Irish Data Research Articles

The Schrems judgments: a silent revolution for Member States’ procedural autonomy?

The Schrems I and Schrems II judgments (C-362/14 Maximillian Schrems v Data Protection Commissioner EU:C:2015:650 and C-311/18 Data Protection Commissioner v Facebook Ireland Limited and Maximillian Schrems EU:C:2020:559) are well known for the sweeping implications that the law student’s crusade against the data giant Facebook had on international data transfers and for the ensuing headache that they gave to companies, as well as to legislators and public authorities on both sides of the Atlantic. What has remained slightly unexplored, on the other hand, are the constitutional side effects of the combined operation of the two judgments on the relationship between the right to an effective remedy and Member States’ procedural autonomy. In its first part, therefore, this article will review the unusual procedural path that, on the basis of the first Schrems ruling, brought the second Schrems case from the Irish Data Protection Commissioner to the Court. The second part will examine the consequences of the two judgments on effective judicial protection, in particular on the extent to which those appear to create an obligation for the Member States to provide new remedies where the rights of individuals are infringed by secondary EU law.

Overtly Headed XPs and Irish Syntax-Prosody Mapping

Analyses of Irish phonological phrasing (Elfner 2012 et seq.) have been influential in shaping Match Theory (Selkirk 2011), an OT approach to mapping syntactic to prosodic structure. We solve two constraint ranking paradoxes concerning the relative ranking of Match and StrongStart. Irish data indicate that while XPs with silent heads can fail to map to phonological phrases in certain circumstances, overtly headed XPs cannot. They also indicate that rebracketing due to the constraint StrongStart occurs only sentence-initially, contrary to predictions. We account for these puzzles by invoking Van Handel's (2019) Match constraint which sees only XPs with overt heads, and by positing a new version of StrongStart which only applies to material at the left edge of the intonational phrase. Our analysis is developed using the Syntax-Prosody in Optimality Theory application (SPOT) and OTWorkplace.

Mathematics as a gendered subject: a deeper insight into students’ attitudes in Irish post-primary schools

This study examines gender differences in students’ attitudes to mathematics in Irish post-primary schools. Large-scale international assessments have shown the achievement gap between boys and girls to be narrowing in recent years, particularly in lower post-primary education. However, women and girls remain significantly under-represented in advanced level mathematics courses and STEM careers. The current research aims to contextualise this state of inequity, providing a deeper understanding of gendered attitudes to mathematics in Ireland today. To this end, Irish data from the 2015 Trends in International Mathematics and Science Study is further analysed, focusing specifically on the student background questionnaire. Various aspects of students’ attitudes to mathematics are investigated, including their interest in mathematics, views on mathematics class, confidence and mathematical self-concept, and perceived importance of mathematics as a subject. The findings show consistent and significant attitudinal gender differences. These differences were generally strongest regarding confidence and self-concept, and attitudes to mathematical problem-solving. Differences regarding attitudes to mathematics lessons were small to negligible.

Dietary intake and growth in children with Prader-Willi syndrome.

The management of Prader-Willi Syndrome (PWS) requires strict dietary supervision to prevent obesity, avoid micronutrient deficiencies and ensure optimal growth. The present study aimed to examine the growth and dietary intake of children with PWS. All children with genetically confirmed PWS attending Children's Health Ireland (CHI) at Tallaght (n=44) were invited to participate. Anthropometry was performed and body composition measured using bioelectrical impedance analysis. Three-day food diaries were used to evaluate dietary intake and the presence of early feeding issues was assessed. Serum haemoglobin, ferritin and vitamin D levels were measured. Nineteen children participated, with a mean (range) age of 7.6(0.6-18.1)years. Most were female (n=14, 74%). Twenty-percent (n=3) were underweight, 60% (n=9) were healthy weight, n=1 was overweight and n=2 were obese. Mean (range) percentage body fat was 25.7% (10%-40%). Eigthy-three percent reported early feeding issues. Ninety-four percent (n=16) achieved ≤100% of estimated average requirement (EAR) for energy. Mean daily energy intake for ≤5years old was 722kcal (9kcalcm-1 /72-112% EAR); for those ≥12years, it was 1203kcal (8.3kcalcm-1 /41%-82% EAR). Suboptimal calcium, vitamin D, iron, zinc and fibre intake was evident. Iron deficiency anaemia and vitamin D insufficiency occurred in two children. The present study provides the first Irish data for PWS and shows that energy intake does not appear to be excessive, with four in five patients being underweight or of a normal BMI. Suboptimal dietary intake of several micronutrients was evident and biochemical nutrient deficiencies were present.

Comments on GDPR Enforcement EDPB Decision 01/020

The European Data Protection Board issued its first Binding Decision on 9 November 2020 in a case in which the Irish Data Commissioner (DPA) was lead enforcement authority. In the judgment of the Irish DPA, a fine of up to EUR 275,000 was appropriate, taking into account all relevant circumstances, including aggravating and mitigating factors. Several other national DPAs raised objections, including the German DPA, which thought that a fine of up to EUR 22 million was relevant, on the basis that it should be 'dissuasive' and therefore 'must be high enough to make data processing uneconomic and objectively inefficient'. Under the DGPR, the EDPB considered all objections, and rejected a surprising number as not satisfying the 'relevant and reasoned' standard. The EDPB issued a binding decision that a sanction must be 'deterrent' and required The Irish DPA to revise its fine. The Irish DPA issued a fine of EUR 450,000. This paper highlights the major rift in theory and practice between different approaches to the effects, if any, of financial sanctions. The case raises fundamental issues over the consistency and coherence of EU enforcement policy, and the level of confidence that may be placed in it. It identifies a conflict between traditional concepts of deterrence, effective, proportionate and dissuasive sanctions, and outcome-focused achievement of compliance. It also raises an underlying conflict between pure economic theory on the effectiveness of penalties and the relevance of the findings on behavioral science on how to affect future behavior.

Associations of the natural and built environment with mental health and wellbeing during COVID-19: Irish perspectives from the GreenCOVID study

BackgroundIn several countries public health efforts to contain the COVID-19 pandemic have included movement restrictions that confine residents to their home or to reduced catchment areas. Household characteristics and assets of nearby spaces may be particularly relevant to support wellbeing and mental health in this context. The aim of this study was to explore wellbeing and mental health associations with factors of the immediate natural and built environment among adults in Ireland during the first wave of the COVID-19 pandemic. MethodsWe did cross-sectional analyses using Irish data from the GreenCOVID study. Participants were recruited online between June and July, 2020, with a convenience sampling approach. All respondents who provided informed consent and data on variables of interest were included in analysis. Wellbeing was assessed with the WHO-5 Wellbeing Index, and mental health with the Kessler Psychological Distress Scale. Means and SD were used to describe the perceived importance of views to green and blue spaces and physical access to outdoor spaces (range 0–10). We used χ2 tests and multiple linear regression models to explore associations of wellbeing and mental health with household type, household problems, number of bedrooms, number of co-habitants, spaces enabling physical access to the outdoors, quality of views and views to green spaces from home. Regression models were controlled by age, gender, city versus non-city household location, marital status, and self-perceived health. FindingsWe included data from 243 participants; mean age was 43 years (SD 16) and most participants were women (n=174 [72%]). Participants perceived that the outdoors helped them cope with restriction measures to a high extent (mean score 8·54 [SD 1·79]; 43% of respondents reported the maximum score), and highly valued views to blue (7·82 [2·45]) and green spaces (8·84 [1·76]). Household problems were significantly associated with lower wellbeing scores (beta=–9·78 [95% CI −15·675 to −3·885]) and increased likelihood of mental disorders (0·583 [0·284 to 0·889]). InterpretationOur findings show high perceived benefits of views to green and blue spaces and access to the outdoors from home during the first wave of COVID-19. Moreover, those living in a household with problems had higher likelihood of poor mental health outcomes. This study highlights the importance of natural and built environment in helping people cope with the negative effects of the restrictions imposed during the COVID-19 pandemic. FundingHealth Research Board (HRB), grant no. SPHeRE-2019-1.

A simulation study of the economic and health impact of a diabetes prevention programme in Ireland.

Type 2 diabetes is a major public health issue that has a large effect on society including its health and social services. The aims of this paper are to generate a projection of the number of cases and explore the potential impact of a preventive intervention targeted at people with pre-diabetes on disease prevalence, complications, mortality and cost. A Markov simulation model of diabetes and pre-diabetes in Ireland, for the period 1991 to 2036, was generated based on international epidemiological data. The simulation was calibrated with the available Irish data on the prevalence of pre-diabetes, diabetes and diabetic complications. The economic and health impact of a hypothetical nationwide preventive intervention programme, which reduces the incidence by a factor consistent with the international literature, was estimated under three scenarios of alternative effectiveness and uptake. The estimated number of people over 40years of age with type 2 diabetes in Ireland is projected to increase from 216,000 in 2020 to 414,000 in 2036. A prevention programme, based on the NHS Diabetes Prevention Programme, is estimated to result in a reduction of between 2000 (0.5%) and 19,000 (4.6%) in the number of prevalent cases of diabetes in 2036 resulting in substantial health and quality of life benefits. A wide range of initiatives with uncertain outcomes will be required to reduce the impact of obesity and type 2 diabetes. A diabetes prevention programme seems likely to be worth pursuing as one element of this set of initiatives.

Diabetes care and pregnancy outcomes for women with pregestational diabetes in Ireland

AimsPre-gestational diabetes mellitus (PGDM) is associated with adverse outcomes. We aimed to examine pregnancies affected by PGDM; report on these pregnancy outcomes and compare outcomes for patients with type 1 versus type 2 diabetes mellitus; compare our findings to published Irish and United Kingdom (UK) data and identify potential areas for improvement. MethodsBetween 2016 and 2018 information on 679 pregnancies from 415 women with type 1 Diabetes Mellitus and 244 women with type 2 diabetes was analysed. Data was collected on maternal characteristics; pregnancy preparation; glycaemic control; pregnancy related complications; foetal and maternal outcomes; unscheduled hospitalisations; congenital anomalies and perinatal deaths. ResultsOnly 15.9% of women were adequately prepared for pregnancy. Significant deficits were identified in availability and attendance at pre-pregnancy clinic, use of folic acid, attaining appropriate glycaemic targets and appropriate retinal screening. The majority of pregnancies (n = 567, 83.5%) resulted in a live birth but the large number of infants born large for gestational age (LGA) (n = 280, 49.4%), born prematurely <37 weeks and requiring neonatal intensive care unit (NICU) admission continue to be significant issues. ConclusionsThis retrospective cohort study identifies multiple targets for improvements in the provision of care to women with pre-gestational DM which are likely to translate into better pregnancy outcomes.

Vitamin D bio-enrichment of pork may offer a food-based strategy to increase vitamin D intakes in the UK population

Hypovitaminosis D is prevalent worldwide, with many failing to achieve the recommended nutrient intake (RNI) for vitamin D (10- 20μg/d)(1). Moreover, the COVID-19 pandemic has re-emphasised the need to avoid vitamin D deficiency to help maintain immune function(2) and the urgent need for food-based strategies to help address this(3). The aims of the current study were to 1) determine any changes to vitamin D intake and status over a 9-year period, and 2) apply dietary modelling to predict the impact of vitamin D bio-enrichment of pork and pork products on population intakes in the UK. Data from the National Diet and Nutrition Survey (NDNS) Rolling Programme Year 1-9 (2008/09-2016/17) were analysed using SPSS to determine nationally representative mean vitamin D intakes and 25(OH)D concentrations [a robust biomarker of vitamin D status]. Subgroup analysis investigating variance in sex, age and season was conducted. Informed by previous studies(4), four theoretical dietary modelling scenarios of vitamin D pork bio-enrichment were analysed (vitamin D content + 50/100/150/200% vs standard). Vitamin D intake in the UK population has not changed significantly from 2008 to 2017 yet, over the same period significant gender difference (M 2.66 ± 1.99μg/d and F 2.30 ± 1.66μg/d, p < 0.05) and seasonal variation in the mean 25(OH)D concentrations were evident. In 2016/17, across all age groups, 13.2% were considered insufficient (25(OH)D <25nmol/L). Across the whole group, theoretical modelling demonstrated an increase of 4.9, 10.1, 15.0 and 19.8% in daily vitamin D intake when vitamin D concentrations in bio-enriched pork were elevated by 50, 100, 150 and 200%, respectively. Based on the 200% modelling scenario, a greater relative change was observed in males (22.6%) compared to females (17.8%), and although older adults (65+ years) had significantly greater vitamin D intakes compared to other age categories (3.28 ± 2.27μg/day), this age group observed the smallest relative increase from the dietary modelling scenarios (14.3%). The greatest relative change was observed amongst 11-18-year olds, where 200% vitamin D bio- enrichment of pork and pork products would result in a 25.2% increase in mean daily vitamin D intakes. Vitamin D intakes have remained stable in the UK across almost a decade, and current results confirm that strategies are required to help the population achieve the RNI for vitamin D. These findings align with Irish data and provides incentive to pursue bio-enrichment practices. Specifically, bio-enrichment of pork meat provides a proof of concept, demonstrating that animal-based strategies may offer an important contribution to help to improve the vitamin D intakes of the UK population, particularly adolescents.

Word Order Alignment in Three-Argument Constructions of Irish

This study examines the ordering of the actor (A), theme (T) and recipient (R) arguments in three-argument clauses, the prepositional ditransitive constructions of Irish. The ordering of the A, T and R arguments in three-argument clauses is an area where linguistic complexity is manifest in the Irish grammar. Across languages, the factors which influence word order adjustments, from a basic word order of A-T-R, are known to include iconicity, information structure and topicalisation, the distinction between given and new information, the effects of the various referential hierarchies, and syntactic weight. We show that some, but not all, of these apply to the Irish data. Under certain conditions, the word order of these Irish three-argument clauses changes in a different alignment. Specifically, if the T is an accusative pronoun then the word order alignment changes and consequently the T occurs after the R in clause final position, yielding an A R-T word order. We argue that post-positioning of the theme PN is due to the alignment effects that can be explained by reference to the nominal and person hierarchies, and their intersection with the principle of syntactic weight. The Irish grammar seems to be disposed to place the accusative object PN T in clause final position in word order, adding an imposed salience. We characterise the effects of the nominal and person hierarchies, and syntactic weight, on word order within these constructions. We use elements of the functional model of Role and Reference Grammar in this characterisation. These word alignment effects raise important questions of the distribution of linguistic complexity across the grammar of Irish, and the interfaces between semantics, and syntax, as well as information structure.

Paediatric viral gastroenteritis and regional predominant viral pathogens in the post-rotavirus vaccination year: prospective Irish regional study.

Acute gastroenteritis harbours a significant global burden. Rotavirus is the primary cause of gastroenteritis in children worldwide. We aim to determine the predominant enteric viral pathogens detected in the post-rotavirus vaccine period (2016-2017) in our region in county Mayo (west of Ireland), United Kingdom. All children up to 3 years old, who presented to Mayo University Hospital with vomiting and diarrhoea, from November 18th, 2016, to November 18th, 2017, had their stools tested by real-time reverse transcription polymerase chain reaction for viral pathogens. A total of 150 stool samples were tested, and 90 (60%) tested positive for a single viral pathogen. Rotavirus was the leading cause of gastroenteritis (37 patients, 24.6%; including 6 rotavirus vaccinated infants), followed by human adenovirus F (19 patients, 13%), norovirus (18 patients, 12%), sapovirus (9 patients, 6%) and astrovirus (7 patients, 5%). Rotavirus remained the predominant cause of gastroenteritis in the first year post-rotavirus vaccination, similar to the national Irish data from the pre vaccination years (July 2014-June 2015).

Techno-Economic and Sustainability Analysis of Potential Cooling Methods in Irish Data Centres

11% of Irish electricity was consumed by data centres in 2020. The Irish data centre industry and the cooling methods utilised require reformative actions in the coming years to meet EU Energy policies. The resell of heat, alternative cooling methods or carbon reduction methods are all possibilities to conform to these policies. This study aims to determine the viability of the resell of waste heat from data centres both technically and economically. This was determined using a novel application of thermodynamics to determine waste heat recovery potential in Irish data centres, and the current methods of heat generation for economical comparison. This paper also explores policy surrounding waste heat recovery within the industry. The Recoverable Carnot Equivalent Power (RCEP) is theoretically calculated for the three potential cooling methods for Irish data centres. These are air, hybrid, and immersion cooling techniques. This is the maximum useable heat that can be recovered from a data centre rack. This study is established under current operating conditions which are optimised for cooling performance, that air cooling has the highest potential RCEP of 0.39 kW/rack. This is approximately 8% of the input electrical power that can be captured as useable heat. Indicating that Irish data centres have the energy potential to be heat providers in the Irish economy. This study highlighted the technical and economic aspects of prevalent cooling techniques and determined air cooling heat recovery cost can be reduced to 0.01 €/kWhth using offsetting. This is financially competitive with current heating solutions in Ireland.

Identifying and addressing psychosocial determinants of adherence to physical distancing guidance during the COVID-19 pandemic - project protocol.

Optimising public health physical distancing measures has been a critical part of the global response to the spread of COVID-19. Evidence collected during the current pandemic shows that the transmission rate of the virus is significantly reduced following implementation of intensive physical distancing measures. Adherence to these recommendations has been poorer than adherence to other key transmission reduction behaviours such as handwashing. There are a complex range of reasons that are likely to predict why people do not or only partially adhere to physical distancing recommendations. In the current project we aim to address the following research questions: (1) What are the psychosocial determinants of physical distancing for the general public and for key socio-demographic sub-groups (e.g., young adults, older adults, etc.)?; (2) Do current Government of Ireland COVID-19 physical distancing communications address the determinants of physical distancing?; and (3) How can communications be optimised and tailored to sub-groups to ensure maximum adherence to guidelines? These will be addressed by conducting three work packages (WPs). In WP1, we will work closely with the iCARE international study, which includes a large online survey of public responses to measures established to reduce and slow the spread of COVID-19, including physical distancing. We will analyse Irish data, comparing it to data from other countries, to identify the key psychosocial determinants of physical distancing behaviour. This will be followed by a qualitative study to explore in depth the barriers and facilitators of physical distancing behaviour among the Irish public (WP2). In WP3, we will conduct a content analysis and evidence mapping of current government messaging around physical distancing, to ensure the findings from this research feed into the development of ongoing communication and future messaging about physical distancing.

Identifying and addressing psychosocial determinants of adherence to physical distancing guidance during the COVID-19 pandemic – project protocol

Optimising public health physical distancing measures has been a critical part of the global response to the spread of COVID-19. Evidence collected during the current pandemic shows that the transmission rate of the virus is significantly reduced following implementation of intensive physical distancing measures. Adherence to these recommendations has been poorer than adherence to other key transmission reduction behaviours such as handwashing. There are a complex range of reasons that are likely to predict why people do not or only partially adhere to physical distancing recommendations. In the current project we aim to address the following research questions: (1) What are the psychosocial determinants of physical distancing for the general public and for key socio-demographic sub-groups (e.g., young adults, older adults, etc.)?; (2) Do current Government of Ireland COVID-19 physical distancing communications address the determinants of physical distancing?; and (3) How can communications be optimised and tailored to sub-groups to ensure maximum adherence to guidelines? These will be addressed by conducting three work packages (WPs). In WP1, we will work closely with the iCARE international study, which includes a large online survey of public responses to measures established to reduce and slow the spread of COVID-19, including physical distancing. We will analyse Irish data, comparing it to data from other countries, to identify the key psychosocial determinants of physical distancing behaviour. This will be followed by a qualitative study to explore in depth the barriers and facilitators of physical distancing behaviour among the Irish public (WP2). In WP3, we will conduct a content analysis and evidence mapping of current government messaging around physical distancing, to ensure the findings from this research feed into the development of ongoing communication and future messaging about physical distancing.

Schrems II: Commission 0

On 16 July 2020, the European Court of Justice (‘ECJ’) issued its judgment in Data Protection Commissioner v. Facebook Ireland Limited, Maximillian Schrems C-311/18 (‘Schrems II’). The case concerned a request for a preliminary ruling by the ECJ pursuant to Article 267 of the Treaty on the Functioning of the European Union (‘TFEU’) made by the Irish High Court. The reference was made in respect of a longrunning complaint made by Mr Schrems to the Irish Data Protection Commissioner in 2013 concerning the transfer of personal data by Facebook Ireland Limited to its parent company, Facebook Inc, in the United States of America (‘US’).

Identifying and addressing psychosocial determinants of adherence to physical distancing guidance during the COVID-19 pandemic – project protocol

Optimising public health physical distancing measures has been a critical part of the global response to the spread of COVID-19. Evidence collected during the current pandemic shows that the transmission rate of the virus is significantly reduced following implementation of intensive physical distancing measures. Adherence to these recommendations has been poorer than adherence to other key transmission reduction behaviours such as handwashing. There are a complex range of reasons that are likely to predict why people do not or only partially adhere to physical distancing recommendations. In the current project we aim to address the following research questions: (1) What are the psychosocial determinants of physical distancing for the general public and for key socio-demographic sub-groups (e.g., young adults, older adults, etc.)?; (2) Do current Government of Ireland COVID-19 physical distancing communications address the determinants of physical distancing?; and (3) How can communications be optimised and tailored to sub-groups to ensure maximum adherence to guidelines? These will be addressed by conducting three work packages (WPs). In WP1, we will work closely with the iCARE international study, which includes a large online survey of public responses to measures established to reduce and slow the spread of COVID-19, including physical distancing. We will analyse Irish data, comparing it to data from other countries, to identify the key psychosocial determinants of physical distancing behaviour. This will be followed by a qualitative study to explore in depth the barriers and facilitators of physical distancing behaviour among the Irish public (WP2). In WP3, we will conduct a content analysis and evidence mapping of current government messaging around physical distancing, to ensure the findings from this research feed into the development of ongoing communication and future messaging about physical distancing.

Irish data on the safety and efficacy of vedolizumab in the treatment of inflammatory bowel disease

Introduction: Vedolizumab (VDZ) is a monoclonal antibody designed to inhibit α4β7 integrin and result in gut-selective anti-inflammatory activity. Real-world data are important in providing information to clinicians on the effectiveness and safety of this agent.Methods: A retrospective, multi-centre study was conducted across 9 Irish academic centres. Adult (≥18 years) patients receiving VDZ for active IBD (ulcerative colitis [UC] or Crohn’s disease [CD]) with at least 6 months follow-up were included in the study cohort. Primary study endpoints were defined as 3-month clinical response and 6-month corticosteroid-free remission. Secondary endpoints included 3-month corticosteroid-free clinical remission, 6-month clinical response, change from baseline in CRP, albumin and faecal calprotectin, and adverse events.Results: One hundred and twenty-nine patients were included in total (64 UC, 65 CD). In the UC cohort, baseline median PMCS was 7 [0 – 9] and 78.1% had prior anti-tumour necrosis factor alpha (anti-TNFα) exposure. Three-month and 6-month endpoints were achieved in 40% and 31%, respectively. Milder disease, CRP, albumin and prior anti-TNFa were associated with endpoints. One minor adverse event was documented. In the CD cohort, baseline HBI was 12 [0 – 29] and 94% previously received anti-TNFa therapy. Three-month and 6-month primary endpoints were achieved in 52% and 48%, respectively. Six-month remission was positively associated with Montreal B1 disease and negatively associated with perianal disease and baseline faecal calprotectin. Adverse events occurred in 11% of cases.Conclusion: These real-world data support the effectiveness and safety of vedolizumab in the treatment of IBD and give valuable insight into predictors of treatment outcomes.SUMMARYThis study reviews the safety and efficacy of treatment with vedolizumab for patients with inflammatory bowel disease across 9 Irish hospitals. It generates valuable and timely real-world data on treatment outcomes to add to the existing evidence base. Our population represents a refractory cohort with most patients previously exposed to at least one anti-TNFa agent and expressing an inflammatory phenotype. Results are reassuringly similar to larger international studies with additional insights into potential predictors of treatment response. This study further supports the safety and efficacy of vedolizumab in the treatment of inflammatory bowel disease. Key SummaryVedolizumab has growing real world data on its safety and efficacy in the treatment of IBD. Data on predictors of response are lacking. Studies such as VARSITY require new real-world data to help identify the place VDZ will occupy in the treatment algorithm for IBDThis study provides national Irish data on the safety and efficacy of VDZ in the treatment of IBD. It gives insight into various predictors of response for both UC and CD. It strengthens the available body of evidence on the use of VDZ and helps us determine its position on the treatment algorithm.

Ileal pouch-anal anastomosis for ulcerative colitis: long-term outcomes and trends over time in a low-volume institution

Ileal pouch-anal anastomosis (IPAA) can restore bowel continuity for patients with ulcerative colitis (UC) who have needed total colectomy with end ileostomy. Internationally, this surgery is recommended for centralisation focussing reflection on Irish outcomes. Retrospective study examining patient outcomes after IPAA in our institution over a 15-year period using data from inflammatory bowel disease database, HIPE codes and clinical charts review between January 2002 and January 2018. Cohorts were analysed overall and in 5-year cohorts as well as by access modality of pouch operation. Contextualising Irish data were identified from published literature review. Thirty-four patients (average age 34.8, 21/64% male) had IPAA for UC locally with 64-month mean follow-up. Overall laparoscopic procedure rate was 39.4% (85% 2013-17) being associated with lower lengths of stay (10.6 ± 8 vs 12.7 ± 6.5days open access). The mean total duration of ileostomy was 27.3 ± 22.5months, being longest most recently and with an open index procedure. Overall pouchitis affected 53% (n = 18) with rates at 1, 5, 10 and 15years being 17.6%, 38.2, 50.0% and 52.9%, respectively. Pouch failure rates at 1, 5 and 10years were 2.9%, 11.8% and 17.6%. Outcomes were similar with other centres publishing from Ireland although none met modern criteria for high-volume practice. Overall outcomes and practice in this study are consistent with previously published studies on IPAA nationally and internationally. While acceptable, the opportunity from surgical centre collaboration outside of the National Cancer and Acute Surgery Strategies is to offer still better outcomes for our patients.

GDPR Myopia: How a Well-Intended Regulation ended up Favoring Google in Ad Tech

This paper shows that while the GDPR, which lies at the core of the EU digital privacy legislation, has arguably delivered positive outcomes by enhancing the protection afforded to users of digital services and strengthening the rights of data subjects, it has also had adverse effects on competition by strengthening the position of Google and other large online platforms on digital markets, at the very same time the European Commission has expressed concerns about the market power held by these companies. This is what we understand by “GDPR Myopia”: in its effort to improve the protection of data subjects, the GDPR worsened one of the main problems experienced in digital markets today, which is increased market concentration and reduced contestability. Worse, the GDPR gave Google a tool to harm rivals by reducing access to the data they need to run their business. The present paper focuses on the adverse consequences of the GDPR on competition in the so-called “ad tech” industry, which comprises the various categories of companies that provide online advertising services to advertisers and publishers of online content. We show that while it could have been initially thought that the GDPR would have negatively impacted Google’s ability to deliver ad tech services given the enormous amount of data it collects and processes, and thus weaken its dominance in such services, the opposite scenario happened. As explained in this paper, the GDPR has strengthened Google’s market position compared to smaller rivals, which have been less capable of absorbing the implementation costs of the GDPR and coping with the restrictions on the collection and processing of data. Google’s questionable data-related practices, and in particular its “internal data free-for-all”, have also so far been left unchallenged by the Irish Data Protection Authority, while the practices of much smaller actors have been subject to harsh intervention by overly zealous Data Protection Authorities. Moreover, Google has used the GDPR – or privacy concerns more generally – as an excuse to engage in practices that have strengthened its control on the ad tech ecosystem to the detriment of advertisers, publishers and smaller rivals. This could be referred to as the “weaponization” of the GDPR, i.e. the use of the GDPR by Google as a strategic tool to strengthen its grip on the ad tech market. Because of its market power, Google has become a de facto privacy regulator able to dictate to rival advertisers, publishers and rival ad tech players its interpretation of the GDPR and other privacy legislation, which is a worrying trend that needs to be countenanced. The purpose of this paper is not to call for the weakening of the GDPR, whose positive impact on users of digital services cannot be ignored. The GDPR has considerably increased privacy awareness among both companies and data subjects across the EU. However, the adverse effects of the GDPR on competition and innovation in certain digital industries should not be ignored. From a policy standpoint, the Commission, as well as the authorities that are entrusted with the enforcement of the GDPR should aim at maintaining or even perhaps increasing the level of protection offered by this legislation, while at the same time trying to mitigate its adverse effects on other dimensions of welfare, such as competition, which are equally important for both businesses and consumers. It is with this objective in mind that the present paper offers various solutions that could be explored to ensure a better balance between privacy and these other welfare dimensions.

Survival Trends Post Cardiac Transplantation: A Comparative Analysis of Irish and International Data (1985-2019)

To determine overall survival outcomes and outcomes according to gender and era of transplantation, for cardiac transplant recipients in the Republic of Ireland and compare these against international published registry data. A retrospective registry was created of all heart transplants performed in the National Heart and Lung Transplant Centre, Dublin between 1985 and 2019. Kaplan Meier analysis and log rank comparison testing were performed for overall mortality as well as subgroup analyses. This data was then compared to international figures published annually by the ISHLT. Overall survival: Median survival was 13.27 years in comparison to 10.9 years internationally over a similar time period. Gender differences: 22.4% of transplants were in females. Median survival in males was 13.9 years and 12.07 years in females (p=0.028). Internationally, median survival was 10.7 years for males and 11.7 years for females. Decade transplanted: Median survival increased from 10.25 years for transplants performed in the 1980s to 15.03 years for those performed 2000-2009 (p=0.034) with survival curves suggesting improved survival for those transplanted after 2010. This compares favourably to ISHLT data: 10.5 years (1992-2001) and 12.4 years (2002-2008). One year survival: This increased from 69.5% for transplants performed in the 1980s, 78% for 1990-1999; 81% for 2000-2009 and 89% for 2010-2019. Conditional on survival to 1 year: Overall median survival was 16.07 years. This has increased from 12.9 years for transplants performed in the 1980s to 18.27 years for those performed 2000-2009 (p=0.069). Survival rates post cardiac transplantation in the Republic of Ireland have increased significantly from the beginning of the program in 1985 and compare favourably to international registry data. Based on data since 2000, 1 year survival is now 89%; median survival is at least 15 years and conditional on surviving to 1 year, median survival is at least 18.27 years.