General Irish Population Research Articles

PA33 Paediatric and adolescent hidradenitis suppurativa: a snapshot of a single centre’s experience

Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory debilitating condition that primarily affects younger people. Its exact prevalence is unknown, but it is estimated to affect at least 1% of the Irish and UK population. Onset is late adolescence and the early 20s in the majority. The impact of early-onset HS (< 18 years) is increasingly recognized, but awareness and knowledge of disease prevalence and severity in Ireland remain sparse. Studies in adults highlight association with a raised body mass index (BMI) and smoking, in addition to an increased prevalence in young females with African American or mixed ancestry. Presently, there is an absence of specific guidelines for management in those aged < 18 years. With rising obesity levels, combined with decreasing pubertal age, we may encounter early-onset HS more often in future. We present a snapshot of patients with HS attending a single paediatric hospital who were considered for systemic therapy. Ten patients were included (eight females). Mean (SD) age of symptom onset was 12.4 (1.9) years, mean (SD) age of presentation was 14 (2.1) and mean duration of symptoms prior to presentation was 1.5 years. Nine received systemic therapy (nine antibiotics and four biologics). Disease severity, defined by Hurley stage, was mild in one, moderate in five and severe in four. All patients had achieved puberty, one was defined as early-onset (age 10 years) and another as precocious (age 9 years). The BMIs varied: one was normal, two were above a healthy weight, five were very overweight and three were severely overweight according to UK centiles. Most patients experienced comorbidities, including, but not limited to, Crohn disease (n = 1), hepatic steatosis (n = 2), pilonidal sinus (n = 3) and acne (n = 5). One had diabetes, two impaired fasting glucose and one hypercholesterolaemia. No patient reported smoking. Passive smoking and blood pressure were not documented. Four patients had positive family histories. Six patients identified as Black Irish (one Irish Caribbean and five Irish Nigerian), two were White Irish, one patient was from India and one was from Poland. We describe a group of individuals aged ≤ 16 years, the majority of whom had moderate–severe HS. They had similar comorbidities to internationally reported literature in early-onset HS. More skin of colour ethnicities are represented than seen in the general Irish population, which probably reflects both the catchment area and severity of the skin conditions experienced. The limitations of our study include under-representation of milder disease due to an inability to perform a full cross-sectional study at present. Further prospective studies are required to capture the prevalence and characteristics of HS fully in our population of children and young adults. Considering the lifetime impact of this condition, guidelines for the management of HS under the age of 18 years should be considered.

Predicting risk of postpartum haemorrhage during the intrapartum period in a general obstetric population

ObjectiveTo develop and validate (both internally and externally) a prediction model examining a combination of risk factors in order to predict postpartum haemorrhage (PPH) in a general obstetric Irish population of singleton pregnancies. Study designWe used data from the National Maternal and Newborn Clinical Management System (MN-CMS), including all singleton deliveries at Cork University Maternity Hospital (CUMH), Ireland during 2019. We defined PPH as an estimated blood loss of ≥ 1000 ml following the birth of the baby. Multivariable logistic regression with backward stepwise selection was used to develop the prediction model. Candidate predictors included maternal age, maternal body mass index, parity, previous caesarean section, assisted fertility, gestational age, fetal macrosomia, mode of delivery and history of PPH. Discrimination was assessed using the area under the receiver operating characteristic curve (ROC) C-statistic. We used bootstrapping for internal validation to assess overfitting, and conducted a temporal external validation using data from all singleton deliveries at CUMH during 2020. ResultsOut of 6,077 women, 5,807 with complete data were included in the analyses, and there were 270 (4.65%) cases of PPH. Four variables were considered the best combined predictors of PPH, including parity (specifically nulliparous), macrosomia, mode of delivery (specifically operative vaginal delivery, emergency caesarean section and prelabour caesarean section), and history of PPH. These predictors were used to develop a nomogram to provide individualised risk assessment for PPH. The original apparent C-statistic was 0.751 (95% CI: 0.721, 0.779) suggesting good discriminative performance. There was minimal optimism adjustment to the C-statistic after bootstrapping, indicating good internal performance (optimism adjusted C-statistic: 0.748). Results of external validation were comparable with the development model suggesting good reproducibility. ConclusionsFour routinely collected variables (parity, fetal macrosomia, mode of delivery and history of PPH) were identified when predicting PPH in a general obstetric Irish population of singleton pregnancies. Use of our nomogram could potentially assist with individualised risk assessment of PPH and inform clinical decision-making allowing those at highest risk of PPH be actively managed.

Thriving or surviving: staff health metrics and lifestyle behaviours within an Irish higher education setting

PurposeDue to the international paucity of empirical evidence, this study aimed to investigate the health metrics and lifestyle behaviours of a staff cohort in a higher education institution (HEI) in Ireland.Design/methodology/approachData were collected from 279 (16.4% response rate) HEI staff (academic, management, clerical/support), via a web-based health questionnaire that incorporated validated measures such as the Mental Health Index-5, Energy and Vitality Index, Cohen's Perceived Stress Scale (short form) and the AUDIT-C drinking subscale. A cluster analytical procedure was used to examine the presence of distinct clusters of individuals exhibiting either optimal or sub-optimal health behaviours.FindingsA multitude of concerning patterns were identified including poor anthropometric profiles (64.4% of males overweight/obese), excessive occupational sitting time (67.8% of females sitting for = 4 h per day), hazardous drinking among younger staff (38.2% of 18–34 year olds), sub-optimal sleep duration on weeknights (82.2% less than 8 h), less favourable mean psychometric indices than the general Irish population, and insufficient fruit and vegetable intake (62.1% reporting <5 daily servings). Cluster analysis revealed “Healthy lifestyle” individuals exhibited significantly lower BMI values, lower stress levels and reported fewer days absent from work compared to those with a “Sub-optimal lifestyle”.Originality/valueIn contrast to the abundance of research pertaining to student cohorts, the current study is the first to examine the clustering of health-related variables in a cohort of HEI staff in Ireland. Findings will be used to inform policy at the host institution and will be of broader interest to higher education stakeholders elsewhere. Future longitudinal studies are required to monitor the health challenges experienced by this influential, yet under-researched cohort.

130 PREDICTORS OF DRIVING STATUS IN OLDER IRISH ADULTS ATTENDING A GERIATRIC OUTPATIENT SERVICE

Abstract Background The main mode of transportation in Ireland remains travel by car. Transport mobility is important for older adults in accessing shops, healthcare, services, community and in maintaining relationships. Cessation of driving is associated with negative effects on mental health, loneliness and physical health. We aimed to explore factors associated with driving status in older adults living in an urban environment. Methods Study included adults aged greater than 65 years attending a geriatric outpatient service in an urban environment and recruited as part of the TUDA (Trinity Ulster, Department of Agriculture) study. We excluded those with a MMSE (Mini-Mental State Exam) less than 24 as we aimed to include only non-dementia patients. Physical frailty was measured with the Timed Up and Go (TUG) and depression with the Center for Epidemiological Studies Depression scale (CES-D). Factors associated with driving status were explored in multinomial regression models. Results 1978 adults, mean age 77.7 ± 7.1 years, 76.0% were female. 35.5% were current drivers but this differed by age category 45.9% (65–75 years), 25% (75–85 years) and 12.5% (85+ years). 28.1% were past drivers. Positive independent predictors of current driving were younger age (P &amp;lt; 0.001), male gender (P &amp;lt; 0.001), married status (P = 0.01), higher socioeconomic status (P &amp;lt; 0.0001) while negative predictors included physical frailty (TUG, P &amp;lt; 0.001), visual impairment (P = 0.01), stroke (P &amp;lt; 0.001), depression (P &amp;lt; 0.001) and self reported loneliness (P = 0.01). Conclusion One third of patients attending a geriatric outpatients in an urban environment were currently driving which is much lower than in the general older Irish population. However, our study included frail adults living in more deprived socioeconomic areas and had a high proportion of females who had never learned to drive. Furthermore, access to urban public transport may be a factor. Non-drivers were more likely to have depression and report loneliness independent of other factors highlighting its negative impact.

Mortality in residential care services for people with disabilities in Ireland

Abstract Background All-cause mortality is higher in people with disability than in people without disability. There is a need for descriptive epidemiological studies of deaths in people with disability to inform the development of public health interventions. All deaths in residential disability services in Ireland are notified to the Chief Inspector in the Health Information and Quality Authority (HIQA). These include notification of unexpected and expected deaths. The herein aim was to describe total, unexpected and expected deaths, and identify leading causes of death in residential disability services in Ireland. Methods Data on deaths in residential disability services in 2019 and 2020 were extracted from the Database of Statutory Notifications from Social Care in Ireland. The number of total deaths was calculated along with the percent and number of unexpected and expected deaths. The primary cause of death notified by services was coded using ICD-11 chapter headings. Results During 2019 and 2020, on average 9,115 people resided in residential disability services. Of these, 395 died, of which 45% (n = 178) were notified as unexpected. The leading causes of unexpected deaths were respiratory system diseases (35%, n = 62) and circulatory system diseases (18%, n = 32). The leading causes of expected death were respiratory system diseases (41%, n = 89) and cancers (31%, n = 67). Conclusions Almost half of deaths in residential disability services were notified as unexpected. Respiratory disease was the leading cause of both expected and unexpected death in people with disability residing in residential services in Ireland; three-fold the general Irish population (10.7%). Public health interventions aimed at reducing respiratory disease may reduce deaths in this group. Key messages In 2019 and 2020, nearly half of deaths of people with a disability residing in residential services were notified as unexpected. Death from respiratory diseases was substantially higher in people with disability living in residential services in Ireland than in the general population and warrants public health intervention.

Predicting risk along the suicidality continuum: A longitudinal, nationally representative study of the Irish population during the COVID-19 pandemic.

IntroductionLittle is known about the lifetime prevalence of different indicators of suicidality in the Irish general population; whether suicidality has increased during the COVID‐19 pandemic; and what factors associated with belonging to different points on a continuum of suicidality risk.MethodsA nationally representative sample of Irish adults (N = 1,032) completed self‐report measures in May 2020 and a follow‐up in August 2020 (n = 715).ResultsLifetime prevalence rates were 29.5% for suicidal ideation, 12.9% for non‐suicidal self‐injury (NSSI), and 11.2% for attempted suicide. There were no changes in past two‐week rates of NSSI and attempted suicide during the pandemic. Correlations between the indicators of suicidality supported a progression from ideation to NSSI to attempted suicide. Suicidal ideation alone was associated with being male, unemployed, higher loneliness, and lower religiosity. NSSI (with no co‐occurring attempted suicide) was associated with a history of mental health treatment. Attempted suicide was associated with ethnic minority status, lower education, lower income, PTSD, depression, and history of mental health treatment.ConclusionSuicidal ideation, NSSI, and attempted suicide are relatively common phenomena in the general adult Irish population, and each has unique psychosocial correlates. These findings highlight important targets for prevention and intervention efforts.

A qualitative study of the perceptions of mental health among the Traveller community in Ireland.

Irish Travellers are a minority ethnic group who experience a high prevalence of mental health problems and a rate of suicide six times higher compared to the general Irish population. This study explores Travellers' perceptions of mental health and its determinants. It also identifies the most relevant factors for promoting positive mental health and wellbeing among this socially excluded group. A descriptive qualitative approach was employed to explore participants' perceptions of mental health and mental health needs. Four focus groups were conducted with a total of 25 adult members of the Travelling community. Inductive thematic analysis was undertaken to identify and interpret the main themes emerging from the participants' responses. Travellers conceptualize mental health mostly in negative terms and showed a lack of awareness of the concept of positive mental health. Travellers showed a strong awareness of the social determinants of mental health identifying employment, better education, suitable accommodation, a reduction of discrimination and improved trust and social cohesion as important determinants that need to be addressed to improve their mental health status. The centrality of cultural identity and social-emotional skills emerged as key factors in promoting positive mental health among Travellers. The findings suggest that Travellers' mental health is multidimensional and requires a socio-ecological approach that addresses the wider determinants of health. Community mental health promotion initiatives should focus on reducing discrimination, enhancing social and emotional wellbeing and self-esteem, improvement of living conditions, reduced mental health stigma, and the promotion of Traveller culture and positive self-identity.

Oral health literacy among third-level university students in cork city; Ireland

Health literacy is considered a social determinant of population health, but also relates to making informed health decisions. Little information is available on the oral health literacy (OHL) among young adults, and this is crucial to inform targeted interventions on oral health and care. This study (i) estimates the prevalence of OHL among the third-level university students in Cork City and (ii) identifies determinants of OHL by exploring potential correlates. All students in University College Cork (~ 21000) were sent out a previously validated questionnaire through the online Lime Survey in April 2018 (n = 1487). Both descriptive and inferential statistics (chi-squared/correlation) were undertaken. OHL score was calculated as adequate (2.1-3.0), marginal (1.1-2.0) or inadequate (0.0-1.0) in regard to the scores attained by the individuals. Adequate OHL prevalence was 23%. OHL was significantly correlated with age (r = 0.10), major discipline (r = - 0.13) and frequency of dental visits (r = - 0.08). Male gender, younger age group and those in non-medical schools had significantly higher inadequate OHL. Approximately, one-in-four third-level university students in Cork City have adequate OHL which is lower compared to the general Irish population but still significantly high in specific groups.

Identifying and characterising adverse childhood experiences (ACE) in a Northern Irish military veteran population

ABSTRACT Background: The experience of childhood adversities, particularly those related to maltreatment and household dysfunction, has been consistently documented in the extant literature as having a detrimental impact on psychological wellbeing across the life course, including adverse outcomes such as mood disorders, anxiety disorders and PTSD. Previous research has uncovered a higher proportion of childhood adversity experiences amongst military populations (Katon et al., 20152015) and that those who experienced trauma during their childhood, and during their military career, were at the greatest risk of a range of psychological concerns. A wealth of research has been conducted to identify what social and psychological constructs may mediate the relationship between adversity and psychopathological outcomes. It has been suggested that one such construct may be resilience; given that resilience can help build immunity to psychopathology following adverse experiences (Denckla et al., 2020). In the context of Northern Ireland, no study to date has examined childhood adversities and psychopathological outcomes or any mediating or moderating factors of this association in UK Armed Forces veterans residing in Northern Ireland. There has however been research on childhood adversities, polyvictimisation profiles, and associated outcomes as reported in the general Northern Irish population. The rates of adversity were high comparative to reports from other countries and one potential explanation for this is the prolonged period of civil conflict experienced by residents, including children, of Northern Ireland. Individuals in polyvictimisation classes were more likely to report a range of psychopathologies compared to those in a class reporting little to no adversity (McLafferty et al., 2015). Objectives: The current study examined, for the first time, the rates of childhood adversity experiences in a sample of UK Armed Forces veterans residing in Northern Ireland. Further, we examined the co-occurrence of reported adverse childhood experiences and subsequently assessed the mediating role of resilience as it pertains to membership in an adversity class and psychopathological outcomes including depression, anxiety, and PTSD. Methods: This study used data collected during the Northern Ireland Veterans’ Health and Wellbeing Study (NIVHWS). This was a large-scale, cross-sectional, self-report survey conducted between December 2017 and June 2019. Overall, 1,329 veterans completed the survey but due to the nature of the survey and the use of skip functions in addition to data reduction due to missingness, the sample for the current analysis was 656 respondents. Respondents completed the Adverse Childhood Experiences Questionnaire, the Connor-Davidson Resilience Scale (CDRS), The Patient health Questionnaire – 9 (PHQ-9), the Generalised Anxiety Disorder −7 (GAD-7) and the PTSD checklist for DSM-5 (PCL-5). Using SPSS version 25 and Mplus version 7.31 we conducted a series of analyses including frequencies, latent class analyses, and mediation analyses. Results: Reported rates of adversities and depression, anxiety, and PTSD were high. Utilising data across 10 childhood adversities (psychological abuse, physical abuse, sexual abuse, felt unloved, neglect, parent separation, witnessed domestic abuse, substance abuse at home, mental health problem at home, household member in prison) we uncovered four classes (1. Baseline/Low Risk, 2. Chaotic Home, 3. Physical and Psychological Abuse and 4. Multi-adversity). Individuals in the Multi- adversity and Abuse classes were much more likely to report depression and anxiety, and those in the Multi-adversity class were more than 2.5 times more likely to have PTSD when compared to the low risk class. Concerning mediation analyses, when resilience was included in the mediation model the impact of childhood adversities on psychological health reduced. Conclusions: Reports of childhood adversities and polyvictimisation is found in a UK Armed Forces veteran population resident in Northern Ireland. Those reporting a greater degree of adversity are at increased risk of a range of adverse psychological outcomes. The association between the experience of adversity in childhood and psychopathological outcomes can however be mediated by a greater degree of resilience.

The prevalence, awareness, treatment, and control of hypertension in older adults with an intellectual disability in Ireland: a cross sectional study.

Hypertension is a leading risk factor for cardiovascular disease, accounting for almost 50% of ischaemic heart disease mortality. This study aims to identify the prevalence, awareness, treatment, and control of hypertension and their predictors in older adults with an intellectual disability (ID). This cross-sectional study utilized data from the ID Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). Participants were drawn from the nationally representative sample and included those who completed the self/informant report measures, in addition to objective blood pressure (BP) measurement. From the 551 individuals with ID, aged ≥40 years, hypertension prevalence was 35.2% [95% confidence interval (CI) 31.2-39.2%]. Of those with hypertension, 44.3% (95% CI 37.1-51.5%) were aware of their hypertensive status, and 64.2% (95% CI 57.3-71.1) were taking antihypertensive medication. Among those on treatment, 70.8% (95% CI 61.8-78.2%) had their BP controlled to below 140/90 mmHg. Significant predictors of awareness were age (P = 0.036) and level of ID (P = 0.004), predictors of treatment were age (P = 0.002), level of ID (P = 0.019), and diabetes (P = 0.001). Both diabetes and female gender were predictors of control of hypertension (P = 0.013 and P = 0.037, respectively). The prevalence of hypertension in older adults with ID was lower than reports for the general Irish population, with overall levels of treatment and control, when identified, higher in the ID population. There was under-treatment and lower levels of awareness among those with more severe ID, which requires addressing. The finding, that when diagnosed, people with ID respond well to treatment should encourage addressing the under-treatment found here.

Prevalence of Insomnia in an Oncology Patient Population: An Irish Tertiary Referral Center Experience

Background:The NCCN Guidelines for Survivorship recommend dedicated sleep assessment. Reported insomnia prevalence in the general Irish population is 6% to 15%. Reported insomnia prevalence internationally among new/recently diagnosed patients with cancer varies from 30.9% to 54.3%. Insomnia prevalence has not been previously quantified in an Irish oncology cohort.Methods:A 40-item questionnaire was prospectively administered to ambulatory patients with cancer aged ≥18 years. Prespecified criteria to define insomnia syndrome combined those of theInternational Classification of Sleep Disorders, version 1, and theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV). The Hospital Anxiety and Depression Scale-Depression/Anxiety (HADS-D/A) was used to screen for potential confounding variables.Results:The response rate to the questionnaire was 87% (294/337). The predominant respondent age group was 55 to 64 years (26%; 77/294), 70.7% were female (208/294), and the most common cancer subtypes were breast (37.4%), colorectal (12.9%), and lung (12.2%). A total of 62% (183/294) of patients reported sleep disturbance after diagnosis, 63% (115/183) reported moderate/severe distress related to this disturbance, and 37% (61/183) reported a significant impact on physical function. Although 33% (98/294) met insomnia syndrome criteria, only 34% (33/98) of these patients had a preexisting history of sleep disturbance. Female sex, age &lt;65 years, cancer subtype, alcohol consumption, and HADS-D/A ≥11 were associated with statistically significant higher odds ratios (OR) of insomnia syndrome. Multivariate analysis identified breast cancer (OR, 3.17;P=.01), age &lt;65 years (OR, 1.8;P=.03), and alcohol consumption (OR, 2.3;P=.005) as independent predictors of insomnia syndrome.Conclusions:Insomnia syndrome prevalence in this cohort is comparable to that reported previously and supports dedicated sleep assessment. This study identifies potentially modifiable risk factors for insomnia and demonstrates additional utility of the HADS score in identifying patients at risk.

COVID-19 and rheumatic musculoskeletal disease patients: infection rates, attitudes and medication adherence in an Irish population.

ObjectivesTo establish, amongst Irish rheumatic musculoskeletal disease (RMD) patients, rates of COVID-19 symptoms and positive tests, DMARD adherence and attitudes to virtual clinics.MethodsAn online survey assessing COVID-19 status, RMD diagnoses, adherence and information sources was disseminated via the Arthritis Ireland website and social media channels.ResultsThere were 1381 respondents with 74.8% on immunosuppressive medication. Symptoms of COVID-19 were reported by 3.7% of respondents of which 0.46% tested positive, consistent with the general Irish population. The frequency of COVID-19 symptoms was higher for respondents with spondyloarthropathy [odds ratio (OR) 2.06, 95% CI: 1.14, 3.70] and lower in those on immunosuppressive medication (OR 0.48, 95% CI: 0.27, 0.88), and those compliant with health authority (HSE) guidance (OR 0.47, 95% CI: 0.25, 0.89). Adherence to RMD medications was reported in 84.1%, with 57.1% using health authority guidelines for information on medication use. Importantly, adherence rates were higher amongst those who cited guidelines (89.3% vs 79.9%, P <0.001), and conversely lower in those with COVID-19 symptoms (64.0% vs 85.1%, P =0.009). Finally, the use of virtual clinics was supported by 70.4% of respondents.ConclusionThe rate of COVID-19 positivity in RMD patients was similar to the general population. COVID-19 symptoms were lower amongst respondents on immunosuppressive medication and those adherent to medication guidelines. Respondents were supportive of HSE advice and virtual clinics.

Awareness of atrial fibrillation—effectiveness of a pilot national awareness campaign

Although atrial fibrillation (AF) causes one-third of strokes in Ireland, studies have shown that public awareness and knowledge of AF are poor. The Irish Heart Foundation conducted a national AF awareness campaign in 2013. The aim of this study was to assess the effectiveness of the campaign in promoting awareness of AF in the general Irish population, by analyzing knowledge of AF at a population level pre- and post-campaign. Two thousand people were surveyed before the campaign to establish baseline knowledge, and the survey was then repeated in a sample of 1000 people in 2months after the end of the campaign. Awareness of AF was low, with 28% (560/2000) of those surveyed reporting they had heard of AF prior to the campaign and 30% (297/1002) after (p 0.347). Of those that had heard of the condition, 58% (174/300) in the pre-campaign group correctly identified AF as an irregular heartbeat compared with 35% (105/297) of the post-campaign group (p < 0.01). Our study shows that overall public knowledge of AF in Ireland is generally poor. While this pilot national awareness campaign had no positive impact on awareness levels, there are several possible reasons for this including the limited funding allocation to the campaign. A further AF awareness campaign is planned for next year.

The iHOPE-20 study: mortality in first episode psychosis-a 20-year follow-up of the Dublin first episode cohort.

Increased mortality rates have been found in those with a diagnosis of psychosis; studies suggest a shortened life expectancy of up to 20years less than that of the general population. This study aimed to investigate the mortality of a first episode psychosis cohort at 20-year follow-up, compare it to that of the general Irish population, and explore whether the mortality gap has changed over time. 171 individuals diagnosed with a first episode psychosis identified between 1995 and 1999 in a community mental health service were traced. Mortality was established by matching death certificates to deceased cohort members (using name, age at date of death, and address at date of death). Date of first presentation to service was used as date of entry point and date of death or end of follow-up as the end point. Of the 171 cases there were 20 deaths during follow-up. Nine deaths were attributed to natural causes; 7 to unnatural causes; and 4 were unknown. Comparing standardised mortality rates at 20-year follow-up to those at 12year showed a reduction in rates over time. Findings suggest that the mortality gap in people with schizophrenia and other psychoses remains high, especially in young males.

Obesity and cardiovascular risk in an oncology day ward population.

The burden of obesity and risk of cardiovascular (CV) disease amongst an oncology population receiving active treatment is ill-defined. We performed a retrospective analysis assessing the incidence of obesity and cardiovascular (CV) risk factors in this group (grp) of patients as well as the predicted 10-year risk of a CV event. Data from all patients (pts) receiving intravenous chemotherapy in an Irish oncology satellite unit over an 18-month period was extracted from chemotherapy prescriptions and electronic patient records. To calculate patients' 10-year risk of developing CV disease, we used QRISK, a predictive risk calculator. The prevalence of obesity (BMI > 30) amongst the total population was 19% (n = 21), with 26% (n = 28) overweight (BMI, 25-< 30). Information on CV risk factors was available in 93 pts. with the following rates being observed: hypertension 34%, dyslipidaemia 19%, current smoker 18% and diabetes 11%. The average 10-year risk of a CV event (stroke/MI) in this cohort was 19.2% (± 16.6), with a relative risk of 1.4 compared to their age-matched controls without CV risk factors. We observed similar or lower rates of obesity and CV risk factors in this cohort compared to the general adult Irish population. The average predicted risk of developing CV disease in this grp was moderate to high. This can have significant future implications with regard to cancer survivorship, disease recurrence and suitability for further oncological treatments.

Parental awareness of testicular torsion amongst Irish parents.

Testicular torsion is the most concerning underlying cause of acute scrotal pain that can lead to loss of the affected testicle. Whether a torted testicle can be salvaged surgically is directly affected by prompt presentation and diagnosis. This study aims to evaluate the awareness of testicular torsion amongst Irish parents and evaluate their response to a potential torsion. An anonymous questionnaire was distributed to parents attending general paediatric clinics and an acute paediatric unit in two paediatric tertiary referral centres. SPSS statistical analysis software was used to perform multivariant analysis of the data. There were 242 completed surveys. Fifty-six percent of responders had an awareness of torsion. In the event of an episode of severe testicular pain parents who were aware of testicular torsion were 4 times more likely to present immediately than those who had no awareness of torsion (OR 4.2, 95% CI1.4-12.2, P < 0.01), and those who identified correctly the critical timeframe were 3 times more likely to present immediately than those who did not (OR 3.0, 95% CI 0.85-10.8, P = 0.08). Of those parents with boys only 11% had discussed what to do in the event of acute scrotal pain. Education of this topic to the general Irish population and in particular to parents and young males is not established. Both knowledge of testicular torsion and awareness of the urgency in presentation are factors that determine parents promptness in seeking medical attention for their child in the setting of acute scrotal pain.

A pot of gold at the end of the rainbow? A spectrum of attitudes to assisted reproductive technologies in Ireland

Objective: New technologies present new ethical dilemmas. Our ethical intuitions may mislead us in relation to new technologies such as nuclear power, vaccines, GMOs and assistive reproductive technologies (ART). Between 1999 and 2008 the number of ART treatment cycles increased by 265% in Ireland. The implications and potentials of such technologies are profound – challenging existing understanding of humans’ relationships to reproduction. Because such technologies are comparatively unregulated, and their use has only been occurring for a single generation, detailed investigation of how awareness of ART influences understanding of personal fertility is needed. Method: Data from a general Irish population of varied ages and both sexes (N = 611) were collected through an online survey which included demographics, knowledge of fertility, knowledge of ART and personal fertility. Results: Latent class analysis revealed a typology of five groups of responders to ART distinguished by their attitudes and knowledge of this technology. These groups are labelled as ‘Worried Yet Willing’, ‘Live and Let Live’, ‘Disengaged’, ‘Judgemental’ and ‘Conflicted’. Conclusion: Responses to the introduction of ART in Ireland fall into at least five distinct groups. Understanding of the distinguishing features of these types of responders is important for fertility healthcare professionals in terms of service development and delivery. Implications for the direction of future related research is discussed.

Genomic insights into the population structure and history of the Irish Travellers

The Irish Travellers are a population with a history of nomadism; consanguineous unions are common and they are socially isolated from the surrounding, ‘settled’ Irish people. Low-resolution genetic analysis suggests a common Irish origin between the settled and the Traveller populations. What is not known, however, is the extent of population structure within the Irish Travellers, the time of divergence from the general Irish population, or the extent of autozygosity. Using a sample of 50 Irish Travellers, 143 European Roma, 2232 settled Irish, 2039 British and 6255 European or world-wide individuals, we demonstrate evidence for population substructure within the Irish Traveller population, and estimate a time of divergence before the Great Famine of 1845–1852. We quantify the high levels of autozygosity, which are comparable to levels previously described in Orcadian 1st/2nd cousin offspring, and finally show the Irish Traveller population has no particular genetic links to the European Roma. The levels of autozygosity and distinct Irish origins have implications for disease mapping within Ireland, while the population structure and divergence inform on social history.

Happiness in texting times.

Assessing national levels of happiness has become an important research and policy issue in recent years. We examined happiness and satisfaction in Ireland using phone text messaging to collect large-scale longitudinal data from 3,093 members of the general Irish population. For six consecutive weeks, participants’ happiness and satisfaction levels were assessed. For four consecutive weeks (weeks 2–5) a different random third of the sample got feedback on the previous week’s mean happiness and satisfaction ratings. Text messaging proved a feasible means of assessing happiness and satisfaction, with almost three quarters (73%) of participants completing all assessments. Those who received feedback on the previous week’s mean ratings were eight times more likely to complete the subsequent assessments than those not receiving feedback. Providing such feedback data on mean levels of happiness and satisfaction did not systematically bias subsequent ratings either toward or away from these normative anchors. Texting is a simple and effective means to collect population level happiness and satisfaction data.

Mortality Rates in the General Irish Population Compared to those with an Intellectual Disability from 2003 to 2012.

Historically, there has been higher and earlier mortality among people with intellectual disability as compared to the general population, but there have also been methodological problems and differences in the available studies. Data were drawn from the 2012 National Intellectual Disability Database and the Census in Ireland. A standardized mortality ratio (SMR) was calculated, as well as average age at death. Ratios and differences were further examined for the influence of age, gender and level of intellectual disability. Mortality in persons with intellectual disability was four times higher and they were, on average, dying 19 years earlier than peers in the general population. Women with intellectual disability were living longer than males with intellectual disability, but differences in survival as compared to the general population were greater for these women. There was little change in average age at death over 10 years, and death was earlier the more severe the level of intellectual disability. The use of mortality ratios rather than average age at death alone is recommended, as well as greater standardization in use of data sets including the whole population, given high levels of earlier deaths in people with intellectual disability.