The Determinants of Self-Rated Health in the Republic of Ireland - Further Evidence and Future Directions

This paper examines the determinants of self-rated health in the Republic of Ireland using data from the 2001 Quarterly National Household Survey Health Module and the 2005 ESRI Time Usage Survey. Results indicate that self-rated health is a useful proxy for self-reported chronic illness indices. Higher education, having private medical insurance cover and being married is associated with better self-rated health. The strong inverse relationship between age and self-rated health is found to be robust to the inclusion of self-reported morbidity. Caregivers display lower self-rated health, even after controlling for age, marital status and education. We find only minor effects of gender. Understanding further the causal nature of the above associations is a key issue for future research.

Sexual Health screening: Experiences of STI and HIV testing

Study aims: To generate a profile of the socio-demographic and background characteristics and sexual health history of adults living in Ireland who have tested for STI and/or HIV To examine whether there are any significant differences in these socio-demographic/background/sexual health history variables between those that have tested for STI/HIV and those that have no

Local sustainable transport fund case study evaluation: Strategic employment sites and business parks summary report

In 2013 the UK Department for Transport commissioned a number of ‘Case Study evaluations’ of the impacts of Local Sustainable Transport Fund (LSTF) investment. One of these was an evaluation of LSTF impacts on Strategic Employment Sites and Business Parks. The aims of the evaluation were: to establish the impact of sustainable transport measures on commute mode use at selected strategic employment sites and business parks; to assess the impacts of these measures on the business performance of employers located at the sites; and to review the effectiveness of the LSTF delivery process. The results confirm findings from previous research that ‘pull factors’ are unlikely to bring about significant changes in commuter travel behaviour without measures which also ‘push’ people into reducing their car-use. Nonetheless, there was evidence from both surveys and interviews that LSTF measures assisted individuals in using alternatives to the car once they had been prompted to do so by ‘push factors’ such as parking restraints, traffic congestion or personal factors. The importance of ‘push factors’ also applied to employers’ engagement with sustainable transport issues, which tended to be prompted by a specific transport ‘problem’

Does pain mediate or moderate the relationship between physical activity and depressive symptoms in older people? Findings from The Irish Longitudinal Study on Ageing (TILDA)

Background. Depression is an increasing problem in older adults, which is exacerbated by under diagnosis and ineffective treatment options. Broadly speaking, as people age, their levels of regular physical activity (PA) decrease, while their experience of chronic pain increases. PA has been shown to be an effective, yet under-utilised, treatment for depression in this age-cohort although the influence of pain on the relationship between PA and depressive symptoms has not been considered. Methods. Secondary analysis of national data from The Irish Longitudinal Study on Ageing (TILDA, 2011) (n = 8163 participants aged 50 years and older) examined the mediating or moderating role of pain in the relationship between depressive symptoms and PA, and the impact of PA, pain and depressive symptoms on health-care utilisation. Results. Approximately 8.5% TILDA older adults were depressed. No mediating or moderating effects of pain were found in the association between PA and depressive symptoms. Higher levels of PA were found to be independently associated with lower depressive symptoms, while higher levels of pain significantly increased the likelihood of depressive symptoms supporting previous findings. Depressive symptoms and higher levels of pain were also found to significantly increase health-care utilisation. Conclusions. Consistent with previous findings in this field, both PA and pain were found to be independently associated with depressive symptoms in Irish older adults. Furthermore, pain does not play a mediating or moderating role in the relationship between PA and depressive symptoms. Continued support for ongoing initiatives in this area aimed at increasing PA in older adults as a means to improve both physical and mental well-being is advised. The absence of any synergistic effect between PA and pain suggests that clinicians and health service providers should continue to promote PA as a treatment for depression, irrespective of the pain levels of their patients

Improving research on parental involvement in sexuality education: Findings from the Irish Contraception and Crisis Pregnancy Survey – 2010

Sexuality education research has highlighted the importance of parental involvement2. Parents largely concur with the idea that they should play a fundamental role in their children’s sexuality education; indeed, 95% of parents in one national UK study felt that discussing contraception with their children was primarily their responsibility3. However, only 58% of those parents had actually done so, suggesting that these beliefs are not always reflected in practice3. Investigating sexuality education frequently occurs via national sexual health surveys. For example both the Irish Study on Sexual Health and Relationships4 and the UK National Survey of Sexual Attitudes and Lifestyles II5 included questions that asked participants about learning about sex when they were growing up. Understanding the factors that influence parents in engaging in sexuality education would benefit from advances in research design and methods

How can pharmacists develop patient-pharmacist communication skills? : a realist review protocol

Background: Good patient-pharmacist communication improves health outcomes. There is, however, room for improving pharmacists’ communication skills. These develop through complex interactions during undergraduate pharmacy education, practice-based learning and continuing professional development. Research is needed to determine how best to approach teaching patient-pharmacist communication. Methods: The aim of the research is to understand how educational interventions develop patient-pharmacist interpersonal communication skills produce their effects. A realist review approach will be used to synthesise the literature to make sense of the complexities of educational interventions. Our review will iteratively progress through the various stages of clarifying scope, locating existing theories, searching for evidence, appraisal of papers, data extraction and synthesis. A scoping review revealed a number of substantive theories, which will be used to build an initial programme theory. This will be explored through available published evidence, which we will find by searching databases such as Medline, EMBASE, PsychInfo, ERIC, Scopus and Web of Science. Judgements will be made on the relevance and rigour of the retrieved literature and will be taken into consideration during analysis and synthesis. Synthesis, testing and refinement of the theories will describe and explain the links between contexts, mechanisms and outcomes of educational interventions for communication development in pharmacy. Discussion: The realist review will provide an analysis of what works when, for whom, how and why, for educational interventions for interpersonal patient-pharmacist communication development. We will also explore barriers to successful communications training and acknowledge any limitations. Ultimately, we plan to provide pharmacy educators with evidence for how best to incorporate educational interventions for communications skills development into pharmacy curricula and for life-long learning opportunities for pharmacists

Reduced duration mismatch negativity in adolescents with psychotic symptoms: further evidence for mismatch negativity as a possible biomarker for vulnerability to psychosis

Background: Deficits in the mismatch negativity (MMN) and P3a components are the most reliable and robust findings in schizophrenia. These abnormalities have also been recently documented in individuals clinically at risk for psychosis, indicating that the MMN may be a potential biomarker for psychosis. However, the at risk samples included in MMN studies are characterised by pre-existing clinical symptomatology and significant functional decline which are related to MMN amplitude. These factors may be potential confounds in determining whether deficient MMN is present prior to clinical manifestation of the disorder. Therefore, investigating the MMN in the extended psychosis phenotype comprising adolescents with psychotic symptoms from the general population may provide important information on whether abnormal MMN is apparent in the earliest stages of risk. Methods: Thirty six adolescents completed a duration deviant MMN task. Fourteen adolescents with psychotic symptoms comprised the at risk group and 22 with no psychotic symptoms comprised the Controls. The task consisted of 85% standard tones (25 ms) and 15% deviant tones (50 ms). The groups were compared on MMN and P3a amplitude and latency across frontocentral and temporal electrodes. Results: Adolescents with psychotic symptoms were characterised by a reduction in MMN amplitude at frontal and temporal regions compared to the controls. Conclusions: This is the first study to demonstrate impaired auditory discrimination for duration deviant tones in nonclinical adolescents with psychotic symptoms. These findings suggest that MMN amplitude may be a possible biomarker for vulnerability to psychosis

Sex education, first sex and sexual health outcomes in adulthood: Findings from a nationally representative survey

Two main questions we aim to answer... 1. Is sex education effective in delaying first sexual intercourse and encouraging contraception use on this occasion? 2. Is receiving sex education related to sexual health outcomes/behaviours in later life and does the context of first sex have any role in this relationship

Reduced P300 amplitude during retrieval on a spatial working memory task in a community sample of adolescents who report psychotic symptoms.

BACKGROUND: Deficits in working memory are widely reported in schizophrenia and are considered a trait marker for the disorder. Event-related potentials (ERPs) and imaging data suggest that these differences in working memory performance may be due to aberrant functioning in the prefrontal and parietal cortices. Research suggests that many of the same risk factors for schizophrenia are shared with individuals from the general population who report psychotic symptoms. METHODS: Forty-two participants (age range 11--13 years) were divided into those who reported psychotic symptoms (N = 17) and those who reported no psychotic symptoms, i.e. the control group (N = 25). Behavioural differences in accuracy and reaction time were explored between the groups as well as electrophysiological correlates of working memory using a Spatial Working Memory Task, which was a variant of the Sternberg paradigm. Specifically, differences in the P300 component were explored across load level (low load and high load), location (positive probe i.e. in the same location as shown in the study stimulus and negative probe i.e. in a different location to the study stimulus) and between groups for the overall P300 timeframe. The effect of load was also explored at early and late timeframes of the P300 component (250-430 ms and 430-750 ms respectively). RESULTS: No between-group differences in the behavioural data were observed. Reduced amplitude of the P300 component was observed in the psychotic symptoms group relative to the control group at posterior electrode sites. Amplitude of the P300 component was reduced at high load for the late P300 timeframe at electrode sites Pz and POz. CONCLUSIONS: These results identify neural correlates of neurocognitive dysfunction associated with population level psychotic symptoms and provide insights into ERP abnormalities associated with the extended psychosis phenotype

Factors associated with crisis pregnancies in Ireland: Findings from three nationally representative sexual health surveys

Background: Findings on the demographic and sexual health characteristics associated with the experience of a crisis pregnancy is important to inform the public health policy of a country, including Ireland. Findings from other jurisdictions have suggested that certain demographic groups are at risk for unintended pregnancies and the disparity between the groups have been growing in recent years. Ireland is a country which experienced much economic and societal change in the first decade of the 21st century, changes which are likely to have affected demographic variables pertaining to sexual health. The current study had two aims: to investigate changes in the socioeconomic characteristics associated with crisis pregnancies over a seven year period [2003 to 2010], and to investigate the recent [2010] socioeconomic risk factors associated with crisis pregnancies in Ireland. Methods: The study compared the results from 18-45 year old women using data from three broadly similar nationally representative Irish sexual health surveys carried out in 2003, 2004-2006 and 2010. Chi square analysis compared of the socioeconomic characteristics across the seven year period and found that a higher proportion of women with two or more children and women for whom religion was not important reported a crisis pregnancy in 2010 compared with earlier years. A logistic regression then investigated the sexual health history and socioeconomic factors associated with the experience of a recent crisis pregnancy using the most recent 2010 data. Results: Receipt of sex education and contraception use at first sex significantly predicted the experiencing of a recent crisis pregnancy. Younger women and those with a lower level of education were more likely to report having experienced a recent crisis pregnancy. Conclusion: Similar demographic groups are at risk for experiencing a crisis pregnancy in Ireland compared with international research, yet the disparities between demographic groups who have experienced a crisis pregnancy appear to be decreasing rather than increasing over a seven year period. Recommendations are made with regard to the provision of continued sex education throughout the lifespan, particularly for those women who are at an increased risk of experiencing a crisis pregnancy