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To assess the prevalence of autism traits in individuals accessing gender affirming treatments, we conducted a cross-sectional survey in the regional specialist gender services in Northern Ireland.
One hundred and twenty-three individuals (38 adolescents and 69 adults) currently attending or who previously attended specialist gender services in Northern Ireland were recruited. Fifty-six individuals assigned male at birth (AMAB) and 66 individuals assigned female at birth (AFAB) took part in the study. Main outcome measures: Autism Quotient (AQ), Cambridge Behavior Scale (EQ), and RAADS-14.
Autism trait prevalence rates of 19.5% (AQ); 25.4% (RAADS-14); and 35.8% (poor empathy traits). A combined measure comprising all three provided a prevalence of 17.2%. There were no mean differences in the scores between AMAB (assigned male at birth) individuals and AFAB (assigned female at birth) individuals.
Autism traits present additional challenges during the assessment and treatment of individuals with gender dysphoria. Autism screening tools can aid in the identification of individual with additional needs.
Research indicates that anti-depressant prescribing is higher in Northern Ireland (NI) than in the rest of the UK, and that socio-economic and area-level factors may contribute to this. The current study provides comprehensive population-based estimates of the prevalence of anti-depressant prescription prescribing in NI from 2011 to 2015, and examined the associations between socio-demographic, socio-economic, self-reported health and area-level factors and anti-depressant prescription.
Data were derived from the 2011 NI Census (N = 1 588 355) and the Enhanced Prescribing Database. Data linkage techniques were utilised through the Administrative Data Research Centre in NI. Prevalence rates were calculated and binary logistic analysis assessed the associations between contextual factors and anti-depressant prescription.
From 2011 to 2015, the percentages of the population in NI aged 16 or more receiving anti-depressant prescriptions were 12.3%, 12.9%, 13.4%, 13.9% and 14.3%, respectively, and over the 5-year period was 24.3%. The strongest predictors of anti-depressant prescription in the multivariate model specified were ‘very bad’ (OR = 4.02) or ‘Bad’ general health (OR = 3.98), and self-reported mental health problems (OR = 3.57). Other significant predictors included social renting (OR = 1.67) and unemployment (OR = 1.25). Protective factors included Catholic religious beliefs, other faith/philosophic beliefs and no faith/philosophic beliefs in comparison to reporting Protestant/other Christian religious beliefs (ORs = 0.78–0.91).
The prevalence of anti-depressant prescription in NI appears to be higher than the prevalence of depressive disorders, although this may not necessarily be attributable to over-prescribing as anti-depressants are also prescribed for conditions other than depression. Anti-depressant prescription was linked to several factors that represent socio-economic disadvantage.
Although substance misuse is a key risk factor in suicide, relatively
little is known about the relationship between lifetime misuse and misuse
at the time of suicide.
To examine the relationship between substance misuse and subsequent
Linkage of coroners' reports to primary care records for 403 suicides
occurring over 2 years.
With alcohol misuse, 67% of the cohort had previously sought help for
alcohol problems and 39% were intoxicated at the time of suicide.
Regarding misuse of other substances, 54% of the cohort was tested.
Almost one in four (38%) tested positive, defined as an excess of drugs
over the prescribed therapeutic dosage and/or detection of illicit
substances. Those tested were more likely to be young and have a history
of drug misuse.
A deeper understanding of the relationship between substance misuse and
suicide could contribute to prevention initiatives. Furthermore,
standardised toxicology screening processes would avoid diminishing the
importance of psychosocial factors involved in suicide as a ‘cause of
Durkheim's seminal historical study demonstrated that religious
affiliation reduces suicide risk, but it is unclear whether this
protective effect persists in modern, more secular societies.
To examine suicide risk according to Christian religious affiliation and
by inference to examine underlying mechanisms for suicide risk. If church
attendance is important, risk should be lowest for Roman Catholics and
highest for those with no religion; if religiosity is important, then
‘conservative’ Christians should fare best.
A 9-year study followed 1 106 104 people aged 16–74 years at the 2001 UK
census, using Cox proportional hazards models adjusted for census-based
In fully adjusted models analysing 1119 cases of suicide, Roman
Catholics, Protestants and those professing no religion recorded similar
risks. The risk associated with conservative Christians was lower than
that for Catholics (HR = 0.71, 95% CI 0.52–0.97).
The relationship between religious affiliation and suicide established by
Durkheim may not pertain in societies where suicide rates are highest at
younger ages. Risks are similar for those with and without a religious
affiliation, and Catholics (who traditionally are characterised by higher
levels of church attendance) do not demonstrate lower risk of suicide.
However, religious affiliation is a poor measure of religiosity, except
for a small group of conservative Christians, although their lower risk
of suicide may be attributable to factors such as lower risk behaviour
and alcohol consumption.
The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown.
To determine die effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.
Prospective, crossover trial.
Setting and Participants.
Thirty HCWs randomized to study versus control scrubs in an intensive care unit.
Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.
Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log mediicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; P = .0002), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; P = .0056), leg cargo pocket at die beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; P = .0028), and abdominal area pocket at die end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; P = .0054).
Study scrubs were associated witfi a 4–7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure die impact of antimicrobial impregnated apparel on MRSA transmission rates.
To compare the efficacy of universal gloving with emollient-impregnated gloves with standard contact precautions for the control of multidrug-resistant organisms (MDROs) and to measure the effect on healthcare workers' (HCWs') hand skin health.
Prospective before-after trial.
An 18-bed surgical intensive care unit.
During phase 1 (September 2007 through March 2008) standard contact precautions were used. During phase 2 (March 2008 through September 2008) universal gloving with emollient-impregnated gloves was used, and no contact precautions. Patients were screened for vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). HCW hand hygiene compliance and hand skin health and microbial contamination were assessed. The incidences of device-associated infection and Clostridium difficile infection (CDI) were determined.
The rate of compliance with contact precautions (phase 1) was 67%, and the rate of compliance with universal gloving (phase 2) was 78% (P = .01). Hand hygiene compliance was higher during phase 2 than during phase 1 (before patient care, 40% vs 35% of encounters; P = .001; after patient care, 63% vs 51% of encounters; P < .001). No difference was observed in MDRO acquisition. During phases 1 and 2, incidences of device-related infections, in number of infections per 1,000 device-days, were, respectively, 3.7 and 2.6 for bloodstream infection (P = .10), 8.9 and 7.8 for urinary tract infection (P = .10), and 1.0 and 1.1 for ventilator-associated pneumonia (P = .09). The CDI incidence in phase 1 and in phase 2 was, respectively, 2.0 and 1.4 cases per 1,000 patient-days (P = .53). During phase 1, 29% of HCW hand cultures were MRSA positive, compared with 13% during phase 2 (P = .17); during phase 1, 2% of hand cultures were VRE positive, compared with 0 during phase 2 (P = .16). Hand skin health improved during phase 2.
Compared with contact precautions, universal gloving with emollient-impregnated gloves was associated with improved hand hygiene compliance and skin health. No statistically significant change in the rates of device-associated infection, CDI, or patient MDRO acquisition was observed. Universal gloving may be an alternative to contact precautions.
Suicide rates vary markedly between areas but it is unclear whether this is due to differences in population composition or to contextual factors operating at an area level.
To determine if area factors are independently related to suicide risk after adjustment for individual and family characteristics.
A 5-year record linkage study was conducted of 1 116 748 non-institutionalised individuals aged 16–74 years, enumerated at the 2001 Northern Ireland census.
The cohort experienced 566 suicides during follow-up. Suicide risks were lowest for women and for those who were married or cohabiting. Indicators of individual and household disadvantage and economic and health status at the time of the census were also strongly related to risk of suicide. The higher rates of suicide in the more deprived and socially fragmented areas disappeared after adjustment for individual and household factors. There was no significant relationship between population density and risk of suicide.
Differences in rates of suicide between areas are predominantly due to population characteristics rather than to area-level factors, which suggests that policies targeted at area-level factors are unlikely to significantly influence suicides rates.
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