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1.
Midwifery ; 132: 103987, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38599130

RESUMO

INTRODUCTION: Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. METHODS: A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. RESULTS: Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed. DISCUSSION: This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.


Assuntos
Pessoal de Saúde , Musicoterapia , Assistência Perinatal , Humanos , Irlanda , Estudos Transversais , Inquéritos e Questionários , Adulto , Assistência Perinatal/métodos , Assistência Perinatal/normas , Assistência Perinatal/estatística & dados numéricos , Feminino , Musicoterapia/métodos , Musicoterapia/normas , Musicoterapia/estatística & dados numéricos , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Gravidez , Pessoa de Meia-Idade , Masculino , Atitude do Pessoal de Saúde
2.
Int Breastfeed J ; 19(1): 13, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38373983

RESUMO

BACKGROUND: Despite concerted efforts by policy developers, health professionals and lay groups, breastfeeding rates in Ireland remain one of the lowest in world, with 63.6% of mothers initiating breastfeeding at birth, dropping to 37.6% of mothers breastfeeding exclusively on hospital discharge. Nipple trauma and difficulties with baby latching are major contributors to the introduction of formula and discontinuation of breastfeeding. Research shows laid-back breastfeeding (LBBF) significantly reduces breast problems such as sore and cracked nipples, engorgement, and mastitis as well as facilitating a better latch. Although the benefits of LBBF are well documented, this position does not seem to be routinely suggested to mothers as an option when establishing breastfeeding. This study aims to determine midwives' and student midwives' knowledge, attitudes, and practices of using laid-back breastfeeding in Ireland. METHOD: A cross-sectional descriptive survey distributed to midwives and student midwives in three maternity hospitals in Ireland and two online midwifery groups based in the Republic of Ireland, during June, July, and August 2021. RESULTS: Two hundred and fifty-three valid responses were received from nine maternity units. Most participants (81.4%) were aware of laid-back breastfeeding. However, only 6.8% of respondents cited it as the position they most frequently use. Over one-third (38.34%) had never used this position with mothers. Those more likely to suggest LBBF had personal experience of it, were lactation consultants or working towards qualification, or had participated in specific education about LBBF. Barriers included lack of education, confidence, time, and experience. Further issues related to work culture, a tendency to continue using more familiar positions and concerns about mothers' anatomy and mothers' unfamiliarity with LBBF. CONCLUSION: Although there was a high level of awareness of laid-back breastfeeding among midwives and student midwives, there are challenges preventing its use in practice. Education specifically related to using LBBF in practice is required to overcome the barriers identified. A greater understanding of mothers' and babies' intrinsic feeding capacities may give midwives more confidence to recommend this method as a first choice, potentially leading to more successful breastfeeding establishment and maintenance.


Assuntos
Aleitamento Materno , Tocologia , Lactente , Recém-Nascido , Feminino , Humanos , Gravidez , Aleitamento Materno/métodos , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Irlanda , Estudantes
3.
Sci Rep ; 14(1): 2523, 2024 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360880

RESUMO

In 1843, a hitherto unknown plant pathogen entered the US and spread to potato fields in the northeast. By 1845, the pathogen had reached Ireland leading to devastating famine. Questions arose immediately about the source of the outbreaks and how the disease should be managed. The pathogen, now known as Phytophthora infestans, still continues to threaten food security globally. A wealth of untapped knowledge exists in both archival and modern documents, but is not readily available because the details are hidden in descriptive text. In this work, we (1) used text analytics of unstructured historical reports (1843-1845) to map US late blight outbreaks; (2) characterized theories on the source of the pathogen and remedies for control; and (3) created modern late blight intensity maps using Twitter feeds. The disease spread from 5 to 17 states and provinces in the US and Canada between 1843 and 1845. Crop losses, Andean sources of the pathogen, possible causes and potential treatments were discussed. Modern disease discussion on Twitter included near-global coverage and local disease observations. Topic modeling revealed general disease information, published research, and outbreak locations. The tools described will help researchers explore and map unstructured text to track and visualize pandemics.


Assuntos
Phytophthora infestans , Solanum tuberosum , Humanos , Doenças das Plantas , Surtos de Doenças , Irlanda
4.
Water Res ; 252: 121182, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38290238

RESUMO

Evapotranspiration is a key hydrological process for reducing stormwater runoff in bioretention systems, regardless of their physical configuration. Understanding the volumes of stormwater that can be returned to the atmosphere via evapotranspiration is, therefore, a key consideration in the design of any bioretention system. This study establishes the evapotranspiration dynamics of three common, structurally different, bioretention vegetation treatments (an Amenity Grass mix, and mono-cultures of Deschampsia cespitosa and Iris sibirica) compared with an un-vegetated control using lab-scale column experiments. Via continuous mass and moisture loss data, observed evapotranspiration rates were compared with those predicted by the FAO-56 Penman-Monteith model for five 14-day dry periods during Spring 2021, Summer 2021, and Spring 2022. Soil moisture reductions over the 14-day trials led to reduced rates of evapotranspiration. This necessitated the use of a soil moisture extraction function alongside a crop coefficient to represent actual evapotranspiration from FAO-56 Penman-Monteith reference evapotranspiration estimates. Crop coefficients (Kc) varied between 0.65 and 2.91, with a value of 1.0 identified as a recommended default value in the absence of treatment-specific empirical data. A continuous hydrological model with Kc=1.0 and a loading ratio of 10:1 showed that evapotranspiration could account for between 1 and 12% of the annual water budget for a bioretention system located in the UK and Ireland, increasing to a maximum of 35% when using the highest Kc observed (2.91).


Assuntos
Desidratação , Solo , Humanos , Estações do Ano , Hidrologia , Irlanda , Chuva
5.
Ir J Med Sci ; 193(2): 1061-1071, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37864675

RESUMO

OBJECTIVE: Identify the impact of COVID-19 lockdown restrictions on the vitamin D status of individuals in the west of Ireland. DESIGN: Cross-sectional study. SETTING: Adults who had wintertime serum 25(OH)D analysis completed in Galway University Hospital. PARTICIPANTS: A total of 16,725 participants (2015-2020 (n = 13,449) and 2020-2021 (n = 3276)). Baseline demographics; sex, age, origin of the sample and the date of sample collection. RESULTS: Median serum vitamin D and serum vitamin D3 concentrations were higher in the 5-month period from October-February 2020-2021 (61 nmol/L (± 36-85 nmol/L) and 60 nmol/L (± 34-85 nmol/L)) respectively, than for the corresponding 5-month period (October-February) in 2015-2020 (53 nmol/L (± 32-78 nmol/L) and 51 nmol/L (± 30-77 nmol/L)) respectively. These changes coincided with a decline in the prevalence of deficiency. In the 5-month period October-February 2020-2021, 19.2% of the population were vitamin D deficient (< 30 nmol/L) compared to 22.5% in the corresponding 5-month period in 2015-2020, and 38.1% were vitamin D deficient (< 50 nmol/L) in the 5-month period October-February 2020-2021 compared to 46.6% in the corresponding 5-month period in 2015-2020. Males were more likely to be deficient at both thresholds (p < 0.001). For the total cohort, at the < 30 nmol/L threshold, inpatients (25.5%) and nursing home residents (34.1%) had higher prevalence of deficiency. CONCLUSIONS: Vitamin D levels were higher in the 5-month period of October-February 2020-2021, and this precipitated a decline in deficiency at both thresholds, indicating that lockdown coincided with enhanced vitamin D status. We postulate that it may be attributable to changes in diet and/or supplementation, or increased sun exposure, but further confirmatory studies are required.


Assuntos
COVID-19 , Deficiência de Vitamina D , Masculino , Adulto , Humanos , Vitamina D , Irlanda/epidemiologia , Estudos Transversais , Deficiência de Vitamina D/epidemiologia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Suplementos Nutricionais
6.
Midwifery ; 127: 103861, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37948792

RESUMO

OBJECTIVE: To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme. DESIGN: A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated. SETTING AND PARTICIPANTS: To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study. FINDINGS: Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.


Assuntos
COVID-19 , Internato e Residência , Tocologia , Estudantes de Enfermagem , Gravidez , Feminino , Humanos , Tocologia/educação , Irlanda , Pandemias , Pesquisa Qualitativa , Estudantes
7.
Torture ; 33(2): 133-150, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37589070

RESUMO

INTRODUCTION: Befriending is one of the rehabilitative services embedded in the holistic approach adopted by Spirasi, the Irish National Centre for the Rehabilitation of Survivors of Torture. Their befriending programme offers survivors one-to-one companionship from trained volunteer befrienders. The literature suggests that befriending programmes can improve quality of life, provide emotional support and combat loneliness. However, there is little empirical research of the effectiveness of befriending programmes for torture survivors. OBJECTIVE: The main objective was to explore, in complementary ways, the impact of the Spirasi befriending programme on befrienders and befriendees and to incorporate their voices into recommendations for optimising the service. METHODS: The methodology consisted of five focus groups (two with befriendees, two with befrienders and one with both) and a portrait workshop facilitated by two community artists, where each befriending pair member created a portrait of their partner to express and visually explore the befriending relationship. Data comprised the focus group transcripts and written feedback on the portrait-creation process. RESULTS: The themes identified in both data sets firmly ground the befriending programme in Spirasi's holistic approach to recovery. For the focus group participants, befriending promotes integration; models trusting, kind and reciprocal relationships; combats loneliness and protects against suicide. They also highlighted the importance of regular befriender training, increasing the programme's reach and developing a befriender community of practice. The portrait workshop was found to strengthen relationships and provide a context of normality, acceptance and shared humanity through compassionate and creative exchanges. CONCLUSIONS: This paper highlights the benefits of the befriending programme within Spirasi's holistic approach and the importance of collaborative expressive arts activities in building befriending relationships. It provides recommendations for good befriending practice which are relevant to all organisations working with survivors of torture as well as those working with people seeking international protection more broadly.


Assuntos
Qualidade de Vida , Tortura , Humanos , Irlanda , Ciências Humanas , Sobreviventes
8.
Surgeon ; 21(6): e346-e351, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37330306

RESUMO

BACKGROUND: Lower urinary tract symptoms due to an enlarged prostate is a common condition. Transurethral resection of the prostate gland (TURP) has been the gold standard treatment. The objective of this study was to assess the trends in the prevalence of TURP procedures in Irish public hospitals within the period of 2005-2021. In addition, we explore the attitudes and practices of urologist in Ireland on this topic. METHODS: An analysis using the Hospital In-Patient Enquiry (HIPE) system using code 37203-00 was undertaken. 16,176 discharges contained the code of interest and had undergone a TURP procedure. The data from this cohort was further analysed. In addition, members of the Irish Society of Urology undertook a bespoke questionnaire to understand the TURP surgery practices. RESULTS: There has been a substantial decline in the prevalence of TURP procedures in Irish public hospitals from 2005 to 2021. The number of patients discharged from Irish hospitals with a TURP procedure was 66% less in 2021 compared to 2005. 75% (n = 36) of urologist surveyed felt that the declining TURP numbers were due to lack of resources, access to theatre/inpatient beds and outsourcing. 91.5% (n = 43) felt that the declining TURP numbers would result in a lack of training opportunities for trainees, 83% (39) felt this has increased morbidity for patients. CONCLUSIONS: TURP procedures in Irish public hospitals has declined over the 16-year period studied. This decline is a concern for patient morbidity and urology training.


Assuntos
Hiperplasia Prostática , Ressecção Transuretral da Próstata , Masculino , Humanos , Próstata/cirurgia , Ressecção Transuretral da Próstata/métodos , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Hospitais Públicos , Irlanda/epidemiologia , Resultado do Tratamento
9.
Sex Reprod Health Matters ; 31(1): 2216526, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37335387

RESUMO

The aim of this study was to explore service providers' lived experiences with abortion care in the Republic of Ireland following liberalisation in 2018 via public referendum. Data were collected using semi-structured interviews conducted between February 2020 and March 2021. Thirteen interviews were completed with providers who were directly involved in caring for patients accessing liberalised abortion care in the Republic of Ireland. The sample includes six general practitioners, three midwives, two obstetricians, and two nurses. Interpretative phenomenological analysis identified five super-ordinate themes in the providers' lived experiences: (1) public reactions to liberalised abortion care; (2) lessons from the service implementation; (3) getting involved in abortion care; (4) moments of moral doubt; and (5) remaining committed to the provision of care. Following liberalisation, providers recalled isolated experiences with anti-abortion sentiments, particularly from those who continue to oppose abortion care. They believed that implementation has been mostly successful in delivering a safe, robust, and accessible service in general practice, though identified ongoing challenges in Irish hospitals. Personally, the providers supported access to care and began providing because they perceived a duty to facilitate access to care. Many, however, reported occasional moral doubts about their work. Despite these, none had considered leaving abortion care and all were proud of their work. They said that patients' stories were a constant reminder about the importance of safe abortion care. Further work is required to ensure that abortion is fully integrated and normalised and that all providers and patients have access to supports.


Assuntos
Aborto Induzido , Tocologia , Gravidez , Feminino , Humanos , Irlanda , Atitude do Pessoal de Saúde , Pesquisa Qualitativa
10.
Proc Nutr Soc ; 82(2): 91-103, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37139629

RESUMO

Over 30 years ago it was proven beyond doubt that folic acid supplementation of mothers in early pregnancy protects against neural tube defects (NTD) in their babies. Such conclusive scientific evidence led to clear recommendations for women worldwide to take 0⋅4 mg/d folic acid before conceiving and in early pregnancy, but implementing these into effective policy has been problematic. As a result, there has been no change in the incidence of NTD in Ireland, the UK or any other European country over the 25-year period that the current strategy, recommending periconceptional folic acid supplements to women, has been in place. Thus preventable NTD are not being prevented. Notably, in September 2021, the UK government announced that starch is to be fortified with folic acid on a mandatory basis. A similar decision is now urgently needed in Ireland, where rates of NTD are among the highest in the world. A policy of mandatory folic acid fortification of food would be highly effective in preventing NTD because it reaches all women, including those who have not planned their pregnancy. International evidence shows that wherever such a policy has been introduced, it has proved to be effective in reducing rates of NTD in that country. Apart from preventing NTD, the driver of policy in the area, other potential health benefits across the lifecycle can be anticipated from folic acid fortification. Urgent action is needed on implementation of mandatory food fortification with folic acid in Ireland so that mothers and their babies can benefit.


Assuntos
Ácido Fólico , Defeitos do Tubo Neural , Gravidez , Humanos , Feminino , Alimentos Fortificados , Irlanda/epidemiologia , Defeitos do Tubo Neural/prevenção & controle , Defeitos do Tubo Neural/epidemiologia , Suplementos Nutricionais
11.
Front Public Health ; 11: 1088728, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36908402

RESUMO

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Background: COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opportunities for health system change that have arisen during the pandemic is still emerging and largely descriptive. This research is situated in the Irish health reform context of Sláintecare, the reform programme which aims to deliver universal healthcare by strengthening public health, primary and community healthcare functions as well as tackling system and societal health inequities. Aims and objectives: This study set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation. Methods: The study, which is qualitative, was underpinned by a co-production approach with Irish health system leadership. Semi-structured interviews were conducted with sixteen health system professionals (including managers and frontline workers) from a range of responses to explore their experiences and interpretations of social processes of change that enabled (or hindered) better access to universal integrated care during the pandemic. A complexity-informed approach was mobilized to theorize the processes that impacted on access to universal, integrated care in Ireland in the COVID-19 context. Findings: A range of circumstances, strategies and mechanisms that created favorable system conditions in which new integrated care trajectories emerged during the crisis. Three key learnings from the pandemic response are presented: (1) nurturing whole-system thinking through a clear, common goal and shared information base; (2) harnessing, sharing and supporting innovation; and (3) prioritizing trust and relationship-building in a social, human-centered health system. Policy and practice implications for health reform are discussed.


Assuntos
COVID-19 , Prestação Integrada de Cuidados de Saúde , Humanos , Reforma dos Serviços de Saúde , Pandemias , Irlanda
12.
Rural Remote Health ; 23(1): 8162, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36802704

RESUMO

INTRODUCTION: Since the outset of COVID-19, we have become more reliant on technology to stay connected to others. Notable benefits of telehealth have been observed, including increased access to health and community support services for community dwelling people living with dementia and their family caregivers and diminishing barriers such as geographical location, mobility issues and increased cognitive decline. Music therapy is an evidence-based intervention for people living with dementia and has been proven to promote improved quality of life, increase social interaction and provide a form of meaningful communication and expression when language becomes difficult. This project is one of the first internationally to pilot telehealth music therapy for this population. METHODS: This mixed methods action research project has six iterative phases of planning, research, action, evaluation, and monitoring. Public and Patient Involvement (PPI) has been sought from members of The Dementia Research Advisory Team at the Alzheimer Society of Ireland at all stages of the research process to ensure the research remains relevant and applicable to those with dementia. The presentation will briefly outline the phases of the project. RESULTS: Preliminary results from this ongoing research suggest that there is feasibility for telehealth music therapy to provide psychosocial support to this population. Collaboration with PPI contributors resulted in the following research priorities: (1) ensuring a person-centered approach; (2) advanced care planning using music; and (3) the signposting of music related supports for community dwelling people living with dementia. Music therapy is being piloted currently and preliminary results will be outlined. DISCUSSION: Telehealth music therapy has the potential to complement existing rural health and community services for people living with dementia, in particular addressing social isolation. Recommendations regarding the relevance of cultural and leisure pursuits on health and well-being of people living with dementia will be discussed, particularly the development of online access.


Assuntos
COVID-19 , Demência , Musicoterapia , Música , Telemedicina , Humanos , Cuidadores/psicologia , Demência/terapia , Demência/psicologia , Vida Independente , Qualidade de Vida , Irlanda
13.
Women Birth ; 36(4): e445-e452, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36804152

RESUMO

PROBLEM: Internationally, little is known about the experiences of the minority who have birthed both in hospital and at home. This group are in a unique position to provide experiential evidence regarding perceptions of care under each approach. BACKGROUND: Obstetric care within the hospital setting is the hegemonic approach to birth in western cultures. Homebirth is at least as safe as hospital birth for those with low-risk pregnancies, yet access is strictly regulated. AIM: To explore how those who have experienced both hospital and homebirth maternity care in Ireland perceived the care received, and experienced birth in each setting. METHODS: 141 participants who birthed both in hospital and at home between 2011 and 2021 completed an online survey. FINDINGS: Participants' overall experience scores were significantly higher for homebirth (9.7/10) than hospital birth (5.5/10). In hospital, midwifery-led care scored significantly higher (6.4/10) than consultant-led care (4.9/10). Qualitative data revealed four explanatory themes: 1) Regulation of birth; 2) Continuity of care and/or carer and establishing relationships; 3) Bodily integrity and informed consent; and 4) Lived experiences of labour and birth at home and in hospital. DISCUSSION: Homebirth was perceived far more positively than hospital birth experiences across all aspects of care surveyed. Findings suggest that those who have experienced both models of care have unique perspectives and aspirations about childbirth. CONCLUSION: This study provides evidence regarding the need for genuine choices for maternity care and reveals the importance of care which is respectful and responsive to divergent ideologies about birth.


Assuntos
Parto Domiciliar , Serviços de Saúde Materna , Tocologia , Gravidez , Feminino , Humanos , Irlanda , Parto , Hospitais
14.
PLoS One ; 18(1): e0279556, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36701403

RESUMO

The power harnessed by cattle traction was undeniably a valuable asset to Neolithic communities. However, data are still lacking on the timing, purposes, and intensity of exploitation of draught animals. This paper sheds new light on a region of Europe-Neolithic Ireland-for which our knowledge is particularly restricted as evidence from both Ireland and Britain in this period has been so far patchy and inconclusive. Using a suite of methods and refined criteria for traction identification, we present new and robust data on a large faunal assemblage from Kilshane, Co. Dublin that strongly support cattle traction in the middle 4th millennium BC in Ireland. Bone pathology data combined with osteometric analysis highlight specialised husbandry practices, producing large males, possibly oxen, for the purpose of cattle traction. This new technology has important implications for early agriculture in the region since it provides a key support for more extensive land management practices as well as for megalithic construction, which increased considerably in scale during this period. We argue that access to draught animals and the exploitation of associated resources were at the heart of wider changes that took place in Neolithic Ireland in the second half of the 4th millennium BC.


Assuntos
Agricultura , Tração , Masculino , Animais , Bovinos , História Antiga , Irlanda , Europa (Continente) , Osso e Ossos , Arqueologia
15.
Nurse Educ Pract ; 67: 103554, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36708639

RESUMO

AIM: The purpose of this study was to identify the current LGBTQ+ health content within midwifery pre-registration programmes and identity education best practice and innovation. BACKGROUND: There have been significant developments in some countries in protecting the rights of LGBTQ+ people. LGBTQ+ people are and do become parents and require access to maternity services. Yet some report heteronormative assumptions, negative and discriminatory attitudes from midwives that results in barriers to service access and feelings of exclusion. DESIGN: This mixed-methods study involved a quantitative and qualitative design. The qualitative findings are reported here. METHODS: All 135 Schools of Nursing and Midwifery across the United Kingdom and Ireland were invited to participate in an online survey and qualitative interview. Thematic analysis of the qualitative data from 29 survey responses and seven midwifery follow-up interviews were conducted. RESULTS: Three themes identified following data analysis: (i) preparing midwifery students for practice; (ii) the diverse family unit; and (iii) safety, privacy and respect. CONCLUSIONS: The findings provide insights into the challenges of meeting the education needs of midwifery students, with an opportunity to develop and implement a curriculum that is reflective of the needs and concerns of LGBTQ+ people within pre-registration midwifery programmes.


Assuntos
Tocologia , Minorias Sexuais e de Gênero , Estudantes de Enfermagem , Humanos , Feminino , Gravidez , Tocologia/educação , Irlanda , Reino Unido , Educação em Saúde , Pesquisa Qualitativa
16.
Ir J Med Sci ; 192(4): 1835-1845, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36224463

RESUMO

BACKGROUND: In humans, zinc is involved in many biological functions acting as signaling ion, neurotransmitter, structural component of proteins, and cofactor for many enzymes and, through this, is an important regulator of the immune and nervous system. Food supplies zinc to the human body, but a high prevalence of inadequate dietary zinc intake has been reported worldwide. AIMS: The objective of this study was to investigate the zinc intake and bioavailability of over 250 women (pregnant and non-pregnant) based in Ireland, in order to evaluate the dietary inadequacy of zinc. METHODOLOGY: We used a food frequency questionnaire designed to assess the zinc intake and bioavailability of the participants. RESULTS: Our results show that 58% of participants are at risk of inadequate zinc intake and that 29% may be zinc deficient. The prevalence of inadequate zinc intake was lower for pregnant women (zinc deficient 9%, at risk 38%) than for non-pregnant women due to more frequent consumption of supplements. Low zinc intake was not correlated with the age of participants and resulted from a combination of inadequate intake of zinc-rich food and relatively higher intake of food items rich in phytate, a major zinc uptake inhibitor. CONCLUSIONS: We conclude that at present, low zinc intake may be prevalent in as much as 87% of women, including 47% of pregnant women. Therefore, zinc status needs to be considered as a factor impacting the health of women, and in particular pregnant women, also in industrialized and developed countries such as Ireland.


Assuntos
Desnutrição , Zinco , Feminino , Humanos , Zinco/análise , Prevalência , Irlanda/epidemiologia , Dieta , Estado Nutricional
17.
Br J Cancer ; 128(1): 42-47, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36347966

RESUMO

BACKGROUND: The management of colorectal peritoneal metastases continues to be a challenge but recent evidence suggests cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can improve survival. Uncertainty about the relationship between age and tumour biology makes patient selection challenging particularly when reported procedure related morbidity is high and impact on survival outcomes unknown. The UK and Ireland Colorectal Peritoneal Metastases Registry was reviewed to assess the influence of age on efficacy of CRS and HIPEC. METHODS: A review of outcomes from the UK and Ireland Colorectal Peritoneal Metastases Registry was performed. Data from 2000 to 2021 were included from five centres in the UK and Ireland, and the cohort were sub-divided into three age groups; <45 years, 45-65 years and >65 years old. Primarily, we examined post-operative morbidity and survival outcomes across the three age groups. In addition, we examined the impact that the completeness of cytoreduction, nodal status, or adverse pathological features had on long-term survival. RESULTS: During the study period, 1138 CPM patients underwent CRS HIPEC. 202 patients(17.8%) were <45 years, 549 patients(48.2%) aged 45-65 years and 387 patients(34%) >65 years. Overall, median length of surgery (CRS and HIPEC), median PCI score and rate of HIPEC administration was similar in all three groups, as was overall rates of major morbidity and/or mortality. Complete cytoreduction rates (CC0) were similar across the three cohorts; 77%, 80.6% and 81%, respectively. Median overall survival for all patients was 38 months following complete cytoreduction. CONCLUSION: Age did not appear to influence morbidity or long-term survival following CRS and HIPEC. When complete cytoreduction is achieved survival outcomes are good. The addition of HIPEC can be performed safely and may reduce local recurrence within the peritoneum.


Assuntos
Neoplasias Colorretais , Hipertermia Induzida , Intervenção Coronária Percutânea , Neoplasias Peritoneais , Humanos , Idoso , Peritônio/patologia , Neoplasias Peritoneais/secundário , Quimioterapia Intraperitoneal Hipertérmica , Procedimentos Cirúrgicos de Citorredução , Neoplasias Colorretais/patologia , Terapia Combinada , Irlanda/epidemiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Taxa de Sobrevida , Sistema de Registros , Reino Unido/epidemiologia , Estudos Retrospectivos
18.
Health Expect ; 26(1): 119-131, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36333948

RESUMO

BACKGROUND: Critical care bed capacity per capita in Ireland is among the lowest in Europe. The COVID-19 pandemic has put additional strain on an over-stretched healthcare system. COVID-19 community assessment hubs (CAHs) were established to prevent unnecessary admission to acute hospitals and to reduce infection spread. OBJECTIVE: The aim of this study was to assess the effectiveness and acceptability of CAHs and identify how the service might be improved or adapted for possible future use. DESIGN: This was a mixed methods study, incorporating co-design with clinical stakeholders. Data collection was via an online survey and semistructured telephone interviews with staff and patients conducted between January and May 2021. SETTING AND PARTICIPANTS: Thirty-one patients completed the survey and nine were interviewed. Twenty interviews were conducted with staff. RESULTS: The findings suggest that the CAH model was successful in providing a dedicated pathway for assessing patients with COVID-19 symptoms, whilst mitigating the risk of infection. Patients were particularly positive about the timely, comprehensive and holistic care they received, as well as the accessibility of the clinics and the friendly attitudes of the staff. Staff welcomed the training and clinical protocols which contributed to their feelings of safety and competency in delivering care to this cohort of patients. They also highlighted the benefits of working in a multidisciplinary environment. Both staff and patients felt that the hubs could be repurposed for alternative use, including the treatment of chronic diseases. DISCUSSION: This study describes staff and patients' experiences of these hubs. An unexpected outcome of this study is its demonstration of the true value of effective multidisciplinary working, not only for the staff who were deployed to this service but also for the patients in receipt of care in these hubs. CONCLUSION: This multidisciplinary patient-centred service may provide a useful model for the delivery of other services currently delivered in hospital settings. PATIENT OR PUBLIC CONTRIBUTION: An earlier phase of this study involved interviews with COVID-19-positive patients on a remote monitoring programme. The data informed this phase. Several of the authors had worked in the CAHs and provided valuable input into the design of the staff and patient interviews.


Assuntos
COVID-19 , Humanos , Irlanda , Pandemias , Atenção à Saúde , Pacientes
19.
J Interprof Care ; 37(3): 480-490, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35880753

RESUMO

Current evidence offers little guidance as to how interprofessional collaboration can be fostered within the context of integrated care and older people. This research describes the co-design of core competencies for interprofessional collaboration within integrated care teams for older people and the development of practical guidance to support teams in building proficiency. Using a co-design approach, we conducted three studies (co-design workshops, qualitative interviews, and an online validation forum), the combined output of which is a Core Competency Framework, that includes three domains describing six competencies for proficiency in interprofessional collaboration within integrated care of older people. Domain one, Knowledge of the Team, includes the competencies; understanding roles, and making referrals. Domain two, Communication, includes the competencies; sharing information and communicating effectively and Domain three, Shared Decision-making, includes the final two competencies; supporting decision making with older people and collective clinical decision-making. In presenting a formal understanding of the competencies for interprofessional collaboration in the integrated care of older people and practical guidance for developing proficiency, this framework provides direction for future health service workforce development.


Assuntos
Prestação Integrada de Cuidados de Saúde , Relações Interprofissionais , Humanos , Idoso , Irlanda , Comunicação , Equipe de Assistência ao Paciente , Comportamento Cooperativo
20.
Br J Nutr ; 129(11): 2011-2024, 2023 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-36047066

RESUMO

The childhood years represent a period of increased nutrient requirements during which a balanced diet is important to ensure optimal growth and development. The aim of this study was to examine food and nutrient intakes and compliance with recommendations in school-aged children in Ireland and to examine changes over time. Analyses were based on two National Children's Food Surveys; NCFS (2003-2004) (n 594) and NCFS II (2017-2018) (n 600) which estimated food and nutrient intakes in nationally representative samples of children (5-12 years) using weighed food records (NCFS: 7-d; NCFS II: 4-d). This study found that nutrient intakes among school-aged children in Ireland are generally in compliance with recommendations; however, this population group have higher intakes of saturated fat, free sugars and salt, and lower intakes of dietary fibre than recommended. Furthermore, significant proportions have inadequate intakes of vitamin D, Ca, Fe and folate. Some of the key dietary changes that have occurred since the NCFS (2003-2004) include decreased intakes of sugar-sweetened beverages, fruit juice, milk and potatoes, and increased intakes of wholemeal/brown bread, high-fibre ready-to-eat breakfast cereals, porridge, pasta and whole fruit. Future strategies to address the nutrient gaps identified among this population group could include the continued promotion of healthy food choices (including education around 'healthy' lifestyles and food marketing restrictions), improvements of the food supply through reformulation (fat, sugar, salt, dietary fibre), food fortification for micronutrients of concern (voluntary or mandatory) and/or nutritional supplement recommendations (for nutrients unlikely to be sufficient from food intake alone).


Assuntos
Dieta , Suplementos Nutricionais , Humanos , Criança , Irlanda , Ingestão de Alimentos , Fibras na Dieta , Inquéritos Nutricionais , Ingestão de Energia , Comportamento Alimentar
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