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In this article, multiple-baseline across participants designs were used to evaluate the impact of a precision teaching (PT) program, within a Tier 2 Response to Intervention framework, targeting fluency in foundational reading skills with at risk kindergarten readers. Thirteen multiple-baseline design experiments that included participation from 35 kindergarten students were included in the current analysis. By combining data from a series of multiple-baseline studies using a multilevel model, we analyzed outcomes to determine an estimated treatment effect. The results indicate that across participants and across studies, PT showed an average increase of 15 correct responses in foundational reading skills per minute. This immediate influence on rates of core reading skills was statistically significant. Moreover, the treatment had a significant positive effect on the time trend indicating that rates in foundational reading skills increased more across time during the treatment phase compared to the baseline phase. The study provides evidence that the obtained rates in foundational reading skills at the end of the intervention were retained after removing the intervention. From the outcomes of the multilevel model, PT can be considered as a promising Tier 2 intervention to increase reading fluency with individuals who are at risk of reading failure.

The literature suggests that gamified learning interventions may increase student engagement and enhance learning. We empirically investigate this by exploring the impact of intrinsic and extrinsic motivation on the participation and performance of over 100 undergraduate students in an online gamified learning intervention. The paper makes a number of contributions. First, by synthesizing the literature the central concepts required for a learning intervention to be considered gamified are mapped and the development of an online gamified learning intervention is described. Second, the effect of gamification on learning outcomes is examined using a pre- and post-intervention survey. We find that gamified learning interventions have a positive impact on student learning. Third, our results show that while generally positive, the impact of gamified interventions on student participation varies depending on whether the student is motivated intrinsically or extrinsically. These findings will be of practical interest to teaching and learning practitioners working in a range of educational contexts, and at all levels of education, who wish to increase student engagement and enhance learning.

Background: This study addresses the fast developing behavioural issue of cyberbullying in schools and its complex legal context. Purpose: This study set out to investigate teachers' perceptions of the extent of cyberbullying and the extent to which school leaders in Northern Ireland and the Republic of Ireland feel knowledgeable and confident about dealing with cyberbullying problems in school. The study also examined the legal responsibility that schools in Northern Ireland and the Republic of Ireland have in dealing with incidents of cyberbullying. Sample: The sample comprised 14 headteachers and senior teachers from primary and post-primary schools (focus groups), and a further 143 school headteachers in Northern Ireland and the Republic of Ireland who responded to the postal questionnaire. Design and Methods: The sample was stratified according to geographical location, school management type and school size. The study had qualitative and quantitative elements. Focus group discussions were held in Northern Ireland and the Republic of Ireland involving experienced primary and post-primary teachers and headteachers. Questionnaires were sent to primary and post-primary school headteachers (n = 143 completed: response rate = 28.6%). Data were analysed to provide a descriptive overview of knowledge and attitudes as well as the experiences of staff working in schools in both jurisdictions. Results: The study indicates that school leaders in both Northern Ireland and the Republic of Ireland reported a level of frustration in their attempts to deal with the growing and very complex problem of cyberbullying. They expressed a desire for more guidance from their respective government departments of education. Analysis of data suggests that confusion surrounding the legal responsibilities of schools was common in both jurisdictions. Findings indicate that rather than relying on evidence-based strategies and procedures proposed by government, school leaders were resorting to ad hoc solutions, at best consulting neighbouring schools, while trying to unravel intricate webs of interpersonal online aggressive acts, many of which had taken place outside of school and outside-of-school hours. Conclusion: Recommendations are made in relation to the development and dissemination of training and resources for schools in both jurisdictions. In describing the challenges faced by school leaders in dealing with cyberbullying, this study highlights, more generally, the need for the development of guidance and professional support frameworks to help educators manage the problems that are presented by this complex and evolving social phenomenon.

Background: Subtest and factor scores have typically provided little incremental predictive validity beyond the omnibus IQ score. Aims: This study examined the incremental validity of Wechsler Intelligence Scale for Children-Fourth UK Edition (WISC-IV[superscript UK]; Wechsler, 2004a, "Wechsler Intelligence Scale for Children-Fourth UK Edition", Harcourt Assessment, London, UK) and factor index scores in predicting academic achievement on the Wechsler Individual Achievement Test-Second UK Edition (WIAT-II[superscript UK]; Wechsler, 2005a, "Wechsler Individual Achievement Test-Second UK Edition", Pearson, London, UK), beyond that predicted by the WISC-IV[superscript UK] FSIQ. Sample: The sample included 1,014 Irish children (ages 6-0 to 16-9) who were referred for evaluation of learning difficulties. Method: Hierarchical multiple regression analyses were used with the WISC-IV[superscript UK] FSIQ (Block 1) and factor index scores (Block 2) as predictors and WIAT-II[superscript UK] subtest and composite scores as dependent variables. Results: The WISC-IV[superscript UK] FSIQ accounted for statistically significant and generally large portions of WIAT-II[superscript UK] subtest and composite score variance. WISC-IV[superscript UK] factor index scores combined to provide statistically significant increments in prediction of most WIAT-II[superscript UK] subtest and composite scores over and above the FSIQ; however, the effect sizes were mostly small as previously observed (i.e., Canivez, 2013a, "Psychol. Assess.", 25, 484; Glutting "et al.", 2006, "J. Spec. Educ.", 40, 103; Nelson "et al.", 2013, "Psychol. Assess.", 25, 618). Individually, the WISC-IV[superscript UK] factor index scores provided small "unique" contributions to predicting WIAT-II[superscript UK] scores. Conclusion: This, in combination with studies of apportioned variance from bifactor confirmatory factor analysis (Watkins et al., 2013, "Int. J. Sch. Educ. Psychol.", 1, 102), indicated that the WISC-IV[superscript UK] FSIQ should retain the greatest weight in WISC-IV[superscript UK] interpretation.

Profiling Elements of Prosody in Speech-Communication (PEPS-C) has not been used widely to assess prosodic abilities of preschool children. This study was therefore aimed at investigating typically developing 4-year-olds' performance on PEPS-C. PEPS-C was presented to 30 typically developing 4-year-olds recruited in southern Ireland. Children were judged to have completed the test if they produced analysable responses to greater than 95% of the items. The children's scores were compared with data from typically developing 5-6-year-olds. The majority (83%) of 4-year-olds were able to complete the test. The children scored at chance or weak ability levels on all subtests. The 4-year-olds had lower scores than 5-6-year-olds in all subtests, apart from one, with the difference reaching statistical significance in 8 out of 12 subtests. The results indicate that PEPS-C could be a valuable tool for assessing prosody in young children with typical development and some groups of young children with communication disorders.

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts. [ABSTRACT FROM AUTHOR]

Objectives: A statistical study comparing osteological and ancient DNA determinations of sex was conducted in order to investigate whether there are sex biases in United Kingdom and Irish Neolithic megalithic burials. Materials and Methods: Genetic and osteological information from human individuals from 32 megalithic sites in the UK and Ireland dating from 4000 to 2500 cal. BCE was collected and statistically analyzed to test whether there is a true over‐representation of males at these sites. The published dataset from the study by Sánchez‐Quinto et al. in 2019 was initially analyzed before being refined and included in a larger dataset. Osteological analysis of sex bias was limited to adults with available sex estimations, and genetic analysis limited to published data Results: Two sites consistently returned significant p‐values suggesting a potential over‐representation in osteological males at one site (Knowe of Midhowe, Orkney) and genetic males in the other (Primrose Grange, Ireland). Cumulative statistical analyses point towards a male bias in the representation of sexes in Neolithic megalithic burials, but these results do not reflect the site‐by‐site and regional variation found in this study. Discussion: The interpretation of sex bias, that is, the over‐representation of one sex over another ‐ depends on other socio‐cultural variables (e.g., kinship) and the emphasis placed on statistical significance. The trend towards males being over‐represented in Neolithic megalithic burials is not as clear as previously thought, and requires further testing and data collection to uncover. [ABSTRACT FROM AUTHOR]

As future employers, nurse managers are in a key position to assess the correspondence between the competence of graduating nursing students and work life demands. The aim of the present study was to assess the competence of graduating nursing students from the perspective of managers, and analyze the factors linked to it. Among European managers in six countries, a cross-sectional survey design with a convenience sample was applied. Data were collected using the Nurse Competence Scale. The study was reported using the STROBE guidelines. Managers (n =538, 65.8%) assessed the level of competence of graduating nursing students as good, but there were statistically significant differences between countries. In a multivariable analysis, managers who had a Doctoral/Master’s degree and were dissatisfied with the nursing program in their country assessed the level of competence as lower. Overall, graduating nursing students seem to meet the competence demands of current work life rather well. Further research is needed to confirm the connection between the managers’ competence assessment and their individual background factors. [ABSTRACT FROM AUTHOR]

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Exposure to air pollution is a known risk factor for asthma exacerbations and hospitalisations. This study aimed to identify if COVID-19 transport restrictions led to improvements in air quality in Dublin and if this had an impact on asthma-related hospital admissions. This was a population-based retrospective cohort study. Daily concentration levels of particulate matter (PM 2.5 and PM 10) and nitrogen dioxide (NO 2) were obtained from the Environmental Protection Agency (EPA). The Hospital In-Patient Enquiry (HIPE) system provided the daily number of asthma-related hospital admissions in Dublin. The figures for 2018–2019 were compared with the period of transport restrictions (from March 2020). During the period of transport restrictions, there was a significant decrease in mean daily concentrations in both PM 2.5 (8.9 vs 7.8 μg/m3, P = 0.002) and NO 2 (24.0 vs 16.7 μg/m3, P < 0.001). There was also a significant reduction in the mean number of daily asthma admissions (4.5 vs 2.8 admissions, P < 0.001). Only NO 2 showed a statistically significant correlation with asthma admissions (r = 0.132, P < 0.001). Transport restrictions introduced to mitigate against COVID-19 led to lower pollutant levels and improved air quality. Previously described associations between pollutants and asthma would indicate that these improvements in air quality contributed to the reduction in asthma-related admissions. The complex nature of PM is the likely explanation for the lack of correlation between its concentration and asthma admissions, unlike NO 2 whose primary source is vehicular emissions. Public Health needs to advocate for transport policies, which can improve air quality and hence improve human health. [ABSTRACT FROM AUTHOR]

Aim: Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns, and decrease the need for surgical intervention. Several studies outside of Ireland demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. Consequently our aim was to assess parental/caregiver knowledge in Ireland, and determine if knowledge levels could be raised following a short educational video intervention.Methods: An educational video based on current European and British best practice guidelines was produced and shown to parents/caregivers waiting in the Pediatric Outpatients Department after a previously validated pre-intervention questionnaire was completed. A post intervention questionnaire was completed following the video. Questionnaires assessed demographics, previous experience and included scenarios to test parental knowledge.Results: 112 parents/caregivers (81.3% female (n = 91), 18.8% male (n = 21)) were questioned. Baseline knowledge was found to be poor overall, however this significantly improved with a simple educational video (pre-score 31.9%, post-test mean score knowledge 92.1%). Pre- and post-test scores showed a statistical significance (x2 = 71.117, P < 0.001, 95% CI).No other variables analysed were shown to be statistically significant predictors of pre- or post-test scores (all p > 0.05).Conclusion: The study found poor parental knowledge of burns first aid in Ireland and shows the use of an educational video was effective in raising knowledge levels. [ABSTRACT FROM AUTHOR]

Introduction: Trauma is one of the leading causes of mortality worldwide, but little is known of the temporal variation in major trauma across England, Wales and Northern Ireland. Proper workforce and infrastructure planning requires identification of the caseload burden and its temporal variation. Materials and Methods: The Trauma Audit Research Network (TARN) database for admissions attending Major Trauma Centres (MTCs) between 1st April 2011 and 31st March 2018 was analysed. TARN records data on all trauma patients admitted to hospital who are alive at the time of admission to hospital. Major trauma was classified as an Injury Severity Score (ISS) >15. Results: A total of 158,440 cases were analysed. Case ascertainment was over 95% for 2013 onwards. There was a statistically significant variation in caseload by year (p < 0.0001), times of admissions (p < 0.0001), caseload admitted during weekends vs weekdays, 53% vs 47% (p < 0.0001), caseload by season with most patients admitted during summer (p < 0.0001). The ISS varied by time of admission with most patients admitted between 1800 and 0559 (p < 0.0001), weekend vs weekday with more severely injured patients admitted during the weekend (p < 0.0001) and by season p < 0.0001). Discussion and Conclusion: There is a significant national temporal variation in major trauma workload. The reasons are complex and there are multiple theories and confounding factors to explain it. This is the largest dataset for hospitals submitting to TARN which can help guide workforce and resource allocation to further improve trauma outcomes. [ABSTRACT FROM AUTHOR]

Context: The Star Excursion Balance Test (SEBT) and the Y-Balance Test (YBT) have 3 common reach directions: anterior (ANT), posteromedial (PM), and posterolateral (PL). Previous research has indicated that reachdistance performance on the ANT reach direction of the SEBT differs from that on the YBT. Kinematic patterns associated with the ANT reach direction of the SEBT and YBT need to be investigated to fully understand this difference, along with the PM and PL reach directions, to deduce any kinematic discrepancies between the 2 balance tests. Objective: To compare and contrast the kinematic patterns associated with test performance on the reach directions common to the SEBT and YBT. Design: Controlled laboratory study. Setting: University laboratory. Participants: 15 healthy male (age 23.33 ± 2.02 y, height 1.77 ± 0.04 m, body mass 80.00 ± 9.03 kg) and 14 healthy female (age 21.14 ± 1.66 y, height 1.63 ± 0.06 m, body mass 59.58 ± 7.61 kg) volunteers. Intervention: Each participant performed 3 trials of the ANT, PM, and PL reach directions of the SEBT and YBT on their dominant leg. Main Outcome Measures: Sagittal-plane lower-limb kinematic profiles were recorded using a 3-D motion-analysis system. Reach distances were also recorded for each reach direction. Results: A significant main effect (P < .05) was observed for test condition with participants reaching farther on the ANT reach direction of the SEBT compared with the YBT. While reaching in the ANT direction participants were characterized by a more flexed position of the hip joint at the point of maximum reach on the YBT (27.94° ± 13.84°) compared with the SEBT (20.37° ± 18.64°). Conclusions: Based on these observed results, the authors conclude that test performance on the SEBT and YBT differ in terms of dynamic neuromuscular demands, as evidenced by differences in reach distances achieved in the ANT reach direction and associated test kinematic profile. [ABSTRACT FROM AUTHOR]

A dense monthly precipitation dataset of Ireland and Northern Ireland was homogenized with several modern homogenization methods. The efficiency of these homogenizations was tested by examining the similarity of homogenization results both in the real data homogenization and in the homogenization of a simulated dataset. The analysis of homogenization results shows that the real dataset is characterized by a large number of, but mostly small, non‐climatic biases, and a moderate reduction of such biases can be achieved with homogenization. Finally, a combination of the ACMANT and Climatol homogenization results was applied to improve the data accuracy before the trend calculations. These two methods were selected for their proven high accuracy, missing data tolerance and ability to complete time series via the infilling of missing values before the trend calculations. Metadata were used within the Climatol method. To facilitate this analysis the study area was split into smaller climatic regions by using the Ward clustering method. Five climatic zones consistent with the known spatial patterns of precipitation in Ireland were established. Linear regression fitting and the Mann‐Kendall test were applied. Low frequency fluctuations were also examined by applying a Gaussian filter. The results show that the precipitation amount generally increases in the study area, particularly in the northwestern region. The most significant increasing trends for the whole study period (1941–2010) are found for late winter and spring precipitation, as well as for the annual totals. In the period from the early 1970s the increase of precipitation is general in all seasons of the year except in winter, but the statistical significance of this increase is weak. [ABSTRACT FROM AUTHOR]

Objective: To determine availability of nutrition information for cancer patients and survivors from Irish healthcare organisations, cancer charity and support groups and assess its quality and readability. Design: Cross‐sectional. Setting: The National Health Service Executive websites were searched, as were the sites of the ten largest cancer charities/support groups identified through the Benefacts website. An additional internet search was conducted to ensure no large organisations/support groups were missed (February 2019). Quality of nutrition content was assessed using an evidence‐based checklist and readability assessed using two validated formulas. Results: Thirty‐two websites were identified, five contained nutrition information for cancer patients (15.6%), and three for cancer survivors (9.3%). The quality of the nutrition content ranged from 19.5 to 29/40 (mean ± SD, 23.2 ± 3.2; median = 21, interquartile range (IQR) = 7). There was a lack of practical strategies for implementation. Only 40% of material had an acceptable readability level (sixth–seventh grade level). Readability scores (mean ± SD) were 68.5 ± 6.0 for Flesch Reading Ease Score and 7.8 ± 1.1 for Flesch–Kincaid Grade Level Score. Conclusion: There is limited nutrition information on Irish health and cancer websites and in particular very few tailored to cancer survivors. Irish health and cancer organisations should consider providing nutrition information that is easily accessible to all. [ABSTRACT FROM AUTHOR]

Background Haemolytic Uraemic Syndrome (HUS) is a serious complication of Shiga toxin-producing Escherichia coli (STEC) infection and the key reason why intensive health protection against STEC is required. However, although many potential risk factors have been identified, accurate estimation of risk of HUS from STEC remains challenging. Therefore, we aimed to develop a practical composite score to promptly estimate the risk of developing HUS from STEC. Methods This was a retrospective cohort study where data for all confirmed STEC infections in Ireland during 2013–15 were subjected to statistical analysis with respect to predicting HUS. Multivariable logistic regression was used to develop a composite risk score, segregating risk of HUS into 'very low risk' (0–0.4%), 'low risk' (0.5–0.9%), 'medium risk' (1.0–4.4%), 'high risk' (4.5–9.9%) and 'very high risk' (10.0% and over). Results There were 1397 STEC notifications with complete information regarding HUS, of whom 5.1% developed HUS. Young age, vomiting, bloody diarrhoea, Shiga toxin 2, infection during April to November, and infection in Eastern and North-Eastern regions of Ireland, were all statistically significant independent predictors of HUS. Demonstration of a risk gradient provided internal validity to the risk score: 0.2% in the cohort with 'very low risk' (1/430), 1.1% with 'low risk' (2/182), 2.3% with 'medium risk' (8/345), 3.1% with 'high risk' (3/98) and 22.2% with 'very high risk' (43/194) scores, respectively, developed HUS. Conclusion We have developed a composite risk score which may be of practical value, once externally validated, in prompt estimation of risk of HUS from STEC infection. [ABSTRACT FROM AUTHOR]

Purpose: A major difficulty identified many years ago in psychiatric care is the shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments which are behaviourally based and therefore appropriate for use in a variety of contexts. The aim of this project was to ascertain the utility of a forensic nursing risk assessment tool - Behavioural Status Index (BEST-Index). The paper aims to discuss these issues. Design/methodology/approach: A multi-site cross-sectional survey was undertaken using mixed method design. Quantitative data was generated using BEST-Index to allow comparisons across three different levels of security (high, medium and low) in Scotland and Ireland. Qualitative data were gathered from patients and multi-disciplinary team (MDT) members using semi-structured interviews and questionnaire. Findings: Measured over an 18-month period, there was a statistically significant improvement in behaviour, when comparing patients in high and medium secure hospitals. Two key themes emerged from patient and staff perspectives: "acceptance of the process" and "production and delivery of information", respectively. The wider MDT acknowledge the value of nursing risk assessment, but require adequate information to enable them to interpret findings. Collaborating with patients to undertake risk assessments can enhance future care planning. Research limitations/implications: Studies using cross-section can only provide information at fixed points in time. Practical implications: The BEST-Index assessment tool is well established in clinical practice and has demonstrated good utility. Originality/value: This project has served to highlight the unique contribution of BEST-Index to both staff and patients alike and confirm its robustness and versatility across differing levels of security in Scottish and Irish forensic mental health services. [ABSTRACT FROM AUTHOR]

Background: Vitamin D status and season are intrinsically linked, and both have been proposed to be associated with glucose homeostasis in pregnancy, with conflicting results. We aimed to determine if exposure to winter and low maternal 25 hydroxyvitamin D (25OHD) in early pregnancy were associated with maternal glucose metabolism. Methods: This is a secondary data analysis of 334 pregnant women enrolled in the ROLO study, Dublin. Serum 25OHD, fasting glucose, insulin and insulin resistance (HOMA-IR) were measured in early (12 weeks' gestation) and late pregnancy (28 weeks' gestation). Season of first antenatal visit was categorised as extended winter (November- April) or extended summer (May-October). Multiple linear regression models, adjusted for confounders, were used for analysis. Results: Those who attended their first antenatal visit in extended winter had lower 25OHD compared to extended summer (32.9 nmol/L vs. 44.1 nmol/L, P < 0.001). Compared to those who attended their first antenatal visit during extended summer, extended winter was associated with increased HOMA-IR in early-pregnancy (46.7%) and late pregnancy (53.7%), independent of 25OHD <30 nmol/L and confounders. Early pregnancy 25OHD <30 nmol/L and extended winter were independently associated with significantly higher fasting glucose in late pregnancy (B = 0.15 and 0.13, respectively). Conclusions: Women who attended their first antenatal visit during the months of extended winter were more likely to have raised insulin resistance in early pregnancy, which had a lasting association to 28 weeks, and was independent of 25OHD. Our novel findings imply that seasonal variation in insulin resistance may not be fully explained by differences in vitamin D status. This could reflect circannual rhythm or seasonal lifestyle behaviours, and requires further exploration. [ABSTRACT FROM AUTHOR]

A brief cold water immersion between 2 continuous high-intensity exercise bouts improves the performance of the latter compared with passive recovery in the heat. We investigated if this effect is apparent in normothermic conditions (∼19 °C), employing an intermittent high-intensity exercise designed to reflect the work performed at the high-intensity domain in team sports. Fifteen young active men completed 2 exhaustive cycling protocols (Ex1 and Ex2: 12 min at 85% ventilatory threshold (VT) and then an intermittent exercise alternating 30-s at 40% peak power ( Ppeak) and 30 s at 90% Ppeak to exhaustion) separated by 15 min of ( i) passive rest, ( ii) 5-min cold-water immersion at 8 °C, and ( iii) 10-min cold-water immersion at 8 °C. Core temperature, heart rate, rates of perceived exertion, and oxygen uptake kinetics were not different during Ex1 among conditions. Time to failure during the intermittent exercise was significantly ( P < 0.05) longer during Ex2 following the 5- and 10-min cold-water immersions (7.2 ± 3.5 min and 7.3 ± 3.3 min, respectively) compared with passive rest (5.8 ± 3.1 min). Core temperature, heart rate, and rates of perceived exertion were significantly ( P < 0.05) lower during most periods of Ex2 after both cold-water immersions compared with passive rest. The time constant of phase II oxygen uptake response during the 85% VT bout of Ex2 was not different among the 3 conditions. A postexercise, 5- to 10-min cold-water immersion increases subsequent intermittent high-intensity exercise compared with passive rest in normothermia due, at least in part, to reductions in core temperature, circulatory strain, and effort perception. [ABSTRACT FROM AUTHOR]

Background: Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research. Methods: A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20-60 years drawn from the Island of Ireland. Surveys were administered in participants' homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations. Results: ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10-20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05). Conclusion: Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to develop a healthy eating motivation score and to determine if dietary, lifestyle and activity behaviours vary across levels of motivation to eat a healthy diet with a view to informing health promotion interventions. Methods: A cross-sectional survey of food intake, physical activity, lifestyles and food choice attitudes was conducted in a nationally representative sample of 1262 adults in the Republic of Ireland aged 18 years and over. Results: Increasing score for health motivation was significantly and positively related to healthy eating and exercise. Women, increasing age, normal BMI, regular exercise and increasing intakes of fruit and vegetables were associated with a higher odds ratio (OR) for having a high healthy eating motivation score. However, despite a high motivation score only 31 % of consumers in the strong motivation group achieved the recommendations for daily fruit and vegetable consumption, while 57 % achieved the fat recommendation. A higher intake of calorie dense foods from the top shelf of the food pyramid and increased time spent watching T.V. was associated with a decreased OR for positive motivation towards healthy eating. Conclusions: Healthy eating promotions directed at women and older adults should focus on supporting people's motivations to attain a healthy diet by addressing issues such as dietary self-control and self-regulation. For men and younger adults, healthy eating promotions will need to address the issues underlying their weak attitudes towards healthy eating. [ABSTRACT FROM AUTHOR]

The present analysis aimed to investigate the changes in the reported portion sizes (PS) of foods and beverages commonly consumed by Irish adults (18–64 years) from the North South Ireland Food Consumption Survey (NSIFCS) (1997–2001) and the National Adult Nutrition Survey (NANS) (2008–10). Food PS, which are defined as the weight of food (g) consumed per eating occasion, were calculated for comparable foods and beverages in two nationally representative cross-sectional Irish food consumption surveys and were published in NSIFCS and NANS. Repeated measure mixed model analysis compared reported food PS at the total population level as well as subdivided by sex, age, BMI and social class. A total of thirteen commonly consumed foods were examined. The analysis demonstrated that PS significantly increased for five foods (‘white sliced bread’, ‘brown/wholemeal breads’, ‘all meat, cooked’, ‘poultry, roasted’ and ‘milk’), significantly decreased for three (‘potatoes’, ‘chips/wedges’ and ‘ham, sliced’) and did not significantly change for five foods (‘processed potato products’, ‘bacon/ham’, ‘cheese’, ‘yogurt’ and ‘butter/spreads’) between the NSIFCS and the NANS. The present study demonstrates that there was considerable variation in the trends in reported food PS over this period. [ABSTRACT FROM PUBLISHER]

Vitamin E is believed to play a preventive role in diseases associated with oxidative stress. The aims of the present study were to quantify vitamin E intake levels and plasma concentrations and to assess dietary vitamin E adequacy in Irish adults. Intake data from the National Adult Nutrition Survey were used; plasma samples were obtained from a representative cohort of survey participants. Plasma α- and γ-tocopherol concentrations were measured by HPLC. The main sources of vitamin E in the diet were ‘butter, spreadable fats and oils’ and ‘vegetables and vegetable dishes’. When vitamin E intake from supplements was taken into account, supplements were found to be the main contributor, making a contribution of 29·2 % to vitamin E intake in the total population. Supplement consumers had significantly higher plasma α-tocopherol concentrations and lower plasma γ-tocopherol concentrations when compared with non-consumers. Consumers of ‘vitamin E’ supplements had significantly higher vitamin E intake levels and plasma α-tocopherol concentrations compared with consumers of other types of supplements, such as multivitamin and fish oil. Comparison with the Institute of Medicine Estimated Average Requirement of 12 mg/d indicated that when vitamin E intake from food and supplement sources was taken into account, 100 % of the study participants achieved the recommended intake levels. When vitamin E intake from food sources was taken into account, only 68·4 % of the females were found to achieve the recommended intake levels compared with 99·2 % of the males. The results of the present study show that dietary vitamin E intake has a significant effect on plasma α- and γ-tocopherol concentrations. Furthermore, they show that the consumption of supplements is a major contributor to overall intake and has a significant effect on plasma vitamin E concentrations in the Irish population. [ABSTRACT FROM PUBLISHER]

Background Pregnant women living at northerly latitudes are at risk of suboptimal vitamin D status. There is a paucity of studies correlating knowledge, attitudes and practices of vitamin D with serum levels amongst pregnant women. We aimed to determine the prevalence of suboptimal vitamin D status in pregnant women of various ethnicities attending two Dublin maternity hospitals and to assess levels of knowledge, attitudes and practices concerning vitamin D. Methods We conducted a cross-sectional study of 116 pregnant women of Irish, Asian, Sub-Saharan African and Middle Eastern and North African ( MENA) origin. Vitamin D status was determined by measurement of serum 25-hydroxyvitamin D (25 OHD). We examined knowledge, attitudes and practices concerning vitamin D using an interview-assisted questionnaire. Results The median ( interquartile range) 25 OHD level was 25.9 (16.5-44.7) nmol L-1. Using a cut-off point of <30 nmol L-1, the proportion at risk of deficiency was significantly higher among MENA (88%; P < 0.001) and Sub-Saharan African women (68%; P = 0.019) than Irish women (36%). Eighty-two women (71%) reported they had insufficient knowledge about vitamin D and its sources. Vitamin D containing supplement usage was the strongest predictor of 25 OHD levels ≥30 nmol L-1 ( odds ratio = 18.03, 95% confidence interval = 5.7256.8, P < 0.001). Conclusions Suboptimal vitamin D status is common in this cohort of pregnant women, especially among those of Sub-Saharan African and MENA origin. Awareness of vitamin D dietary sources is poor among all subgroups. Recommending vitamin D containing supplements may be the best strategy at present for improving vitamin D status with a need for increased vitamin D education. [ABSTRACT FROM AUTHOR]

Warm-up protocols are commonly used to acutely enhance the performance of dynamic activities. This study examined the acute effect of low-load gluteal exercises on the biomechanics of single-leg drop jumps. Eight men and seven women (18–22 years old) performed 10 single-leg drop jumps on three separate days. The gluteal exercises were performed within the warm-up on day 2. Contact time, flight time, peak vertical ground reaction force (GRF), rate of force development, vertical leg-spring stiffness, and reactive strength index were determined. A repeated measures analysis of variance was used to examine differences on all variables across days. Significant differences were found for contact time, peak GRF, and flight time between days 1 and 2 and for flight time between days 1 and 3 (p ≤ 0.05)with no significant difference in any variables between days 2 and 3. This suggested that the improvements in day 2 were due to practice effects rather than the gluteal activation exercises. In addition, a typical error analysis was used to determine individual responses to the gluteal exercises. The results using this analysis showed no discernible response pattern of enhancement or fatigue for any participant. [ABSTRACT FROM PUBLISHER]

Research is presented that examined the effect of plyometric stimulus on the production of post-activation potentiation (PAP) in 20 professional rugby players' jump performance. The study found that a series of plyometric exercises increased the height of countermovement jumps (CMJs) and peak force during the session and also that the PAP effect on CMJ height was comparable to the PAP effect in a heavy resistance training protocol.

Objectives: The objectives of this study were to evaluate the effects of the physical motion of a horse (riding therapy) combined with the audiovisual perception of this motion on a group of children with dyspraxia in terms of cognition, mood arousal, and gait variability. Design: The study design was a pretest/post-test. Settings/location: The study was conducted at the Fettercairn Youth Horse Project, Fettercairn, Tallaght, Dublin. Subjects: Forty (40) children ranging from 6 to 15 years of age with a primary diagnosis of dyspraxia were the study subjects. Interventions: Children meeting inclusion criteria participated in six 30-minute horse-riding sessions and two 30-minute audiovisual screening sessions. Outcome measures: A Standard Progressive Matrices test (also known as the Ravens test) was used to measure aspects of general intelligence. A Childhood Depression Inventory (CDI) questionnaire was used to assess cognitive, affective, and behavioral signs of depression. A GAITRite Pressure Mapping System analyzed foot function and gait variability by measuring single and double support, cycle time, cadence, toe in/out, and stride length. Results: Significant improvements were evident on the Ravens test and the CDI by the end of the study period. The amount of both single and double support required while completing the walking task also was significantly reduced. Improvements were visible on toe in/out values, cycle time, and cadence. Changes in stride length did not reach statistical significance. Conclusions: These findings support the theory that riding therapy and/or the perception of beat-based rhythms, as experienced by the rider on the horse, stimulates cognition, mood, and gait parameters. In addition, the data also pointed to the potential value of an audiovisual approach to equine therapy. [ABSTRACT FROM AUTHOR]

Background: Prehabilitation is defined as preparing an individual to withstand a stressful event through enhancement of functionalcapacity.Hypothesis: We hypothesized that a preoperative exercise program would enhance postoperative outcomes after anterior cruciateligament reconstruction (ACLR).Study Design: Randomized controlled clinical trial; Level of evidence, 1.Methods: Twenty volunteers awaiting ACLR were randomly assigned to a control or exercise intervention group. The exercisegroup completed a 6-week gym- and home-based exercise program. Assessments include single-legged hop test; quadricepsand hamstring peak torque and magnetic resonance imaging cross-sectional area (CSA); Modified Cincinnati Knee Rating Systemscore; and muscle biopsy of the vastus lateralis muscle completed at baseline, preoperatively, and 12 weeks postoperatively.Myosin heavy chain (MHC) isoforms protein and messenger RNA (mRNA) expression were determined with SDS-PAGE (sodiumdodecyl sulfate polyacrylamide gel electrophoresis) and RT-PCR (real-time polymerase chain reaction), respectively; IGF-1(insulin-like growth factor 1), MuRF-1 (muscle RING-finger protein-1), and MAFbx (muscle atrophy f-box) mRNA expressionwere determined with quantitative RT-PCR.Results: Following 6 weeks of exercise intervention, the single-legged hop test results improved significantly in the exerciseinjuredlimb compared with baseline (P = .001). Quadriceps peak torque in the injured limb improved with similar gains in CSAcompared with baseline (P = .001). However, this was not significantly increased compared with the control group. Quadricepsand vastus medialis CSA were also larger in the exercise group than in controls (P = .0024 and P = .015, respectively). The modifiedCincinnati score was better in the exercise-injured limb compared with baseline. At 12 weeks postoperatively, the rate ofdecline in the single-legged hop test was reduced in the exercise group compared with controls (P = .001). Similar trendswere not seen for quadriceps peak torque and CSA. The vastus medialis CSA had regressed to similar levels as the control group(P = .008). The modified Cincinnati score continued to increase in the exercise group compared with controls (P = .004). Theexpression of the hypertrophic IGF-1 gene was significantly increased after the exercise intervention (P = .028), with a decreaseback to baseline 12 weeks postoperatively (P = .012). Atrophic MuRF-1 gene expression was decreased after intervention comparedwith baseline (P = .05) but increased again at 12 weeks postoperatively (P = .03). The MAFbx levels did not change significantlyin either group and within each time point. On the mRNA level, there was a shift from MHC-IIx isoform to MHC-IIaafter exercise, with significant changes compared with control preoperatively (P = .028). Protein testing was able to reproducethis increase for MHC-IIa isoform expression only.Conclusion: The 6-week progressive prehabilitation program for subjects undergoing ACLR led to improved knee function basedon the single-legged hop test and self-reported assessment using the modified Cincinnati score. These effects were sustained at12 weeks postoperatively. This study supports prehabilitation as a consideration for patients awaiting ACLR; however, furtherstudies are warranted. [ABSTRACT FROM AUTHOR]

Oral Diseases (2011) 18, 60-66 Objective: To test the reliability and responsiveness of the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), in measuring the quality of life (QofL) in patients with chronic oral mucosal conditions. Methods: A random sample of 160 patients with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis received a copy of the COMDQ. A subset of 100 patients received the questionnaire on two further occasions, 2 weeks and 3 months later. Statistical tests were carried out to evaluate the test-retest reliability and responsiveness of this instrument. Results: This study has demonstrated that the COMDQ has good test-retest reliability with an intraclass correlation coefficient of 0.81 and is responsive to changes in the patients' overall conditions. Conclusion: In conclusion, this study has further demonstrated the reliability and responsiveness of the COMDQ in assessing QofL in patients with chronic oral mucosal diseases. [ABSTRACT FROM AUTHOR]

Objective: To explore whether distance to and density of food outlets within the local area have an impact on individual dietary quality, controlling for the socioeconomic characteristics of individuals and their households. Methods: An analysis of the Survey of Lifestyle, Attitudes and Nutrition in Ireland (SLÁN), a two-stage clustered sample of 10 364 individuals aged 18+ from the Republic of Ireland. Socioeconomic status was measured using net household income and highest level of education. Diet was assessed via a food frequency questionnaire and the results scored in terms of cardiovascular risk. Food availability was measured in terms of distance to (Euclidean and network) and density of different types of food outlets. Dietary quality was decomposed using fixed effects regression models. Results: There is a pronounced gradient in distances to nearest food store and quality of diet by socioeconomic status. Controlling for individual and household socioeconomic status and demographic characteristics, individuals who live closer to a larger food outlet or who live in an area with a higher density of larger food outlets have a significantly better diet in terms of cardiovascular risk. Conclusions: Studies outside of North America have failed to find that the physical availability of food plays a significant role in socioeconomic gradients in diet and nutrition. This study suggests that food availability in the Republic of Ireland plays a small but statistically significant role in influencing the diets of individuals and communities and, as such, may also influence socioeconomic inequalities in health. [ABSTRACT FROM AUTHOR]

Abstract: In this study, the concentrations of total gaseous mercury in baseline air masses arriving at Mace Head, Ireland after having traversed the thousands of kilometres uninterrupted fetch of the North Atlantic Ocean, have been used for the assessment of possible trends in the atmospheric mercury background concentration over a 14-year period (i.e., 1996–2009), a statistically significant negative (downwards) trend of −0.028 ± 0.01 ng m−3 yr−1, representing a trend of 1.6–2.0% per year, has been detected in the total gaseous mercury levels in these baseline air masses. These findings are set in the context of the available literature studies of atmospheric Hg trends. [Copyright &y& Elsevier]

Browne D, Whelton H, O'Mullane D, Tavener J, Flannery E. The aesthetic impact of enamel fluorosis on Irish adolescents. Community Dent Oral Epidemiol 2011; 39: 127-136. © 2011 John Wiley & Sons A/S To assess the impact of differing degrees of enamel fluorosis on dental aesthetics according to Irish adolescents. The same participants also aesthetically rated other variations in dental appearances including a carious lesion, bleached teeth and a demarcated opacity. One hundred and fifty adolescents examined seven identical template photographs of an attractive dental smile displaying varying levels of enamel fluorosis (TF1, TF2, TF3), a demarcated opacity, no fluorosis (TF0), anterior caries and very white or bleached teeth. By indicating their level of agreement or disagreement with five statements on a five-point Likert scale, the participants rated the aesthetic acceptability of each of the photographs. Using paired t-tests with the Bonferroni correction, it was found that the photographs depicting the very white teeth and anterior caries were rated as the most and least aesthetically pleasing images, respectively. There was no significant difference in the ratings of the photographs displaying TF0, TF1 and TF2 levels of fluorosis indicating that these photographs were viewed similarly ( P > 0.002). The remaining two photographs (TF3 and the demarcated opacity) were rated similarly and significantly worse ( P < 0.002) than the photographs showing no or low grades of fluorosis (TF0, TF1 and TF2). TF3 level of fluorosis represented the break point at which enamel fluorosis became aesthetically objectionable to these participants. Low grades of fluorosis (TF1 and TF2) were rated similarly to the photograph depicting no fluorosis (TF0). [ABSTRACT FROM AUTHOR]

Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients 'at risk' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored. An education programme, incorporating 'Malnutrition Universal Screening Tool (MUST)' training, was implemented in eight of 10 eligible primary care practices (14 general practitioners and nine practice nurses attended), in seven private nursing homes (20 staff nurses attended) and two health centres (53 community nurses attended) in conjunction with a community dietetics service for patients at risk of malnutrition. Nutritional knowledge was assessed before, immediately after, and 6 months after the intervention using self-administered, multiple-choice questionnaires. Reported changes in practice and the acceptability of the education programme were considered using self-administered questionnaires 6 months after the intervention. A significant increase in nutritional knowledge 6 months after the intervention was observed ( P < 0.001). The management of malnutrition was reported to be improved, with 69% (38/55) of healthcare professionals reporting to weigh patients 'more frequently', whereas 80% (43/54) reported giving dietary advice to prevent or treat malnutrition. Eighty-percent (44/55) of healthcare professionals stated that 'MUST' was an acceptable nutrition screening tool. An education programme supported by a community dietetics service for patients 'at risk' of malnutrition increased the nutritional knowledge and improved the reported management of malnourished patients in the community by healthcare professionals. [ABSTRACT FROM AUTHOR]

The age-related decline in basal limb blood flow appears to be related to the pathogenesis of metabolic syndrome, noninsulin-dependent diabetes, and cardiovascular disease. Resistance training improves basal limb blood flow and vascular conductance in middle-aged men and women, but it is unknown whether similar vascular effects of training occur in the elderly. This study aimed to examine the effects of a 12-week progressive resistance training program using elastic bands on basal leg blood flow, vascular conductance, and functional performance in postmenopausal elderly women. Sixteen healthy postmenopausal females (age, 67 ± 5 years) were randomly assigned to a control (n = 8) or resistance training (n = 8) group, where they underwent 2 supervised strength sessions per week for 12 weeks. Prior to and at completion of this 12-week period, functional and strength performance and leg haemodynamic responses were measured. The training intervention produced significant increases in basal leg blood flow (31%), vascular conductance (34%), and a significant reduction in cardiac work (i.e., rate pressure product) at rest, as well as significant improvements in the 3 functional ability tests performed (30-s bicep curl, 30-s sit to stand, and back scratch). Haemodynamic or functional performance responses were not altered after the 12 weeks in the control group. This study demonstrates that a resistance training program using elastic bands elicits significant improvements in basal leg blood flow in postmenopausal elderly women. La diminution associée à l'âge du débit sanguin de base dans les membres semble reliée à la pathogenèse du syndrome métabolique, du diabète de type 2 et de la maladie cardiovasculaire. L'entraînement à la force améliore le débit sanguin de base et la conductance vasculaire chez des femmes et des hommes d'âge mûr, mais on ne sait pas si les mêmes effets vasculaires se présentent chez des personnes âgées. Cette étude se propose d'analyser les effets d'un programme d'entraînement progressif à la force sur le débit sanguin de base dans la jambe, sur la conductance vasculaire et la capacité fonctionnelle de femmes âgées et postménopausées. Le programme d'entraînement de 12 semaines se fait au moyen de bandes élastiques. On répartit aléatoirement 16 femmes postménopausées en bonne santé et âgées de 67 ± 5 ans dans 2 groupes, l'un servant de contrôle (n = 8) et l'autre constituant le groupe expérimental (n = 8); dans ce dernier, les sujets participent à un programme d'entraînement à la force à raison de deux séances par semaine, et ce, sur une période de 12 semaines. Avant et après le programme d'entraînement, on évalue les capacités musculaire et fonctionnelle en plus des réponses hémodynamiques de la jambe. Le programme d'entraînement suscite une augmentation significative du débit sanguin de base dans la jambe (31 %), de la conductance vasculaire (34 %) et une diminution significative du travail cardiaque (soit le produit de la tension systolique par la fréquence des contractions cardiaques) au repos en plus d'une amélioration significative de la performance au cours de 3 tests de capacité fonctionnelle : nombre de flexions du coude en 30 s, nombre de redressements de la position assise à la position debout et degré de rapprochement des mains placées dans le dos. Chez le groupe de contrôle, on n'observe aucune modification de la capacité fonctionnelle et des réponses hémodynamiques du début à la fin de la période expérimentale. D'après les observations faites dans cette étude, un programme d'entraînement à la force au moyen de bandes élastiques suscite une amélioration significative du débit sanguin de base dans les jambes chez des femmes postménopausées et âgées. [ABSTRACT FROM AUTHOR]

Abstract: The measurement of travel costs in recreational demand modeling has been a contentious issue for many decades. This article explores the use of a number of alternative methods of incorporating time costs in the travel cost modeling process. Travel cost values where the opportunity cost of time is excluded, where it is included as a percentage of the individual''s reported wage rate and where it based on an estimated wage from a secondary data source (the European Community Household Panel) are compared and then used in a conditional logit model to estimate the demand for whitewater kayaking in Ireland. We then evaluate the effect of different treatments of the cost of travel time on the welfare impacts of a number of different management scenarios for kayaking rivers in Ireland, and find that statistically significant differences emerge. [Copyright &y& Elsevier]