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To assess the impact of the COVID-19 pandemic on first-episode psychosis (FEP) presentations across two Early Intervention in Psychosis (EIP) services in Ireland, by comparing pre-pandemic and post-pandemic cohorts.
Methods:
A cross-sectional observational design with retrospective medical record review was employed. The study population comprised 187 FEP patients (77 in pre-pandemic and 110 in post-pandemic cohort). Outcomes measured included duration of untreated psychosis (DUP), FEP presentation numbers, referral sources, global assessment of functioning scores, inpatient admissions, substance misuse and service delivery methods. Statistical analyses utilised chi-square tests to assess categorical variables, Mann–Whitney U tests to compare non-normally distributed continuous variables and Kruskal–Wallis tests to examine interactions between categorical and continuous variables.
Results:
A significant increase in FEP presentations was observed in the post-pandemic cohort (p = 0.003), with an increase in all urban areas and a decrease in the study’s only rural area. The difference in DUP between cohorts was not significant. However, significant interaction between gender, cohort and DUP was shown (p = 0.008), with women in the post-pandemic cohort experiencing longer DUP (p = 0.01). A significant rise in telephone (p = 0.05) and video consultations (p = 0.001) offered was observed, in the post-pandemic cohort. A similar number of in-person appointments were attended across both cohorts.
Conclusions:
This study highlights the impact of the pandemic on FEP presentations, particularly rurally and regarding increased DUP among women. These findings underscore the need for flexible EIP services to respond to public health crises. Despite increased presentations, services adapted, maintaining service continuity through telehealth and modified in-person contact.
Examines Robert Montgomery’s early years as consul in Alicante, Spain focusing on his multiple identities as Irishman, American, and Spaniard. Discusses Alicante’s evolving commerce and the growth of American shipping networks despite the impact of the Barbary Wars.
Youth self-harm (SH) is viewed as a public health concern and one of the main reasons for urgent psychiatry assessment. This systematic review sought to establish prevalence of SH among youth in Ireland.
Methods:
A systematic review using pre-defined search terms was conducted (Jan 1980–March 2024).
Results:
From a total of 204 papers identified, 18 were included. Significant variation in rates of SH was found. Limiting data to adolescent years (15–18), best estimates for overall lifetime rates of SH ranged from 1.5% (when rates of SH were reported based on a two-stage study design), to 23% (where SH was limited to non-suicidal SH). SH was typically higher in females, impulsive in nature, and occurred in the home setting. Whilst almost half of youth sought help before (43.7%) or after (49.8%) the SH episode, this was most often to a friend or family member. Overall rates of professional help seeking were low.
Conclusions:
Robust studies using clear definitions of terms, separately capturing SH with and without suicidal intent, and distinguishing SH in the context of a mental illness, are required to inform service developments. Given the frequent occurrence of SH among youth accompanied by predominance of help seeking via friends and family, it is imperative that psychoeducation is delivered to families and peers. Out of hours community and specialist mental health services are essential to address this important issue.
In this first book devoted to Milton's engagement with Ireland, Lee Morrissey takes an archipelagic approach to his subject. The study focuses on the period before the Cromwellian Conquest, explaining Milton's emergence as a public figure because of Ireland and tracing the paradoxical resonances of Milton's republicanism in Ireland to this day. Informed by developments in Irish history but foregrounding a lucid discussion of Milton's governmental prose works, Morrissey explores the tension between Milton's long-established image as a proto-Enlightenment, democratic figure, and the historical reality of his association with a Protestant invading force. Milton's Ireland incisively negotiates this complex subject, addressing clear absences in Milton scholarship, in the history of Ireland, and in the fraught relationship between Ireland and England.
Transnationalism in Irish Literature and Culture offers a wide-ranging set of essays exploring the travels of Irish literature and culture over the last century and more. The essays focus on writers and artists whose work has been taken up and re-read overseas; on cultural producers who have engaged with transnational scales in their work; and on critical practices that pay attention to comparative, global, and planetary dimensions of Irish literature and culture. Nation and territory have long been central to cultural production in Ireland, especially as both remain significantly contested, but a continued focus on these inherited scales has hindered critical attention to transnational routes and roots that exist alongside and challenge the nation. This volume sets agenda for the future of study of transnationalism in Irish literature and culture, recognizing the need for a new set of theories and methodologies that are adequate to our emerging world.
The Citizen of the World is a highly readable yet deceptively sophisticated text, using the popular eighteenth-century device of the imaginary observer. Its main narrator, the Chinese philosopher Lien Chi Altangi, draws on traditional ideas of Confucian wisdom as he tries (and sometimes fails) to come to terms with the commercial modernity and spectacle of imperial London. Goldsmith explores a moment of economic and social transformation in Britain and at the same time engages with the ramifications of a global conflict, the Seven Years' War (1756–63). He also uses his travelling Chinese narrator as a way of indirectly addressing his own predicament as an Irish exile in London. This edition provides a reliable, authoritative text, records the history of its production, and includes an introduction and explanatory notes which situate this enormously rich work within the political debates and cultural conflicts of its time, illuminating its allusiveness and intellectual ambition.
Professor William Ivory (Ivor) Browne, consultant psychiatrist, who died on 24 January 2024, was a remarkable figure in the history of medicine in Ireland and had substantial influence on psychiatric practice and Irish society. Born in Dublin in 1929, Browne trained in England, Ireland, and the US. He was chief psychiatrist at St Brendan’s Hospital, Grangegorman, Dublin from 1965 to 1994 and professor of psychiatry at University College Dublin from 1967 to 1994. Browne pioneered novel and, at times, unorthodox treatments at St Brendan’s. Along with Dr Dermot Walsh, he led the dismantling of the old institution and the development of community mental health services during the 1970s and 1980s. He established the Irish Foundation for Human Development (1968–1979) and, in 1983, was appointed chairman of the group of European experts set up by the European Economic Community for reform of Greek psychiatry. After retirement in 1994, Browne practiced psychotherapy and pursued interests in stress management, living system theory, and how the brain processes trauma. For a doctor with senior positions in healthcare and academia, Browne was remarkably iconoclastic, unorthodox, and unafraid. Browne leaves many legacies. Most of all, Browne is strongly associated with the end of the era of the large ‘mental hospital’ at Grangegorman, a gargantuan task which he and others worked hard to achieve. This is his most profound legacy and, perhaps, the least tangible: the additional liberty enjoyed by thousands of people who avoided institutionalisation as a result of reforms which Browne came to represent.
International pressures, Brexit and the resurgence of nationalism have created new divides in the regions of the United Kingdom. Brendan O’Leary examines the impact of Conservative policy in Scotland, Northern Ireland, and Wales, focusing on how prime ministers have handled campaigns and support for Scottish independence, the ruling coalitions in Wales, and also the new post-Brexit framework and demographic pressures in Northern Ireland. The chapter ends with a dire overall evaluation of the condition of the union as a result of Conservative policy.
Chapter 7 shows that EU leaders had already started in the 1980s to steer the trajectory of national public services in a commodifying direction. The commodifying pressures from direct EU interventions reached a peak in 2004 with the Commission’s draft Services Directive, which failed to become law because of unprecedented transnational protest movements. After the financial crisis however, the EU’s shift to its new economic governance (NEG) regime empowered EU executives to pursue public service commodification by new means. Our analysis reveals that the NEG prescriptions on public services for Germany, Italy, Ireland, and Romania consistently pointed in a commodifying direction, by demanding both a curtailment of public resources for public services and the marketisation of public services. Although our analysis uncovers some decommodifying prescriptions, namely, quantitative ones calling for more investment at the end of the 2010s, they were usually justified with policy rationales subordinated to NEG’s commodification script.
Chapter 6 shows that workers’ wages and employment relations were, until the 2008 crisis, shaped by horizontal market pressures rather than direct political vertical EU interventions in the labour policy area. That changed radically after the EU’s shift to its new economic governance (NEG) regime. We found that the EU’s NEG prescriptions on wage levels, collective bargaining, and hiring and firing mechanisms followed a consistent trajectory that furthered the commodification of labour in Italy, Ireland, and Romania, but less so in Germany. Instead, Germany received decommodifying NEG prescriptions on wage policy that were linked to a rebalance-the-EU-economy policy rationale. Although this policy rationale was still compatible with NEG’s overarching commodifying script, the diverging policy orientation of prescriptions in this area across countries made it hard for unions to challenge NEG transnationally.
Chapter 9 analyses the EU governance of water and the countervailing mobilisations against its commodification. Initially, European law decommodified water services through the harmonisation of quality standards that took them out of regulatory competition between member states. However, from the 1990s onwards, the Commission repeatedly attempted to commodify water through liberalising EU laws. When these attempts failed, EU executives tried to advance commodification by new means, namely, through the EU’s new economic governance (NEG) prescriptions. Our analysis revealed that all qualitative prescriptions on water services issued from 2009 to 2019 to Germany, Ireland, Italy, and Romania called for their marketisation, despite recent calls to increase public investment. Like preceding attempts by draft EU directives, the NEG’s consistent commodification script triggered transnational protests by unions and social movements that defended water as a human right and as a public service, namely, under the banner of the successful Right2Water European Citizens’ Initiative.
Chapter 10 traces the EU governance of health services and its discontents. The first European interventions in the health sector facilitated mobile workers’ access to health services in their host countries, thereby decommodifying cross-border care, albeit by recourse to solidaristic mechanisms situated at national rather than EU level. Since the 1990s however, European horizontal market pressures and EU public deficit criteria have led governments to curtail healthcare spending and to introduce marketising reforms. Thereafter, healthcare became a target of EU competition and free movement of services law. In 2006, transnational collective action of trade unions and social movements moved EU legislators to drop healthcare from the scope of the draft EU Services Directive. After the financial crisis of 2008 however, EU executives pursued commodification of healthcare through new means, as shown by our analysis of their new economic governance (NEG) prescriptions for Germany, Italy, Ireland, and Romania. Even when commodifying prescriptions were on occasion accompanied by decommodifying ones, the latter remained subordinated to the former. Although NEG’s country-specific methodology hampered transnational protests, the overarching commodification script of NEG prescriptions led not only to transnational protests by the European Federation of Public Service Unions, but also to the formation of the European Network against the Privatisation and Commercialisation of Health and Social Protection, which unites unionists and social-movement activists.
Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder occurring in approximately one in twenty young people in Ireland, and in one-third of those attending Irish Child and Adolescent Mental Health Services (CAMHS). It is important to treat ADHD, as un/poorly treated ADHD is associated with a raft of negative health and socio-economic outcomes. Effective interventions for ADHD are available, and the use of standardised, evidence-based pathways for assessment and management of ADHD optimises outcomes. Despite this, there is no national standardised clinical pathway for assessment and treatment of ADHD in Ireland. ADMiRE, the first public healthcare specialist service for children and adolescents in Ireland, has developed a strongly evidence-based, efficient, effective and safe clinical pathway for assessment and management of ADHD. This paper describes the ADMiRE Clinical Pathway and references ADMiRE resources that are available to other services.
During his lifetime, Swift was a national figure in Ireland: the Dean of St Patrick’s Cathedral, the Drapier, the Hibernian Patriot. Following his death, Swift became an inescapable presence in the thought of Irish writers of many different political persuasions. This chapter charts Swift’s posthumous reputation in Ireland. Whereas English writers such as Thackeray and Macaulay denied Swift’s Irish identity altogether, many Irish writers claimed Swift as one of their own. This chapter presents a broad survey of how Swift’s Irishness has been received by Irish writers including Wilde, Joyce, Yeats, Austin Clarke, Bendam Kennelly, and Derek Mahon.
Swift was, in modern parlance, a Dubliner: he was born in the Irish capital, died there, and for more than half of his life kept his principal residence there. But he was bitterly critical of the urban world around him, repeatedly declaring his preference for the Irish countryside or for English hospitality in place of the depressing reality of life in the heart of Dublin. This chapter explores Swift’s troubled relationship with the city of his birth, looking at its social and political make-up during his lifetime, and how he portrayed the city in his writings.
This chapter examines Swift’s complex relationship to colonialism. Arguing that we cannot understand Swift’s anti-colonialism as part of what we might think of as some kind of progressive or liberatory project, the chapter explores the seeming inconsistency of his contemptuous attitude towards colonised peoples (particularly the ‘Savage Irish’). The colonisation and oppression of Ireland, and his complex position as both beneficiary and subject of it, is important to Swift’s writings. But this background also makes it difficult to pin down precise ideological positions or find straightforward political analogies or critiques in his works. The chapter concludes with an extended reading of Gulliver’s Travels, situating it in the broader context of debates around colonialism
Population and Irish confessional demographics feature heavily in Swift’s political pamphlets. His writing on these topics helped shape popular perceptions of Ireland in the eighteenth century, a period that witnessed the emergence of an Irish diaspora across the British Atlantic world. This chapter considers the role that confessional demography played in Swift’s Irish political writings and the later influence of those writings on the formation of early anti-Irish nativism in colonial America. This first section looks at the role of demographic anxieties in A Modest Proposal. The second section addresses Swift’s concerns about religious dissent in Ireland. The third and final section explores the influence of Swift’s writings in colonial America.
This chapter provides an overview of the Irish literary scene during the late seventeenth and early eighteenth centuries. There was a growing demand for literature of all kinds and the work of local poets, songwriters, playwrights, and pamphleteers appeared alongside printed material imported from London; local verses and satires circulated widely in manuscript. As a boy, Swift was immersed in this material and in later life he contributed to it. The easy availability of books and pamphlets made Dublin, at least for its better-educated and more affluent citizens, an attractive place to live.
This chapter explores Swift’s relationship with the Church of Ireland. Despite hopes for a clerical preferment in England, in 1714 Swift was appointed dean of St Patrick’s Cathedral in Dublin. As dean, Swift occupied one of the highest positions in the Church of Ireland. This chapter outlines the history of the Church of Ireland and its troubled relationship with the Church of England in the seventeenth century, before addressing its constitutional and political position during Swift’s tenure.
This chapter sets out why a history of Ulster loyalism in the three counties after partition matters and outlines the literature on ethnic conflict, Ulster loyalism, and terrorism and political violence in Ireland. The chapter then sets out the book’s two main arguments. First, memories of the violence experienced by one generation of Protestants in the three counties entrenched a sense of separation from the new Irish state on the part of subsequent generations. Intergenerational grievance and inter-communal distance kept loyalism alive and set the conditions for militancy and revenge in the future, including during the Troubles. Three-county loyalists played an important role in Ulster loyalist militant movements in Northern Ireland after partition.