http://hdl.handle.net/10468/89 2013-05-20T12:31:01Z 2013-05-20T12:31:01Z Fitzgerald, Anthony P. Perry, Ivan J. Corcoran, Paul Keeley, Helen S. Ruelbach, Udo Arensman, Ella http://hdl.handle.net/10468/875 2013-01-24T12:49:13Z 2012-01-01T00:00:00Z

The incidence and repetition of hospital-treated deliberate self harm: findings from the world's first national registry Fitzgerald, Anthony P.; Perry, Ivan J.; Corcoran, Paul; Keeley, Helen S.; Ruelbach, Udo; Arensman, Ella Background: Suicide is a significant public health issue with almost one million people dying by suicide each year worldwide. Deliberate self harm (DSH) is the single most important risk factor for suicide yet few countries have reliable data on DSH. We developed a national DSH registry in the Republic of Ireland to establish the incidence of hospital-treated DSH at national level and the spectrum and pattern of presentations with DSH and repetition. Methods and Findings: Between 2003 and 2009, the Irish National Registry of Deliberate Self Harm collected data on DSH presentations to all 40 hospital emergency departments in the country. Data were collected by trained data registration officers using standard methods of case ascertainment and definition. The Registry recorded 75,119 DSH presentations involving 48,206 individuals. The total incidence rate fell from 209 (95% CI: 205–213) per 100,000 in 2003 to 184 (95% CI: 180–189) per 100,000 in 2006 and increased again to 209 (95% CI: 204–213) per 100,000 in 2009. The most notable annual changes were successive 10% increases in the male rate in 2008 and 2009. There was significant variation by age with peak rates in women in the 15–19 year age group (620 (95% CI: 605–636) per 100,000), and in men in the 20–24 age group (427 (95% CI: 416–439) per 100,000). Repetition rates varied significantly by age, method of self harm and number of previous episodes. Conclusions: Population-based data on hospital-treated DSH represent an important index of the burden of mental illness and suicide risk in the community. The increased DSH rate in Irish men in 2008 and 2009 coincided with the advent of the economic recession in Ireland. The findings underline the need for developing effective interventions to reduce DSH repetition rates as a key priority for health systems.

2012-01-01T00:00:00Z Harrington, Janas Fitzgerald, Anthony P. Layte, Richard Lutomski, Jennifer Molcho, Michal Perry, Ivan J. http://hdl.handle.net/10468/876 2013-01-10T03:00:11Z 2011-12-01T00:00:00Z

Sociodemographic, health and lifestyle predictors of poor diets Harrington, Janas; Fitzgerald, Anthony P.; Layte, Richard; Lutomski, Jennifer; Molcho, Michal; Perry, Ivan J. Objective Poor-quality diet, regarded as an important contributor to health inequalities, is linked to adverse health outcomes. We investigated sociodemographic and lifestyle predictors of poor-quality diet in a population sample.Design A cross-sectional analysis of the Survey of Lifestyle, Attitudes and Nutrition (SLÁN). Diet was assessed using an FFQ (n 9223, response rate = 89 %), from which a dietary score (the DASH (Dietary Approaches to Stop Hypertension) score) was constructed.Setting General population of the Republic of Ireland.Subjects The SLÁN survey is a two-stage clustered sample of 10 364 individuals aged 18 years.Results Adjusting for age and gender, a number of sociodemographic, lifestyle and health-related variables were associated with poor-quality diet: social class, education, marital status, social support, food poverty (FP), smoking status, alcohol consumption, underweight and self-perceived general health. These associations persisted when adjusted for age, gender and social class. They were not significantly altered in the multivariate analysis, although the association with social support was attenuated and that with FP was borderline significant (OR = 1·2, 95 % CI 1·03, 1·45). A classical U-shaped relationship between alcohol consumption and dietary quality was observed. Dietary quality was associated with social class, educational attainment, FP and related core determinants of health.Conclusions The extent to which social inequalities in health can be explained by socially determined differences in dietary intake is probably underestimated. The use of composite dietary quality scores such as the DASH score to address the issue of confounding by diet in the relationship between alcohol consumption and health merits further study.

2011-12-01T00:00:00Z Cashman, Kevin D. Fitzgerald, Anthony P. Kiely, Mairead Seamans, Kelly M. http://hdl.handle.net/10468/863 2012-12-21T03:00:10Z 2011-12-01T00:00:00Z

A systematic review and meta-regression analysis of the vitamin D intake-serum 25-hydroxyvitamin D relationship to inform European recommendations Cashman, Kevin D.; Fitzgerald, Anthony P.; Kiely, Mairead; Seamans, Kelly M. The present study used a systematic review approach to identify relevant randomised control trials (RCT) with vitamin D and then apply meta-regression to explore the most appropriate model of the vitamin D intake–serum 25-hydroxyvitamin D (25(OH)D) relationship to underpin setting reference intake values. Methods included an updated structured search on Ovid MEDLINE; rigorous inclusion/exclusion criteria; data extraction; and meta-regression (using different model constructs). In particular, priority was given to data from winter-based RCT performed at latitudes >49•58°N (n 12). A combined weighted linear model meta-regression analyses of natural log (Ln) total vitamin D intake (i.e. diet and supplemental vitamin D) versus achieved serum 25(OH)D in winter (that used by the North American Dietary Reference Intake Committee) produced a curvilinear relationship (mean (95% lower CI) serum 25(OH)D (nmol/l) = 9•2 (8•5) Ln (total vitamin D)). Use of non-transformed total vitamin D intake data (maximum 1400 IU/d; 35µg/d) provided for a more linear relationship (mean serum 25(OH)D (nmol/l) = 0•044 × (total vitamin D) + 33•035). Although inputting an intake of 600 IU/d (i.e. the RDA) into the 95% lower CI curvilinear and linear models predicted a serum 25(OH)D of 54•4 and 55•2 nmol/l, respectively, the total vitamin D intake that would achieve 50 (and 40) nmol/l serum 25(OH)D was 359 (111) and 480 (260) IU/d, respectively. Inclusion of 95% range in the model to account for inter-individual variability increased the predicted intake of vitamin D needed to maintain serum 25(OH)D ≥50 nmol/l to 930 IU/d. The model used to describe the vitamin D intake–status relationship needs to be considered carefully when setting new reference intake values in Europe.

2011-12-01T00:00:00Z Savage, Eileen Beirne, Paul V. Ní Chróinín, Muireann Duff, Alistair Fitzgerald, Anthony P. Farrell, Dawn http://hdl.handle.net/10468/608 2013-03-08T03:01:13Z 2011-07-01T00:00:00Z

Self-management education for cystic fibrosis Savage, Eileen; Beirne, Paul V.; Ní Chróinín, Muireann; Duff, Alistair; Fitzgerald, Anthony P.; Farrell, Dawn Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted.

2011-07-01T00:00:00Z