Trust in cervical screening and attributions of blame for interval cancers following a national controversy.

Objectives: This study investigated levels of trust and attributions of blame in connection with a cervical screening programme following a controversy related to the programme's audit, incorporating an experimental test of the effectiveness of new information materials.

Design: We compared responses in Ireland (N = 872) to equivalent responses in Scotland (N = 400). Participants in Ireland were randomly assigned to either a treatment group that received the information materials or a control group that did not.

A scoping review and behavioural analysis of factors underlying overuse of antimicrobials.

Background: Overuse of antimicrobials is a challenging global issue that contributes to antimicrobial resistance. Despite widespread awareness of the problem among members of the medical community and various attempts to improve prescription practices, existing antimicrobial stewardship programmes are not always effective. In our view, this may reflect limited understanding of factors that influence prescription of antimicrobials as empirical therapy, implying a need to address the psychological mechanisms behind some of the specific behaviours involved.

What is the impact of multimorbidity on out-of-pocket healthcare expenditure among community-dwelling older adults in Ireland? A cross-sectional study.

Objectives: Individuals with multimorbidity use more health services and take more medicines. This can lead to high out-of-pocket (OOP) healthcare expenditure. This study, therefore, aimed to assess the association between multimorbidity (two or more chronic conditions) and OOP healthcare expenditure in a nationally representative sample of adults aged 50 years or over.

Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries-A systematic review.

Health system resilience has never been more important than with the COVID-19 pandemic. There is need to identify feasible measures of resilience, potential strategies to build resilience and weaknesses of health systems experiencing shocks. The purpose of this systematic review is to examine how the resilience of health systems has been measured across various health system shocks.

Psychological patterns of poverty in Russia: Relationships among socioeconomic conditions, motivation, self-regulation and well-being.

This article aims to extend our understanding of the link between socioeconomic conditions and psychological variables. It focuses on the effects of five distinct socioeconomic indicators on a range of psychological variables in samples of 162 individuals living below the poverty line and 188 of their more well-off counterparts in Russia. Participants completed a questionnaire containing measures of socioeconomic indicators (i.

Community ethnic density, ethnic segregation, and ethnic minorities' common mental disorders in the UK.

Studies in the UK demonstrate evidence that ethnic minorities living in communities with a higher proportion of co-ethnics report better mental health: co-ethnic density effects. This paper aims to address three gaps in this literature. Firstly, most UK research has focused on acute mental disorders (e.

Individual and community social capital, mobility restrictions, and psychological distress during the COVID-19 pandemic: a multilevel analysis of a representative US survey.

This paper explores the role of social capital in mitigating the mental health harms of social/mobility restrictions instigated in the wake of the COVID-19 pandemic. We test whether: (a) social capital continued to predict lower mental distress during the pandemic; and (b) whether social capital buffered (moderated) the harm of social/mobility restrictions on psychological distress. In addition, we test the level at which social capital mitigation effects operated, i.

Failure to take-up public healthcare entitlements: Evidence from the Medical Card system in Ireland.

While population health and welfare can be improved through the provision of non-cash benefits, such as free healthcare, many welfare improving schemes have low rates of take up amongst those eligible for such a benefit. One interesting example of this is the Medical Card scheme in Ireland. Medical Cards are a non-cash benefit that provide free primary, community, and hospital care, as well as heavily subsidised prescriptions drugs, for those below specific income means-test threshold.

Mortality risk associated with combinations of loneliness and social isolation. Findings from The Irish Longitudinal Study on Ageing (TILDA).

Background: Social distancing and similar measures in response to the coronavirus disease 2019 pandemic have greatly increased loneliness and social isolation among older adults. Understanding the association between loneliness and mortality is therefore critically important. We examined whether combinations of loneliness and social isolation, using a metric named social asymmetry, was associated with increased mortality risk.

Linking death registration and survey data: Procedures and cohort profile for The Irish Longitudinal Study on Ageing (TILDA).

Research on mortality at the population level has been severely restricted by an absence of linked death registration and survey data in Ireland. We describe the steps taken to link death registration information with survey data from a nationally representative prospective study of community-dwelling older adults. We also provide a profile of decedents among this cohort and compare mortality rates to population-level mortality data.

Comparing Underlying and Contributory Cause of Death in Registry Data With End-of-Life Proxy Interviews: Findings From The Irish Longitudinal Study on Ageing (TILDA).

Cause of death is an important outcome in end-of-life (EOL) research. However, difficulties in assigning cause of death have been well documented. We compared causes of death in national death registrations with those reported in EOL interviews.

Changes in self-concept and risk of psychotic experiences in adolescence: a longitudinal population-based cohort study.

Background: Psychotic experiences (PEs) are commonly reported in adolescence and are associated with a range of negative outcomes. Few targets for intervention for PEs have been identified. One potential target is self-concept: an individual's beliefs about his/her personal attributes.

A European late starter: lessons from the history of reform in Irish health care.

The Irish health care system is unusual within Europe in not providing universal, equitable access to either primary or acute hospital care. The majority of the population pays out-of-pocket fees to access primary health care. Due to long waits for public hospital care, many purchase private health insurance, which facilitates faster access to public and private hospital services.

High Radon Areas and lung cancer prevalence: Evidence from Ireland.

This paper examined the relationship between radon risk and lung cancer prevalence using a novel dataset combining spatially-coded survey data with a radon risk map. A logit model was employed to test for significant associations between a high risk of indoor radon and lung cancer prevalence using data on 5590 people aged 50+ from The Irish Longitudinal Study on Ageing (TILDA) and radon risk data from Ireland's Environmental Protection Agency (EPA). The use of data at the individual level allowed a wide range of potentially confounding factors (such as smoking) to be included.

The impact of frailty on healthcare utilisation in Ireland: evidence from the Irish longitudinal study on ageing.

Introduction: To examine the impact of frailty on medical and social care utilisation among the Irish community-dwelling older population to inform strategies of integrated care for older people with complex needs.

Methods: Participants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) representative of the Irish community-dwelling older population were analysed (n = 3507). The frailty index was used to examine patterns of utilisation across medical and social care services.

Disparities In Cancer Care And Costs At The End Of Life: Evidence From England's National Health Service.

In universal health care systems such as the English National Health Service, equality of access is a core principle, and health care is free at the point of delivery. However, even within a universal system, disparities in care and costs exist along a socioeconomic gradient. Little is known about socioeconomic disparities at the end of life and how they affect health care costs.

Unmet healthcare needs in Ireland: Analysis using the EU-SILC survey.

The analysis used the 2013 Survey of Income and Living Conditions to examine the extent and causes of unmet need for healthcare services in Ireland. The analysis found that almost four per cent of participants reported an unmet need for medical care. Overall, lower income groups, those with poorer health status and those without free primary care and/or private insurance were more likely to report an unmet healthcare need.

Costs of formal and informal care in the last year of life for patients in receipt of specialist palliative care.

Background: Economic evaluation of palliative care has been slow to develop and the evidence base remains small.

Aim: This article estimates formal and informal care costs in the last year of life for a sample of patients who received specialist palliative care in three different areas in Ireland.

Design: Formal care costs are calculated for community, specialist palliative care, acute hospital and other services.

The 2011 proposal for Universal Health Insurance in Ireland: Potential implications for healthcare expenditure.

The Irish healthcare system has long been criticised for a number of perceived weaknesses, including access to healthcare based on ability-to-pay rather than need. Consequently, in 2011, a newly elected government committed to the development of a universal, single-tier system based on need and financed through Universal Health Insurance (UHI). This article draws on the national and international evidence to identify the potential impact of the proposed model on healthcare expenditure in Ireland.

Socioeconomic differentials in mortality by cause of death in the Republic of Ireland, 1984-2008.

Context/problem: Comparative analysis of relative and absolute mortality differentials between socioeconomic groups are now available. These show consistently increasing relative increases in mortality differentials but complex trends in absolute mortality differentials.

Objective: This paper provides an analysis of relative and absolute trends in mortality by cause of death and socioeconomic group (SEG) from 1984 to 2008 among men and active women aged 30-64 years in Ireland and compares these results with recent European and US studies to give an overview of trends.

National variations in operative vaginal deliveries in Ireland.

Objective: To compare the percentage of operative vaginal delivery (OVD) among all publicly funded maternity hospitals in Ireland and to develop quality control performance tables to facilitate national benchmarking.

Methods: The analysis included deliveries of neonates weighing 500 g or more in publicly funded hospitals in Ireland in 2010. Information was obtained from the Irish National Perinatal Reporting System.

Breastfeeding and risk of overweight and obesity at nine-years of age.

Whether breastfeeding is protective against the development of childhood overweight and obesity remains the subject of considerable debate. Although a number of meta-analyses and syntheses of the literature have concluded that the greater preponderance of evidence indicates that breastfeeding reduces the risk of obesity, these findings are by no means conclusive. The present study used data from the Growing Up in Ireland study to examine the relationship between retrospectively recalled breastfeeding data and contemporaneously measured weight status for 7798 children at nine-years of age controlling for a wide range of variables including; socio-demographic factors, the child's own lifestyle-related behaviours, and parental BMI.

Prenatal exposure to maternal smoking and childhood behavioural problems: a quasi-experimental approach.

This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children's behavioural problems at 9 years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population.

The effect of breastfeeding on children's educational test scores at nine years of age: results of an Irish cohort study.

This retrospective cross-sectional paper examines the relationship between early breastfeeding exposure and children's academic test scores at nine years of age independent of a wide range of possible confounders. The final sample comprised 8226 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population.

The Irish health system: developments in strategy, structure, funding and delivery since 1980.

As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment.