Winter deaths are a known health and social care challenge for many countries. A previous interna... more Winter deaths are a known health and social care challenge for many countries. A previous international comparison showed significant differences in excess winter deaths across Europe in the 1990s, with the northern countries having lower excess winter mortality than those in southern Europe. The Excess Winter Deaths Index (EWDI) is the ratio of deaths in the winter period (December to March) compared with deaths in the non-winter period. Data from the Eurostat database and national registries were used to calculate the EWDI for 31 countries in Europe across the time period 2002/2003 to 2010/2011. National EWDI values show heterogeneity, with a broad pattern of increasing EWDI values from northern to southern Europe and increasing mean winter temperature (r(2) = 0.50, P > 0.0001). Malta, Portugal, Spain, Cyprus and Belgium all had an EWDI that was statistically significantly higher than the average EWDI for the other 30 European countries. There was no clear association between c...
European populations are ageing rapidly yet, although, it is widely recognized that some individu... more European populations are ageing rapidly yet, although, it is widely recognized that some individuals age more successfully than others, an agreed concept of successful ageing remains elusive. We sought to develop a model of successful ageing in a British population, which combines the subjective and objective elements of successful ageing that have previously been proposed. Structural equation modelling was used to provide a model of successful ageing, defined in subjective and objective terms. The data comprised 15,000 subjects aged ≥ 50 years in England, recruited to the Health and Lifestyle Surveys (HALS) (followed up >7 years) and the English Longitudinal Survey of Ageing (ELSA) (followed up >2 years). A model was developed using a 50% random sample from HALS and tested in the other 50% and in ELSA. We examined the association of risk of disease, functioning and engagement with society at baseline with confidence and continued engagement at follow-up. The model developed in the 50% sample of HALS was strong and reproducible in the other data sets. Low risk and good function at baseline are associated with confidence and continued engagement at follow-up, with engagement at baseline independently associated with engagement at follow-up. This model provides reproducible insights on the nature of ageing well, confirming the importance of personal resilience and continued involvement in physical and social activities. Far from retiring, engagement with life and society should be the norm for ageing populations.
... in resources for the NHS might affect the demand for private hospital care, and the impact of... more ... in resources for the NHS might affect the demand for private hospital care, and the impact of onesector on the ... Thirdly, what are the objectives of a healthcare system? One answer is that healthcare should be available to all regardless of income or where we live—this is the ...
A survey of 400 Ealing residents was conducted from the Department of Public Health in Ealing Hea... more A survey of 400 Ealing residents was conducted from the Department of Public Health in Ealing Health Authority to ascertain why the response to the call/recall letters issued by the Family Health Service Authority (FHSA) was at most 33%. Views about the service were also investigated. The findings were that satisfaction with the service was high and more women were covered than previously thought. However with close to 40% inaccuracies on the prior notification list (even after amendments by the GPs), few assumptions about the response to the call/recall system could be made until the FHSA mailing list is systematically reformed. A small but well defined group of older women were very infrequent, if ever attenders; their reasons were amenable to health education and encouragement by health professionals. Easily identifiable differences between ethnic minorities and women from U.K. backgrounds related to the choice of screening venues. However there were indicators of more fundamenta...
The Journal of the Royal Society for the Promotion of Health, 1989
Between 1977-87, 17 farm accident deaths were recorded in a county of population 52,379 in the no... more Between 1977-87, 17 farm accident deaths were recorded in a county of population 52,379 in the north-east of Ireland. In 1986, a further 150 non-fatal cases were recorded in the county during a national survey of non-fatal farm accidents. Tractors were the commonest cause of fatal and non-fatal accidents and the latter were frequently serious. Although 63% of fatal, and 60% of non-fatal accidents occurred to farmers, 31% of fatal and 15% of non-fatal cases were farmer's children, and these were mainly under 12 years old. The commonest age group of fatal cases was between 1-15 years, and of non-fatal cases between 46-60 years. The latter age group is representative of the national age group of Irish farmers. There were fewer than three deaths in this series which were beyond the control of the deceased or their guardian, and many non-fatal accidents were associated with risk taking by the deceased. The very low profile afforded farm safety at all levels in Ireland is inappropriate as there is no evidence that farm accidents have decreased either in number or severity in recent years. Examples of non-accidental deaths on the farm are presented to illustrate the need for personal alarm systems for the elderly farmer; furthermore, a 'distressed farmer' scheme run by farming interests is recommended for farmers whose social isolation and financial worries have become an unbearable burden to them.
Farms in Ireland remain a dangerous environment for children despite increasing publicity about f... more Farms in Ireland remain a dangerous environment for children despite increasing publicity about farming hazards based on international research. A one year prospective study on farm accidents was carried out in four Irish accident and emergency departments. During this time, four deaths and 62 cases of injury aged 15 years and under were seen. Half the cases required admission to hospital; tractor accidents were common and serious. Most injuries occurred to the extremities but 13 (21 per cent) had multiple injuries. Forty-three (69 per cent) of the children required outpatient follow-up and twenty-seven of these (63 per cent) had more than one outpatient re-visit. The Irish farming community is still unappreciative of the risks to their children on the farm, and urgent attention needs to be directed towards educational and legislative measures to improve the safety profile of Irish farms.
Winter deaths are a known health and social care challenge for many countries. A previous interna... more Winter deaths are a known health and social care challenge for many countries. A previous international comparison showed significant differences in excess winter deaths across Europe in the 1990s, with the northern countries having lower excess winter mortality than those in southern Europe. The Excess Winter Deaths Index (EWDI) is the ratio of deaths in the winter period (December to March) compared with deaths in the non-winter period. Data from the Eurostat database and national registries were used to calculate the EWDI for 31 countries in Europe across the time period 2002/2003 to 2010/2011. National EWDI values show heterogeneity, with a broad pattern of increasing EWDI values from northern to southern Europe and increasing mean winter temperature (r(2) = 0.50, P > 0.0001). Malta, Portugal, Spain, Cyprus and Belgium all had an EWDI that was statistically significantly higher than the average EWDI for the other 30 European countries. There was no clear association between c...
European populations are ageing rapidly yet, although, it is widely recognized that some individu... more European populations are ageing rapidly yet, although, it is widely recognized that some individuals age more successfully than others, an agreed concept of successful ageing remains elusive. We sought to develop a model of successful ageing in a British population, which combines the subjective and objective elements of successful ageing that have previously been proposed. Structural equation modelling was used to provide a model of successful ageing, defined in subjective and objective terms. The data comprised 15,000 subjects aged ≥ 50 years in England, recruited to the Health and Lifestyle Surveys (HALS) (followed up >7 years) and the English Longitudinal Survey of Ageing (ELSA) (followed up >2 years). A model was developed using a 50% random sample from HALS and tested in the other 50% and in ELSA. We examined the association of risk of disease, functioning and engagement with society at baseline with confidence and continued engagement at follow-up. The model developed in the 50% sample of HALS was strong and reproducible in the other data sets. Low risk and good function at baseline are associated with confidence and continued engagement at follow-up, with engagement at baseline independently associated with engagement at follow-up. This model provides reproducible insights on the nature of ageing well, confirming the importance of personal resilience and continued involvement in physical and social activities. Far from retiring, engagement with life and society should be the norm for ageing populations.
... in resources for the NHS might affect the demand for private hospital care, and the impact of... more ... in resources for the NHS might affect the demand for private hospital care, and the impact of onesector on the ... Thirdly, what are the objectives of a healthcare system? One answer is that healthcare should be available to all regardless of income or where we live—this is the ...
A survey of 400 Ealing residents was conducted from the Department of Public Health in Ealing Hea... more A survey of 400 Ealing residents was conducted from the Department of Public Health in Ealing Health Authority to ascertain why the response to the call/recall letters issued by the Family Health Service Authority (FHSA) was at most 33%. Views about the service were also investigated. The findings were that satisfaction with the service was high and more women were covered than previously thought. However with close to 40% inaccuracies on the prior notification list (even after amendments by the GPs), few assumptions about the response to the call/recall system could be made until the FHSA mailing list is systematically reformed. A small but well defined group of older women were very infrequent, if ever attenders; their reasons were amenable to health education and encouragement by health professionals. Easily identifiable differences between ethnic minorities and women from U.K. backgrounds related to the choice of screening venues. However there were indicators of more fundamenta...
The Journal of the Royal Society for the Promotion of Health, 1989
Between 1977-87, 17 farm accident deaths were recorded in a county of population 52,379 in the no... more Between 1977-87, 17 farm accident deaths were recorded in a county of population 52,379 in the north-east of Ireland. In 1986, a further 150 non-fatal cases were recorded in the county during a national survey of non-fatal farm accidents. Tractors were the commonest cause of fatal and non-fatal accidents and the latter were frequently serious. Although 63% of fatal, and 60% of non-fatal accidents occurred to farmers, 31% of fatal and 15% of non-fatal cases were farmer's children, and these were mainly under 12 years old. The commonest age group of fatal cases was between 1-15 years, and of non-fatal cases between 46-60 years. The latter age group is representative of the national age group of Irish farmers. There were fewer than three deaths in this series which were beyond the control of the deceased or their guardian, and many non-fatal accidents were associated with risk taking by the deceased. The very low profile afforded farm safety at all levels in Ireland is inappropriate as there is no evidence that farm accidents have decreased either in number or severity in recent years. Examples of non-accidental deaths on the farm are presented to illustrate the need for personal alarm systems for the elderly farmer; furthermore, a 'distressed farmer' scheme run by farming interests is recommended for farmers whose social isolation and financial worries have become an unbearable burden to them.
Farms in Ireland remain a dangerous environment for children despite increasing publicity about f... more Farms in Ireland remain a dangerous environment for children despite increasing publicity about farming hazards based on international research. A one year prospective study on farm accidents was carried out in four Irish accident and emergency departments. During this time, four deaths and 62 cases of injury aged 15 years and under were seen. Half the cases required admission to hospital; tractor accidents were common and serious. Most injuries occurred to the extremities but 13 (21 per cent) had multiple injuries. Forty-three (69 per cent) of the children required outpatient follow-up and twenty-seven of these (63 per cent) had more than one outpatient re-visit. The Irish farming community is still unappreciative of the risks to their children on the farm, and urgent attention needs to be directed towards educational and legislative measures to improve the safety profile of Irish farms.
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Papers by Yvonne Doyle