RSS 1.0Journal articles & published research
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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)
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Frameworks for self-management support for chronic disease: a cross-country comparative document analysis.(BMC health services research, 2018-07-25)Differences across frameworks may have implications for their success including: the extent to which people with chronic disease are involved in policy making; the courses of action taken to enhance SMS; and planned implementation processes including governance and infrastructure. Further research is needed to examine how differences in frameworks have affected implementation and to identify the critical success factors in SMS policy implementation.
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Model of Care for Anaesthesia(Model of Care for Anesthesia Working Group, 2018)
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Irish Hip Fracture Database National Report 2015(National Office of Clinical Audit, 2016-11)
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National Audit of Hospital Mortality Annual Report 2016(National Office of Clinical Audit, 2017)
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National Major Trauma Audit National Report 2014-2015.(National Office of Clinical Audit, 2016)
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Team interventions in acute hospital contexts: a systematic search of the literature using realist synthesis.(BMC Health Services Research, 2018-07-11)The advantage of using realist synthesis to extrapolate data from the literature is that it considers the context and mechanisms that will impact effectiveness of healthcare team interventions. This methodological approach provides a different perspective to other types of syntheses and offers insight as to why certain contextual elements may yield more success than others. Findings therefore tend to have more practical implications. Specificity of detail in terms of how external drivers impact on healthcare team interventions was limited in the articles extracted for analysis. This broader perspective is therefore an important consideration for future research.
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The CHARMS pilot study: a multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland.(Pilot and feasibility studies, 2018-07)This article reports the successful piloting of a novel sexual counselling implementation intervention in cardiac rehabilitation. The utilisation of an extended reporting framework and the ADePT process facilitated the identification of adaptations necessary to ensure the feasibility of a definitive trial, thereby maximising methodological transparency.
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Major Trauma Audit National Report 2016(National Office of Clinical Audit, 2018)
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The awareness of healthcare staff towards post-stroke cognitive impairment: a cross sectional study.(The Journal of Physical Therapy Science, 2018-06)[Purpose] This study aimed to determine the awareness amongst healthcare staff of post-stroke cognitive impairment in a university teaching hospital and supporting stroke rehabilitation unit. [Subjects and Methods] A cross sectional study was employed to collect data from 20 healthcare staff about post-stroke cognitive impairment. This study was conducted in Ireland at two sites, the Acute Stroke unit in Cork University Hospital, and the Stroke Rehabilitation unit and Assessment and Treatment Centre in St. Finbarr's Hospital. [Results] Approximately 75% of participants felt that they had knowledge about post-stroke cognitive deficits, with around 50% of them having patients with persistent cognitive decline between 40% and 60%. Most participants (70%) agreed that cognitive function should be routinely assessed and the majority (85%) discussed the potential impact of post-stroke cognitive deficits with patients and their families. However, some participants need to be aware of post-stroke cognitive deterioration. [Conclusion] Although there was evidence of good practice, a small number of healthcare staff felt that they did not have sufficient knowledge about post-stroke cognitive deficits. Thus, further professional education should be provided to improve the knowledge of healthcare staff about potential cognitive impairments after stroke.
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Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group(2018-06-19)Abstract Background Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion. Recommendations Adhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO. Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention. Discussion This guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
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Case fatality ratios for serious emergency conditions in the Republic of Ireland: a longitudinal investigation of trends over the period 2002–2014 using joinpoint analysis(BMC health services research, 2018-06-29)
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Autotransplantation of premolars in children with congenitally absent teeth: a report of three cases(Irish Medical Journal, 2018-06)
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Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews.(BMC Public Health, 2018-01)Within each UVG identified, there are a variety of health beliefs and objections to vaccination. In addition, similar factors are shared by several of these groups. Communication strategies regarding these similar factors such as educating people about the risks associated with being vaccinated versus not being vaccinated, addressing their concerns, and countering vaccination myths present among members of a specific UVG through a trusted source, can establish a reliable relationship with these groups and increase their vaccination uptake. Furthermore, other interventions such as improving access to health care could certainly increase vaccination uptake in Roma and Irish travellers.
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The ExPeCT (Examining Exercise, Prostate Cancer and Circulating Tumour Cells) trial: study protocol for a randomised controlled trial.(Trials, 2017-10-04)Clinicaltrials.gov NLM identifier: NCT02453139 . Registered on 12 May 2015. This document contains excerpts from the ExPeCT trial protocol Version 1.5, 28 July 2016.
