Limited transmission of SARS-CoV-2 in schools in Ireland during the 2020-2021 school year.

BackgroundThe role of schools in SARS-CoV-2 transmission has been a debated topic since the beginning of the COVID-19 pandemic.AimTo examine SARS-CoV-2 transmission in all schools in Ireland during the 2020-21 school year.MethodsIn a national descriptive cross-sectional study, we investigated PCR-confirmed cases of COVID-19 among students (aged < 20 years) and staff (aged ≥ 20 years) who attended school during their infectious period to identify school close contacts. SARS-CoV-2 PCR test results of all school close contacts were pooled to obtain an overall positivity rate and to stratify positivity rate by school setting and role (i.e. student or staff).ResultsIn total, 100,474 individuals were tested as close contacts in 1,771 schools during the 2020-21 school year. An overall close contact positivity rate of 2.4% was observed across all schools (n = 2,373 secondary cases). The highest positivity rate was seen in special schools (3.4%), followed by primary (2.5%) and post-primary schools (1.8%) (p < 0.001). Of the close contacts identified, 90.5% (n = 90,953) were students and 9.5% (n = 9,521) were staff. Overall, students had a significantly higher positivity rate than staff (2.4% vs 1.8%, p < 0.001).ConclusionThis study demonstrated that a low level of SARS-CoV-2 transmission occurred in Irish schools during the 2020-21 academic year. In the event of future pandemics, and as the COVID-19 pandemic continues, there is a need to carefully weigh up the harms and benefits associated with disrupted education to mitigate infectious disease transmission before reflexively closing classes or schools.

The use of the IAEA MARIS database in determining the variability of sediment distribution coefficients in the marine environment and potential implications for marine dispersion modelling.

A prototype tool has been developed for deriving sediment distribution coefficients,Kd, in the marine environment by harvesting simultaneous measurements of activity concentrations of radionuclides in seawater and sediments based on the International Atomic Energy Agency's Marine Radioactivity Information System (MARIS). As a case study, theKdvariability in the Baltic Sea was investigated as this region has been extensively monitored by HELCOM since 1984 resulting in a comprehensive dataset with good spatial and temporal coverage and required ancillary parameters. The prototype tool was used to derive a dataset ofin-situapparentKd(a)values derived from measurements of seawater and sediment in quasi-equilibrium conditions from the Baltic Sea over a period of approximately 35 years. For Cs, a comprehensive analysis of the Baltic SeaKd(a)dataset was undertaken, focusing on the temporal trend ofKd(a)and comparing the results toKdvalues derived elsewhere. For Sr and Pu, for which there were fewer data records available a more rudimentary analysis was carried out. The CsKd(a)median values derived from137Cs data in this study were estimated to be 2154 l kg-1for seabed sediment and 10 000 l kg-1for suspended sediment. The value derived for seabed sediment is in good agreement with the previously recommended ocean margin CsKdvalue of 4000 l kg-1. The analysis demonstrated the important distinction in the Baltic Sea betweenKdvalues for seabed sediment and suspended sediments, which differed by an order of magnitude. The analysis also highlighted the dependence ofKdvalues on the variation in both the salinity of seawater and the type of seabed sediment. Such variability can significantly influence outcomes when modelling the behaviour of radionuclides in marine dispersion modelling.

222Rn and 226Ra Concentrations in Spring Water and Their Dose Assessment Due to Ingestion Intake.

222Rn and 226Ra concentrations of less than a few to several thousands of Bq L-1 have been observed in several underground bodies of water around the world. Although regulations for these concentrations in water have been implemented internationally, there are currently no regulations in place in Japan. However, concentrations that exceed these internationally recognized regulatory values have also been observed in Japan. In this study, concentrations in spring water in the northern part of Japan were measured and the effective dose from intake of the water was evaluated. 222Rn concentrations were measured using a liquid scintillation counter, and 226Ra concentrations were measured using a high purity germanium detector after chemical preparation. The measured 222Rn concentrations (=12.7 ± 6.1 Bq L-1) and 226Ra concentrations (<0.019-0.022 Bq L-1) did not exceed the reference values set by international and European/American organizations. A conservative estimate of the annual effective ingestion dose of 8 µSv for 222Rn and 226Ra obtained in this study is much smaller than the estimated overall annual effective dose of 2.2 mSv from natural radiation to the Japanese population. However, this dosage accounts for 8% of the WHO individual dosing criteria of 0.1 mSv/year for drinking water.

A unique high natural background radiation area - Dose assessment and perspectives.

The biological effects of low dose-rate radiation exposures on humans remains unknown. In fact, the Japanese nation still struggles with this issue after the Fukushima Dai-ichi Nuclear Power Plant accident. Recently, we have found a unique area in Indonesia where naturally high radiation levels are present, resulting in chronic low dose-rate radiation exposures. We aimed to estimate the comprehensive dose due to internal and external exposures at the particularly high natural radiation area, and to discuss the enhancement mechanism of radon. A car-borne survey was conducted to estimate the external doses from terrestrial radiation. Indoor radon measurements were made in 47 dwellings over three to five months, covering the two typical seasons, to estimate the internal doses. Atmospheric radon gases were simultaneously collected at several heights to evaluate the vertical distribution. The absorbed dose rates in air in the study area vary widely between 50 nGy h-1 and 1109 nGy h-1. Indoor radon concentrations ranged from 124 Bq m-3 to 1015 Bq m-3. That is, the indoor radon concentrations measured exceed the reference levels of 100 Bq m-3 recommended by the World Health Organization. Furthermore, the outdoor radon concentrations measured were comparable to the high indoor radon concentrations. The annual effective dose due to external and internal exposures in the study area was estimated to be 27 mSv using the median values. It was found that many residents are receiving radiation exposure from natural radionuclides over the dose limit for occupational exposure to radiation workers. This enhanced outdoor radon concentration might be as a result of the stable atmospheric conditions generated at an exceptionally low altitude. Our findings suggest that this area provides a unique opportunity to conduct an epidemiological study related to health effects due to chronic low dose-rate radiation exposure.

Assessment of Radiation Dose from the Consumption of Bottled Drinking Water in Japan.

Activity concentrations of 234U, 235U, 238U, 226Ra, 228Ra, 222Rn, 210Po, 210Pb, 40K, 3H, 14C, 134Cs and 137Cs were determined in 20 different Japanese bottled drinking water commercially available in Japan. The origins of the mineral water samples were geographically distributed across different regions of Japan. Activity concentrations above detection limits were measured for the radionuclides 234U, 235U, 238U, 226Ra, 228Ra and 210Po. An average total annual effective dose due to ingestion was estimated for adults, based on the average annual volume of bottled water consumed in Japan in 2019, reported to be 31.7 L/y per capita. The estimated dose was found to be below the recommended World Health Organisation (WHO) guidance level of 0.1 mSv/y for drinking water quality. The most significant contributor to the estimated dose was 228Ra.

Ongoing mumps outbreak among adolescents and young adults, Ireland, August 2018 to January 2020.

Between 18 August 2018 and 24 January 2020, 3,736 mumps cases were notified in Ireland. The highest numbers of notifications were observed in the age group 15-24 years. Vaccination status was reported for 32% (n = 1,199) of cases: 72% of these had received two doses of measles-mumps-rubella (MMR) vaccine. Vaccination uptake after free MMR vaccination targeting colleges and universities since early 2019 was low. Therefore, a national media campaign began in January 2020.

Does overbite reduction affect smile esthetics?

OBJECTIVES: To compare the effects of two common methods of overbite reduction on smile esthetics. MATERIALS AND METHODS: A prospective clinical trial was conducted with 32 patients in whom overbite reduction was achieved using a maxillary incisor intrusion arch (18 patients) or flat anterior bite plate (14 patients). Clinical and cephalometric records were compared pretreatment (T1), after overbite reduction (T2), and posttreatment (T3). RESULTS: Both treatment groups experienced a reduction in overbite and maxillary and mandibular incisor proclination during treatment (T1-T3). The center of resistance of the maxillary incisor and the incisal edge was significantly intruded in the intrusion arch group during overbite reduction (T1-T2). However, most of the intrusion of the center of resistance was lost by the end of treatment (T2-T3). Both treatment groups experienced a reduction in maxillary incisor display and flattening of the smile arc during overbite reduction. CONCLUSIONS: Both overbite reduction methods caused a decrease in incisor display and flattening of the smile arc. Smiles were improved in some patients by the end of treatment. However, reduction in incisor display persisted. Clinicians should take precautions to prevent negative effects of overbite reduction.

A Single-arm, Practical Application Assessment of User Experience and Peristomal Skin Condition Among Persons With an Ileostomy Using a New Barrier Seal With Assisted Flow.

Peristomal skin complications are a common problem for persons with an ileostomy. PURPOSE: The purpose of this pilot study was to solicit user feedback and perform an initial assessment of the performance of a new barrier seal designed to decrease the risk of chemical-induced dermatitis. METHODS: Seven (7) potential participants who were at least 18 years of age, >6 months post surgery, with an end or loop ileostomy and unbroken peristomal skin, and who were capable of changing their appliance themselves or had the availability of care assistance were identified and recruited by the stoma care nurse at the University Hospital, Limerick, Ireland. At the initial visit and after 1 and 2 weeks, participants were asked to rate device comfort, security, and handling; skin condition was assessed by the research nurse using the Ostomy Skin Tool. Descriptive statistics were used to tabulate the results. RESULTS: Five (5) participants completed the study. Discoloration, erosion, and tissue overgrowth scores improved in 3 of 5 patients, and the mean Ostomy Skin Tool score decreased from 5.4 ± 2.19 at the initial assessment to 4 ± 1.87 at the week 2 visit. Comfort, handling, and security ratings increased from a median of 8 at the beginning of the study to 10 at week 2. CONCLUSION: Initial patient feedback regarding the new product was positive, and skin assessment results suggest the new seal may help improve peristomal skin condition. Larger studies with longer patient follow-up are needed to confirm the results of this pilot evaluation.

Changes in Peristomal Skin Condition and User Experience of a Novel Ostomy Barrier Ring With Assisted Flow: A 6-Week Feasibility Study.

PURPOSE: This purpose of this study was to evaluate a novel barrier ring with an assisted flow mechanism by assessing changes in peristomal moisture-associated skin damage (MASD) and perceptions of comfort, security, handling, and discretion in persons with an ileostomy for 6 months or longer. DESIGN: Single-arm, open-labeled feasibility study. SUBJECTS AND SETTINGS: Twenty participants (aged ≥18 years) with an ileostomy for 6 months or more participated in the study and 12 completed data collection. The primary reason for dropouts concerned compatibility issues with the barrier ring when used with certain convex pouching systems. METHODS: Participants used the barrier ring along with their normal ostomy pouching system for a period of 6 weeks. Changes in skin condition were assessed using the Ostomy Skin Tool (OST). Participants' perception of the barrier rings' comfort, security, handling, and discretion were also recorded on a 10-point scale, where participants would offer a low score if their experience was negative and a higher score if their experience was positive. Participants changed pouches and barrier rings at their own discretion. For participants who completed the study, the average skin condition and median ratings of comfort, security, handling, and discretion at 6 weeks were compared to baseline values. RESULTS: Twelve of the 20 participants (60%) completed the study. For those who completed, the mean score on the OST decreased from 6.2 ± 1.90 (mean ± SD) at baseline to 3.4 ±1.73 at 6 weeks, indicating a mean reduction of 2.8 (95% CI, -1.6 to -3.9; P < .001). The peristomal skin condition of 9 participants improved, whereas 3 experienced no change. All participants who completed the study rated comfort, handling, security, and discretion highly (median score 10 at baseline and at 6 weeks). CONCLUSIONS: Study findings indicate the novel ostomy barrier ring may reduce levels of peristomal MASD in persons living with an ileostomy, though a more extensive trial with a control group is recommended.

International Rn-222 in drinking water interlaboratory comparison.

A radon in drinking water interlaboratory comparison (ILC) was conducted between eight laboratories in Europe. The majority of the measurement results submitted were in agreement with the assigned value, with a single result deemed questionable. The questionable result does not deviate significantly from the assigned value but the measurement uncertainties associated with this result could be too small. The results from this ILC indicate that there is good agreement between participating laboratories for radon in water measurements.

The trainee in difficulty: a supportive structured approach.

Trainees in difficulty provide a significant management challenge. This article describes the processes and outcomes of 4 years experience of a deanery-wide supportive structured approach based on the concept of trust and specialty-based local faculty groups.

Effects of complex hydrodynamic processes on the horizontal and vertical distribution of Tc-99 in the Irish Sea.

The increased discharge of Tc-99 from the Sellafield plant following the commissioning of the Enhance Actinide Removal Plant in 1994 was reflected in higher Tc-99 activity concentrations over much of the Irish Sea. The presence of this radionuclide in the marine environment is of concern not only because of its long half life but also high bio-concentration factor in commercially valuable species, such Norway lobster (Nephrops norvegicus) and common lobster (Homarus gammarus). Accurate predictions of the transport, and spatial and temporal distributions of Tc-99 in the Irish Sea have important environmental and commercial implications. In this study, transport of the Tc-99 material was simulated in order to develop an increased understanding of long-term horizontal and vertical distributions. In particular, impact of seasonal hydrodynamic features such as the summer stratification on the surface-to-bottom Tc-99 ratio was of interest. Also, material retention mechanisms within the western Irish Sea were explored and flushing rates under various release conditions and meteorological forcing were estimated. The results show that highest vertical gradients are observed between June and July in the deepest regions of the North Channel and the western Irish Sea where radionuclide-rich saline-poor water overlays radionuclide-poor saline-rich Atlantic water masses. Strong correlation between top-to-bottom ratio of Tc-99 and strength of stratification was found. Flushing studies demonstrate that as the stratification intensifies, residence times within the western Irish Sea increase. In stratified waters of the gyre Tc-99 material is flushed out from the upper layer much quicker than from the bottom zone. The research also shows that in the gyre the biologically active upper layers above the thermocline are likely to contain higher concentrations than the near-bed region. Long-term horizontal and vertical distributions as determined in this study provide a basis for assessment of a potential biota exposure to Tc-99.

The characterisation of gait patterns of people with multiple sclerosis.

BACKGROUND: There are relatively few reports describing gait patterns in multiple sclerosis (MS) and most are confined to the analysis of temporal distance parameters with some assessment of joint range of motion. The aim of this study was to perform a biomechanical characterisation of gait patterns among people with MS across a wide range of severity of ambulatory impairment. METHODS: Sixteen patients with MS were recruited for this study. Initially, the spasticity of lower limb muscle groups was measured and ambulatory ability was graded. Patients were then placed in two groups based on the level of severity of ambulatory ability. Kinematic, kinetic and EMG gait data from both MS groups were then compared to a control group of 10 healthy subjects. RESULTS: Patients with MS in both groups were found to walk with reduced gait speed, reduced maximum hip and knee extension, ankle plantarflexion angle and propulsive force compared to the control group. In general, the same gait impairments were found in both MS groups compared to the control group, and were greater for the more severely affected MS patient group. INTERPRETATION: This study highlights typical gait patterns of people with MS and provides an indication of common pathways in the degeneration of ambulatory ability as a consequence of disease progression. This information should enable improved clinical treatment of ambulation, as well as the prescription, or even design, of appropriate assistive devices.

Ambulatory rehabilitation in multiple sclerosis.

Multiple sclerosis (MS) is an autoimmunogenic disease involving demyelination within the central nervous system. Many of the typical impairments associated with MS can affect gait patterns. With walking ability being one of the most decisive factors when assessing quality of life and independent living, this review focuses on matters, which are considered of significance for maintaining and supporting ambulation. This article is an attempt to describe current research and available interventions that the caring healthcare professional can avail of and to review the present trends in research to further these available options. Evidence-based rehabilitation techniques are of interest in the care of patients with MS, given the various existing modalities of treatment. In this review, we summarise the primary factors affecting ambulation and highlight available treatment methods. We review studies that have attempted to characterise gait deficits within this patient population. Finally, as ambulatory rehabilitation requires multidisciplinary interventions, we examine approaches, which may serve to support and maintain ambulation within this patient group for as long as possible.

Children's depression, gender and age norms for an Irish national (primary) school population.

OBJECTIVES: To provide normative data for older national (primary) school children, broken down by age and gender, for the Children's Depression Inventory-Short version (CDI-S) and revised norms for the Children's Depression Inventory-Parent version (CDI-P) and its subscales. METHOD: Forty-three randomly selected national schools took part in this study. Participants were 1,255, fifth and sixth class, Irish national school children who completed the Children's Depression Inventory Short Form (CDI-S). In total 1,018 parents completed the corresponding parent form, the Children's Depression Inventory-Parent version (CDI-P). RESULTS: Norms for the CDI-S and the CDI-P subscales were produced. Revised norms for the CDI-P are proposed. Results revealed no significant age or gender difference in depressive symptomatology as measured by respondent's CDI-S and total CDI-P scores. Parent's ratings of their children's depression levels (CDI-P) and children's self-reported depression levels (CDI-S) were significantly correlated. The CDI-S and CDI-P displayed good internal reliability. CONCLUSION: Results indicate the utility of both the CDI-S and the CDI-P for assessing depressive symptoms in national school children in Ireland. This study confirms that national school children do display symptoms of depression. School based policies, materials and services supporting and promoting positive mental health should be developed, implemented and resourced.