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The Health and Safety Execultive lymphoedema model of care was published in 2018 highlighting the lack of dedicated lymphoedema services in Ireland. This led to the introduction of a proof-of-concept primary care specialist lymphoedema clinic. The clinic was responsible for all patients from their county. A comprehensive dataset was gathered which included the patient's history for 1 year prior to their presentation at clinic and then 6 monthly. A quality of life tool (LymQoL) and a patient satisfaction survey were completed. Completed 1-year data showed a significant reduction in GP and public health nurse visits as well as a reduction in the occurrence of cellulitis and associated hospital admissions. All areas of quality of life were improved and patient satisfaction was either excellent (89%) or very good (11%). The 1-year findings strongly support the roll-out of specialist clinics to all regional health areas. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to describe the epidemiology of multisystem inflammatory syndrome in children (MIS‐C) in the Republic of Ireland, in the context of all cases of COVID‐19 in children, during the first year of the SARS‐CoV‐2 pandemic. Methods: Cases of MIS‐C were identified by prospective surveillance in Irish hospitals from April 2020 to April 2021. Paediatric COVID‐19 cases and outbreaks in schools or childcare facilities were notified to and routinely investigated by Public Health. Univariate and bivariate analyses were carried out in Excel, Stata and JMP statistical package. Results: Fifty‐four MIS‐C cases (median age 7.58 years; males 57%) were identified over the study period. MIS‐C incidence was higher in certain ethnicities ('black' 21.3/100,000 [95% CI 4.3–38.4]; and 'Irish Traveller' 14.7/100,000 [95% CI −5.7‐35.1]) than those of 'white' ethnicity (3.4 /100,000). MIS‐C cases occurred in three temporal clusters, which followed three distinct waves of community COVID‐19 infection, irrespective of school closures. Formal contact tracing identified an epidemiological link with a COVID‐19‐infected family member in the majority of MIS‐C cases (77%). In contrast, investigation of COVID‐19 school outbreaks demonstrated no epidemiological link with MIS‐C cases during the study period. Conclusion: Efforts at controlling SARS‐CoV‐2 transmission in the community may be a more effective means to reduce MIS‐C incidence than school closures. Establishing a mandatory reporting structure for MIS‐C will help delineate the role of risk factors such as ethnicity and obesity and the effect of vaccination on MIS‐C incidence. [ABSTRACT FROM AUTHOR]

Background: This study aimed to ascertain patients' experience of the out-patient venous service being provided,; identify the level of patient satisfaction with the service and identify areas for further improvement and development. Method: A prospective descriptive quantitative study. A questionnaire was distributed to all patients who used the service between June 2017 and March 2018. A total of 195 questionnaires was distributed with 162 valid questionnaires returned; response rate of 83%. Results: This study found high satisfaction levels with endovenous ablation procedures, with concomitant phlebectomy, in the ambulatory outpatient setting and patient experiences of the service are overwhelmingly positive. Conclusion: Study findings support the management of ambulatory outpatient varicose vein endovenous ablation procedures as a feasible alternative to day surgery theatre settings and is the blueprint for future management of varicose vein surgery in Ireland. [ABSTRACT FROM AUTHOR]

The advent of the Great Recession and the widespread adoption of fiscal austerity policies have heightened concern about inequality and its effects. We examine how the distribution of income in Ireland—a country which experienced one of the most severe economic contractions—has evolved over the years 2008 to 2013. Standard cross‐sectional analysis of the income distribution shows broad stability in the Gini coefficient and in decile shares, with one main exception: the share of the bottom decile fell sharply, with the largest fall in average incomes being for that group. Longitudinal analysis shows that the falls in the average income for the bottom decile were not due to decreasing income for those remaining in the bottom decile, but to falls in income from those initially located in higher deciles. The extent of redistribution through taxes and transfers increased strongly, as measured by the Reynolds‐Smolensky index, which rose from 0.20 before the onset of the crisis to 0.27 in 2013. Analysis indicates that about three‐quarters of this increased redistribution is due to automatic stabilisers and one‐quarter to discretionary policy changes. [ABSTRACT FROM AUTHOR]

Background: carotid sinus massage (CSM) is a valuable clinical test for carotid sinus syndrome (CSS) and relies on accurately locating the carotid sinus (CS). Objective: in this study, we sought to examine the accuracy of using anatomical landmarks for locating the CS. Methods: consecutive patients (n = 20) were recruited prospectively. Two clinicians, trained in CSM, were asked to locate the CS using anatomical landmarks. A point on the skin overlying the CS was then marked by a vascular technician using ultrasound. Accuracy of techniques was compared using intra-class correlation coefficients and Bland--Altman statistics. Results: anatomical landmarks underestimated the CS location by 1.5 ± 1.3 cm. Error extremes ranged from 4 cm below to 2 cm above CS using anatomical landmarks. A moderate correlation between ultrasound and anatomical landmarks was found, r= 0.371 (P = 0.031). Conclusion: this is the first study to characterise the accuracy of standard anatomical landmarks used in CSM. Results suggest that the point of maximal pulsation has the lowest associated error. Future work should examine CSM yield across this and a range of other methodological factors. [ABSTRACT FROM AUTHOR]

The application of microsimulation techniques to tax and welfare policies is well established in many countries, including Ireland. The richness of the data contained in SILC, the CSO's Survey on Income and Living Conditions, means that similar methods can also be applied to the analysis of policy in some other key areas. Income-tested health entitlements, which include most medical cards and many GP visit cards, are a major feature of the Irish health system. We examine how the income tests for such schemes can be modelled using the detailed income and demographic information in the CSO Survey on Income and Living Conditions. The ESRI's SWITCH model is extended to apply the rules for income-related cards to each family in this nationally representative sample. A key issue which emerges is the apparently low level of take up among those entitled to GP visit cards. This has implications for the costing of policy changes, such as a shift to Universal Health Insurance (UHI) or widening of the age bands qualifying for non-income tested GP visit cards. [ABSTRACT FROM AUTHOR]

Whole-body occupational exposure to artificial radiation sources in Ireland for the years 1996-2005 has been reviewed. Dose data have been extracted from the database of the Radiological Protection Institute of Ireland, which contains data on >95% of monitored workers. The data have been divided into three sectors: medical, industrial and education/research. Data on exposure to radon in underground mines and show caves for the years 2001-05 are also presented. There has been a continuous increase in the number of exposed workers from 5980 in 1996 to 9892 in 2005. Over the same time period, the number of exposed workers receiving measurable doses has decreased from 676 in 1996 to 189 in 2005 and the collective dose has also decreased from 227.1 to 110.3 man millisievert (man mSv). The collective dose to workers in the medical sector has consistently declined over the 10-y period of the study while that attributable to the industrial sector has remained reasonably static. In the education/research sector, the collective dose typically represents 5% or less of the total collective dose from all practices. Over the 10 y of the study, a total of 77 914 annual dose records have been accumulated, but only 4040 (<6%) of these represent measurable radiation doses in any given year. Over the same time period, there were 283 instances in which exposed workers received individual annual doses >1 mSv and 21 of these exceeded 5 mSv. Most of the doses >1 mSv were received by individuals working in diagnostic radiology (which also includes interventional radiology) in hospitals and site industrial radiography. There has been only one instance of a dose above the annual dose limit of 20 mSv. Evaluating the data for the period 2001-05 separately, the average annual collective dose from the medical, industrial and educational/research sectors are ∼60, 70 and 2 man mSv with the average dose per exposed worker who received a measurable dose being 0.32, 0.79 and 0.24 mSv, respectively. Diagnostic radiology and site industrial radiography each represents >60% of the collective dose in their respective sectors. Available data on radon exposure in one underground mine and in three show caves indicate an annual collective dose of 75 man mSv from these work activities. By comparison, previous estimates of exposure of Irish air crew to cosmic radiation have given rise to an estimated collective dose of 12 000 man mSv. It can be concluded therefore that the natural radioactivity sources account for well >90% of all occupational exposure in Ireland. This evaluation does not include an estimate of exposure to radon in above-ground workplaces--these data are currently being evaluated and their inclusion will increase both the total occupational collective dose as well as the percentage of that dose due to natural radiation. [ABSTRACT FROM AUTHOR]

This paper assesses the individual and collective doses in Ireland due to cosmic radiation. Information on the exposure to cosmic radiation at ground level is reviewed and published data on the frequency of routes flown by Irish residents is used to calculate the dose due to air travel. Occupational exposure of aircrew is also evaluated. Experimental data on cosmic radiation exposure at ground level is in good agreement with international estimates and the average individual dose is calculated as 300 µSv annually. Published data on international air travel by Irish residents shows a 50% increase in the number of flights taken between 2001 and 2005. This increase is primarily on short-haul flights to Europe, but there have been significant percentage increases in all long-haul flights, with the exception of flights to Africa. The additional per capita dose due to air travel is estimated to be 45 µSv, of which 51% is accumulated on European routes and 34% on routes to the United States. Exposure of aircrew to cosmic radiation is now controlled by legislation and all airlines holding an Air Operator's Certificate issued by the Irish Aviation Authority are required to report annually the doses received by their employees in the previous year. There has been a 75% increase in the number of aircrew receiving doses >1 mSv since 2002. In 2004 and 2005 the average individual doses received by Irish aircrew were 1.8 and 2.0, mSv, respectively. The corresponding per caput dose for the entire population is <3 µSv. While this is low compared with the per caput doses from other sources of cosmic radiation, aircrew exposure represents a higher collective dose than any other identified group of exposed workers in Ireland. [ABSTRACT FROM AUTHOR]

The article examines the effectiveness of a remediation program which was put into place in 200 Irish primary and post primary schools that were found to have radon levels which exceeded legal limits. The radon levels were determined by the Radiological Protection Institute of Ireland which carried out a national program of radon measurements in primary and post primary schools in Ireland between 1998 and 2004. A discussion of the remediation tools which were put into place to remove the radon is presented.

The identification of meat and bone meal (MBM) as a significant factor in the spread of bovine spongiform encephalopathy (BSE) has resulted in the introduction of restrictions on the use and movement of MBM and tallow. This has led to a requirement for alternative uses for these products. This paper reports on a risk assessment performed on the use of tallow as a fuel oil extender in diesel engines. With up to 4000 tonnes of tallow being produced each year in Ireland, combustion with energy recovery represents a viable, cost-efficient utilization route. A stochastic (Latin Hypercube sampling) simulation model was developed to assess the infectivity risk to humans associated with potential airborne exposure to the combustion products when using tallow as a combustion fuel in diesel engines. The model simulates the potential infectivity pathways that tallow follows, including its production from animals with potentially subclinical BSE and processing the tallow with segregation and heat treatments. The model uses probability distributions for the most important input parameters. The assessment takes into account a number of epidemiological parameters that include tissue infectivity, species barrier, disease incidence, and heat inactivation. Two scenarios, reflecting the infectivity risk in different animal tissues defined by the European Commissions Scientific Steering Committee (SSC), were performed. It is seen from the model results that the risk of a human contracting variant Creutzfeldt-Jakob Disease (vCJD) from potential airborne exposure to BSE, resulting from the combustion of tallow, is extremely small even when model uncertainty is taken into account (mean individual risk values ranging from 10[sup -11.43] to 10[sup -7.23] per year/person). The risks are a number of orders of magnitude less than the sporadic annual incidence level of CreutzfeldtJakob Disease (CJD) in Europe (approximately 10[sup -6]). [ABSTRACT FROM AUTHOR]

During the First World Family Therapy Congress, Dublin, 1989, the author was the Donly women on a six member panel discussing ‘The New Paradigm’. This article re-presents her attempt to re-member women and other ‘invalid’ subjects, (e.g. those in poverty) in what was imagined would be an otherwise male oriented discourse. Until recently, within family therapy, the contrary and negatory experiences of women in families and society gained little recognition. This article joins others in adding herstory to history. [ABSTRACT FROM AUTHOR]

Introduction: Non-attendance at out-patient clinics results in inefficiency, wasted resources and delays other patients from accessing services. We conducted a review of patients that did not attend (DNA) their second appointment over a 12 month period, to establish the reasons why patients failed to repeatedly attend, and to assess what proportion of these failed attendances were potentially preventable. 2,573 patients were scheduled for appointments (790 new patients, 1,783 review patients). 858 (33.3%) patients failed to attend. 147 patients did not attend (DNA) their second appointment. Of these 147 patients, 32 were new appointments, and 115 were reviews. The mean age was 45.1 yrs (range 12-91yrs), with the M:F ratio of 1:1.3. Chart review showed that of the 115 review patients, 74 were being managed conservatively, 7 were pre-op, 14 post-op (all for minor procedures) and 18 were being followed up after joint injection. Conclusion: One-third of patients did not attend (DNA) for their scheduled appointments. However 82.9% of those patients who were sent a second appointment re-attended. 74 (64%) of the review patients who did not attend for a 2nd appointment were being managed conservatively, most commonly for low back pain-47 (40.9%). Patients who are being managed non-operatively should be considered for discharge, with an option to be seen on an "as needed" basis. This would reduce the number of missed appointments. [ABSTRACT FROM AUTHOR]

Reviews several theatrical productions performed in Dublin, Ireland in 2005. "The Home Place," starring Tom Courtenay and directed by Adrian Noble; "I, Keano," starring Dessie Gallagher and directed by Peter Sheridan; "Winter," starring Gary Murphy and directed by Rachel West.

The article reviews several plays in Dublin, Ireland, including "Further Than the Furthest Thing," starring Michael Fitzgerald, "Sizwe Bansi Is Dead," starring Yare Jegbefume, and "An Ideal Husband," Derbhle Crotty.

The article reviews several theatrical productions staged in Dublin, Ireland as of December 2007 including "Uncle Vanya," written by Brian Friel, directed by Robin Lefevre and performed by Owen Roe, "The Playboy of the Western World," written by Roddy Doyle and Bisi Adigun and performed by Eileen Walsh and Giles Terara and "Woman and Scarecrow," written by Marina Carr, directed by Selina Cartmell and performed by Olwyn Fouere.

The article reviews several plays performed in Dublin, Ireland in 2006 including "Hedda Gabler," directed by Thomas Ostermeier and starring Katharina Schuttler at the Abbey Theatre, "The Vacationers," directed by Evgeny Marchelli at the Gaiety Theatre, and "Doubt," directed by Gerard Stembridge and starring Aidan Kelly at the Abbey Theatre.

The article reviews several theatrical plays performed in Dublin, Ireland in 2005, including "The Winter's Tale," directed by Edward Hall, "Romeo and Juliet," directed by Oskaras Korsunovas, and "Dandelions," directed by Michael Caven.

Reviews several theatrical productions performed during the 2004 Dublin Theatre Festival in Ireland. "Twelfth Night," directed by Declan Donnellan; "Shining City," performed by Michael McHatton; "Death of a Salesman," directed by Joe Dowling.

BackgroundThe role of schools in SARS-CoV-2 transmission has been a debated topic since the beginning of the COVID-19 pandemic.AimTo examine SARS-CoV-2 transmission in all schools in Ireland during the 2020-21 school year.MethodsIn a national descriptive cross-sectional study, we investigated PCR-confirmed cases of COVID-19 among students (aged < 20 years) and staff (aged ≥ 20 years) who attended school during their infectious period to identify school close contacts. SARS-CoV-2 PCR test results of all school close contacts were pooled to obtain an overall positivity rate and to stratify positivity rate by school setting and role (i.e. student or staff).ResultsIn total, 100,474 individuals were tested as close contacts in 1,771 schools during the 2020-21 school year. An overall close contact positivity rate of 2.4% was observed across all schools (n = 2,373 secondary cases). The highest positivity rate was seen in special schools (3.4%), followed by primary (2.5%) and post-primary schools (1.8%) (p < 0.001). Of the close contacts identified, 90.5% (n = 90,953) were students and 9.5% (n = 9,521) were staff. Overall, students had a significantly higher positivity rate than staff (2.4% vs 1.8%, p < 0.001).ConclusionThis study demonstrated that a low level of SARS-CoV-2 transmission occurred in Irish schools during the 2020-21 academic year. In the event of future pandemics, and as the COVID-19 pandemic continues, there is a need to carefully weigh up the harms and benefits associated with disrupted education to mitigate infectious disease transmission before reflexively closing classes or schools.