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BACKGROUND: Tractors and quad bikes pose a significant risk of fatal injuries among farmers, particularly affecting older farmers. This study aimed to explore the barriers and facilitators to the adoption of machine related safety behaviors among older farmers in Irish farm settings. METHOD: Four focus groups were conducted via Zoom in February 2021. Nineteen Irish farmers from four farm types participated. The discussions were audio-recorded, transcribed verbatim, and analyzed using an inductive, reflexive thematic analysis approach. The themes identified were then mapped to the COM-B (Capability-Opportunity-Motivation) model, providing a systematic theoretical basis for designing a future intervention to reduce machine-related accidents. RESULTS: The analysis identified five inductive themes that encompassed both barriers and facilitators in farm safety practices: (1) Capability to manage competing responsibilities; (2) Characteristics of the farm and its work environment; (3) Availability and affordability of resources; (4) Prevailing sociocultural opportunities; and (5) Perceived likelihood and cost-benefit analysis in safety decision-making. These themes captured the complex interplay of capability, opportunity, and motivation in farmers' decision-making processes. The study also revealed limitations in existing interventions, such as voluntary guidelines and educational methods, in effectively addressing these barriers. CONCLUSIONS: Farmers' abilities (capability), prevailing sociocultural factors, resource availability (opportunity), and their perceived consequences and benefits (motivation) affect how safely they work with machines. The study emphasizes the need for comprehensive, theory-driven approaches that consider the interplay of capability, opportunity, and motivational factors that may support or impede machine safety. Understanding the challenges faced by Irish farmers highlights potential strategies for safety intervention, and these strategies should be co-designed with farmers and attentive to the local context. PRACTICAL APPLICATIONS: The study provides a template for understanding farmers' perspectives using the COM-B model. The findings can inform the development of theoretically informed intervention strategies based on the Behavior Change Wheel framework.
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Agricultores , Grupos Focales , Humanos , Agricultores/psicología , Agricultores/estadística & datos numéricos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Irlanda , Accidentes de Trabajo/prevención & control , Granjas , Agricultura , Salud Laboral , Investigación Cualitativa , Motivación , Toma de DecisionesRESUMEN
Streptococcus mitis is a leading cause of infective endocarditis (IE). However, our understanding of the genomic epidemiology and pathogenicity of IE-associated S. mitis is hampered by low IE incidence. Here we use whole genome sequencing of 129 S. mitis bloodstream infection (BSI) isolates collected between 2001-2016 from clinically diagnosed IE cases in the UK to investigate genetic diversity, antimicrobial resistance, and pathogenicity. We show high genetic diversity of IE-associated S. mitis with virtually all isolates belonging to distinct lineages indicating no predominance of specific lineages. Additionally, we find a highly variable distribution of known pneumococcal virulence genes among the isolates, some of which are overrepresented in disease when compared to carriage strains. Our findings suggest that S. mitis in patients with clinically diagnosed IE is not primarily caused by specific hypervirulent or antimicrobial resistant lineages, highlighting the accidental pathogenic nature of S. mitis in patients with clinically diagnosed IE.
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Bacteriemia , Infecciones Estreptocócicas , Streptococcus mitis , Humanos , Streptococcus mitis/genética , Streptococcus mitis/aislamiento & purificación , Reino Unido/epidemiología , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/epidemiología , Irlanda/epidemiología , Bacteriemia/microbiología , Bacteriemia/epidemiología , Endocarditis/microbiología , Endocarditis/epidemiología , Genoma Bacteriano/genética , Secuenciación Completa del Genoma , Masculino , Femenino , Variación Genética , Genómica , Anciano , Filogenia , Persona de Mediana Edad , Farmacorresistencia Bacteriana/genética , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/epidemiología , Adulto , Factores de Virulencia/genética , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Virulencia/genéticaRESUMEN
Misinformation surrounding crises poses a significant challenge for public institutions. Understanding the relative effectiveness of different types of interventions to counter misinformation, and which segments of the population are most and least receptive to them, is crucial. We conducted a preregistered online experiment involving 5228 participants from Germany, Greece, Ireland, and Poland. Participants were exposed to misinformation on climate change or COVID-19. In addition, they were pre-emptively exposed to a prebunk, warning them of commonly used misleading strategies, before encountering the misinformation, or were exposed to a debunking intervention afterwards. The source of the intervention (i.e. the European Commission) was either revealed or not. The findings show that both interventions change four variables reflecting vulnerability to misinformation in the expected direction in almost all cases, with debunks being slightly more effective than prebunks. Revealing the source of the interventions did not significantly impact their overall effectiveness. One case of undesirable effect heterogeneity was observed: debunks with revealed sources were less effective in decreasing the credibility of misinformation for people with low levels of trust in the European Union (as elicited in a post-experimental questionnaire). While our results mostly suggest that the European Commission, and possibly other public institutions, can confidently debunk and prebunk misinformation regardless of the trust level of the recipients, further evidence on this is needed.
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COVID-19 , Comunicación , Unión Europea , Confianza , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Masculino , Femenino , Adulto , Polonia , Alemania , Cambio Climático , Grecia , Encuestas y Cuestionarios , Irlanda , SARS-CoV-2 , Persona de Mediana Edad , Adulto JovenRESUMEN
Deep-sea corals are rarely identified to species due to a lack of taxonomic expertise and paucity of sampling. Herein we describe a new genus from the family Keratoisididae collected from the Northeast Atlantic. Using both nuclear (2010 conserved element loci) and complete mitogenome phylogenies, we found this genus to be closely related to the genera Dokidisis and Jasonisis . In the nuclear phylogeny, each genus occupied a distinct well-supported clade. All three genera lack thorned- or double-star sclerites in the pharynx; instead they have flattened rods, a potential unifying feature of the keratoisidid group J3 of Watling et al . (2022) . The newly described genus Explorisis gen. nov. has a unique sclerome including spindles and tapered rods that differentiates it from its sister genera. Explorisis katharina sp. nov. is characterised by volcano to cylindrical shaped polyps, striated rods and spindles in the polyp body, and elongated flattened rods in the coenenchyme, whereas Explorisis poppyae sp. nov. has heavily granulated spindles and rods in both the polyp body and coenenchyme. Genetic variation within the mitogenomes across both Explorisis gen. nov. species is limited with mutations in just 3 of 14 protein coding regions. ZooBank: urn:lsid:zoobank.org:pub:141BD76E-8C83-43BE-8E1E-B8C53CD7CEF7.
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Antozoos , Filogenia , Antozoos/genética , Antozoos/clasificación , Animales , Irlanda , Especificidad de la Especie , Genoma Mitocondrial/genética , Océano AtlánticoRESUMEN
BACKGROUND: Gambling marketing communications create a public health risk by increasing the normalisation of gambling in sports. In a context where broad level studies report significant underage gambling, currently no evidence exists on how these communications are received by children in the Republic of Ireland (hereafter Ireland) and Northern Ireland. To build this evidence base and provide granular detail below broad level data, this study explored the sport consumption habits and views of Irish children (aged 14-17 years) on their exposure, awareness and perceptions of the relationship between sport and gambling. METHODS: Drawing on a constructivist approach to data collection, 6 face-to-face focus groups were staged with a total of 51 youth sport consumers from both sides of the border region on the island of Ireland. RESULTS: Four main themes were established. First, mediated sport consumption was predominantly via mobile social media. Second, we found that their exposure to gambling marketing was high and while frequently seen through social media channels it was also prevalent in peer-to-peer conversations and on the main street. Third, we found mixed responses on their perceptions about gambling and sport. While many felt that sport and gambling were a good fit, they were aware of the financial risks involved. Few children understood the wider social risks with gambling harm. Fourth, children were sceptical of claims made in gambling communications. These findings highlight concerns about how exposure to gambling marketing is impacting children's views on sport and on gambling. These views need to be taken into consideration when broadcasters and sport organizations are entering into commercial associations. CONCLUSIONS: Gambling marketing is noticed by children watching mass and social media, and in the towns in the border regions of the island of Ireland. Our study provides children's viewpoints on this topic which complements the larger quantitative studies in Ireland and Northern Ireland that highlight the growing prevalence of children and gambling. This study not only extends the literature on the exposure, awareness and perceptions of children on the island of Ireland but provides crucial evidence to public health advocates in this region demonstrating the pervasiveness of gambling communications in and around children's spaces.
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Grupos Focales , Juego de Azar , Mercadotecnía , Investigación Cualitativa , Humanos , Juego de Azar/psicología , Juego de Azar/epidemiología , Irlanda , Adolescente , Masculino , Femenino , Mercadotecnía/métodos , Deportes/psicología , Medios de Comunicación Sociales/estadística & datos numéricos , Irlanda del NorteRESUMEN
Introduction: Social disconnection and deaths by suicide among older adults are both important public health concerns, particularly in the context of ageing populations. The association between death ideation and behaviours, and social disconnection is well established and both functional and structural social relationships have been identified as predictive of suicide-related thoughts and behaviours. The "Wish to Die" (WTD) involves thoughts of or wishes for one's own death or that one would be better off dead is a commonly used indicator to capture death ideation. It has been shown to be as predictive as active ideation of future suicide attempt. Methods: Data were from a large cohort of community-dwelling older adults aged 50+, The Irish Longitudinal Study on Ageing (TILDA). Cross-sectional analyses of the association between numerous markers of social disconnection (loneliness, social isolation, living alone, marital status, social participation, volunteering, and attending religious service) and WTD were conducted. Results: Multiple markers of social disconnection were associated with a "wish to die". However, loneliness was the strongest risk factor while attendance of religious services was an important protective behaviour. Discussion: There is a strong association between social disconnection and a WTD among older adults. There is also a strong association between depression and a WTD, while attending religious services or similarly prosocial settings may protect older adults from experiencing negative thoughts about dying.
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Vida Independiente , Soledad , Aislamiento Social , Humanos , Anciano , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Estudios Longitudinales , Irlanda , Soledad/psicología , Aislamiento Social/psicología , Factores de Riesgo , Ideación Suicida , Anciano de 80 o más Años , Participación SocialRESUMEN
Providers are essential to the delivery of abortion care. Yet, they often occupy an ambiguous space in political discourse around abortion. The introduction of a new abortion service in Ireland invites us to look afresh at providers. Since the Health (Regulation of Termination of Pregnancy) Act 2018 came into force, by far the most common form of abortion care has been early medical abortion (EMA). This is typically provided by General Practitioners (GPs), with approximately 10% of GPs having chosen to provide EMA. This article draws on an empirical study of providers to investigate their motivations for, and experiences of, provision and their views on colleagues who have not chosen to provide. The study shows that for many providers, the choice to provide was grounded in a moral commitment to protecting women's rights to autonomy and health and ensuring that the harms of the past were not repeated. The article argues that notwithstanding increased normalisation of EMA in Ireland, conscience still has a role to play in abortion care provision and it is important to reflect on the various aspects of this role.
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Aborto Inducido , Conciencia , Humanos , Irlanda , Aborto Inducido/ética , Aborto Inducido/legislación & jurisprudencia , Femenino , Embarazo , Médicos Generales/psicología , Actitud del Personal de SaludRESUMEN
Marine species raft on floating litter, including various plastics, potentially spreading non-native species and threatening global marine habitats. Despite limited attention, Didemnum vexillum, an invasive colonial tunicate in Europe, colonised coasts of southwest Scotland (2009) and northeast Ireland (2012), likely transported via rafting. We studied D. vexillum survival and performance on three plastic types (Polyethylene, Polypropylene and Polystyrene) finding high survival rates over 42 days, with colonies thriving best on PS. Using these data, hydrodynamic and particle tracking models simulated dispersal from existing Irish Sea colonies, projecting potential rafting distances of up to â¼150 km for surface particles influenced by tide and wind, and half that for neutrally-buoyant mid-depth particles driven by tidal currents alone. Hence, the modelling supports the potential for dispersion of this species within the Irish Sea via rafting. This study highlights marine plastics as a vector that may facilitate widespread dispersal of non-native species.
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Especies Introducidas , Plásticos , Animales , Irlanda , Escocia , Ecosistema , Distribución AnimalRESUMEN
SETANTA (Study of HEarT DiseAse and ImmuNiTy After COVID-19 in Ireland) study aimed to investigate symptom burden and incidence of cardiac abnormalities after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/COVID-19 and to correlate these results with biomarkers of immunological response and coagulation. SETANTA was a prospective, single-arm observational cross-sectional study condcuted in a primary practice setting, and prospectively registered with ClinicalTrials.gov (identifier: NCT04823182). Patients with recent COVID-19 infection (≥ 6 weeks and ≤ 12 months) were prospectively enrolled. Primary outcomes of interest were markers of cardiac injury detected by cardiac magnetic resonance imaging (CMR), which included left ventricular ejection fraction, late gadolinium enhancement and pericardial abnormalities, as well as relevant biomarkers testing immunological response and coagulopathy. 100 patients (n = 129 approached) were included, amongst which 64% were female. Mean age of the total cohort was 45.2 years. The median (interquartile range) time interval between COVID-19 infection and enrolment was 189 [125, 246] days. 83% of participants had at least one persistent symptom, while 96% had positive serology for prior SARS-CoV-2 infection. Late gadolinium enhancement, pericardial effusion, was present in 2.2% and 8.3% respectively, while left ventricular ejection fraction was below the normal reference limit in 17.4% of patients. Von Willebrand factor antigen was elevated in 32.7% of patients and Fibrinogen and D-Dimer levels were found to be elevated in 10.2% and 11.1% of patients, respectively. In a cohort of primary practice patients recently recovered from SARS-CoV-2 infection, prevalence of persistent symptoms and markers of abnormal coagulation were high, despite a lower frequency of abnormalities on CMR compared with prior reports of patients assessed in a hospital setting.Trial Registration: Clinicaltrials.gov, NCT04823182 (prospectively registered on 30th March 2021).
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Trastornos de la Coagulación Sanguínea , COVID-19 , Cardiopatías , SARS-CoV-2 , Humanos , COVID-19/complicaciones , COVID-19/sangre , Femenino , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cardiopatías/sangre , Cardiopatías/etiología , Estudios Transversales , SARS-CoV-2/aislamiento & purificación , Trastornos de la Coagulación Sanguínea/etiología , Trastornos de la Coagulación Sanguínea/sangre , Trastornos de la Coagulación Sanguínea/epidemiología , Adulto , Biomarcadores/sangre , Irlanda/epidemiología , Imagen por Resonancia Magnética , Atención Primaria de Salud , Carga SintomáticaRESUMEN
INTRODUCTION: Falls are a serious health problem in long-term care facilities (LTCFs), affecting more than 50% of residents. A key role of LTCF staff is to assess fall risks and implement fall prevention activities. Understanding the barriers and facilitators is key to successful implementation. METHODS: This descriptive qualitative study involving four LTCF facilities (varied provider types and sizes) in southwest Ireland. We recruited a convenience sample of 17 LTCF staff, who participated in semi-structured online 1:1 interviews (n = 7) or small group interviews (n = 10). The data were analysed using Braun and Clarke's reflective thematic analysis. RESULTS: The participants included two directors of nursing, three therapists, one ward manager, one general practitioner, five nurses and five healthcare assistants. Six main themes were identified, reflecting factors that influenced fall prevention: a need for sufficient staff and appropriate skill mix; fall policy, documentation and leadership; equipment and safe environments; person-centred care; staff knowledge, skills and awareness in falls prevention; and staff communication and collaborative working. A wide range of approaches that supported LTCF staff to overcome barriers were identified, including audits and feedback, falls champions, fall prevention leaders, daily communication (e.g., safety pauses) and staff collaboration. Formal multidisciplinary meetings and identification systems to highlight residents at high risk of falling were not considered helpful. Staff suggested that education should be briefer, ongoing and practice-based ("brief but often") to promote ownership and responsibility. CONCLUSION: LTCF staff identified several approaches to prevent falls in LTCFs as part of usual care, rather than lengthy, formal meetings and training. The potential role of families in fall prevention was under-appreciated and should be investigated further.
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Accidentes por Caídas , Cuidados a Largo Plazo , Humanos , Accidentes por Caídas/prevención & control , Femenino , Personal de Salud/psicología , Irlanda , Masculino , Anciano , Investigación Cualitativa , Casas de Salud , Adulto , Persona de Mediana EdadRESUMEN
BACKGROUND: Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS). METHODS: We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores. RESULTS: A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale. CONCLUSION: Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.
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Empatía , Estudiantes de Medicina , Humanos , Estudiantes de Medicina/psicología , Estudios Transversales , Masculino , Femenino , Bahrein , Curriculum , Educación de Pregrado en Medicina , Adulto Joven , Encuestas y Cuestionarios , Adulto , Relaciones Interpersonales , IrlandaRESUMEN
BACKGROUND: In Ireland and internationally, small-group learning (SGL) has been shown to be an effective way of delivering continuing medical education (CME) and changing clinical practice. RESEARCH QUESTION: This study sought to determine the benefits and limitations, as reported by Irish GPs, of the change of CME-SGL from face-to-face to online learning during COVID. METHODS: GPs were invited to participate via email through their respective CME tutors. The first of three rounds of a survey using the Delphi method gathered demographic information and asked GPs about the benefits and/or limitations of learning online in their established small groups. Subsequent rounds obtained a consensus opinion. RESULTS: Eighty-eight GPs across Ireland agreed to participate. Response rates varied from 62.5% to 72% in different rounds. These GPs reported that attending their established CME-SGL groups allowed them to discuss the practical implications of applying guidelines in COVID care into practice (92.7% consensus), reviewing new local services and comparing their practice with others (94% consensus); helping them feel less isolated (98% consensus). They reported that online meetings were less social (60% consensus), and informal learning that occurs before and after meetings did not take place (70% consensus). GPs would not like online learning to replace face-to face-CME-SGL after COVID (89% consensus). CONCLUSION: GPs in established CME-SGL groups benefited from online learning as they could discuss how to adapt to rapidly changing guidelines while feeling supported and less isolated. They report that face-to-face meetings offer more opportunities for informal learning.
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COVID-19 , Técnica Delphi , Educación a Distancia , Educación Médica Continua , Médicos Generales , Humanos , COVID-19/epidemiología , Irlanda , Educación Médica Continua/métodos , Educación a Distancia/organización & administración , Educación a Distancia/métodos , Médicos Generales/educación , Masculino , Femenino , Pandemias , Persona de Mediana Edad , SARS-CoV-2 , Procesos de Grupo , Adulto , Actitud del Personal de SaludRESUMEN
INTRODUCTION: Hospital overcrowding where patient admissions exceed capacity is associated with worse outcomes in Emergency Department. Developments in emergency stroke care have been associated with improvements in stroke outcome but are dependent on effective, organised care. We examined if overcrowding in the hospital system was associated with negative changes in stroke outcome. METHODS: Data on overcrowding were obtained from the Irish Nurses and Midwives Organisation (INMO) 'Trolley Count' database recording the number of patients cared for on trolleys/chairs in all acute hospitals each midnight. These were compared with quarterly data from the Irish National Audit of Stroke from 2013 to 2021 inclusive. Variables analysed were inpatient mortality rate, thrombolysis rate for ischaemic stroke, median door to needle time and median length of stay. RESULTS: 579449 patient episodes were recorded by Trolley Watch over the period, (Quarterly Median 16719.5, range 3389-27015). Average Quarterly Thrombolysis rate was 11.3% (sd 1.3%) Median Quarterly Inpatient Mortality rate was 11.8% (Range 8.9-14.0%). Median Quarterly Length of stay was 9 days (8-11 days). Median quarterly door to needle was 65 min (45-80 min). Q1 was typically the worst for overcrowding with on average 19777 incidences (sd 4786). This was significantly higher than for Q2 (mean 13540 (sd 4785) p = 0.005 t-test) and for Q3 (mean 14542 (sd 4753) p = 0.03). No significant correlation was found between quarterly Trolley watch episodes and inpatient mortality (r = 0.084, p = 0.63), median length of stay r=-0.15, p = 0.37) or thrombolysis rate (r = 0.089 p = 0.61). There was an unexpected significant negative correlation between trolley watch data and median door to needle time (r=-0.36, p = 0.03). CONCLUSION: Despite increasing hospital overcrowding, stroke services still managed to preserve standard of care. We could find no association between levels of overcrowding and deterioration in selected indices of patient care.
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Aglomeración , Mortalidad Hospitalaria , Accidente Cerebrovascular , Humanos , Irlanda , Accidente Cerebrovascular/terapia , Accidente Cerebrovascular/mortalidad , Tiempo de Internación/estadística & datos numéricos , Femenino , Servicio de Urgencia en Hospital/estadística & datos numéricos , Masculino , Terapia Trombolítica/estadística & datos numéricos , Anciano , Auditoría Médica , Tiempo de Tratamiento/estadística & datos numéricos , Persona de Mediana EdadRESUMEN
OBJECTIVE: Learning from adverse outcomes in health and social care is critical to advancing a culture of patient safety and reducing the likelihood of future preventable harm to service users. This review aims to present an overview of all clinical claims finalised in one calendar year involving publicly funded health and social care providers in Ireland. DESIGN: This is a retrospective observational study. The Clinical Risk Unit (CRU) of the State Claims Agency identified all service-user clinical claims finalised between 1 January 2017 and 31 December 2017 from Ireland's National Incident Management System (n=713). Claims that had incurred financial damages were considered for further analysis (n=356). 202 claims underwent an in-depth qualitative review. Of these, 57 related to maternity and gynaecology, 64 to surgery, 46 to medicine, 20 to community health and social care and 15 related to children's healthcare. RESULTS: The services of surgery and medicine ranked first and second, respectively, in terms of a number of claims. Claims in maternity services, despite ranking third in terms of claims numbers, resulted in the highest claims costs. Catastrophic injuries in babies resulting in cerebral palsy or other brain injury accounted for the majority of this cost.Diagnostic errors and inadequate or substandard communication, either with service users and/or interprofessional communication with colleagues, emerged as common issues across all clinical areas analysed. Quantitative analysis of contributory factors demonstrated that the complexity and seriousness of the service user's condition was a significant contributory factor in the occurrence of incidents leading to claims. CONCLUSION: This national report identifies common issues resulting in claims. Targeting these issues could mitigate patient safety risks and reduce the cost of claims.