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This chapter outlines the effective remobilisation and arming of elements of the Monaghan Ulster Volunteer Force in 1920 and refutes claims of a loyalist “collapse” by providing evidence of loyalist paramilitary activities after a wave of republican counter-reprisals in late March 1921. It contends that a number of IRA operations in the area of County Monaghan bordering Rosslea went badly wrong, and that a successful, well-organised loyalist defence helped to bring both sides to agree a formal truce in April 1921. Loyalist resistance continued elsewhere in Monaghan until the national truce of July 1921, putting the IRA under considerable pressure in parts of the county. It also argues that ties between Ulster loyalists in Belfast and those in Monaghan persisted, helping the latter to resist boycotting of their business interests, and shoring up their political position through the Protestant Defence Association in the new Free State.
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.
This chapter considers the presence and efficacy of loyalist armed resistance in Cavan from 1920 to 1923. It argues that resistance was generally less intense and more poorly organised in Cavan compared to Monaghan. A dispersed population meant that loyalist deterrence was primarily focused on pockets of the county that had sufficient numbers to contest republican control. The IRA in the area near Cavan town, where much of the Protestant population was concentrated, was more reluctant to carry out executions or inflict significant violence than in County Monaghan. This made resistance to arms raids less dangerous and successful relative to elsewhere in the county. Nevertheless, a poorly organised loyalist defence network in the Rathkenny area underlined the dangers of provoking republican violence through overt and ineffective resistance. West Cavan resembled shared similar experiences of IRA violence to that seen in neighbouring County Leitrim. A willingness by the IRA in West Cavan and Leitrim to resort to occasionally shocking acts of violence meant that the loyalist community in this area suffered disproportionately from acts of intimidation compared to east and south Cavan.
This chapter examines the phenomenon of three-county loyalists’ considerable impact on Northern Ireland’s security forces and radical or militant Ulster movements since partition. It describes how these individuals generally came from families that were threatened with, or experienced, republican or agrarian violence after partition. The chapter also explores the important roles played by three-county loyalists in paramilitary organisations such as the Ulster Defence Association during the Troubles. A number of these individuals came from areas that had seen high levels of loyalist militancy in the first half of the century, suggesting an intergenerational consistency across the twentieth century.
This chapter underlines the main contribution of the book. It argues that Ulster loyalism has survived within the Irish state to the present day. The ’affective bonds’ or culture created in previous generations persisted. Three counties’ loyalists were still willing to embrace an Ulster identity even after the partition of the province. What mattered more than political logic or calculation was sentiment. It also observes an enduring strain of frontier militancy in Ulster, summarises the tactical successes of three counties’ loyalists and their wider movements in the 1920s and again in 1970s but concludes that militancy in successive conflicts only served to delay conciliatory reforms, truces and peace agreements.
This chapter considers evidence of loyalist paramilitary activities and resistance in County Donegal in the early 1920s. It investigates why a vibrant UVF movement, active in the county from 1912 to 1914, did not mount a sustained resistance to the IRA in the county from 1920 to 1923. It suggests that low levels of republican violence in the county during the Anglo-Irish War required a more limited response and goes on to demonstrate that Donegal’s loyalists prioritised the defence of Londonderry during a critical period in 1920. Unlike Monaghan, a number of Donegal’s outstanding UVF leaders were killed during the First World War or did not return home. There is also some evidence that erstwhile units of the Donegal UVF quickly and collectively allied themselves with pro-treaty forces during the Civil War (26 June 1922–24 May 1923). The exception was Pettigo, where loyalists targeted republicans in the wake of the British occupation of the village over a seven-month period, during which time they also campaigned to be included in the new Northern Ireland.
This chapter examines the resurgence of suspicions among republicans towards real or imagined loyalists in the three counties, that some Protestants were acting as a loyalist ’fifth column’ for the security forces and/or paramilitaries in Northern Ireland. A successful loyalist cross-border paramilitary campaign in the early 1970s precipitated an IRA counter-intelligence operation to eliminate spies in the three counties. Families that were well known locally for their historical involvement in loyalism were again targeted by the IRA in the 1970s. The chapter outlines the suspicions and inter-communal violence in County Monaghan that led to the murder of Senator Billy Fox and the burning of the family home of his fiancée, Marjorie Coulson.
In 1920, the three Ulster counties of Cavan, Donegal and Monaghan were excluded from Northern Ireland. What happens to an abandoned people? And what is the impact on subsequent generations? At a time of uncertainty over the future of Northern Ireland, the history of Ulster loyalists who found themselves on the 'wrong side' of the Irish border is especially relevant. Memories of the violence and betrayal experienced by one generation of protestants in the three counties entrenched an intergenerational Ulster loyalist identity. Subsequently, three-county loyalists who moved across the border played an important role in militant politics. Examining armed resistance in these counties and the radicals who came from them, Edward Burke argues that violence or terrorism perpetrated by 'lost Ulster' loyalists enjoyed considerable success. Spanning the Anglo-Irish War to the Troubles and beyond, Ulster's Lost Counties demonstrates the grip of identity and betrayal since the partition of Ireland.
We investigated concurrent outbreaks of Pseudomonas aeruginosa carrying blaVIM (VIM-CRPA) and Enterobacterales carrying blaKPC (KPC-CRE) at a long-term acute-care hospital (LTACH A).
Methods:
We defined an incident case as the first detection of blaKPC or blaVIM from a patient’s clinical cultures or colonization screening test. We reviewed medical records and performed infection control assessments, colonization screening, environmental sampling, and molecular characterization of carbapenemase-producing organisms from clinical and environmental sources by pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing.
Results:
From July 2017 to December 2018, 76 incident cases were identified from 69 case patients: 51 had blaKPC, 11 had blaVIM, and 7 had blaVIM and blaKPC. Also, blaKPC were identified from 7 Enterobacterales, and all blaVIM were P. aeruginosa. We observed gaps in hand hygiene, and we recovered KPC-CRE and VIM-CRPA from drains and toilets. We identified 4 KPC alleles and 2 VIM alleles; 2 KPC alleles were located on plasmids that were identified across multiple Enterobacterales and in both clinical and environmental isolates.
Conclusions:
Our response to a single patient colonized with VIM-CRPA and KPC-CRE identified concurrent CPO outbreaks at LTACH A. Epidemiologic and genomic investigations indicated that the observed diversity was due to a combination of multiple introductions of VIM-CRPA and KPC-CRE and to the transfer of carbapenemase genes across different bacteria species and strains. Improved infection control, including interventions that minimized potential spread from wastewater premise plumbing, stopped transmission.
Primary aim – To improve how physical health issues are addressed for inpatients with eating disorders
Secondary aim – To improve efficiency within the MDT
Background
The Yorkshire Centre for Eating Disorders (YCED) is an inpatient unit for the treatment of patients with anorexia and bulimia nervosa. Anorexia nervosa has the highest mortality of all psychiatric disorders with an extensive list of physical manifestations. This project was designed to help better address the physical health concerns of our patients by introducing a primary care style, once weekly clinic that patients could self-refer to.
Method
Questionnaires were designed to assess whether a once weekly physical health clinic would benefit the service.
The clinic was run on a weekly basis from 26th April to 24th June 2019. Follow-up questionnaires were designed and distributed to both patients and staff following this period. Data were analysed with Microsoft Excel to determine if improvement had been made.
Result
N = 12 inpatients responded to the initial questionnaires, n = 2 were discharged during the 8 week period so were included in the analysis but did not complete the follow-up questionnaire.
100% of the staff (n = 8) felt a once weekly clinic would benefit their patients. 62% (n = 5) stated they felt distracted from their other duties with physical health requests.
33% (n = 4) of the inpatient group felt the clinic would benefit them with 67% (n = 8) stating indifference to the idea.
26 appointments were conducted in the physical health clinic with 80% (n = 8) of the service users accessing at least once. 70% (n = 7) stated their physical health concerns had been better addressed since the clinic had been started.
90% (n = 9) of inpatients and 90% (n = 9) of staff responded that the physical health clinic should remain permanent. 90% (n = 9) of staff stated they had more time for their other duties since the introduction of the clinic.
Prior to the clinic 63% (n = 5) of staff responded that in a typical day they were approached between 2-5 times for physical health requests with the other 37% (n = 3) being approached once.
Following the clinic 80% (n = 8) of staff responded that they were approached once in a typical working day.
Conclusion
The qualitative data from the questionnaires indicated success in both improving patient care and reducing nursing workload.
The physical health clinic has been made a permanent feature on the ward and has been continued by the incoming foundation doctor and ward ANP.
Sex-related differences in psychopathology are known phenomena, with externalizing and internalizing symptoms typically more common in boys and girls, respectively. However, the neural correlates of these sex-by-psychopathology interactions are underinvestigated, particularly in adolescence.
Methods
Participants were 14 years of age and part of the IMAGEN study, a large (N = 1526) community-based sample. To test for sex-by-psychopathology interactions in structural grey matter volume (GMV), we used whole-brain, voxel-wise neuroimaging analyses based on robust non-parametric methods. Psychopathological symptom data were derived from the Strengths and Difficulties Questionnaire (SDQ).
Results
We found a sex-by-hyperactivity/inattention interaction in four brain clusters: right temporoparietal-opercular region (p < 0.01, Cohen's d = −0.24), bilateral anterior and mid-cingulum (p < 0.05, Cohen's d = −0.18), right cerebellum and fusiform (p < 0.05, Cohen's d = −0.20) and left frontal superior and middle gyri (p < 0.05, Cohen's d = −0.26). Higher symptoms of hyperactivity/inattention were associated with lower GMV in all four brain clusters in boys, and with higher GMV in the temporoparietal-opercular and cerebellar-fusiform clusters in girls.
Conclusions
Using a large, sex-balanced and community-based sample, our study lends support to the idea that externalizing symptoms of hyperactivity/inattention may be associated with different neural structures in male and female adolescents. The brain regions we report have been associated with a myriad of important cognitive functions, in particular, attention, cognitive and motor control, and timing, that are potentially relevant to understand the behavioural manifestations of hyperactive and inattentive symptoms. This study highlights the importance of considering sex in our efforts to uncover mechanisms underlying psychopathology during adolescence.