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People with intellectual disabilities are high users of acute hospital care. Given their varied and often complex health-care needs, they often experience health inequalities and inequities, contributing to poorer health outcomes. As nurses are the largest health-care workforce with a patient-facing role, they have an important responsibility in meeting this populations health needs. The purpose of this paper is to explore key issues relating to the role nurses play in providing equitable health care for people with intellectual disabilities.

This service feature draws upon relevant literature to examine key contextual issues highlighting the importance of nurses in providing equitable health care for people with intellectual disabilities.

The findings from this service feature highlight the importance of nurses taking a leadership role in advocating for, and actively supporting the health needs of people with intellectual disabilities. Nurses’ leadership role, along with implementing reasonable adjustments, should be underpinned by education and training relating to the bespoke health needs of people with intellectual disabilities. This should help nurses promote the health and well-being of this population.

Addressing this populations health needs is a collective responsibility of all nurses. There are many examples of how nurses can be supported through policy, education, training and advocacy and this needs to be considered by key stakeholders and addressed as a matter of priority.

Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017–2019 was used. Annual rates per 1,000 were calculated by age and gender.

The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18–29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner’s environment and relationships.

There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

To the best of the authors’ knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

This study aims to conduct a geographical analysis of the distribution and type of activities developed by social enterprises in rural and urban areas of Ireland.

The study analyses data of more than 4,000 social enterprises against a six-tier rural/urban typology, using descriptive statistics and non-parametric tests to test six hypotheses.

The study shows a geographical rural–urban pattern in the distribution of social enterprises in Ireland, with a positive association between the remoteness of an area and the ratio of social enterprises, and a lack of capital-city effect related to the density of social enterprises. The analysis also shows a statistically significant geographical rural–urban pattern for the types of activities developed by social enterprises. The authors observe a positive association between the remoteness of the areas and the presence of social enterprises operating in the community and local development sector whereas the association is not significant for social enterprises developing welfare services.

The paper shows the potential of using recently developed rural–urban typologies and tools such as geographical information systems for conducting geographical research on social enterprises. The findings also have implications for informing spatially sensitive policymaking on social enterprises.

The merging of a large national data set of social enterprises with geographical tools and data at subregional level contributes to the methodological advancement of the field of social enterprises, providing tools and frameworks for a nuanced and spatially sensitive analysis of these organisations.

Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.

A national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October–November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question “If you had concerns about your working conditions, would you raise them?”. In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.

Reputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.

This study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.

Emergency Department (ED) presentations in older people are associated with a wide range of adverse events, which increase the risk of lengthy hospitalisation and poor outcomes. Pathfinder is an inter-organisational initiative delivered in partnership between Beaumont Hospital Occupational Therapy and Physiotherapy departments and the National Ambulance Service. Pathfinder responds to non-serious and non-life-threatening emergency medical service (EMS) calls. This study aims to demonstrate how Pathfinder can safely treat a proportion of older people at home by using alternative care pathways (ACPs), therefore avoiding unnecessary ED presentations. Once a decision has been reached to treat the person at home, the Pathfinder follow-up team delivers functional rehabilitation and case management in the persons’ home over the subsequent days.

This paper outlines the Pathfinder assessment, management and interventions in one clinical case example. Outcome measures include the level of patient satisfaction obtained via routine telephone feedback questionnaire and re-presentation to Beaumont Hospital within 30 days.

This paper illustrates through a case example the benefit of a collaborative multi-disciplinary rapid response team for non-serious and non-life-threatening EMS calls in older adults. The patient in this case example had no further EMS calls or ED presentations for 30 days after Pathfinder intervention and reported a high level of satisfaction with the service.

ED presentation was avoided through comprehensive multi-disciplinary assessment, including immediate access to intensive follow-up support in the person’s own home.

The Pathfinder service is improving access to ACPs for older people in the Beaumont Hospital catchment area. Pathfinder will now be spread nationally, with local adaptation, so that older people in other parts of Ireland will also benefit from this integrated model of care.

Patient feedback surveys confirm older adults want access to alternative care pathways.

Computing ethics represents a long established, yet rapidly evolving, discipline that grows in complexity and scope on a near-daily basis. Therefore, to help understand some of that scope it is essential to incorporate a range of perspectives, from a range of stakeholders, on current and emerging ethical challenges associated with computer technology. This study aims to achieve this by using, a three-pronged, stakeholder analysis of Computer Science academics, ICT industry professionals, and citizen groups was undertaken to explore what they consider to be crucial computing ethics concerns. The overlap between these stakeholder groups are explored, as well as whether their concerns are reflected in the existing literature.

Data collection was performed using focus groups, and the data was analysed using a thematic analysis. The data was also analysed to determine if there were overlaps between the literature and the stakeholders’ concerns and attitudes towards computing ethics.

The results of the focus group analysis show a mixture of overlapping concerns between the different groups, as well as some concerns that are unique to each of the specific groups. All groups stressed the importance of data as a key topic in computing ethics. This includes concerns around the accuracy, completeness and representativeness of data sets used to develop computing applications. Academics were concerned with the best ways to teach computing ethics to university students. Industry professionals believed that a lack of diversity in software teams resulted in important questions not being asked during design and development. Citizens discussed at length the negative and unexpected impacts of social media applications. These are all topics that have gained broad coverage in the literature.

In recent years, the impact of ICT on society and the environment at large has grown tremendously. From this fast-paced growth, a myriad of ethical concerns have arisen. The analysis aims to shed light on what a diverse group of stakeholders consider the most important social impacts of technology and whether these concerns are reflected in the literature on computing ethics. The outcomes of this analysis will form the basis for new teaching content that will be developed in future to help illuminate and address these concerns.

The multi-stakeholder analysis provides individual and differing perspectives on the issues related to the rapidly evolving discipline of computing ethics.

The literature on economic forecasting, is showing an increase in criticism, of the inaccuracy of forecasts, with major implications for economic, and fiscal policymaking. Forecasts are subject to the systemic uncertainty of human systems, considerable event-driven uncertainty, and show biases towards optimistic growth paths. The purpose of this study is to consider approaches to improve economic foresight.

This study describes the practice of economic foresight as evolving in two separate, non-overlapping branches, short-term economic forecasting, and long-term scenario analysis of development, the latter found in studies of climate change and sustainability. The unique case of Ireland is considered, a country that has experienced both steep growth and deep troughs, with uncertainty that has confounded forecasting. The challenges facing forecasts are discussed, with brief review of the drivers of growth, and of long-term economic scenarios in the global literature.

Economic forecasting seeks to manage uncertainty by improving the accuracy of quantitative point forecasts, and related models. Yet, systematic forecast failures remain, and the economy defies prediction, even in the near-term. In contrast, long-term scenario analysis eschews forecasts in favour of a set of plausible or possible alternative scenarios. Using alternative scenarios is a response to the irreducible uncertainty of complex systems, with sophisticated approaches employed to integrate qualitative and quantitative insights.

To support economic and fiscal policymaking, it is necessary support advancement in approaches to economic foresight, to improve handling of uncertainty and related risk.

While European Union Regulation (EC) 1466/97 mandates pursuit of improved accuracy, in short-term economic forecasts, there is now a case for implementing advanced foresight approaches, for improved analysis, and more robust decision-making.

Building economic resilience and adaptability, as part of a sustainable future, requires both long-term strategic planning, and short-term policy. A 21st century policymaking process can be better supported by analysis of alternative scenarios.

To the best of the authors’ knowledge, the article is original in considering the application of scenario foresight approaches, in economic forecasting. The study has value in improving the baseline forecast methods, that are fundamental to contemporary economics, and in bringing the field of economics into the heart of foresight.

Despite the potential for research institutes to advance interdisciplinary research on university campuses, There have been few studies on how interdisciplinary research centres integrate multiple disciplines in practice, how they influence the collaborative behaviours of scientists and how they establish collaborative communities. This study aims to provide a deeper understanding of how interdisciplinary research is being enabled at research institutes and offers signposts for how research institutes can further embed interdisciplinarity within their units.

Within this study, 30 interviews were conducted with leadership and faculty within 4 sustainability research institutes in the USA exploring how research institutes support interdisciplinary research within their units. A thematic analysis on the interview data revealed themes on how research institutes are enabling interdisciplinary research within their organisations and universities.

The study highlights eight themes on how research institutes are, and can further, enable interdisciplinary research within their organisations and universities. Some of the themes are fully implemented within the research institutes, whilst others are more aspirational and highlight where institutes can create additional capability and capacity for interdisciplinary research within their units and universities.

Whilst the study is limited to four major sustainability research institutes the findings will be applicable to all research centres and institutes attempting to create interdisciplinary research environments.

The study will be of particular interest to research institutes and university leadership who wish to cultivate a deeper culture of interdisciplinary research within their organisations.

The advancement of inter- and transdisciplinary research within universities are seen by many academic institutions, expert groups and funding bodies as essential for solving wicked problems and grand challenges facing society. The findings of this paper will help universities increase their capacity for interdisciplinary research.

There are few comparable publications in terms of methodology, approach and focus on research institutes.

HealthPathways is an online decision support portal, primarily aimed at General Practitioners (GPs), that provides easy to access and up to date clinical, referral and resource pathways. It is free to access, with the intent of providing the right care, at the right place, at the right time. This case study focuses on the experience and learnings of a HealthPathways program in metropolitan Sydney during the COVID-19 pandemic. It reviews the team's program management responses and looks at key factors that have facilitated the spread and scale of HealthPathways.

Available data and experiences of two HealthPathways program managers were used to recount events and aspects influencing spread and scale.

The key factors for successful spread and scale are a coordinated response, the maturity of the HealthPathways program, having a single source of truth, high level governance, leadership, collaboration, flexible funding and ability to make local changes where required.

There are limited published articles on HealthPathways. The focus of spread and scale of HealthPathways during COVID-19 is unique.