Factors influencing specialty choice and the effect of recall bias on findings from Irish medical graduates: a cross-sectional, longitudinal study.

Background: Despite being a vital part of medical workforce planning and development, how medical students and graduates choose their career specialty is still not well understood. This study aimed to identify the factors medical graduates consider important influences in their choice of specialty after their first year of practice, and to test the validity of relying on respondent recall to measure changes in specialty choice.

Methods: The baseline survey was administered online to all final year students in Ireland's six medical schools.

Peripheral bone density measurement: An interdisciplinary initiative for improving health outcomes for people with learning disabilities.

Challenges exist in respect of people with intellectual disabilities who, with the increasing life expectancy, have a growing risk of age-related degenerative conditions. Changes in bone health are associated with increasing age and the bone health of people who have intellectual disabilities is well documented in the literature as being poor in comparison to the general population. A heel scan clinic was set up in an intellectual disability service as a service improvement initiative.

Short-Term Air Pollution as a Risk for Stroke Admission: A Time-Series Analysis.

Background: The harmful effects of outdoor air pollution on stroke incidence are becoming increasingly recognised. We examined the impact of different air pollutants (PM2.5, PM10, NO2, ozone, and SO2) on admission for all strokes in two Irish urban centres from 2013 to 2017.

Improving the quality of antibiotic prescribing through an educational intervention delivered through the out-of-hours general practice service in Ireland.

Background: Antibiotic resistance is a threat to our health and health systems. Up to 70% of antibiotics are prescribed in general practice. In Ireland, Out-of-hours (OOH) services are mostly provided by co-operatives of GPs and the 11 main OOH centres cover up to 90% of the population.

Quality and safety in the time of Coronavirus: design better, learn faster.

The COVID-19 pandemic has required health systems to change much faster than normal. Many staff have experienced training in quality improvement and patient safety methods which can be used to support the design of new systems and to accelerate learning about new and adapted practices. This article sets out the principles of quality improvement and patient safety science, applying them in a selection of approaches, methods and tools, which may be useful in crisis situations such as the current pandemic.

General practitioners' views on malnutrition management and oral nutritional supplementation prescription in the community: A qualitative study.

Background & Aims: Malnutrition or undernutrition, arising from a deficiency of energy and protein intake, occurs commonly among community-dwelling individuals in developed countries. Once identified, malnutrition can be effectively treated in the majority of cases with dietary advice and the prescription of oral nutritional supplements (ONS) for patients who can eat and drink orally. However, previous research has reported inadequate screening and treatment of malnutrition in the community.

Development of an international standard set of outcome measures for patients with atrial fibrillation: a report of the International Consortium for Health Outcomes Measurement (ICHOM) atrial fibrillation working group.

Aims: As health systems around the world increasingly look to measure and improve the value of care that they provide to patients, being able to measure the outcomes that matter most to patients is vital. To support the shift towards value-based health care in atrial fibrillation (AF), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international Working Group (WG) of 30 volunteers, including health professionals and patient representatives to develop a standardized minimum set of outcomes for benchmarking care delivery in clinical settings.

Methods And Results: Using an online-modified Delphi process, outcomes important to patients and health professionals were selected and categorized into (i) long-term consequences of disease outcomes, (ii) complications of treatment outcomes, and (iii) patient-reported outcomes.

Awareness and Preventative Behaviours Regarding Toxoplasma, Listeria and Cytomegalovirus Among Pregnant Women.

Aim Infection with toxoplasma, listeria and cytomegalovirus (CMV) infections can negatively affect pregnancy outcomes. Awareness of these infections, knowledge of preventive practices and pertinent behaviours was assessed. Methods A survey of patients at antenatal clinics in a Dublin maternity hospital was conducted over a six month period.

Preparedness and management of global public health threats at points of entry in Ireland and the EU in the context of a potential Brexit.

Health security in the European Union (EU) aims to protect citizens from serious threats to health such as biological agents and infectious disease outbreaks- whether natural, intentional or accidental. Threats may include established infections, emerging diseases or chemical and radiological agents. Co-ordinated international efforts attempt to minimize risks and mitigate the spread of infectious disease across borders.

The association between benzodiazepine use and falls, and the impact of sleep quality on this association: data from the TILDA study.

Background: Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults.

Aim: This study assesses the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50.

Design: Cross-sectional analysis of data from wave 1 of The Irish Longitudinal Study on Ageing.

Analysis of low birth weight first-born babies by geography and deprivation as an aid to policy and service targeting.

Background: Low birth weight (LBW), which is defined as a birth weight of <2500 g, is considered to be an indicator of a range of negative health outcomes.

Methods: The feasibility of using child health data at small area (SA) level to explore patterns of LBW in an Irish region comprising the counties of Dublin, Kildare and Wicklow (DKW) for the 2006-2015 period was assessed. A logistic regression model was created using R software.

Burnout in the emergency department: Randomized controlled trial of an attention-based training program.

Background: Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.

Objective: The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital.

The Burden of Severe Lactational Mastitis in Ireland from 2006 to 2015.

This aim of this paper is to describe the trends in the burden of severe lactational mastitis among women in Ireland through an analysis of postnatal mastitis hospital admission rates from 2006 to 2015. Data on all postnatal hospitalisations with principal diagnosis of mastitis were extracted from the Hospital Inpatient Enquiry system. Trends in annual admission rates per 10,000 live births were analysed using non-parametric trend tests.

Intensive home care packages for people with dementia: a realist evaluation protocol.

Background: Dementia presents a significant challenge to health systems and to the person and family affected. Home care is increasingly seen as a key service in addressing this challenge in a person-centred and cost-effective way. Intensive Home Care Packages (IHCPs) were introduced in Ireland to provide personalised and high levels of support for people with dementia to remain at home or be discharged home from hospital, and to build on the work of the HSE & Genio Dementia Programme.

An Audit of Neural Tube Defects in the Republic Of Ireland for 2012-2015.

Neural tube defects (NTD) are potentially preventable in two-thirds of cases by periconceptional maternal Folic Acid (FA) supplementation. A national audit for the years 2009-11 showed no decline in NTD rates over twenty years. The aim of this national audit was to determine trends/rates and inform revision of national FA supplementation and food fortification strategies.

Mantra meditation programme for emergency department staff: a qualitative study.

Objectives: Rates of burnout and stress in healthcare practitioners are steadily increasing. Emergency department (ED) staff are particularly susceptible to such poor outcomes. Mantra meditation (MM) may contribute to increased well-being.

The barriers and facilitators to the implementation of National Clinical Programmes in Ireland: using the MRC framework for process evaluations.

Background: A major healthcare reform agenda in Ireland is underway which underpins the establishment of a series of National Clinical Programmes (NCPs), which aim to take an evidence based approach to improve quality, access and value. The current study aimed to determine the enablers and barriers to implementation of the NCPs.

Methods: A qualitative methodology advocated by the Medical Research Council (MRC) framework on conducting process evaluations of complex interventions guided this research.

A national measles outbreak in Ireland linked to a single imported case, April to September, 2016.

Endemic measles transmission was interrupted for the first time in Ireland in 2015. In May 2016, a case of measles was confirmed in an adult who had travelled from Hungary to Ireland (index case). Cases subsequently arose in five of the eight public health regions around the country.

Physical activity and mental health in an Irish population.

Background: Physical activity represents a modifiable behaviour which may be associated with increased likelihood of experiencing positive mental health.

Aims: The aim of this study was to examine the association between self-rated physical activity and subjective indicators of both positive and negative mental health in an Irish adult population.

Methods: Based on data from a population-based, observational, cross-sectional study, participants were categorised using the International Physical Activity Questionnaire (IPAQ) into those who reported that they did and did not meet recommended physical activity requirements.

Extensive hepatitis A outbreak in an urban childcare facility in Ireland, associated with considerable adult morbidity.

Hepatitis A infection results in a spectrum of illness from asymptomatic disease to severe fulminant hepatitis. Since 2000, <50 cases have been reported annually in Ireland. We report on an outbreak of hepatitis A associated with a childcare facility(CCF) in 2015 in Ireland.

The Uptake of Human Papillomavirus Vaccine In Irish Schools: The Impact Of Disadvantage.

HPV vaccine Gardasil© is offered to girls in first year of secondary school in Ireland. We aimed to determine the association between HPV vaccine uptake among girls for academic year 2013/2014, by school and school characteristics: socioeconomic disadvantage and religious ethos. The National Schools Immunisation System (SIS) was searched to determine HPV vaccine uptake in schools for 2013/2014 (prior to recent anti-HPV vaccine publicity).

Chemsex, risk behaviours and sexually transmitted infections among men who have sex with men in Dublin, Ireland.

Background: Drug use for or during sex ('chemsex') among MSM has caused concern, because of the direct effects of the drugs themselves, and because of an increased risk of transmission of sexually transmitted infections (STIs). This study aimed to assess the prevalence of chemsex, associated behaviours and STIs among attendees at Ireland's only MSM-specific sexual health clinic in Dublin over a six week period in 2016.

Methods: The questionnaire collected demographic data, information on sexuality and sexual practice, self-reported history of treatment for STIs, and chemsex use.

Optimization of folic acid supplementation in the prevention of neural tube defects.

Background: We examined the relationship between timing and duration of folic acid (FA) supplementation in achieving red blood cell (RBC) folate levels in early pregnancy which are optimal (>906 nmol/l) for the prevention of neural tube defects (NTDs).

Methods: Clinical, FA supplementation and dietary folate details were computerized at the first antenatal visit. Maternal blood samples were analysed for RBC and serum folate.