The Uptake of Human Papillomavirus Vaccine In Irish Schools: The Impact Of Disadvantage.

HPV vaccine Gardasil© is offered to girls in first year of secondary school in Ireland. We aimed to determine the association between HPV vaccine uptake among girls for academic year 2013/2014, by school and school characteristics: socioeconomic disadvantage and religious ethos. The National Schools Immunisation System (SIS) was searched to determine HPV vaccine uptake in schools for 2013/2014 (prior to recent anti-HPV vaccine publicity). The disadvantaged status and ethos of each school was added to the report. In total 577 schools were identified. Mean vaccine uptake was 83.7%. Disadvantaged schools had a lower mean uptake (%) than other schools (79.4% vs 85.0%, difference 5.58%, 95%CI 2.69-8.21) and were twice as likely to have an uptake of ?50% (OR 2.07, 95% CI 2.76 - 5.18). No difference was found between schools of different ethoses. HPV vaccine uptake is lower in disadvantaged Irish schools. Policies should be developed to ensure a more equitable uptake of HPV vaccine.

Patients Hospitalised with an Acute Exacerbation of COPD: Is There a Need for a Discharge Bundle of Care?

Acute Exacerbations of COPD (AECOPD) are the commonest cause of hospitalisation for patients with COPD. A number of interventions are known to improve care for such patients. Internationally and in Ireland, there is significant variation in care delivered to such patients. We reviewed admissions with AECOPD (n = 174) to an Irish teaching hospital during one year, to determine if recommended interventions had been delivered to patients prior to discharge. The most frequently delivered of such interventions were: assessment of oxygen requirements 151 (87%) and arrangements for follow-up 135 (78%). The least frequently delivered were: referral for pulmonary rehabilitation 19 (11%) and advice given regarding influenza vaccination 27 (17%). Patients who received care from a respiratory physician or respiratory clinical nurse specialist (RCNS) received more interventions than those cared for by other specialties. This study demonstrates poor compliance with internationally agreed interventions. The introduction of a discharge bundle of care for use in Irish hospitals should be considered.

A Survey of Lung Health and COPD Awareness amongst Participants at a Mobile Spirometry Clinic.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death in Ireland. It affects over 440,000 people 10%of Ireland's population), but awareness of COPD is low. COPD Support Ireland is a national charity established to advocate for and support those with COPD. For World COPD Day 2013, a mobile clinic visited 5 locations to provide information about COPD and free spirometry testing. In this study, we evaluated participants' level of knowledge about COPD and whether this was correlated with a number of variables. Participants completed a questionnaire (352). Questionnaires were analysed to ascertain this self-presenting population's characteristics. Most (247, 70.2%) were smokers/ex-smokers, yet only 168 (47.7%) knew of COPD. Almost 18% (63, 17.9%) required referral to GPs with abnormal spirometry results. Our findings suggest the need for greater COPD education and awareness to increase earlier diagnosis, reduce health care costs and improve quality of life.