S. Allwright - Academia.edu (original) (raw)

Papers by S. Allwright

Hospital admission for acute pancreatitis in the Irish population, 1997–2004: could the increase ... more Hospital admission for acute pancreatitis in the Irish population, 1997–2004: could the increase be due

BMC Public Health, 2007

Background: Objectives: To compare support for, and perceptions of, the impacts of smoke-free wor... more Background: Objectives: To compare support for, and perceptions of, the impacts of smoke-free workplace legislation among bar workers in the Republic of Ireland (ROI) pre-and post-implementation, and to identify predictors of support for the legislation. Methods: Setting: Public houses (pubs) in three areas of the ROI. Design: Comparisons pre-and post-implementation of smoke-free workplace legislation. Participants: From a largely non-random selection, 288 bar workers volunteered for the baseline survey; 220 were followed up one year later (76.4%). Outcome measures: Level of support for the legislation, attitude statements concerning potential impacts of the law and modelled predictors of support for the legislation. Results: Pre-implementation 59.5% of participants supported the legislation, increasing to 76.8% postimplementation. Support increased among smokers by 27.3 percentage points from 39.4% to 66.7% (p < 0.001) and among non-smokers by 12.4% percentage points from 68.8% to 81.2% (p = 0.003). Pre-legislation three-quarters of participants agreed that the legislation would make bars more comfortable and was needed to protect workers' health. Post-legislation these proportions increased to over 90% (p < 0.001). However, negative perceptions also increased, particularly for perceptions that the legislation has a negative impact on business (from 50.9% to 62.7%, p = 0.008) and that fewer people would visit pubs (41.8% to 62.7%, p < 0.001). After adjusting for relevant covariates, including responses to the attitude statements, support for the ban increased two to threefold post-implementation. Regardless of their views on the economic impact, most participants agreed, both pre-and post-implementation, that the legislation was needed to protect bar workers' health. Conclusion: Smoke-free legislation had the support of three-quarters of a large sample of bar workers in the ROI. However, this group holds complex sets of both positive and negative perspectives on the legislation. Of particular importance is that negative economic perceptions did not diminish the widely held perception that the ban is needed to protect workers' health.

Irish medical journal, 1989

This report examines the claim that Irish mortality in the second quarter (April-June) of 1986 in... more This report examines the claim that Irish mortality in the second quarter (April-June) of 1986 increased due to the cloud of radioactive material released by the damaged reactor in Chernobyl. Over the period 1971-1987, based on date of registration, the death rates in the second quarter showed marked year to year variation often exceeding that expected on the basis of chance alone. In 1986 the percentage of annual deaths occurring between April and June, and the death rate itself, were both significantly higher than in most other years between 1981 and 1987. The 1986 figures were not however, significantly higher than those observed in years prior to 1981. Since the distribution of mortality by cause was not consistent with the hypothesis relating low level radiation to immediate mortality, and since causality cannot be inferred from a temporal association per se, the Chernobyl accident cannot be implicated in the excess mortality observed in the second quarter of 1986.

British Journal of General Practice, 1996

Several previous studies have examined the health of carers, but they have usually focused on eld... more Several previous studies have examined the health of carers, but they have usually focused on elderly subjects and have often not had representative control samples. To determine whether caring for a partner with Parkinson's disease is associated with a worsening social, psychological and physical well-being than people with partners who do not suffer with Parkinson's disease. One hundred and fifty-four carer spouses of subjects with Parkinson's disease, and 124 non-carer spouses of randomly selected population controls recruited from a national case-control study of early-onset Parkinson's disease in the Republic of Ireland, between 1992-1994, were studied. Outcome was measured along three dimensions: social functioning, assessed by the frequency of social contacts, outings and holidays; psychological well-being, measured by the General Health Questionnaire; and physical health, measured by the career's use of medical services, medications and episodes of chroni...

Journal of public …, 2007

Objective To investigate trends in the incidence of acute pancreatitis by examining emergency adm... more Objective To investigate trends in the incidence of acute pancreatitis by examining emergency admissions to acute public hospitals over an 8-year period; to compare trends for alcohol-related pancreatitis admissions with biliary tract-related admissions and to profile the patients admitted with an acute pancreatitis diagnosis. Methods All in-patient emergency admissions for which an acute pancreatitis diagnosis (ICD-9-CM Code 577.0) was recorded as principal diagnosis were identified for years 1997-2004 inclusive. Alcohol-related acute pancreatitis admissions (i.e. had alcohol misuse recorded as comorbidity) were identified using ICD-9-CM-codes 303 and 305. Biliary tract disease-related admissions (i.e. had biliary tract disease recorded as comorbidity) were identified using ICD-9-CM codes 574.0-576.0 inclusive. Pearson's x 2-test was used to compare proportions in groups of categorical data and x 2-tests for trend were used to identify linear trends. Results There were 6291 emergency admissions with a principal diagnosis of acute pancreatitis during the 8 year study period, with 622 admissions in 1997 compared to 959 admissions in 2004, an increase of 54.1%. Age standardized rates rose significantly from 17.5 per 100 000 population in 1997 to 23.6 per 100 000 in 2004, (P , 0.01 for linear trend). There were 1205 admissions with alcohol misuse recorded as a co-morbidity increasing from 13.9% (87/622) of acute pancreatitis admissions in 1997 to 23.2% (223/959) in 2004. This increase was significantly greater than the increase observed for biliary tract disease-related admissions, 19.6% (122/622) in 1997 to 23.5% (225/959) in 2004. Rates for total acute pancreatitis admissions were highest in those aged 70 years and over; the majority (3563, 56.6%) of the admissions were male with a mean age of 51.1 years (SD 19.9); the mean age for male admissions was significantly younger than for female admissions (49.1 versus 53.6 years, P , 0.001). However, for alcohol-related admissions, rates were highest in those aged 30-49 years and patients admitted with alcohol misuse recorded were significantly younger than those who did not have alcohol misuse recorded (42.0 versus 53.2 years, P , 0.001). Median length of stay was 7 days. Conclusions Hospital admissions for acute pancreatitis rose from 17.5 per 100 000 population in 1997 to 23.6 per 100 000 in 2004. The proportion of admissions that had alcohol misuse recorded as a co-morbidity rose more markedly than those with biliary tract disease and the rise was more pronounced in younger age groups. The increasing trend in alcohol-related acute pancreatitis parallels the rise in per capita alcohol consumption. Given the continuing rise in binge drinking, particularly among young people, this is a cause for concern.

The Cochrane Database of Systematic Reviews

Health education research, 2015

This study examined educational differences in associations of noticing anti-tobacco information ... more This study examined educational differences in associations of noticing anti-tobacco information with smoking-related attitudes and quit intentions among adult smokers. Longitudinal data (N = 7571) from two waves of six countries of the International Tobacco Control (ITC) Europe Surveys were included. Generalized estimating equation analyses and multiple linear and logistic regression analyses were conducted. Higher educated smokers noticed anti-tobacco information slightly more often than lower educated smokers (F(2) = 25.78, P < 0.001). Noticing anti-tobacco information was associated with more negative smoking-related attitudes (β = 0.05, P < 0.001) and more quit intentions (OR = 1.08, P < 0.001). Among smokers without a quit intention at baseline, a positive association was found for noticing anti-tobacco information at baseline with follow-up quit intention (OR = 1.14, P = 0.003). No other longitudinal associations were found. No educational differences were found in t...

Tobacco control, 2014

Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate th... more Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Net...

Communicable disease and public health / PHLS, 2000

Self-reported hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection status was comp... more Self-reported hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection status was compared with the results of oral fluid assays of antibodies to these viruses in prisoners from nine of the 15 prisons in the Republic of Ireland. A total of 1205 out of 1366 prisoners completed a confidential questionnaire and 1193 provided analysable oral fluid specimens for testing for antibodies to HBV core antigen (anti-HBc), HCV (anti-HCV), and HIV (anti-HIV). The self-reported prevalence of hepatitis infection (hepatitis B: 5%; hepatitis C: 19%) was lower than that derived from oral fluid assays (anti-HBc: 9%; anti-HCV: 37%). The self-reported prevalence of HIV infection was similar to that found by oral fluid assay (2%). Many discrepancies were found between self-reported results and the results of oral fluid assays. Of those who reported being positive for HBV, HCV, or HIV, 48%, 5%, and 58%, respectively, tested negative on the oral fluid assay. Of those who reported a previous nega...

The British journal of general practice : the journal of the Royal College of General Practitioners, 1996

Irish medical journal

Routine data sources can provide clues to the temporal and geographical patterns of Parkinson&#39... more Routine data sources can provide clues to the temporal and geographical patterns of Parkinson's disease. Mortality trends show divergent age specific rates, with decreasing mortality for younger age-groups and increasing mortality for older age-groups. Cohort analysis showed a pattern consistent with the hypothesis that Parkinson's disease may have increased after the encephalitis lethargica pandemic. Hospital admission data suggest a rural excess of cases. The interpretation of this finding is complicated by the role of a variety of potential biases. Research is needed to examine urban-rural differences and environmental risk factors.

Reviews, 1996

Background Shared care has been used in the management of many chronic conditions with the assump... more Background Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than either primary or specialty care alone. It has been defined as the joint participation of primary care physicians and specialty care physicians in the planned delivery of care, informed by an enhanced information exchange over and above routine discharge and referral notices. It has the potential to offer improved quality and coordination of care delivery across the primary-specialty care interface and to improve outcomes for patients. Objectives To determine the effectiveness of shared-care health service interventions designed to improve the management of chronic disease across the primary-specialty care interface. Search strategy We searched the Cochrane Effective Practice and Organisation of Care Group (EPOC) Specialised Register (and the database of studies awaiting assessment); Cochrane Central Register of Controlled Trials (CENTRAL); Database of Abstracts of Reviews of Effects (DARE); MEDLINE (from 1966); EMBASE (from 1980) and CINAHL (from 1982). We also searched the reference lists of included studies. Selection criteria Randomised controlled trials, controlled before and after studies and interrupted time series analyses of shared-care interventions for chronic disease management. The participants were primary care providers, specialty care providers and patients. The outcomes included physical health outcomes, mental health outcomes, and psychosocial health outcomes, treatment satisfaction, measures of care delivery including participation in services, delivery of care and prescribing of appropriate medications, and costs of shared care. Data collection and analysis Three review authors independently assessed studies for eligibility, extracted data and assessed study quality. Main results Twenty studies of shared care interventions for chronic disease management were identified, 19 of which were randomised controlled trials. The majority of studies examined complex multifaceted interventions and were of relatively short duration. The results were mixed. Overall there were no consistent improvements in physical or mental health outcomes, psychosocial outcomes, psychosocial measures including measures of disability and functioning, hospital admissions, default or participation rates, recording of risk factors and satisfaction with treatment. However, there were clear improvements in prescribing in the studies that considered this outcome. The methodological quality of studies varied considerably with only a minority of studies of high-quality design. Cost data were limited and difficult to interpret across studies.

Tobacco Control, 2006

To evaluate the psychosocial and behavioural impact of the first ever national level comprehensiv... more To evaluate the psychosocial and behavioural impact of the first ever national level comprehensive workplace smoke-free law, implemented in Ireland in March 2004. Design: Quasi-experimental prospective cohort survey: parallel cohort telephone surveys of national representative samples of adult smokers in Ireland (n = 769) and the UK (n = 416), surveyed before the law (December 2003 to January 2004) and 8-9 months after the law (December 2004 to January 2005). Main outcome measures: Respondents' reports of smoking in key public venues, support for total bans in those key venues, and behavioural changes due to the law. Results: The Irish law led to dramatic declines in reported smoking in all venues, including workplaces (62% to 14%), restaurants (85% to 3%), and bars/pubs (98% to 5%). Support for total bans among Irish smokers increased in all venues, including workplaces (43% to 67%), restaurants (45% to 77%), and bars/ pubs (13% to 46%). Overall, 83% of Irish smokers reported that the smoke-free law was a ''good'' or ''very good'' thing. The proportion of Irish homes with smoking bans also increased. Approximately 46% of Irish smokers reported that the law had made them more likely to quit. Among Irish smokers who had quit at post-legislation, 80% reported that the law had helped them quit and 88% reported that the law helped them stay quit. Conclusion: The Ireland smoke-free law stands as a positive example of how a population-level policy intervention can achieve its public health goals while achieving a high level of acceptance among smokers. These findings support initiatives in many countries toward implementing smoke-free legislation, particularly those who have ratified the Framework Convention on Tobacco Control, which calls for legislation to reduce tobacco smoke pollution. * We use the term ''tobacco smoke pollution'' although other terms, such as ''environmental tobacco smoke'', ''secondhand smoke'', and ''passive smoke'' have been used.

Scandinavian Journal of Public Health, 2013

Tobacco-related cancers and, in particular, lung cancer still represents a substantial public hea... more Tobacco-related cancers and, in particular, lung cancer still represents a substantial public health epidemic across Europe as a result of high rates of smoking prevalence. Countries in Europe have proposed and implemented tobacco control policies to reduce smoking prevalence, with some countries being more progressive than others. The aim of this study was to examine factors that influenced women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s attitudes across five European countries relative to comprehensive smokefree laws in their countries. A cross-sectional landline telephone survey on attitudes towards tobacco control laws was conducted in five European countries: France, Ireland, Italy, the Czech Republic, and Sweden. Attitudinal scores were determined for each respondent relative to questions about smokefree laws. Logistic regression models were used to obtain odds ratios with 95% confidence intervals. A total of 5000 women were interviewed (1000 women from each country). The majority of women, regardless of smoking history, objected to smoking in public buses, enclosed shopping centers, hospitals, and other indoor work places. More women who had quit smoking believed that new tobacco control laws would prompt cessation - as compared with women who still smoked. In general, there is very high support for national smokefree laws that cover bars, restaurants, and public transport systems. As such laws are implemented, attitudes do change, as demonstrated by the differences between countries such as Ireland and the Czech Republic. Implementing comprehensive smokefree laws will gain high approval and will be associated with prompting people to quit.

Respiratory Medicine, 2004

We aim to assess whether respiratory symptoms are associated with lung function in young adults, ... more We aim to assess whether respiratory symptoms are associated with lung function in young adults, and whether any such relation is similar in those with asthma, in men and women, and in different countries. Study participants (aged 20-44 years) were randomly selected from the general population in 35 centres in 15 countries as part of the European Community Respiratory Health Study. In all, 12,541 subjects (47%) completed a respiratory symptoms questionnaire and spirometry, metacholine challenge and immunoglobulin E tests. Indicators of diagnosed asthma showed the largest association with airways obstruction (FEV 1 Fmaximal 1-s forced expiratory volume/forced vital capacityFFVCo70%), followed by symptoms of wheezing or shortness of breath, in both genders. Among the 96% of subjects whose FEV 1 /FVC ratios were greater or equal to 70%, wheezing or shortness of breath was associated with lower FEV 1 levels (À211 ml in men and À169 ml in women (Po0:01)), independent of diagnosed asthma, smoking, atopy or bronchial responsiveness. This association was not explained by a lower FVC. Symptoms of chronic bronchial mucus hypersecretion (chronic phlegm) were unrelated to both airways obstruction and

The Lancet, 1974

I refer to your leader of Jan. 11 on oral glucose/ electrolyte therapy for acute diarrhoea. In th... more I refer to your leader of Jan. 11 on oral glucose/ electrolyte therapy for acute diarrhoea. In this country we have summer epidemics of severe diarrhoea accompanied by vomiting. I have found that dehydration can be avoided, and vomiting prevented, in many instances, by giving the patients teaspoonfuls (as you advise) of iced water, with the ice cubes still in the glass. Where even this is not tolerated, one tablespoonful of brandy or whisky to a glass (200-300) of iced water has prevented vomiting in all cases I have seen so far. I shall in future add the electrolytes and glucose you recommend.

Journal of Allergy and Clinical Immunology, 2002

Background: The effects of home dampness and mold exposure on adult asthma are not clear. Objecti... more Background: The effects of home dampness and mold exposure on adult asthma are not clear. Objective: We aimed to investigate the associations between housing characteristics related to dampness, mold exposure, and house dust mite levels and adult asthma in 38 study centers from the European Community Respiratory Health Survey. Methods: Data about the present home, heating and ventilation systems, double glazing, floor covers, recent water damage, and mold exposure were obtained by means of an interviewer-led questionnaire. The associations between these factors and asthma, as defined on the basis of symptoms in the last year, and of bronchial responsiveness, as determined with methacholine challenge, were evaluated. Odds ratios (ORs) were obtained by using random-effects meta-analyses adjusted within study centers for sex, age group, and smoking status. Results: Fitted carpets and rugs in the bedroom were related to fewer asthma symptoms and bronchial responsiveness (OR range, 0.69-0.91). This effect was consistent across centers and more pronounced among house dust mite-sensitized individuals. Reported mold exposure in the last year was associated with asthma symptoms and bronchial responsiveness (OR range, 1.14-1.44). This effect was homogeneous among centers and stronger in subjects sensitized to Cladosporium species. In centers with a higher prevalence of asthma, the prevalence of reported indoor mold exposure was also high. This association was observed for reported mold exposure by asthmatic subjects (Spearman r s = 0.46), as well as reported mold exposure by nonasthmatic subjects (r s = 0.54). Reported mold exposure was highest in older houses with recent water damage. Conclusion: We conclude that indoor mold growth has an adverse effect on adult asthma. (J Allergy Clin Immunol 2002;110:285-92.)

Irish Journal of Medical Science, 2008

Background Few studies have examined smoking behaviour among bar workers, an occupational group t... more Background Few studies have examined smoking behaviour among bar workers, an occupational group traditionally exposed to high levels of secondhand smoke. This study set out to: (1) establish baseline prevalence of smoking and cigarette consumption among Cork bar workers prior to the introduction of the Republic of Ireland's (ROI) smokefree workplace legislation (29th March 2004); (2) compare gender-and age-specific smoking rates in Cork bar workers with the equivalent occupational classes within the general population; (3) estimate the adjusted odds of being a smoker for Cork bar workers relative to the general population. Methods A cross-sectional random sample of bar workers in Cork city and a cross-sectional random telephone survey of the general population (ROI) were conducted prior to the smokefree legislation. Results 129 bar workers were enrolled and 1240 individuals from the general population. Self reported smoking prevalence among Cork bar workers was 54% (58% using cotinine-validated measures), with particularly high rates in women (70%) and 18 to 28 year olds (72%). The overall self reported rates in the general population sub-sample were substantially lower at 28%; 28% in women and 36% among 18 to 28 year olds. Bar workers were twice as likely to be smokers as the general population sub-sample (adjusted odds ratio = 2.15, 95% CI 1.45 to 3.17). Conclusions Cork bar workers constitute an occupational group with an extremely high smoking prevalence. In addition to high secondhand smoke exposure prior to the smokefree legislation, this makes bar workers a high risk group for smoking-related illnesses.