The Domestic Death of a Global Icon? A Situational Analysis of the Irish Public House

The public house has formed an intrinsic part of the Irish way of life for centuries, but it may soon be gone due to changes in demographics, alcohol consumption, and other variables including psychographic and geographic factors. Changes in Irish society during the rise in affluence characteristic of the Celtic Tiger era, and applicable Government policies have all played a role in altering the Irish pub culture. This research examines the current situation of the public house market in Ireland today with an aim of recommending some viable solutions to this declining industry. Government intervention in the future will be a key issue in order to address the imbalance in the retail alcohol market through corrective regulation. A quantitative approach was applied in this study and the research questionnaire yielded 316 responses representing a cross section of Irish society today. The findings reveal that there is an increased incidence of ‘at-home’ alcohol consumption, especially due to economic factors and the availability of cheaper alcohol from retail outlets. Respondents indicate that public houses did not represent ‘value for money’ anymore, and were perceived as being out-dated and unwelcoming. The findings reveal that publicans need to analyse their local market, diversify and innovate to generate new business, in order to survive and reverse the demise of the Irish public house. This study will be of benefit to the hospitality industry, Industry trade associations e.g., Vintners Federation of Ireland, Licensed Vintners Association, Government bodies, policy makers and the Irish Hospitality Institute

A contextual review of the provision of campus-based licensed trade facilities in a modern context: A case study on the feasibility of opening a student bar at Cork Institute of Technology.

This study was undertaken during the summer of 2014 at the request of the Students Union in response to an application to them with the view to the opening of a bar on campus at Cork Institute of Technology (CIT). The study reports on the current economic climate and other factors that have contributed to the continuous decline in alcohol sales in the on-trade in Ireland which is the alleged main contributing factor to the changed drinking culture of young Irish people today. A quantitative approach was applied and the research questionnaire yielded 1,229 responses representing the student body of CIT, both past and present.\ud The findings of the survey influenced the decision by the Students Union not to pursue the establishment of a campus bar at Cork Institute of Technology in the foreseeable future. This study should be of benefit to the hospitality industry, industry trade associations, such as the Vintners Federation of Ireland and th

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London