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Supporting students with emotional disturbance/behavioural disorder (EBD) in mainstream schools is complex. An alternative school-based model of provision for students with EBD, titled the Altered Provision Project (APP), was piloted in the Irish mainstream post-primary schools. The rationale behind APP was that students with EBD require additional teaching in self-management of behaviour from qualified teachers, rather than the care support provided by a Special Needs Assistant (SNA). This paper reports the findings of a review of APP, focusing on the types of interventions utilised with students with EBD that were found to be implemented the Irish mainstream post-primary schools involved in the project. Findings indicate that a range of different interventions is in place. However, schools require greater guidance and support, particularly in terms of planning and implementing bio-psychosocial approaches. Furthermore, a significant gap in the findings was the lack of evidence of multi-disciplinary interventions as reported by the participants.

Mathematics is a core subject in the UK curriculum, with high standards achievement a policy of the UK government. Innovative approaches and strategies have been advocated to achieve these high standards. One approach that has been advocated is Precision Teaching, supported by its successful application in schools in the United States. For this study, a 12-week programme was devised to develop student fluency in the multiplication timetables. A key skill task was devised and scores compared before and after programme implementation. Pre-programme scores revealed poor student performance on this key skill. Post-programme results show an improvement for children using Precision Teaching, with some outperforming the average of their classmates. The paper endorses previous findings that fluency is important for student progress through the curriculum. It also endorses research findings that adding practice and timed assessment improve student performance levels. These results were achieved with minimal disruption and materials. The paper recommends educational practitioners to support further research into the practicalities and suggested benefits of fluency-orientated education. (Contains 4 figures.)

This paper outlines a programme "Safe and Social" that has been implemented with adults with intellectual disability across multiple contexts in a service based in Ireland. The emphasis within the programme is on providing service users and staff with a framework and the necessary language to discuss social behaviours and boundaries, moving away from an emphasis on rules and regulations. The programme draws on visual supports of three nested circles, red indicating "not ok", green indicating "ok" and a central circle that is used to set the topic of discussion. Over a series of seven modules, adults with intellectual disabilities and their support staff are encouraged to collaboratively problem solve some of the behaviours and understandings that can undermine social acceptability and compromise personal safety. Based on positive outcomes over a five-year period, we highlight the need for further research to explore the effectiveness of the programme.

Background: Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness. Method: Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up. Results: There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions. Conclusion: Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour. (Contains 4 figures and 6 tables.)

This paper examines the sources of stress and the effects of managing challenging behaviour on principals of special schools in Ireland, including schools for pupils with an intellectual disability, emotional disturbance, specific learning disability and physical and sensory disability, and children of traveller families. In this study principals rated the degree of stress and the potential stressors in managing incidents of challenging behaviour. Further, the degree of disruption to school management activities and the perceived likely effects of incidents of challenging behaviour on teachers and other pupils in the classroom were identified. A postal survey was conducted across all special schools in Ireland (N = 111), with 67% (n = 74) of principals responding. Further follow-up interviews were conducted with a random sample of principals. The study found that managing incidents of challenging behaviour was stressful for principals; it disrupted school management activities and significantly interfered with the education of pupils exhibiting challenging behaviour and that of "other pupils" (i.e. pupils not exhibiting challenging behaviour). Principals were clearly concerned about the welfare of their staff and the provision of an effective educational environment. Recommendations for future research and management of special schools are provided. (Contains 9 tables.)

Physical inactivity levels are rising globally. In response, public health investigators have sought to design and implement effective interventions to raise levels of physical activity in populations, communities and individuals. Usually, such interventions are built around theories of behaviour change in which notions of motivation and incentivisation loom large. Drawing on focus group evidence derived in the context of a cluster RCT aimed at increasing levels of physical activity in the workplace, this paper offers a critical look at the factors that seemingly stimulate and sustain that activity. In particular, using novel methods of data analysis we illustrate how motives and motivation – often interpreted as a driving force 'in' individuals – can be more usefully seen as distributed; as a property of systems (incorporating technologies, organisational structures, and social interaction) rather than of persons. In our discussion, we outline various theoretical as well as empirical grounds for making such claims and conclude by drawing out the implications of our work for public health policy and research. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to evaluate the evidence base of the Food Dudes healthy eating programme, specifically the short- and long-term effectiveness of the intervention for consumption of fruit and vegetables both at school and at home and displacement of unhealthy snack consumption. Design/methodology/approach - Articles were identified using Academic Search Complete, PsycARTICLES, Medline and PubMed databases keywords for the period January 1995 to August 2013. Articles were included if they reported an empirical evaluation of the Food Dudes programme aimed at children aged between 4-11 years. Articles were included regardless of geographical location and publication type (i.e. published and "grey" literature). Findings -- Six articles were included for review. Findings indicated that the programme was moderately effective in the short term; however, the long-term effectiveness of the programme is unknown. The ability of the programme to generalise to the home setting and to displace unhealthy snack foods also requires further investigation. Originality/value -- This is the first independent review of the Food Dudes programme. In light of the extensive roll out of the Food Dudes programme, an appraisal of the evidence surrounding the programme is timely. The review highlights that sustaining fruit and vegetable intake cannot be achieved through behaviour-based interventions alone and the long-term maintenance of fruit and vegetable consumption requires more than the implementation of an intervention found to be effective in a controlled research environment. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]

Background: Before COVID‐19, people with intellectual disabilities were digitally excluded, facing difficulties accessing and using technology. The pandemic outbreak closed down many in‐person services and supports for this population. Methods: This study examined changes in technology use to support the healthcare and social connections of older adults with intellectual disability in Ireland (n = 682) during COVID‐19. Decision tree analyses explored factors associated with using technology for health and social connection; and to explore relationships between technology use and subjective outcomes of stress/anxiety and of positives during this period. Findings: Technology use for healthcare and social connection increased during COVID‐19, but not enough to make up for the loss of in‐person care/connection. Residence type was associated with increased use of technology for healthcare utilisation, with the highest rates among community group home residents and the lowest among those in independent/family settings. Increased technology use to speak with both family and friends was associated with prior digital skills and digital access. Increased technology use was significantly associated with both positive and negative experiences during the pandemic. Conclusions: The COVID‐19 pandemic offered an opportunity for increased digital connection for older adults with intellectual disabilities, but not all benefitted. Those with prior skills, available supports, and the greatest need to connect were more likely to enhance their use of technology. The complexity of the COVID‐19 period, including the general impact on mental health and well‐being, means that the role technology played in supporting quality of life and mitigating stress/anxiety needs further and longer‐term investigation. Accessible summary: Older adults with an intellectual disability in Ireland used technology more during the COVID‐19 pandemic—to use health services, and to speak to family and friends.Having digital skills before COVID‐19 helped people to increase their use of technology.Technology helped many people to stay connected, but did not fully make up for the loss of in‐person services and contact.Participants who used technology more during COVID‐19 were more likely to report some positive things during COVID‐19.Participants who used technology more were also more likely to feel stress or anxiety during COVID‐19.This shows that COVID‐19 was difficult for many people. But the study also shows that most people also found some good things during this time. [ABSTRACT FROM AUTHOR]

Aims: Type 2 diabetes is a risk factor for late‐life dementia, but dementia prevention strategies have yet to be comprehensively evaluated in people with diabetes. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated cognitive benefits of a 2‐year multidomain lifestyle intervention. However, given the intensive nature of FINGER, there is uncertainty about whether it can be implemented in other high‐risk populations. Our aim was to explore attitudes towards dementia risk, and barriers to an intervention based on the FINGER model in older adults with type 2 diabetes living in rural areas of Ireland. Methods: Focus groups were conducted with 21 adults (11 men and 10 women) aged 60+ years with type 2 diabetes living in border regions of north and south Ireland. Data were analysed using thematic analysis. Results: There was limited understanding of diabetes as a risk factor for late‐life dementia. The main barriers to engagement with the multidomain intervention were eating foods that were not compatible with cultural norms, time and travel constraints, and perceived lack of self‐efficacy and self‐motivation for adopting the desired diet, exercise and computerised cognitive training (CCT) behaviours. Facilitators for intervention acceptability included the provision of culturally tailored and personalised education, support from a trusted source, and inclusion of goal setting and self‐monitoring behavioural strategies. Conclusions: While there was high acceptability for a brain health intervention, several barriers including cultural food norms and low self‐efficacy for adopting the diet, exercise and CCT components would need to be considered in the intervention design. Findings from this study will be used to inform local decisions regarding the adaptation of FINGER for people with type 2 diabetes. The feasibility of the adapted multidomain intervention will then be evaluated in a future pilot trial. [ABSTRACT FROM AUTHOR]

Little attention has been given to how Para athletes use their platforms for disability activism. This paper fills this gap by examining how Irish Para athletes take actions to create social change around disability. A qualitative methodology was adopted. 28 elite-level Irish Para athletes were recruited and participated in interviews. The data set was analysed using a reflexive thematic analysis. Three themes: 'Para athlete activisms' captures different ways of doing disability activism; 'tensions between different activist identities' concerns (hyper)critical discourses about various activist identities; 'ableist influences on Para sport culture' captures contexts that enable or prevent performing disability activism. The central theoretical contribution is an interpretation of Para athlete activism in terms of a contextually informed continuum of behaviour change. This article is an evidence base for Para sport cultures that wish to connect with disability activism. Practical opportunities are discussed around the psychology of adversity, social legacy value, identity politics and challenging ableism. • There are different ways of doing activism. • Athlete activism is a contextually informed continuum of behaviour change. • Disability activist identities involve tensions, contradictions and paradoxes. • Degree of activist performance is influenced by social and political change. • Para sport contexts are by no-means immune to the influence of an ableist ideology. [ABSTRACT FROM AUTHOR]

This report describes the development of the first national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland. This project brought together for the first time all higher education institutions nationwide in a novel collaboration with the national health service i.e. the Health Service Executive (HSE), to develop a standardized national curriculum for undergraduate health care professions. The curriculum sits within the framework of Making Every Contact Count, the goal of which is to re-orientate health services to embed the ethos of prevention through lifestyle behavior change as part of the routine care of health professionals. The core focus of Making Every Contact Count is chronic disease prevention, targeting four main lifestyle risk factors for chronic disease; tobacco use, alcohol consumption, physical inactivity and unhealthy eating. Making Every Contact Count is a key component of Healthy Ireland, the Irish national framework for health and wellbeing. The aim of the curriculum is to prepare newly qualified health professionals with the skills needed to support patients to achieve lifestyle behavior change delivered as part of routine clinical care. [ABSTRACT FROM AUTHOR]

Purpose: Higher Education Institutions observe that many students are experiencing mental health issues, such as high levels of anxiety and stress. Young adults are recognised as a vulnerable group who carry the burden of mental health problems worldwide. Mental health interventions can be effective in positively influencing students' emotional and behavioural wellbeing. Design/methodology/approach: In the current study, the principles of Intervention Mapping (IM) were applied to guide the development, implementation, and evaluation of a specifically tailored mental health programme for a selected student cohort in a large Higher Education Institute in Ireland. Mixed qualitative (Delphi technique and focus group discussions) and quantitative (survey) data were gathered to gain a broad perspective of mental health concerns and learning needs among a sample of higher education students (n = 99). Findings: Existing evidence guided by theoretical frameworks were blended to create a specifically tailored mental health programme to meet the needs of higher education students in Ireland. Results indicate that the established six-stages of IM provide an empirical process that has the potential to effectively respond to the mental health needs of students in higher education. IM identifies the priority needs of students in higher education and ensures that suitable behaviour change techniques for mental health are addressed. 10; Originality/value: IM is a suitable method to critically and collaboratively develop a mental health intervention for the overall wellbeing of the general higher education student population, both nationally and globally. 10; [ABSTRACT FROM AUTHOR]

BACKGROUND: Irish farmers are a high-risk group for cardiovascular disease (CVD) which imposes not only a risk to their health but has more far-reaching implications for occupational health and safety. OBJECTIVE: This study assessed the impact of a workplace health screening and health behaviour change programme among a sub-group of male Irish farmers. METHODS: Data were collected from male livestock farmers (n = 310) who attended health screenings at livestock marts. Participating farmers also received lifestyle advice to prompt health behaviour change. Health behaviour change was tracked by two phone questionnaires at Week 1 (n = 224) and Week 12 (n = 172). All data were entered into SPSS v22 and analysed using chi-square and regression techniques. RESULTS: At Week 12, 48% reported having changed at least one health behaviour. The majority of farmers were referred to their GP and by Week 12, 32% had acted on this advice. Participants most in need of health behaviour change based on adverse health screening results were, paradoxically, the least likely to contemplate or engage in health behaviour change. CONCLUSIONS: Findings demonstrate that whilst workplace health screenings can be a catalyst for behaviour change for some farmers, more follow-up supports are needed to encourage sustainable behaviour change. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore lymphoma survivors' experiences on their end of treatment and follow‐up care at a large urban haematology centre in Ireland. Methods: This was a qualitative study using semistructured interviews with lymphoma patients post‐treatment (n = 14). Thematic analysis guided the analysis of interview data. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) guidelines. Findings: Five main themes were identified following analysis of the interview data: dealing with uncertainty, changed relationships, returning to work, extended recovery time and concerns for the future. Findings of note were that some participants were unaware that their treatment had ended, many experienced recurrent infections which prolonged recovery time, and many had no recall of discussions on healthy lifestyle behaviours or recommended screening programmes at their follow‐up visits. Conclusions: The findings suggest that the period of transition from active treatment to survivorship can be challenging for lymphoma survivors, and they experience ongoing needs. While the challenges of survivorship in lymphoma mirror those of other cancers, this cohort of patients require focused preparation for the end of active treatment and the transition to follow‐up care. Moreover, this patient group requires repeated specific education on late effects and second cancers, education with regards to identifying the signs of cancer recurrence and promotion of healthy lifestyle practices. Relevance to clinical practice: This study highlights the importance of a dedicated end of treatment visit with the clinical nurse specialist to confirm the completion of active treatment with lymphoma patients and focus on health promotion. [ABSTRACT FROM AUTHOR]

Aims and Objectives This study investigated experiences of women with a primary diagnosis of ACS ( NSTEMI and Unstable Angina) in the 6-8 week period following discharge from hospital. The aim was to report the experience of the mediating impact of a newly-diagnosed disease. Background Cardiovascular disease is the main cause of mortality in women. Treatment modalities have improved health outcomes and survival rates, however, quality of life and ongoing morbidity after discharge is not clearly understood from a gender specific perspective. Design A naturalistic case study design guided this study. Methods Thirty women participated ( n = 30); a within-case followed by a cross-case analysis provided meticulous knowledge of each case. Data collection included participant diaries and face to face interviews. Data were analysed using modified analytic induction which allowed the emergence of theoretical insights. The theoretical concepts, liminality and transitioning were used to inform the analysis. Within-methods triangulation captured the depth and breadth of the women's experiences. Results The data provide an insight into women's experiences following ACS and highlight a need for support structures and services after discharge. Many women reported a period of disrupted normality following discharge from hospital. While a number of women had transitioned towards recovery, many remained in a liminal space 'betwixt and between' health and illness. Cardiac rehabilitation was reported as a positive experience for those who were attending. Conclusions The findings provide a platform for a wider discourse on the needs of women with ACS in the immediate period after discharge from hospital. Women may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with CHD. Relevance to clinical practice It is essential that secondary prevention services are modelled and tailored to meet the needs of women and evaluated appropriately to ensure positive outcomes. Nursing could have a key role to play in managing and providing this support. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aims to examine the effectiveness of the use of telephone empowerment-based health coaching as a cost-effective alternative to changing health behaviours of adults with Type 2 diabetes. Background Guidelines regarding lifestyle management to reduce the risk of complications in diabetes include changing patterns of eating, physical activity and smoking cessation. Traditional education/behavioural methods of support for behaviour change reveal mixed and mainly short-term effects. Design A mixed method case study approach was used ( n = 10). Methods Data were collected by means of physiological measurements survey and focus group interview both before and after telephone a coaching intervention. Results Participants took greater responsibility for health and revealed high self-efficacy scores. Short-term benefits were seen in physiological variables at three months but these deteriorated with the cessation of the intervention indicating the need for continuous support. Conclusion Telephone coaching is a cost-effective approach to supporting health behaviour change for those with diabetes. It embraces the principles of empowerment and warrants further evaluation in supporting long-term behavioural changes. As such coaching emerges as a suitable proposition for this cohort. Relevance to clinical practice Health coaching has a positive impact on health behaviours for those with diabetes. Health coaching facilitates an increase in personal control of health and builds confidence in self-managing diabetes. Patients feel really supported and become motivated towards self-care. [ABSTRACT FROM AUTHOR]

Background: Current advice to women in Ireland is to abstain from alcohol when pregnant or breastfeeding. This study aims to establish whether women embrace this advice when pregnant and if there is a need for additional midwifery-led education in relation to alcohol consumption and breastfeeding. Methods: A cohort study of 907 women who booked for antenatal care and to give birth in a large maternity hospital in Dublin, was undertaken from 2010–2011. Eligible women completed an interview at the first visit, a postal questionnaire during the third trimester of pregnancy, and were followed-up until the birth and discharge. Results: During pregnancy women who planned to exclusively breastfeed continued to consume alcohol at a rate similar to those who did not plan to breastfeed (30.2% compared with 27.5%; (OR 1.13; 95% CI; 0.84–1.53). Consuming alcohol was associated with older maternal age, Irish nationality and private health care. Intention to exclusively breastfeed was associated with socioeconomic group, non-Irish nationality and private health care. The findings at follow-up were similar to the first set of results with almost a third of women who consumed alcohol in pregnancy exclusively breastfeeding at the time of hospital discharge; (OR 1.28; 95% CI, 0.95–1.73) Conclusions: Many women who plan to breastfeed continue to consume alcohol in pregnancy despite national and international guidelines that recommend abstention. There may be opportunities in the antenatal period to influence behavioural change in relation to breastfeeding and alcohol consumption. [ABSTRACT FROM AUTHOR]

Aim: Being physically active has many proven health benefits and promoting physical activity to patients in primary care is an important component of public health programmes. This study examined the knowledge and practices of general practitioners and physiotherapists in the promotion of physical activity in primary care. Subject and methods: A cross-sectional population survey was conducted in Ireland to establish participants' knowledge of physical activity guidelines and current practice in the promotion of physical activity. A total of 342 general practitioners (response rate 65 %; n = 543) and 89 physiotherapists (response rate 88 %; n = 101) responded to the survey. Results: More physiotherapists (50.5 %; n = 45) than general practitioners (28 %; n = 97) correctly reported the minimal physical activity guidelines ( X² = 16.56, p < .005, df = 1). General practitioners reported screening physical activity opportunistically (41 %; n = 139) and when related to a patient's presenting complaint (37 %; n = 126). Physiotherapists reported screening physical activity routinely (34 %; n = 30) and when related to the presenting complaint (28 %; n = 25). With the exception of overweight patients, general practitioners were more likely than physiotherapists to promote physical activity to patients with known cardiovascular risk factors such as hypertension ( X² = 49.65, p < .001, df = 2) and hypercholesterolemia ( X² = 32.58, p < .001, df = 2). Physiotherapists, however, were more likely to promote physical activity to healthy populations ( X² = 9.91; p < .01, df = 2). Education and advice was the intervention most frequently used (general practitioners 76 %; n = 258, physiotherapists 97 %; n = 86). Conclusion: Despite high levels of awareness of physical activity promotion amongst general practitioners and physiotherapists, there is scope to improve physical activity promotion particularly to healthy populations and ongoing challenges to incorporate evidence based interventions into routine care. [ABSTRACT FROM AUTHOR]