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Aims: We explored trends in gabapentinoid prescribing, drug seizures and postmortem toxicology using a national pharmacy claims database, law enforcement drug seizures data and a population‐based postmortem toxicology database. Methods: Gabapentinoid prescribing rates per 100 000 eligible population (2010–2020), annual number of drug seizures involving gabapentinoids (2012–2020) and gabapentinoid detection (positive) rates per 100 postmortem toxicology case (2013–2020) were calculated. Negative binomial regression models were used to evaluate longitudinal trends for gabapentin and pregabalin separately. Results: Gabapentin (adjusted rate ratio [RR] 1.06, 95% confidence interval [CI] 1.05–1.06, P <.001) and pregabalin (adjusted RR 1.08, 95% CI 1.08–1.09, P <.001) prescribing increased annually, with higher rates of pregabalin (vs. gabapentin) observed every year. Drug seizures involving pregabalin also increased over time (RR 1.54 95% CI 1.25–1.90, P <.0001). Of the 26 317 postmortem toxicology cases, 0.92% tested positive for gabapentin, and 6.37% for pregabalin. Detection rates increased for both gabapentin (RR 1.28, 95% CI 1.11–1.48, P <.001) and pregabalin (RR 1.13, 95% CI 1.11–1.48, P <.001) between 2013 and 2020. A total of 1901 cases (7.2%) tested positive for heroin/methadone; this sub‐group had a higher detection rate for pregabalin (n = 528, 27.8%) and gabapentin (n = 41, 2.2%) over the study period, with a high burden of codetections for pregabalin with benzodiazepines (peaking at 37.3% in 2018), and pregabalin with prescription opioids (peaking at 28.9% in 2020). Conclusion: This study raises concerns regarding the wide availability of pregabalin in Ireland, including a growing illicit supply, and the potential for serious harm arising from poly drug use involving pregabalin among people who use heroin or methadone. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is associated with lower socioeconomic status (SES). The adverse influence of HS on education and employment may explain this. It remains unknown whether HS causes downward social trajectories, i.e., social drift, or whether those affected are born into a lower SES. We aimed to assess the influence of HS on education and employment and compare the highest educational attainment of participants with their parents. Methods: An anonymous online survey was distributed by patient-led organisations. Frequencies were compared with χ2 and disease interactions with one-way ANOVA. Results: Among 335 respondents from 10 countries, 94.9% completed secondary/high school, 71.3% completed further education, 41.8% completed an undergraduate degree, 20% completed postgraduate education, 10.7% completed a masters, and 2.1% completed a doctorate. Participant education was greater than parental education (p < 0.001). Despite this, 24.2% were unemployed and 15.2% were receiving illness benefit. Compared to national statistics, HS participants from Ireland (p = 0.003), the USA (p < 0.001), and the UK (p < 0.001) were more likely to be unemployed/receiving illness benefit despite higher educational attainment in Ireland (p = 0.006) and the USA (p = 0.003) with similar education in the UK (p = 0.153). Conclusions: Social drift describes downward social trajectories due to the development of a disease. Participants in this study report greater education than their parents and the background population, but despite this, they are experiencing downward social trajectories with higher unemployment and receipt of illness benefit. Disease onset in HS tends to be at peak educational age. Education does not appear to be impaired by early disease with disease accumulation during employment years limiting opportunities. [ABSTRACT FROM AUTHOR]

Background: Most adolescent girls fail to meet current physical activity guidelines. Physical activity behaviours track from childhood into adulthood and providing adolescent girls with opportunities to be physically active may have health benefits beyond childhood. The effects of walking interventions on adult cardiometabolic health are known, however less is understood about the potential of walking to promote physical activity in adolescents. Following the Walking In ScHools (WISH) feasibility study, this definitive trial aimed to evaluate the effectiveness of a novel, low-cost, school-based walking intervention at increasing physical activity levels of adolescent girls (aged 12–14 years). Methods: Female pupils were recruited from eighteen schools across the border region of Ireland and in Northern Ireland. In intervention schools (n = 9), girls aged 15–18 years, were trained as walk leaders, and led the younger pupils in 10–15 min walks before school, at break and lunch recess. All walks took place in school grounds and pupils were encouraged to participate in as many walks as possible each week. The primary outcome measure was accelerometer determined total physical activity (counts per minutes, cpm). Results: In total, 589 pupils were recruited to the study. At baseline, pupils engaged in a median (interquartile range (IQR)) 35.7 (21.2) mins moderate-vigorous physical activity (MVPA) per day and only 12% (n = 66) of participants met physical activity guidelines (60 min MVPA per day). The intervention was delivered for a mean (standard deviation (SD)) 19.9 ± 0.97 weeks. The mean post-intervention total physical activity for the intervention group was 676 cpm and 710 cpm in the control group. Post-intervention total physical activity did not statistically differ between groups when adjusted for age, body mass index z-scores and baseline physical activity (mean difference, -33.5, 95% CI = -21.2 to 88.1; p = 0.213). Conclusions: 'Scaling-up' physical activity interventions is challenging and despite a promising feasibility study, the results of this fully powered trial suggest that in this context, the WISH intervention did not increase device measured physical activity. Since the COVID-19 pandemic, school environments have changed and although pupils enjoyed the programme, attendance at walks was low, indicating that there is a need to better understand how to implement interventions within schools. Trial registration: ISRCTN; ISRCTN12847782; Registered 2nd July 2019. [ABSTRACT FROM AUTHOR]

The development of a system of regulation in early childhood care and education (ECCE) in Ireland was a slow process. Some decades passed between initial calls for regulation and the actual implementation of standards in 1997, reflecting the delay and inaction that has characterised ECCE policy implementation in general in Ireland. The present system has been criticised by some as not being far-reaching enough and a review, originally promised in 2001, is still overdue at time of writing. The question arises as to whether a regulatory system can fulfil the dual functions of, first, ensuring that services are meeting acceptable minimal standards and, second, supporting services to improve quality of provision beyond minimum standards and which promote children's development and learning. This question is explored in the light of discussions with the various stakeholders, recent policy developments in ECCE in Ireland, and the international debate on the relationship between regulations and quality. (Contains 10 notes and 1 table.)

The first legislative control over early education services in Ireland came into place in 1996, in the form of the Child Care (Pre-School Services) Regulations (Department of Health, 1996). The research hypothesis of this study was that the implementation of the Regulations would have had an impact on quality of early childhood care and education (ECCE) services in Ireland. The specific objectives of the study were: to examine a sample of pre-schools to investigate both structural and process aspects of quality; to examine the possible relationship between these elements of quality; and to interview both Supervisors of these pre-schools and a small sample of Pre-school Officers to investigate their attitudes towards the Regulations. It was acknowledged at the outset that related factors, such as increased level of investment and improved levels of training, may have affected quality of provision. The baseline data used for the purposes of this study were gathered in 1994/1995 during Phase II of the IEA2 Preprimary Project (IEA/PPP). This was a large cross-national study that investigated the quality of care and education that children from various countries received at four years of age. Full details of the Irish aspect of Phase II can be found in "A Window on Early Education in Ireland: the First National Report of the IEA Preprimary Project" (Hayes, O'Flaherty, & Kernan, 1997). Use of these data allowed comparison of both structural and process elements in ECCE provision before the implementation of the Regulations, and six years after their implementation in 2002. The methodology of the present study involved revisiting a subsample of the original IEA/PPP national sample, undertaking structured observations and administering questionnaires to teachers and supervisors. A number of key issues emerged from the research. First, improvements were found in the quality of the pre-school provision in the present study as compared with that of the original study, although it is not clear the extent to which these improvements relate directly to the Regulations. The results also suggest that the need for training is becoming more widely accepted in the sector in Ireland. As predicted, increased awareness of training for ECCE professionals, and increased levels of funding appear also to have had an effect on quality. A third issue emerging from this study was the changing role of the pre-school teacher. The findings of this study also provided information regarding the nature of the relationship between regulation and quality provision. Related to this was the interaction between structural and process variables in quality ECCE provision. Full details of the study can be found in O'Kane (2004a). This paper concentrates on how the findings relate to two of the themes identified: interaction between structural and process aspects of quality, and training. (Contains 7 notes and 3 tables.)

The benefits of methadone maintenance treatment (MMT) may be compromised by the continued use of other substances during treatment. Polysubstance use has been identified as a major contributing factor to treatment discontinuation, a known risk factor for drug overdose. We examined trends in immunoassay drug positivity rates for amphetamines, benzodiazepines, cannabis, cocaine and opioids, and (2) trends in polysubstance positivity rates for drug combinations associated with increased risk of drug overdose among patients attending the national drug treatment centre in Ireland for MMT between 2010 and 2020. Repeated cross-sectional study of patients attending the national drug treatment centre (NDTC) for MMT (total N = 1942) between 2010 and 2020, focused on urine drug samples provided for testing to the NDTC clinical testing laboratory (n = 221,564). Samples were analysed using immunoassay during the study period. Mixed-effects logistic regression models evaluate time trends in drug positivity. A random intercept accounts for repeat testing of individual patients. The study reports Adjusted Odds Ratios (AOR) for time (per year) with 95 % Confidence Intervals (95 % CI). Drug positivity rates increased over time for benzodiazepines (AOR 1.02, 95 % CI 1.01–1.03, p <.0001), cannabis (AOR 1.06, 95 % CI 1.05–1.08, p <.0001) and cocaine (AOR 1.28, 95 % CI 1.27–1.29, p <.0001), with decreasing trends for opioids (AOR 0.91, 95 % CI 0.91–0.92, p <.0001). Methadone and benzodiazepines were co-detected in over two-thirds of all samples during the study period. Co-detection of methadone and benzodiazepines with cocaine was also found to be increasing (AOR 1.24, 95 % CI 1.23–1.25, p <.0001), with weighted polysubstance positivity rates reaching 29.2 % in 2020. The co-detection of methadone and benzodiazepines with opioids decreased over the study period (AOR 0.92, 95 % CI 0.91–0.92, p <.0001), ranging from 36.7 % in 2010 to 26.9 % in 2020. Interventions are needed to target the persistently high use of benzodiazepines among patients in receipt of methadone due to their synergistic effects with opioids on respiratory depression, enhancing the risk of overdose. The growing use of cocaine among people in MMT also needs to be addressed. • Benefits of methadone maintenance treatment (MMT) may be compromised by polysubstance use. • Analysis of trends in drug positivity rates among 1942 patients in MMT 2010–2020 • Methadone and benzodiazepines co-detected in two-thirds of all urine samples • Co-detection of methadone, benzodiazepines & cocaine increased over time. [ABSTRACT FROM AUTHOR]

Aim: To estimate and examine hospitalisation costs of Type 1 and Type 2 diabetes in an Irish public hospital. Methods: A retrospective audit of hospital inpatient admissions over a 5‐year period was undertaken, and a wide range of admission‐related data were collected for a sample of 7,548 admissions. Hospitalisations were costed using the diagnosis‐related group methodology. A series of descriptive, univariate and multivariate regression analyses were undertaken. Results: The mean hospitalisation cost for Type 1 diabetes was €4,027 and for Type 2 diabetes was €5,026 per admission. Sex, admission type and length of stay were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 1 diabetes. Age, admission type, diagnosis status, complications status, discharge destination, length of stay and year were significantly associated with hospitalisation costs for admissions with a primary diagnosis of Type 2 diabetes. Length of stay was associated with higher mean costs, with each additional day increasing Type 1 diabetes costs by €260 (p = 0.001) and Type 2 diabetes by €216 (p < 0.001). Unscheduled admissions were associated with significantly lower costs than elective admissions; €1,578 (p = 0.035) lower for Type 1 diabetes and €2,108 (p < 0.001) lower for Type 2 diabetes. Conclusions: This study presents estimates of the costs of diabetes care in the Irish public hospital system and identifies the factors which influence costs for Type 1 and Type 2 diabetes. These findings may be of interest to patients, the public, researchers and those with influence over diabetes policy and practice in Ireland and internationally. [ABSTRACT FROM AUTHOR]

Summary: Atopic dermatitis (AD) is one of the most common inflammatory skin diseases in the developed world, affecting 1–3% of the adult population in Europe. This inflammatory disease can have a marked impact on affected individuals, leading to significant impairment in physical wellbeing and quality of life (QoL). The aim of this study was to investigate the psychosocial impact and financial burden of AD on patients in Ireland. To increase our understanding of the psychosocial and financial aspects of AD disease burden in the Irish population, an online survey was designed. The survey was launched by the Irish Skin Foundation, and included questions focusing on disease severity, disease control, psychosocial impact, interrupted sleep, missed work and school days, and financial cost. The survey showed that the impact of AD on QoL was profound. The survey demonstrated that 85% of adults described interrupted sleep, 70% reported social anxiety, 65% avoid exercise and sports, 52% avoid social activities, 52% avoid sexual intimacy and 43% feel they are depressed as a result of their AD. Approximately one‐quarter of those surveyed can spend up to €2300 annually on over‐the‐counter, prescription and alternative treatments. This study has shown the significant impact AD has on patients living in Ireland. It also highlights that out‐of‐pocket costs for patients is higher compared with previous studies across European countries. [ABSTRACT FROM AUTHOR]

Overview: Businesses can benefit from university–industry collaborations, yet they rarely take full advantage of them. Scientists who serve as principal investigators (PIs) act as the nucleus of university–industry collaborations and partner with industry to cocreate value. We conducted a case study of PIs at publicly funded research universities, institutes, and organizations in Ireland to explore how having commercial experience influences how PIs approach technology transfer and how they develop new business models, products, and services. We learned that PIs' prior commercial experience influences how they approach their research, project work, and project selection and affects how they commercialize knowledge and outputs from their scientific research––that is, patents, licences, agreements, etc.––throughout the project's life cycle. In university–industry collaborations, PIs' commercial experience can impact industry partners' attempts to realize technology transfer and market impacts. [ABSTRACT FROM AUTHOR]

Adolescent girls in the UK and Ireland fail to meet physical activity (PA) guidelines. PA behaviours track from childhood into adulthood. The effects of walking interventions on adult health are known; however, the potential of walking to promote PA in adolescents is less known. This study evaluated the effectiveness of a novel, school-based walking intervention aimed at increasing PA levels of adolescent girls. In this cluster-randomised controlled trial, female pupils aged 12–14 years were recruited from 18 (mixed or single-sex) schools across the border region of Ireland and Northern Ireland. Schools were randomly assigned to either the control group (usual physical activity; n=9) or the intervention group (n=9) by independent faculty staff using an online randomisation tool (randomization.com). In intervention schools, female pupils aged 15–18 years were trained as walk leaders and led the younger pupils in 10–15 min walks before school, at break, and at lunchtime. Walks were in school grounds and pupils were encouraged to join as many walks as possible. The intervention was delivered for a full school year excluding holidays (for a total of 18–21 weeks). Accelerometers measured PA, and the primary outcome was total PA (counts per minute [cpm]). Ethics approval was granted by Ulster University Research Ethics Committee and written informed consent (parent or guardian) and assent (pupils) was obtained. This study is registered with the ISRCTN Registry, 12847782. The study took place from Sept 1, 2021, to May 31, 2023. In total, 589 pupils were recruited (n=286 in intervention group; n=303 in control group). Median moderate-vigorous PA (MVPA) at baseline was 36·1 min/day (IQR 23·0) for the intervention group and 35·3 min/day (19·8) for the control group. Only 37 (15%) girls in the intervention group and 29 (10%) girls in the control group met PA guidelines (60 min/day of MVPA). The mean total PA after intervention was 676 cpm (SD 18·7) for the intervention group and 710 cpm (SD 17·7) for the control group. Post-intervention total PA did not differ between groups when adjusted for age, body-mass index, z-scores, and baseline PA (mean difference –33·5, 95% CI –21·2 to 88·1; p=0·213). Scaling up PA interventions is challenging. Despite a promising feasibility study, the results of this fully powered trial indicate that in this context, the walking programme did not increase PA. Since the COVID-19 pandemic, school environments have changed, and although pupils enjoyed the programme, attendance at walks was low. There is a need to better understand the implementation of interventions such as this within schools. Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN). [ABSTRACT FROM AUTHOR]

Adequate I intake is important before conception and during pregnancy for optimal infant neurodevelopment. Recent studies have highlighted the prevalence of I deficiency in the UK and Ireland. It is possible that optimal I intake may be impeded by a poor knowledge of I nutrition. This study aimed to investigate I knowledge among women of childbearing age in the UK and Ireland and to determine whether a relationship exists between I knowledge and dietary I intake. Females (aged 18–45 years) were invited to complete an online questionnaire, which assessed knowledge of I and estimated dietary I intake using a FFQ. A total of 520 females of childbearing age completed the study. I knowledge was poor; only one-third (32 %) of the participants correctly identified pregnancy as the most important stage of the lifecycle for I, and 41 % of participants could not correctly identify any health problem related to I deficiency. The median daily I intake was estimated as 152 µg/d. Almost half (46 %) of the participants failed to meet dietary recommendations (140 µg/d) for I. A higher dietary I intake was positively associated with greater I knowledge (r 0·107; P=0·016). This study suggests that knowledge of I nutrition is low among women of childbearing age, and those with a greater knowledge of I nutrition had a higher dietary I intake. Initiatives to educate women of childbearing age on the importance of I nutrition should be considered as part of a larger public health strategy to address I deficiency. [ABSTRACT FROM PUBLISHER]

This study examines the effect of leadership changes on (1) the initiation of organizational turnarounds, (2) turnaround performance, and (3) the leadership approaches adopted. Set in an Irish context, we use four in-depth case studies purposefully selected at different stages of the turnaround process. In our findings we describe under what circumstances chief executive officer (CEO) changes are likely; the importance of humility, trust, and integrity to turnaround leadership; and why certain companies might purposefully delay the implementation of CEO changes. In addition, we found that newly appointed outsider CEOs and insider leaders who are not replaced are differentiated in the manner by which they manage expectations and implement retrenchment-oriented moves at the outset of the turnaround process. [ABSTRACT FROM AUTHOR]

This article examines the increasing use of Northern Ireland as a ‘model’ for resolving conflicts. It seeks to identify what may constitute an Irish ‘model’ and to examine it in relation to three key aspects of existing conflict resolution theory: the timings of peace processes, the role of third parties and how to deal with ‘spoilers’. The article argues that the existing theory is currently ill-matched to both the Northern Ireland case and the ‘model’ that some have sought to extrapolate from it. It stresses the need to examine the Northern Ireland case in context if we are to learn any lessons from it that may be of use in other conflict resolution attempts. [ABSTRACT FROM AUTHOR]

The article focuses on the Irish botanical garden at Dublin, Ireland. It notes that Dr. Walter Wade and politician John Forster presented a petition to establish a public botanical garden in the city to the Irish Parliament in 1790. The Dublin society bought a 16 Irish acres of land for the garden, and printed posters to announce that they had taken sixteen acres of ground for establishing a botanical garden for promoting a scientific knowledge in the branch of Agriculture.

This article explores the source of the issue of decommissioning, examines why it remained an important issue for so long and assesses the impact that the decommissioning issue has had on the peace process. Was the issue’s dominance inevitable, given the necessity to remove the IRA’s illegally held weapons; the result of poor handling of the question by the British and Irish governments; or the outcome of the actions of elements within unionism which sought to derail the process? The article suggests the dominance is at least in part a result of actions by the British and Irish governments. Whilst these actions are understandable and explainable in the context of the unique situation of the fledgling peace process, it illustrates that mistakes were made which, if avoided, might have meant the process would not have been stalled by the issue of decommissioning for as long as it was. [ABSTRACT FROM AUTHOR]

Nuala O'Faolain's novel My Dream of You connects the Great Famine and contemporary women's status in the Republic of Ireland. Her narrative structure juxtaposes an embedded story from the 1840s with the main story arc, set in contemporary Ireland, relating the legacy of the Great Famine both to postcolonial attitudes about food and eating and to women's limited political roles in the Republic. The text presents mirrored female characters from the famine-era Big House and the mid-twentieth century to create a gendered association between the eras. This textual strategy of spiraling from the Famine to more recent oppression of women provides insight into Ireland's obsessive control of female reproductive ability. O'Faolain's text repeats images of land, fertility, food production (and consumption), women's bodies, and reproduction, suggesting a link between the failure of the land to produce food and the need to control unruly female bodies. Women's bodies and their fertility become ciphers for the health of Ireland, rather than spaces for individual consciousness. Finally, O'Faolain's text questions the outcomes of such symbolism. [ABSTRACT FROM AUTHOR]

The idea that conflicts cannot be resolved until they are ‘ripe’ has been influential in conflict resolution literature in recent years. This article critiques the theoretical underpinnings of ripeness using the Northern Ireland peace process as a case study. It highlights the problems that results from the subjectiveness of both the theory itself and the information needed to apply it. By critically examining William Zartman's six ‘propositions’ of ripeness, the inadequacy of the approach is highlighted and claims that the theory can help predict when conflicts are ripe for resolution are shown to be unsustainable. It advocates a more dynamic approach to conflict resolution than ripeness suggests that parties and mediators adopt. [ABSTRACT FROM AUTHOR]

Objectives To compare exposure to secondhand smoke and respiratory health in bar staff in the Republic of Ireland and Northern Ireland before and after the introduction of legislation for smoke-free workplaces in the Republic. Design Comparisons before and after the legislation in intervention and control regions. Setting Public houses in three areas in the Republic (intervention) and one area in Northern Ireland (control). Participants 329 bar staff enrolled in baseline survey; 249 (76%) followed up one year later. Of these, 158 were non-smokers both at baseline and follow-up. Main outcome measures Salivary cotinine concentration, self reported exposure to secondhand smoke, and respiratory and sensory irritation symptoms. Results In bar staff in the Republic who did not themselves smoke, salivary cotinine concentrations dropped by 80% after the smoke-free law (from median 29.0 nmol/l (95% confidence interval 18.2 to 43.2 nmol/l)) to 5.1 nmol/l (2.8 to 13.1 nmol/l) in contrast with a 20% decline in Northern Ireland over the same period (from median 25.3 nmol/l (10.4 to 59.2 nmol/l) to 20.4 nmol/l (13.2 to 33.8 nmol/l)). Changes in self reported exposure to secondhand smoke were consistent with the changes in cotinine concentrations. Reporting any respiratory symptom declined significantly in the Republic (down 16.7%, -26.1% to -7.3%) but not in Northern Ireland (0% difference, -32.7% to 32.7%). After adjustment for confounding, respiratory symptoms declined significantly more in the Republic than in Northern Ireland and the decline in cotinine concentration was twice as great. Conclusion The smoke-free law in the Republic of Ireland protects non-smoking bar workers from exposure to secondhand smoke.

In the early 1990s the British and Irish governments moved away from the policy of attempting to marginalise the IRA and Sinn Féin to enticing republicanism into mainstream politics. This article examines why the two governments made this apparent shift in policy. The British and Irish governments were persuaded to change their policy on Northern Ireland due to a variety of factors, all of which need to be examined if the origins of the peace process are to be understood. The article questions existing explanations that portray the origins of the peace process and the Downing Street Declaration as simply a victory for Irish nationalism without taking account of the concessions secured by the British government from the Irish during the protracted negotiations. [ABSTRACT FROM AUTHOR]

Background: Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension.Methods: Observational data on 6076 adults of 18-102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008-2012 using standardised methods.Results: The variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34-6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027).Conclusions: The MTHFR 677TT genotype is associated with higher BP independently of homocysteine and predisposes adults to an increased risk of hypertension and poorer BP control with antihypertensive treatment, whilst better riboflavin status is associated with a reduced genetic risk. Riboflavin intervention may thus offer a personalised approach to prevent the onset of hypertension in adults with the TT genotype; however, this requires confirmation in a randomised trial in non-hypertensive adults. [ABSTRACT FROM AUTHOR]

Mental health disorders are major contributors to disease burden in older people. Deficient status of folate and the metabolically related B vitamins may be implicated in these conditions. This study aimed to investigate folate, vitamin B 12 , vitamin B 6 , and riboflavin in relation to depression and anxiety in aging and also considered the role of fortified foods as a means of optimizing B-vitamin status and potentially reducing the risk of these mental health disorders. The Trinity Ulster Department of Agriculture (TUDA) aging study was a cross-sectional cohort study. Community-dwelling adults (n = 5186; ≥60 years) recruited from 2 jurisdictions within the island of Ireland from 2008 to 2012. Depression and anxiety were assessed using the Centre for Epidemiological Studies Depression (CES-D) and the Hospital Anxiety and Depression (HAD) scales, respectively. The following B-vitamin biomarkers were measured: red blood cell folate, serum total vitamin B 12 , plasma pyridoxal-5-phosphate (PLP; vitamin B 6), and erythrocyte glutathione reductase activation coefficient (EGRac; riboflavin). Biomarker values in the lowest 20% of status for folate (odds ratio [OR] 1.79; 95% CI 1.23-2.61), vitamin B 6 (OR 1.45, 95% CI 1.01-2.06), or riboflavin (OR 1.56, 95% CI 1.10-2.00), but not vitamin B 12 , were each associated with an increased risk of depression (CES-D score ≥16). Correspondingly, B vitamin–fortified foods if consumed daily were associated with a reduced risk of depression (OR 0.54, 95% CI 0.41-0.70). A deficient status of vitamin B 6 (OR 1.73, 95% CI 1.07-2.81), but not other vitamins, was associated with increased anxiety. Better B-vitamin status may have a role in impacting positively on mental health in older adults. Regular intake of fortified foods can provide a means of optimizing B-vitamin status and thus could contribute to reducing depression. If confirmed by a randomized trial, these results may have implications for nutrition and mental health policy, and thus quality of life, in older people. [ABSTRACT FROM AUTHOR]

Introduction: There is an increasing concern about the misuse of prescription drugs. Misuse refers to the intentional repurposing of prescribed drugs and/or the use of illicitly sourced prescription drugs, which may be counterfeit or contaminated. Drugs with the greatest potential for misuse are prescription opioids, gabapentinoids, benzodiazepines, Z-drugs and stimulants., Objective: The aim of this study is to provide a comprehensive analysis of the supply, patterns of use and health burden associated with prescription drugs with potential for misuse (PDPM) in Ireland between 2010 and 2020. Three inter-related studies will be carried out. The first study will describe trends in supply of PDPM using law enforcement drug seizures data and national prescription records from national community and prison settings. The second study aims to estimate trends in the detection of PDPM across multiple early warning systems using national forensic toxicology data. The third study aims to quantify the health burden associated with PDPM nationally, using epidemiological indicators of drug-poisoning deaths, non-fatal intentional drug overdose presentations to hospitals and drug treatment demand., Methods and Analysis: A retrospective observational study design, with repeated cross-sectional analyses, using negative binomial regression models or, where appropriate, joinpoint regression., Ethics and Dissemination: The study has received approval from the RCSI Ethics Committee (REC202202020). Results will be disseminated in peer-reviewed journals, scientific and drug policy meetings and with key stakeholders via research briefs., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)