Increase in observed mental health difficulties one year after acute coronary syndrome: general practitioner survey.

BACKGROUND: General practitioners (GPs) are often the first to assess mental health difficulties after acute coronary syndrome (ACS). AIMS: To determine whether GPs observed an increase in mental health difficulties one-year post-hospitalisation for ACS. METHODS: Postal survey. RESULTS: GPs rated patients (n = 442) as having probable (GP assessed 10%) or definite (formally assessed 7%) mental health difficulties pre-hospitalisation. Post-hospitalisation the prevalence of probable cases increased significantly to 19% (OR = 4.3, 95% CI 2.1-10.2, P \u3c 0.001). In multivariate analysis, only smoking at index hospitalisation was associated with being assessed as a new case of probable/formal mental health difficulties (RR = 2.1, 95% CI 1.3-3.4, P = 0.003). Forty-seven percent of cases were prescribed some medication for this problem. CONCLUSIONS: GPs recorded a significant increase in mental health difficulties in ACS patients 12 months after hospitalisation, with smoking used as an indicator of new cases

The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality.

OBJECTIVE: The objective of this study was to investigate the use of short-form depression scales in assessing 1-year mortality risk in a national sample of patients with acute coronary syndrome (ACS). METHODS: Patients with ACS (N=598) completed either the Hospital Anxiety and Depression Scale depression subscale (HADS-D) or the Beck Depression Inventory-Fast Scale (BDI-FS). Their mortality status was assessed at 1 year. RESULTS: Cox proportional hazards modeling showed that patients depressed at baseline (combining HADS-D and BDI-FS depressed cases) were more likely to die within 1 year [hazard ratio (HR)=2.8, 95% CI=1.4-5.7, P=.005], even when controlling for major medical and demographic variables (HR=4.1, 95% CI=1.6-10.3, P=.003). Scoring above the threshold on the HADS-D predicted mortality (HR=4.2, 95% CI=1.8-10.0, P=.001), but scoring above the threshold on the BDI-FS did not (HR=1.8, 95% CI=0.6-5.6, P=.291). CONCLUSION: The HADS-D predicted increased risk of 1-year mortality in patients with ACS

Gender differences in the presentation and management of acute coronary syndromes: a national sample of 1365 admissions

Background Gender differences in presentation and management of acute coronary syndromes (ACS) are well established internationally. This study investigated differences in a national Irish sample. Design Cross-sectional survey. Methods All centres (n= 39) admitting cardiac patients to intensive/coronary care provided information on 25 consecutive acute myocardial infarction patients and other ACS patients admitted concurrently (n= 1365 episodes). Patient data was analyzed in terms of those with prior ACS/revascularization, and those without. Results Men with prior established ACS/revascularization were twice as likely to have received revascularization procedures (coronary artery bypass graft or percutaneous coronary intervention) prior to admission when controlling for age, total cholesterol and insurance status [odds ratio (OR) 1.97, 95% confidence interval (CI) 1.18–3.29, P = 0.011]. No gender differences were seen in acute-phase reperfusion (OR 0.96, 95% CI 0.76–1.24, P \u3e0.05) or antiplatelet therapy (OR 0.99, 95% CI 0.69–1.41, P \u3e 0.05). For patients with prior ACS/revascularization, men were twice as likely to receive statins on discharge after adjustment for age and total cholesterol (OR 1.94, 95% CI 1.02–3.71, P= 0.045). Conclusions Women were treated differently to men. Fewer women with a positive history of ACS received revascularization prior to current admission and fewer women were prescribed lipid-lowering medications on discharge. Acute phase hospital treatment was not gender determined. These findings have implications for secondary prevention in Ireland

“Howya gettin’ on?” Investigating Public Transport Satisfaction Levels in Galway, Ireland

Public transport transforms urban communities and the lives of citizens living in them by stimulating economic growth, promoting sustainable lifestyles and providing a greater quality of life. Globally, the healthiest cities have one thing in common, a public and active transport network that does not depend on each person owning a personal motorised vehicle. Growing dependence on the automobile has created a multitude of problems, some of which public transport can help solve. Adverse social, environmental and health effects related to automobile emissions and car-dependency suggest that using public transport will result in a decrease in an individual&rsquo s carbon footprint, will lessen overall CO2 emissions, and will help to ease urban traffic congestion as well as encourage more effective and efficient land use. With many urban areas experiencing ongoing traffic problems, it is acknowledged that any sustainable long-term solution must entail a significant public transport element. The aim of this research study, conducted in November and December 2017, was to obtain essential baseline information on service user satisfaction levels with the existing public bus services in Galway City, Ireland. By measuring levels of satisfaction, it is possible to build our overall knowledge of the public transport network and thus identify improvements in the service that would lead to an increase in bus passenger numbers and result in reductions in the amount of cars on the roads. Results suggest deficiencies in public transport infrastructure, such as Dedicated Bus Lanes, and the lack of attention to customer services are hindering improvements in the public bus service. Document type: Articl

October 9, 2006

The Breeze is the student newspaper of James Madison University in Harrisonburg, Virginia

SLAN 2007: Survey of Lifestyle, Attitudes and Nutrition in Ireland Mental Health and Social Well-being Report

This report presents the main findings on the mental health and social well-being of Irish adults from the 2007 Survey of Lifestyle, Attitudes and Nutrition (SLÁN 2007) in Ireland, commissioned by the Department of Health and Children. The report is part of a series based on the main 2007 survey (Morgan et al, 2008), which for the first time included questions on the mental health and social well-being status of the Irish adult population. Respondents were asked a series of questions on different aspects of mental health, including positive mental health and well-being, common mental health problems and clinical symptoms of depression and generalised anxiety disorder. A number of questions were also included on perceived stigma, quality of life, deliberate self-harm, loneliness, social support and social well-being. The SLÁN 2007 survey involved 10,364 respondents (62% response rate), aged 18 and over, with sub-studies on body size and a detailed physical examination. The sample is representative of the general population in Ireland when compared with Census 2006 figures and was further weighted to match the Census for analysis. SLÁN 2007 is, therefore, the largest national survey to date on the extent of both positive and negative mental health in the Irish adult population. This report presents the findings on mental health and social well-being and considers the influence of key socio-demographic variables, including age, gender, social class, education, income, residential location, employment status and marital status. The relationships between mental health, social well-being and self-rated health are also examined

Back-illuminated electron multiplying technology: The world's most sensitive CCD for ultra low-light microscopy

ABSTRACT The back-illuminated Electron Multiplying Charge Coupled Device (EMCCD) camera stands to be one the most revolutionary contributions ever to the burgeoning fields of low-light dynamic cellular microscopy and single molecule detection, combining extremely high photon conversion efficiency with the ability to eliminate the readout noise detection limit. Here, we present some preliminary measurements recorded by a very rapid frame rate version of this camera technology, incorporated into a spinning disk confocal microscopy set-up that is used for fast intracellular calcium flux measurements. The results presented demonstrate the united effects of: (a) EMCCD technology in amplifying the very weak signal from these fluorescently labelled cells above the readout noise detection limit, that they would otherwise be completely lost in; (b) back-thinned CCD technology in maximizing the signal/shot noise ratio from such weak photon fluxes. It has also been shown how this innovative development can offer significant signal improvements over that afforded by ICCD technology. Practically, this marked advancement in detector sensitivity affords benefits such as shorter exposure times (therefore faster frame rates), lower dye concentrations and reduced excitation powers and will remove some of the barriers that have been restricting the development of new innovative low-light microscopy techniques

Chlamydia Screening in Ireland: a pilot study of opportunistic screening for genital Chlamydia trachomatis infection in Ireland (2007-2009). Economic evaluation

Economic Evaluation The aim of the economic evaluation was to examine the cost effectiveness of the two screening models tested in the Chlamydia Screening in Ireland Pilot (CSIP) study: (a) Clinical Setting screening, and (b) ’Pee-in-a-pot’ periodic screening in third level institution/college settings. The methodological approach comprised of a dynamic transmission model paired with an economic model. In both analyses, screening was compared to a control strategy of no organised screening, that is existing care in Ireland. A public health system or provider perspective was adopted with respect to costs. The analysis considered the cost of screening to the health service, and the costs of infection and complications, not any additional costs reported by young people in accepting a chlamydia screening test. Health outcomes were assessed in terms of major outcomes (MOs) averted and quality adjusted life years (QALYs) gained. The costs of Clinical Setting screening were presented in terms of the cost per offer (€26 ), the cost per negative case (€66), the cost per positive case (€152), and the cost per partner notified and treated (€74). The costs of ’Pee-in-a-pot’ screening were presented in terms of the cost per negative case (€39), the cost per positive case (€125), and the cost per partner notified and treated (€74). In both analyses, screening was estimated to result in fewer major outcomes, fewer QALYs lost, and higher healthcare costs compared to the control strategy. The incremental cost effectiveness analyses indicated that screening in the Clinical Setting would result in an incremental cost per MO averted of €6,093 and an incremental cost per QALY gained of €94,717. ’Pee-in-a-pot’ screening was estimated to result in incremental cost effectiveness ratios of €2,294 per MO averted and €34,486 per QALY gained respectively. In Ireland, there is no fixed and generally agreed cost effectiveness threshold below which health care technologies would be considered by policy makers to be costeffective. Nonetheless, on the basis of other technologies that are currently funded, it is not likely that screening delivered in the Clinical Setting, given an incremental cost per QALY in the region of the €94,717 found in this study, would be considered cost effective. ’Pee-in-a-pot’ screening in third level institution/college settings may be considered cost effective if a cost effectiveness threshold in the region of €45,000 per QALY gained is used. This is open to question, however, given the current economic climate and its resulting impact in terms of imposing further constraints on future healthcare budgets. It is also important to note that this strategy would have minimal in impact in reducing overall chlamydia prevalence in the population, if not supported by general population screening and prevention strategy

SLAN 2007: Suirbhe ar Nosanna Maireachtala, Dearcai agus Cothu in Eirinn: Priomhthuarascail

Is éard atá sa tuarascáil seo na príomhthorthaí ó Shuirbhé ar Nósanna Maireachtála, Dearcaí agus Cothú in Éirinn 2007 (SLÁN 2007). Is é seo an tríú suirbhé SLÁN agus an suirbhé is mó agus is é seo an chéad suirbhé a áirítear teangacha eile ann seachas Béarla agus Gaeilge. Rinneadh staidéir eile roimhe seo in 1998 (Friel et al, 1999) agus 2002 (Kelleher et al, 2003). Tá an dá thuarascáil seo le fáil ar an láithreán gréasáin www.healthpromotion.ie/publications. Rinneadh príomhshuirbhé SLÁN 2007 trí agallaimh duine le duine. Bhí dhá staidéar foghrúpa ann (i) tomhas airde, meáchain agus imlíne coime (foghrúpa freagróirí níos óige) agus (ii) scrúdú fisiciúil níos mionsonraithe (foghrúpa de fhreagróirí níos sine). Is é a bhí mar aidhm leis an staidéar sonraí náisiúnta maidir le sláinte ghinearálta, iompraíochtaí sláinte agus úsáid seirbhísí sláinte a bhailiú i measc daoine fásta a bhfuil cónaí orthu in Éirinn. Dhírigh staidéar an dá fhoghrúpa ar eolas ríthábhachtach maidir le próifílí riosca sláinte daoine fásta níos óige agus níos sine a sholáthar. Roghnaíodh téamaí SLÁN 2007 bunaithe ar thosaíochtaí reatha náisiúnta beartais agus seirbhíse. Baineadh úsáid as príomhcháipéisí lena n-áirítear an Straitéis Náisiúnta Sláinte, Ardchaighdeán agus Cothroime (An Roinn Sláinte agus Leanaí, 2001); an Straitéis Náisiúnta um Chur chun Cinn na Sláinte (An Roinn Sláinte agus Leanaí, 2000); agus ceathrú Tuarascáil Bhliantúil an Phríomh-Oifigigh Mhíochaine (An Roinn Sláinte agus Leanaí, 2005). Trí chomhairliúchán breise leis an gcuibhreannas taighde, chuir an Grúpa Maoiniúcháin agus Comhairleach sraith míreanna tosaíochta agus soláimhsithe a bhí le meas le chéile. Príomhriachtanas ba ea sraith príomhshonraí sláinte den daonra náisiúnta a sholáthar – sonraí a chiallódh go mbeadh sé indéanta comparáid a dhéanamh laistigh d’fhoghrúpaí staidéir (inscne, aois agus aicme shóisialta), sna réigiúin seirbhíse sláinte laistigh d’Fheidhmeannacht na Seirbhíse Sláinte (HSE), agus le príomhdhaonraí comparáide eile (go háirithe Tuaisceart Éireann) mar aon le suirbhéanna SLÁN a rinneadh roimhe seo. Ba é an tAonad Cothú Sláinte agus Beartais sa Roinn Sláinte agus Leanaí a mhaoinigh SLÁN 2007. Ba é cuibhreannas SLÁN 2007 a rinne na suirbhéanna agus an anailís. I measc chomhaltaí an Chuibhreannais bhí Coláiste Ríoga na Máinleá in Éirinn (RCSI), Coláiste na hOllscoile, Corcaigh (UCC), Ollscoil na hÉireann, Gaillimh (OÉG) agus an Institiúid Taighde Eacnamaíochta agus Sóisialta (ESRI)