10 research outputs found

    Methods of Suicide by Women in Ireland 1980-2009

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    Irish female methods of suicide from 1980 till 2009 were investigated in order to determine the likelihood of the method of suicide as determined by decade as well as the age at death. Secondary data analysis was conducted on the National Suicide Research Foundation (NSRF) dataset. Multinomial logistic regression was used to compare methods of suicide using odds ratios. Log-linear analysis was conducted in order to investigate possible interactions between the variables. A stepwise backward elimination procedure determined the most parsimonious model to account for the observed frequencies. Follow-up chi-square analyses were conducted on the three-way interaction in order to separately assess possible interactions of decade and age on method of suicide. Findings showed that the odds of hanging increased over time in comparison to overdosing and drowning. Interaction effects are present between all three variables and there is a significant association between age and decade for hanging but not so for overdosing or drowning. It is concluded that hanging is a method which is indeed increasing over time for women in Ireland

    Medical-attention injuries in community cricket: A systematic review

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    Objectives: The aim was to identify and describe outcomes from original published studies that present the number, nature, mechanism and severity of medically treated injuries sustained in community-level cricket. Design: Systematic review. Methods: Nine databases were systematically searched to December 2019 using terms cricket∗ and injur∗ . Original, peer-reviewed studies reporting injury for at least one injury descriptor (body region, nature of injury and/or mechanism of injury) in community-level cricketers of all ages were included. Qualitative synthesis, critical appraisal and descriptive summary results are reported within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: Six studies were included: five reported hospital-treated data and one reported insurance claims data. Two had a low risk of bias. In hospital-based studies, fractures were the most frequent injury type. Upper and lower limb injuries (age ≥ 15 years) and injuries to the head (age \u3c 15 years) were the most common body region injured. Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type. Conclusion: Hospital treatment data were most prominent, which emphasised injuries of a more serious nature or requiring acute care. These injuries were primarily fractures, dislocation/sprain and strains, bruising and open wounds with the majority resulting from players being struck by the ball. Research into whether properly fitted protective equipment, at an approved standard, is worn and is effective, is recommended. © © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ

    Collegiate Athletes\u27 Concussion Awareness, Understanding, and -Reporting Behaviors in Different Countries With Varying Concussion Publicity

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    CONTEXT: Concussions are a global public health concern, and education on the importance of self-reporting may not reach all athletes to the same degree around the world. OBJECTIVE: To determine if differences were present in the concussion awareness, understanding, and -reporting behaviors of collegiate athletes\u27 in 3 countries with varied degrees of concussion publicity. DESIGN: Cross-sectional survey. SETTING: Collegiate sports medicine clinics. PATIENTS OR OTHER PARTICIPANTS: Collegiate athletes in the United States (n = 964; high publicity), Ireland (n = 302; moderate publicity), and Jordan (n = 129; low publicity). The degree of concussion publicity was categorized based on the extent of national public health awareness initiatives, care guidelines, research publications, and mass media coverage. MAIN OUTCOME MEASURE(S): Participants completed a 10- to 15-minute survey on concussion awareness, understanding, and -reporting behaviors. The main outcome measures were concussion education (awareness; 21 options; select all sources of concussion information), concussion knowledge (understanding; maximum score of 49), and diagnosed/nondisclosed concussion history (reporting behaviors; self-report yes/no items). RESULTS: A higher proportion of Jordanian athletes reported never having received concussion information previously (73.6%) than Irish (24.2%) or US athletes (9.4%). Knowledge differed among countries (P \u3c .0001, η2 = .28), with US athletes displaying higher total knowledge scores (40.9 ± 4.5) than Jordanian (35.1 ± 5.6) and Irish (32.1 ± 3.5) athletes. Greater percentages of Irish and US athletes reported a history of a diagnosed concussion (31.8% and 29.6%, respectively) and history of concussion nondisclosure (25.2% and 15.5%, respectively) than Jordanian athletes (2.3% and 0.0% for history of a diagnosed concussion and history of concussion nondisclosure, respectively). CONCLUSIONS: In the United States, where concussion publicity is high, formal legislation exists, and sports medicine resources and concussion awareness and understanding were increased. More culturally appropriate concussion initiatives are needed globally to ensure that athletes around the world can identify concussive injuries and understand the dangers of continued sport participation while concussed

    Physical and Lifestyle Factors Influencing Bone Density in Jockeys: A Comprehensive Update of the Bone Density Status of Irish Jockeys

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    International Journal of Exercise Science 14(6): 324-337, 2021. Compromised bone density in jockeys has previously been identified as an important health and safety concern in horseracing. Despite this, no update on the bone density status in Irish jockeys has been provided in the past decade. The study aimed to conduct a comprehensive update of the current bone density status in professional Irish jockeys and identify possible contributory physical and lifestyle factors. Eighty-five professional male jockeys (flat n = 39; national hunt (NH) n = 46) completed a dual-energy X-ray absorptiometry (DXA) scan for the assessment of body composition and bone mineral density (BMD) at the lumbar spine (LS), femoral neck (FN) and hip, 24-hour food recall, bone-specific physical activity questionnaire (BPAQ) and lifestyle questionnaire on weight making practices and injury history. Z-scores were interpreted to assess current bone density status. Correlation analysis was used to identify physical and lifestyle factors associated with bone mineral apparent density (BMAD). Results revealed a high prevalence of low BMD (Z-score \u3c - 1.0) at the LS (44%), FN (15%) and hip (29%) in Irish jockeys. Analysis of jockeys physical characteristics found a positive relationship with the LS but not FN BMAD. Riding experience and timing of weight cut in NH and the practice of cutting weight in flat jockeys negatively influenced BMAD sites, while supplement use in flat jockeys displayed a positive effect on LS BMAD. Findings indicate the need for targeted individualised support strategies. Further investigation is required into jockey-specific intervention strategies that promote the development of optimal bone health in professional jockeys

    Wearable Vital Sign Sensors and Their Potential within Low and Middle Income Countries

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    Healthcare workers continue to operate in challenging environments when assessing and treating patients in low and middle-income countries (LMIC). These difficulties are exacerbated when it comes to the assessment of infant vital signs e.g. pulse, blood pressures. As part of the EU funded Supporting LIFE project, our aim is to develop a Mobile Health (mHealth) Android application with Wearable Vital Sign Technology (WVST) integration for infant vital sign assessment. Subsequently, the objective of this research is to conduct a state of the art review of WVST systems for infant vital sign assessment with specific focus on identifying those technologies pursuing or having recently received Food and Drug Administration (FDA) approval. With the exponential growth in mHealth solutions and the ongoing discourse on the importance of mHealth compliance with regulatory standards, this factor acted as the baseline selection criteria for the investigation. Moreover, the need for an Android compatible open API WVST further bounded the scope of this study. Our market analysis reveals that there remains a dearth of appropriate, compatible WVSTs that could be considered as possible candidates for selection as part of the Supporting LIFE mHealth solution given that most commercial WVST offerings are designed for adult use. In addition, there appears to be a paucity of empirical research on the use of WVST for capturing and monitoring the vital signs of sick children in LMIC

    MRI-guided core needle biopsy of the breast: Radiology-pathology correlation and impact on clinical management.

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    OBJECTIVE: Breast MRI is used to screen high-risk patients and determine extent of disease in breast cancer (BC) patients. The goal of this study was to determine the pathologic correlates of breast MRI abnormalities biopsied under MRI guidance. METHODS: We retrospectively identified 101 MRI-guided core needle biopsies (CNB) of the breast from 79 women over a 4-year period. MRI-detected lesions biopsied with ultrasound or stereotactic guidance were excluded. MRI studies and pathology were reviewed by breast radiologists and pathologists. RESULTS: Of the 79 patients, 72 (91%) had a history of prior (n = 13) or concurrent (n = 59) BC. There were 101 MRI abnormalities: 60 (59%) with non-mass enhancement (NME) and 41 (41%) with mass enhancement. Pathology was benign in 83/101 (82%), including in the majority of NME lesions (43/60, 72%). The most common benign findings were: fibrocystic changes (FCC) (49%), sclerosing lesions (13%), and fibroadenoma (FA) (9%). There were 18 (18%) malignant diagnoses: 8 (44%) invasive lobular carcinoma (ILC), 7 (39%) ductal carcinoma in situ (DCIS), and 3 (17%) invasive ductal carcinoma (IDC). Of the 18 malignant diagnoses, 16 (89%) occurred in 14 unique patients with concurrent BC. Based on the malignant MRI-guided CNB, 6 (46%) of these patients had additional (sentinel lymph node biopsy or contralateral breast surgery) or more extensive (wider lumpectomy) surgery. CONCLUSION: In this series, most MRI-guided CNB of the breast were benign. The vast majority of malignant diagnoses occurred in patients with concurrent BC and frequently resulted in changes in clinical management

    Extracranial and Intracranial Vasculopathy With "Moyamoya Phenomenon" in Association With Alagille Syndrome.

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    Background: Alagille syndrome (AGS) is an autosomal-dominant, multisystem disorder caused by mutations in the JAG1 gene. Case Description: A 34-year-old man was referred to our service 10 years ago with focal seizures with impaired awareness and transient slurred speech. He had a 5-year history of intermittent left monocular low-flow retinopathy. He has a family history of AGS. General examination revealed mild hypertension, aortic regurgitation, and livedo reticularis. Neurological examination was normal. Investigations: He had mild hyperlipidaemia and persistently-positive lupus anticoagulant consistent with primary anti-phospholipid syndrome. Color Doppler ultrasound revealed low velocity flow in a narrowed extracranial left internal carotid artery (ICA). MR and CT angiography revealed a diffusely narrowed extracranial and intracranial left ICA. Formal cerebral angiography confirmed severe left ICA narrowing consistent with a left ICA ?vasculopathy? and moyamoya phenomenon. Transthoracic echocardiogram revealed a bicuspid aortic valve and aortic incompetence. Molecular genetic analysis identified a missense mutation (A211P) in exon 4 of the JAG1 gene, consistent with AGS. Discussion: AGS should be considered in young adults with TIAs/stroke and unexplained extracranial or intracranial vascular abnormalities, and/or moyamoya phenomenon, even in the absence of other typical phenotypic features. Gene panels should include JAG1 gene testing in similar patients

    Estimation of the period prevalence of inflammatory bowel disease among nine health plans using computerized diagnoses and outpatient pharmacy dispensings

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    BACKGROUND: There are few contemporary estimates of prevalence rates for inflammatory bowel disease (IBD) in diverse North American communities. METHODS: We estimated the period prevalence of IBD for January 1, 1999, through June 30, 2001, among 1.8 million randomly sampled members of nine integrated healthcare organizations in the US using computerized diagnoses and outpatient pharmaceutical dispensing. We also assessed the positive predictive value (PPV) and sensitivities of 1) the case-finding algorithm, and 2) the 30-month sampling period using medical chart review and linkage to a 78-month dataset, respectively. RESULTS: The PPV of the case-finding algorithm was 81% (95% confidence interval [CI], 78-87) and 84% (95% CI, 79-89) in two different organizations. In both, the sensitivity of the optimal algorithm, compared with the most inclusive, exceeded 90%. The sensitivity of the 30-month sampling period compared with 78 months was 61% (95% CI, 57-64) in one organization. Applying a slightly more sensitive case-finding algorithm, the average period prevalence of IBD across the nine organizations, standardized to the age- and gender-distribution of the US population, 2000 census, was 388 cases (95% CI, 378-397) per 100,000 persons (range 209-784 per 100,000; average follow-up 26 months). The prevalence of Crohn\u27s disease, ulcerative colitis, and unspecified IBD was 129, 191, and 69 per 100,000, respectively. CONCLUSIONS: The observed average prevalence was similar to prevalence proportions reported for other North American populations (369-408 per 100,000). Additional research is needed to understand differences in the occurrence of IBD among diverse populations as well as practice variation in diagnosis and treatment of IBD

    E-cigarette device and liquid characteristics and E-cigarette dependence: A pilot study of pod-based and disposable E-cigarette users.

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    BACKGROUND: E-cigarette device and liquid characteristics, such as electrical power output and liquid nicotine concentration, determine the rate at which nicotine is emitted from the e-cigarette (i.e., nicotine flux), and thus are likely to influence user nicotine dependence. We hypothesize that nicotine flux would be associated with the e-cigarette dependence scale (EDS) among pod-based and disposable e-cigarette products. METHODS: Data were obtained from online panel participants between 18 and 65 years of age, who had indicated that they were either former or current e-cigarette users and resided within the United States (N=1036). To be included in these analyses, participants had to provide information regarding device type (pod-based or disposable), power (watts), and nicotine concentration (mg/mL), from which we could determine nicotine flux (μg/s) (N=666). To assess the relationship between nicotine flux and EDS, a series of multivariable linear regressions were conducted. Each model was separated by device type and adjusted for by age and past 30-day e-cigarette use. RESULTS: Greater nicotine flux was associated with higher EDS scores among pod-based e-cigarette users (beta = 0.19, SE = 0.09, p-value = 0.043), but not users of disposable e-cigarettes. Neither power nor nicotine concentration were associated with EDS scores among users of either e-cigarette device type. CONCLUSION: Results support the hypothesis that nicotine flux is positively associated with nicotine dependence in a sample of current users of pod-based and disposable e-cigarettes
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