Using Simulated Data to Examine the Determinants of Acute Hospital Demand at the Small Area Level

The aim of this article is to establish whether spatial variation exists in acute hospital utilization in Ireland and, if it does, to identify the microlevel factors influencing this variation. First, an alignment process is used to calibrate the acute inpatient attendance and nights spent in hospital variables produced by a spatial microsimulation model at both the national and the subnational levels. Comparing the results of the national and subnational alignment allows us to examine whether spatial variation exists. Second, after establishing that hospital utilization displays a significant spatial pattern, we use a nationally representative survey to determine which individual‐level factors significantly affect inpatient attendance and the number of nights spent in hospitals. Using the calibrated data from the aforementioned spatial microsimulation model, we examine whether the spatial patterns of those variables found to influence hospital utilization match the spatial pattern of actual hospital utilization rates at the small area, electoral division level. That is, are the individuals/areas with the highest demand for acute hospital services utilizing acute hospital services? Finally, the results of this research are discussed in relation to both the national and international literature. El objetivo de este artículo es determinar si existe variación espacial en la utilización aguda y urgente (acute) de hospitales en Irlanda, y de ser así, identificar los factores microeconómicos que influyen en esta variación. En primer lugar, se utiliza un proceso de alineación para calibrar las variables de concurrencia (asistencia) de pacientes hospitalizados con casos agudos y de noches de estancia en el hospital, producidas por un modelo microsimulación espacial, tanto para niveles nacionales como subnacionales. Comparar los resultados de alineación de los niveles nacionales y subnacionales nos permite examinar si existe variación espacial. En segundo lugar, después de establecer que la utilización de hospitales muestra un patrón espacial significativo, empleamos una encuesta (un censo) nacional representativa para determinar qué factores a nivel individual afectan significativamente la concurrencia de pacientes hospitalizados y el número de noches de estancia en los hospitales. Al usar los datos calibrados del ya mencionado modelo de microsimulación espacial, analizamos si los patrones espaciales de esas variables que influyen en la utilización de hospitales concuerdan con el patrón espacial de las tasas reales (existentes) de utilización hospitalaria al nivel de las áreas pequeñas de división electoral (DE). En otras palabras, ¿Son las/los individuos/áreas con la mayor demanda de casos agudos de servicios de hospitalización las/los que están utilizados los servicios de hospitalización aguda? Finalmente, los resultados de esta investigación se analizan (discuten) en relación a la literatura especializada nacional e internacional. 本文的研究目的在于通过建立模型以检验爱尔兰急症医院的利用是否存在空间分异。如果存在空间分异,则识别影响其空间分异的微观尺度的驱动因子。首先,在国家和地方两个尺度,通过空间微观模型对所要构建模型的求诊人数及他们花费的夜间数进行校正和调整,并通过对比国家与地方两个尺度的校准结果,来检验其是否存在空间分异。其次,通过建立的模型检验出急诊医院的利用具有显著的空间模式,利用一份具有全国代表性的调查以确定哪些个体层面因素显著影响着求诊人数与在医院花费的夜间数。利用上述空间微观模拟模型检测影响医院利用的那些变量的空间模式,与实际的医院利用率的空间模式在被划分的小区域尺度上是否匹配。也就是说,这些对急症医院服务具有最大需求的个体或区域是否真正实际在使用着这些服务。最后,将本文结果与国内和国际文献进行了相关探讨。.     

DNA in cremated bones from an early bronze age cemetery cairn

The discovery of polymeric DNA in charred wheat grains and other burnt plant remains prompted us to examine a set of cremated bones for the presence of ancient DNA. Extracts of cremated bones from an early Bronze Age cemetery cairn were analysed by hybridization probing and the polymerase chain reaction. Hybridization with two probes targeting human DNA resulted in strong positive signals. Polymerase chain reactions directed at a multicopy sequence in human nuclear DNA were successful, extracts of five burials giving amplification products of the expected size. Exploitation of ancient DNA in cremated bones could be of great value in archaeology as it may enable information pertaining to sex and kinship to be obtained from fragmented material.     

“Bound in darkness and idolatry”? Protestant working-class underachievement and unionist hegemony

Over the past decade or more there has been a growing concern at the levels of educational underachievement within loyalist working-class areas of Northern Ireland. The inability of both educational and social policy initiatives over the past decade to improve the situation in any meaningful way has raised important questions concerning how the problem can be tackled more effectively. Placing the issue within the theoretical framework of Gramsci's hegemony, this paper argues that there is a need to better understand the historical nature of the problem and to recognise the political and social forces that have shaped its existence. It argues that there is a need to move away from explaining Protestant underachievement simply by the availability of jobs in Ulster's industrial past and to place its roots in the complex battle for social, political, and economic power since the 1801 Act of Union.     

Irish language education and the national ideal: the dynamics of nationalism in Northern Ireland

Since the beginning of the Northern Ireland conflict in the late 1960s, Irish nationalism has been identified as a prominent force in the political culture of the state. Recent studies have suggested, however, that the ‘Nationalist’ population has become increasingly content within the new political framework created by the peace process and the aspiration for Irish unity diminished. In placing the Northern Ireland situation within the theoretical framework of nationalism, this paper will analyse how these changing priorities have been possible. Through an analysis of Irish language study in Northern Ireland's schools, the paper will examine how the political ideals espoused by the nationalist Sinn Féin Party reflected the priorities of the ‘nationalist community’. It will be contended that the relationship between the ideology and ‘the people’ is much more complex than is often allowed for and that educational inequalities are a significant contributing factor to this.