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Cognitive cognitive load theory (CLT) has been conceived for improving instructional design practices. Although researched for many years, one open problem is a clear definition of its cognitive load types and their aggregation towards an index of overall cognitive load. In Ergonomics, the situation is different with plenty of research devoted to the development of robust constructs of mental workload (MWL). By drawing a parallel between CLT and MWL, as well as by integrating relevant theories and measurement techniques from these two fields, this paper is aimed at investigating the reliability, validity and sensitivity of three existing self-reporting mental workload measures when applied to long learning sessions, namely, the NASA Task Load index, the Workload Profile and the Rating Scale Mental Effort, in a typical university classroom. These measures were aimed at serving for the evaluation of two instructional conditions. Evidence suggests these selected measures are reliable and their moderate validity is in line with results obtained within Ergonomics. Additionally, an analysis of their sensitivity by employing the descriptive Harrell-Davis estimator suggests that the Workload Profile is more sensitive than the Nasa Task Load Index and the Rating Scale Mental Effort for long learning sessions. [ABSTRACT FROM AUTHOR]

Aims: The aim of this paper is to propose a methodology for classifying prisons into distinct drug-use risk categories based on prisoners’ use of specified prescription and illegal drugs. The categories of prisons thus defined have particular relevance for the planning of drug-related interventions, education and services in Irish prisons. The methodology may be transferable to, and of value in, prison systems elsewhere.Methods: From the 14 prisons in Ireland, 824 randomly selected prisoners completed a self-administered questionnaire on lifetime, last year and last month use of specified prescription and non-prescription drugs. Questions were derived from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and other sources. Oral fluid samples were collected for verification of recent drug use. The EMCDDA definition of “recent problematic drug use” was used inpost hochierarchical cluster analysis to define categories of prisons with similar drug-use patterns.Findings: Four categories of prisons, designated “low”, “medium”, “high” and “very high” drug use, were identified. While the prisons comprising each category were known, drug use patterns in individual prisons were not disclosed because of concerns about prisoner confidentiality in a small jurisdiction. The clusters identified were used to contextualise subsequent analyses of drug use, the availability and use of harm-reduction services and differential service requirements by prison category.Conclusions: The methodology described allows for identification of prison categories by drug-use patterns. With restrictions on disclosure of information by individual prison, it provides more valuable information than would derive from data on all prisons combined. [ABSTRACT FROM PUBLISHER]

Recent research has highlighted the importance of parental involvement in sexuality education, and studies of sexuality education sometimes take place through national sexual health surveys. This paper aims to identify key parental characteristics that predict parental involvement in sexuality education while also encouraging a debate on how this topic is optimally investigated. Data used in this study comprised a subset from a nationally representative cross-sectional telephone survey of adults (18–45 years) living in Ireland (N = 3002). Parents (21–45 years) of a child/children aged 6 years or older at the time of the study (n = 966) were included in analyses. Results using propensity score analysis found that parents who reported engaging in sexuality education with their children were more likely to be women, aged 36–45 years, and also were more likely to have a larger number of children. Advancing the field of sexuality education research could be facilitated by the application of survey method and the advanced statistical techniques used here. Furthermore, a stand-alone national survey assessing parental involvement in sexuality education would be a worthy contribution to this knowledge base. [ABSTRACT FROM PUBLISHER]

The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice. [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. Dealing with work related stress is a declared priority of European Union mental health policy. A particularly under-researched sector in this regard is the community vocational support sector for people with mental health and intellectual disability problems. Aims. To report on the organisational profile of the vocational support and rehabilitation sector forpeople with mental health and intellectual disabilities as this relates to occupational stress, in five European countries (Austria, Ireland, Italy, Romania and UK). Methods. A sector profile questionnaire was distributed to representative organisations in five countries and a short face-to-face survey was conducted with 25 local managers (five from each country) to draw up a profile and facilitate a comparative description and analysis. Results. It was found that there is no national and European data collected at any level in this sector upon which to base effective policy interventions to combat occupational stress specific to professionals working in this sector. Results indicate that the sector in a number of the countries sampled does not have effective mechanisms in place to deal with occupational stress. Conclusion. Developing effective transnational occupational stress management policy that supports staff working in this sector and measuring its success is greatly impaired by a failure to effectively define the purpose of the sector and collect and collate national data to support it. [ABSTRACT FROM AUTHOR]

Identification of occupational workplace injury risk factors is dependent on gaining sufficient and reliable data on both injury occurrence and associated workplace factors. Assessing workplace injury risk factors associated with farming is challenged by non-collection, non-reporting, or under-reporting by farmers, particularly those operating family farms in a self-employed manner. A supplementary (or add-on) farm operator (FO) workplace injury survey was undertaken in association with the Irish National Farm Survey (NFS), which is responsible for provision of Irish farm-level data to the European Commission (EC) Farm Accountancy Data Network (FADN). Data from this add-on survey were analyzed in association with farm and socio-economic data routinely collected by NFS as a component of the FADN. The combined data-set was analyzed using both descriptive and inferential statistical techniques including multivariate logistic regression to identify risk factors for occurrence of farm operator workplace injuries (FOWI). FOWI levels were significantly higher on farms where both the FO and their spouse engaged in Off Farm Employment (OFE). More generally, FO injury levels were associated with farm workload and investment levels. The study demonstrates how FADN farm and socio-economic data can be combined with additional FO workplace injury data to identify workplace injury risk factors. The study identifies a risk factor for FOWI occurrence where both FO and spouse engaged in OFE. More generally, it indicates that farm workplace injuries are associated with farm management-related factors. [ABSTRACT FROM AUTHOR]

Auditory-perceptual judgements are regarded as the standard method for assessing speech disorders. However, the results of auditory-perceptual evaluations and rater reliability can be affected by various factors, such as concurrent problems in multiple speech subsystems. This study investigated the effect of a co-occurring articulation disorder on auditory-perceptual judgements of hypernasality and the effect of co-occurring hypernasality on judgements of an articulation disorder. The speech stimuli were sentences produced by a male speaker who simulated four levels of hypernasality (typical nasality, and mild, moderate, and severe hypernasality) at four levels of disordered articulation (typical articulation, and mild, moderate, and severe articulation disorder). Thirty speech and language therapy students used visual analogue scales to rate the severity of hypernasality and articulation disorder for each speech sample. Results showed that the hypernasality ratings were significantly higher when articulation disorder co-occurred compared to those without. However, there was no significant difference between mild, moderate and severe concurrent articulation disorder on hypernasality ratings. The speech samples with typical articulation and those with severe articulation disorder were rated as more severe in terms of articulation problem when combined with severe hypernasality. However, there was no significant hypernasality effect on articulation ratings for speech with mild or moderate articulation disorder. The present results generally agreed with previous findings regarding the effect of co-occurring speech problems on auditory-perceptual judgements. Clinicians are advised to be cautious of the potential impact. If possible, speech evaluation using instrumental techniques should be used to supplement auditory-perceptual judgements. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has launched a program to promote Global Cooperation on Assistive Technology (GATE) to implement those parts of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) referring to assistive technology and products. A particular vulnerable group deeply affected by health inequity affecting access to assistive products are people with intellectual disabilities. Objective: The objective of this study is to understand the barriers and facilitators to effectively access and continuously use essential assistive products for people with intellectual disabilities. Materials and methods: Face-to-face interviews with 15 adults with a mild to profound intellectual disability and 15 providers of assistive products were conducted to gain insights about current use, needs, knowledge, awareness, access, customization, funding, follow-up, social inclusion, stigma and policies around assistive products and intellectual disability. The technique of constant comparative analysis was used to analyze the data. Results and conclusion: An overview of factors is presented that fit within seven domains for access and eight domains for continuous use of assistive products for people with intellectual disabilities. It illustrates that access and continuous use are influenced by different barriers and facilitators. These different influences should be taken into account in country policies and frameworks that seek to implement the UNCRPD through assistive technology. Proactive assessment for assistive products by health professionals is rare and the vast majority of people with intellectual disabilities depend on carers to signal the need. A lack of education for carers around available assistive products and the benefits of assistive products for people with intellectual disabilities may lead to an underutilization for this group. The paternalistic attitude of care providers towards people with intellectual disabilities limits access and use to certain (high-tech) assistive products. The segmented and disjointed aspect of public funding to support assistive products found in this study is a key issue for policymakers who aspire to adhere to implementing the UNCRPD equally in all areas of their country. [ABSTRACT FROM AUTHOR]

There is a need to ensure public health policies are robustly evaluated to establish their benefits and harms on the population and subgroups. We aimed to assess the comparability of Northern Ireland (NI) and Republic of Ireland (RoI) alcohol-related data to determine their suitability for evaluating the effectiveness of alcohol policies on alcohol consumption, sales, and related outcomes. A comparability analysis of NI and RoI alcohol-related hospital admissions, deaths, consumption, sales, and crime administrative and survey data was undertaken. Data sources were compared, where applicable, in terms of coding systems, population coverage, definitions, quality, response/completion rates, and question similarity. The NI and RoI consumption and sales data were found not to be comparable enough for use in a natural experiment study; comparability for hospital admission data was acceptable. Key barriers to comparability included variations in population coverage and lack of overlap in questionnaire topics. Data access issues made it difficult to fully determine data comparability for alcohol-related crime and deaths. By contrast, NI alcohol-related data were more comparable with other UK countries, making comparisons for the purpose of policy evaluation possible. RoI would benefit from identifying another economically and culturally similar country with comparable alcohol-related data. [ABSTRACT FROM AUTHOR]

The stigma associated with a diagnosis of mental illness is well known yet has not reduced significantly in recent years. Health professionals, including nurses, have been found to share similar negative attitudes towards people with labelled with mental illness as the general public. The low uptake of mental health nursing as a career option reflects these stigmatised views and is generally regarded as one of the least popular areas of in which to establish a nursing career. The aim of the current project was to examine nursing students' attitudes towards the concept of mental illness and mental health nursing across four European countries (Ireland, Finland, Norway and the Netherlands), and Australia, using the Opening Minds Scale and the Mental Health Nurse Education survey. The surveys were distributed to students prior to the commencement of the mental health theory component. Attitudes towards mental health nursing were generally favourable. Differences in opinion were evident in attitudes towards mental illness as a construct; with students from Australia and Ireland tending to have more positive attitudes than students from Finland, Norway and the Netherlands. The future quality of mental health services is dependent on attracting sufficient nurses with the desire, knowledge and attitudes to work in mental health settings. Understanding attitudes towards mental illness and mental health nursing is essential to achieving this aim. [ABSTRACT FROM AUTHOR]

Purpose: Research has shown that accent variation can affect typically developing (TD) children’s understanding of language, as well as that of children with speech difficulties, neuro-typical adults and those with aphasia and dementia. This study aims to investigate the effect of regional native accents on sentence comprehension in children with language impairment (LI), an area not previously explored. Method: Forty-three children with LI (mean age 6.04) and forty-five younger TD children (mean age 4.10), matched on a measure of sentence comprehension, completed a sentence comprehension task spoken in three regional accents. Instructions were spoken in the children’s local Irish accent, a neutral-Irish accent and an unfamiliar Northern-Irish (NI) accent. Instructions were adapted from the Token Test and were matched on syllable length and complexity. Result: The two groups performed similarly overall on the task. Children had significantly greater difficulty understanding instructions spoken in the NI accent than in either of the other two accents. The ability to process accent variation was significantly associated with receptive language and phonological short term memory ability. Conclusions: Variation in regional accents may be negatively impacting the performance of children on language comprehension assessments. Potential effects on diagnostic or clinical decisions will require further exploration. [ABSTRACT FROM AUTHOR]

This study examined the prevalence of depressive symptoms and suicidal ideation among 220 first year undergraduate university students in Ireland. Data were collected using the Centre for Epidemiological Studies Depression Scale and the Suicidal Behaviours Questionnaire. Findings indicated that 59% of participants experienced depressive symptoms and 28.5% had suicidal ideation. Financial stress and poor relationships with both parents, increased the odds of experiencing depressive symptoms. Sexual orientation, financial stress, and poor relationships with fathers, increased the odds of experiencing suicidal ideation. Suicidal ideation was also higher in those who had sought help in the past from mental health professionals. Nurses need to be aware of the factors associated with mental ill-health in this population. [ABSTRACT FROM AUTHOR]

Dominant theories in loneliness literature describe it as a biological, universal phenomenon, yet culture also plays a role. Previous researchers have called for an exploration of the meaning of loneliness in diverse cultures. In order to examine this meaning among rural older Irish adults, we conducted semi-structured interviews with a sample of nine such individuals who had identified as socially isolated and opted into receipt of a befriending service to help alleviate this isolation. An interpretative phenomenological framework was used to inform design and data analysis. Themes were developed from transcripts of the interviews. Results describe four themes within the data:presence or absence of others and loneliness; loneliness as a consequence of inactivity; loneliness as a type of vulnerability; andpersonal preferences, personal characteristics, and loneliness. Results are discussed in terms of their theoretical and practical implications. Of particular interest are the associations that participants drew between loneliness and boredom, and loneliness and security, since this suggests that intervening upon these relatively modifiable experiences may serve to alleviate loneliness for older adults. [ABSTRACT FROM PUBLISHER]

This study estimates a demand relationship for second tier soccer in Ireland to test the uncertainty outcome hypothesis (UOH). Using data from three recent playing seasons, the UOH is found to be upheld. In addition, well-determined effects for fixture quality, recent team performance and travel distance between the competing teams’ stadia are also obtained. [ABSTRACT FROM AUTHOR]

Gaelic Football and Hurling are two sporting codes within the Gaelic Athletic Association. The purpose of this study was to report the body composition phenotype of inter-county Gaelic athletic association players, comparing groups by code and field position. 190 senior, male, outfield inter-county players (144 hurlers and 46 Gaelic footballers) were recruited. Stature and body mass was measured, estimates of three components of body composition, i.e. lean mass, fat mass and bone mineral content was obtained by dual energy X-ray absorptiometry (DXA), and normative data for Gaelic athletic association athletes by code and position was compared. Other than in the midfield, there was limited difference in body composition between codes or playing position. Stature-corrected indices nullified any existing group differences between midfielders for both codes. Further comparisons with a non-athletic control group (n = 431) showed no difference for body mass index (BMI); however, the athletic group has a lower fat mass index, with a greater lean mass in accounting for the matched BMI between groups. In addition to providing previously unknown normative data for the Gaelic athletic association athlete, a proportional and independent tissue evaluation of body composition is given. [ABSTRACT FROM AUTHOR]

Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (<16 years) who had pain as a symptom (regardless of cause) at any stage during the prehospital phase of care were included in this study. Over the study period, 6,371 children attended the four EDs by emergency ambulance, of which 2,635 (41.4%, 95% confidence interval 40.2–42.3%) had pain as a documented symptom on the ambulance patient care report (PCR) form. Overall 32% (n= 856) of children who complained of pain were subject to a formal pain assessment during the prehospital phase of care. Younger age, short transfer time to the ED, and emergency calls between midnight and 6 am were independently associated with decreased likelihood of having a documented assessment of pain intensity during the prehospital phase of care. Of the 2,635 children who had documented pain on the ambulance PCR, 26% (n= 689) received some form of analgesic agent prior to ED arrival. Upon ED arrival 54% (n= 1,422) of children had a documented pain assessment and some form of analgesic agent was administered to 50% (n= 1,324). Approximately 41% of children who attend EDs in Ireland by ambulance have pain documented as their primary symptom. This study suggests that the management of acute pain in children transferred by ambulance to the ED in Ireland is currently poor, with documentary evidence of only 26% receiving prehospital analgesic agents. [ABSTRACT FROM PUBLISHER]

This study explores substance use, psychosocial problems, and the relationships to educational status in 193 adolescents (school dropouts, 63; alternative education, 46; mainstream students, 84) who attended a substance abuse treatment facility in Dublin, Ireland, within a 42-month period. For each adolescent, data on demographics, family background, substance use, psychiatric history, and offending behaviors were collected. The study found that the 3 groups exhibited statistically significant differences in their substance use problems, with the school dropouts displaying significantly more problems. The need for early detection and intervention of at-risk students, and collaborative interagency work aimed at addressing substance use, cannot be overemphasized as strategies to ultimately prevent school dropout. [ABSTRACT FROM AUTHOR]

UK and Ireland guidelines state that all pregnant women should have their first antenatal care appointment by 13 weeks of pregnancy (antenatal booking). We present the results of an analysis looking at the association between maternal ethnicity and late antenatal booking in HIV-positive women in the UK and Ireland. We analysed data from the National Study of HIV in Pregnancy and Childhood (NSHPC). We included all pregnancies in women who were diagnosed with HIV before delivery and had an estimated delivery date between 1 January 2008 and 31 December 2009. Late booking was defined as antenatal booking at 13 weeks or later. The baseline reference group for all analyses comprised women of “white” ethnicity. Logistic regression models were fitted to estimate adjusted odds ratios (AOR). There were 2721 eligible reported pregnancies; 63% (1709) had data available on antenatal care booking date. In just over 50% of pregnancies (871/1709), the antenatal booking date was ≥13 weeks of pregnancy (i.e., late booking). Women diagnosed with HIV during the current pregnancy were more likely to present for antenatal care late than those previously diagnosed (59.1% vs. 47.5%, p<0.001). Where women knew their HIV status prior to becoming pregnant, the risk of late booking was raised for those of African ethnicity (AOR 1.80; 95% confidence interval (CI) 1.14, 2.82; p=0.011). In women diagnosed with HIV during pregnancy, the risk of late booking was also higher for women of African ethnicity (AOR 2.98: 95% CI 1.45, 6.11; p=0.003) and for women of other black ethnicity (AOR 3.74: 95% CI 1.28, 10.94; p=0.016). Overall, women of African or other black ethnicity were more likely to book late for antenatal care compared with white women, regardless of timing of diagnosis. This may have an adverse effect on maternal and infant outcomes, including mother-to-child transmission of HIV. [ABSTRACT FROM PUBLISHER]

Objective: Stimulated by findings that continuous feedback on client progress improves therapy outcomes (Lambert, Whipple, & Smart, 2001a, Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69, 159–172) and by arguments that any instrument taking more than 5 min to implement is impractical, this study was a randomised controlled trial investigating the effects of session-by-session progress feedback using the ultra-brief Outcome Rating Scale. Method: A between-subjects design was used. Participants (n = 110) were randomly assigned ‘feedback’ or ‘no feedback’ status, and attended one of eight therapists in a university counselling service. Results: The results showed that there was not a significant difference between the feedback and no-feedback conditions. Both conditions improved therapeutically; however, the feedback condition had a greater effect size (0.85 vs. 0.64), suggesting that with a larger sample statistical significance may have been attained. Between the two conditions there was not a significant difference found in participants classified as reliably changed, unchanged, or deteriorated. However, when the clients were divided into groups on the basis of their presenting issue, the clients with anxiety whose therapists used feedback had significantly better outcomes at the end of therapy than the clients whose therapists did not receive the feedback. Conclusion: Contrary to previous studies, the feedback on the client's progression provided to the therapist had only a small effect on improving therapy outcome. The feedback, however, improved outcomes of the clients presenting with anxiety. [ABSTRACT FROM PUBLISHER]

Background. Involuntary admission is one of the most ethically challenging practices in medicine, yet we are only beginning to learn more about the patient's perspective. Aims. To investigate (i) peoples' perception of the necessity of their involuntary admission at one year after discharge (ii) readmission rates to hospital and the influence of insight and recovery style. Methods. We interviewed individuals admitted involuntarily at one year following discharge using the Mac Arthur Admission Experience Interview, Birchwood Insight Scale, the Drug Attitude Inventory, Global Assessment of Functioning and the Recovery Style Questionnaire. Results. Sixty-eight people (84%%) were re-interviewed at one year and fewer (60%%) reported that their involuntary admission had been necessary when compared to inception (72%%). Of the 33%% that changed their views, most reflected negatively on their involuntary admission. We found that insight was moderately associated with the acknowledgement that the involuntary admission was necessary. Within a year, 43%% were readmitted to hospital and half of these admissions were involuntary. Individuals with a sealing over recovery style were at four times the risk of involuntary readmission. Conclusions. Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated with recovery style. [ABSTRACT FROM AUTHOR]

This article aims to theorize how a sample of menopausal women, lesbian and heterosexual, construct the ending of their periods, and what the experience means for them. Findings indicate that for most of the lesbian participants (who were in a sizeable minority), emotions of loss at the ending of periods were simultaneously expressed alongside positive feelings, and they engaged in greater introspection around the issue than did heterosexual women. However, lesbians did not all take up a singular subject position in relation to menstruation, indicating that there is fragmentation and plurality in how the body is experienced across a group. [ABSTRACT FROM AUTHOR]

Background: International experience has demonstrated that the medical profession is becoming less dominated by men. This 'feminization of medicine' has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. Purpose: The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. Method: A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. Results: There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. Conclusions: This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors' attitudes toward undergraduate medical education. [ABSTRACT FROM AUTHOR]

Prevalence surveys in Ireland indicate an increased trend of youth drug use with rural areas reporting comparable drug availability and prevalence of use in urban settings (Currie, C., Nic Gabhainn, S., Godeau, E., Roberts, C., Smith, R., & Currie, D. (Eds.). (2008). Inequalities in young people's health: HBSC international report from the 2005/2006 survey. Copenhagen: WHO Regional Office for Europe). Few studies have explored the contexts and meaning of drug use on rural youth transitions in terms of increased drug prevalence, recent influx of rural drug activity, normative tolerance of recreational drug consumption and fragmentation of traditional rural communities. Qualitative interviews were conducted with 220 young people (15--17 years), and 78 service providers in a rural area of Ireland, in order to yield contextualized narratives of their experiences of drug use and achieve a wider exploration of processes, drug transitions and realities of rural youth. The thematic analysis of the research described varied pathways, attitudes and typologies of rural youth drug use, ranging from abstinent, recreational and moderated to maturing out. The research suggests support for a ''differentiated'' normalization theory (Shildrick, T. (2002). Young people, illicit drug use and the question of normalisation theory. Journal of Youth Studies, 5, 35--48) in terms of consumerist and normative rural youth drug use transitions in their negotiation of risk within integrating rural and urban dichotomies. In conclusion, it is recommended that drug education programmes need to situate localized rural drug taking behaviours within a wider understanding of rural community life. [ABSTRACT FROM AUTHOR]

There is increasing anecdotal and scientific evidence of the presence of fatigue following stroke. This study examines this fatigue and evaluates the relationship between fatigue and other factors post-stroke, such as physical function, depression and reintegration to normal living. A cross-sectional case--control methodology was used. People with stroke were recruited from two day hospitals, Volunteer Stroke Scheme meetings and active retirement groups. Control subjects were recruited from active retirement groups in the same catchment area. One hundred people with stroke and 100 age- and gender-matched controls completed four standardized outcome measures: the Multidimensional Fatigue Inventory, Geriatric Depression Scale, Barthel Index and Reintegration to Normal Living Index. Demographic details were also recorded. Fatigue levels are significantly higher in people who have had a stroke. No relationship was demonstrated between fatigue and physical function or reintegration to normal living. Fatigue and depression co-existed in many respondents; however, fatigue was also seen to be independent of depression. Depression did not have an effect on fatigue in people with stroke. Fatigue needs to be considered in the rehabilitation process post-stroke. It is independent of depression and may persist up to 3 years post-stroke. [ABSTRACT FROM AUTHOR]