“Improbabilities abound”: Daphne du Maurier’s Rule Britannia and the Speculative Political Future

Contextualising Daphne du Maurier’s Rule Britannia (1970) in what I tentatively identify as a speculative books boom of the late 1960s and 1970s, this paper posits that speculative fiction as a literary category is both a broad and hybrid one, but one that is often used synonymously with science fiction. Following this observation, this paper explores the effects of du Maurier’s amalgamation of genres and intertextual resonances on the mood of suspicion, unease and desolation that pervades this speculative work. This article explores how Rule Britannia‘s uneasy mood speaks to an equally troubled cultural moment for Britain. Rule Britannia interrogates cultural and national symbols at a moment of concentrated cultural and national anxiety. Examining what it means for du Maurier to write an invasion narrative for Britain in 1972, when British identity is at a cultural and historical crossroads, this paper argues that du Maurier takes a hard look at Britain in its post-war context, drawing attention to its perceived failings, its weakened global status and its shifting national identity. Du Maurier imagines a coloniser-turned-colonised invasion narrative for a previously powerful country coming to terms with post-war economic strife, bankruptcy, Cold War global tensions and the process of decolonisation

Rheology of sludge in pour-flush toilets: understanding the requirements for pit emptying technology design

Pour-flush (PF) toilets are seen as bridging the gap between basic on-site sanitation and the water-borne sewerage systems that people aspire to. Limited studies have been conducted on the rheological properties of PF sludge, which are a key component in designing and selecting appropriate pit emptying equipment. Samples from active and standing PF leach pits were tested for moisture content and viscosity. The two variables were linked using the fresh faeces viscosity model (Woolley et al., 2014). A second model was used to demonstrate how the volume and moisture of material in standing PF leach pits changed over time. This showed that PF leach pits could be emptied using a pump within two months of active use. Alternatively, PF leach pits can be left for up to five years after which the volume will have reduced to 45 % of the original volume and can be dug out manually

Antimicrobial stewardship activities in hospitals in Ireland and the United Kingdom: a comparison of two national surveys.

Best practice guidelines recommend that a multidisciplinary Antimicrobial Management Team (AMT) conduct antimicrobial stewardship (AMS) activities in hospitals. In order to continuously improve AMS activities in Irish hospitals it is important to benchmark performance by comparison with other countries. The purpose of this study was to compare the membership of AMTs and AMS activities conducted in Irish and United Kingdom (UK) hospitals. The research used a postal questionnaire to determine the membership and activities of AMTs, which was issued to the specialist antimicrobial pharmacist or pharmacist in charge at all Irish Hospitals and all UK National Health Service Hospitals. The membership of AMTs and the extent of AMS activities conducted were compared between the countries. The response rates to the surveys were 73% (n = 51) in Ireland and 33% in the UK (n = 273). 57% of Irish respondents reported having an AMT compared to 82% in the UK (p < 0.001). Significantly more AMTs in the UK had a specialist antimicrobial pharmacist on the team (95% UK, 69% Ireland, p < 0.001). A higher proportion of Irish respondents reported measuring the overall volume of antimicrobial prescribing (Ireland 85%, UK 72%, p = 0.057). A higher proportion of UK respondents reported measuring the appropriateness of antimicrobial prescribing (76% UK, 58% Ireland, p = 0.019) and the appropriateness of restricted antimicrobial prescribing (64% UK, 52% Ireland, p = 0.140). In conclusion, Irish and UK AMTs need to be supported to recruit and retain specialist antimicrobial pharmacists and to achieve higher rates of audit, prescription appropriateness review and feedback activities

Issues associated with planning, implementing, managing and operating public transport projects in Ireland

Whilst considering the context to which public transport is planned in Ireland and internationally, the research has been concerned with studying the methodology and the roles of key stakeholders for the planning, implementation, management and operation of public transport projects in order to gauge the efficiency and suitability of the Irish planning process in relation to our international counterparts The paper will present principal findings from structured interviews undertaken with key stakeholders involved in the Irish process and will provide a basis for debating the issues raised as a consequence of these interviews.. Key issues raised include: 1) the possible complexity of the planning process in Ireland, 2) the role of political agendas in the decision making process; and, 3) the governance and institutional arrangements for planning public transport projects in Ireland in contrast to other international countries

Hospital doctors in Ireland and the struggle for work–life balance

Ireland has a high rate of doctor emigration. Challenging working conditions and poor work–life balance, particularly in the hospital sector, are often cited as a driver. The aim of this study was to obtain insight into hospital doctors’ experiences of work and of work–life balance. In late 2019, a stratified random sample of hospital doctors participated in an anonymous online survey, distributed via the national Medical Register (overall response rate 20%; n = 1070). This article presents a qualitative analysis of free-text questions relating to working conditions (n = 469) and work–life balance (n = 314). Results show that respondent hospital doctors, at all levels of seniority, were struggling to achieve balance between work and life, with work–life imbalance and work overload being the key issues arising. Work–life imbalance has become normalized within Irish hospital medicine. Drawing on insights from respondent hospital doctors, this study reflects on the sustainability of this way of working for the individual doctors, the medical workforce and the Irish health system. If health workforce planning is about getting the right staff with the right skills in the right place at the right time to deliver care, work–life balance is about maintaining doctor wellbeing and encouraging their retention

A qualitative process evaluation of the introduction of procalcitonin testing as an antimicrobial stewardship intervention

Background Successful antimicrobial stewardship interventions are imperative in today’s environment of antimicrobial resistance. New antimicrobial stewardship interventions should include qualitative analysis such as a process evaluation to determine which elements within an intervention are effective and provide insight into the context in which the intervention is introduced. Objective To assess the implementation process and explore the contextual factors which influenced implementation. Setting An academic teaching hospital in Cork, Ireland. Methods A process evaluation was conducted on completion of a feasibility study of the introduction of a procalcitonin antimicrobial stewardship intervention. The process evaluation consisted of semi-structured face-to-face interviews of key stakeholders including participating (senior) doctors (5), medical laboratory scientists (3) and a hospital administrator. The Consolidated Framework for Implementation Research was used to guide data collection, analysis, and interpretation. Main outcome measures Qualitative assessment of the intervention implementation process, the contextual factors which influenced implementation and identification of improvements to the intervention and its implementation and determine if proceeding to a randomised controlled trial would be appropriate. Results Analysis of the interviews identified three main themes. (1) The procalcitonin intervention and implementation process was viewed positively to support prescribing decisions. Participants identified modifications to procalcitonin processing and availability to improve implementation and allow procalcitonin to be “more of a clinical influence”. (2) In the antimicrobial stewardship context the concept of fear of missing an infection and risks of potentially serious outcomes for patients emerged. (3) The hospital context consisted of barriers such as available resources and facilitators including the hospital culture of quality improvement. Conclusion This process evaluation provides a detailed analysis of the implementation of procalcitonin testing as an antimicrobial stewardship intervention. The positive findings of this process evaluation and feasibility study should be built upon and a full randomised controlled trial and economic evaluation should be conducted in a variety of hospital settings to confirm the effectiveness of procalcitonin as an antimicrobial stewardship intervention

What happens inside a pour-flush pit? Insights from comprehensive characterization

The pour-flush toilet is extensively used in many countries, but the biodegradation within pour-flush leach pits has not been fully characterised. We present a comprehensive physical, chemical, and microbiological analysis of pour-flush active and standing leach pits in South Africa. Four household toilet sites were sampled four times over 11 months. The pour-flush pit filling rate was estimated to be 0.11m3/y, which is lower than those of other sanitation technologies. Faecal sludge in active leach pits had similar ash, VS, CODT and TKN as other onsite technologies, but higher moisture content. The CODT in pour-flush sludge decreased 85% in 27 days in a short-term laboratory test. Microbial DNA sequencing showed that both aerobic and anaerobic degradation occurred in active and standing pits. Specific microorganisms were identified and differences in microbial communities in active, standing, and single pits were described, providing important insights into processes occurring within pour-flush pits

Blockchain-based governance models for COVID-19 digital health certificates: a legal, technical, ethical and security requirements analysis

This paper analyses the requirements of a blockchain-based data governance model for COVID-19 digital health certificates. Recognizing a gap in the existing literature, this paper aims to answer the research question “To what extent does a blockchain-based governance model for COVID-19 digital health certificates in the EU meet the relevant legal, technical, ethical and security requirements?” This paper identifies the required standards and develops a novel framework to determine the viability of blockchain as a governance model. The results of our evaluation indicate that while a private permissioned blockchain can meet the requirements to some degree, the governance element is key to legal compliance; legal risks and ethical implications remain unresolved with the use of blockchain. The paper also found that this model comes with the loss of the main advantages of blockchain – decentralization and anonymity. This evaluation framework may be used in other contexts and for assessing other technologies

‘That's just how medicine is': A remote ethnographic study of Ireland's failure to meet the core work needs of its hospital doctors

This study focuses on hospital doctors' experiences of work during the pandemic. The context is the Irish health system, under considerable strain due to the pandemic and a legacy of austerity/under-funding. Although medicine is considered a prestigious job, hospital doctors often endure challenging working conditions and work-life imbalance. In this paper we consider how a narrative of ‘medicine-as-vocation’ is used to excuse challenging working conditions and to impede change. West and Coia (2019) proposed a set of core work needs required to support doctor wellbeing and minimise work-related stress, i.e. autonomy/control, belonging and competence and these are applied as a lens to examine the everyday work experiences of respondent hospital doctors. Data collection was conducted in 2021 using a remote ethnographic method – Mobile Instant Messaging Ethnography (MIME) - developed by the research team to enable data collection at a time of pandemic restrictions (Humphries, Byrne, et al, 2022). Twenty-eight hospital doctors were recruited for the study. Each respondent was interviewed twice and engaged in a 12-week conversation with the research team via WhatsApp. We report hospital doctors' experiences of heavy workloads, weak line management and the challenges of influencing change at work. Overall, the findings presented demonstrate the myriad ways that Ireland is failing to meet the core work needs of its hospital doctors and how ‘medicine-as-vocation’ is used to justify organisational neglect