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1.
BMJ Open ; 11(4): e045590, 2021 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-33811055

RESUMO

AIMS: To evaluate temporal trends of acute coronary syndromes (ACS) treated via percutaneous coronary intervention (PCI) throughout the COVID-19 outbreak in a European healthcare system affected but not overwhelmed by COVID-19-related pathology. METHODS AND RESULTS: We performed a retrospective multicentre analysis of the rates of PCI for the treatment of ACS within the period 2 months pre and post the first confirmed COVID-19 case in Ireland, as well as comparing PCI for ST-elevation myocardial infarction (STEMI) with the corresponding period in 2019. During the 2020 COVID-19 period (29 February-30 April 2020), there was a 24% decline in PCI for overall ACS (incidence rate ratio (IRR) 0.76; 95% CI 0.65 to 0.88; p<0.001), including a 29% reduction in PCI for non-ST-elevation ACS (IRR 0.71; 95% CI 0.57 to 0.88; p=0.002) and an 18% reduction in PCI for STEMI (IRR 0.82; 95% CI 0.67 to 1.01; p=0.061), as compared with the 2020 pre-COVID-19 period (1 January-28 February 2020). A 22% (IRR 0.78; 95% CI 0.65 to 0.93; p=0.005) reduction of PCI for STEMI was seen as compared with the 2019 reference period. CONCLUSION: This study demonstrates a significant reduction in PCI procedures for the treatment of ACS since the COVID-19 outbreak in Ireland. The reasons for this decline are still unclear but patients need to be encouraged to seek medical attention when cardiac symptoms appear, in order to avoid incremental cardiac morbidity and mortality due to a reduction in coronary revascularisation for the treatment of ACS.


Assuntos
Síndrome Coronariana Aguda , Intervenção Coronária Percutânea/estatística & dados numéricos , Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/cirurgia , Assistência à Saúde , Humanos , Irlanda/epidemiologia , Pandemias , Estudos Retrospectivos , Resultado do Tratamento
2.
Open Heart ; 8(1)2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33731419

RESUMO

OBJECTIVES: CT coronary angiography (CTCA) is a well-validated clinical tool in the evaluation of chest pain. In our institution, CTCA availability was increased in January 2020, and subsequently, expanded further to replace all exercise testing during the COVID-19 pandemic. Our objective was to assess the impact of increased utilisation of CTCA on length of stay in patients presenting with chest pain in the prepandemic era and during the COVID-19 pandemic. METHODS: Study design was retrospective. Patients referred for cardiology review between October 2019 and May 2020 with chest pain and/or dyspnoea were broken into three cohorts: a baseline cohort, a cohort with increased CTCA availability and a cohort with increased CTCA availability, but after the national lockdown due to COVID-19. Coronary angiography and revascularisation, length of stay and 30-day adverse outcomes were assessed. RESULTS: 513 patients (35.3% female) presented over cohorts 1 (n=179), 2 (n=182), and 3 (n=153). CTCA use increased from 7.8% overall in cohort 1% to 20.4% in cohort 3. Overall length of stay for the patients undergoing CTCA decreased from a median of 4.2 days in cohort 1 to 2.5 days in cohort 3, with no increase in 30 days adverse outcomes. Invasive coronary angiogram rates were 45.8%, 39% and 34.2% across the cohorts. 29.6% underwent revascularisation in cohort 1, 15.9% in cohort 2 and to 16.4% in cohort 3. CONCLUSIONS: Increased CTCA availability was associated with a significantly reduced length of stay both pre-COVID-19 and post-COVID-19 lockdown, without any increase in 30-day adverse outcomes.


Assuntos
Dor Aguda/diagnóstico , Dor no Peito/diagnóstico , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Serviço Hospitalar de Emergência , Pacientes Internados , Dor Aguda/epidemiologia , Idoso , Dor no Peito/epidemiologia , Feminino , Seguimentos , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos
3.
Artigo em Inglês | MEDLINE | ID: mdl-33669828

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March-May 2020). Doctors were interviewed via Zoom™ or telephone. Interview transcripts were analyzed using structured thematic analysis. Five composite narratives are presented which have been crafted to illustrate themes and experiences emerging from the data. This study found that despite the risks of contracting COVID-19, many doctors saw some improvements to their physical well-being in the first wave of the pandemic. However, most also experienced a decline in their mental well-being due to anxiety, emotional exhaustion, guilt, isolation and poor support. These findings shed light on doctor well-being during COVID-19, and the ways in which they have been affected by the pandemic, both professionally and personally. The paper concludes by highlighting how doctors' work life and well-being can be better supported during and after the COVID-19 pandemic.


Assuntos
Pandemias , Médicos/psicologia , Feminino , Nível de Saúde , Hospitais , Humanos , Irlanda/epidemiologia , Masculino , Saúde Mental
4.
Bone Joint J ; 103-B(3): 469-478, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641419

RESUMO

AIMS: To develop and externally validate a parsimonious statistical prediction model of 90-day mortality after elective total hip arthroplasty (THA), and to provide a web calculator for clinical usage. METHODS: We included 53,099 patients with cemented THA due to osteoarthritis from the Swedish Hip Arthroplasty Registry for model derivation and internal validation, as well as 125,428 patients from England and Wales recorded in the National Joint Register for England, Wales, Northern Ireland, the Isle of Man, and the States of Guernsey (NJR) for external model validation. A model was developed using a bootstrap ranking procedure with a least absolute shrinkage and selection operator (LASSO) logistic regression model combined with piecewise linear regression. Discriminative ability was evaluated by the area under the receiver operating characteristic curve (AUC). Calibration belt plots were used to assess model calibration. RESULTS: A main effects model combining age, sex, American Society for Anesthesiologists (ASA) class, the presence of cancer, diseases of the central nervous system, kidney disease, and diagnosed obesity had good discrimination, both internally (AUC = 0.78, 95% confidence interval (CI) 0.75 to 0.81) and externally (AUC = 0.75, 95% CI 0.73 to 0.76). This model was superior to traditional models based on the Charlson (AUC = 0.66, 95% CI 0.62 to 0.70) and Elixhauser (AUC = 0.64, 95% CI 0.59 to 0.68) comorbidity indices. The model was well calibrated for predicted probabilities up to 5%. CONCLUSION: We developed a parsimonious model that may facilitate individualized risk assessment prior to one of the most common surgical interventions. We have published a web calculator to aid clinical decision-making. Cite this article: Bone Joint J 2021;103-B(3):469-478.


Assuntos
Artroplastia de Quadril/mortalidade , Modelos Estatísticos , Mortalidade/tendências , Osteoartrite do Quadril/cirurgia , Complicações Pós-Operatórias/mortalidade , Medição de Risco/métodos , Fatores Etários , Tomada de Decisão Compartilhada , Inglaterra/epidemiologia , Feminino , Humanos , Internet , Irlanda/epidemiologia , Masculino , Valor Preditivo dos Testes , Sistema de Registros , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , País de Gales/epidemiologia
5.
BMJ Open ; 11(3): e046872, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658262

RESUMO

OBJECTIVES: To investigate the experiences and views of practitioners in the UK and Ireland concerning changes in bereavement care during the COVID-19 pandemic. DESIGN: Online survey using a snowball sampling approach. SETTING: Practitioners working in hospitals, hospices, care homes and community settings across the UK and Ireland. PARTICIPANTS: Health and social care professionals involved in bereavement support. INTERVENTIONS: Brief online survey distributed widely across health and social care organisations. RESULTS: 805 respondents working in hospice, community, and hospital settings across the UK and Ireland completed the survey between 3 August and 4 September 2020. Changes to bereavement care practice were reported in: the use of telephone, video and other forms of remote support (90%); supporting people bereaved from non-COVID conditions (76%), from COVID-19 (65%) and people bereaved before the pandemic (61%); funeral arrangements (61%); identifying bereaved people who might need support (56%); managing complex forms of grief (48%) and access to specialist services (41%). Free-text responses demonstrated the complexities and scale of the impact on health and social care services, practitioners and their relationships with bereaved families, and on bereaved people. CONCLUSIONS: The pandemic has created major challenges for the support of bereaved people: increased needs for bereavement care, transition to remote forms of support and the stresses experienced by practitioners, among others. The extent to which services are able to adapt, meet the escalating level of need and help to prevent a 'tsunami of grief' remains to be seen. The pandemic has highlighted the need for bereavement care to be considered an integral part of health and social care provision.


Assuntos
Luto , Cuidados Paliativos na Terminalidade da Vida , Pandemias , Apoio Social , Humanos , Irlanda/epidemiologia , Inquéritos e Questionários , Reino Unido/epidemiologia
6.
Eur J Health Law ; 28(1): 81-101, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33652383

RESUMO

This article reflects on COVID-19 restrictions imposed on elders in Ireland through the lens of the right to private and family life (Article 8 ECHR), focusing on stay at home orders and recommendations advising elders to avoid social contact. Furthermore, we examine restrictions on visiting nursing homes given the high death toll in that setting. In our analysis, we zero in on the principles of foreseeability and proportionality, highlighting areas of concern and aspects that we submit should be considered in a proportionality assessment. Ultimately, we argue that it is a mistake to view the COVID-19 pandemic solely as an emergency. In this manner, the solutions suggested through the law - restrictions on movement and visitation bans - are too narrow and fail to address the underlying structures, such as, issues in the healthcare system, the limited home help for elderly and poor conditions in nursing homes.


Assuntos
/prevenção & controle , Surtos de Doenças/legislação & jurisprudência , Família , Isolamento de Pacientes/legislação & jurisprudência , Privacidade , Visitas a Pacientes/legislação & jurisprudência , Idoso , Instituição de Longa Permanência para Idosos/normas , Humanos , Irlanda/epidemiologia , Casas de Saúde/normas
8.
Artigo em Inglês | MEDLINE | ID: mdl-33504101

RESUMO

Mitigating the adverse physical health risks associated with COVID-19 has been a priority of public health incentives. Less attention has been placed on understanding the psychological factors related to the global pandemic, especially among vulnerable populations. This qualitative study sought to understand the experiences of children and adolescents during COVID-19. This study interviewed 48 families during the COVID-19 pandemic restrictions, and a national lockdown, to understand its impacts. The study used an Interpretative Phenomenological Analysis (IPA) methodology. Parents and children discussed the negative impact of the restrictions on young people's wellbeing. Children and adolescents experienced adverse mental health effects, including feelings of social isolation, depression, anxiety, and increases in maladaptive behaviour. Families with children with Autism Spectrum Disorders reported increased mental health difficulties during this period mostly due to changes to routine. The findings highlight the impact of severe restrictions on vulnerable populations' wellbeing and mental health outcomes, including children, adolescents, and those with Autism spectrum disorder (ASD).


Assuntos
/psicologia , Saúde Mental , Pandemias , Adolescente , Saúde do Adolescente , Transtorno do Espectro Autista/psicologia , Criança , Saúde da Criança , Controle de Doenças Transmissíveis , Humanos , Irlanda/epidemiologia , Populações Vulneráveis
9.
Artigo em Inglês | MEDLINE | ID: mdl-33466304

RESUMO

E-cigarette-only use and dual-use are emerging behaviours among adolescent nicotine product users which have not yet been sufficiently explored. This study examines the prevalence of, and the factors associated with, nicotine product use in adolescence. The study is a cross-sectional analysis of the 2018 Planet Youth survey completed by 15-16 year olds in the West of Ireland in 2018. The outcome of interest was current nicotine product use, defined as use at least once in the past 30 days. A main effects multinomial logistic regression model was used to examine the association between potential risk and protective factors and nicotine product use. Among 4422 adolescents 22.1% were current nicotine product users, consisting of 5.1% e-cigarette only users, 7.7% conventional cigarette only users, and 9.3% dual-users. For risk factors, the odds of association were weaker for e-cigarette only use compared to conventional cigarette and dual use. Participating in team sport four times/week or more significantly reduced the odds of conventional cigarette and dual use but had no association with e-cigarette only use (Cig: adjusted odds ratio (AOR) 0.63, 95% confidence interval (CI) 0.44-0.90; Dual-use: AOR 0.63, 95% CI 0.43-0.93). Similarly, having higher value for conventional social norms reduced the odds of conventional cigarette and dual use but not e-cigarette only use. This is the first study to show, among a generalisable sample, that dual-use is the most prevalent behaviour among adolescent nicotine product users in Ireland. Risk factor profiles differ across categories of use and prevention initiatives must be cognisant of this.


Assuntos
Fumar Cigarros/epidemiologia , Vaping/epidemiologia , Adolescente , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Irlanda/epidemiologia , Masculino
10.
Zoonoses Public Health ; 68(2): 121-130, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33428331

RESUMO

The aim of this work was the establishment of a national laboratory sentinel surveillance service for human clinical Campylobacter in Ireland. This included detailed genomic molecular epidemiology of Campylobacter for 2019. For February-December 2019, 24 clinical microbiology laboratories in Ireland submitted all PCR/culture-positive clinical Campylobacter spp. specimens to Public Health Laboratory (PHL) Dublin one week out of every four. Antimicrobial susceptibility testing (AST) according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria was carried out for Campylobacter spp. isolates for ciprofloxacin, tetracycline and erythromycin. Batch whole genome sequencing (WGS) was carried out on cultures and analysis was performed to determine species, genotype, identify antimicrobial resistance (AMR) and virulence determinants and identify clusters. A total of 75 isolates and 366 PCR-positive stools were received, and 277 isolates recovered (55.7% recovery from stools). Of 257 isolates characterized by WGS, 86.4% (n = 222) were Campylobacter jejuni, 11.7% (n = 30) Campylobacter coli and 1.9% (n = 5) Campylobacter lari. There were 20 clonal complexes with ST-21 clonal complex most prevalent at 26.8% (n = 69). 50.5% (n = 140) of isolates were susceptible to all three antimicrobials tested. 39.3% (n = 109) isolates were ciprofloxacin resistant, 26.3% (n = 73) tetracycline resistant and two isolates erythromycin resistant. Congruence between phenotypic and genotypic AST was observed. There was 95.9% and 95.6% sensitivity and specificity for WGS to predict ciprofloxacin sensitivity and 98.6% and 99.5% sensitivity and specificity for WGS to predict tetracycline sensitivity. Virulence factors flaA, racR, ciaB and cdtB were detected in all isolates. WGS identified 31 potential clusters for public health alert. This sentinel surveillance of human campylobacteriosis in Ireland establishes the basis for a national reference service. Linking with other partners in a 'One Health' framework will help us better understand sources of infection to reduce disease burden and the threat of AMR.


Assuntos
Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Campylobacter/isolamento & purificação , Vigilância de Evento Sentinela , Antibacterianos/farmacologia , Campylobacter/efeitos dos fármacos , Campylobacter/genética , Análise por Conglomerados , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Farmacorresistência Bacteriana , Regulação Bacteriana da Expressão Gênica , Genoma Bacteriano , Genótipo , Humanos , Irlanda/epidemiologia , Fatores de Virulência/genética , Fatores de Virulência/metabolismo , Sequenciamento Completo do Genoma
11.
Phys Ther Sport ; 48: 83-90, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33395617

RESUMO

OBJECTIVES: The aim of this study was to describe the self-reported injury, training, and running technique choices of regular runners in four international regions. DESIGN AND SETTING: 756 participants began an expert derived self-report online survey in Ireland, USA, Hong Kong and Australia. PARTICIPANTS: 325 participants completed the survey (age = 38 ± 10 years; weight = 68.0 ± 13.1 kg; height = 1.70 ± 0.10 m). MAIN OUTCOME MEASURES: Descriptive statistics are reported examining injury incidence and location; shoe and orthosis choices; and training and technique practices. A backwards logistic regression was implemented to examine associations between injury and training choices. RESULTS: 68.3% reported having an injury in the last year. 81.45% of these injuries were believed to be running related. A large variation in training and footwear choices were observed for respondents. The regression (P ≤ 0.001) explained 20% of the variance in injury selection (Nagelkerke R2) and was able to identify 73% of cases accurately. Associated injury factors included competitive running, running on more than one surface, younger age, having a lower running age, and a higher proportion of running at an easy intensity. CONCLUSIONS: The high amount of variability in runner's choices highlights the lack of consistent information being presented to them and may be the reason for the high injury incidence.


Assuntos
Condicionamento Físico Humano/efeitos adversos , Condicionamento Físico Humano/métodos , Corrida/lesões , Adulto , Austrália/epidemiologia , Desenho de Equipamento , Feminino , Hong Kong/epidemiologia , Humanos , Incidência , Irlanda/epidemiologia , Masculino , Autorrelato , Sapatos , Inquéritos e Questionários , Estados Unidos/epidemiologia
13.
Public Health ; 190: 147-151, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33386140

RESUMO

OBJECTIVES: The objective of this study was to inform public health practitioners who are designing, adapting and implementing testing and tracing strategies for Coronavirus disease (COVID-19) control. STUDY DESIGN: The study design is monitoring and evaluation of a national public health protection programme. METHODS: All close contacts of laboratory-confirmed cases of COVID-19 identified between the 19th May and 2nd August were included; secondary attack rates and numbers needed to test were estimated. RESULTS: Four thousand five hundred eighty six of 7272 (63%) close contacts of cases were tested with at least one test. The secondary attack rate in close contacts who were tested was 7% (95% Confidence Interval [CI]: 6.3 - 7.8%). At the 'day 0' test, 14.6% (95% CI: 11.6-17.6%) of symptomatic close contacts tested positive compared with 5.2% (95% CI: 4.4-5.9%) of asymptomatic close contacts. CONCLUSIONS: The application of additional symptom-based criteria for testing in this high-incidence population (close contacts) is of limited utility because of the low negative predictive value of absence of symptoms.


Assuntos
/estatística & dados numéricos , Busca de Comunicante/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Portador Sadio , Criança , Pré-Escolar , Busca de Comunicante/métodos , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade
14.
Epilepsy Behav ; 115: 107675, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33342712

RESUMO

As part of our ongoing interest in patient- and family-centered care in epilepsy, we began, before the onset of the CoVID-19 pandemic, to evaluate the concerns and preferences of those delivering and receiving care via telemedicine. CoVID-19 arrived and acted as an unexpected experiment in nature, catalyzing telemedicine's widespread implementation across many disciplines of medicine. The arrival of CoVID-19 in Ireland gave us the opportunity to record these perceptions pre- and post-CoVID. Data were extracted from the National Epilepsy Electronic Patient Record (EEPR). Power BI Analytics collated data from two epilepsy centers in Dublin. Analysis of data on reasons for using the telephone support line was conducted. A subset of patients and clinicians who attended virtual encounters over both periods were asked for their perception of telemedicine care through a mixed methods survey. Between 23rd December 2019 and 23rd March 2020 (pre-CoVID era), a total of 1180 patients were seen in 1653 clinical encounters. As part of a telemedicine pilot study, 50 of these encounters were scheduled virtual telephone appointments. Twenty eight surveys were completed by clinicians and 18 by patients during that period. From 24th March 2020 to 24th June 2020, 1164 patients were seen in 1693 encounters of which 729 (63%) patients were seen in 748 scheduled virtual encounters. 118 clinician impressions were captured through an online survey and 75 patients or carers completed a telephone survey during the post-CoVID era. There was no backlog of appointments or loss of care continuity forced by the pandemic. Clinicians expressed strong levels of satisfaction, but some doubted the suitability of new patients to the service or candidates for surgery receiving care via telemedicine. Patients reported positive experiences surrounding telephone appointments comparing them favorably to face-to-face encounters. The availability of a shared EEPR demonstrated no loss of care contact for patients with epilepsy. The survey showed that telemedicine is seen as an effective and satisfactory method of delivering chronic outpatient care.


Assuntos
/psicologia , Gerenciamento Clínico , Registros Eletrônicos de Saúde , Epilepsia/psicologia , Relações Médico-Paciente , Telemedicina/métodos , Adulto , Agendamento de Consultas , /prevenção & controle , Cuidadores/psicologia , Epilepsia/epidemiologia , Epilepsia/terapia , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Projetos Piloto , Inquéritos e Questionários
15.
Clin Exp Dermatol ; 46(1): 142-144, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32705718

RESUMO

COVID-19 healthcare workers (HCWs) require frequent handwashing and use of personal protective equipment (PPE) to prevent infection. However, evidence is emerging that these practices are causing adverse effects on their skin integrity. A single-centre, cross-sectional study of HCWs from an Irish hospital was undertaken to evaluate the degree of COVID-19-related irritant contact dermatitis (ICD) between April and May 2020. Of 270 participants surveyed, 223 (82.6%) reported symptoms of ICD. The hands were the most commonly affected site (76.47%) and the most frequently reported symptom was dry skin (75.37%). Nearly all (268; 99.26%) HCWs had increased hand-washing frequency, but 122 (45.35%) did not use emollients. In the ICD group, 24.7% cited a history of dermatitis compared with 4.3% of unaffected staff (P < 0.001). The ICD group recorded PPE usage for an average of 3.15 h compared with the non-ICD group at 1.97 h (P = 0.21). Promoting awareness of COVID-19-related ICD is vital to highlight prevention and treatment for frontline staff.


Assuntos
/complicações , Dermatite Irritante/etiologia , Equipamento de Proteção Individual/efeitos adversos , /genética , Conscientização , /patologia , Estudos de Casos e Controles , Estudos Transversais , Dermatite de Contato/etiologia , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Emolientes/uso terapêutico , Feminino , Desinfecção das Mãos , Pessoal de Saúde , Humanos , Irlanda/epidemiologia , Irritantes/efeitos adversos , Masculino
16.
BMJ Open ; 10(12): e042930, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371046

RESUMO

OBJECTIVE: Our study aims to understand the psychological impact of the COVID-19 pandemic among healthcare workers (HCWs) at acute hospital settings in the South-East of Ireland, as a crucial step in guiding policies and interventions to maintain their psychological well-being. DESIGN: Observational cohort study. PARTICIPANTS AND SETTING: 472 HCWs participated from two distinct acute hospital settings, A and B, in the South-East of Ireland. PRIMARY AND SECONDARY OUTCOME MEASURES: Measures of psychological distress-depression, anxiety, acute and post-traumatic stress disorder (PTSD)-as dictated by the Depression, Anxiety and Stress Scale (DASS-21) and Impact of Event Scale-Revised (IES-R). An independent sample t-test and a Mann-Whitney U test was used to determine significance of difference in continuous variables between groups. Categorical variables were assessed for significance with a χ2 test for independence. RESULTS: The DASS-21 provided independent measures of depression (mean 4.57, IQR 2-7), anxiety (mean 3.87, IQR 1-6) and stress (mean 7.41, IQR 4-10). Positive scores were reflected in 201 workers (42.6%) for depression and 213 (45.1%) for both anxiety and stress. The IES-R measured subjective distress on three subscales: intrusion (mean 1.085, IQR 0.375-1.72), avoidance (mean 1.008, IQR 0.375-1.5) and hyperarousal (mean 1.084, IQR 0.5-1.667). Overall, 195 cases (41.3%) were concerning for PTSD. Site B scored significantly higher across all parameters of depression (5.24 vs 4.08, p<0.01), anxiety (4.66 vs 3.3, p<0.01), stress (8.91 vs 6.33, p<0.01) and PTSD (0.058 vs 0.043, p<0.01). Worse outcomes were also noted in HCWs with underlying medical ailments. CONCLUSION: Psychological distress is prevalent among HCWs during the COVID-19 pandemic; screening for adverse mental and emotional outcomes and developing timely tailored preventative measures with effective feedback are vital to protect their psychological well-being, both in the immediate and long-term.


Assuntos
Ansiedade , Pessoal de Saúde , Hospitais/estatística & dados numéricos , Estresse Ocupacional , Transtornos de Estresse Pós-Traumáticos , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/etiologia , /psicologia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Política de Saúde , Humanos , Irlanda/epidemiologia , Masculino , Saúde Mental/tendências , Determinação de Necessidades de Cuidados de Saúde , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Estresse Ocupacional/psicologia , Serviços Preventivos de Saúde , Escalas de Graduação Psiquiátrica , Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-33352735

RESUMO

Frailty in middle-aged and older adults is associated with diabetes-related complications. The impact of and interaction between diabetes and frailty on psychosocial wellbeing and mortality in Ireland for adults aged ≥50 years were assessed using data from the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes status (self-reported), frailty phenotype (≥3/5 criteria), low self-rated health ("fair" or "poor"), depression screening (EURO-D index score ≥4), and low quality of life (QoL) (CASP-12 index score < 35). Among the 970 participants, those with diabetes (n = 87) were more likely to be frail (23% vs. 8%; p < 0.001), have low self-rated health (46% vs. 19%; p < 0.001), depression (25% vs. 17%; p = 0.070), and low QoL (25% vs. 18%, p = 0.085). Adjusting for diabetes, age and sex, frailty independently predicted low self-rated health (OR: 9.79 (5.85-16.36)), depression (9.82 (5.93-16.25)), and low QoL (8.52 (5.19-13.97)). Adjusting for frailty, age and sex, diabetes independently predicted low self-rated health (2.70 (1.63-4.47)). The age-sex adjusted mortality hazard ratio was highest for frailty with diabetes (4.67 (1.08-20.15)), followed by frailty without diabetes (2.86 (1.17-6.99)) and being non-frail with diabetes (1.76 (0.59-5.22)). Frailty independently predicts lower self-reported wellbeing and is associated with reduced survival, underpinning its role as an integral part of holistic diabetes care.


Assuntos
Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Idoso Fragilizado/psicologia , Fragilidade/epidemiologia , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Depressão/psicologia , Europa (Continente)/epidemiologia , Feminino , Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Princípios Morais , Prevalência , Apoio Social
18.
BMJ Open ; 10(12): e040488, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371026

RESUMO

PURPOSE: The purpose of the Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project is to create a large retrospective cohort of adults in Ireland to examine the validity of DXA diagnostic classification, risk assessment tools and management strategies for osteoporosis and osteoporotic fractures for our population. PARTICIPANTS: The cohort includes 36 590 men and women aged 4-104 years who had a DXA scan between January 2000 and November 2018 at one of 3 centres in the West of Ireland. FINDINGS TO DATE: 36 590 patients had at least 1 DXA scan, 6868 (18.77%) had 2 scans and 3823 (10.45%) had 3 or more scans. There are 364 unique medical disorders, 186 unique medications and 46 DXA variables identified and available for analysis. The cohort includes 10 349 (28.3%) individuals who underwent a screening DXA scan without a clear fracture risk factor (other than age), and 9947 (27.2%) with prevalent fractures at 1 of 44 skeletal sites. FUTURE PLANS: The Irish DXA HIP Project plans to assess current diagnostic classification and risk prediction algorithms for osteoporosis and fractures, identify the risk predictors for osteoporosis and develop novel, accurate and personalised risk prediction tools, by using the large multicentre longitudinal follow-up cohort. Furthermore, the dataset may be used to assess, and possibly support, multimorbidity management due to the large number of variables collected in this project.


Assuntos
Informática Médica , Osteoporose , Absorciometria de Fóton , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Criança , Pré-Escolar , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Estudos Retrospectivos , Adulto Jovem
19.
J Forensic Leg Med ; 76: 102072, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33157341

RESUMO

All Covid-19 deaths and all nursing home and residential home deaths in Ireland must by law be reported to the Coroner, the independent Judicial Officer of the State, in the District in which they occur. This enables accurate and early collation of these death reports. Between January 1, 2015 and June 30, 2020 3342 deaths were reported to the Coroner's District for Kildare. From March 11, 2020, when the first Covid-19 death occurred in Ireland in County Kildare, to June 30, 2020 there were 1738 Covid-19 deaths nationally of which 139 were reported in Kildare with 113 (81%) of these deaths in nursing and residential homes. The calculated excess number of deaths notified for January to June 2020 compared with 2015-2019 was 198 (41%) of the 484 total deaths reported with a 131 (45%) excess in the 293 deaths in nursing and residential homes. Covid-19 deaths accounted for 70% and 86% of these excess deaths respectively. Following subtraction of the 18 non-natural cause deaths and 139 Covid-19 deaths from the total excess there remained an unexplained excess of 60 deaths due to natural causes in March to June of 2020 compared with 2015-2019. The peak excess total death percentage was 359% in April 2020, commencing with a small excess in March (30%), continuing into May (63%) and falling again in June (37%). In the nursing and residential home setting those excess death percentages were most marked at 527% in April, with 27% in March, 54% in May and 17% in June. Underlying medical conditions were recorded in 99% of those dying from Covid-19 and the average age of the deceased was 82.5 years with median of 78 years and 55% of those dying were female and 45% male. The clinical epidemiology and documented excess mortality of the reported deaths are chronicled and analysed to learn also about the future challenges with the continuing Covid-19 infection. A centralized national mortality database providing near real-time death certification enhances infectious disease surveillance and prompt clinical epidemiology and mortality excess studies and reduces under-reporting of Covid-19 deaths.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Sistema de Registros/estatística & dados numéricos , Adulto , Causas de Morte , Médicos Legistas , Bases de Dados Factuais , Atestado de Óbito , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pandemias
20.
BMC Public Health ; 20(1): 1635, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33183297

RESUMO

BACKGROUND: The internet is now the first line source of health information for many people worldwide. In the current Coronavirus Disease 2019 (COVID-19) global pandemic, health information is being produced, revised, updated and disseminated at an increasingly rapid rate. The general public are faced with a plethora of misinformation regarding COVID-19 and the readability of online information has an impact on their understanding of the disease. The accessibility of online healthcare information relating to COVID-19 is unknown. We sought to evaluate the readability of online information relating to COVID-19 in four English speaking regions: Ireland, the United Kingdom, Canada and the United States, and compare readability of website source provenance and regional origin. METHODS: The Google® search engine was used to collate the first 20 webpage URLs for three individual searches for 'COVID', 'COVID-19', and 'coronavirus' from Ireland, the United Kingdom, Canada and the United States. The Gunning Fog Index (GFI), Flesch-Kincaid Grade (FKG) Score, Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG) score were calculated to assess the readability. RESULTS: There were poor levels of readability webpages reviewed, with only 17.2% of webpages at a universally readable level. There was a significant difference in readability between the different webpages based on their information source (p < 0.01). Public Health organisations and Government organisations provided the most readable COVID-19 material, while digital media sources were significantly less readable. There were no significant differences in readability between regions. CONCLUSION: Much of the general public have relied on online information during the pandemic. Information on COVID-19 should be made more readable, and those writing webpages and information tools should ensure universal accessibility is considered in their production. Governments and healthcare practitioners should have an awareness of the online sources of information available, and ensure that readability of our own productions is at a universally readable level which will increase understanding and adherence to health guidelines.


Assuntos
Compreensão , Informação de Saúde ao Consumidor/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Internet , Pandemias , Pneumonia Viral/epidemiologia , Canadá/epidemiologia , Humanos , Irlanda/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
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