Evaluation of the Doodle Families Literacy Programme Pilot

The Doodle Families Literacy Programme was a pilot programme that was delivered in three DEIS Band 1 primary schools in Limerick during the period of April to June 2015 for First Class children and their parents.Doodle Families was originally designed as an afterschool programme, but the pilot schools delivered it during the school day or bridging the school day and afterschool time. Doodle Families was delivered in two four week blocks, with families participating in one session per week.The pilot programme objectives were:* To pilot Doodle Families as a follow up to Doodle Den;* To train a panel of facilitators from three pilot schools and local services to deliver the programme.* To verify programme content, implementation issues and training needs to support the replication of Doodle Families.The aim of the evaluation of Doodle Families was to assess the implementation of the programme, how it was delivered and how those involved in the delivery felt about the programme, including school staff, parents, children, school principals and external organisations

Erosion of Meaning in Life: African Asylum Seekers’ Experiences of Seeking Asylum in Ireland

The narratives of 16 African asylum seekers indicated that the asylum system in Ireland eroded the various sources from which they could derive meaning in life (MIL). The endurance of a protracted asylum process, prohibition from entering the labour force and residence in institutionalized accommodation appeared to erode asylum seekers’ sense of self-efficacy, purpose, worth, value and belonging. Experiencing a cumulative erosion of all derivations of MIL appeared to inform asylum seekers’ appraisals that they were living a post-migratory life devoid of meaning and consequently reduced psychological wellbeing. Study findings warrant further investigation into the mediating role MIL may play in asylum seekers’ post-migratory mental health while also indicating that current and future responses to asylum seekers’ mental distress must be adequately cognisant of and actively address the socio-cultural and socio-political context that asylum seekers inhabit

PAI-1 Regulates the Invasive Phenotype in Human Cutaneous Squamous Cell Carcinoma

The emergence of highly aggressive subtypes of human cutaneous squamous cell carcinoma (SCC) often reflects increased autocrine/paracrine TGF-β synthesis and epidermal growth factor receptor (EGFR) amplification. Cooperative TGF-β/EGFR signaling promotes cell migration and induces expression of both proteases and protease inhibitors that regulate stromal remodeling resulting in the acquisition of an invasive phenotype. In one physiologically relevant model of human cutaneous SCC progression, TGF-β1+EGF stimulation increases the production of several matrix metalloproteinases (MMPs), among the most prominent of which is MMP-10—an MMP known to be elevated in SCC in situ. Activation of stromal plasminogen appears to be critical in triggering downstream MMP activity. Paradoxically, PAI-1, the major physiological inhibitor of plasmin generation, is also upregulated under these conditions and is an early event in progression of incipient epidermal SCC. One testable hypothesis proposes that TGF-β1+EGF-dependent MMP-10 elevation directs focalized matrix remodeling events that promote epithelial cell plasticity and tissue invasion. Increased PAI-1 expression serves to temporally and spatially modulate plasmin-initiated pericellular proteolysis, further facilitating epithelial invasive potential. Defining the complex signaling and transcriptional mechanisms that maintain this delicate balance is critical to developing targeted therapeutics for the treatment of human cutaneous malignancies

Towards a Full Life: An Evaluation of Family Support Programmes for People with a Disability in Ireland

For the past five decades,there has been an increasing awareness of the need for service and societal responses to people with disabilities to be addressed through a person-centered approach. A person-centered approach is one which seeks to put the person first. The principle of person-centeredness, which is identified as one of the four key principles underpinning Irish health policy, is based in the belief that in order to meet the desires and needs of an individual, their "unique identity...particular gifts and wounds...right to choose, and...capacity to develop, participate and contribute" must be maintained centre stage. Furthermore, it is recognised that person-centered approaches must take account, not only of the person with disability, but also of the family, as their role may be key in ensuring that true person-centerednessis achieved This is particularly relevant to the establishment and maintenance of the person's circle of support beyond professional services. Thus, whereas person-centerednessis rightly focused on the person, there is a need for service providers to also have a family-centred focus, which is aimed at supporting family to support their family member who has a disability.In 2010, Genio grant aided four family focused initiatives with a focus on building capacity in a variety of stakeholders in order to promote and support the inclusion of people with disabilities. The initiatives involved training and capacity building with families of people with disability, including people with severe and complex disabilities. The general aim of the initiatives was to increase family members' knowledge and skills and enable them to plan better lives for their family member and to advocate on their behalf. In 2012, Genio commissioned a team of researchers, from Trinity College Dublin, to conduct an evaluation of the four grant-aided family-focused initiatives from the perspectives of families of people with disabilities and services/organisations. The evaluation employed a multi-method approach using qualitative and quantitative methods to provide a comprehensive evaluation. Data was collected using individual interviews, surveys and documentary analysis

Evaluation: Programme to Support Palliative and Hospice Care in the Republic of Ireland, Final Report

Investment in end-of-life care has made Ireland a world leader in advancing palliative and hospice care but regional inequities persist, according to an evaluation by Professor Mary McCarron and colleagues at Trinity College Dublin.This evaluation examined The Atlantic Philanthropies' End of Life programme -- which aimed to improve the care and quality of life for patients dying from an incurable illness and to ensure they and their families received excellent end-of-life care and services. From its first grant in 2004 through its final grant in 2010, Atlantic invested 25 million in the programme

Stakeholder perspectives of Community Mental Health Forums: a qualitative study in Sierra Leone

Abstract Background Mental health is the leading cause of disability worldwide. In the wake of both a civil war and an Ebola outbreak, Sierra Leone ranks as one of the lowest ranked countries on the Human Development Index (UNDP. Human Development Report 2015, Work for Human Development. The United Nations Development Programme; 2015). The WHO identified Sierra Leone among its priority countries for the piloting of its Mental Health Gap Action Programme (mhGAP). Aligned to these efforts, CBM and their affiliated partners employed the use of Community Mental Health Forums (CMHFs), facilitated by Mental Health Nurses (MHNs), as a sensitive and practical way of engaging key community stakeholders to discuss and address issues of mental health. This study sought firstly, to identify factors that affect the successful implementation of CMHFs, as identified by programme participants. Second, the study sought to identify what changes participants perceived as having taken place as a result of their participation in CMHFs. Methods 10 MHNs and 52 forum participants were purposely selected to take part in key informant interviews and focus group discussions, conducted across eight districts in Sierra Leone. Interview transcripts were analysed across four rounds of coding, using a mixture of deductive and inductive approaches. Results Results identified three themes, Traditional Beliefs and Culture; Health System; and Inclusive Approaches as affecting the implementation of CMHFs in their districts. Participants further perceived that their participation in the Community Mental Health Forums resulted in changes taking place across the themes of Awareness and beliefs, Behaviours towards people experiencing psychological distress, and as leading to greater Collaboration and cooperation between formal and informal mental health practitioners. Conclusions Results are discussed in the context of the extant literature and a novel framework, that incorporates multiple best practice recommendations and factors which influence the successful implementation of CMHFs is put forward. </jats:sec

Systematic review of educational interventions on older LGBT+ adults : recommendations for practice, education and research

Aim of the review: Research demonstrates that inequalities in outcomes on health and social wellbeing for LGBT+ older adults are perpetuated by a lack of inclusive services and cultural competence among the health and social care workforce. The aim of this review is to describe the educational interventions used to educate health and social care practitioners on the needs of older LGBT+ adults and the impact of such interventions on practitioners' knowledge, attitudes and competence. Search and review methodology: A systematic search of peer-reviewed papers published before February 2020 was conducted in the electronic databases MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC, Social Sciences Full Text and Web of Science. The search resulted in a screening of 2509 papers with 9 matching the inclusion criteria which were rated using the MERSQI quality measure. Findings: Positive outcomes were demonstrated across the studies, especially an increase in knowledge. Increases in skills and attitudes was less evident, especially in studies using shorter and less diverse intervention designs. Findings suggest that interventions that incorporate diverse teaching strategies, especially interactive experiential activities such as storytelling and inclusion of LGBT+ older adults, leads to higher engagement, increased awareness and empathy in participants. Conclusions and implications: Professional and vocational education is an important tool to improve cultural competency. Findings suggest that educators need to diversify intervention contents, approach LGBT+ education from an interdisciplinary perspective and involve LGBT people in the design, delivery and evaluation of education. This may have a positive impact on transfer of learning into practice and provide a more sustainable approach in addressing LGBT+ ageing inequalities in practice settings. Findings also suggest that researchers need to develop more robust study designs such as randomized controlled trials and focus on the longitudinal effects of educational interventions, which could improve the quality of study designs. Ethical approval: Ethical approval was not necessary

Defining and researching the concept of resilience in LGBT+ later life : findings from a mixed study systematic review

Within the literature, resilience is described as either a trait, an outcome or a process and no universal definition exists. A growing body of research shows that older LGBT+ adults show signs of resilience despite facing multiple inequalities that negatively impact their health and social wellbeing. The aim of this review was to examine how resilience is defined in LGBT+ ageing research and how it is studied. A mixed-study systematic search of peer-reviewed research papers published before June 2022 was conducted using the electronic databases CINAHL, Embase, Medline, PsycInfo, Social Science Database and Web of Science. This resulted in the screening of 7101 papers 27 of which matched the inclusion criteria. A quality appraisal was conducted using the Mixed Methods Appraisal Tool. Findings show that papers often lack a clear definition of resilience and application of resilience theory within the studies, although many of the papers conceptualised resilience as either a trait, process or an outcome. However, resilience was rarely the primary focus of the studies and was researched using a variety of measurement instruments and conceptual frameworks. Given the socioeconomic disparities, diverse social relations, histories of discrimination and stigma, and acts of resistance that have shaped the lives of older LGBT+ populations, resilience is a topic of growing interest for researchers and practitioners. Clear definitions of resilience and application of resilience theory could help improve methods used to study the concept and lead to more robust findings and the development of effective interventions. Greater clarity on the concept of resilience could also broaden the focus of research that informs policies and practice, and support practitioner training in resilience and the particular experiences of older LGBT+ adults

Exploring the concept of resilience in older LGBT+ people : a mixed study systematic review

[Abstract not available

Protocol for a realist review of workplace learning in postgraduate medical education and training

Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities. Those tasked with the design and delivery of postgraduate medical education and training need to understand the relationship between the processes of medical workplace learning and these contextual elements in order to optimise conditions for learning. We propose to conduct a realist synthesis of the literature to address the overarching questions; how, why and in what circumstances do doctors learn in clinical environments? This review is part of a funded projected with the overall aim of producing guidelines and recommendations for the design of high quality clinical learning environments for postgraduate medical education and training