RSS 1.0Journal articles & published research
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Health Literacy, Health Service Delivery and Health Outcomes: Current Understanding and Future Directions(Irish Medical Journal, 2018-10)
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Exercise Rehabilitation Services Provided by Physiotherapy Departments in Cancer Care in Ireland(Irish Medical Journal, 2018-10)
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An Evaluation of The Role of The Traveller Mental Health Liaison Nurse in Carlow and Kilkenny(School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, 2018-10)
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The knowledge and attitudes of general practitioners to the assessment and management of pain in people with dementia(BMC Family Practice, 2018-10)
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An Evaluation of the MindOut Programme in Disadvantaged Post-Primary Schools (Executive Summary)(Health Service Executive, 2018-10-01)
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Specialized cleaning associated with antimicrobial coatings for reduction of hospital-acquired infection: opinion of the COST Action Network AMiCI (CA15114).(Journal of Hospital Infection, 2018-07-01)Recognized issues with poor hand hygiene compliance among healthcare workers and reports of recontamination of previously chemically disinfected surfaces through hand contact emphasize the need for novel hygiene methods in addition to those currently available. One such approach involves antimicrobial (nano) coatings (AMCs), whereby integrated active ingredients are responsible for elimination of micro-organisms that come into contact with treated surfaces. While widely studied under laboratory conditions with promising results, studies under real-life healthcare conditions are scarce. The views of 75 contributors from 30 European countries were collated regarding specialized cleaning associated with AMCs for reduction of healthcare-associated infection. There was unanimous agreement that generation of scientific guidelines for cleaning of AMCs, using traditional or new processes, is needed. Specific topics included: understanding mechanisms of action of cleaning materials and their physical interactions with conventional coatings and AMCs; that assessments mimic the life cycle of coatings to determine the impact of repetitive cleaning and other aspects of ageing (e.g. exposure to sunlight); determining concentrations of AMC-derived biocides in effluents; and development of effective de-activation and sterilization treatments for cleaning effluents. Further, the consensus opinion was that, prior to widespread implementation of AMCs, there is a need for clarification of the varying responsibilities of involved clinical, healthcare management, cleaning services and environmental safety stakeholders.
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Air embolism following bronchoscopy with fine needle aspiration: An unexpected complication.(Respiratory Medicine Case Reports, 2018-01-01)Flexible fibreoptic bronchoscopy with fine needle aspiration is a common procedure, useful in the diagnosis and assessment of lung disease. There are known complications associated with such a procedure that are well documented in the literature. However, there are only four cases of air embolus following fine needle aspiration during bronchoscopy described in the literature. Due to the varying clinical manifestations of the complication, it remains underrecognized by the clinical community and was not described at all by the most recent British Thoracic society 2013 statement on bronchoscopy. The following two case reports describe incidences where air emboli ensued following bronchoscopy with fine needle aspiration. They examine four notable, and arguably avoidable, risk factors that can exacerbate an air embolus and offer guidance on both imaging and treatment for any physician faced with a corresponding clinical picture.
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The barriers and facilitators to the implementation of National Clinical Programmes in Ireland: using the MRC framework for process evaluations.(BMC Health Services Research, 2018-09-24)A major healthcare reform agenda in Ireland is underway which underpins the establishment of a series of National Clinical Programmes (NCPs), which aim to take an evidence based approach to improve quality, access and value. The current study aimed to determine the enablers and barriers to implementation of the NCPs. A qualitative methodology advocated by the Medical Research Council (MRC) framework on conducting process evaluations of complex interventions guided this research. Purposive sampling techniques were used to recruit participants from seven NCPs across both acute and chronic healthcare domains, comprised of orthopaedics, rheumatology, elective surgery, emergency medicine, paediatrics, diabetes and chronic obstructive pulmonary disease. A total of 33 participants were interviewed using a semi-structured interview guide. Participants included current and previous Clinical Leads, Programme Managers, Health Service Executive management, hospital Chief Executive Officers, representatives of General Practice, and a Nursing and a Patient representative. Thematic analyses was conducted. A range of factors of different combinations and co-occurrence were highlighted across a total of six themes, including (i) positive leadership, governance and clinical networks of the NCPs, (ii) the political and social context in which the NCPs operate, (iii) constraints on resources, (iv) a passive attitudinal resistance to change borne from poor consultation and communication, (v) lack of data and information technology, (vi) forces outside of the NCPs such as the general practitioner contract thwarting change of the model of care. The MRC framework proved a useful tool to conduct this process evaluation. Results from this research provide real world experiences and insight from the people charged with implementing large-scale health system improvement initiatives. The findings highlight the need for measured responses that acknowledge both direct and non-direct challenges and opportunities for successful change. Combined, it is recommended that these elements be considered in the planning and implementation of large-scale initiatives across healthcare delivery systems, both in Ireland and internationally.
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Developing a PPI Strategy: A Guide Practical advice on developing a patient and public involvement (PPI) strategy for research activities(Medical Research Charities Group, 2018)
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A Good Death: Progress Report: Developments in End of Life Care in Irish Hospitals since the publication of the Ombudsman’s report in 2014.(Office of the Ombudsman, 2018-09)
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Incidence of Thyroid Cancer among Patients with Thyroid Nodules(Irish Medical Journal, 2018-09)
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The Physical Examination on Admission to the Acute Psychiatric Unit - complete Audit cycle(Irish Medical Journal, 2018-09)
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The human mesenteric lymph node microbiome differentiates between Crohn’s disease and ulcerative colitis(Journal of Crohn's and Colitis (JCC), 2018-09)
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Influenza infection directly alters innate IL-23 and IL-12p70 and subsequent IL-17A and IFN-γ responses to pneumococcus in vitro in human monocytes.(Plos One, 2018-01-01)Influenza virus is highly contagious and poses substantial public health problems due to its strong association with morbidity and mortality. Approximately 250,000-500,000 deaths are caused by seasonal influenza virus annually, and this figure increases during periods of pandemic infections. Most of these deaths are due to secondary bacterial pneumonia. Influenza-bacterial superinfection can result in hospitalisation and/or death of both patients with pre-existing lung disease or previously healthy individuals. The importance of our research is in determining that influenza and its component haemagglutinin has a direct effect on the classic pneumococcus induced pathways to IL-17A in our human ex vivo model. Our understanding of the mechanism which leaves people exposed to influenza infection during superinfection remain unresolved. This paper demonstrates that early infection of monocytes inhibits an arm of immunity crucial to bacterial clearance. Understanding this mechanism may provide alternative interventions in the case of superinfection with antimicrobial resistant strains of bacteria.
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Addiction Social Work Fellowship Program in Canada(Journal of Social Work Practice in the Addictions, 2018)
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It's not all about price: factors associated with roll-your-own tobacco use among young people - a qualitative study.(BMC Public Health, 2018-08-08)Smoking prevalence in Ireland is falling in all age groups, but the prevalence of roll-your-own (RYO) tobacco use is rising among young people. This qualitative study aims to explore and understand the factors associated with young people's use of RYO products. Semi-structured individual and focus group interviews were conducted with young people aged 16-22 years. Participants were recruited from a higher education institution and youth organisations working with early school leavers across Dublin. In total, there were 62 participants in the study, consisting of 22 individual interviews and eight focus group interviews with 40 participants. Categoric and thematic data analysis was used to generate the findings. We identified two broad themes, incentivising and disincentivising factors. The lower cost of RYO products compared to pre-manufactured cigarettes was the most important incentive for users. However, other product characteristics, such as the artisanal factors associated with RYO products were also found. Social and environmental influences were apparent, in which certain groups and environments facilitated and normalised RYO practices. Amenities and facilities often provided smokers with normalised spaces which could be dedicated to the enactment of rolling practices and to the creation and maintenance of social bonds with other users. Disincentives included negative features related to the product itself, adverse health effects, and the effects of tobacco denormalisation. While the lower cost of RYO products is very important for young smokers, other product characteristics and influences also incentivise and disincentivise use. A more comprehensive understanding of the multi-dimensional appeal of these products will assist policymakers to target strategies to reduce the attractiveness to young smokers of these products.
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Therapeutics Today June 2018(St. James’s Hospital, 2018-06)
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Therapeutics Today August 2018(St. James’s Hospital, 2018-08)
