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Item The effectiveness of social prescribing in the management of long-term conditions in community-based adults: a systematic review and meta-analysis(SAGE Publications, 2024) O’Sullivan, Declan J.; Bearne, Lindsay M.; Harrington, Janas M.; Cardoso, Jefferson Rosa; McVeigh, Joseph G.Objective: The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults. Data Sources: Eleven electronic databases were searched for randomized and quasi-randomized controlled trials. Review Methods: Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed. Results: Twelve studies (n=3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e. cancer and diabetes demonstrated significant improvements in quality of life (n=2 studies) and disease specific psychological outcomes respectively (n=3 studies). There was some evidence for improvement in physical activity (n=2 studies) but most changes were within group only (n=4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being. Conclusion: Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.Item Maternal hypertensive disorders of pregnancy and depression or anxiety in adolescence: Findings from the Millennium Cohort Study - a reply(Elsevier, 2024-03-19) Keenan, Martin; Khashan, Ali S.; O'Byrne, Laura J.; O'Keeffe, Gerard W.; Al Khalaf, Sukainah; Maher, Gillian M.Item Maternal hypertensive disorders of pregnancy and depression or anxiety in adolescence: Findings from the Millennium Cohort Study(Elsevier, 2023-11-18) Keenan, Martin; Khashan, Ali S.; O'Byrne, Laura J.; O'Keeffe, Gerard W.; Al Khalaf, Sukainah; Maher, Gillian M.Background: The short-term effects of hypertensive disorders of pregnancy (HDP) on the health of the fetus are well known; however, their impacts on the risk of mental health in the exposed offspring are not fully understood. Our aim was to examine the association between HDP and depression/anxiety at age 17 years. Methods: We used data from The Millennium Cohort Study, a nationally representative longitudinal study of children born in the United Kingdom. Data on HDP and potential confounders were collected when children were 9-months. Data on depression and anxiety were collected as one variable when children were aged 17 years using self-reported doctor diagnosis, and reclassified as depression/anxiety (overall), depression/anxiety with treatment, and depression/anxiety without treatment. Crude and adjusted logistic regression models were performed to examine the association between HDP and depression/anxiety, adjusting for several maternal and socio-economic factors. Results: There were 9517 singleton mother-child pairs included in the analyses. Adjusted logistic regression suggested an association between HDP and depression/anxiety (adjusted odds ratio, (aOR):1.30 [95 % CI, 1.02–1.66]) at age 17 years. A similar association was observed for HDP and depression/anxiety with treatment (aOR:1.33 [95 % CI, 1.01–1.73]) and HDP and depression/anxiety without treatment (aOR: 1.30 [95 % CI, 0.80–2.12]), although the latter did not reach statistical significance. Limitations: Data on severity and classifications of HDP were not available. Conclusion: Exposure to HDP may be associated with an increased likelihood of depression or anxiety at age 17 years. Future research should consider severity and different classifications of HDP.Item The impact of maternal inflammatory conditions during pregnancy on the risk of autism: methodological challenges(Elsevier, 2024-10-11) Khashan, Ali S.; O'Keeffe, Gerard W.In the current issue of Biological Psychiatry: Global Open Science, Croen et al. (1) report the results of a case-control study that examined the association between inflammatory conditions during pregnancy and the risk of autism spectrum disorder (ASD) and other neurodevelopmental disorders. They proposed that maternal inflammation during pregnancy stemming from immune or metabolic dysregulation would adversely impact ASD risk, and that individual and combinations of maternal conditions may lead to different outcomes in offspring. They found that maternal asthma (odds ratio [OR] = 1.62 [95% CI, 1.15–2.29]) and obesity (OR = 1.51 [95% CI, 1.07–2.13]) are associated with a higher risk of ASD in offspring. Strikingly, the combination of asthma and extreme obesity had the greatest odds of ASD (OR = 16.9 [95% CI, 5.13–55.71]), among female children only. This suggests that while individual maternal conditions can impact a child’s risk of ASD, the combination of certain maternal conditions may have a significantly greater impact on this risk than either condition alone. Refers to: Inflammatory Conditions During Pregnancy and Risk of Autism and Other Neurodevelopmental Disorders Biological Psychiatry Global Open Science, Volume 4, Issue 1, January 2024, Pages 39-50 Lisa A. Croen, Jennifer L. Ames, Yinge Qian, Stacey Alexeeff, Paul Ashwood, Erica P. Gunderson, Yvonne W. Wu, Andrew S. Boghossian, Robert Yolken, Judy Van de Water, Lauren A. Weiss. https://doi.org/10.1016/j.bpsgos.2023.09.008Item Implementation of a Frailty Care Bundle (FCB) targeting mobilisation, nutrition and cognitive engagement to reduce hospital associated decline in older orthopaedic trauma patients: pretest-posttest intervention study(Hylonome Publications, 2024-03) Naughton, Corina; de Foubert, Marguerite; Cummins, Helen; McCullagh, Ruth; Wills, Teresa; Skelton, Dawn A.; Dahly, Darren; O’Mahony, Denis; Ahern, Emer; Tedesco, Salvatore; Sullivan, Bridie O.; Health Research Board; Health Service ExecutiveObjective: To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods: We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models. Results: We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count. Conclusion: It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850)