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Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits. We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland. Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening. Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools. Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals). Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed. To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties. [ABSTRACT FROM AUTHOR]

Background: How many patients should we be patch testing? A previous study suggested that the minimum proportion of a population to be patch tested for allergic contact dermatitis was 1:700 annually. Objectives: To evaluate if the current minimum rate for patch testing has changed over the 20 years since the previous study in order to maximize the value. Methods: In cooperation with the British Society for Cutaneous Allergy, a proforma for collation of retrospective data between January 2015 and December 2017 was sent to patch‐test centers in the United Kingdom (UK) and the Republic of Ireland (ROI). The number of positive tests was analyzed against the proportion of population tested to see what proportion of the population would yield the greatest number of positive results. Results: Responses from 11 centers showed that the minimum number needed to patch test had increased to 1:550 per head of population per year using the current criteria. Conclusions: In agreement with previous studies, we should be patch testing more people than we are. We could reduce the threshold for referral of patients we patch test to derive the most benefit from this investigation. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is described as the gold standard of infant feeding and is beneficial to both infant and maternal health, reducing healthcare costs. Breastfeeding rates are low in Ireland. Interventions that support and protect breastfeeding are required. Aim: To conduct a service evaluation of a hospital-based specialist postnatal breastfeeding clinic. Methods: A telephone questionnaire was administered to 99 participants who attended a breastfeeding specialist clinic. Descriptive analysis was conducted on the quantitative data. The qualitative data was anonymised and subjected to thematic analysis. Results: Of the 99 women, 99% were breastfeeding at 6 weeks, 92% at 3 months and 77% at 6 months, respectively. The majority of women attended with one breastfeeding challenge (63%) while 24% of women attended with two breastfeeding challenges. Conclusions: Skilled professional breastfeeding support, in addition to peer support, is an effective and acceptable way to increase breastfeeding among women who present with common breastfeeding challenges. [ABSTRACT FROM AUTHOR]

BACKGROUND: Thoracic spine pain and dysfunction (TSPD) has received less attention in the literature compared to the lumbar and cervical spine, which has created challenges for differential diagnosis in the region. AIMS: The study purpose was to describe the clinical activity and outcomes of TSPD patients attending a clinical specialist physiotherapist (CSP)-led orthopaedic and rheumatology triage service, known as the 'Musculoskeletal Assessment Clinic' (MAC). METHODS: The Clinical Audit department of St Vincent's University Hospital, Dublin, approved this study. A retrospective service evaluation was carried out of patients who attended the MAC with TSPD between August 2012 and October 2015. Data were analysed using descriptive statistics with SPSS version 20. RESULTS: Of the n = 5,143 new patients referred to the MAC over a period of 37 months, 88 of these (2%) (mean age 36.66, years sd = 16.61), were referred primarily for TSPD. Sixty nine percent (n = 61) of patients were categorized as non-specific thoracic spine pain (NSTSP) and 18% (n = 16) structural. Seventy-six investigations were requested for 59% (n = 52) of patients and plain radiograph was the most frequently requested (40.8%, n = 31). Eighty percent (n = 70) of patients were independently managed by CSPs, with 16% (n = 14) of patients being referred for a surgical or medical consultant opinion. CONCLUSION: The majority (80%) of the patients were independently managed by the CSPs. Presentations of TSPD to a physiotherapy-led triage service in a secondary care setting attributable to underlying serious pathologies appears to be rare. Replication of this study in other healthcare institutions would be useful for corroborating our findings. [ABSTRACT FROM AUTHOR]

Although Northern Ireland has high levels of mental health problems, there has been a relative lack of systematic research on mental health services that can provide an evidence base for legal, policy, and service developments. This article aims to provide a review of the central issues relating to mental health service provision in Northern Ireland, and to gather the perceptions of different stakeholders of these services. The study utilised in‐depth qualitative interviews, focus groups, and an online survey to collect data from respondents throughout the region. This method involved the completion of semistructured interviews with significant mental health commissioners and senior managers, and with service‐users and their key workers. Focus groups sessions were also completed with mental health professionals, service‐users, and carers. Data collection occurred between December 2014 and June 2015. Thematic analysis was used to identify key issues. The findings identified that considerable progress had been made not only in the development of mental health services in the last decade, but also highlighted the significant limitations in current services. Most notably, strengths in provision included the transition from long‐stay hospital care to community‐based services and person‐centred approaches. The researchers identified the need to improve funding, address problems with fragmentation, and gaps in service provision. Based on these findings, the authors consider the implications for practice and policy relating to the human and organisational aspects of service development. In particular, services should be developed focusing on a recovery ethos and on person‐centred and relationship‐based approaches. The needs of carers should additionally be considered and programmes developed to tackle stigma. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe a small scale pilot study undertaken in Northern Ireland to gather service user feedback from individuals who have been subject to adult safeguarding procedures.Design/methodology/approach The aims, methods and findings of the “Adult Safeguarding: 10,000 Voices” pilot project are presented.Findings The pilot project highlighted how an initiative which captures the experiences of patients, service users, carers and staff in the health and social care sector (10,000 Voices) could be successfully adapted for use in adult safeguarding, facilitating the collation of complex experiences and enabling insights to be gleaned and shared.Research limitations/implications The pilot study is limited by the small number of participants. The findings are preliminary.Practical implications For the first time in Northern Ireland the 10,000 Voices model was utilised in the context of a non-health related service, namely, adult safeguarding.Social implications This outline of the model and methodology for obtaining service user feedback can inform user involvement in other contexts.Originality/value This paper provides an accessible overview of an innovative approach to engaging service users in adult safeguarding, such approaches, to date have been limited. [ABSTRACT FROM AUTHOR]

Background: People with MS (PwMS) can experience a number of diverse needs which may be met by community-based services such as those delivered by MS Ireland (MSI), where Community Workers (CWs) provide support to PwMS on an individualised basis. However, while such support may be critical in helping PwMS adapt and cope with the challenges of living with MS, there has been little evaluation of the outcomes and impacts of this service to date. This study aimed to explore the perceived effectiveness and impacts of community work from the perspectives of both PwMS and CWs., Methods: Using stakeholder engagement and public and patient involvement (PPI), two surveys were developed for (1) CWs, and (2) services users of MSI. A series of open and closed questions centred on the effectiveness of community work in meeting twelve distinct categories of needs taken from an adapted framework of rehabilitation and healthcare needs of PwMS. Both CWs and service users rated the extent to which these various needs were met through community work, as well as describing the mechanisms by which needs were met, and the challenges faced in meeting these needs. Separately, both groups described the perceived impacts of community work using open-text responses., Results: Fifteen CWs and 367 PwMS, 269 (73%) of whom knew their CW, participated. Both groups rated community work positively in meeting the needs for information, emotional/psychological support and coordination of care, with lower perceived capacity for community work to meet needs for employment accommodations, caregiver support and homecare. Mann Whitney U tests did not find any significant difference between groups in the perceived capacity of community work to meet the various needs examined (p>.05). Core mechanisms by which CWs meet needs are by signposting to relevant services, listening, and facilitating peer support. Difficulty accessing external services was the primary challenge identified in meeting needs. Positive impacts of community work included the role that CWs play in fostering confidence and acceptance of MS, and in helping service users overcome the challenges of MS., Conclusion: Results suggest how CWs can help meet the needs of PwMS, while also highlighting the numerous positive impacts that community work has for this group. While it is clear that a number of unmet needs may remain due to a lack of access to other external services, this study shows how community-based services may play an important role in helping PwMS adapt to living with MS., (Copyright © 2022. Published by Elsevier B.V.)

Background: The Strengths and Difficulties Added Value Score (SDQ AVS) uses a large epidemiological study to predict follow-up parental SDQ scores for the evaluation of routine outcomes. Method: We tested the prediction of the SDQ AVS derived from a national population survey separately on scores for the waiting list control and intervention groups in a randomised controlled trial. If the SDQ AVS is to be clinically useful, it needs to function as expected across different populations. Results: In the control arm, the SDQ AVS predicted an effect size of 0.15 (95% CI -0.01-0.30) compared to an expected effect size of 0, as the children in this arm received no treatment. In the experimental arm, the SDQ AVS predicted an effect size of 0.62 (95% CI 0.42- 0.83) compared to the study effect size of 0.53. Change scores overestimated the effect size in both arms (control 0.50 95% CI 0.34-0.66, intervention 0.85 95% CI 0.66-1.04). Conclusion: Our findings suggest that the SDQ AVS adjusts for spontaneous improvement, regression to the mean and attenuation. [ABSTRACT FROM AUTHOR]

Background: In Ireland, weekend and night medical cover for community based patients is largely provided by general practice co-operatives. Doctors working in this service do not have direct access to patients' medical records which challenges continuity of care., Objectives: This study investigates the opinion of general practitioners (GPs) on the potential value of a formalised method of information transfer regarding their palliative patients to out-of-hours GP co-operatives. The survey was designed to identify the information that is necessary to offer appropriate anticipated end-of-life care., Methods: A questionnaire was sent to all 414 GPs registered in the Irish Medical Directory in the southwest of Ireland. Data were analysed with Microsoft Excel and SPSS V.12.0., Results: 52% response rate with exclusion of incomplete questionnaires allowed analysis of 212 data sets. Currently, 82% of GPs do not routinely transfer information pertaining to end-of-life issues to the out-of-hours service. Despite this, 96% would value a standardised way of transferring information. 67% felt they sometimes refer unnecessarily to hospital emergency departments due to lack of information. The most important items of information identified by study participants are as follows: ▸ Diagnosis (97%) ▸ Medications (94%) ▸ Patient insight (91%) ▸ Patient wishes regarding end-of-life care (90%) ▸ Anticipated problems and suggested management(90%)., Conclusions: A structured format for information transfer regarding end-of-life care is deemed important by GPs when working on-call at night and weekends. Diagnosis, patient preference and management plans are valued.