Dervla Kelly

The contributions of adjusted ambient ultraviolet B radiation at place of residence and other determinants to serum 25-hydroxyvitamin D concentrations.

Solar ultraviolet B (UVB) radiation is the major source of vitamin D (vitD) for humans.

Ambient UVB Dose and Sun Enjoyment Are Important Predictors of Vitamin D Status in an Older Population

Background: UVB-induced skin synthesis is considered the key source of vitamin D, yet exposure to UVB is poorly accounted for in epidemiological studies.Objectives: The aim of this study was to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentration with accurately measured ambient UVB dose, sun enjoyment, supplements, and other factors.Methods: An all-Irish cohort of community-dwelling participants aged >60 y [median age: 73; 67% female; median 25(OH)D: 54.5 nmol/L] was used. Participants from this large, cross-sectional study completed a questionnaire to provide information on demographic factors and lifestyle (including supplement use and sun enjoyment). The Tropospheric Emission Monitoring Internet Service database was used to extract the daily ambient UVB dose at wavelengths that could induce vitamin D synthesis (D-UVB) over Ireland (latitude: 51°N-55°N). Blood sampling occurred throughout the year. Ambient exposure at the place of residence was calculated for each participant individually. Associations between determinants and serum 25(OH)D concentration were examined in a multivariate model. Random forest analysis was used to establish prediction models of vitamin D deficiency, and area under the curve (AUC) is shown.Results: In total, 5138 individuals were included. Median D-UVB was 63 mJ/cm2, which varied between seasons and latitudes, despite the small latitude differential. Vitamin D supplementation (β = 27.7; P < 10 × 10-10), D-UVB (β = 1.58 per 1000 mJ/cm2; P < 10 × 10-10), and sun enjoyment (β = 6.6; P < 0.001) were strongly positively associated with serum 25(OH)D. Those who avoided sunshine were largely at risk of deficiency (<40 nmol/L), whereas those who enjoyed sunshine tended to be vitamin D sufficient (≥50 nmol/L). D-UVB and sun enjoyment improved prediction of deficiency in non-supplement-taking individuals; the overall AUC improved by 3.5%.Conclusion: D-UVB and sun enjoyment are important predictors of vitamin D status, even in this elderly population at northern latitudes. Accurate estimation of ambient UVB can help to further clarify the role of other determinants of vitamin D status and inform sunshine recommendation guidelines.

Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland

Objective To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries. Setting Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE)—Primary Care Reimbursement Services (PCRS). Participants Children aged 0–15 years, on the HSE-PCRS database between January 2002 and December 2011, were included. Primary and secondary outcome measures Prescribing rates were reported over time (2002–2011) and duration (≤ or >90 days). Age (0–4, 5–11, 12–15) and gender trends were established. Rates of concomitant prescriptions for antiepileptic, antipsychotics, antidepressants and psychostimulants were reported. European prescribing data were retrieved from the literature. Results Rates decreased from 2002 (8.56/1000 GMS population: 95% CI 8.20 to 8.92) to 2011 (5.33/1000 GMS population: 95% CI 5.10 to 5.55). Of those children currently receiving a BZD prescription, 6% were prescribed BZD for >90 days. Rates were higher for boys in the 0–4 and 5–11 age ranges, whereas for girls they were higher in the 12–15 age groups. A substantial proportion of children receiving BZD drugs are also prescribed antiepileptic (27%), antidepressant (11%), antipsychotic (5%) and psychostimulant (2%) medicines. Prescribing rates follow a similar pattern to that in other European countries. Conclusions While BZD prescribing trends have decreased in recent years, this study shows that a significant proportion of the GMS children population are being prescribed BZD in the long term. This study highlights the need for guidelines for BZD prescribing in children in terms of clinical indication and responsibility, coprescribing, dosage and duration of treatment.

HPViewer: sensitive and specific genotyping of human papillomavirus in metagenomic DNA

Motivation: Shotgun DNA sequencing provides sensitive detection of all 182 HPV types in tissue and body fluid. However, existing computational methods either produce false positives misidentifying HPV types due to shared sequences among HPV, human and prokaryotes, or produce false negative since they identify HPV by assembled contigs requiring large abundant of HPV reads. Results: We designed HPViewer with two custom HPV reference databases masking simple repeats and homology sequences respectively and one homology distance matrix to hybridize these two databases. It directly identified HPV from short DNA reads rather than assembled contigs. Using 100 100 simulated samples, we revealed that HPViewer was robust for samples containing either high or low number of HPV reads. Using 12 shotgun sequencing samples from respiratory papillomatosis, HPViewer was equal to VirusTAP, and Vipie and better than HPVDetector with the respect to specificity and was the most sensitive method in the detection of HPV types 6 and 11. We demonstrated that contigs‐based approaches had disadvantages of detection of HPV. In 1573 sets of metagenomic data from 18 human body sites, HPViewer identified 104 types of HPV in a body‐site associated pattern and 89 types of HPV co‐occurring in one sample with other types of HPV. We demonstrated HPViewer was sensitive and specific for HPV detection in metagenomic data. Availability and implementation: HPViewer can be accessed at https://github.com/yuhanH/HPViewer/. Supplementary information: Supplementary data are available at Bioinformatics online.

Health Care Utilisation by Bullying Victims: A Cross-Sectional Study of A 9-Year-Old Cohort in Ireland

Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU) is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1), 8,568 9-year-olds, and their carers. Being bullied was assessed by a self-reported questionnaire completed by children at home. HCU outcomes consisted of the following: visits to GP, Mental Health Practitioner (MHP), Emergency Department (ED), and nights in hospital by parent interview. Bivariate logistic regression and gender-stratified Poisson models were used to determine association. Victimisation by bullying independently increased visits to GP (OR 1.13, 95% confidence interval (CI): 1.03 to 1.25; p = 0.02), MHP (OR 1.31, 95% CI: 1.05 to 1.63; p = 0.02), though not ED visits (OR 0.99, 95% CI: 0.87 to 1.13; p = 0.8) or nights in hospital (OR 1.07 95% CI: 0.97 to 1.18; p = 0.2), adjusting for underlying chronic condition(s) and socio-demographic confounders. Victimised girls made higher GP visits (RR 1.14, 95% CI: 1.06 to 1.23; p < 0.001) and spent more nights in hospital (RR 1.10, 95% CI: 1.04 to 1.15; p < 0.001). Victimised boys were more likely to contact MHPs (RR 1.21, 95% CI: 1.02 to 1.44; p = 0.03). 9-year-old bullied subjects were more likely to utilise primary care services than non-bullied 9-year-olds. Different HCU patterns were observed according to gender and gender differences in the presentation of victimisation. Our findings may lead to the development of clinical practice guidelines for early detection and appropriate management of bullied children.

P124 Bullying and Health Care Utilisation in 9-year-olds: Baseline Analysis of a Longitudinal Cohort

Background Being victimised by bullying is strongly associated with having an underlying chronic condition. The aim of this study was to determine whether primary and/or secondary healthcare utilisation (HCU) is increased in children who are bullied independent of having an underlying chronic illness or disability. Methods Cross-sectional survey of the first wave of the childhood (9-year-old) cohort of the Irish National Longitudinal Study of Children, encompassing 8,568 9-year-olds and their primary carers. Bully victimisation was assessed by a self-reported questionnaire completed by the child at home. The principal HCU outcomes obtained by interview-administered questionnaire with the primary caregiver at home were: visits to general practitioner (GP), Mental Health Practitioner (MHP) and nights spent in hospital in the previous 12 months. Results In logistic regression models, being victimised by bullying independently increased GP visits (OR = 1.13, 95% CI: 1.03–1.25, p = 0.02); MHP visits (OR = 1.31, 95% CI: 1.05–1.63, p = 0.02), though not nights in hospital (OR = 1.07 95% CI: 0.97–1.18, p = 0.18), irrespective of presence of chronic illness or disability. Gender stratified Poisson models demonstrated that victimised girls made increased GP visits (RR = 1.14, 95% CI: 1.06–1.23, p < 0.001) and spent nights in hospital (RR = 1.10, 95% CI: 1.04–1.15, p < 0.001); whereas victimised boys were more likely to contact MHPs (OR = 1.21, 95% CI: 1.02–1.44, p = 0.03). Conclusion 9-year-olds who are victims of bullying are more likely to utilise healthcare services. Different types of HCU patterns were observed by gender. Our study suggests health professionals need to be vigilant that medically unexplained symptoms and behavioural problems in children may be manifestations of bully victimisation, which may present differently in boys and girls. This has important implications for early detection of bullying and appropriate management of victimised children.