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Aims: To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks., Background: Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society., Design: Discussion paper., Data Sources: Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014)., Implications for Nursing: Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice., Conclusion: Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction., (© 2015 John Wiley & Sons Ltd.)

This paper charts the development of one of Ireland's first comprehensive schools located in Carraroe in County Galway. Through a systematic, historical analysis of Department of Education and diocesan correspondence, this article provides a unique insight into how official policy was reconciled at ground level. The analysis exposes the ambiguity of previous studies surrounding the role of the church hierarchy in educational reform during the 1960s and seeks to clearly identify key personnel involved in consolidating policy concerning the comprehensive school scheme. Underpinning this narrative, is the deliberate exclusion, by both church and state, of local school authorities from policy decision-making regarding the comprehensive school in Carraroe. In particular, this paper illustrates how a paradigm shift in Department of Education negotiation tactics provided the government with an effective means for introducing new educational policy measures in the future.

This specially themed ""Getting of Wisdom," Learning in Later Life" Edition of the "Australian Journal of Adult Learning" ("AJAL") is not so much concerned with the issue of ageing itself, but more about quality of life regardless of age. It is about taking, but also giving back as best as possible at any age. This special issue is a result of the one week "The Getting of Wisdom Exchange", a collaboration between around 100 adult education practitioners and researchers from ten countries from Australia, New Zealand, Asia and Europe. In this issue, papers are presented from Sweden, Ireland, Aotearoa/New Zealand, Australia, Slovenia, Poland, Germany, Portugal and the United Kingdom. Papers cover different topics and open questions about various issues in older people's learning.

School self-evaluation (SSE) has emerged as a widely used approach to school evaluation in recent decades. This has occurred in the context of what is referred to as "New Public Management," an element of which seeks to empower public institutions to make decisions locally about improving their processes and standards. Inspection regimes in many countries have developed legislative, methodological, and support mechanisms for schools to carry out SSE. This paper, by using the evolution of the SSE process in Irish education, analyses the efficacy of SSE by exploring teachers and school principals' perceptions of both the challenges and supports concerning the integration of SSE in their schools. Results derived from this study suggest that respondents were, overall, fully aware of the support services available to them. However, support capacity challenges also emerged, in particular as it relates to data use and target setting. Importantly, it is argued that since there are striking resemblances between SSE as it has developed in Ireland and other systems, the challenges and solutions identified in this paper will have wide application in other contexts.

Purpose: To examine the perspective of third-level university students in the context of the value proposition of construction apprenticeships in Ireland. Design/methodology/approach: The research uses a qualitative method, conducting semi-structured interviews with 20 third-level university students enrolled on a Bachelor of Science (Honours) degree program in Construction Management in Ireland. Findings: The results highlight six themes. These include that society appears to be directly and/or indirectly steering students towards university. This is driven by what appears to be a prevailing stigma in that apprenticeships are not seen as an achievement by society. Also, apprenticeships are seen as a limited career choice, while also being one which appears to repel female entrants. Practical implications: If the shortage of new skilled workers entering the construction industry continues, construction organisations will not have the necessary resources to tender for, and subsequently, complete new work. Social implications: The perception of what could have been seen as potential new apprenticeship entrants, but ultimately chose university, is worth examining further with a view to industry addressing the shortcomings identified. This therefore can provide an opportunity to stem the tide of reducing apprenticeship numbers, while also providing a viable alternative to university for those who wish to pursue alternative routes of entering the sector. Originality/value: The paper uniquely focuses on the third-level university student's perspectives and what influenced their decision to pursue third-level university education over that of an apprenticeship within the built environment; an area which has yet to be investigated.

The way in which young people's post-school intentions and pathways reflect their social background has been the subject of a good deal of research. However, much less attention has been paid to social differentiation in the amount and kind of career guidance information received by young people and its role in reinforcing or ameliorating social differentiation in transitions. This article contributes by examining the extent to which sources of information and guidance activities vary by social background and school social mix and the consequences of this variation for intentions to go on to higher education. The paper draws on data from a large-scale longitudinal study of young people in Ireland, the Growing Up in Ireland study. It finds that young people from more advantaged backgrounds are much more reliant on their parents as a source of information and advice, reflecting access to insider knowledge of the educational system, and are more likely to pay for private guidance services. In contrast, young people from less advantaged backgrounds and those attending schools with a concentration of working-class students are more reliant on school-based sources of information, though these resources are insufficient to boost their chances of making the transition to higher education.

Alternative education provision in Ireland is under-researched. This paper is a qualitative investigation of the perspectives of a purposive sample of ten teachers on curriculum, pedagogy and assessment in their respective alternative settings of a voluntary education centre, a Youthreach centre and a post-primary special school. 'Funds of knowledge' ideas contribute to the theoretical framework of the study [Moll, Luis C., Cathy Amanti, Deborah Neff, and Norma Gonzalez. 1992. 'Funds of Knowledge for Teaching: Using a Qualitative Approach to Connect Homes and Classrooms.' "Theory Into Practice" 31 (2): 132-141]. The findings in this paper focus on: (1) how curriculum is enacted and mediated in alternative education settings; (2) the pedagogical decisions of teachers as they strive to connect their students to learning and (3) the tensions in assessment practices as teachers and alternative settings attempt to provide authentic and yet certified evidence of learning through the formal state assessment processes. This article is timely as it offers a view of the under-researched area of alternative settings in Ireland.

The study at the heart of this paper was conducted in 2017 to gather data on Irish post-primary teachers' conceptions of assessment at the time immediately following the introduction of a revised policy for assessment by the Department of Education and Skills (DES). Central to the reform policy was an increased emphasis on formative assessment and a requirement that teachers engage in summative assessment for certification purposes -- something that had never applied previously. The paper provides an overview of the literature on teachers' beliefs, including Brown's (2004, 2006) Teachers' Conceptions of Assessment Inventory. Data from an implementation of the inventory with 489 Irish teachers are used to consider how they conceive of assessment, how these conceptions compare and contrast with those held by teachers in other jurisdictions where the instrument has been used and how the data might be used to inform policy change and implementation in Ireland.

Background: Clinical decision-making (CDM) plays an integral role to surgeons work and has ramifications for patient outcomes and experience. The factors influencing a surgeons decision-making and the utility of cognitive decisional short cuts used in CDM known as 'heuristics' remains unknown. The aim of this paper is to explore how general surgeons make decisions in high-stake biliary tract clinical scenarios., Methods: This was a cross sectional survey comprising of two sections-a 'demographics section' and a 'clinical vignettes section'. Participants were recruited by an email distributed by the Royal College of Surgeons in Ireland. Non-parametric testing examined relationships and content analysis was applied for clinical reasoning., Results: 73 participants or 37.6% of the overall population completed the survey. 71.4% of these were male. Most (50%) were higher trainees with moderate levels of overall reflective practice in decision-making. A majority of participants chose conservatively in high-stake biliary tract clinical cases with disease factors (43.5%) weighted highest, followed by personal factors (41.1%) and patient factors (15.4%) in clinical reasoning. The presence of a 'hook' associated with commonly used heuristics did not significantly change decision-making behaviour., Conclusion: In high-stake scenarios, surgeons make conservative clinical decisions, predominantly dominated by disease and personal justifications. The utility of heuristics in lower-stake scenarios should be explored regarding clinical decision-making rationale and outcomes. Practitioners should consider use of patient factors in high-stake decisions to enable shared decision-making when appropriate which can reduce post-decisional regret and support the vision of patient-centred care.

The COVID-19 pandemic has created an opportunity to examine the initial policies developed by Australian, Canadian, English, German, Greek and Irish governments to limit the spread of the virus. This has revealed governments' conceptualisation of the early childhood sector and its workforce. This paper argues that neoliberal ideology and neoliberal imaginaries have already influenced the early childhood sector globally. During the pandemic, the choices that governments made at the outset of the pandemic has allowed their priorities and underlying ideology to be more transparent. Using an ethnographic methodology, early childhood researchers from each of the six countries, examined their individual governments policy responses and the effects on the early childhood sector during its initial months (between March and June 2020). The authors consider the extent to which this may have implications for the sector in how it should continue its ongoing pursuit of professionalisation of the sector.

Formal consent for children's research participation legally resides with adults, and guidelines typically recommend consulting children about their participation only from 7 years of age. How can researchers support younger children's informed decision-making about their research participation, particularly in larger-scale studies without extended researcher-participant engagement? In this paper, we share our experience of four studies (270 children) using drawings, observations, interviews, and biological and anthropometric measures and the visual information booklets we devised to support young children's informed agreement. Critically evaluating the notion that 'evolving capacities' necessarily increase with age, we consider young children's contextualised decision-making capacity. Reflecting on process and outcomes, we conclude that simple visual information booklets benefit not only children but all actors in the research process, functioning as material artefacts that remind adults as well as children of young children's right to choice about research participation.

In this paper, I address Jacque Lacan's theory of the four discourses, namely, master/slave, university, hysteric and analyst. The four discourses are explored via interviews with five postgraduate business students from a leading Irish business school. Three of the students were prepared to abdicate responsibility for career decision-making to me, thereby suggesting the discourses of the master/slave and university. The remaining two students expected to retain greater control over the career decision-making process which implies a shift in position to the discourse of the analyst. I propose that career counselling should primarily reside in the discourse of analyst, with supporting reference to the discourses of hysteric, university and master/slave. Currently, there is no inclusion of Lacan in career theory.

The concept of data-informed decision making (DIDM), a term used interchangeably with data-driven decision making (DDDM) and data-based decision making (DBDM), is relatively new to Irish education and the school planning process. This research sought to clarify what data principals use and how they use that information for school improvement considering new school self-evaluation requirements. The paper begins by charting the rise internationally of data use in school planning, decision making and accountability. It proceeds to describe the policy context in this area in Ireland and then reports recent research with school leaders around how data is collected and used in their work. Although the paper focusses on Ireland, it is tentatively suggested that school leaders, teachers and policymakers in other countries, and there are many, which have come late to the expectation that school improvement and accountability should be heavily data-informed may find the efforts of Irish principals in this regard of interest.

Background: A new legal capacity act was introduced in Ireland in 2015. This study aimed to identify and critically examine key issues in the area of decision-making capacity from the perspective of psychologists working with adults with an intellectual disability., Methods: A qualitative exploratory approach was employed, and the study was positioned in a social constructionist framework. Purposive and snowballing sampling methods were used to recruit 15 clinical psychologists working with adults with an intellectual disability. Data were collected with the use of individual semistructured interviews. Interview transcripts were analysed using a model of thematic analysis., Results: Six themes were identified: (1) a presumption of capacity but a culture of incapacity, (2) supporting decision making as a process, (3) authenticity of decision making, (4) need for support and training, (5) contributions of psychology and (6) the way forward., Conclusions: Participants described that people with intellectual disabilities were often excluded from decision-making processes. They welcomed the functional approach to decision making, considered substituted decision making to be necessary within a support framework and described supporting decision making as a process. Systemic, resource and attitudinal challenges were identified., (© 2020 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

As with school self-evaluation in most European countries, the Irish education system now promotes the involvement and inclusion of stakeholders such as parents and students in the evaluation process. Yet, in the Irish context, there is limited research exploring the role of these stakeholders in this internal mode of school evaluation. To address this lacuna, this research draws on a national survey of post-primary school principals and interviews conducted with 109 stakeholders now placed at the centre of the evaluation process: school staff, parents and students. While there are some optimistic indications in the data, this research highlights that only slight progress has been made in terms of including parents and students in school self-evaluation in Ireland. The data presented in this paper corroborate that many age-old obstacles in the Irish context still exist and continue to dominate. Ultimately, this research concludes that changes in policy do not necessarily produce changes in practice.

Across many countries, young people are differentiated into academic and vocational tracks, a pattern that is closely related to their social class background. The Irish secondary system has been largely undifferentiated, but the introduction of a pre-vocational programme, the Leaving Certificate Applied (LCA), has brought an element of tracking into upper secondary education. This article explores whether allocation into the LCA track reflects processes similar to those highlighted in international research. It goes further than these studies by explicitly recognising the role of school organisation in influencing student's learning careers and educational decisions. The purpose of this paper is to estimate the determinants of track placement in the Republic of Ireland. Using in-depth qualitative case study interviews with students from Irish post-primary schools, this paper examines the factors influencing students' decisions to enter the LCA programme. This paper explores the extent to which individual agency and school-level factors influence track choice by focusing on the learning careers of individual students within specific school contexts.

The term "participation" is widely used to refer to the involvement of children and young people in decision-making on issues that affect their lives. The Health and Information Quality Authority (HIQA) is the national inspectorate for social care in Ireland. HIQA monitors Tusla, Ireland's child and family agency, for compliance with national children's standards, including standards on children and young people's participation rights. This paper outlines findings of a secondary analysis of data in relation to participation standards in HIQA foster care, residential care and special care inspection reports over a two-year period from 2013 to 2015 (n = 40). The thematic analysis explores the degree to which the reports found that children in care are provided with the opportunity to influence decisions in relation to their everyday lives, to participate in child in care reviews, receive information, avail of advocacy services and have access to a complaints mechanism. While there is much evidence of good practice across all sectors, some notable differences between the realisation of participation standards in residential care and foster care were found. This baseline analysis was undertaken prior to the implementation of a comprehensive participation strategy by Tusla across the organisation and highlights areas in which practice can be improved or mainstreamed in this work programme.

Background: The UN Convention on the Rights of Persons with Disabilities (CRPD) provides the benchmark for assessing human rights and citizenship for people with disabilities. This emphasises autonomy, choice, independence, equality and participation for individuals as its fundamental guiding principles. Methods: This paper explores the exercise of human rights and citizenship for older adults with intellectual disabilities (ID) in Ireland, including choice-making, advocacy and political participation. Cross-sectional data (n = 701) is drawn from wave 2 of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Rates of participation are reported, along with bivariate associations across a range of demographic, personal and social variables, while factors associated with level of choice-making and voting are explored. Results: We found very low rates of choice-making, advocacy and political participation amongst this population. Two factors of choice were explored: "key life choice" and "everyday choice." Some commonalities were identified between the two factors, yet key differences were also noted. Type of residence was the strongest predictor of key life choice yet not significant in everyday choice, while the reverse was true for functioning in activities of daily living. Other factors were also significant in determining choice, including level of ID, contact with family, functional limitation, literacy, age, having friends and respondent type. Conclusions: Low rates of participation reported here impinge on the rights of older adults with ID under the principles of the UN CRPD. Choice-making emerged as a multi-factorial phenomenon, with different factors important depending on the type of choice involved. This encourages a nuanced and personalised response from policy and support services to overcome individual challenges to participation as equal citizens. The significance of respondent type also highlights the difficulty of including self-report, supported and proxy participants in ID research.

School inspection, school self-evaluation and the relationship between them are important themes in current educational policy debates. Many education systems are seeking to find a balance between the, at times, conflicting demands for a robust, transparent and effective system of school evaluation that at the same time allows for professional growth and development within schools. These tensions play out in different ways across different systems and this paper seeks to explore points of commonality and contrast between the Irish and Icelandic experience. The paper begins by reporting research in Ireland which demonstrates that while self-evaluation is theoretically a key component of the national system of school evaluation, in reality there is little sign of it emerging in any significant way in practice in schools. In contrast, research from Iceland is reported which shows that, after a slow beginning, self-evaluation in schools is now bearing fruit in a variety of ways. From these diverse experiences, some conclusions are drawn concerning the conditions under which self-evaluation can become embedded in education systems. (Contains 5 tables.)

Young people in Irish schools are required to choose whether to sit secondary exam subjects at higher or ordinary level. This paper draws on a mixed methods longitudinal study of students in 12 case-study schools to trace the factors influencing take-up of higher level subjects within lower secondary education. School organisation and process are found to shape the extent to which young people actually have a "choice". Streaming practices, which are more prevalent in schools serving socio-economically disadvantaged communities, constrain the degree of choice young people have over their subject levels, with those in lower stream classes usually allocated to ordinary level. Even where schools have mixed ability base classes, schools influence access to higher level subjects. In the middle-class and socially mixed schools, teachers are more likely to expect and encourage all students to take higher level. In contrast, in working-class schools there are sharp declines in the proportion taking higher level subjects as they approach the national exam taken at the end of lower secondary education. Early decisions about not pursuing higher level are found to have long-term consequences. The findings contribute to our understanding of how curriculum differentiation reinforces social class differences in educational pathways.

This research focused on supporting pre-service teachers' (PSTs') learning through the development of pedagogical principles of learning about meaningful physical education (LAMPE) in two physical education teacher education (PETE) programs. In this paper, we share four in-depth examples of the enactment of the pedagogical principles of LAMPE by physical education teacher educators. Data sources included teacher educator weekly reflections, critical friend responses and conversations, non-participant observations, and PST work samples developed in lessons. The four examples highlight decision-making moments and provide further direction on how the pedagogical principles of LAMPE support PST learning about meaningful physical education and illustrate the value of a coherent set of pedagogical principles, such as those offered by LAMPE, in guiding teacher educators' decision-making.

Background: This article considers the impact of differential task difficulty on student engagement and progression within an Irish primary school context. Gaining and maintaining student engagement during learning tasks such as homework is a significant and understandable on-going challenge for teachers. The findings of this study hold the potential to support teachers' decision-making processes regarding the development of student tasks. Purpose: The research study aimed to explore the impact of task difficulty on student engagement and subsequent progression in the computerised navigation task Pac-Man. The central research questions addressed in this article were; do subtle variances in task difficulty impact on student volition and consequently, will this result in a significant variance in students' levels of improvement? Sample: Sixty students from a large urban, coeducational primary school in the south of Ireland were identified as a suitable sample cohort. All students were in their final year of primary school within the Irish education system and were between 11 and 12 years of age. Design and methods: The study employed the use of the popular arcade game Pac-Man. In a test--retest approach, 60 primary school students completed the standard computerised navigation task with a seven-day interval. Between testing, participants were randomly subdivided into three cohorts. Each cohort of 20 participants received a different version of the Pac-Man game to practise with for one week. Cohort A received a version of the Pac-Man game of lesser difficulty, Cohort B received the standard Pac-Man game and Cohort C received a version of greater difficulty. A paired-samples t-test (repeated measures) was employed to compare the scores achieved by each of the three cohorts both pre- and post-practice. As an indication of the resulting effect size for each cohort the eta-squared statistic was subsequently calculated. In order to support any future meta-analysis, Cohen's d statistic is also provided in this paper. Analysis of variance (ANOVA) was employed to explore differences between groups with regard to progression scores and number of games played when practising. Results: The results of this small scale study found the cohort who received the easier version of the task presented the greatest overall improvement in performance between the pre- and post-tests. No statistically significant difference was found in the change in scores of the three cohorts--potentially due to the small sample size. However, paying attention to the size of the effect indicated that, over seven days, there was an 80% improvement in performance for Cohort A, 63% improvement for Cohort B and 26% improvement for Cohort C. The results highlight the negative impact of increased task difficulty on students' volition and consequently, on overall progress in the task. Conclusions: Further research with larger student populations would be needed to assess the generalisability of the results. However, the findings suggest that when designing tasks to promote student learning, particularly self-directed tasks such as homework, it is important that teachers afford ample opportunity for student success.

Article 12 of the United Nations Convention on the Rights of the Child provides for the views of the child to be given due weight in accordance with the child's age and maturity. Legislation in Ireland recognizes the rights of children to have a voice in educational matters. Based on a sample of 2838 14-year-olds in Ireland and using questionnaire data from the International Civic and Citizenship Education Study, this paper uses a multilevel model to examine the student and school characteristics associated with civic participation at school. Results indicate that boys have lower levels of civic participation at school than girls, but among boys only, civic participation at school varies in accordance with levels of perceived influence on decision making. Findings are discussed in the context of the rights of children to participate in decisions that affect them and with reference to Bandura's social cognitive theory. (Contains 6 tables and 2 figures.)

The complex effects of the global financial crisis (GFC) have affected countries differently. The concept of stimulus packages to enable economies to withstand its full effects was widespread, as were decisions by several countries to invest in higher education as a means of stimulating the economy while placing workforce development and research on a firmer footing. While the GFC increased awareness of the need to invest in the knowledge economy, governments adopted approaches reflecting their different fundamental priorities. Arguably Ireland was left with little leeway, whereas Australia's far better economic position might have provided an opportunity to invest in higher education through its stimulus packages. This paper examines the policy choices that Australian and Irish governments made both before, and in response to, the GFC to assess how these decisions have prepared higher education for the future. (Contains 3 notes and 3 figures.)

This paper reports on exploratory, qualitative research conducted with eight people with experience of mental health treatment about their understanding of decision-making capacity. While acknowledging that there are times when mental or emotional distress can interfere with the capacity to make decisions, participants described how their capacity can be reduced by a set of social and environmental factors. These factors include the lack of treatment options available from which to choose, lack of trust of the information provider, inaccessible information, the effects of medication that literally "stops your ability to think", lack of empathy with mental or emotional distress, and lack of time to process information. Participants highlighted the issue of power and powerlessness when describing how incapacity is determined within mental health services. Participants' articulations of capacity in relation to mental health are in accord with a social model of disability approach to capacity. (Contains 1 note.)

Enabling pupils with special educational needs to participate more fully in the assessment, planning and evaluation of their own learning has become a principle enshrined within the legislation of many countries in recent years. Educational policy in both England and the Republic of Ireland has recognised the desirability of increased pupil involvement, and this is reflected in policy documents and in legislation which highlights the requirement of schools to take greater account of the views of pupils. This paper documents the approaches to increased pupil involvement in decision-making adopted in England and Ireland and provides an overview of the key challenges that face policy-makers and educators in ensuring meaningful participation for children and young people with special educational needs.

This paper draws on quantitative and qualitative research from social housing tenants in Ireland, exploring the relationship between digital access to financial resources and financial well-being. We find that using the mobile phone to check a bank balance is associated with decisions around financial commitments (not running out) and resilience (having savings, being able to withstand a shock). Using the internet to check a bank balance is correlated with not having financial difficulties. However, paying bills via mobile phone is correlated with not having money left over at the end of the month and not saving, suggesting an increasing impulsiveness in decision making. IT-enabled banking and commerce have positive and negative implications for day-to-day money management and expenditure decisions. We therefore suggest further multi-disciplinary research on the opportunities for information technology to inform policy and practice around prudent money management decision making for consumers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine persuasion and personality variables as predictors of entrepreneurial intention in a cross-cultural sample. Design/methodology/approach: Undergraduates in the USA and the Republic of Ireland completed measures of personal efficacy, achievement motivation, ambiguity tolerance, attitudes toward entrepreneurship, and entrepreneurial intention. Findings: The results suggest that the decision to become an entrepreneur comes about differently in different cultures. US participants appear to perceive entrepreneurship as a societally sanctioned and appropriate outlet for their achievement motivation. While achievement motivation correlated with entrepreneurial intention for the US participants, this result did not obtain for the Irish subjects. In both cultures, those who have come to believe that being an entrepreneur is consistent with their self-image showed strong entrepreneurial intention independent of their other beliefs about entrepreneurship. This study suggests that recollections of positive interpersonal and mass media messages about entrepreneurship encourage entrepreneurial intention--but only for US participants. Other factors discussed in this report appear to mitigate the effect of such recollections for the Irish. Research limitations/implications: This study is part of a larger research program that includes following up on these participants at a later date. With longitudinal data, we will be able to track the relationship between stated entrepreneurial intention and later business startup. Originality/value: This investigation compares factors influencing entrepreneurial intention in the USA and Ireland. (Contains 4 tables and 3 figures.)

Business managers are faced with complex decisions involving a wide range of issues--technical, social, environmental, and financial--and their interaction. Our education system focuses heavily on presenting structured problems and teaching students to apply a set of tools or methods to solve these problems. Yet the most difficult thing to teach is the defining of the problem itself. Unlike a jigsaw puzzle, in which the overall picture and the individual pieces are clearly defined, real-life business problems require managers to see the "big picture" and define the dilemma. If they cannot see the "whole", they cannot see the "holes" where information is lacking. The boundaries of the problem are too often based on what managers know, not on what they need to know. This paper reviews the roots of holistic systems thinking in the work of philosophers, psychologists and physical scientists. It looks at the extent to which the ability to see and develop models of whole systems is a natural skill of some people rather than a learned skill. It reviews efforts to measure the capability in individuals and the psychological influences on holistic thinking. It then discusses alternative ways in which the capability to see the (w)holes can be developed. (Contains 2 figures.)

Purpose: This paper aims to describe a novel community development and how the synergies arising from the interaction of diverse perspectives (including arts and health, person centredness, co-production and shared leadership) have led to a transformative initiative for individuals and a local community in the Republic of Ireland. Design/methodology/approach: This is a descriptive case study. It includes the personal narrative of an expert by experience who is one of the co-authors. Links to short digital films are also included along with references to internal evaluation documents and published literature. Reflections from the nurses who contributed to the initiative and a university academic are also incorporated. Findings: A space in the community built around the principles of relational practice has evolved into an alchemical space, enabling creativity, recovery and well-being. The benefits arising out of this network of social relationships have contributed to personal recovery, integration with the local community and generated social capital. This has enhanced mental health and well-being locally. Practical implications: Statutory Irish health policy is reflective of developments in health care internationally, with an emphasis on greater delivery of care in the community. This views citizens as active partners in the maintenance of their health and well-being. This case study illustrates how this has unfolded in practice in a rural mental health community context. Originality/value: This paper adds to the evidence base that demonstrates the potential benefits of participation in the arts to individual recovery journeys. In addition, it shows that when arts and health perspectives coalesce with the wider domain of relational practice, the synergies arising contribute positively to the health and well-being of local communities. [ABSTRACT FROM AUTHOR]

Drawing on findings from a psycho-social qualitative doctoral study, this paper considers the intimate and extraordinary emotional intensity, ambivalence and pain associated with the experience of mother social workers engaging with mothers and their infants in the context of child protection work. In this yearlong study undertaken with a group of female Irish child protection social workers, their role as mothers was an unanticipated emergent theme and was found to be inextricably linked to their work and their capacity for realistic decision-making. We consider the wider contexts of societal ambivalence about motherhood, mothering and social work itself, as a way of locating these experiences as fully psycho-social. The work discussion seminars offered as part of the research study afforded a rare opportunity for workers to talk about predicaments, failures and worries, in conditions of containment for anxiety, support for their learning, and a confidential reflective setting. [ABSTRACT FROM AUTHOR]

The effects of climate change are multiple and fundamental. Decisions made today may result in irreversible damage to the planet's biodiversity and ecosystems, the detrimental impacts of which will be borne by today's children, young people and those yet unborn (future generations). The use of citizens' assemblies (CAs) to tackle the issue of climate change is growing. Their remit is future focused. Yet is the future in the room? Focusing on a single case study, the recent Irish CA and Joint Oireachtas Committee on Climate Action (JOCCA) deliberations on climate action, this paper explores the extent to which children, young people and future generations were included. Its systemic analysis of the membership of both institutions, the public submissions to them and the invited expertise presented, finds that the Irish CA was 'too tightly coupled' on this issue. This may have been beneficial in terms of impact, but it came at the expense of input legitimacy and potentially intergenerational justice. Referring to international developments, it suggests how these groups may be included through enclave deliberation, institutional innovations, design experiments and future-oriented practice.. [ABSTRACT FROM AUTHOR]

Ireland has been a full member of the European Union since 1973. As a member state of the EU, Ireland plays an important role in the formation of European policies and decision-making that affect the development of the European Union. Ireland perceives the European integration process as an opportunity to strengthen the economy and raise the standard of living of its citizens. Over the years of membership in the EU, Ireland has received significant support and financial assistance from the European Union, which has enabled a number of economic and social reforms to be implemented. Slovenia is a small country in Southern Europe that joined the European Union in 2004, along with other Central and Eastern European countries. As a member of the EU, Slovenia has the right to participate in all its programs and initiatives, as well as to influence decision-making within the EU. The country adopted the euro as its currency in 2007. Slovenia has a high level of development and is one of the best EU countries in terms of living standards. The country also exports goods such as automobiles, electronics, engineering, pharmaceuticals, and other products. Slovenia also has a developed tourism industry. The paper compares the economic development of Ireland and Slovenia in the context of the European Union. Ireland has a more developed economy that provides high GDP growth rates, large amounts of investment and stable exports of goods and services. On the other hand, Slovenia has a less developed economy, with a lower rate of GDP growth, but with a higher level of employment and less dependence on foreign exports. The article also examines the peculiarities of the economic policy of each country, in particular, the role of the state in stimulating economic growth and attractiveness for investors. The study indicates that Ireland successfully implemented a strategy of attracting foreign investment and creating favorable conditions for business, which contributed to the rapid development of the country's economy. In turn, Slovenia focused on developing the domestic market and supporting small and medium-sized businesses. The history of economic development of each country and their current economic indicators, such as GDP, unemployment, investment, etc., are analyzed. The key factors that helped each country achieve success in economic development are identified. The problems and unique challenges that these countries face in terms of regional problems affecting the EU are considered. Overall, the article provides useful information about the economic development of Ireland and Slovenia, their characteristics and the factors that contributed to their economic development in the context of the European Union. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a qualitative experience of patients and frontline staff. It demonstrates the application of the "Picture-Understanding-Action" approach and shares the lessons learnt. Design/methodology/approach: Using co-design and applying the "Picture-Understanding-Action" approach, the project team supported the directors of the Irish health system to identify and test a qualitative and quantitative picture of the quality of care across the health system. A "Quality Profile" consisting of quantitative indicators, analysed using SPC methods was used to provide an overview of the "critical few" indicators across health and social care. Patient and front-line staff experiences added depth and context to the data. These methods were tested and evolved over the course of six meetings, leading to quality of care being prioritised and interrogated at board level. Findings: This project resulted in the integration of quality as a substantive and prioritised agenda item. Using best practice SPC methods with associated training produced better understanding of performance of the system. In addition, bringing patient and staff experiences of quality to the forefront "people-ised" the data. Originality/value: The application of the "Picture-Understanding-Action" approach facilitated the development of a co-designed quality agenda item. This is a novel process that shifted the focus from "providing" information to co-designing fit-for-purpose information at board level. [ABSTRACT FROM AUTHOR]

Since the We the Citizens project of 2011, Ireland has begun to establish itself as a world leader in the use of national deliberative fora for considering policy change. In many ways, it marks a radical departure from the tightly-controlled, executive-dominated parliamentary politics of Dáil Éireann. Thus far, innovative deliberative processes have had a direct influence on two hugely transformative moral/social referendums: the marriage equality referendum of 2015 (recommended by the 2013–14 Convention on the Constitution) and the abortion referendum of 2018 (recommended by the Citizens' Assembly in 2017). With the extensive recommendations of the recent Citizens' Assembly on Gender Equality, there may yet be more deliberation-led social transformation to come. This paper considers the involvement and influence of women in Ireland's deliberative processes and their contribution to the country's ongoing social transformation. Particular attention is paid to the much greater descriptive representation offered by these sortition-formed assemblies compared to Ireland's electoral bodies, and their record of delivering 'woman-friendly' outcomes is assessed. Consideration is also given to the possibility that these processes may resolve some of the tension between descriptive and substantive representation through women's direct participation in deliberative decision-making. [ABSTRACT FROM AUTHOR]

Background: Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support final year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods: This study aimed to evaluate a simulation-based education initiative from the perspectives of final year undergraduate nursing and midwifery students (N = 95). An online survey, using the validated Simulation Effectiveness Tool – Modified (SET-M), was distributed to final year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results: The results of the study highlight final year nursing and midwifery students' perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confidence and gain experience in preparation for real-life practice. Students reported feeling more confident in their assessment skills, in providing care and interventions in responding to changes in a person's health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefing and debriefing sessions were highlighted as important aspects of the simulation which helped to increase student confidence and cultivate meaningful learning. Conclusion: Simulation-based education is a valuable teaching and learning modality, particularly for final year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well‐being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia‐related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development. Aims: To establish the current practices of SLTs managing dementia‐related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered. Methods & Procedures: An anonymous, cross‐sectional web‐based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open‐ended questions were analysed using conventional content analysis. Outcomes & Results: A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self‐rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources. Conclusions & Implications: The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well‐being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper addsWhat is already known on the subjectResearch indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice.What this paper adds to existing knowledgeThis paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints.What are the potential or actual clinical implications of this work?These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia‐related dysphagia and mealtime difficulties effectively. [ABSTRACT FROM AUTHOR]

This paper offers a conceptual evaluation of primary assessment policy and the policy process in the Republic of Ireland. It considers, in particular, the National Council for Curriculum and Assessment's policy document, A Programme for Reform: curriculum and assessment policy towards the new century and within that, the policy statement, The Curriculum at Primary Level: programme development and pupil assessment and it also refers to the primary teachers' union stance on assessment. It critically evaluates the Irish policy position on assessment in the light of recent literature in this field. The main argument of the paper is that the proposed policy is preoccupied with measurement issues and it does not sufficiently recognise the complexity of implementing formative assessment. The paper also seeks to explain the nature of current policy in Ireland with reference to the decision-making process and comparisons with other systems outside Ireland, particularly England/Wales, are made, where appropriate. [ABSTRACT FROM AUTHOR]

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers' conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family's situation in terms of the range of issues identified and candidate 'causes'. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies' involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning. [ABSTRACT FROM AUTHOR]

Background: There is limited United Kingdom (UK) literature on general practice-based pharmacists' (PBPs') role evolution and few studies have explored general practitioners' (GPs') experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs' experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI). Methods: A paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically. Results: The response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion: Most GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs', community pharmacists' and patients' views of this role in general practice is required to corroborate study findings. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report on the findings of a qualitative study that explored the views and experiences of young people leaving care during the first phase of the Covid-19 pandemic in Northern Ireland. Design/methodology/approach: A qualitative approach was adopted involving semi-structured interviews with 24 care leavers 18–25 years old from across the region. Interviews were conducted remotely online or by telephone and explored young people's lived experiences during the pandemic including their views on the formal support services and how best to provide ongoing for support care leavers during the pandemic. Findings: Study findings highlight how known adversities for care leavers are exacerbated during the pandemic, having a detrimental impact, particularly on their emotional well-being. The response of the state as a corporate parent in mitigating the impact of the pandemic was found to be inadequate; with a need for much clearer communication, transparent and prompt decision-making and targeted specialist mental health services. The account given by the young people also highlighted the importance of participation and relationship-based practice to build on the young people's resilience in the context of high levels of social isolation and limited access to informal support systems. Originality/value: This research, based on the views of care experienced young people themselves, is the first study in Northern Ireland to report on the impact of the Covid 19 pandemic on care leaving. As such it makes a contribution to this emerging international field of study and, given the persistence of the pandemic, provides empirical findings and a social justice perspective of ongoing relevance to policy and practice with young people leaving care. [ABSTRACT FROM AUTHOR]

This paper examines the influence of the Troika on the retrenchment and reform of social security in Ireland during its bailout between 2010 and 2013. To do this, it draws on data from in-depth interviews with senior civil servants and civil society organisation staff who met with the Troika as part of their quarterly missions to Ireland during this period. The key themes which emerged from these interviews include the largely domestic origins of social security retrenchment and reform; the surprising, and distinctive, positions adopted by the European Commission and the International Monetary Fund (IMF); the extent of the Irish government's room for manoeuvre in this area, and the ways in which the Irish government defended social security against proposals for additional cuts put forward by the Troika. The paper concludes by arguing that the scope for domestic decision-making was heavily constrained, yet non-trivial, and that the Troika's influence comprised not only ‘powering’ but also ‘persuasion’. [ABSTRACT FROM PUBLISHER]

The Irish General Practitioner Training (GP) Programme is currently moving to Competency-Based Medical Education (CBME), facilitated by Programmatic Assessment (PA) and Entrustable Professional Activities (EPAs). These new assessment and feedback mechanisms may provide a rich and much sought-after dataset. However, given the possible number of feedback and assessment events, and the variety of modalities used, aggregating and interpreting these can be costly and difficult. Dashboard implementations (DI) have been purposed as a solution to bridge the gap between the large datasets and the training community at all levels. To explore the Irish GP training community's perceptions on how an EPAs DI could facilitate the delivery of GP training in Ireland. A qualitative approach was taken, using a focus group representative of different groups in the training community. Concurrently, an EPAs DI was developed. Focus group transcripts were analysed in an iterative fashion using Template Analysis to generate themes and subthemes. Numerous advantages were seen in relation to the implementation of an EPAs DI around entrustment decisions, constructive alignment and summative decision-making. These advantages, however, need to be tempered with the realisation that the EPAs DI is not and should not be misinterpreted as being the learning analytic panacea for GP training. This paper outlines the perceptions from a postgraduate medical education training community on an EPAs DI, which would be applicable to other training communities considering introducing similar mechanisms. [ABSTRACT FROM AUTHOR]