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PUBLISHED ; Since their re-establishment in the early decades of the nineteenth century the Jesuits have successfully maintained a position at the pinnacle of Catholic elite education. In this article I propose to discuss Irish education in the context of global trends in cosmopolitan and elite forms of education. All across Europe we find the Jesuits competing for regional elites and sub elites in this period, and the Irish Jesuits are part of this transnational pattern. I will then focus on the two most important nineteenth century foundations ?Tullabeg (1818-86) and Clongowes (1814-)? as the exemplary ?elite? Jesuit boarding schools in Ireland. I will then briefly discuss two less socially ascendant but nevertheless important day schools, Belvedere College (1841-) and Gonzaga (1899-), both in Dublin. The educational product was intentionally politically muted, informed by a desire for Catholic advancement in all aspects of life, including imperial service, religious leadership, gaining a foothold in the prestigious professions, and ?where possible? advocating for general Catholic advancement. As with Jesuit education elsewhere in this period it was an explicitly elitist project at the beginning of the nineteenth century, with greater market segmentation evident later in the century with the advent of the prestigious urban day-schools.

Background with rationalePrevious work has shown the existence of a sharp socio-economic gradient with respect to orthodontic services in Northern Ireland. The work demonstrated that those of lower socio-economic status had an odds ratio of 0.79 (95% CI 0.69 - 0.91) compared to those of higher socio-economic status with respect to the consumption of orthodontic services. In response to this, an objective measure of treatment need for such publicly funded services was introduced in 2014.
Main AimThis study will use a record-linkage methodology to examine the relationship between use of publicly funded orthodontic care and the introduction of the index of treatment need (IOTN) in Northern Ireland in 2014.
Methods/ApproachFollowing a similar approach to that used previously, data related to use of orthodontic services was linked to socio-economic characteristics from the 2011 Census for members of the Northern Ireland Longitudinal Study. The relationship between socio-economic status and uptake of orthodontic services in the 3 years before and after the introduction of IOTN will be examined using an interrupted time series analysis as well as by the comparison of concentration indices across the study period.
ResultsAll results must be cleared by the Northern Ireland Statistical Research Agency before release. We expect cleared results to be available imminently and anticipate these showing a change in the uptake of publicly funded orthodontic services as well as a reduction in the socio-economic gradient over time.
ConclusionThe identification of inequalities in the use of publicly funded services requires an appropriate policy response. We anticipate that the introduction of IOTN as a criterion for access to publicly funded care will have successfully reduced the use of such services unrelated to need and the existence of inequalities in service use conditioned on need.

BACKGROUND: Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop. METHODS: Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend. RESULTS: Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education. CONCLUSION: While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-022-01696-w.

Background: Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop. Methods: Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend. Results: Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education. Conclusion: While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction.

In this article we compare the pattern of service utilization in the period preceding the health‐care reforms introduced by New Labour with service utilization following the refoms. Data from the 1997 and 2003 waves of the British Household Panel Survey are used to estimate a series of utilization functions. These show that GP utilization overall fell, for women more than men and for the sick more than others. The results suggest that GPs responded to the changing context the reforms created but there are different interpretations of that response. They support the contention that GPs devoted greater attention to preventative services post‐reform than had previously been the case. They are also consistent with the contention that GPs responded less directly to the needs of their patients, either because they became more sophisticated in interpreting those needs or conscious of the increased opportunity costs of responding to them.

Background: Low- and middle-income countries (LMICs) experienced increasing rates of colorectal cancer (CRC) incidence in the last decade and lower 5-year survival rates compared to high-income countries (HICs) where the implementation of screening and treatment services have advanced. This review scoped and mapped the literature regarding the content, implementation and uptake of CRC screening interventions as well as opportunities and challenges for the implementation of CRC screening interventions in LMICs. Methods: We systematically followed a five-step scoping review framework to identify and review relevant literature about CRC screening in LMICs, written in the English language before February 2020. We searched Medline, Embase, Web of Science and Google Scholar for studies targeting the general, asymptomatic, at-risk adult population. The TIDieR tool and an implementation checklist were used to extract data from empirical studies; and we extracted data-informed insights from policy reviews and commentaries. Results: CRC screening interventions (n = 24 studies) were implemented in nine middle-income countries. Population-based screening programmes (n = 11) as well as small-scale screening interventions (n = 13) utilised various recruitment strategies. Interventions that recruited participants face-to-face (alone or in combination with other recruitment strategies) (10/15), opportunistic clinic-based screening interventions (5/6) and educational interventions combined with screening (3/4), seemed to be the strategies that consistently achieved an uptake of > 65% in LMICs. FOBT/FIT and colonoscopy uptake ranged between 14 and 100%. The most commonly reported implementation indicator was 'uptake/reach'. There was an absence of detail regarding implementation indicators and there is a need to improve reporting practice in order to disseminate learning about how to implement programmes. Conclusion: Opportunities and challenges for the implementation of CRC screening programmes were related to the reporting of CRC cases and screening, cost-effective screening methods, knowledge about CRC and screening, staff resources and training, infrastructure of the health care system, financial resources, public health campaigns, policy commitment from governments, patient navigation, planning of screening programmes and quality assurance.