• Admissions and costs to acute hospitals resulting from road traffic crashes, 2005-2009.

      Sheridan, A; Howell, F; McKeown, N; Bedford, D; Department of Public Health, HSE Dublin North East, Railway St, Navan, Co Meath. (2012-03-01)
      Road traffic crashes (RTCs) remain a leading cause of death and injury. The aim of this study was to explore the use of hospital data as a source of RTC-related injury data in Ireland, as current systems are believed to under-estimate the burden. Information on inpatient discharges for years 2005-2009, admitted with RTC-related injuries were extracted from HIPE. There were 14,861 discharges; 9,661 (65.0%) were male, with an average age of 33 years. The median length of stay was two days. The most common diagnosis was head injury (n = 4,644; 31.2%). The average inpatient hospital cost was Euro 6,395 per discharge. 1,498 (10.1%) were admitted to intensive care units. This study has identified 3.5 times more serious injuries (14,861) than identified in the Road Safety Authority (RSA) statistics (4,263) indicating that the extent of road injuries is greater than previously estimated. Hospital data could be used annually in conjunction with RSA and other data; ideally the data should be linked.
    • A cluster of Legionnaires' disease and associated Pontiac fever morbidity in office workers, Dublin, June-July 2008.

      Ward, M; Boland, M; Nicolay, N; Murphy, H; McElhiney, J; Collins, C; Lynch, M; McCarthy, M; O' Donnell, J; Department of Public Health, Health Services Executive, Dublin, Ireland. mary.wardbarrett@hse.ie (2010)
      In June and July 2008, two office workers were admitted to a Dublin hospital with Legionnaires' disease. Investigations showed that cooling towers in the basement car park were the most likely source of infection. However, positive results from cooling tower samples by polymerase chain reaction (PCR) did not correlate with subsequent culture results. Also, many employees reported Pontiac fever-like morbidity following notification of the second case of Legionnaires' disease. In total, 54 employees attended their general practitioner or emergency department with symptoms of Legionnaires' disease or Pontiac fever. However, all laboratory tests for Legionnaires' disease or Pontiac fever were negative. In this investigation, email was used extensively for active case finding and provision of time information to employees and medical colleagues. We recommend clarification of the role of PCR in the diagnosis of legionellosis and also advocate for a specific laboratory test for the diagnosis of the milder form of legionellosis as in Pontiac fever.
    • Congenital anomalies and proximity to landfill sites.

      Boyle, E; Johnson, H; Kelly, A; McDonnell, R; Health Information Unit, Department of Public Health, Eastern Regional Health Authority, Dublin. (2004-01)
      The occurrence of congenital anomalies in proximity to municipal landfill sites in the Eastern Region (counties Dublin, Kildare, Wicklow) was examined by small area (district electoral division), distance and clustering tendancies in relation to 83 landfills, five of which were major sites. The study included 2136 cases of congenital anomaly, 37,487 births and 1423 controls between 1986 and 1990. For the more populous areas of the region 50% of the population lived within 2-3 km of a landfill and within 4-5 km for more rural areas. In the area-level analysis, the standardised prevalence ratios, empirical and full Bayesian modelling, and Kulldorff's spatial scan statistic found no association between the residential area of cases and location of landfills. In the case control analysis, the mean distance of cases and controls from the nearest landfill was similar. The odds ratios of cases compared to controls for increasing distances from all landfills and major landfills showed no significant difference from the baseline value of 1. The kernel and K methods showed no tendency of cases to cluster in relationship to landfills. In conclusion, congenital anomalies were not found to occur more commonly in proximity to municipal landfills.
    • Factors predicting completion in a cohort of opiate users entering a detoxification programme.

      Mullen, Louise; Keenan, Eamon; Barry, Joseph; Long, Jean; Mulholland, Deirdre; Grogan, Loretto; Delargy, Ide; Strategic Health Planning, Population Health Directorate, Dr. Steeven's Hospital, HSE, Dublin 8, Ireland. Louise.mullen@hse.ie (2010-12)
      To determine the outcome and factors influencing outcome among a cohort of drug users commencing detoxification from opiate use.
    • General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

      Brabazon, E D; Carton, M W; Murray, C; Hederman, L; Bedford, D; Department of Public Health, Health Service Executive Dublin North East, Navan, County Meath, Ireland. elaine.brabazon@hse.ie (2010)
      The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.
    • The impact of legislation in Ireland on handheld mobile phone use by drivers.

      O'Meara, M; Bedford, D; Finnegan, P; Howell, F; Murray, C; Department of Public Health, HSE-North East, Railway St, Navan, Co Meath. (Irish medical journal, 2008)
      Under the Road Traffic Act, 2006 handheld mobile phone use whilst driving is an offence liable to a fine and penalty points. The aim of this study was to determine whether there has been a change in driver behaviour following the introduction of this legislation. This study found that 2.3% of drivers were still using a handheld mobile phone.
    • Interpreting asymptomatic bacteriuria.

      Cormican, Martin; Murphy, Andrew W; Vellinga, Akke; Centre for Health from Environment, Ryan Institute, and Medical School, NUI Galway, Galway, Ireland. martin.cormican@hse.ie (BMJ (Clinical research ed.), 2011)
    • Out-of-hospital cardiac arrest (OHCA) survival in rural Northwest Ireland: 17 years' experience.

      Masterson, Siobhán; Wright, Peter; Dowling, John; Swann, David; Bury, Gerard; Murphy, Andrew; Department of Public Health Medicine, Health Service Executive North-West, Letterkenny, Donegal, Ireland. siobhan.masterson@hse.ie (2011-05)
      SAVES, the name used to describe a register of survivors of out-of-hospital cardiac arrest (OHCA), was established in rural Northwest Ireland in 1992. From 1992 to 2008, 80 survivors were identified (population 239,000 (2006)). Most incidents were witnessed (69/70) and all were in shockable rhythm at the time of first rhythm analysis (66/66). Of 66 patients who could be traced, 46 were alive in December 2008. Average survival rates appeared to increase over the lifetime of the database. SAVES has also contributed to the development of a national OHCA register.
    • Patient satisfaction with a hepatitis B vaccination programme among persons with an intellectual disability.

      Cooney, Fionnuala; Department of Public Health Medicine, Bridgewater House, Rockwood Parade, Sligo, Ireland. fionnuala.cooney@hse.ie (Journal of intellectual disabilities : JOID, 2009-09)
      This article demonstrates that a patient satisfaction survey can be carried out to evaluate the acceptability of a hepatitis B vaccination programme among persons with an intellectual disability. In this exploratory study, involving six clients, 41 care staff and three managers of intellectual disability services, core themes were identified on the acceptability of the programme. The following recommendations are made: a respectful attitude should be shown to all clients by the healthcare providers; appropriate information about the programme should be provided that is tailored to the needs and receptive capability of all recipients and their carers; the intervention should be delivered in an environment, and by healthcare personnel, familiar to clients; carers should be attentive to the possibility of adverse effects; and explicit, ethically stringent policies should be in place on the use of physical restraint. The article makes suggestions regarding future work in assessing patient satisfaction among this client group.
    • Potential organ donor audit in Ireland.

      Hegarty, M; O'Neill, W; Colreavy, F; Dwyer, R; Cunningham, P; Hanlon, M; Department of Public Health, HSE Dublin Mid-Leinster, Tullamore, Co Offaly. mary.hegarty@hse.ie (2010-11)
      As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1/9/07-31/8/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information/education campaigns.
    • Review of acute cancer beds.

      Evans, D S; Kiernan, R; Corcoran, R; Glacken, M; O'Shea, M; Department of Public Health, HSE West, Merlin Park Hospital, Galway. (2012-01)
      A review of admissions to cancer services at University Hospital Galway (UHG) was undertaken to assess the appropriateness of hospital usage. All cancer specialty patients admitted from 26-28 May 2009 were reviewed (n = 82). Chi square tests, Exact tests, and One-way ANOVA were utilised to analyse key issues emerging from the data. Fifty (61%) were classified as emergencies. Twenty three (67%) occupied a designated cancer bed with 24 (30%) in outlying non-oncology wards. The mean length of stay was 29.3 days. Possible alternatives to admission were identified for 15 (19%) patients. There was no evidence of discharge planning for 50 (60%) admissions. There is considerable potential to make more appropriate utilisation of UHG for cancer patients, particularly in terms of reducing bed days and length of stay and the proportion of emergency cancer admissions, and further developing integrated systems of discharge planning.
    • Sub-optimal asthma control in teenagers in the midland region of Ireland.

      Kelly, I; Fitzpatrick, P; Department of Public Health, HSE, Arden Road, Tullamore, Co. Offaly, Ireland. ina.kelly@hse.ie (Irish journal of medical science, 2011-12)
      Internationally, many children with asthma are not attaining achievable asthma control.
    • Ten-year survival of Down syndrome births.

      Hayes, C; Johnson, Z; Thornton, L; Fogarty, J; Lyons, R; O'Connor, M; Delany, V; Buckley, K; Health Information Unit, Eastern Health Board, Dr Steevens Hospital, Dublin, Ireland. (1997-08)
      To determine the survival status of children with Down syndrome (DS), and to document factors influencing survival.
    • Trends in COPD mortality and in-patient admissions in men & women: evidence of convergence.

      O'Farrell, A; De La Harpe, D; Johnson, H; Bennett, K; Health Intelligence Unit, Health Service Executive, Palmerstown, Dublin 20. ann.ofarrell@hse.ie (2011-09)
      Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality. Although more prevalent in men, it is anticipated that, due to the convergence in smoking rates, the prevalence rate in women will surpass that of men. There were 14,519 deaths attributable to COPD in the period 2000-2009. Although deaths decreased for both sexes, reduction in deaths was significantly higher among men (test for trend, p<0.01 for men vs. p=0.06 for women). Smoking rates decreased for both sexes from 1980-2009 with the percentage reduction in smoking significantly greater in men (11.5% vs. 7.0%, p<0.001). There has been a convergence in COPD deaths and COPD hospital in-patient discharges for men and women that mirrors the trend in the convergence of male and female smoking rates. This study provides evidence of the need for effective smoking cessation programmes that are targeted at women as well as men.