ATTRACTING AND RETAINING INTERNATIONAL HIGHER EDUCATION STUDENTS: IRELAND. ESRI RESEARCH SERIES NUMBER 88 MAY 2019

International student mobility has grown significantly worldwide over the past two decades, increasing from two million to five million between 1999 and 2016 (OECD, 2018). The EU is one of the main destinations for international students, with 1.6 million international students enrolled in the EU in 2016 (OECD, 2018). The importance of attracting international students was most recently highlighted in EU Directive 2016/801 on the conditions of entry and residence of third-country nationals for the purpose of research, studies, training, voluntary service, pupil exchange schemes or educational projects and au pairing.1 While Ireland has not opted into the Directive, the publication of two international education strategies since 2010 and reform of the non-EEA student immigration framework reflect the importance now being attached to promoting the higher education of non-EEA students in Ireland. Immigration of non-EEA nationals for the purposes of higher education in Ireland grew by 45 per cent between 2013, when 9,325 first residence permits were issued to students, and 2017, when 13,519 such permits were issued.2 This study examines policy, law and practice in Ireland relating to non-EEA students undertaking a full-time course of study leading to a higher education qualification in public and private third-level institutions. The study focuses on recent developments in policy on the internationalisation of higher education and changes to the student immigration framework that took place between 2012 and 2018. In particular, it looks at measures to attract non-EEA students to Ireland and retain those students following the completion of their studies.3 Non-EEA nationals enrolled in English language and further education programmes are outside the scope of this study

POLICY AND PRACTICE TARGETING THE LABOUR MARKET INTEGRATION OF NON-EU NATIONALS IN IRELAND. ESRI RESEARCH SERIES NUMBER 89 JUNE 2019

Increases in immigration inflows to both the European Union (EU) and Ireland between 2014 and 2016, due in part to the ‘refugee and migrant crisis’, have resulted in an increased focus on integration policies, outcomes and measures, including in the area of labour market integration. Employment is crucial for the integration of migrants into the economic and social life of their host country, so labour market integration is a very important part of integration policy (European Commission, 2016). In recent years, many Member States have updated existing labour market integration policies or have developed new ones. Ireland, like the majority of EU Member States (EMN, 2019), pursues a policy of mainstreaming service provision in the area of integration, with targeted initiatives to meet specific needs. This study first considers labour migration policy, which manages and shapes overall access of non-European Economic Area (EEA) nationals to the Irish labour market.1 Under the employment permits system administered by the Department of Business, Enterprise and Innovation (DBEI), non-EEA nationals may apply to access the Irish labour market. The report then looks at specific policies and measures which aim to improve labour market integration for non-EU nationals living in Ireland. The focus is on labour integration measures for regularly staying non-EU nationals with a right to work. Measures specifically targeting non-EEA students, graduates, asylum seekers and beneficiaries of international protection are beyond the study scope. The effect of general labour market and social policy provision in Ireland on labour market integration is also outside the scope. Examples of public and private sector practices are discussed together with examples of community sector practices that receive public funds

Haze in Pluto's atmosphere: Results from SOFIA and ground-based observations of the 2015 June 29 Pluto occultation

On UT 29 June 2015, the occultation by Pluto of a bright star (r′ = 11.9) was observed from the Stratospheric Observatory for Infrared Astronomy (SOFIA) and several ground-based stations in New Zealand and Australia. Pre-event astrometry allowed for an in-flight update to the SOFIA team with the result that SOFIA was deep within the central flash zone (~22 km from center). Analysis of the combined data leads to the result that Pluto's middle atmosphere is essentially unchanged from 2011 and 2013 (Person et al. 2013; Bosh et al. 2015); there has been no significant expansion or contraction of the atmosphere. Additionally, our multi-wavelength observations allow us to conclude that a haze component in the atmosphere is required to reproduce the light curves obtained. This haze scenario has implications for understanding the photochemistry of Pluto's atmosphere

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research