Older people in deprived areas in Ireland face problems of poor brain health

People who live in disadvantaged areas have a greater risk of developing cognitive dysfunction than people in better off areas, a study by Professor Helene McNulty and colleagues at the University of Ulster has found.

The findings of this study, funded by the Centre for Ageing Research and Development in Ireland, are based on novel analysis of existing data collected for the TUDA Ageing north-south cohort study of over 5,000 older people in Ireland. The latest results show that – over and above factors like lower levels of education – living in a disadvantaged area significantly predicts cognitive dysfunction in ageing. This means that older people living in deprived areas of Ireland, North and South, are more likely to suffer mental illnesses ranging from mild cognitive impairment to dementia.

Although cognitive dysfunction generally increased with age, older people living in the most deprived areas were more at risk of poor cognitive health compared with a person of the same age living in a less deprived area.

Compared with people in the least deprived areas, people living in the most deprived areas had:

• 3 years less education
• A greater likelihood of anxiety and depression
• Higher body mass index
• Lower rates of physical activity
• Higher rates of smoking

The full report is entitled 'Socio-economicdeprivation and risk of age-related cognitive dysfunction: results from theTUDA Ageing Cohort Study'.

The latest findings from the TUDA study were presented recently at the annual Scientific Meeting of the Irish Gerontological Society in Galway. 

View more information here

BMJ Study: High milk diet 'may not cut risk of bone fractures'

Drinking lots of milk may not lower the risk of fracturing bones, a study in the British Medical Journal suggests.

The research, conducted in Sweden, showed women who drank more than three glasses a day were actually more likely to break bones than those who had less.

View Reserach article here: Milk intake and risk of mortality and fractures in women and men: cohort studies

The researchers cautioned that their work only suggested a trend and should not be interpreted as proof that high milk consumption caused fractures.  Factors such as alcohol and weight were likely to play a role, they said.

A team of scientists in Sweden examined the dietary habits of 61,400 women in 1987-1990 and 45,300 men in 1997 and then monitored their health for years afterwards.  Participants were asked to complete questionnaires on how frequently they consumed common foods such as milk, yoghurt and cheese over a one-year period.

Researchers then tracked how many developed fractures and how many participants died in the years afterwards.

In the 20-year follow-up period in which the women were monitored, those who drank more than three glasses, or 680ml, of milk a day were more likely to develop fractures than those who had consumed less.  The high-intake group had a higher risk of death too.

Prof Karl Michaelsson, lead researcher at Uppsala University, said: "Women who drank three or more glasses a day had twice the chance of dying at the end of the study than those who drank less than one glass a day. And those who had a high milk intake also had a 50% higher risk of hip fracture."

Men were monitored for an average of 11 years after the initial survey and the results showed a similar but less pronounced trend

.

When fermented milk products such as yoghurt were considered, the opposite pattern was observed - people who consumed more had a lower risk of fractures.

Prof Michaelsson says the findings could be due to sugars in milk, which have been shown to accelerate ageing in some early animal studies

"The results should, however, be interpreted cautiously given the observational design of our study."

Dietary advice should not be changed until more research had been conducted, he said.  British experts said the research should be treated with caution because the milk in Sweden is fortified with vitamin A which could have an impact on the findings.

View more here

World-leading experts from the field of stem cell science to convene at NUI Galway

World-leading experts from the field of stem cell science will convene at NUI Galway on 29-30 October 2014. The Galway International Stem Cell Conference will focus on the latest developments in basic science and translational aspects of Mesenchymal Stem Cell (MSC) research in Ireland, the UK and worldwide. A type of adult stem cell, Mesenchymal Stem Cells or MSCs, have shown huge potential for use in many medical therapies.

In addition to plenary talks from internationally renowned speakers, the program is structured to include oral paper presentations selected from submitted abstracts. With Ireland hosting the event this year, there will be a particular focus on some of the ground breaking research taking place here. The latest plans from researchers at NUI Galway for stem cell trials in Galway, focusing on arterial disease in the lower leg and osteoarthritis in the knee will be discussed.

According to Professor Frank Barry, Scientific Director of REMEDI at NUI Galway: “The impact of this conference will be high because it focuses on those aspects of basic science and clinical evaluation which represent obstacles to translation. New biological insights have emerged recently about stem cells and their clinical potential has been demonstrated. However, there are still substantial gaps in knowledge in the field, such as how we can standardise the mass production of stem cells in facilities around the world.”

View more here

More new books added to our Collection

Located at 618.8 BAS

Located at 616.70231 ORT

Located at 610.289 PAT

Located at 616.075 DIF

Located at 616.044 McEV

Located at 613 PRO

Cancer-killing stem cells engineered in lab

Toxin-producing stem cells (in blue) help kill brain tumour cells in the tumour cavity (in green)

Scientists from Harvard Medical School have discovered a way of turning stem cells into killing machines to fight brain cancer.  

In experiments on mice, the stem cells were genetically engineered to produce and secrete toxins which kill brain tumours, without killing normal cells or themselves.  Researchers said the next stage was to test the procedure in humans.

A stem cell expert said this was "the future" of cancer treatment.

The study, published in the journal Stem Cells, was the work of scientists from Massachusetts General Hospital and the Harvard Stem Cell Institute.

For many years, they had been researching a stem-cell-based therapy for cancer, which would kill only tumour cells and no others.

They used genetic engineering to make stem cells that spewed out cancer-killing toxins, but, crucially, were also able to resist the effects of the poison they were producing.

They also posed no risk to normal, healthy cells.

In animal tests, the stem cells were surrounded in gel and placed at the site of the brain tumour after it had been removed.

Their cancer cells then died as they had no defence against the toxins.

View more information here

Healthy Ireland survey

More than 10,000 Irish households are to be surveyed to find out just how healthy the nation is, mentally and physically, the Department of Health has confirmed.

The Healthy Ireland survey is the first for seven years and will start in the coming weeks.

The Department and Healthy Ireland said the households to be surveyed have been randomly selected and they hope the results will be available by May 2015.

The survey, conducted by Ipsos MRBI, will look at a number of key health indicators including:

• Nutrition;
• Alcohol consumption;
• Smoking;
• Level of physical activity;
• Weight management;
• Wellbeing.

“If we are going to help people to stay healthy, we need to have an idea of how healthy they are,” said Health Minister Leo Varadkar. “So this new survey will be really useful in making sure that the right policies are in place. It will also tell us what areas we need to focus on in future.

“The Healthy Ireland initiative was set up to improve the nation’s physical and mental health. We haven’t had a comprehensive survey since 2007, and there have been huge changes since then. On the one hand, more people are more aware of the importance of diet, lifestyle, health, wellbeing and mental fitness. But as a nation, we now face even bigger challenges on obesity, stress, diet, and many other areas. So there’s a big job ahead of us.”

He said the results of the survey would give his department a “baseline” set of data, telling it how healthy or unhealthy Ireland is.

View more here

New books added to our Collection

Located at 616.890231 INT

Located at 616.50231 LYO

Located at 362.6 ASH

Located at 616.99449042 HES

Located at 616.890231 ENG

University's study of eyeball link to Alzheime'rs

Researchers at Dundee University are to lead a £1.1m study into whether eye tests can reveal the onset of Alzheimer's disease.

A team from the university's school of computing will carry out the three-year study with colleagues in Edinburgh.

Evidence suggests changes to veins and arteries in the eye could be linked to diseases including stroke and cardiovascular disease.

The team will study if this could act as an "early warning" of Alzheimer's.

The new study uses specially-developed computer software to analyse high-definition images of the eye from multiple instruments to establish whether such changes in the eye could act as an early indicator of Alzheimer's disease.

Emanuele Trucco, professor of computational vision at the school of computing, is leading the project.

He said: "If you can look into someone's eyes using an inexpensive machine and discover something which may suggest a risk of developing dementia, then that's a very interesting proposition.

"There is the promise of early warning in a non-invasive way and there is also the fact that we even might be able to use the test to differentiate between different types of dementia."

View full report on BBC/Health

Recent acquisitions

Located at 362.1730941 ALL

Located at 362.1 MAN

Located at 616.029 NIC

Concern over mental health services for children

An Oireachtas committee was told the waiting list for Child and Adolescent Mental Health services is too high

An Oireachtas committee has heard that a third of children and adolescents in need of mental health services up to June this year, were admitted to adult wards.

The Director of Mental Health Reform told the Oireachtas Health Committee this morning that despite the Mental Health Code of Practice stating no child should be admitted into an adult ward outside exceptional circumstances, of 158 admissions, 53 were to adult units.

Dr Shari McDaid said this was "too many". She also told the committee that the waiting list for Child and Adolescent Mental Health services is too long. By July this year, 2,757 children were waiting to be seen by CAMS. Dr McDaid said that while that represented a 2% decrease on the previous year, "there are a large number of children waiting to be seen".

She also criticised the Health Service Executive, saying it had been very slow in deciding where to spend the money allocated to Mental Health Services, noting that it decided where to spend the 2014 allocation in September of this year.

Dr McDaid said it is the third year the decision on spending has been delayed, and said she hoped the HSE would be quicker with that decision in 2015.

View here

Open Access Research Award

The HSE Open Access Research Advisory Group have announced a new Open Access Research Award.

The research must address a specific health problem. Areas of inquiry can draw on expertise from anywhere across the spectrum, from the medical, nursing, health and social care disciplines to management. Its ultimate aim should be to fuel significant progress and/or a fundamental change in our collective understanding of an important issue.

Categories include:

• Mental Health
• Acute Hospitals
• Primary Care
• Social Care
• Health and Well Being
• Quality & Patient Safety
• National Cancer Control Programme
• National Clinical Programmes

The proposal must meet the following minimum requirements:
Identify a principal investigator
Approach a topic of local or national significance
Identify a health service improvement as a result of the research
The output must be published in a peer-reviewed journal and openly accessible. Major dissertations which are openly accessible are also eligible. The authors must agree to deposit the research in Lenus the Irish health repository.
The research must have been published in the past 24 months.

Deadlines for entry
The 'Nomination for open access health research award' form is available at www.lenus.ie
Applicants should submit their form online by 5pm 28th November 2014. The successful applicant will be notified on 12th December 2014.

Key Dates & Times
Application Opening date 20th October, 2014, 09:00

Application Closing Date 28th November, 2014, 17:00

View more information here

Recent acquisitions

Located at 300.72 BAR

Located at 362.2 PIL

Located at 618.9201 GRI

Located at 174.29073 BAI

New world-class medical device research centre is to be established at NUI Galway

Pictured is Professor Abhay Pandit, NUI Galway with Professor Mark Ferguson, Director General of SFI. The aerosol technology allows drugs to be nebulized into a fine particle mist that can be absorbed through the lungs while maintaining drug integrity

A new world-class medical device research centre is to be established at NUI Galway as part of a €245 million Government investment in science and technology. In addition, NUI Galway is to play a key role in two other research centres announced today in Dublin by Richard Bruton, T.D. Minister for Jobs, Enterprise and Innovation, and Damien English, T.D. Minister for Skills, Research and Innovation.

An announcement of a total of five new SFI Research Centres today is a major investment by the Government in scientific research which is closely aligned to industry and enterprise needs, job opportunities and societal goals. A total of €155 million of Irish exchequer funding will be invested in the new world class research centres of scale. The new funding will be delivered through Science Foundation Ireland’s (SFI) Research Centres Programme coupled with over €90 million in cash and in-kind contributions from industry partners. The funding will be provided over the next six years with a mid-term review.

View Press Release here

Brain scans show cause of seasonal affective disorder

Scientists say they have identified the underlying reason why some people are prone to the winter blues, or seasonal affective disorder (SAD).

People with Sad have an unhelpful way of controlling the "happy" brain signalling compound serotonin during winter months, brain scans reveal.

As the nights draw in, production of a transporter protein ramps up in Sad, lowering available serotonin.

The work was presented this week at the ECNP congress in Berlin. Source: European College of Neuropsychopharmacology

The University of Copenhagen researchers who carried out the trial say their findings confirm what others have suspected - although they only studied 11 people with Sad and 23 healthy volunteers for comparison.

Using positron emission tomography (PET) brain scans, they were able to show significant summer-to-winter differences in the levels of the serotonin transporter (SERT) protein in Sad patients.

The Sad volunteers had higher levels of SERT in the winter months, corresponding to a greater removal of serotonin in winter, while the healthy volunteers did not.

Lead researcher, Dr Brenda Mc Mahon, said: "We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons.

"The serotonin transporter (SERT) carries serotonin back into the nerve cells where it is not active - so the higher the SERT activity, the lower the activity of serotonin."

Prof Siegfried Kasper, of the European College of Neuropsychophar­macology, which this year is holding its annual congress in Berlin, said: "SERT fluctuations associated with Sad have been seen in previous studies, but this is the first study to follow patients through summer and winter comparisons.

"It seems to offer confirmation that SERT is associated with Sad."

There are a range of treatments available for Sad, such as light therapy and cognitive behavioural therapy.

"We know that eating a balanced diet, cutting down on caffeine and getting some exercise can help, as can spending as much time as possible outdoors because - even when it's overcast - light will be higher than indoors."

Sad affects about two million people in the UK, and more than 12 million people across northern Europe.

View Research Study here: Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder. 

View BBC article here

Water and Birth Study

It's beyond water: Stories of women's experience of using water for labour and birth The Lancet

This Lancet study aimed to give ‘voice’ to women's experiences of using water for labour and birth.

Purpose:
This study aimed to give ‘voice’ to women's experiences of using water for labour and birth.

Participants:
Five women from a large urban region in New Zealand, who used water for labour and birth, at home and in hospital.

Methods:
The study employed an interpretive design using audio-taped conversations as the method of data collection and a thematic analysis of the women's stories.

Findings:
Data analysis produced two core categories; ‘Getting to the water’ which revealed the impact of preparing for and anticipating the water; and ‘Getting into the water’ which provided a sanctuary and a release from pain.

Conclusion:
The all-encompassing warmth associated with being enveloped in warm water cradled, supported, relaxed, comforted, soothed, sheltered and protected the women; it created a barrier and offered a sense of privacy. Water can be used in any form, even the act of thinking about, preparing for and anticipating the water opened possibilities for these women. The women used water to reduce their fear of pain and of childbirth itself; to cope with pain, not necessarily to remove or diminish pain; and to maintain control over the process of birth. The women indicated that it was not necessary to actually give birth in the water to achieve these benefits. Listening to the stories of women provides us with insights into what is important to them. Women's knowledge contributes an important part of the evidence on which we base our practice.

Innovative Surgery Supports Spinal Cord

A man paralysed from the waist down after his spinal cord was severed in a stabbing attack is able to walk again after undergoing pioneering surgery.

The 38-year-old Bulgarian patient, who suffered his injury in 2010, is believed to be the first person in the world to recover from complete severing of the spinal nerves.

Surgeons used nerve-supporting cells from Mr Fidyka’s nose to provide pathways along which the broken tissue was able to grow.  Despite success in the laboratory, it is the first time the procedure has been shown to work in a human patient.

Professor Geoffrey Raisman, whose team at University College London's Institute of Neurology discovered the technique, said: "We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury."

A Polish team led by one of the world's top spinal repair experts, Dr Pawel Tabakow, from Wroclaw Medical University, performed the surgery.  The procedure involved transplanting olfactory ensheathing cells (OECs) from the nose to the spinal cord.

OECs assist the repair of damaged nerves that transmit smell messages by opening up pathways for them to the olfactory bulbs in the forebrain.

Re-located to the spinal cord, they appear to enable the ends of severed nerve fibres to grow and join together - something that was previously thought to be impossible.

While some patients with partial spinal injury have made remarkable recoveries, a complete break is generally assumed to be unrepairable.

Prof Raisman said: "The observed wisdom is that the central nervous system cannot regenerate damaged connections. I've never believed that."

"Nerve fibres are trying to regenerate all the time. But there are two problems - crash barriers, which are scars, and a great big hole in the road."

"In order for the nerve fibres to express that ability they've always had to repair themselves, first the scar has to be opened up, and then you have to provide a channel that will lead them where they need to go."
He stressed that what had been achieved was a leap forward beyond promoting "plasticity" - the re-wiring of remaining connections.

View full report here

New mental health support website launched

'Your Mental Health' new website launched

A new website is being launched to provide information on mental health support services around Ireland.

Yourmentalhealth.ie is part of an awareness campaign by the National Office for Suicide Prevention.

It focuses on the "little things" that can help people feeling under pressure - including keeping active, talking to others and drinking less alcohol.

"The website has been constructed to give information about mental health - what it looks alike and what it feels like to mentally well, and mentally unwell," said Gerry Raleigh, Director of the National Office for Suicide Prevention. It gives very clear signposts for people in their locality of what services are available to them"

View press release here

Randomized Control Trials (RCTs)

To help remove the mystery associated with Randomized Control Trials (RCT), included is a review of a recent Library acquisition -

JADAD and ENKIN'S - Randomized Control Trials (RCT) - Questions, Answers and Musings (BMJ Books - 2nd edition)

 LOCATED AT - 615.50724 JAD

Reviewed by Paul S. Myles

Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Victoria

Since my early days in medicine, and later, clinical research, I was told and have taught that a double-blind randomised controlled trial (RCT) is the gold standard when evaluating new treatments in clinical settings. A sure way to avoid bias! But the results of an RCT, or its interpretation, can be misleading. It would be fair to say that all readers of this journal know of some RCTs that have been badly conducted, reported and interpreted and so have often disappointed. It is these issues that are nicely explored in this book: the authors state (p. 44), “Both of us were, and are, strong and enthusiastic proponents of RCTs. Indeed our support for RCTs has become even stronger as we have become more aware of their limitations. But it is no longer a blind faith, rather one that has been through and survived the crisis of doubt.”

This small, easy-to-read book explores the basic principles and purpose of randomisation in trial design, sources of bias, assessment of quality and recommendations for reporting trials, meta-analysis, and their roles in evidence-based practice. To my mind the best chapters are those detailing the many sources of bias, and the importance of clinical decision-making when determining whether a published RCT is relevant to an individual practice. Most readers would be aware of selection bias and ascertainment bias, but what about rivalry bias, small trial bias, flashy title bias, and belligerence bias? We know that the interpretation of medical ‘facts’ is heavily influenced by the vagaries of human perception and behaviour (and they’re not all nice).

One of the appealing features of this book is the musings section at the end of each chapter. Here the authors bring their own personal views and experience into play, dissecting the strengths and weaknesses of what is detailed in the particular chapter. For instance, on decision making they state, “we believe that the still present tendency to place RCTs at the top of the evidence hierarchy is fundamentally wrong … we are also very concerned that over-emphasis on randomised trials will divert scare resources from more relevant research into the determinants of health and illness, and blind us to the vital roles of common sense, experience, and personal values in health care”. Is it unethical not to do an RCT? Why is it that repeated calls for systematic reviews to be a requirement as a preamble to any proposed RCT remains unheard? Such musings provide food for thought, challenging established dogma and perhaps some of the readers’ beliefs. Evidence-based medicine might be a good thing, but it is dependent on progress in trial design, interpretation and uptake into clinical practice. This book is a welcome addition to my department's library.

New additions to our Library Collections

Located at 610.73 CUL

Located at 174.2 CHA

Located at 174.28 BAN

Located at 616.83 MUS

The Study of Epidemiology:

What is Epidemiology?

Epidemiology is the study of how often diseases occur in different groups of people and why.
Epidemiological information is used to plan and evaluate strategies to prevent illness and as a guide to the management of patients in whom disease has already developed.

Like the clinical findings and pathology, the epidemiology of a disease is an integral part of its basic description. The subject has its special techniques of data collection and interpretation, and its necessary jargon for technical terms. This short book aims to provide an ABC of the epidemiological approach, its terminology, and its methods. Our only assumption will be that readers already believe that epidemiological questions are worth answering. This introduction will indicate some of the distinctive characteristics of the epidemiological approach.

All findings must relate to a defined population
A key feature of epidemiology is the measurement of disease outcomes in relation to a population at risk. The population at risk is the group of people, healthy or sick, who would be counted as cases if they had the disease being studied. For example, if a general practitioner were measuring how often patients consult him about deafness, the population at risk would comprise those people on his list (and perhaps also of his partners) who might see him about a hearing problem if they had one. Patients who, though still on the list, had moved to another area would not consult that doctor. They would therefore not belong to the population at risk.

The importance of considering the population at risk is illustrated by two examples. In a study of accidents to patients in hospital it was noted that the largest number occurred among the elderly, and from this the authors concluded that "patients aged 60 and over are more prone to accidents." Another study, based on a survey of hang gliding accidents, recommended that flying should be banned between 11 am and 3 pm, because this was the time when 73% of the accidents occurred. Each of these studies based conclusions on the same logical error, namely, the floating numerator: the number of cases was not related to the appropriate "at risk" population. Had this been done, the conclusions might have been different. Differing numbers of accidents to patients and to hang gliders must reflect, at least in part, differing numbers at risk. Epidemiological conclusions (on risk) cannot be drawn from purely clinical data (on the number of sick people seen).

Implicit in any epidemiological investigation is the notion of a target population about which conclusions are to be drawn. Occasionally measurements can be made on the full target population. In a study to evaluate the effectiveness of dust control measures in British coal mines, information was available on all incident (new) cases of coal workers' pneumoconiosis throughout the country.

View here in BMJ

Diagnosis and Treatment of Ebola in 'UpToDate'

• Search for the most UpToDate information on the Ebola virus disease
• Topic search on UpToDate in another language

Connect to UpToDate in the library catalogue here

Principles of Human Anatomy 13th Edition

The 13th edition of the popular Anatomy book Principles of Human Anatomy by Gerard Tortora has now arrived in the Nursing & Midwifery Library Located at 611 TOR

New books added to the library

Located at 615.1 BAK 

Located at 618.92462 EVI

Implications of concussion in sport

‘Concussion is the public health issue of our time and the most common form of brain injury’, this was the message iterated by brain injury specialists Acquired Brain Injury Ireland in Leinster House recently, at the hearings on the Implications of Concussion in Sport, held by the Joint Committee on Health and Children.

Speaking at the hearing was Barbara O’ Connell, CEO Acquired Brain Injury Ireland, she said, “Campaigning about concussion is a call for a change in concussion education and guidelines, along with an increased awareness among young players, coaches and parents.

Dublin football player and ABI Ireland Ambassador Michael Darragh Macauley was also present at Leinster house to talk about concussion from a players perspective; he said “As players we are our own worst enemies when it comes to sitting out with a concussion. Aconcussed player has impaired decision making when you are asking them are they fine, so we are in no fit state to make the correct call. The decision for a player to sit out after a knock to the head must be decided by the coach or management team. Don’t leave the decision up to us – Take us out of the game”.

Less than 10% of concussions are actual knock-outs, leaving 90% of concussions to be detected by the coach or reported by the player. To tackle the concussion crisis we must give players, coaches and parents the tools to recognise the signs and symptoms of a concussed player; and get these players off the pitch.

Report Implications of Concussion in Sport 

View full press release here

Recent Obesity Study - UCC/UCD

Childhood overweight and obesity rates have plateaued in primary school aged children in the Republic of Ireland, reveals research published today in the open access journal BMC Public Health. The study found that although obesity rates remain high, there is evidence that they have stabilised and may be beginning to fall.

The prevalence of obesity dropped from 7pc to 4pc after 2008, the analysis of 14 previous studies of children between 2002 and 2012 found.

Despite the trend, the researchers in University College Cork and University College Dublin warned against complacency.

They say there is some room for cautious optimism but that the current plateau is at an "unacceptably high level".

The study found that up to one in 50 of the primary school children are morbidly obese, and there was no significant change in the rate over the decade.

The combined prevalence of overweight and obesity in children varied from 20pc-34pc.  There was little variation in the rate of children over time who were overweight, although the most recent study showed a fall. But this may be due to the young age of the children, who were seven years old.

The Irish studies found that on average the prevalence of overweight and obesity is higher in girls than in boys.

The study showed that during the last three decades of the 20th Century, a two to three-fold increase in overweight and obesity prevalence in school age children was reported across regions in North America and Western Europe.

It was forecast that obesity rates would continue to rise in the future but recent studies have showed that rates in developed countries may be starting to stabilise.

Eimear Keane of University College Cork said: "Our research suggests that prevalence rates of childhood obesity in Ireland have levelled off.

"Obesity continues to have a significant impact on health and well-being, therefore policies that tackle the problem should be intensified."

The authors stressed the need to have a standardised method for the conduct of studies that measure overweight and obesity in childhood.

View research article here: Trends and prevalence of overweight and obesity in primary school aged children in the Republic of Ireland from 2002-2012: a systematic review