The Changing Structure of the Homeless Population in Cork City: Implications for Theories of Homelessness and Service Provision

The last two decades have seen extensive reform of policy on homelessness in Ireland, but these changes have not been underpinned by any extensive research which would shed light on the causes of homelessness and help in the design of settlement services. This article, which describes the results of the first detailed survey of the homeless population of Cork city, is intended to address the dearth of empirical evidence on homelessness in Ireland. This information is presented in three parts. The opening section of this article outlines the methods which were used to collect data on the homeless population in Cork. The findings of this research are outlined in the middle part of the article and where possible compared to the results of other equivalent research which has been carried out in other parts of Ireland and abroad. This section presents evidence on: the numbers of homeless people; their personal characteristics; a socio-economic profile of respondents, their housing history and accommodation preferences. Finally, in the concluding section of the paper, the implications which this research has for the explanations of the causes of homelessness which are most prominent in the international literature and for current policy on the settlement of homeless people in Ireland are outlined

Exploring the Utility of the Simple View of Reading in Irish Children Attending Schools in Areas Designated as Socially Disadvantaged

Evidence suggests that children living in areas designated as socially disadvantaged may be at risk for literacy difficulties. The Simple View of Reading (Gough & Tunmer, 1986; Hoover &Gough, 1986) is a theoretical model that sets out to describe the processes that children need to develop to become proficient readers, that is word recognition or decoding processes and language comprehension processes. The overall aim of this study was to investigate the utility of the Simple View of Reading in a cohort of Irish children attending schools designated as socially disadvantaged. The objectives were twofold. The first objective was to investigate predictors of reading accuracy, spelling and reading comprehension skills in this sample. The second objective was to investigate whether or not these predictors varied with age. The sample comprised fifty-nine children attending two schools. Inclusion criteria were: children between the ages of 5-8 years; a sample of children within three ranges of reading abilities as rated by their teachers (teachers were asked to rate the children’s reading ability as above average, average or below average); and a minimum score of 80 on the British Picture Vocabulary Scales (BPVS) (Dunn et al., 1997) to be included. Reading accuracy (single word reading and passage reading), reading comprehension, and spelling were measured using three standardised tests i.e., Weschler Individual Attainment Test 11UK, Teachers Version (WIAT, 11UK-T) (Weschler, 2006), the York Assessment of Reading for Comprehension (YARC) (Snowling et al., 2009), and the Single Word Spelling Test (SWST), (Sacre & Masterson, 2000). Potential predictors of literacy skills, such as phonemic awareness and phonic knowledge skills, were measured using criterion-referenced tests. Vocabulary was also a potential predictor and was measured using the BPVS. There was mixed evidence for the Simple View of Reading. While phonic knowledge, phonemic knowledge and non-word reading were predictors of reading, other factors such as vocabulary were also predictors. Although vocabulary was a predictor of reading comprehension for the total sample, the picture was less clear when the effect of age was explored. To conclude, there was mixed evidence to support the Simple View of Reading.  Nonetheless, the findings were encouraging in that children were acquiring literacy skills

Clonal expansion of community-associated meticillin-resistant Staphylococcus aureus (MRSA) in people who inject drugs (PWID)::Prevalence, risk factors and molecular epidemiology, Bristol, United Kingdom, 2012 to 2017

Background: In 2015, Bristol (South West England) experienced a large increase in cases of meticillin-resistant Staphylococcus aureus (MRSA) infection in people who inject drugs (PWID). Aim: We aimed to characterise and estimate the prevalence of MRSA colonisation among PWID in Bristol and test evidence of a clonal outbreak. Methods: PWID recruited through an unlinked-anonymous community survey during 2016 completed behavioural questionnaires and were screened for MRSA. Univariable logistic regression examined associations with MRSA colonisation. Whole-genome sequencing used lineage-matched MRSA isolates, comparing PWID (screening and retrospective bacteraemia samples from 2012-2017) with non-PWID (Bristol screening) in Bristol and national reference laboratory database samples. Results: The MRSA colonisation prevalence was 8.7% (13/149) and was associated with frequently injecting in public places (odds ratio (OR): 5.5; 95% confidence interval (CI):1.34–22.70), recent healthcare contact (OR: 4.3; 95% CI: 1.34–13.80) and injecting in groups of three or more (OR: 15.8; 95% CI: 2.51–99.28). People reporting any one of: injecting in public places, injection site skin and soft tissue infection or hospital contact accounted for 12/13 MRSA positive cases (sensitivity 92.3%; specificity 51.5%). Phylogenetic analysis identified a dominant clade associated with infection and colonisation among PWID in Bristol belonging to ST5-SCCmecIVg. Conclusions: MRSA colonisation in Bristol PWID is substantially elevated compared with general population estimates and there is evidence of clonal expansion, community-based transmission and increased infection risk related to the colonising strain. Targeted interventions, including community screening and suppression therapy, education and basic infection control are needed to reduce MRSA infections in PWID

Domestic violence in Ireland: an overview of national strategic policy and relevant international literature on prevention and intervention initiatives in service provision

Introduction In order to address the problem of domestic violence from a strategic and evidence based perspective it is necessary to have a broad understanding of the current national and international policy and practice initiatives relating to this issue. In developing strategies to guide future service planning and provision it is important to be cognisant of contemporary findings from academic and practice arenas and incorporate key learning into service development at the strategic and front-line levels. Therefore, the purpose of this document is two-fold: (i) to provide a detailed account of the Irish legislative and institutional context in which those planning for, and providing services to, victims and perpetrators of domestic violence operate; and (ii) to present a conceptualisation of domestic violence as a means of understanding its causes, consequences, and prevention and intervention strategies based on a review of international literature. In particular, the role of the health services and health professionals in developing and implementing such strategies is outlined and discussed. It is envisaged that the in-depth nature of this review, taking into account current policy and practice trends and developments, both nationally and internationally, will provide strategic direction to those responsible in the HSE for developing and providing domestic violence services. More specifically, the objectives of this review are: (a) To inform HSE service providers on the current strategic policy regarding domestic violence in Ireland; (b) To contribute to operational policy and planning regarding domestic violence service provision in the health and social services; (c)To facilitate HSE management and health and social service professionals in the development and enhancement of prevention and intervention initiatives regarding domestic violence. The document is divided into three sections. The first section provides a summary of the Irish policy context relating to domestic violence. In particular, it examines the following themes: - Definitions of domestic violence in use in Ireland; - The extent of domestic violence in Ireland; - Major policy and legislative initiatives in place to address domestic violence;5 - A brief account of statutory and voluntary service provision to victims of domestic violence. The second section details key points of learning extracted from a search of international theoretical and evidence-based literature. It describes the key findings from the international literature on the prevention and intervention of domestic violence in developed countries. The literature was sourced through extensive library searches using electronic databases including: Academic and Business Source Premier (EBSCO), JSTOR, Zetoc, Web of Science (ISI), and ScienceDirect (Elsevier). The Google Scholar web based search engine was also used. Some of the main areas covered in this section include: - The extent of health outcomes for women and children resulting from domestic violence; - Conceptual frameworks regarding the problem of domestic violence; - Universal and targeted strategies utilised to address both victims and perpetrators of domestic violence; - The role of health professionals in addressing domestic violence; - The Criminal Justice approach and interventions; - Evaluative work relating to domestic violence prevention and intervention strategies. The third section concludes with a brief overview of the strategic policy context of domestic violence. A series of high-level strategic points emanating from sections 1 and 2 are then summarised. Nine core principles are then outlined from the relevant literature, as a normative guide to those working in the highly sensitive area of domestic violence. The frameworks with which to address the problem, namely the public health approach, the ecological model, and the three prevention levels are then reiterated. Based on these an action model for domestic violence service provision is outlined. This report was drafted and initially circulated to the HSE National Strategy Group on Domestic Violence for comment and opinion. As a result, the third section of the report was redrafted as outlined above in partnership with the strategy group, based on their desire for translating the key findings of the report into a framework for practice.peer-reviewe

Impacts of an HIA on inter-agency and inter-sectoral partnerships and community participation: lessons from a local level HIA in the Republic of Ireland

This study evaluates the impacts of a locally based health impact assessment (HIA) on community participation, inter-sectoral and inter-agency partnership in local decision and policy-making processes. The methods comprised a series of semi-structured interviews with key informants followed by thematic analysis of transcribed responses. The study revealed a number of positive impacts among both community and service providers. A particularly advantageous impact was the facilitation of community learning through a local action group formed as a recommendation of the HIA that provided community development and HIA training. During the HIA process all participants increased their knowledge of health determinants and recognized a broader range of evidence sources for local decision-making. Participants also developed a greater understanding of each other\u27s roles and perspectives. Additionally, the study revealed a number of barriers to HIA. Differing views on the role of HIA were evident whereby community members tended to regard HIA as an advocacy tool for local issues impacting on health in their locality, while service providers perceived its role more in terms of networking and collaboration. A key area remaining to be tackled in terms of partnership working is the approach of service agencies to enabling meaningful community participation in local decision-making processes. In this respect, attention to the cultural dimension of inter-sectoral working, and the need for training for both service agency staff and community members prior to or at the initial stages of HIA are required. Such changes could facilitate more meaningful community inclusion and help to address the current power imbalance between these two sectors.Eastern Regional Health Authority, Dublin, Ireland