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Re-Examining the Relationship Between Export Upgrading and Economic Growth: Is there a Threshold Effect?
Get PDFThe main objective of this study is to examine the non-linear link between export upgrading and economic growth for 58 advanced and developing countries over the period of 1995-2015. For this purpose, an innovative dynamic panel threshold regression model (CS-ARDL) that allows control for cross-country heterogeneity, cross-sectional dependence, and feedback effects is employed to capture this non-linear relationship. The empirical results indicate that there exist threshold effects in the export upgrading-growth relationship. In particular, our findings suggest an inverted U-shaped relation between export sophistication and output growth. Below a critical level (1.3 for advanced countries and –0.7 for developing countries), more export complexity fosters economic growth. However, excessive export complexity might have adverse spillovers on long-term economic growth. Furthermore, we show that the effect of export sophistication on economic growth is asymmetric to advanced and developing countries when it is above and below the threshold level
How do the Foreign-Born Rate Host Country Health Systems? Evidence from Ireland
Get PDFThis article evaluates how foreign-born residents perceive the Irish health system compared to the Irish-born. Using data from the European Social Survey (2002-2012), the article finds that the foreign-born are more positive than the native-born regarding the Irish health system. This positive attitude is most pronounced in the first years after their arrival and decreases with time spent in Ireland. However, perceptions vary according to the country of origin: Polish migrants are much more positive about the Irish health system than the Irish, while British-born residents rate the system just slightly more positively than Irish natives
The Impact of Free GP Care on GP Utilisation in Ireland
Get PDFThe successful implementation of the ongoing roll-out of free GP care for all private patients in Ireland, begun in 2015, requires an estimate of its impact on GP utilisation. However, estimates of this impact vary widely. For example, a recent study based on administrative records of six GP practices, predicts an extra 4.4 million GP visits. This paper argues that little reliance should be placed on this estimate due to methodological and sample selection issues, as well as the use of demonstrably inappropriate assumptions. Instead, more reliance should be placed on estimates derived from retrospective self-reporting surveys (e.g. Growing Up in Ireland, the Irish Longitudinal Study on Ageing) which suggest that extending free GP care to all private patients is likely to result in an increase of around 2.5 million GP visits. The increase in demand for GP services occasioned by free GP care feeds into the wider debate about the enhanced role of primary care in Ireland and the corresponding increase in funding
Prevalence of Non-Prescribed Drug Use in Hospital Patients Assessed by Urine Toxicology Testing
Get PDFTo analyse the results of a survey for non-prescribed drug use in selected patient populations in Tallaght University Hospital to determine the patterns of drug use by urine toxicology testing. Urine toxicology screening results done by the Alere Triage® TOX Drug Screen Meter were extracted from the Clinical Chemistry Lab database from the 5th of March to the 23rd of March at Tallaght University Hospital. Results were analysed to determine which drug tested positive most commonly. Benzodiazepines were the most prevalent drugs of abuse in urine toxicology, accounting for 25.62% of all positive results, this was followed by Cannabis and Amphetamines with 21.67% and 20.20% respectively. The largest age group that presented was between 30-39 inclusive. Benzodiazepines are the most prevalent positive result in drug of abuse screens in Tallaght University Hospital and the 30-39 age group contained the most positives and number of samples sent for toxicology analysis, supporting the claims of recent literature
Economic Stress and the Great Recession in Ireland: The Erosion of Social Class Advantage
Get PDFIn this paper we address the issue of whether the Great Recession in Ireland led to increased social class polarisation in the experience of economic stress. Rather than observing polarisation, we find evidence for ‘middle class squeeze’ involving the self-employed and a significant erosion of the advantages associated with the higher social classes. These outcomes derived primarily from a weakening of the degree of association between social class and income class and a reduction of the buffering effect of social class within the lower income classes. By 2012 social class had no impact on economic stress net of income class
HPV-associated Oropharyngeal Cancer: A Distinct Clinical Entity
Get PDFIt is now widely accepted that cervical cancer cannot develop in the absence of Human papillomavirus (HPV) infection. Less well known is the link between HPV and oropharyngeal cancer (OPC). With falling smoking rates, OPC rates were expected to decline. However this has not occurred, potentially due to a rise in HPV-associated OPC. This literature review aims to provide a summary of the most recent data regarding risk factors, biomarkers and prognosis for HPV-positive OPC, and to compare these findings with HPV-negative OPC. In light of its improved prognosis, this paper will also discuss the potential merits of treatment de-escalation in cases of HPV-positive OPC. A search was carried out on PubMed with the keywords Human papillomavirus, oropharyngeal cancer, and head and neck cancer. The search focused on papers published in the past 5 years but did not exclude seminal or relevant studies published earlier. Conclusion: HPV-associated oropharyngeal cancer should be recognised as a distinct clinical entity, which stands in contrast to HPV-negative OPC with regards to its aetiology, risk factors, chemotherapy and radiation therapy sensitivity and therefore also prognosis. More research is required to determine appropriate treatment and public health strategies
“Go mór i mbéal an phobail” – Antidepressants and Their Effects on the Mouths of the Public.
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Open vs. Laparoscopic Hernia Repair for Unilateral Inguinal Hernia: Are There Better Outcomes with Development in Skills?
Get PDFInguinal hernia refers to the protrusion of bowel or omentum through a weakening in the abdominal wall – specifically the inguinal canal. The gold standard treatment for bilateral inguinal hernia is laparoscopy. However, there is presently no consensus in the gold standard surgical method of unilateral inguinal hernia treatment. Unilateral inguinal hernias have been shown to be effectively treated in both open and laparoscopic fashion. Intrigued by this dichotomy in treatment for the ailment, we investigated the effectiveness of both procedures over two time periods (2000-2005 vs. 2012-2017) for the treatment of unilateral inguinal hernia. The primary outcome measure that was used for comparison was recurrence rates. The 2000-2005 period exhibited a lower recurrence rate for open procedure whereas the 2012-2017 period favoured the laparoscopic technique. However, these observed differences were not statistically significant in favouring one technique over the other
News: Adam Kay: Stories From A Former Medic
No full textThis past Monday, the Robert Smith Lecture Theatre in Saint James’s Hospital filled up —except for the front row, presumably a universal law for any given lecture theatre — for a lunchtime talk with Adam Kay. The former senior registrar in obstetrics and gynaecology, and author of the bestseller This Is Going to Hurt, spoke about his book based on the diaries he kept throughout his years working in the NHS.
Trinity College’s BioSoc hosted the now-TV writer/comedian and awarded him an honorary patronage of the society on the same day as his sold out gig at the National Concert Hall in Dublin. The audience of about 200 was made up largely of medical students, but a good few junior doctors were attending as well — bleeps going off at regular intervals provided a subtle but apropos background for the talk.
The event began by awarding the medal to Kay, followed by a reading of a passage from the book (one of two genital-degloving anecdotes the audience was treated to in the short space of an hour) and a conversation with Rían Hayes, president of BioSoc, who made sure to crush any smidgen of doubt as to whether he had “done his research” for the event. In fairness to him, this did show, and resulted in a nicely flowing and informative conversation. The last part involved the audience in a Q&A session with the comedian.
Kay’s delivery of anecdotes and sarcastic remarks were honoured with a good chuckle each time without fail. In response to a question about whether he had additional funny stories that didn’t make the final cut — he answered with degloving story number two which elicited the same cringe-eliciting response as the first. He went further to compare his work on the book to that of a sound mixer, trying to find the right balance between funny, serious, absurd and tragic, and he made sure his audience got a taste of all sides during his talk. For every story about hungover students ending up face-first in a patient’s abdomen, he also gave glimpses into a life where six out of seven missed Christmases was the norm. An amusing recount of a meeting with British Politician Jeremy Hunt (who more than likely agreed to the meeting to stop the constant stream of Kay’s book addressed to him flooding his office) displayed how the issue of burnout is ever-increasing in the medical profession.
My very first thought after finishing the book (in a single afternoon, which is testament to how entertaining the writing is) was that I should buy this for friends and family, as it conveys the nature of my future occupation more accurately (and probably in an infinitely more entertaining manner) than any of my recounts of personal experiences. Kay confirmed that this was no accident.
“I wanted it to be the books that doctors could say: This is what it’s like!” he said, proving not only that he had very clear intentions with publishing his story, but that the execution was spot-on. Another message that was obviously important to the author, and one that his story very much underlines, is the necessity of healthcare professionals taking good care of themselves and each other. He stressed how vital it is to be armed with some personal way of coping in such a challenging line of work.
One audience member intending to work in the UK inquired about whether things have improved since he left his job in the NHS. Kay gave a sobering reminder of further cuts to the health care budget after 2010 and did no sugarcoating in pointing out how the ultimate solution would be “loads of more money.” He said that objectively, individuals, or even doctors as a group, could do very little to change things in that regard.
On a more positive note, Kay also pressed the importance of making a decision on a career path with “both eyes wide open”, musing on how this crucial choice in his case may have been influenced during medical school by a well-respected registrar. Kay compared different specialties to being like sine waves, some — such as O&G — with extreme highs and lows, and others with somewhat flatter waveforms (insert obvious jab at dermatology), something he strongly advised to take into account when choosing a career.
When the conversation turned to his life as a comedian and TV-writer, Kay didn’t shy away from getting very real about how different the satisfaction that his current job and that being a doctor provided, describing the former as being a lot less tangible and several degrees removed from the impact it was making. This was one of the few times during the talk when some sense of remorse seeped through his words. The same could be felt when he was talking about the end of his days as a doctor, and how hard he found it to open up about what he was going through at the time. As a member of the audience put it afterwards: “Despite how funny he was, you could still sense the sadness he felt around the events that ended his career.”
While many of the answers were based largely on the book, with a good few almost direct quotes from diary entries, Kay’s deadpan delivery kept even those who could see the punchline coming very much entertained. The audience also heard several unwritten stories, for instance painting the hilarious picture of the comedian performing (after a kindly warm-up from Ellie Goulding) a foul-mouthed parody song about the London Underground at Prince Harry’s birthday in St James’s Palace.
Just as reading his book, this talk with Adam Kay was thoroughly entertaining, if somewhat bittersweet. It’s no surprise whatsoever that he seemed to have struck a chord with the crowd in the lecture theatre of a university hospital: his honesty, down to earth personality, and sarcastic humour gave his very important messages about doctors’ well being, or the state of health care a rare degree of authenticity. Apart from heartfelt giggles about the absurdity of what medicine can be at times, Kay’s story and current work also encourage to take the time to make well thought out decisions in pursuing this demanding career. Given the flying start of his new career, and the amount of people he reached one way or another in the last few years, I do believe there is genuine hope for maybe a couple less “guns and badges” handed in before their time down the line – and quite possibly a surge in secret diary-keeping among junior doctors.
Photographs Courtesy Joe Deega