Omalizumab Reduces Unplanned Healthcare Interactions in Irish Patients With Chronic Spontaneous Urticaria

Chronic spontaneous urticaria (CSU) is a common, debilitating skin disorder associated with impaired quality of life and psychological comorbidity. Symptoms can be difficult to control and many individuals will not respond to first line treatment. Due to the chronic and unpredictable nature of the disorder, patients frequently have repeated healthcare attendances. Despite this, little is known about healthcare resource utilization internationally. Furthermore, there is no Irish data to inform fundholding decision makers. Omalizumab is an anti IgE monoclonal antibody used in refractory urticaria. It is a comparatively high cost medicine and access to this treatment can be challenging. Recent assessments of omalizumab compared with usual care suggest that omalizumab is a cost-effective treatment for refractory urticaria. We carried out a retrospective review of 47 patients commenced on omalizumab. We evaluated unplanned primary and secondary care attendances and urticaria symptomatology before and after treatment. As expected, patients with refractory disease that were commenced on omalizumab had objective improvements in urticaria symptoms. Importantly, we show that this is reflected in a dramatic reduction in unplanned healthcare interactions at primary care and emergency departments. These data suggest that omalizumab may benefit these patients by reducing disease activity and thereby reducing the need for unplanned healthcare interactions.

The incidence of lung cancer in Northern Ireland: 1991–1992

Introduction Lung cancer is the leading cause of cancer deaths in many Western countries, but its incidence has never been studied in Northern Ireland. Aims Accordingly, the present study was mounted to determine, for the first time, the incidence of the condition in Northern Ireland and to compare the findings with other regions in the British Isles. Methods A notification study of the incidence of lung cancer (ICD 162) was conducted in Northern Ireland during 1991/1992. Notifications from 6 sources were computerised and linked. Incident cases were identified and analysed in relation to Age, Sex and Geographical region—Northern Ireland, England and Wales, Scotland and the Republic of Ireland. Results Some 900 incident cases of lung cancer were identified. The incidence rate per 100,000 population was found to be 57.04. Mortality underestimated incidence by 12.5%. ($$p<0.05$$ p < 0.05 ). The male to female incidence ratio was 2.1: 1, and this ratio was similar in other regions, except Scotland, where the ratio was 1.7:1. The null hypothesis of a common incidence distribution across regions was formally rejected. A variety of models were fitted and a model in which the log-odds on incidence was a quadratic function of age fitted most of the regional data. Conclusions Northern Ireland had the lowest incidence of lung cancer in the UK, but its overall rate was still 40% higher than that observed in the Republic of Ireland which had the lowest rate in the British Isles. Across regions, the pattern of incidence by age and sex was complicated, but a linear logistic model fitted all of the Irish data and the female data in Scotland, satisfactorily.

Examining the Prospects for Developing a National Child Maltreatment Surveillance System in Ireland

The Irish Government pledged to reducing the prevalence of child maltreatment under the WHO Regional Committee for Europe plan on reducing child maltreatment. As a first step towards a rights-based and public health approach to maltreatment prevention, the WHO plan recommends making child maltreatment more visible across the region, with better surveillance through the use of national surveys that use standardized, validated instruments. We review the policy context, present current Irish data holdings, and outline some of the complexities reported in the literature concerning various surveillance methods in the context of the proposal to establish and maintain a surveillance system for CM in Ireland. Conclusions highlight the need for Ireland to adopting an approach to surveillance as soon as it is feasible. The paper outlines how such a programme is necessary to address the current absence of evidence on which prevention policies can be developed and to compliment the current child protection system. Drawing on a review of current methods in use internationally, we outline options for an Irish child maltreatment surveillance programme.

Trade credit, trade income elasticity and the international transmission of shocks

The paper examines the impact of trade credit on cyclical fluctuations in international trade. It provides new empirical evidence based on firm-level UK and Irish data showing that exporters use trade credit more actively and intensively than non-exporters. The study introduces inter-firm lending into an open economy general equilibrium model with heterogeneous firms and endogenous entry into the exports market. It demonstrates that trade credit amplifies the impact of macroeconomic shocks on international trade both along the intensive and extensive margins and that it significantly contributes to the high trade income elasticity observed in the data.

Assessing and protecting the mental health of the nation: A methodological protocol detailing Irish data from the COVID-19 Psychological Research Consortium (C19PRC) study

Funded by the Health Research Board and the Irish Research Council, this project was launched to determine what effect the pandemic has had on the mental health of the people of Ireland during the first year of the pandemic.

Overtly Headed XPs and Irish Syntax-Prosody Mapping

Analyses of Irish phonological phrasing (Elfner 2012 et seq.) have been influential in shaping Match Theory (Selkirk 2011), an OT approach to mapping syntactic to prosodic structure. We solve two constraint ranking paradoxes concerning the relative ranking of Match and StrongStart. Irish data indicate that while XPs with silent heads can fail to map to phonological phrases in certain circumstances, overtly headed XPs cannot. They also indicate that rebracketing due to the constraint StrongStart occurs only sentence-initially, contrary to predictions. We account for these puzzles by invoking Van Handel's (2019) Match constraint which sees only XPs with overt heads, and by positing a new version of StrongStart which only applies to material at the left edge of the intonational phrase. Our analysis is developed using the Syntax-Prosody in Optimality Theory application (SPOT) and OTWorkplace.

In Data We Trust

This chapter discusses issues of data quality and veracity in open datasets, using a variety of examples from the Irish data system. These examples include the Residential Property Price Register (RPPR), the Dublin Dashboard project, the TRIPS database, and Irish crime data. There are a number of issues with Irish crime data, such as crimes being recorded in relation to the police stations that handle them, rather than the location they are committed. There are also issues in the standardization of crime categorization, with some police officers recording the same crimes in slightly different ways, and also in timeliness of recording. Moreover, there are difficulties of retrieving data from the crime management software system. In addition to errors, every dataset has issues of representativeness — that is, the extent to which the data faithfully represents that which it seeks to measure. In generating data, processes of extraction, abstraction, generalization and sampling can introduce measurement error, noise, imprecision and bias. Yet internationally, there has been much work expended on formulating data-quality guidelines and standards, trying to get those generating and sharing data to adhere to them, and promoting the importance of reporting this information to users.

Word Order Alignment in Three-Argument Constructions of Irish

This study examines the ordering of the actor (A), theme (T) and recipient (R) arguments in three-argument clauses, the prepositional ditransitive constructions of Irish. The ordering of the A, T and R arguments in three-argument clauses is an area where linguistic complexity is manifest in the Irish grammar. Across languages, the factors which influence word order adjustments, from a basic word order of A-T-R, are known to include iconicity, information structure and topicalisation, the distinction between given and new information, the effects of the various referential hierarchies, and syntactic weight. We show that some, but not all, of these apply to the Irish data. Under certain conditions, the word order of these Irish three-argument clauses changes in a different alignment. Specifically, if the T is an accusative pronoun then the word order alignment changes and consequently the T occurs after the R in clause final position, yielding an A R-T word order. We argue that post-positioning of the theme PN is due to the alignment effects that can be explained by reference to the nominal and person hierarchies, and their intersection with the principle of syntactic weight. The Irish grammar seems to be disposed to place the accusative object PN T in clause final position in word order, adding an imposed salience. We characterise the effects of the nominal and person hierarchies, and syntactic weight, on word order within these constructions. We use elements of the functional model of Role and Reference Grammar in this characterisation. These word alignment effects raise important questions of the distribution of linguistic complexity across the grammar of Irish, and the interfaces between semantics, and syntax, as well as information structure.