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Biomedical subjects

F Howell

Publications and source records attributed to F Howell.

At least 19 recordsLinked to original sources
PubMed2006

Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK Survey.

OBJECTIVE: To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004. DESIGN: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8-9 months after the law (December 2004 to January 2005). MAIN OUTCOME MEASURES: Respondents' reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law. RESULTS: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a "good" or "very good" thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit. CONCLUSION: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution.

Adolescent↗
PubMed2006

Characteristics of women seeking emergency contraception in general practice.

The aim of this study was to profile the users of emergency contraception (EC) attending general practices and a general practice out-of-hours co-operative service using a pre-piloted questionnaire. Questionnaires were offered to 171 women and completed by 144 (84.2%). Mean age was 24.4 years (Standard Deviation = 6.7, range 14 to 51). Most were single, 116 (80.6%). Those who had no regular partner at the time of seeking EC were more likely to have > or =6 lifetime sexual partners than those in stable relationships (OR: 3.5; CI: 1.14-10.86, p < 0.03). At the time of seeking EC 121 (84.0%) were using some method of contraception. Ninety-three (64.6%) presented within 24 hours of sexual intercourse. Concerns about condoms were the commonest reason for seeking EC. For 55 (38.2%) this was their first time to use EC. Thirty-three (22.9%) were drunk at the time of intercourse.

Adolescent↗
PubMed2006

Blood alcohol levels in persons who died from accidents and suicide.

Although it is known that alcohol is associated with a high proportion of fatal accidents and suicides, little information is available in Ireland on blood alcohol concentrations (BACs) of those who died. This study was undertaken to identity the (BACs) in persons who died as a result of suicide or injury. The study was a retrospective review of coroners' records to identify BACs in three counties in Ireland. All cases where the person died as a result of injury or suicide in 2001 and 2002 were included. There were 129 deaths eligible for inclusion. Of these, 98 (76%) were male, 55 (42.6%) were road traffic accidents (RTAs), 31 (24.0%) suicides, 12 (9.3%) substance misuse, 11 (8.5%) house fires and 20 (15.5%) others. Of the 55 who died as a result of RTAs, 22 (40%) had positive BACs ranging from 16mg/100 ml to 325 mg/100 ml. Of the 31 who died as a result of suicide, 28 (90.3%) were male. BACs were available for 29 (93.5%). Of these, 16 (55.5%) had alcohol detected. Persons aged less than 30 years were more likely to have alcohol in their blood (p < 0.002). The mean BAC for persons aged less than 30 was 191.5 mg/100 ml compared to 84.0 mg/100 ml for those aged 30 and over. The mean BAC for adults who died in house fires was 225.2 mg/100 ml. The high BACs in those who died as a result of suicide or injury reflect the high level of alcohol consumption and binge drinking in Ireland.

Accidents↗
PubMed2004

The burden of alcohol misuse on emergency in-patient hospital admissions among residents from a health board region in Ireland.

AIMS: To identify in-patient emergency admissions to acute hospitals of residents from a health board region in the Republic of Ireland with an acute alcohol intoxication diagnosis; to profile the admissions and to assess whether the increase in alcohol consumption in Ireland has been mirrored by an increase in alcohol related emergency admissions over the same time period. DESIGN: A retrospective review of hospital admissions using Hospital In-Patient Enquiry (HIPE) data and alcohol consumption trends using data from the Central Statistics Office (CSO). SETTING: Acute hospitals in the Republic of Ireland. PARTICIPANTS: All residents from a health board region admitted with a recorded alcohol intoxication emergency admission to non-private acute hospitals in Ireland. MEASUREMENTS: All in-patient emergency admissions for which an acute alcohol intoxication diagnosis (ICD Codes 303.0 and 305.0) was recorded of residents from one health board region were extracted from the HIPE system for years 1997-2001 inclusive. Pearson's chi2 test was used to compare proportions in groups of categorical data and chi2 test for trend was used to identify linear trends. Age standardized rates were calculated for each year and trend analysis carried out. Demographic data on the patients were also extracted from the database. FINDINGS: There were 3289 acute alcohol intoxication admissions to acute hospitals of residents from the study region recorded for years 1997-2001 inclusive. There were 777 acute alcohol intoxication admissions in 2001 compared to 432 admissions in 1997, an increase of 80%. Age standardized rates showed a significant increasing linear trend (P < 0.001). Over half the admissions occurred on weekends. The average length of stay was 2.7 days (95% CI 2.5-2.8) with just under a quarter (24.3%) of these admissions being discharged on the same day. The majority of these patients were male (71.5%), 40.9% were under 30 years old and over half (59.4%) were single. CONCLUSIONS: This study shows that alcohol intoxication accounted for a substantial number of emergency in-patient admissions to acute hospitals in one health board region in Ireland and that the age standardized recorded acute alcohol related emergency admission rate increased significantly over the 5-year period, 1997-2001. This increase mirrored the national increase in alcohol consumption over the same time period.

Adolescent↗
PubMed2004

Consumer satisfaction with child health clinics.

Consumer satisfaction surveys are used to assist in monitoring the quality of health care service delivery. In order to capture the views of those attending child health clinics in the community setting, a cohort of attendees to child health clinics in a health board region was sent a pre-piloted questionnaire enquiring about the clinic type attended, appointment details, facilities and environment of the health centre attended and experiences of communication and information at the clinic. Of 3,424 parents/guardians contacted, 2,402 (70.1%) replied. Two thousand (83.3%) had an appointment, with 61.1% attending first appointment within 3 months of referral. Median time spent in the centre was 25.0 minutes (ranging from 5 to 150 minutes). Respondents were satisfied with structural facilities with the exception of baby-changing facilities. Respondents agreed that their child's condition (92.1 %) and treatment options (88.7%) were fully explained, with adequate time for discussion (87.8%). Only 44% (n=736) reported receiving written takeaway information regarding their child's condition. Respondents agreed their child was put at ease by staff (85.7%), and the visit was worthwhile (93.9%). This study has identified key areas where administration and health care professionals can improve the quality of what is already perceived to be a good service.

Child↗
PubMed2004

Smoking, alcohol & illicit drug use among young people in a health board region in 1997 and 2002: a comparative study.

The objectives of this study were to document and compare patterns of licit and illicit drug use among adolescents in a health board region in 1997 and 2002. 1516 students in 1997 and 1426 in 2002, randomly selected from post-primary schools in the region, completed a questionnaire, incorporating items related to smoking, alcohol and illicit drug use. Lifetime smoking prevalence in 2002 (50.8%) showed a statistically significant decrease from 1997 (57.1%). There was also a statistically significant decrease in regular smoking (1997 - 30.7%; 2002 - 18.2%). There was no significant change in regular alcohol consumption (57.3% - 1997; 53.7% - 2002). However, there was an increase in binge drinking at weekends and reports of feeling drunk more than ten times (24% - 1997; 27.2% - 2002). In 2002, 41.2% had ever taken an illicit drug, a statistically significant increase from 1997 (34.9%); 15.1% were regular users, also a statistically significant increase from 1997 (11.9%). These findings highlight that while the misuse of illicit drugs has increased, smoking has significantly declined since 1997. However, alcohol continues to be a major problem within this age-group. This study has implications for the implementation of services and strategies aimed at reducing smoking, alcohol and drug use within this population.

Adolescent↗
PubMed2003

Wheeze, eczema and rhinitis in 6-7 year old Irish schoolchildren.

The aim of this study was to determine the prevalence of wheeze, eczema and rhinitis in 6-7 year old schoolchildren in Louth and Meath and assess their risk factors. The ISAAC (International Study for Asthma and Allergies in Childhood) questionnaire was used. The response rate was 64.1% (n = 1899). The prevalence rates for wheeze, eczema and rhinitis were 17.4%, 11.2% and 20.2% respectively, with 2.4% of children reported to be suffering from all 3 conditions. The main risk factors for wheeze were male sex and smoking in the home. Ninety-five (28.7%) children with wheeze had no diagnosis of asthma. Of these children 36 (37.9%) had wheeze with exercise, 55 (59.9%) had a dry cough not associated with a cold or flu and 13 (13.7%) reported more than 4 attacks of wheeze in the last year. This study suggests underdiagnosis and undertreatment of atopic illness in this age group. It also suggests decreasing exposure to passive smoking and early recognition and treatment will improve quality of life for many children.

Child↗
PubMed2003

Evaluation of a community fissure sealant programme in County Meath, Ireland.

OBJECTIVE: To evaluate the fissure sealant programme operated by the North Eastern Health Board Dental Service in County Meath, Republic of Ireland. The fissure sealant programme forms part of the school dental service aimed at children in first class (age group 6-7 years). DESIGN: Cross sectional study with retrospective analysis of dental records. CLINICAL SETTING: Schools in County Meath in 1999. PARTICIPANTS: Children in fourth class (mean age 9.6 years) in the school year 1999/2000 who had participated in the fissure sealant programme in the school year 1996/97. MAIN OUTCOME MEASURES: Sealant retention using the criteria of Simonsen. RESULTS: The mean age of sealant was 2.3 years. Fifty six percent of sealants were completely retained, 27% were partially retained and 12.8% were missing. The majority (73%) of children had some sealant on at least one tooth. Caries experience in previously sealed teeth was low (2.9%). Children who had all four first permanent molars sealed had a significantly lower DMFT (visual) than those who had no sealants (Wilcoxan p < 0.0001). CONCLUSION: Despite lack of maintenance of sealants in this study, retention rates compared favourably with similar international studies and caries experience in previously sealed teeth was low. The use of a written sealant policy and protocol for sealant application and equipment maintenance could further improve retention rates. Children who had no sealants had significantly poorer dental health than children who had all four first permanent molars sealed.

Child↗
PubMed2001

Towards NeuroML: model description methods for collaborative modelling in neuroscience.

Biological nervous systems and the mechanisms underlying their operation exhibit astonishing complexity. Computational models of these systems have been correspondingly complex. As these models become ever more sophisticated, they become increasingly difficult to define, comprehend, manage and communicate. Consequently, for scientific understanding of biological nervous systems to progress, it is crucial for modellers to have software tools that support discussion, development and exchange of computational models. We describe methodologies that focus on these tasks, improving the ability of neuroscientists to engage in the modelling process. We report our findings on the requirements for these tools and discuss the use of declarative forms of model description--equivalent to object-oriented classes and database schema--which we call templates. We introduce NeuroML, a mark-up language for the neurosciences which is defined syntactically using templates, and its specific component intended as a common format for communication between modelling-related tools. Finally, we propose a template hierarchy for this modelling component of NeuroML, sufficient for describing models ranging in structural levels from neuron cell membranes to neural networks. These templates support both a framework for user-level interaction with models, and a high-performance framework for efficient simulation of the models.

Animals↗
PubMed2001

Influenza vaccination uptake in 1999 and older persons recall of vaccination.

The aims of this study were to assess the uptake of the influenza vaccine by medical card patients aged 65 years and older and to assess if using older persons' recall of vaccination was a reliable method of assessing uptake. A questionnaire was mailed to 360 medical card patients aged 65 years and older and from the returns a subset were selected and the GPs contacted to ascertain whether the patients had received the vaccine or not. A total of 293 questionnaires were returned (response rate of 81.4%). One hundred and forty-four (49.1%) stated that they received the influenza vaccine. GPs were contacted in respect of 64 patients to check on their vaccination record. Only 2 (3.1%) of the questionnaires differed to the GP records in respect of vaccination. The result being that the uptake rates as assessed by the patients' recall and by checking GPs records were almost identical. (Kappa statistic: 0.94) In conclusion the uptake for older persons with medical cards was low at 49.1%. Using older persons recall to estimate uptake is valid and accurate.

Aged↗
PubMed2001

A review of family planning services by general practitioners in a health board region.

In 1994 the North Eastern Health Board published a study, which ascertained the range of family planning services provided by General Practitioners (GPs) in the area. This study highlighted some service and training needs, which have since been addressed. This study has been repeated to evaluate service developments. All GPs on the NEHB mailing list were sent a pre-piloted questionnaire about the range of family planning services they provide, their referral patterns should they not provide the service themselves and their comments on how the health board could assist in the enhancement of family planning services. The data were analysed using the software package JMP and statistical analysis was carried out using either the Chi-square test or Fishers exact test. There was a response rate of sixty six percent. There has been a decrease in the number of GPs in single-handed practices (24% vs 50% in 1994) and an increase in the number of practices who employ a practice nurse. Almost one third of GPs providing family planning services are women (18% in 1994) and over half of GPs hold a family planning certificate (33% in 1994). The range of services provided has increased and more GPs are now fitting intrauterine contraceptive devices (19% vs 14%). This study highlights significant developments in the family planning service and indicates that general practice is capable of providing a fully comprehensive service.

Adult↗
PubMed2000

Quality of life following total hip replacement.

Orthopaedic surgeons have traditionally used disease-specific scoring systems that focus on relief of pain and improvement in function. However, these allow little scope for patient assessed outcomes such as quality of life. This study assessed quality of life before and after Total Hip Replacement (THR) using the Short Form 36 (SF-36) questionnaire. 100 patients were interviewed pre-operatively and 9 months to one year post-operatively. Data on waiting times/length of stay/complication rates were collected by reviewing clinical notes. The mean length of stay was 22.0 +/- 10.6 days, with a pre-operative length of stay of 5.0 days. 12 patients in all had a post-operative complication, including one post-operative death. There was a statistically significant improvement in overall SF-36 score (+19%) and in 7 out of the 8 parameters that make up the SF-36 score (p < 0.001). Patients undergoing THR in Navan showed a statistically significant improvement in their quality of life post-operatively. Complication rates were in keeping with international norms. It is apparent that patients receive a high quality of care.

Aged↗
PubMed2000

Smoking and quitting among Irish teenage males.

Nicotine addiction in adulthood is usually preceded by exposure to cigarettes in adolescence. A minimal exposure may be sufficient to produce addiction. Strategies to reduce adult smoking must address those factors, which influence teenage smoking. In this study we aimed to establish the prevalence of smoking in male secondary schools, to measure the association between student's smoking status and parental, peer and sibling smoking and to describe attempted quitting. An anonymous questionnaire was given to 1070 male secondary school pupils in two schools in County Louth. Twenty-seven percent of respondents smoked every day or on most days. Having a best friend who smoked was associated with personal smoking (O.R. 11.75, C.I. 8.6-16.08) as was sibling smoking (O.R. 3.49, C.I. 2.67-4.57.) Seventy percent of smokers stated that they wanted to stop and 75% that they had tried to stop. Only five smokers (1.2%) had been advised to quit by their general practitioner. We conclude that smoking is as prevalent among teenage boys in Ireland as it has been shown to be elsewhere and that most teenagers are unable rather than unwilling to stop.

Adolescent↗
PubMed1999

Cases of meningococcal infection and bacterial meningitis occur every day and require an 'out of hours' public health response.

Analysis of hospital admissions data over three years in Ireland showed that the 1478 cases of meningococcal disease and meningitis were admitted at the same frequency every day of the week. The need for and the cost effectiveness of an 'out of hours' service in order to manage the community aspects of meningococcal disease/meningitis requires further attention.

Humans↗