Frank Houghton

Diabetes mellitus in Irish general practice: Level of care as reflected by HbA1c values

Objective: To assess the level of care given to people with diabetes by general practitioners and factors affecting it. Methods: A cross-sectional study of Irish general practitioners, looking at practice characteristics and patient care over the previous 2 years; a nationally representative sample of 27 general practitioners. A total of 1030 people with diabetes were studied, of whom 201 were type 1 and 829 were type 2. Results: The response rate was 27 out of 52 (52%). HbA1c values were not related to the patients socioeconomic status. The average HbA1c for type 1 people with diabetes was 7.81%, and for type 2 it was 7.1%. HbA1c values were measured 3.02 times for type 1 and 3.16 times for people with type 2 diabetes. This is a good standard of care, especially for type 2 disease. Computerized practices and those patients whose care was shared with the hospital achieved better control, even though HbA1c levels were checked less frequently with computerization. The use of a protocol in the practices also improved care. Those practices employing a nurse had increased frequency of measurement of HbA1c and better control on univariate but not on multivariate analysis. Possible reasons for this are discussed. Conclusion: Diabetes Mellitus is treated to a good standard in Irish general practice, especially type 2 disease. This standard appears to be independent of the patients socio-economic status, is improved by GPs being computerised, in group practices and by providing care according to a protocol. Shared care also improves control. Employing a practice nurse may also improve care.

Children's depression, gender and age norms for an Irish national (primary) school population

OBJECTIVES To provide normative data for older national (primary) school children, broken down by age and gender, for the Childrens Depression Inventory-Short version (CDI-S) and revised norms for the Childrens Depression Inventory-Parent version (CDI-P) and its subscales. METHOD Forty-three randomly selected national schools took part in this study. Participants were 1,255, fifth and sixth class, Irish national school children who completed the Childrens Depression Inventory Short Form (CDI-S). In total 1,018 parents completed the corresponding parent form, the Childrens Depression Inventory-Parent version (CDI-P). RESULTS Norms for the CDI-S and the CDI-P subscales were produced. Revised norms for the CDI-P are proposed. Results revealed no significant age or gender difference in depressive symptomatology as measured by respondents CDI-S and total CDI-P scores. Parents ratings of their childrens depression levels (CDI-P) and childrens self-reported depression levels (CDI-S) were significantly correlated. The CDI-S and CDI-P displayed good internal reliability. CONCLUSION Results indicate the utility of both the CDI-S and the CDI-P for assessing depressive symptoms in national school children in Ireland. This study confirms that national school children do display symptoms of depression. School based policies, materials and services supporting and promoting positive mental health should be developed, implemented and resourced.

The Brief Symptom Inventory-18 (BSI-18): norms for an Irish third-level college sample

A baseline assessment of mental health status was conducted in an Irish third-level student population. In addition to a number of other measures, the Brief Symptom Inventory-18 (BSI-18), a relatively new and unexamined measure in the Irish context, was administered. Based on a quota sample, data were collected from a sample of 763 participants. In line with previous findings, females reported significantly higher levels of symptomatology than males on all three subscales (Somatization, Depression and Anxiety) and the Global Severity Index. Final year students were also noted to have significantly worse mental health than non-final year students. In addition, differences were noted between the present Irish female sample and US women in BSI-18 scores. Results support the use of the BSI-18 in Ireland. The development of specific Irish norms is therefore proposed and provisional norms for third-level college students are provided.

Tertiary Level Students and the Mental Health Index (MHI-5) in Ireland

An examination of student mental health was conducted using the five item Mental Health Index (MHI), a subscale of the widely used SF-36 (Short Form Health Survey). Results support the use of the MHI, which was found to be to be a valid and reliable measure of mental health in Irish third-level students. As anticipated, females reported significantly higher levels of symptoms than males on the MHI. It was also noted that final year students report significantly worse mental health than other students. Comparison with a general population mean for a corresponding age group indicate significantly lower mental health status being recorded by the students in this study. Suggestions for further research are made.

Reflection and comment: Health GIS in the mid‐west: Unexpected developments and directions

Abstract The use of Geographical Information Systems (GIS) to address health issues is growing rapidly internationally. In Ireland, however, health GIS remains in its infancy. Nonetheless, significant progress has been made recently in one former Health Board in connection with developments in primary care. This project has dramatically increased the profile of GIS in health circles within the region. However, concerns emerged around with the growing professionalisation of the GIS function during this project. These included the tendency to hire GIS experts from technical, rather than social science backgrounds, and the conceptualisation of GIS in senior circles as a management control tool. Health (Medical) Geographers need to decide whether they wish to oppose the introduction of GIS in Irish health circles, ignore it, or actively try to lead and influence developments in this field. This last option is proposed to ensure that GIS remains a tool for exploring, identifying, highlighting and combating ine...

Ethics in academic publishing: a timely reminder

Most, if not all, academic librarians are by now familiar with the term “predatory publishing.”

Gender and the children's depression inventory's (CDI) ‘crying’ question

Objectives : Following disruption from students, particularly boys, during the administration of item 10, the ‘feel like crying’ question, of the Childrens Depression Inventory (CDI), this study sought to explore the issue of non-response to this question. It was decided that particular attention should be given to gender differences in responses and non-responses, based on the experiences of researchers administering this measure. Method : Chi-square analysis of non-responses was conducted on CDI items collected from a total sample of 2,297 second year and pre-leaving certificate students from 23 randomly selected schools in the Mid-West region of Ireland. Results : Analysis identified item 10 as being significantly less likely to be completed than any other item. Further analysis revealed that boys were significantly less likely to respond to this question than girls. Conclusion: A modification of the wording to item 10 is suggested to ameliorate this difficulty.

The Children’s Depression Inventory (CDI) in Ireland: Revision & Subscale Analysis

Abstract Houghton, O’Connell & O’Flaherty (1998) produced the first set of Irish norms for the Children’s Depression Inventory (CDI). However, since this research was conducted in 1996, Ireland has undergone profound social, economic and political changes. This study sought to replicate elements of the original Irish normative study to determine if these norms were still valid. Additionally, this study sought to produce Irish norms for the CDI’s five subscales (negative mood, interpersonal problems, ineffectiveness, anhedonia and negative self-esteem), an area of examination overlooked to date in Ireland. Results from a multistage, stratified random-sampling survey conducted in 2002, involving 2,297 post-primary school students from the mid-west region of Ireland, identified significantly lower levels of depressive symptoms among girls compared to results from 1996. As expected, depressive symptoms among girls were significantly higher than among boys. Similarly depressive symptoms among older adolescents...

The Askeaton Investigation and the failure of Irish health information systems

Sporadic concerns over animal health problems have been voiced in north county Limerick since the late 1980s. This issue came to the fore in late 1994 when local concerns developed to encompass human health in the area. The MidWestern Health Board responded by attempting to investigate the health status of the local population in an effort to identify possible pollution related illnesses. Fourteen studies were initiated but several of the studies proved unfeasible given the limitations of the computerised health information systems, or had to completed by hand or interview. This investigation highlighted the almost total failure of Irish health information systems to respond to any form of in-depth analysis of population health status. This proved costly both financially and in terms of the delay that ensued, which allowed fear and concern to spread. As alarm escalated the number of conditions residents felt should be investigated increased. The geographical coding of all health information below county level, at least to DED level and ideally to point location is the most basic reform necessary for population health surveillance and investigation.

Antimicrobial resistance (AMR) and the United Nations (UN)

The true threat of antimicrobial resistance (AMR) as revealed to all in the World Health Organizaion’s (WHO) 2014 global report on AMR surveillance 1]. The following year the WHO then launched its esponse plan, the Global Action Plan on Antimirobial Resistance in coordination with the Food nd Agriculture Organization of the United Nations FAO) and the World Organisation for Animal Health OIE) [2]. The threat is present not only in the MENA Middle East and North Africa) region, but throughut the world [3—5]. The (US) Centers for Disease ontrol and Prevention (CDC) currently identify 18 rug-resistant threats to the US, which in its hazrd classification schema are defined as ‘‘Urgent hreats’’, ‘‘Serious Threats’’, and ‘‘Concerning’’ 6]. To help quantify the danger posed, it is orth noting that the WHO estimate that in 2014 lone there were 480,000 new cases of multidrugesistant tuberculosis (MDR-TB) [5]. AMR presents a eal and growing threat notably in relation to HIV, alaria, pneumonia, gonorrhea, and a variety of ost-operative infections [5]. Individual governments are already looking at his issue seriously [7], but perhaps the greatest ope for the future in response to the AMR threat ies in the recent United Nation’s (UN) statement ommitting national leaders to combat AMR through oordinated multi-sectoral approaches. [8]. This tatement resulted from a meeting held on the 1st September 2016 that took place at the UN uilding in New York, and was convened by the resident of the 71st session of the UN General ssembly, H.E. Peter Thomson. This has particuar significance, as it is only the 4th time that a ealth issue has been examined by the UN General ssembly (other issues addressed have included HIV nd non-communicable diseases). This intervention uilds on the foundation of the recent UN Mission