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  • Review of international ethics frameworks used in policy-making in the context of screening

    Health Information and Quality Authority (HIQA); Health Information and Quality Authority (HIQA) (Health Information and Quality Authority (HIQA), 2021-11-30)
  • Future of Probiotics and Prebiotics and the Implications for Early Career Researchers.

    Spacova, Irina; Dodiya, Hemraj B; Happel, Anna-Ursula; Strain, Conall; Vandenheuvel, Dieter; Wang, Xuedan; Reid, Gregor (2020-06-24)
    The opportunities in the fields of probiotics and prebiotics to a great degree stem from what we can learn about how they influence the microbiota and interact with the host. We discuss recent insights, cutting-edge technologies and controversial results from the perspective of early career researchers innovating in these areas. This perspective emerged from the 2019 meeting of the International Scientific Association for Probiotics and Prebiotics - Student and Fellows Association (ISAPP-SFA). Probiotic and prebiotic research is being driven by genetic characterization and modification of strains, state-of-the-art in vitro, in vivo, and in silico techniques designed to uncover the effects of probiotics and prebiotics on their targets, and metabolomic tools to identify key molecules that mediate benefits on the host. These research tools offer unprecedented insights into the functionality of probiotics and prebiotics in the host ecosystem. Young scientists need to acquire these diverse toolsets, or form inter-connected teams to perform comprehensive experiments and systematic analysis of data. This will be critical to identify microbial structure and co-dependencies at body sites and determine how administered probiotic strains and prebiotic substances influence the host. This and other strategies proposed in this review will pave the way for translating the health benefits observed during research into real-life outcomes. Probiotic strains and prebiotic products can contribute greatly to the amelioration of global issues threatening society. The intent of this article is to provide an early career researcher's perspective on where the biggest opportunities lie to advance science and impact human health.
  • Developing a complex intervention targeting antipsychotic prescribing to nursing home residents with dementia.

    Walsh, Kieran A; Byrne, Stephen; McSharry, Jenny; Browne, John; Irving, Kate; Hurley, Eimir; Rochford-Brennan, Helen; Geoghegan, Carmel; Presseau, Justin; Timmons, Suzanne; et al. (PMC, 2021-02-19)
    Background: Antipsychotics are commonly prescribed to people living with dementia in nursing home settings, despite strong guideline recommendations against their use except in limited circumstances. We aimed to transparently describe the development process for a complex intervention targeting appropriate requesting and prescribing of antipsychotics to nursing home residents with dementia in Ireland, by nurses and general practitioners (GPs) respectively. Methods: We report the development process for the 'Rationalising Antipsychotic Prescribing in Dementia' (RAPID) complex intervention, in accordance with the 'Guidance for reporting intervention development studies in health research' (GUIDED) checklist.  The UK Medical Research Council framework for developing and evaluating complex interventions guided our overall approach, incorporating evidence and theory into the intervention development process. To unpack the intervention development process in greater detail, we followed the Behaviour Change Wheel approach. Guided by our stakeholders, we conducted three sequential studies (systematic review and qualitative evidence synthesis, primary qualitative study and expert consensus study), to inform the intervention development. Results: The RAPID complex intervention was developed in collaboration with a broad range of stakeholders, including people living with dementia and family carers, between 2015 and 2017. The finalised RAPID complex intervention was comprised of the following three components; 1) Education and training sessions with nursing home staff; 2) Academic detailing with GPs; 3) Introduction of an assessment tool to the nursing home. Conclusions: This paper describes the steps used by the researchers to develop a complex intervention targeting antipsychotic prescribing to nursing home residents with dementia in Ireland, according to the GUIDED checklist. We found that the GUIDED checklist provided a useful way of reporting all elements in a cohesive manner and complemented the other tools and frameworks used. Transparency in the intervention development processes can help in the translation of evidence into practice.
  • Bringing Shame Out of the Shadows: Identifying Shame in Child Sexual Abuse Disclosure Processes and Implications for Psychotherapy.

    McElvaney, Rosaleen; Lateef, Rusan; Collin-Vézina, Delphine; Alaggia, Ramona; Simpson, Megan; Dublin City University, Dublin, Ireland. 2McGill University, Montreal, Canada. 3University of Toronto, Canada. 4Carlton University, Ottawa, Canada. (SAGE Journals, 2021-08-30)
  • New hepatitis C virus infection, re-infection and associated risk behaviour in male Irish prisoners: a cohort study, 2019.

    Crowley, Des; Avramovic, Gordana; Cullen, Walter; Farrell, Collette; Halpin, Anne; Keevans, Mary; Laird, Eamon; McHugh, Tina; McKiernan, Susan; Miggin, Sarah Jayne; et al. (BMC, 2021-06-08)
  • Strains Isolated From Kombucha: Fundamental Insights, and Practical Application in Low Alcohol Beer Brewing.

    Bellut, Konstantin; Krogerus, Kristoffer; Arendt, Elke K (2020-04-23)
    With a growing interest in non-alcoholic and low alcohol beer (NABLAB), researchers are looking into non-conventional yeasts to harness their special metabolic traits for their production. One of the investigated species is Lachancea fermentati, which possesses the uncommon ability to produce significant amounts of lactic acid during alcoholic fermentation, resulting in the accumulation of lactic acid while exhibiting reduced ethanol production. In this study, four Lachancea fermentati strains isolated from individual kombucha cultures were investigated. Whole genome sequencing was performed, and the strains were characterized for important brewing characteristics (e.g., sugar utilization) and sensitivities toward stress factors. A screening in wort extract was performed to elucidate strain-dependent differences, followed by fermentation optimization to enhance lactic acid production. Finally, a low alcohol beer was produced at 60 L pilot-scale. The genomes of the kombucha isolates were diverse and could be separated into two phylogenetic groups, which were related to their geographical origin. Compared to a Saccharomyces cerevisiae brewers' yeast, the strains' sensitivities to alcohol and acidic conditions were low, while their sensitivities toward osmotic stress were higher. In the screening, lactic acid production showed significant, strain-dependent differences. Fermentation optimization by means of response surface methodology (RSM) revealed an increased lactic acid production at a low pitching rate, high fermentation temperature, and high extract content. It was shown that a high initial glucose concentration led to the highest lactic acid production (max. 18.0 mM). The data indicated that simultaneous lactic acid production and ethanol production occurred as long as glucose was present. When glucose was depleted and/or lactic acid concentrations were high, the production shifted toward the ethanol pathway as the sole pathway. A low alcohol beer (<1.3% ABV) was produced at 60 L pilot-scale by means of stopped fermentation. The beer exhibited a balanced ratio of sweetness from residual sugars and acidity from the lactic acid produced (13.6 mM). However, due to the stopped fermentation, high levels of diacetyl were present, which could necessitate further process intervention to reduce concentrations to acceptable levels.
  • Meeting Malaria.

    de Sousa, Emma (2020)
  • Characterization of the 'White' Appearing Clots that Cause Acute Ischemic Stroke.

    Health Information and Quality Authority (HIQA); Mereuta, Oana Madalina; Rossi, Rosanna; Douglas, Andrew; Gil, Sara Molina; Fitzgerald, Seán; Pandit, Abhay; McCarthy, Ray; Gilvarry, Michael; Ceder, Eric; et al. (Health Information and Quality Authority (HIQA), 2021-09-27)
  • A cost comparison study to review community versus acute hospital models of nursing care delivered to oncology patients.

    O'Mahony, Cian; Murphy, Kevin D; O'Brien, Gary L; Aherne, Joe; Hanan, Terry; Mullen, Louise; Keane, Maccon; Donnellan, Paul; Davey, Claire; Browne, Helen; et al. (Elsevier, 2020-09-28)
  • Public Reporting of Adverse Events From Long-Term Care Facilities for Older Persons and People With Disability in Ireland 2013-2019: Development of an Openly Accessible Database and Descriptive Analyses.

    Health Information and Quality Authority (HIQA); O'Regan, Stephanie; McGrane, Niall; Dunbar, Paul; Dunnion, Mary; Leistikow, Ian; O'Connor, Laura M; Health Information and Quality Authority (HIQA), Unit 1301, City Gate, Mahon, Cork, Republic of Ireland. 2Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, the Netherlands; Dutch Health and Youth Care Inspectorate, Utrecht, the Netherlands. 3Health Information and Quality Authority (HIQA), Unit 1301, City Gate, Mahon, Cork, Republic of Ireland. Electronic address: (Health Information and Quality Authority (HIQA), 2021-10-15)
  • Does high COVID-19 spread impact neighbouring countries? Quasi-experimental evidence from the first year of the pandemic in Ireland.

    Ahmed, Rakesh; May, Peter (2021-09-06)
    Background : Coronavirus disease 2019 (COVID-19) has necessitated public health responses on an unprecedented scale. Controlling infectious diseases requires understanding of the conditions that increase spread. Prior studies have identified sociodemographic, epidemiological and geographic associations. Ireland offers an unusual opportunity to quantify how high infection rates in one country impacted cases in a neighbouring country. Methods : We analysed official statistics on confirmed COVID-19 cases on the island of Ireland for 52 weeks from March 2020. Our main research question was: Did higher cases in Northern Ireland (NI) impact the number of cases in the Republic of Ireland (ROI)? We used least squares regression to compare confirmed cases in ROI counties that border NI with the rest of the state. We included in our model sociodemographic, epidemiological and geographic factors. We employed the latitude of each county town as an instrumental variable to isolate a quasi-experimental estimate of the cross-border spread. Results : In the quasi-experimental framework, and controlling for population density, age distribution and circulatory disease prevalence, border counties had an extra 21.0 (95%CI: 8.4-33.6) confirmed COVID-19 cases per 1000 people. This equates to an estimated 9,611 additional cases in ROI, or 4% of the national total in the first year of the pandemic. Our results were substantively similar in non-experimental frameworks, with alternative additional predictors, and in sensitivity analyses. Additionally, population density in ROI counties was positively associated with confirmed cases and higher proportions of residents in the professional classes was negatively associated. Conclusion : On the island of Ireland during the first year of the COVID-19 pandemic, high infection rates in NI increased cases in the neighbouring ROI. Maximising co-ordination of pandemic responses among neighbouring countries is essential to minimising disease spread, and its associated disruptions to society and the economy. Socioeconomic disadvantage appeared to confer significant additional risk of spread.
  • End-of-life experience for older adults in Ireland: results from the Irish longitudinal study on ageing (TILDA).

    May, Peter; Roe, Lorna; McGarrigle, Christine A; Kenny, Rose Anne; Normand, Charles (2020-02-14)
  • Caring for someone at home who is nearing the end of life

    Irish Hospice Foundation (Irish Hospice Foundation, 2021-05)
  • Population-based palliative care planning in Ireland: how many people will live and die with serious illness to 2046?

    May, Peter; Johnston, Bridget M; Normand, Charles; Higginson, Irene J; Kenny, Rose Anne; Ryan, Karen (2019-12-03)
    Background: All countries face growing demand for palliative care services.  Projections of need are essential to plan care in an era of demographic change.   We aim to estimate palliative care needs in Ireland from 2016 to 2046. Methods: Static modelling of secondary data.  First, we estimate the numbers of people in Ireland who will die from a disease associated with palliative care need.  We combine government statistics on cause of death (2007-2015) and projected mortality (2016-2046).  Second, we combine these statistics with survey data to estimate numbers of people aged 50+ living and dying with diseases associated with palliative care need.  Third, we use these projections and survey data to estimate disability burden, pain prevalence and health care utilisation among people aged 50+ living and dying with serious medical illness. Results: In 2016, the number of people dying annually from a disease indicating palliative care need was estimated as 22,806, and the number of people not in the last year of life aged 50+ with a relevant diagnosis was estimated as 290,185.  Equivalent estimates for 2046 are 40,355 and 548,105, increases of 84% and 89% respectively.  These groups account disproportionately for disability burden, pain prevalence and health care use among older people, meaning that population health burdens and health care use will increase significantly in the next three decades. Conclusion: The global population is ageing, although significant differences in intensity of ageing can be seen between countries. Prevalence of palliative care need in Ireland will nearly double over 30 years, reflecting Ireland's relatively young population.  People living with a serious disease outnumber those in the last year of life by approximately 12:1, necessitating implementation of integrated palliative care across the disease trajectory. Urgent steps on funding, workforce development and service provision are required to address these challenges.
  • Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review.

    McCarron, Mary; Lombard-Vance, Richard; Murphy, Esther; May, Peter; Webb, Naoise; Sheaf, Greg; McCallion, Philip; Stancliffe, Roger; Normand, Charles; Smith, Valerie; et al. (2019-04-25)
  • Hypertensive disorders of pregnancy and the risk of chronic kidney disease: A Swedish registry-based cohort study.

    Health Service Executive; Barrett, Peter M; McCarthy, Fergus P; Evans, Marie; Kublickas, Marius; Perry, Ivan J; Stenvinkel, Peter; Khashan, Ali S; Kublickiene, Karolina; School of Public Health, University College Cork, Cork, Ireland. 2Irish Centre for Maternal and Child Health Research, University College Cork, Cork, Ireland. 3Department of Obstetrics & Gynaecology, Cork University Maternity Hospital, Cork, Ireland. 4Division of Renal Medicine, Department of Clinical Intervention, Science and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. 5Department of Obstetrics & Gynaecology, Karolinska University Hospital, Stockholm, Sweden. (Plos Medicine, 2020-08-14)
  • Adverse Pregnancy Outcomes and Long-term Maternal Kidney Disease: A Systematic Review and Meta-analysis.

    Health Service Executive; Barrett, Peter M; McCarthy, Fergus P; Kublickiene, Karolina; Cormican, Sarah; Judge, Conor; Evans, Marie; Kublickas, Marius; Perry, Ivan J; Stenvinkel, Peter; et al. (Jama Network, 2020-02-05)
  • Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a 'natural experiment' allowing analysis of data from the prior two decades.

    Health Service Executive; Philip, Roy K; Purtill, Helen; Reidy, Elizabeth; Daly, Mandy; Imcha, Mendinaro; McGrath, Deirdre; O'Connell, Nuala H; Dunne, Colum P; Division of Neonatology, Department of Paediatrics, University of Limerick School of Medicine, Limerick, Ireland 2Division of Neonatology, Department of Paediatrics, University Maternity Hospital Limerick (UMHL), Limerick, Ireland. 3Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland. 4Midwifery and Neonatal Nursing, University Maternity Hospital Limerick (UMHL), Limerick, Ireland. 5Advocacy and Policymaking, Irish Neonatal Health Alliance (INHA), Dublin, Ireland. 6Obstetrics and Gynaecology, University Maternity Hospital Limerick (UMHL), Limerick, Ireland. 7Centre for Interventions in Infection, Inflammation and Immunity (4i), University of Limerick School of Medicine, Limerick, Ireland. 8Clinical Microbiology, University Hospital Limerick (UHL), Dooradoyle, Limerick, Ireland. (BMJ Journals, 2020-09-30)
  • Health service use among adults with cerebral palsy: a mixed-methods systematic review.

    Manikandan, Manjula; Kerr, Claire; Lavelle, Grace; Walsh, Michael; Walsh, Aisling; Ryan, Jennifer M; Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland. 2School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK. 3Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. 4National Clinical Programme for People with Disability, Clinical Design and Innovation Office, Health Service Executive, Dublin, Ireland. 5College of Health and Life Sciences, Brunel University, London, UK. (Wiley, 2021-10-27)

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