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Biomedical subjects

S Allwright

Publications and source records attributed to S Allwright.

14 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↗
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↗
PubMed2001

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey.

OBJECTIVES: To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in entrants to Irish prisons and to examine risk factors for infection. DESIGN: Cross sectional, anonymous survey, with self completed risk factor questionnaire and oral fluid specimen for antibody testing. SETTING: Five of seven committal prisons in the Republic of Ireland. PARTICIPANTS: 607 of the 718 consecutive prison entrants from 6 April to 1 May 1999. MAIN OUTCOME MEASURES: Prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in prison entrants, and self reported risk factor status. RESULTS: Prevalence of antibodies to hepatitis B core antigen was 37/596 (6%; 95% confidence interval 4% to 9%), to hepatitis C virus was 130/596 (22%; 19% to 25%), and to HIV was 12/596 (2%; 1% to 4%). A third of the respondents had never previously been in prison; these had the lowest prevalence of antibodies to hepatitis B core antigen (4/197, 2%), to hepatitis C (6/197, 3%), and to HIV (0/197). In total 29% of respondents (173/593) reported ever injecting drugs, but only 7% (14/197) of those entering prison for the first time reported doing so compared with 40% (157/394) of those previously in prison. Use of injected drugs was the most important predictor of antibodies to hepatitis B core antigen and hepatitis C virus. CONCLUSIONS: Use of injected drugs and infection with hepatitis C virus are endemic in Irish prisons. A third of prison entrants were committed to prison for the first time. Only a small number of first time entrants were infected with one or more of the viruses. These findings confirm the need for increased infection control and harm reduction measures in Irish prisons.

Adolescent↗
PubMed2000

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in Irish prisoners: results of a national cross sectional survey.

OBJECTIVES: To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in the prison population of the Republic of Ireland and to examine risk factors for infection. DESIGN: Cross sectional, anonymous, unlinked survey, with self completed risk factor questionnaire and provision of oral fluid specimen for antibody testing. SETTING: Nine of the 15 prisons in the Republic of Ireland. PARTICIPANTS: 1366 prisoners, of whom 1205 (57 women) participated. In the smaller prisons all prisoners were surveyed, while in the three largest prisons one half of the population was randomly sampled. Three small prisons believed not to have a problem with injecting drug use were excluded. MAIN OUTCOME MEASURES: Prevalence of antibodies to hepatitis B core antigen, antibodies to hepatitis C virus, and antibodies to HIV. Self reported risk factor status. RESULTS: Prevalence of antibodies to hepatitis B core antigen was 104/1193 (8.7%; 95% confidence interval 7.2% to 10.5%), to hepatitis C virus, 442/1193 (37%; 34.3% to 39.9%), and to HIV, 24/1193 (2%; 1.3% to 3%). The most important predictor of being positive for hepatitis B and hepatitis C was a history of injecting drug use. Thirty four women (60%) and 474 men (42%) reported ever injecting drugs. A fifth (104) of 501 injecting drug users reported first injecting in prison, and 347 (71%) users reported sharing needles in prison. CONCLUSIONS: Infection with hepatitis C secondary to use of injected drugs is endemic in Irish prisons. Better access to harm reduction strategies is needed in this environment.

AIDS-Related Opportunistic Infections↗
PubMed2000

Comparison between self-reported hepatitis B, hepatitis C, and HIV antibody status and oral fluid assay results in Irish prisoners.

Self-reported hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection status was compared with the results of oral fluid assays of antibodies to these viruses in prisoners from nine of the 15 prisons in the Republic of Ireland. A total of 1205 out of 1366 prisoners completed a confidential questionnaire and 1193 provided analysable oral fluid specimens for testing for antibodies to HBV core antigen (anti-HBc), HCV (anti-HCV), and HIV (anti-HIV). The self-reported prevalence of hepatitis infection (hepatitis B: 5%; hepatitis C: 19%) was lower than that derived from oral fluid assays (anti-HBc: 9%; anti-HCV: 37%). The self-reported prevalence of HIV infection was similar to that found by oral fluid assay (2%). Many discrepancies were found between self-reported results and the results of oral fluid assays. Of those who reported being positive for HBV, HCV, or HIV, 48%, 5%, and 58%, respectively, tested negative on the oral fluid assay. Of those who reported a previous negative test result for HBV, HCV, or HIV, 10%, 37%, and 2%, respectively, had positive oral fluid assays. Self-reports of hepatitis and HIV infection status are unreliable and should not be used as a basis for planning preventive and treatment services for prisoners. All prisoners should have the opportunity to be tested for HBV, HCV, and HIV infection.

Antibodies, Viral↗
PubMed1996

The effects of caring for a spouse with Parkinson's disease on social, psychological and physical well-being.

BACKGROUND: Several previous studies have examined the health of carers, but they have usually focused on elderly subjects and have often not had representative control samples. AIM: To determine whether caring for a partner with Parkinson's disease is associated with a worsening social, psychological and physical well-being than people with partners who do not suffer with Parkinson's disease. METHOD: One hundred and fifty-four carer spouses of subjects with Parkinson's disease, and 124 non-carer spouses of randomly selected population controls recruited from a national case-control study of early-onset Parkinson's disease in the Republic of Ireland, between 1992-1994, were studied. Outcome was measured along three dimensions: social functioning, assessed by the frequency of social contacts, outings and holidays; psychological well-being, measured by the General Health Questionnaire; and physical health, measured by the career's use of medical services, medications and episodes of chronic illness. RESULTS: Carer spouses were less likely to get out of the house once a week at least (odds ratio 1.79, 95% confidence intervals 1.00-3.20) or to have had a holiday in the last year (odds ratio 1.71, 95% confidence intervals 1.01-2.90). Contact with friends and neighbours decreased with increasing care provision. For spouses providing a lot of care, there was an almost fivefold increase in psychiatric morbidity (odds ratio 4.86, 95% confidence intervals 1.5-15.9) after adjusting for other variables. Most of the medical outcomes were less favourable among carers, but only the use of tranquilizers (odds ratio 3.73, 95% confidence intervals 1.18-11.8) and episodes of chronic illness (odds ratio 2.96, 95% confidence intervals 1.27-6.94) were significant. CONCLUSIONS: Overall, career spouses have slightly worse social, psychological and physical profiles. For social outcomes, increasing care provision is associated with fewer contacts, outings and holidays. For psychological and physical measures, carers providing a lot of care experience worse health. These results have implications for targeting appropriate interventions.

Caregivers↗
PubMed1995

Secular trends in mortality from asthma in children and young adults: Republic of Ireland, 1970-91.

Trends in mortality attributed to asthma in children (0-14 years) and young adults (15-44 years) and the age group 5-34 years were examined for the Republic of Ireland over the period 1970-91. Childhood mortality rates were low with no clear trend. A recent rise in asthma mortality was observed in the 5-34 year olds but not in the 15-44 year age group. More detailed examination of these rates revealed that the rise in mortality in the 5-34 year olds derived from the age band 25-34 years. This increase is masked in the 15-44 year age group by wide fluctuations in mortality in the age band 35-44 years. A similar discrepancy in asthma mortality trends for the 15-44 and 5-34 year age groups has been reported in Britain. Possible reasons for the recent rise in asthma mortality in the 25-34 year age group are discussed.

Adolescent↗
PubMed1989

Acute effects of the Chernobyl nuclear accident on Irish mortality?

This report examines the claim that Irish mortality in the second quarter (April-June) of 1986 increased due to the cloud of radioactive material released by the damaged reactor in Chernobyl. Over the period 1971-1987, based on date of registration, the death rates in the second quarter showed marked year to year variation often exceeding that expected on the basis of chance alone. In 1986 the percentage of annual deaths occurring between April and June, and the death rate itself, were both significantly higher than in most other years between 1981 and 1987. The 1986 figures were not however, significantly higher than those observed in years prior to 1981. Since the distribution of mortality by cause was not consistent with the hypothesis relating low level radiation to immediate mortality, and since causality cannot be inferred from a temporal association per se, the Chernobyl accident cannot be implicated in the excess mortality observed in the second quarter of 1986.

Accidents↗
PubMed1985

Cardiac function in acute hypothyroidism.

It has been established that chronic hypothyroidism may affect cardiac function by several mechanisms. It is not known how long the patient has to be hypothyroid for cardiac involvement to develop. This study was undertaken to assess the effect of a short period of hypothyroidism (10 days) on cardiac function. Nine patients who had had total thyroidectomy, had received ablative radioiodine for thyroid cancer and were euthyroid on replacement therapy were studied while both euthyroid and hypothyroid. Cardiac assessment was performed by X-ray, ECG, echocardiography and gated blood-pool scans. After 10 days of hypothyroidism, the left-ventricular ejection fraction failed to rise after exercise in 4 of the 9 patients studied, which was significant (P less than 0.002). No significant changes in cardiac size or function at rest were detected. This functional abnormality in the absence of any demonstrable change in cardiac size and the absence of pericardial effusion with normal basal function suggest that short periods of hypothyroidism may reduce cardiac reserve, mostly because of alterations in metabolic function.

Acute Disease↗
PubMed1982

A comparative study of 99mTc and 131I in thyroid scanning.

Thyroid scans performed with both 99mTc pertechnetate (99mTcO4) and (131I) were compared in 46 patients with palpable thyroid nodules to determine whether 131I scanning is any longer a necessary procedure. A discrepancy between the two types of scan existed in only three cases, in one of which the thyroid nodule showed uptake of 99mTcO4 but not of 131I. Subsequent surgery revealed a thyroid malignancy in this patient. In each of the other two discrepancies a nodule "cold" on 99mTcO4 scanning was apparently functioning on 131I scanning, and was found to be benign at surgery. As the convenience and lower radiation absorbed dose of 99mTcO4 patients compared with 131I make it a better scanning agent, it is recommended that 99mTcO4 scans of the thyroid be first nodules. If these nodules prove to be functioning equally with paranodular tissue, a 131I scan should also be performed to help exclude a possible thyroid malignancy.

Goiter↗
PubMedDate not supplied

The management of first trimester miscarriage by general practitioners in Ireland.

A single shot questionnaire was sent to 500 general practitioners, with 39 per cent valid response, to audit first trimester miscarriage management. With threatened miscarriage 60 per cent were cared for at home (10 per cent of these had ultrasound) and 40 per cent were transferred to hospital. The miscarriage rate was 14 per cent-61.7 per cent had no symptoms (of these 42.2 per cent had a positive pregnancy test), 24.4 per cent had threatened miscarriage with 11.6 per cent incomplete and 2.3 per cent complete. The general practitioner is ideally placed to develop initial clinical management strategies and direct access to ultrasound would be helpful.

Abortion, Spontaneous↗
PubMedDate not supplied

Using HIPE data as a research and planning tool: limitations and opportunities.

BACKGROUND: The Hospital Inpatient Enquiry (HIPE) system is an important information source for research and health service planning activities. However, as it was not designed explicitly for these purposes, some limitations exist. AIMS: To make recommendations that would increase the value of HIPE as a research and planning tool. METHODS: Experiences of using HIPE for research and planning exercises were analysed so as to identify its limitations and their impact on research and planning. RESULTS: Limitations were identified regarding data quality, policy issues and the general system. CONCLUSIONS: To increase the utility of HIPE as a research and planning tool, a number of changes are recommended, including: expanding the system to cover private hospitals and outpatient and emergency services; adopting routine small area and socio-economic coding; adopting unique personal identifiers; publishing regular detailed reports with in-depth analyses; and considering making hospital identifiers available in certain circumstances.

Databases as Topic↗
PubMedDate not supplied

The epidemiology of Parkinson's disease in the Republic of Ireland: observations from routine data sources.

Routine data sources can provide clues to the temporal and geographical patterns of Parkinson's disease. Mortality trends show divergent age specific rates, with decreasing mortality for younger age-groups and increasing mortality for older age-groups. Cohort analysis showed a pattern consistent with the hypothesis that Parkinson's disease may have increased after the encephalitis lethargica pandemic. Hospital admission data suggest a rural excess of cases. The interpretation of this finding is complicated by the role of a variety of potential biases. Research is needed to examine urban-rural differences and environmental risk factors.

Age Factors↗