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Dashboards use a suite of visual analytics, such as various forms of graphs (e.g., line graphs, histograms, bar charts, pie charts), maps, and infographics (e.g., gauges, traffic lights, meters, arrows) to display and communicate time series and spatial data. 1 Most contemporary dashboards are dynamic (i.e., being updated as data, including real-time data, are released) and interactive (e.g., allowing selecting, filtering, and querying data; zooming in or out, panning, and overlaying; changing type of visualization).2 The power and utility of dashboards is that they act as effective cognitive tools for making sense of and tracking voluminous, varied, and quickly transitioning data, enabling users to examine emerging patterns and trends and make evidence- informed decisions and policy responses.3,4 Consequently, dashboards have become common across sectors as a means to communicate, monitor, track, analyze, and act on large volumes of dynamic data.

Background: Risk factors for poor maternal perinatal mental health include a previous mental health diagnosis, reduced access to perinatal services, economic concerns and decreased levels of social support. Adverse maternal perinatal mental health can negatively influence the psychological wellbeing of infants. The outbreak of the COVID-19 pandemic presented an additional stressor. While literature on the impact of COVID-19 on perinatal mental health exists, no systematic review has focused specifically on maternal perinatal mental health during periods of COVID-19 lockdown. Aims: This systematic review explores how periods of COVID-19 lockdown impacted women's perinatal mental health. Methods: Searches of CINAHL, PsycARTICLES, PsycINFO, PubMed, Scopus and Web of Science were conducted for literature from 1st January 2020 - 25th May 2021. Quantitative, peer-reviewed, cross-sectional studies published in English with perinatal women as participants, and data collected during a period of lockdown, were included. Data was assessed for quality and narratively synthesized. Findings: Sixteen articles from nine countries met the inclusion criteria. COVID-19 lockdowns negatively impacted perinatal mental health. Risk factors for negative perinatal mental health noted in previous literature were confirmed. In addition, resilience, educational attainment, trimester, and ethnicity were identified as other variables which may influence mental health during perinatal periods experienced during lockdown. Understanding nuance in experience and harnessing intra and interpersonal support could advance options for intervention. Conclusion: Developing resources for perinatal women that integrate informal sources of support may aid them when normal routine is challenged, and may mediate potential long-term impacts of poor perinatal maternal health on infants.

In 2020, schools worldwide closed due to the COVID-19 pandemic. Almost one million young people and children were impacted in Ireland, with those from ‘marginalised’ backgrounds being especially vulnerable due to pre-existing inequalities. The Crisis Coping for Marginalised Young People: Living and Learning through COVID- 19 project aimed to explore youth pandemic life and learning experiences and to support the needs of, particularly marginalised, young people, culminating in the implementation of supports for students in schools. Here, we present a praxeological account of the benefits and challenges associated with our novel methodology which involved working ‘through’ 14 final-year student teachers’ practitioner research projects in their designated disadvantaged or socio-demographically diverse placement schools (11) across six counties in the Republic of Ireland, involving 269 students. Supervised closely by the lead researchers, the teacher-researchers conducted empirical research in their schools (involving questionnaires with students and interviews with Principals) to inform the design of academic, social and mixed school-based interventions which were subsequently implemented and evaluated. The empirical findings pointed to young people’s concerns about social isolation, the stability of friendships and having fallen behind academically, and Principals’ concerns about supporting those from marginalised backgrounds and about creating a safe and happy environment upon return to in-person school. In this paper, we highlight our significantly improved understanding of the COVID-related experiences of young people from marginalised backgrounds but point to the uncertain effectiveness of the interventions for improving their educational readjustment. Further, we critically interrogate the challenges encountered which constrained the lead researchers’ and teacher-researchers’ actions.

Background: There has been an exponential growth in the prevalence of gestational diabetes (GDM) in the past decade, due in part to internationally adopted changes in the diagnostic criteria. Other important factors driving this trend include increasing rates of obesity, advancing maternal age and women embarking on pregnancy with progressively more complex background medical conditions. The significance of the increased rates of GDM is confronting healthcare systems that are striving to continue the provision of exemplary maternal and perinatal care in the context of ever more limited resources and over-burdened infrastructure. The advent of telemedicine, and its many branches, provides an opportunity to alleviate the pressure applied by the rising prevalence of many chronic health conditions. I sought to evaluate the impact of smartphone app-assisted care delivery in the context of GDM. To this end, I designed and developed a mobile phone app and hospital portal to facilitate self-management and remote monitoring for a cohort of women with GDM attending the diabetes obstetric clinic at a large tertiary-referral maternity hospital.  Methods: A comprehensive design and development phase of a prospective smartphone app and medical portal involving focus group discussions with key stakeholders and collaborators from industry and technology led to the eventual deployment of ‘GDMapp’. Women with a first-time diagnosis of GDM, commencing a trial of medical nutrition and lifestyle therapy, were approached for consideration of enrolment to an app-assisted healthcare model as an adjunctive measure of the standard telemedicine diabetes clinic. A proportion of participants additionally consented to acquisition of umbilical cord blood C-peptide levels at delivery. Patient and staff satisfaction with GDMapp-assisted care were evaluated through the distribution of questionnaires following study completion. Glycaemic, maternal, perinatal, and neonatal outcomes were compared between the app-using group and a matched historical control group availing of the standard telemedicine care pathway. A cost minimisation analysis was performed to assess the economic impact of implementation of app-assisted care. Data variables were summarised using univariable descriptive statistics and the groups were compared using statistical hypothesis testing.  Results: Final analysis involved 168 participants engaging in app-assisted healthcare delivery for GDM and a historical control group of 162 prospectively recruited patients from the telemedicine clinic, which represented the usual standard of care. Patients using the newly developed app had lower overall glycaemic indices across both fasting (p=0.022) and postprandial (p Conclusions: The development of an app-assisted model of care for GDM has shown promise in alleviating the healthcare burden on an over-stretched, resource limited hospital department. Use of GDMapp has facilitated and encouraged patient centred care, which has been readily adopted by patients, as demonstrated by significantly improved postprandial glycaemic control reflecting the benefit of the educational, motivational, and self-management tools within the app. This pathway of care has taken on increased merit in the face of the COVID-19 pandemic and offers an economically viable, clinically safe, and effective care provision structure for women diagnosed with GDM in Ireland. 

The Covid-19 pandemic has highlighted the importance of health technologies to mitigate against the spread of the disease and improve care, dominantly including life-saving vaccines. But the pandemic has also highlighted that the current biopharmaceutical business model, based on the enclosure of these technologies and on the immense accumulation of capital it enables, leads to vast inequalities in healthcare particularly in low and middle-income countries. We believe that the pharmaceutical industry has a moral duty to enable and enact global solidarity through tech sharing instead of tech hoarding, but judging by current technology transfer practices we question their willingness to assume their role in organizing healthcare markets through solidaristic principles. In the absence of a voluntary adoption of solidaristic principles and practices by biopharmaceutical firms, the institutionalization of global solidarity as a fundamental organizing principle for healthcare markets is necessary to strengthen resilience and know-how globally. With this call, we add to existing conceptualizations of solidarity by (a) introducing a global level of solidarity and (b) thinking through the concept not as an abstract humanistic stance but as a concrete organizing principle for global healthcare markets.

AbstractIn the face of the global pandemic caused by the disease COVID-19, researchers have increasingly turned to simple measures to detect and monitor the presence of the disease in individuals at home. We sought to determine if measures of neuromotor coordination, derived from acoustic time series, as well as phoneme-based and standard acoustic features extracted from recordings of simple speech tasks could aid in detecting the presence of COVID-19. We further hypothesized that these features would aid in characterizing the effect of COVID-19 on speech production systems. A protocol, consisting of a variety of speech tasks, was administered to 12 individuals with COVID-19 and 15 individuals with other viral infections at University Hospital Galway. From these recordings, we extracted a set of acoustic time series representative of speech production subsystems, as well as their univariate statistics. The time series were further utilized to derive correlation-based features, a proxy for speech production motor coordination. We additionally extracted phoneme-based features. These features were used to create machine learning models to distinguish between the COVID-19 positive and other viral infection groups, with respiratory- and laryngeal-based features resulting in the highest performance. Coordination-based features derived from harmonic-to-noise ratio time series from read speech discriminated between the two groups with an area under the ROC curve (AUC) of 0.94. A longitudinal case study of two subjects, one from each group, revealed differences in laryngeal based acoustic features, consistent with observed physiological differences between the two groups. The results from this analysis highlight the promise of using nonintrusive sensing through simple speech recordings for early warning and tracking of COVID-19.

The distribution and redistribution of household incomes are explored at multiple geographical scales (state, region, county, metropolitan area and electoral district) using several databases compiled by the Central Statistics Office. This work complements an extensive body of published research that has been mostly undertaken at the level of the State without much consideration of trends and patterns at the levels of regions and smaller units. The focus here is primarily on a geographical exploration at different spatial scales of the distribution of incomes and of the factors that have influenced the distributions. International research has concluded that the transition to neoliberal economic strategies in most economically advanced countries over the last forty years was accompanied by an increasing divergence in per capita incomes between regions. In Ireland, however, the impact of neoliberal economic strategies in the context of an exceptionally open economy, was moderated for a period of over twenty years from the mid 1980s by an innovative and dynamic national model of social partnership. Personal and household incomes in Ireland increased significantly over the last 30 years and the overall level of inequality measured across all households in the State decreased, but it is still high in comparison to other EU countries, especially for market-based income. At the regional level, disparities in household incomes have declined but there remain large differences between the Dublin-dominated East region and the strongly rural Border and Midland regions. The transition to lower levels of inequality occurred in phases linked to the trajectory of the national economy. Inter-regional convergence was more likely during periods of significant economic slow-down as in the 1980s and again in the immediate aftermath of the economic and financial crisis in 2008. This particular form of convergence was not due to poorer regions ‘catching up’ with richer regions. It was instead more likely to be associated with a weakening of the stronger regions, while State transfers to low-income households and regions remained more resilient. Over the longer term, the evidence points towards a pattern of convergence between urban and rural areas in average household incomes. The micro-geographical data for 2016 at the level of Electoral Districts provide two important insights that are not apparent from regional data. Firstly, after exclusion of the five largest cities, there is no statistical relationship between median household incomes and the population size of settlements. The relative location of settlements in relation to the larger centres of employment, and especially the extent of commuting, is much more important. Secondly, the 2016 data show that the highest levels of inequality in income distribution profiles occur in both the cities and in some of the poorest rural counties, while the lowest levels are found in counties that experienced the highest levels of population increase over recent decades. The overall distribution map of household incomes is directly influenced by two sets of factors. The first relates to the spatial distributions of employment and earnings in different economic sectors. The second relates to the role of State transfers that provide benefits to a wide range of persons and households. They are especially important for places that may be considered ‘left-behind’ in the overall restructuring of the economy and society. In addition to the direct influences on the geography of incomes levels there are important background factors related especially to demography, education, female participation in the labour force and where households choose to live. The findings from the research have implications for many areas of public policy, most especially in relation to the spatial organisation of economic and social development. These challenges are not unique to Ireland and have contributed to narratives that extend beyond economic considerations to include potential adverse impacts on social cohesion, spatial justice and on basic principles of democracy if the underlying processes are not addressed. The experience from other countries, along with the patterns that remained dominant in Ireland, is that traditional approaches to regional development are no longer adequate. Policies that sought to overcome market failures and that relied on welfare transfers from rich to poor regions did not succeed. Neither did policies that sought to maximise the national economic growth by promoting agglomeration into the largest cities. The more recent focus on place-based development with a more explicit concern for a holistic, human-centred approach informed by principles of spatial justice offers a prospect for a better future in all regions and places. While this research was being undertaken, there were some significant events that may impact on the future geography of incomes in Ireland. These include such international events as the departure of the UK from the EU, the legacy of the COvID 19 pandemic which accelerated a transition to new working arrangements including remote working, and the disruption of the global economy following the Russian invasion of Ukraine with consequent impacts on the costs of living especially for the elderly and those living in some rural areas. In addition, in Ireland there are very significant challenges in relation to the supply and affordability of housing. The critical roles of further and higher education in relation to employment and regional development are being addressed through recent reforms in both sectors, though these need to be linked more strongly to the overall strategy for regional development. Further research is needed to examine in more detail the relationship between the geographical distribution of incomes and commuting, and how it may be impacting on summary measures for rural and urban areas. In addition, a more sophisticated approach to the identification of a multi-level typology of places that includes both urban and rural areas and the linkages between them is urgently required to avoid a risk of over-simplification in the interpretation of the patterns revealed by the data.

Abstract Background The collateral damage of SARS-CoV-2 is a serious concern in the Emergency Medicine (EM) community, specifically in relation to delayed care increasing morbidity and mortality in attendances unrelated to COVID-19. The objectives of this study are to describe the profile of patients attending an Irish ED prior to, and during the pandemic, and to investigate the factors influencing ED utilisation in this cohort. Methods This was a cross-sectional study with recruitment at three time-points prior to the onset of COVID-19 in December 2019 (n = 47) and February 2020 (n = 57) and post-Lockdown 1 in July 2020 (n = 70). At each time-point all adults presenting over a 24 h period were eligible for inclusion. Clinical data were collected via electronic records and a questionnaire provided information on demographics, healthcare utilisation, service awareness and factors influencing the decision to attend the ED. Data analysis was performed in SPSS and included descriptive and inferential statistics. Results The demographic and clinical profile of patients across time-points was comparable in terms of age (p = 0.904), gender (p = 0.584) and presenting complaint (p = 0.556). Median length of stay in the ED decreased from 7.25 h (IQR 4.18–11.22) in February to 3.86 h (IQR 0.41–9.14) in July (p ≤ 0.005) and differences were observed in disposition (p ≤ 0.001). COVID-19 influenced decision to attend the ED for 31% of patients with 9% delaying presentation. Post-lockdown, patients were less likely to attend the ED for reassurance (p ≤ 0.005), for a second opinion (p ≤ 0.005) or to see a specialist (p ≤ 0.05). Conclusions Demographic and clinical presentations of ED patients prior to the first COVID-19 lockdown and during the reopening phase were comparable, however, COVID-19 significantly impacted health-seeking behaviour and operational metrics in the ED at this phase of the pandemic. These findings provide useful information for hospitals with regard to pandemic preparedness and also have wider implications for planning of future health service delivery.

Objectives To audit the transparent and open science standards ofhealth and medical sciences journal policies and explore the impact of the COVID-19 pandemic. Design  Repeat cross-sectional study.  Setting 19 journals listed in Google Scholar’s Top Publications for health and medical sciences.  Participants Blood, Cell, Circulation, European Heart Journal, Gastroenterology, Journal of Clinical Oncology, Journal of the American College of Cardiology, Nature Genetics, Nature Medicine, Nature Neuroscience, Neuron, PLoS ONE, Proceedings of the National Academy of Sciences, Science Translational Medicine, The British Medical Journal, The Journal of the American Medical Association, The Lancet, The Lancet Oncology, and The New England Journal of Medicine  Main outcome measures We used the Transparency and Openness Promotion (TOP) guideline and the International Committee of Medical Journal Editors (ICMJE) requirements for disclosing conflicts of interest (COIs) to evaluate journals standards.  Results TOP scores slightly improved during the COVID-19 pandemic, from a median of 5 (IQR: 2–12.5) out of a possible 24 points in February 2020 to 7 (IQR: 4–12) in May 2021, but overall, scores were very low at both time points. Journal policies scored highest for their adherence to data transparency and scored lowest for preregistration of study protocols and analysis plans and the submission of replication studies. Most journals fulfilled all ICMJE provisions for reporting COIs before (84%; n = 16) and during (95%; n = 18) the COVID-19 pandemic.  Conclusions The COVID-19 pandemic has highlighted the importance of practising open science. However, requirements for open science practices in audited policies were overall low, which may impede progress in health and medical research. As key stakeholders in disseminating research, journals should promote a research culture of greater transparency and more robust open science practices.