Barriers to healthcare and self-reported adverse outcomes for autistic adults: a cross-sectional study.

Objectives: Autistic people experience poor physical and mental health along with reduced life expectancy compared with non-autistic people. Our aim was to identify self-reported barriers to primary care access by autistic adults compared with non-autistic adults and to link these barriers to self-reported adverse health consequences.

Design: Following consultation with the autistic community at an autistic conference, , we developed a self-report survey, which we administered online through social media platforms.

Sexual assault and psychosis in two large general population samples: Is childhood and adolescence a developmental window of sensitivity?

Background: Research has shown a strong relationship between psychosis and sexual assault. Theories on developmental trauma as a causal factor for psychosis suggest that exposure to sexual trauma in childhood would have a stronger association with psychosis than sexual trauma in adulthood. We hypothesized that exposure to sexual trauma earlier in childhood and adolescence would be more strongly associated with hallucinations, delusional beliefs and psychotic disorder than sexual trauma that occurred later in life.

Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment.

Unlabelled: Using a discrete choice experiment, we aimed to assess patients' preferences with regard to adopting lifestyle behaviours to prevent osteoporotic fractures. Overall, the 1042 patients recruited from seven European countries were favourable to some lifestyle behaviours (i.e.

Recognising autism in healthcare.

Recognition of autism and the associated co-occurring physical and mental health issues has increased over recent years. However, undergraduate and postgraduate curricula take time to adapt and to impact on what is delivered in training so healthcare professionals, including doctors, report little training on these topics. Doctors need to know when someone might be autistic in order to respond to them appropriately.

Autism: making reasonable adjustments in healthcare.

The accompanying article set out why it is important to identify autistic people and the negative consequences of not recognising or understanding autism, including more severe illness and premature death. This article sets out what clinicians can do to help reduce those negative consequences by making 'reasonable adjustments' in any healthcare service in which they work.

How does proximal femur BMD of healthy Irish adults compare to NHANES III? Results of the DXA-HIP Project.

Unlabelled: This study examines the distribution of proximal femur bone mineral density in a cohort of healthy Irish adults. These values are similar to those of the NHANES III Caucasian cohorts, supporting international recommendations to use this reference group for calculating DXA T-scores and Z-scores in Irish adults.

Introduction: Bone mineral density (BMD) is widely used in the assessment and monitoring of osteoporosis.

Systematic Review and Meta-analysis: Psychosis Risk in Children and Adolescents With an At-Risk Mental State.

Objective: The "At Risk Mental State" (ARMS) approach to psychosis, also called "Clinical/Ultra High Risk," has had a major impact on psychosis services internationally. Despite well-established developmental differences in the prevalence and expression of psychotic symptoms from childhood into adulthood, there has been no systematic review of psychosis transitions specifically in children and adolescents up to age of 18 years. Evidence for this age group is crucial for developmentally appropriate clinical decisions by child and adolescent psychiatrists.

Initiating technology dependence to sustain a child's life: a systematic review of reasons.

Background: Decision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions.

COVID-19 health and social care access for autistic people: European policy review.

Background: The global COVID-19 pandemic has had an unprecedented impact on European health and social care systems, with demands on testing, hospital and intensive care capacity exceeding available resources in many regions. This has led to concerns that some vulnerable groups, including autistic people, may be excluded from services.

Methods: We reviewed policies from 15 European member states, published in March-July 2020, pertaining to (1) access to COVID-19 tests; (2) provisions for treatment, hospitalisation and intensive care units (ICUs); and (3) changes to standard health and social care.

Utility of Osteoporosis Self-Assessment Tool as a Screening Tool for Osteoporosis in Irish Men and Women: Results of the DXA-HIP Project.

Many algorithms have been developed and publicised over the past 2 decades for identifying those most likely to have osteoporosis or low BMD, or at increased risk of fragility fracture. The Osteoporosis Self-assessment Tool index (OSTi) is one of the oldest, simplest, and widely used for identifying men and women with low BMD or osteoporosis. OSTi has been validated in many cohorts worldwide but large studies with robust analyses evaluating this or other algorithms in adult populations residing in the Republic of Ireland are lacking, where waiting times for public DXA facilities are long.

Measurement of Membrane Attack Complex in RPE Cells.

Initiation of the complement system results in the formation of a multiprotein pore termed the membrane attack complex (MAC, C5b-C9). MAC pores accumulate on a cell surface and can result in cell lysis. The retinal pigment epithelium (RPE) is a single monolayer of pigmented epithelial cells located at the posterior poll of the eye that forms the outer blood retinal barrier.

Presentation of mixed diabetic ketoacidosis and metabolic acidosis due to ileal neobladder reconstruction.

Diabetic ketoacidosis (DKA) is one of the most serious acute metabolic complications of diabetes mellitus. It is characterised by the biochemical triad of hyperglycaemia, ketonemia/ketonuria, and an increased anion gap metabolic acidosis. In this case, a 40-year-old male patient presented to the emergency department, with vomiting, nausea, polydipsia, polyuria and weight loss.

A comparison of airway pressures for inflation fixation of developing mouse lungs for stereological analyses.

The morphometric analysis of lung structure using the principles of stereology has emerged as a powerful tool to describe the structural changes in lung architecture that accompany the development of lung disease that is experimentally modelled in adult mice. These stereological principles are now being applied to the study of the evolution of the lung architecture over the course of prenatal and postnatal lung development in mouse neonates and adolescents. The immature lung is structurally and functionally distinct from the adult lung, and has a smaller volume than does the adult lung.

The wisdom in ISCHEMIA.

The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) study was published recently demonstrating that over a period of 3.3 years a routine invasive approach along with optimised medical therapy (OMT) was not superior to OMT alone in patients with stable coronary artery disease and at least moderate to severe ischemia. Considerable interest and discussion have emerged over the applicability of the trial to real-world settings and the limitations of the trial.

Modeling the impact of obesity on cost of hip and knee arthroplasty.

Purpose: This study aimed to determine the proportions of total knee arthroplasty (TKA) and total hip arthroplasty (THA) attributable to obesity in Ireland and the associated hospital costs.

Methods: Sex- and age-specific numbers of primary TKA and THA procedures and length of stay were estimated using Irish population data from the Central Statistics Office (sex and age) and data from the national Hospital Inpatient Enquiry (numbers of TKA and THA procedures, length of stay, diagnostic-related group codes, sex, and age). Population attributable fractions of TKA and THA related to obesity were calculated using relative risks for different weight groups obtained from published literature.

Impact of clinical leadership in advanced practice roles on outcomes in health care: A scoping review.

Aim: To undertake a scoping review of the literature exploring the impact of clinical leadership in advanced practice roles in relation to patient, staff and organisational outcomes.

Background: An increasing number of publications as well as job specifications have identified clinical leadership as a cornerstone of advanced practice roles. However, it is unclear whether embedding clinical leadership in such roles has led to improvements in patient, staff or organisational outcomes.