6 results
Comparison of mental health presentations of 16–25-year-olds to the Emergency Department during the COVID-19 pandemic.
- C. Mohan, O. Conaty, A. Moughty, A. Doherty, E. Barrett, A. M. Clarke
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S210
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Introduction
Studies reported an initial decrease in the number of presentations and incidence of self-harm in young people during the pandemic. As the pandemic progressed young people may have experienced increased levels of distress, contributing to worsened mental health. There is a need for mental health services to evaluate the presentations of young people presenting to the Emergency Department (ED) so that services can meet the needs of young people.
ObjectivesTo examine the mental health presentations of young people (aged 16-25) to the ED and how this may have changed since the start of the pandemic.
MethodsThis study reviewed all 16–25-year-olds presenting to the Mater Misericordiae University Hospital (MMUH) who were triaged with a mental health issue in a 2 month period (September-October) over three years – 2019 (Period A), 2020 (Period B), 2021 (Period C). Approval for this service evaluation was granted by the Clinical Audit and Effectiveness Committee at the MMUH.
ResultsOf 232 presentations across all periods, there was no significant difference in the number of presentations in each study period - Period A (n=76), Period B (n=79) and Period C (n=77). In all three periods, most presentations occurred out of hours (A: 57.9% [n=44]; B: 74.7% [n=59]; C: 68.8% [n=53]) statistically significant (p=0.034) from before (A) to during the pandemic (B and C). Out of hours arrival by ambulance was most common in in Periods A and B (45.5% and 55.9%). Over all three periods discharge home was the most frequent outcome of assessment (A: 69.7% [n=53]; B: 70.9% [n=56]; C: 76.6% [n=59]). Overall, there was a decrease in self-harm presentations over the period (A: 47.4% [n=36]; B: 41.8% [n=33]; C: 40.3% [n=31]). The percentage of presentations with self-laceration increased during the pandemic (A: 33.3% [n=12]; B: 39.4% [n=13]; C: 48.4% [n=15]). There was a significant increase in attendees who were already taking psychotropic medications (p<0.001).
ConclusionsThe findings suggest that the majority of 16–25-year-olds present out of hours and do not require admission. Although the number of presentations remained similar, the increase in out of hours presentations and arrivals by ambulance in Period B may reflect increased distress in the initial stages of the pandemic, and restricted access to services. The higher rates of medication prescribing suggests that these young people are already receiving health care, but that their needs are not being fully met. Mental health services should be designed to provide access to mental health care out of hours when young people are most likely to require them.
Disclosure of InterestNone Declared
Experiences of self-harm and suicidality in a community sample of Irish Travellers
- R. Mcmanus, M. McGovern, K. Tong, J. O’ Brien, A. Doherty
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1115
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Introduction
Irish Travellers are an indigenous minority in Ireland with distinct history and culture, of which nomadism was traditionally an important feature. Travellers experience disadvantages in education, employment, housing and health. Suicide is a big problem in the Traveller community, their suicide rate is 11%: 6 to 7 times higher than the general population. 59.4% of Traveller men and 62.7% of Traveller women reported that their mental health has not been good for one or more days in the last 30. Despite the high rates of suicide, there is a paucity of clinical research into mental health of Travellers.
ObjectivesAim was to improve the scientific knowledge of the mental health of Irish Travellers by addressing the gap in the scientific literature.
The objective was to conduct a qualitative assessment of Travellers who have experienced self-harm and suicidal thoughts themselves, or who have a family member who has experienced same, by exploring their personal experience of distress, adversity and illness.
MethodsWe conducted semi-structured interviews exploring the following topics: self-harm, bereavement by suicide, experience of mental illness and of seeking treatment, stigma, discrimination and perceptions of research participation. Participants were recruited from community Traveller organisations in order to improve participation. Data were analysed using Nvivo software for thematic analysis.
ResultsOur participants aged from 22-62. 67% reported a personal history of self-harm, 83% had a psychiatric diagnosis. None were actively engaged with a Psychiatric team.
The main themes from the data were discrimination, identity issues, cultural understanding in healthcare settings, mental health and wider societal issues. Our findings showed that many Travellers who suffer from mental health problems and suicidal thoughts, find it hard to discuss problems openly within their families and communities due to stigma and shame, despite the high incidence of suicide. Many reported experiencing idenity crises, and a sense of not belonging in society, particularly since the introduction of legislation preventing them from aspects of their traditional lifestyles. Other common topics were literacy issues, womens and LGBTQplus rights.
ConclusionsTravellers are a marginalised group in our society with high rates of socioeconomic deprivation, which we know is a factor in mental illness and thoughts of self-harm or suicide. There is a need for improved education for mental healthcare workers into the culture of Travellers and for increased sensitivity and awareness of how to engage with patients with literacy issues. Stigma remains an issue within the Travelling community and more work needs to be done to improve engagement between Travellers and mental health services in order to prevent acute mental health crises and/or suicidal behaviour. Travellers remain a difficult to reach and under-researched group in our society.
Disclosure of InterestNone Declared
The Effects of 24h Water Deprivation when Associated with Some Aspects of Transportation on the Behaviour and Blood Chemistry of Sheep
- R E Jackson, M S Cockram, P J Goddard, O M Doherty, I M McGilp, N K Waran
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- Animal Welfare / Volume 8 / Issue 3 / August 1999
- Published online by Cambridge University Press:
- 11 January 2023, pp. 229-241
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When sheep are transported they are potentially exposed to a number of factors, including water and feed deprivation, low space allowance and elevated environmental temperature, that are not related to vehicle motion but could result in animal welfare problems, either on their own or in combination. In a 2x2 factorial experiment, groups of sheep (n = 6) were moved from individual pens where they had access to hay and water to environmental chambers kept at either 14°C or 21°C. Within each chamber, half the sheep had access to water but they were all kept at a space allowance of 041m2 sheep−1 without feed. After 24h they were returned to their individual pens and offered hay and water. Behaviour and a range of biochemical measurements of dehydration and feed restriction were recorded before, during and after the treatment period. During the treatment period there was no evidence of dehydration, and sheep with access to water drank less than they did before the treatment. The plasma concentration of free fatty acids increased during fasting and, post-treatment, the intake of hay was greater than before treatment. The rapid post-treatment intake of dry feed was associated with some evidence of dehydration, as indicated by increased plasma osmolality and plasma vasopressin concentration. This suggests that following provision and consumption of large quantities of feed after a period without access to feed and water during transportation, sheep must be allowed sufficient time to drink before a subsequent journey is undertaken.
Impact of dietary fatty acids on metabolic activity and host intestinal microbiota composition in C57BL/6J mice
- Elaine Patterson, Robert M. O' Doherty, Eileen F. Murphy, Rebecca Wall, Orla O' Sullivan, Kanishka Nilaweera, Gerald F. Fitzgerald, Paul D. Cotter, R. Paul Ross, Catherine Stanton
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- Journal:
- British Journal of Nutrition / Volume 111 / Issue 11 / 14 June 2014
- Published online by Cambridge University Press:
- 20 February 2014, pp. 1905-1917
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- 14 June 2014
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Different dietary fat and energy subtypes have an impact on both the metabolic health and the intestinal microbiota population of the host. The present study assessed the impact of dietary fat quality, with a focus on dietary fatty acid compositions of varying saturation, on the metabolic health status and the intestinal microbiota composition of the host. C57BL/6J mice (n 9–10 mice per group) were fed high-fat (HF) diets containing either (1) palm oil, (2) olive oil, (3) safflower oil or (4) flaxseed/fish oil for 16 weeks and compared with mice fed low-fat (LF) diets supplemented with either high maize starch or high sucrose. Tissue fatty acid compositions were assessed by GLC, and the impact of the diet on host intestinal microbiota populations was investigated using high-throughput 16S rRNA sequencing. Compositional sequencing analysis revealed that dietary palm oil supplementation resulted in significantly lower populations of Bacteroidetes at the phylum level compared with dietary olive oil supplementation (P< 0·05). Dietary supplementation with olive oil was associated with an increase in the population of the family Bacteroidaceae compared with dietary supplementation of palm oil, flaxseed/fish oil and high sucrose (P< 0·05). Ingestion of the HF-flaxseed/fish oil diet for 16 weeks led to significantly increased tissue concentrations of EPA, docosapentaenoic acid and DHA compared with ingestion of all the other diets (P< 0·05); furthermore, the diet significantly increased the intestinal population of Bifidobacterium at the genus level compared with the LF-high-maize starch diet (P< 0·05). These data indicate that both the quantity and quality of fat have an impact on host physiology with further downstream alterations to the intestinal microbiota population, with a HF diet supplemented with flaxseed/fish oil positively shaping the host microbial ecosystem.
Effects of high dietary concentration of lactose and increased soya-bean meal inclusion in starter diets for piglets
- K. M. Pierce, J. J. Callan, P. McCarthy, J. V. O'. Doherty
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- Journal:
- Animal Science / Volume 79 / Issue 3 / December 2004
- Published online by Cambridge University Press:
- 18 August 2016, pp. 445-452
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- December 2004
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A 3 X 2 factorial experiment was conducted to investigate the interactions between lactofeed 70 (LF70) (860 g/kg whey permeate, 140 g/kg soya-bean meal; Volac International, UK) and soya-bean meal (SBM) or dried skim milk (DSM) in piglet diets. Three hundred and thirty-six piglets were selected after weaning at 21 days with an initial live weight of 6-35 kg. They were blocked on the basis of live weight and within each block assigned to one of six dietary treatments. The pigs were offered the following starter diets : (1) 300 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (2) 200 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (3) 100 g/kg LF70 with 215 g/kg SBM and 100 g/kg DSM; (4) 300 g/kg LF70 with 325 g/kg DSM; (5) 200 g/kg LF70 with 325 g/kg DSM; (6) 100 g/kg LF70 with 325 g/kg DSM. The starter diets were offered for 25 days. Following this, a weaner diet (14 g/kg lysine, 14-5 MJ/kg digestible energy) was given for a period of 12 days. There was a significant interaction between LF70 level and protein source on average daily gain (ADG P < 0.001) and food conversion ratio (FCR P < 0.05) during the starter period. There was a linear increase in ADG and a linear improvement in FCR with increasing LF70 levels in diets with SBM. However, there was a linear decrease in ADG with increasing LF70 levels in diets with DSM. There was a significant interaction (P < 0.001) between LF70 level and protein source on average daily food intake (ADFI) during the starter period. At high LF70 levels, the inclusion of DSM reduced ADFl compared with SBM. However, there was no difference between DSM and SBM at the medium and low LF70 levels. There was a significant interaction between LF70 level and protein source in organic matter digestibility (OMD) (P < 0.01) and gross energy digestibility (GED) (P < 0.01). The pigs offered diets containing DSM had a significantly lower OMD and GED at low LF70 levels compared with pigs offered diets containing SBM. However, the inclusion of DSM had no significant effect on OMD or GED at the medium and high LF70 levels. There was a quadratic response in nitrogen digestibility (ND) with increasing concentrations of LF70 (P < 0.05). There was an increase in ND to 200 g/kg LF70 inclusion, however there was no further increase in ND above 200 g/kg LF70 inclusion. In conclusion, increasing the inclusion of lactofeed from 100 g/kg to 300 g/kg in starter diets where soya-bean meal comprised the principle protein source improved food efficiency and increased daily gain and daily food intake when compared with diets where dried skim milk comprised the principle protein source.
Effect of lairage during 24 h of transport on the behavioural and physiological responses of sheep
- M. S. Cockram, J. E. Kent, R. E. Jackson, P. J. Goddard, O. M. Doherty, I. M. McGilp, A. Fox, T. C. Studdert-Kennedy, T. I. McConnell, T. O'Riordan
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- Animal Science / Volume 65 / Issue 3 / December 1997
- Published online by Cambridge University Press:
- 02 September 2010, pp. 391-402
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- December 1997
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The effects on the behavioural and physiological responses of sheep of providing rest, food and water (lairage) during 24 h of either road transport or stationary confinement (treatment) were investigated. Twenty-four hours of continuous treatment was compared with 12 h of treatment followed by either 12 h of lairage, 3 h of lairage or 3 h of food and water on the vehicle, followed by a second 12 h of treatment. A further group of sheep was kept as controls. The plasma cortisol concentration was increased at the start of the journey and after 24 h of continuous transport it was still greater than that in controls (P < 0·05). Apart from a mobilization of body energy reserves as indicated by raised plasma concentrations offree fatty acids after 12 h and β-hydroxybutyrate after 24 h there was no evidence that the welfare of the sheep during the journey was compromised after a particular time. During the lairage and immediately after the second 12-h transport period, the sheep appeared to be hungry. Although sheep transported for 24 h without lairage drank more post transport than controls, there was no biochemical evidence of dehydration during the journey. The sheep lay down during the journey and there was no apparent difference between lairage treatments in the proportion of scans spent lying down during either the second 12-h treatment period or during the first 12 h post treatment. There were fewer potentially traumatic events during the second 22 h of the 24-h journey than during the first 12 h of the journey and no apparent effect of lairage during the journey on the frequency of potentially traumatic events during the second 12-h period of transport.
There was evidence to suggest that a period of lairage during a 24-h journey can be beneficial in providing sheep with an opportunity to eat, drink and avoid the stressors associated with transport. However, providing hay and water on the vehicle during a 3-h stationary period as compared with unloading into a lairage cannot be recommended. Although sheep readily ate hay on the vehicle, they did not drink sufficient water. This resulted in dehydration and a greater plasma cortisol concentration during the remainder of the journey than in those that had been lairaged for 12 h and a greater water intake post transport than in those given either no lairage or 12 h of lairage.