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2.
Health Educ Res ; 38(2): 139-149, 2023 03 23.
Article in English | MEDLINE | ID: mdl-36539329

ABSTRACT

This study examined whether knowledge of sexual consent buffers the relationship between risk factors for sexual violence (SV) and SV perpetration among first-year college men. The study data were drawn from a longitudinal study with 1144 first-year college men. A series of generalized linear models were conducted to examine whether knowledge of sexual consent moderated the relationship between SV risk factors and SV perpetration. Knowledge of sexual consent moderated the effect of hypermasculinity (P < 0.001), binge drinking (P < 0.001), rape-supportive social norms (P = 0.007) and peer support for SV (P < 0.001) such that there was a positive association between risk factors and SV perpetration among those with lower, but not higher, knowledge of sexual consent. Knowledge of sexual consent did not significantly moderate the relationship between SV perpetration and outcome expectancies for non-consensual sex (P = 0.387) and pornography use (P = 0.494). Knowledge of sexual consent may counteract risk factors for SV perpetration among young college men. The findings highlight the need for consent education to be incorporated in youth comprehensive sexual education to increase knowledge of sexual consent prior to college and campus-based SV prevention programming delivered to college students.


Subject(s)
Sex Offenses , Male , Adolescent , Humans , Protective Factors , Longitudinal Studies , Sex Offenses/prevention & control , Sexual Behavior , Universities
4.
Int J Tuberc Lung Dis ; 25(6): 491-497, 2021 06 01.
Article in English | MEDLINE | ID: mdl-34049612

ABSTRACT

BACKGROUND: In March 2011, the Department of Public Health East in Ireland were notified of two cases of TB in two prisoners sharing a cell. We define the resulting outbreak and highlight the role of public health and laboratory-based molecular epidemiology in mapping and control of a prison outbreak.METHODS: Cases were identified through clinical presentation, contact tracing, case-finding exercise or enhanced laboratory surveillance. Mycobacterium tuberculosis isolates were genotyped and underwent whole-genome sequencing (WGS).RESULTS: Of the 34 cases of TB linked to the outbreak, 27 were prisoners (79%), 4 prison officers (12%) and 3 community cases (9%). M. tuberculosis was isolated from 31 cases (culture positivity: 91%). A maximum of six single-nucleotide polymorphisms separated the isolates, with 22 being identical, suggestive of a highly infectious 'super-spreader´ within the prison. Isolates belonged to the Beijing sub-lineage, and were susceptible to first-line anti-TB agents. A case-finding exercise incidentally detected a prisoner with multidrug-resistant TB. Of the 143 prison officers screened, 52% had latent TB infection. Litigation costs exceeded five million euros.CONCLUSION: This constitutes the largest prison outbreak of TB in Western Europe investigated using WGS. A robust prison entry TB screening and education programme is required to effect better TB control, and prevent future outbreaks and attendant litigation.


Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Multidrug-Resistant , Disease Outbreaks , Europe , Humans , Mycobacterium tuberculosis/genetics , Prisons , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiology
6.
J Infect ; 76(1): 55-67, 2018 01.
Article in English | MEDLINE | ID: mdl-29031637

ABSTRACT

OBJECTIVES: The primary objective of this work was to examine the acquisition and spread of multi-drug resistant (MDR) tuberculosis (TB) in Ireland. METHODS: All available Mycobacterium tuberculosis complex (MTBC) isolates (n = 42), from MDR-TB cases diagnosed in Ireland between 2001 and 2014, were analysed using phenotypic drug-susceptibility testing, Mycobacterial-Interspersed-Repetitive-Units Variable-Number Tandem-Repeat (MIRU-VNTR) genotyping, and whole-genome sequencing (WGS). RESULTS: The lineage distribution of the MDR-TB isolates comprised 54.7% Euro-American, 33.3% East Asian, 7.2% East African Indian, and 4.8% Indo-Oceanic. A significant association was identified between the East Asian Beijing sub-lineage and the relative risk of an isolate being MDR. Over 75% of MDR-TB cases were confirmed in non-Irish born individuals and 7 MIRU-VNTR genotypes were identical to clusters in other European countries indicating cross-border spread of MDR-TB to Ireland. WGS data provided the first evidence in Ireland of in vivo microevolution of MTBC isolates from drug-susceptible to MDR, and from MDR to extensively-drug resistant (XDR). In addition, they found that the katG S315T isoniazid and rpoB S450L rifampicin resistance mutations were dominant across the different MTBC lineages. CONCLUSIONS: Our molecular epidemiological analyses identified the spread of MDR-TB to Ireland from other jurisdictions and its potential to evolve to XDR-TB.


Subject(s)
Extensively Drug-Resistant Tuberculosis/epidemiology , Extensively Drug-Resistant Tuberculosis/microbiology , Mycobacterium tuberculosis/genetics , Adult , Extensively Drug-Resistant Tuberculosis/transmission , Female , Genome, Bacterial , Genotype , Humans , Ireland/epidemiology , Male , Molecular Epidemiology , Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/isolation & purification , Phylogeny , Whole Genome Sequencing
7.
QJM ; 110(5): 333, 2017 05 01.
Article in English | MEDLINE | ID: mdl-28339640
9.
Ir Med J ; 109(4): 396, 2016 Apr 11.
Article in English | MEDLINE | ID: mdl-27685490

ABSTRACT

The prevalence of Mycobacterium avium complex (MAC) pulmonary disease is increasing globally. However, reliable national and international data relating to its epidemiology and management is lacking. During the period 2003-2014, MAC was isolated from the pulmonary samples of 75 patients at the Irish Mycobacteria Reference Laboratory (IMRL). Most patients (42, 56%) had underlying pulmonary disease, and 37 (49%) had clinical/radiographic characteristics consistent with MAC pulmonary disease. However, only 18 patients (24%) fulfilled internationally accepted criteria for diagnosis/treatment of this disease. Treatment was started in 13 (72%) of these cases, which is similar to internationally published treatment rates. The diagnosis of significant MAC pulmonary disease can be difficult, and treatment is not always warranted even when diagnostic criteria are met.

12.
Transpl Infect Dis ; 16(4): 672-5, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24995624

ABSTRACT

We report a case of Mycobacterium kansasii presenting as an obstructing endobronchial mass in a patient post stem cell transplant. The patient had a complete clinical, microbiological, and radiological response to anti-tuberculous treatment. To our knowledge, this is the first case of M. kansasii presenting post transplant with an obstructing lung mass simulating relapse or post-transplant lymphoma.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium kansasii/isolation & purification , Stem Cell Transplantation/adverse effects , Adult , Clarithromycin/administration & dosage , Clarithromycin/therapeutic use , Drug Resistance, Bacterial , Ethambutol/administration & dosage , Ethambutol/therapeutic use , Female , Humans , Isoniazid/administration & dosage , Isoniazid/therapeutic use , Mycobacterium kansasii/drug effects , Rifampin/administration & dosage , Rifampin/therapeutic use
13.
Ir Med J ; 106(7): 200-4, 2013.
Article in English | MEDLINE | ID: mdl-24218745

ABSTRACT

Treatment of Latent Tuberculosis Infection (LTBI) is an important component of any TB control strategy. Acceptance and completion of treatment is poor. We undertook this study to identify barriers to acceptance & completion of treatment. Patients attending TB clinics completed a self-administered survey. Medical notes and electronic pharmacy records were reviewed. 143 surveys were completed. 70 (49%) completed treatment. Patients were less likely to accept treatment (p = 0.01, RR 0.781, CI 0.643-0.950) and less likely to complete treatment (p = 0.01, RR 0.640, CI 0.462-0.885) when concerned about the side effects of LTBI medication. Completion of LTBI treatment is sub-optimal. The major barrier identified was fear about side effects caused by LTBI medications.


Subject(s)
Antitubercular Agents/adverse effects , Latent Tuberculosis/drug therapy , Medication Adherence , Adult , Aged , Aged, 80 and over , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Young Adult
14.
Ir J Med Sci ; 178(2): 161-6, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19129978

ABSTRACT

OBJECTIVES: To investigate the prevalence of ATPIII- and IDF-defined metabolic syndrome (MetS) in an Irish screening population and to determine the calculated cardiovascular risk for each group. DESIGN: A total of 1,716 subjects were enrolled over a 12-month period. MAIN OUTCOMES: The ATPIII-defined prevalence of MetS in this population was 13.2%. Using IDF criteria, 21.4% of subjects were identified as having the MetS. Correlation between the two definitions was high; however, IDF criteria identified an additional 9.5% (n = 164) of the population as having MetS, which ATPIII criteria failed to recognise. CONCLUSION: We noted a higher prevalence of MetS in the studied population when defined by IDF criteria. However, those identified by IDF and not by ATPIII definition did not have a higher cardiovascular risk score by either Framingham or European Score than those without MetS. Thus, application of the ATPIII definition of MetS, may be the more practical.


Subject(s)
Cardiovascular Diseases/epidemiology , Mass Screening , Metabolic Syndrome/epidemiology , Adult , Aged , Cohort Studies , Cross-Sectional Studies , Female , Health Status Indicators , Humans , Ireland/epidemiology , Male , Metabolic Syndrome/chemically induced , Middle Aged , Prevalence , Risk Assessment , Risk Factors , Statistics as Topic , Surveys and Questionnaires
15.
Ir J Med Sci ; 178(1): 29-33, 2009 Mar.
Article in English | MEDLINE | ID: mdl-18953626

ABSTRACT

AIM: To assess the contribution of alcohol, drug abuse and suicide attempts to out of hospital cardiac arrests (OHCA) who are admitted to our intensive care unit (ICU). METHODS: Retrospective review of all OHCA admitted to the ICU over a 2-year period. RESULTS: There were 26 OHCA. Six patients survived, all of whom had a cardiac aetiology for their arrest. Ten patients arrested due to external factors (drug misuse n = 4, alcohol excess n = 1, suicide attempts n = 4 and accidental choking n = 1). All of the patients who arrested secondary to external factors were young (37.2 +/- 13.58 years), 90% were male and all died in hospital. All of the cases of drug misuse involved cocaine. CONCLUSION: Alcohol, drug misuse and suicide attempts contribute significantly to the number of OHCA which are admitted to ICU. Moreover, cocaine usage has contributed to a number of OHCA in our study.


Subject(s)
Emergency Medical Services/statistics & numerical data , Heart Arrest/epidemiology , Intensive Care Units/statistics & numerical data , Substance-Related Disorders/epidemiology , Suicide, Attempted/statistics & numerical data , APACHE , Adult , Aged , Alcoholism/epidemiology , Female , Humans , Ireland/epidemiology , Male , Middle Aged , Retrospective Studies
16.
J Cyst Fibros ; 8(1): 9-13, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18718821

ABSTRACT

INTRODUCTION: Hypoxia and hypercapnia are closely linked to morbidity and mortality in patients with Cystic Fibrosis (CF). The aims of this study were to describe the changes in blood gases during and following an acute pulmonary exacerbation in adults with CF. METHODS: We performed a prospective observational study of patients with CF admitted for management of an acute exacerbation. Blood gas and spirometric analysis was performed on admission, throughout the treatment period, and 31 days after discharge (day 45). RESULTS: At presentation, eight of nineteen patients had evidence of either hypoxia (PaO(2)<8 kPa) and/or hypercapnia (PaCO(2)>6.6 kPa). Blood gas parameters stabilized following two weeks of intravenous antibiotic therapy, with little difference evident in between treatment completion and subsequent review following discharge. Hypercapnia reversed in three patients, with persistent hypercapnia evident in two patients. CONCLUSION: In our study group, hypoxemia and hypercapnia were frequently observed at presentation of the acute exacerbation. Blood gases stabilized following two weeks of intravenous antibiotic therapy, with arterial PCO(2) one month following hospital discharge generally similar to that at time of discharge.


Subject(s)
Blood Gas Analysis , Cystic Fibrosis/blood , Cystic Fibrosis/complications , Hypercapnia/etiology , Hypoxia/etiology , Adult , Anti-Bacterial Agents/therapeutic use , Bronchodilator Agents/therapeutic use , Cystic Fibrosis/drug therapy , Disease Progression , Drug Therapy, Combination , Female , Humans , Hypercapnia/blood , Hypoxia/blood , Male , Middle Aged , Prospective Studies , Recovery of Function , Spirometry , Young Adult
19.
J Dairy Sci ; 87(6): 1739-46, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15453487

ABSTRACT

Forty-eight Holstein bull calves were assigned to a 2 x 2 x 2 factorial arrangement in a completely randomized block design. Main effects were colostrum versus a serum-derived colostrum supplement, 0 versus 1 g of trypsin inhibitor added at the initial 2 feedings, and milk replacer containing 0 or 50% CP from whole egg. Calves were bled at 0, 6, 12, 18, and 24 h after birth for determination of serum immunoglobulin (Ig). G. Serum IgG concentrations were lower in calves consuming the colostrum supplement compared with calves consuming colostrum. Apparent efficiency of absorption of IgG was similar. Trypsin inhibitor did not affect IgG concentrations or absorption of IgG. Calves were fed either milk replacer for 28 to 35 d (preweaning phase) and weaned when they consumed 0.7 kg of starter grain for 2 consecutive days. The postweaning phase was from weaning to d 56. Feeding colostrum supplement resulted in higher fecal scores postweaning (1.90 vs. 1.58) and overall (1.85 vs. 1.65) and fewer days medicated preweaning (5.1 vs. 2.2 d) and postweaning (3.9 vs. 1.9 d) and overall (9.0 vs. 4.2 d). Calves were treated for upper respiratory tract infections and diarrhea. Dry matter intake and weaning age were not affected by treatment. Postweaning (1.69 vs. 1.2 kg) and overall (1.22 vs. 1.0 kg), calves that received colostrum and egg milk replacer consumed more dry matter and starter. Postweaning, calves fed colostrum and egg milk replacer had similar or greater body weight and gains compared with calves fed colostrum and milk protein milk replacer. Preweaning, feed efficiency was greater for calves fed colostrum (0.44 vs. 0.34), trypsin inhibitor (0.42 vs. 0.36), and milk protein milk replacer (0.48 vs. 0.30) compared with calves fed colostrum supplement, no trypsin inhibitor, and egg milk replacer, respectively. Trypsin inhibitor increased feed efficiency postweaning. Calves fed trypsin inhibitor and milk protein milk replacer were more efficient preweaning and overall than calves fed trypsin inhibitor and egg milk replacer. Results indicate that the blood derived colostrum supplement did not provide as much IgG as colostrum (4.55 g/L vs. 14.6 g/L, respectively), that feeding 1.0 g of trypsin inhibitor did not enhance serum IgG concentrations, and that the egg milk replacer-fed calves fed colostrum performed nearly as well as calves fed colostrum and the milk protein milk replacer.


Subject(s)
Animal Feed , Animal Nutritional Physiological Phenomena , Cattle/growth & development , Cattle/immunology , Colostrum/immunology , Trypsin Inhibitors/administration & dosage , Absorption , Animals , Animals, Newborn/growth & development , Animals, Newborn/immunology , Animals, Newborn/metabolism , Cattle/metabolism , Dietary Proteins/administration & dosage , Dietary Supplements , Egg Proteins, Dietary/administration & dosage , Food, Formulated , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Random Allocation , Weaning
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