience.Lessons learntA recurring theme in the healthcare sector is that doctors who have gone through years of formal training often fail to recognise the innate leadership skills they have acquired on their journey to become a consultant. This was evident within the ADEPT group as the majority did not identify themselves as leaders prior to undertaking the fellowship. Distinguishing, nurturing and reframing these skills or use outside of the clinical area are important considerations when developing leadership training in healthcare.Strategy for improvementThe programme will require ongoing review especially given the increasing demand placed on healthcare leadership from the sequelae of the COVID pandemic and an aging society with complex health needs. A ten year follow up to include opinions on the FMLM Fellow Scheme is suggested.

Establishing an Intensive Care follow up clinic for patients in Belfast, Northern Ireland

Introduction: National guidance states that follow up should be offered to all patients who have spent more than four days in intensive care1 with specific guidance for the follow up of COVID patients released in May 2020.2 Prior to the pandemic, in the Belfast trust, there was no follow-up service provided for intensive care patients. The pandemic presented many new challenges to intensive care, with a high number of patients requiring follow up after discharge. It also presented a unique problem in that follow up clinics could not be delivered in the traditional face to face manner. Objective(s): To set up a follow up service that assessed patient recovery from COVID 19 and offered rehabilitation, in a manner that could be delivered safely during a national lockdown. Method(s): A database was collated of all the patients who had been treated in intensive care, during the first wave of the pandemic with a confirmed positive COVID-19 sample. A follow up pathway (Figure 1) was designed for the clinic based on the BTS and FICM guidelines.2-3 The multidisciplinary team used Microsoft Teams to complete clinic proformas for each patient, share files and perform virtual appointments. Patient questionnaires were collated using the forms app within MS Teams. Patients filled in various objective health questionnaires at both their 6 and 12 week appointments to allow the team to assess their rehabilitation. Once the appointments were completed the proformas were entered into their permanent medical record on the Northern Ireland Electronic Care Record (NIECR). Result(s): There were 42 patients treated in the pandemic's first wave, 40 were reviewed at 6 weeks and 39 at 12 weeks post hospital discharge. Anonymous feedback was gathered electronically from patients about their experience of the clinic. The feedback from the patients was overwhelmingly positive. To date the clinic has offered follow up to nearly 300 patients and is still in use. It has grown in size and has received input from the Belfast trust for further staffing and resources. The project recently received joint first prize in the innovation and transformation in care category for the Health and Social Care Quality Improvement (HSCQI) awards in the trust. Conclusion(s): This project highlights the essential requirement for follow-up after an intensive care admission with significant ongoing morbidity demonstrated in this patient cohort. It is currently still the only service with this breadth of MDT input in Northern Ireland. The initial use of MS Teams has allowed this service to run safely during a pandemic but it has since been adapted as the pandemic has evolved and is now offered to all Intensive care patients. Its collaborative platform allows for immediate communication throughout the whole team, and the ability for the team to be flexible. In essence, we have set up a unique and robust system that can be easily used to offer excellent follow up to Intensive care patients within the Belfast trust.

An Audit Showing the Successful Operation of a Nurse-Led Gout Clinic during the Covid-19 Pandemic

Background/Aims Research has shown nurse-led gout clinics provide better outcomes compared to usual care. This District General Hospital set up a pilot nurse-led gout clinic in autumn 2019. This aimed to improve patients' understanding of their condition, achieve better control of serum uric acid levels (SUA), reduce flares and prevent Emergency Department attendances. Methods A modified clinic protocol, closely modelled on BSR guidance was agreed within the department. With consultant supervision, one nurse specialist provided a mix of in-person and telephone appointments. Targets were set aiming for SUA <360mumol/L for most patients and <300mumol/L for those with erosive change or tophi. All patients were offered prophylaxis. Patients required a rheumatologist's diagnosis of gout or crystal confirmation for enrolment. Exclusion criteria were significant renal or hepatic derangement. Within 3 months of the service starting SARS-CoV-2 impacted the operation of healthcare worldwide and led to the closure of routine outpatient clinics in Northern Ireland. A decision was made to switch the gout clinic to run entirely by telephone. Blood testing was facilitated through primary care and phlebotomy hubs. Results Over a 19-month period, 78 patients were treated and audited through this clinic: 69 men and 9 women. Average age was 57, mean SUA 509 mumol/L at referral and 322 mumol/L on discharge. 69 patients received allopurinol and 9 received febuxostat. No patients required uricosuric drugs. All patients were offered and agreed to take prophylaxis with a majority (85.8%) remaining on it for 3-6 months. Patients required a mean of 3.38 appointments prior to discharge from the clinic. The mean dose of urate lowering therapy on discharge was 315.9mg allopurinol and 93.3mg febuxostat. 95% experienced >=2 flares during their enrolment in the clinic with no patients requiring Emergency Department attendance due to gout flare. Conclusion The nurse-led gout clinic was well received by patients and was effective as a telephone service during the pandemic when so many services were stood down. The clinic was able to continue to provide education, deliver effective reductions in uric acid as well as reduce incidence of flares and Emergency Department attendances. Lower doses of urate lowering therapy than expected were needed to achieve target. A small number of patients were discharged prior to enrolment for initial non-engagement which may have been exacerbated by the lack of face-to-face appointments. Our COVID-19 model did struggle with those patients needing an interpreter. In-person initial appointments have since been restarted;however, a greater proportion of reviews will continue to be offered by telephone given the unexpected success of the model. This audit showed that a nurse-led gout clinic can run successfully, even during a pandemic with a significant reliance on telephone consultations.

Ethnic and gender trends at the annual British Association of Urological Surgeons (BAUS) meeting: A review of BAUS programmes over a 13-year period (2009-2021)

Objective: In this paper, we wanted to review the annual British Association of Urological Surgeons (BAUS) programme to analyse the female and ethnic minority (EM) representation and find out whether there is ethnic and gender disparity, and if it does reflect the reality of the workforce. Method(s): To investigate gender and EM representation, we requested data for BAUS annual meetings over a 13-year period (2009-2021). All speakers and chairpersons for all four sub-sections including Endourology, Oncology, Andrology and Female, Neurological and Urodynamic urology (FNUU) were collated. We also looked at the geographic distribution of the speakers (London area, rest of England, Scotland, Northern Ireland and Wales). Data were analysed separately before and after the COVID-19 pandemic (cut-off March 2020), as in the latter 2 years, the meeting was held virtually. Result(s): A total of 2569 speakers (range: 135-323 speakers/year) were included in our analysis and 2187 (85%) speakers were from the United Kingdom. Of the UK speakers, more than three-quarters (76.6%, n = 1676) were males and females of White ethnicity and (23.4%, n = 511) were EM. The vast majority of speakers throughout the years were males (86%, n = 1891) with only 14% (n = 296) females regardless of their origin and ethnicity. The presence of EM females was only 1.9% (n = 43). The percentage of female representation rose consistently over time from 6.7% (n = 8) in 2009 to 21.1% (n = 44) in 2020, suggesting an upward trend. Regional distribution showed 31%, 63%, 3.6%, 1.6% and 0.2% from London, Rest of England, Scotland, Wales and Northern Ireland, respectively. Both gender and EM representation doubled in the last 2 years during the pandemic (p < 0.001). Conclusion(s): Annual BAUS meetings have seen a higher proportion of ethnic and gender representation in recent years. However, considering the workforce within urology, more needs to be done to address this historical disparity. Hopefully, the BAUS 10-point programme will provide a framework for addressing Equality, Diversity and Inclusion issues related to this bias. Level of Evidence: Not applicable.Copyright © British Association of Urological Surgeons 2022.

Willingness-to-pay for robot-delivered tourism and hospitality services-An exploratory study

Purpose: This paper aims to investigate potential consumers' willingness to pay for robot-delivered services in travel, tourism and hospitality, and the factors that shape their willingness to pay. Design/methodology/approach: An online survey yielded a sample of 1,573 respondents from 99 countries. Independent samples t-test, Analysis of variance (ANOVA), cluster, factor and regression analyses were used. Findings: Respondents expected to pay less for robot-delivered services than human-delivered services. Two clusters were identified: one cluster willing to pay nearly the same price for robotic services as for human-delivered services, whilst the other expected deep discounts for robotic services. The willingness-to-pay was positively associated with the attitudes towards robots in tourism, robotic service experience expectations, men and household size. It was negatively associated to travel frequency, age and education. Research limitations/implications: The paper's main limitation is its exploratory nature and the use of a hypothetical scenario in measuring respondents' willingness to pay. The data were gathered prior to the COVID-19 pandemic and do not reflect the potential changes in perceptions of robots due to the pandemic. Practical implications: Practitioners need to focus on improving the attitudes towards robots in tourism because they are strongly and positively related to the willingness to pay. The marketing messages need to form positive expectations about robotic services. Originality/value: This is one of the first papers to investigate consumers' willingness to pay for robot-delivered services in travel, tourism and hospitality and factors that shape their willingness to pay. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Medicines optimisation for residents with dementia during the COVID-19 pandemic: a qualitative study of the views and experiences of care home managers

Introduction: The COVID-19 pandemic has disproportionately affected people with dementia, especially those in care homes (1). The pandemic may have exacerbated existing medication challenges that care home residents with dementia may experience, such as issues with adherence and administration. Aim(s): To explore the views experiences of care home managers in Northern Ireland (NI) about optimising medicines use and accessing primary healthcare services for residents with dementia during the COVID-19 pandemic and identify key lessons for supporting care home staff with medicines optimisation for residents with dementia both now and during future health crises. Method(s): Care home managers were recruited using several approaches which utilised purposive and snowball sampling. Participant sampling and recruitment commenced in January 2022 and finished in July 2022. The interview topic guide was developed based on published literature, current COVID-19 guidelines for care homes, and following discussion within the research team;it was piloted with two nurses with experience of working in care homes. Semi-structured interviews were conducted either using an online video-conferencing platform or via the telephone after obtaining written informed consent from participants. All interviews were audio recorded, transcribed verbatim, and analysed using thematic analysis (2). Analysis of data is ongoing. Result(s): Fourteen interviews were conducted, lasting between 25 and 56 minutes. Findings to date have highlighted the challenges care homes have faced whilst caring for residents with dementia during the pandemic. Participants described changes to the way in which primary healthcare services were provided. In particular, provision of services from general practice (e.g. prescribing, consultations) were mostly conducted over the telephone and/or online and some participants reported that this had an impact on medication review: ''it's only the review of medication that has not been done during the pandemic'' [CHM-07]. Restrictions on visiting to care homes during the initial and middle phases of the pandemic affected aspects of medicines optimisation for residents with dementia and an already stretched care sector: There was a lot of problems prior to COVID. COVID just made those problems monumental'' [CHM-14]. Most participants perceived that community pharmacy services were not affected by the pandemic and medication supply continued: We haven't had an issue with community pharmacy to be honest with you'' [CHM-03]. Participants identified lessons for future health crises including the need for improved communication with general practitioners, the importance of a multidisciplinary team effort to optimise medicines for residents with dementia, along with input from residents' family members, and greater support for care homes. Conclusion(s): This study has highlighted the difficulties that care home managers have faced in accessing general practice services during the pandemic and the impact this has had on residents with dementia receiving medication review. Whilst these findings add to a limited evidence base, they may not be generalisable to other parts of the UK. Future work will focus on development of a questionnaire study with care home managers.

The International Education Index: A global approach to education policy analysis, performance and sustainable development

Before the COVID‐19 pandemic, the world struggled to address growing educational inequalities and fulfil the commitment to Sustainable Development Goal 4, which seeks to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The pandemic has exacerbated these inequalities and changed how education functions, moving to online and hybrid methods. The challenges in global education highlighted and worsened by the pandemic make it necessary to re‐evaluate education systems and the policies in place to support access, quality and equal opportunity. This article focuses on analysing education policies at a national level. It tests a pilot policy analysis tool, the International Education Index (IEI), developed as a starting point to begin this reconsideration and create an accessible and comprehensive way to evaluate national education systems to inform decision‐making and policies in the new context. This research uses Ireland and Northern Ireland to test the IEI pilot tool. The IEI consists of 54 questions across nine indicators, including institutional frameworks, education strategies, digital skills and infrastructure, twenty‐first century skills, access to basic social services, adherence to international standards, legal frameworks, data gathering and availability and international partnerships. Countries can score 108 points to be categorised as having developed, emerging or nascent national education systems. Ireland scored 94 and Northern Ireland 81, indicating that they have developed national education systems.

The dilemmas around digital citizenship in a post-Brexit and post-pandemic Northern Ireland: towards an algorithmic nation?

Northern Ireland (NI) has pervasively been a fragile and often disputed city-regional nation. Despite NI's slim majority in favour of remaining in the EU, de facto Brexit, post-pandemic challenges and the Northern Ireland Protocol (NIP) have revealed a dilemma: people of all political hues have started to question aspects of their own citizenship. Consequently, this article suggests an innovative approach called 'Algorithmic Nations' to better articulate its emerging/complex citizenship regimes for this divided and post-conflict society in which identity borders and devolution may be facilitated through blockchain technology. This article assesses implications of this dilemma for a city-regionalised nation enmeshed within the UK, Ireland and Europe. This article explores digital citizenship in NI by applying 'Algorithmic Nations' framework particularly relating to intertwined (i) cross-bordering, (ii) critical awareness, (iii) digital activism and (iv) post-pandemic realities and concludes with three dilemmas and how 'Algorithmic Nations' framing could better integrate NI's digital citizenship. [ FROM AUTHOR] Copyright of Citizenship Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

"Education cannot cease": the experiences of parents of primary age children (age 4-11) in Northern Ireland during school closures due to COVID-19

This paper reports the research findings from an online survey of parents of primary-age pupils in Northern Ireland during the COVID-19 pandemic. The aims of the study were to explore how parents supported their child/ren's home learning;to ascertain the communication, guidance and resources between home and school;and to learn from the experiences of parents to enable more effective practices to be established should similar circumstances arise in the future. The survey yielded 2,509 responses and highlighted the divergence of practices in relation to home-school communications across schools as well as the challenges experienced by parents, particularly those who had one or more children with special educational needs and/or those who had Free School Meal Entitlement. The study was guided by Epstein's Framework of the Six Types of Involvement, most specifically the spheres of parenting, learning from home, communication, collaborating with the community and decision-making. Within Epstein's framework, the challenges and tensions between family, school and work are explored. Recommendations are made that will be helpful to parents, schools, teacher-educators, policy-makers and researchers in informing the shape and delivery of education in Northern Ireland and internationally both during and following the challenge of the current COVID-19 pandemic and for similar situations that may arise in the future. The findings and conclusions are relevant not only to the Northern Ireland education context, but also make a valuable contribution to global dialogue on what this experience has revealed about inequities in education systems and how these should be addressed going forward. [ FROM AUTHOR] Copyright of Educational Review is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Obstacles to Public Health that even Pandemics cannot Overcome: The Politics of Covid-19 on the Island of Ireland 1//A RESPONSE/A REPLY

The relationship between politics and public health is increasingly evident as governments throughout the world vary in their acceptance and implementation of technical guidance in the response to the SARS-CoV-2 pandemic. This paper reports a qualitative study of public health policies for CoviD-19 in Northern Ireland (NI) and the Republic of Ireland (RoI) across a timeline emphasising the first wave of the pandemic (February to June 2020). Inter-jurisdictional commitments for health as contained in the Good Friday Agreement provide a framework for cooperation and coordination of population health on the island of Ireland. This study of north-south cooperation in the response to CoviD19 applies ten indicators from the Oxford CoviD-19 Government Response Tracker (OxCGRT) codebook to establish if cooperation and policy alignment of key public health measures are evident in the Northern Ireland Assembly and Government of Ireland responses. The study concludes that notwithstanding the historical and constitutional obstacles to an all-island response to CoviD-19, there is evidence of significant public health policy alignment brought about through ongoing dialogue and cooperation between the health administrations in each jurisdiction over the course of the first wave of the pandemic.

Cross-Border Cooperation Health in Ireland//A RESPONSE

Providing healthcare services commands the largest allocation of public funding on both sides of the Irish border and concerns over the efficiency and effectiveness of these systems are perennial. Over the past two decades health has been identified as a key area for cross-border collaboration. However, in the absence of an overarching framework or strategy, there is little clarity about objectives. Using the responses to the COVID-19 pandemic as a case study it demonstrates that even in the face of an existential crisis, political leaders default to debates over culture and identity. The paper sets out how the healthcare systems in the two jurisdictions share similar core principles and values and face similar social, economic and political pressures. They have adopted broadly comparable approaches to tackling systemic issues, such as an ageing and growing population, evolving healthcare needs, workforce planning and financial pressures. It argues that there is potential for greater cross-border cooperation but this requires high-level political agreement and must be based on robust evidence. As this paper shows, there are significant barriers to developing all-island approaches, but these are not insurmountable.

Collaborating on Healthcare on an All-Island Basis: A Scoping Study *

Over the past two decades health has been identified as a key area for increased cross-border working on the island of Ireland. To date though, the approach has been minimalist and often project specific. The global pandemic, the continuing fallout from Brexit and the establishment of the Shared Island initiative have pushed the broad issue of healthcare cooperation up the policy agenda. Theoretically, closer cooperation could deliver economies of scale, value for money, opportunities for clinical specialisation, and facilitate the sharing of knowledge. However, despite its obvious potential and policy significance, cross-border collaboration in healthcare has been the subject of remarkably little research attention. This small-scale qualitative study is based on in-depth interviews with 49 individuals with expertise and experience in this area. From these interviews six broad themes emerged: support for collaboration, lack of strategic direction, knowledge sharing, CoviD-19, data and opportunities for future cooperation. Given the similar social, economic and political pressures faced by both healthcare systems, it is concluded that leveraging the strengths from cross-border collaboration should be a policy priority.

Walk and Talk Bereavement Support: Piloting an Innovative Service at Marie Curie Northern Ireland

Introduction At the advent of COVID-19 the bereavement support service in Belfast Hospice had to quickly adapt to new ways of working to ensure continued service provision, with counsellors transitioning to video-link platforms and telephone to facilitate client sessions. However, counsellors reported challenges building a rapport with clients online, and had concerns that the client's grief was compounded by loneliness and social isolation. In response, the Marie Curie walk and walk bereavement support project, in partnership with the National Trust, was proposed as an innovative solution. Taking traditional counselling sessions outdoors meant the counsellors could maintain adherence to COVID-19 guidance, while supporting the mental health and wellbeing of bereaved clients. Furthermore, nature therapy has been shown to enhance both physical and mental health, reducing symptoms of depression. Whilst there are studies that demonstrate the benefit of nature therapy for mental health outcomes, research is limited in bereavement care. Aims Supporting the mental health and wellbeing of bereaved clients. Methods A pilot Walk and Talk bereavement therapy brings together the skilful, compassionate counselling work of Marie Curie staff and volunteers in beautiful, restorative National Trust spaces. We plan to conduct semi-structured interviews with service users to explore their experience of walk and talk therapy. Results To date, the feedback received has been overwhelmingly positive, this is based on informal verbal feedback gathered by counsellors at the end of each session. Conclusions Despite the physical distancing barriers faced during COVID-19, staff and volunteers were able to overcome these challenges through innovation, creativity, and flexibility, to provide person-centred, compassionate bereavement care and support Impact Work is ongoing, but we hope to continue to develop the walk and talk bereavement service with the National Trust, to support the mental and physical health and wellbeing of people affected by dying, death and bereavement.

Person and situation effects in predicting outgroup prejudice and avoidance during the COVID-19 pandemic

Recent theories of intergroup relations suggest that factors relevant to disease, disgust, and contagion predict prejudice towards ethnic outgroups. The current research explored the influence of contextual pathogen threat and individual differences in threat sensitivity on outgroup prejudice and avoidance in the context of the COVID-19 pandemic. Data were collected from a sample of British adults in June 2020 (N = 524). A multi-level approach was employed to capture differences in confirmed COVID-19 cases across different regions in the UK. Results demonstrated that even in a "strong" pandemic context, individual differences in both disgust sensitivity (DS) and intergroup disgust sensitivity (ITG-DS) explained variability in outgroup distancing. Subjective perceptions of contextual pathogen prevalence, but not actual infection rates, also predicted greater outgroup avoidance. However, a significant cross-level interaction revealed that DS predicted outgroup distancing in regions with higher numbers of confirmed COVID-19 cases, but not in areas of lower infection. Thus, individual differences in pathogen avoidance may be especially influential under high situational pathogen stress. There was also some evidence that pathogen threat also predicted greater ingroup attraction. Results provide important insights into factors that promote or inhibit positive intergroup relations during pandemics. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Austerity and Irish Women's Writing and Culture, 1980–2020

Even now, following Brexit and the Covid-19 pandemic, amidst the current cost of living crisis, it is unclear whether austerity measures will once again come into play. [...]the collection Austerity and Irish Women's Writing and Culture, 1980-2020, edited by Deirdre Flynn and Ciara L. Murphy, is a timely and important contribution to Irish studies. [...]as Flynn and Murphy's introduction indicates, not only are already meagre state supports cut in times of crisis, but any attempts at improving the social standing of marginalized groups are abandoned too. LIP's collaborative approach challenged the idea of the lone male genius Irish writer, and it was decidedly underfunded, leading to claims of it being an "amateur endeavour" compared to the more established all-male Field Day company's pamphlets. [...]they could even be considered intersectional feminists due to their focus on the connection between conflict, class, and gender.