Beyond McMahon – the future of asylum reception in Ireland: Conference summary

The conference ‘Beyond McMahon – the Future of Asylum Reception in Ireland’ took place on Wednesday 25th April 2018 in the Western Gateway Building in University College Cork (UCC). Organised jointly by Nasc, the Migrant and Refugee Support Centre, and UCC’s Centre for Criminal Justice and Human Rights (CCJHR), the conference was generously funded by the Irish Human Rights and Equality Commission (IHREC). The conference aimed to assess developments in the Irish asylum reception system (‘direct provision’) since the establishment of a Working Group on the Protection Process and Direct Provision, and its report,the ‘McMahon Report’(2015). Using the Report and its recommendations as a starting point, this conference aimed to examine the future of, and possible alternatives to, direct provision in Ireland. To this end, the conference gathered experts from other European jurisdictions and individuals with experience of Ireland’s current reception system, including – importantly – input from asylum seekers. Fiona Finn, CEO of Nasc, introduced the conference’s goal succinctly: it aimed to catalyse a change in the current Irish reception system. This summary hopes to record some of the main ideas and concerns related by speakers and audience members at the conference, so that they may be used for future reference

Racism and hate crime in Ireland: is the legislative and policy framework adequate? Conference summary

Hosted by Nasc, the Irish Immigrant Support Centre and the Centre for Criminal Justice and Human Rights, UCC, this conference aimed to promote an open dialogue on Racism and Hate Crime in Ireland. Expert speakers and practitioners from a variety of fields were invited to explore the effectiveness of our current legislative and policy framework and to discuss the impact of hate crime, racism and discrimination of minority groups in Ireland. A number of key issues, and further points for consideration and recommendations were highlighted throughout the day by each of the speakers. This summary aims to highlight the emerging issues and themes, and to draw on these to suggest the next steps to take to respond effectively to racism and hate crime in Ireland

Desired Chinese medicine practitioner capabilities and professional development needs: a survey of registered practitioners in Victoria, Australia

Background The State of Victoria in Australia introduced Chinese medicine practitioner registration in 2000 and issued its education guidelines in late 2002 for introduction in 2005. This study obtained practitioners' views on desired capabilities for competent Chinese medicine practice and to identify professional development needs. Methods A questionnaire, consisting of 28 predefined capabilities in four categories with a rating scale of importance from one to five, was developed and sent to all registered Chinese medicine practitioners in the State of Victoria, Australia in October, 2005. Results Two hundreds and twenty eight completed questionnaires were returned which represented a response rate of 32.5%. Of the four categories of capabilities, technical capabilities were considered to be the most important for clinical practice. Specifically, the ability to perform acupuncture treatment and/or dispense an herbal prescription was ranked the highest. In contrast, research and information management capabilities were considered the least important. The educational background of practitioners appeared to be an important factor influencing their rating of capabilities. Significantly, nearly double the number of practitioners with Australian qualifications than practitioners trained overseas valued communication as an important capability. For continuing professional education, clinical skills courses were considered as a priority while research degree studies were not. Conclusion Registered Chinese medicine practitioners viewed skills training as important but did not support the need for research and information management training. This represents a significant hurdle to developing Chinese medicine as a form of evidence-based healthcare

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Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.

BACKGROUND AND PURPOSE: Blood supply through collateral pathways improves regional cerebral blood flow and may protect against ischemic events. The effect of collaterals on the risk of stroke and transient ischemic attack (TIA), in the presence of angiographic severe internal carotid artery (ICA) stenosis, was assessed. METHODS: Angiographic collateral filling through anterior communicating and posterior communicating arteries and retrograde filling through ophthalmic arteries were determined in all patients at entry into the North American Symptomatic Carotid Endarterectomy Trial. Kaplan-Meier event-free survival analyses were performed on 339 medically treated and 342 surgically treated patients. RESULTS: The presence of collaterals supplying the symptomatic ICA increased with severity of stenosis. Two-year risk of hemispheric stroke in medically treated patients with severe ICA stenosis was reduced in the presence of collaterals: 27.8% to 11.3% (P=0.005). Similar reductions were observed for hemispheric TIA (36.1% versus 19.1%; P=0.008) and disabling or fatal strokes (13.3% versus 6.3%; P=0.11). For surgically treated patients, the perioperative risk of hemispheric stroke was 1.1% in the presence of collaterals versus 4. 9% when absent. The 2-year stroke risks for surgical patients with and without collaterals were 5.9% versus 8.4%, respectively. Neither comparison in the surgical group was statistically significant. The observed reductions were independent of the degree of ICA stenosis and other vascular risk factors. CONCLUSIONS: Collaterals are associated with a lower risk of hemispheric stroke and TIA, both long term and perioperatively. Angiographic identification of collaterals assists in identifying patients with severe ICA stenosis at lower risk of stroke and TIA

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The accuracy and reproducibility of video assessment in the pitch-side management of concussion in elite rugby

Objectives To investigate the accuracy and reliability of side-line video review of head impact events to aid identification of concussion in elite sport. Design Diagnostic accuracy and inter-rater agreement study. Methods Immediate care, match day and team doctors involved in the 2015 Rugby Union World Cup viewed 20 video clips showing broadcaster’s footage of head impact events occurring during elite Rugby matches. Subjects subsequently recorded whether any criteria warranting permanent removal from play or medical room head injury assessment were present. The accuracy of these ratings were compared to consensus expert opinion by calculating mean sensitivity and specificity across raters. The reproducibility of doctor’s decisions was additionally assessed using raw agreement and Gwets AC1 chance corrected agreement coefficient. Results Forty rugby medicine doctors were included in the study. Compared to the expert reference standard overall sensitivity and specificity of doctors decisions were 77.5% (95% CI 73.1–81.5%) and 53.3% (95% CI 48.2–58.2%) respectively. Overall there was raw agreement of 67.8% (95% CI 57.9–77.7%) between doctors across all video clips. Chance corrected Gwets AC1 agreement coefficient was 0.39 (95% CI 0.17–0.62), indicating fair agreement. Conclusions Rugby World Cup doctors’ demonstrated moderate accuracy and fair reproducibility in head injury event decision making when assessing video clips of head impact events. The use of real-time video may improve the identification, decision making and management of concussion in elite sports