• Obesity Prevention Programs in Children: The Most Effective Settings and Components. A Literature Review

      Merrotsy, Alison; McCarthy, Aoife; Flack, Jennifer; Coppinger, Tara (Journal of Obesity and Chronic Diseases, 2018)
    • Obstructive sleep apnoea in adults

      Ruth, Alan (Nursing in General Practice, 2014-09)
    • Offloading for the treatment of the diabetic foot: a systematic review [Thesis] / by Ana Lucia de Oliveira

      de Oliveira, Ana Lucia M; National University of Ireland Royal College of Surgeons in Ireland Faculty of Nursing and Midwifery (Royal College of Surgeons in Ireland, 2013-06)
    • Older LGBT people's experiences and concerns with healthcare professionals and services in Ireland

      Sharek, Danika Burke; McCann, Edward; Sheerin, Fintan; Glacken, Michele; Higgins, Agnes (International Journal of Older People Nursing, 2014-11)
    • Older Patients’ Views of Health Care Interactions in Ireland

      Gibney, Sarah; Moore, Tara; Department of Health (HLRP: Health Literacy Research and Practice, 2018-10)
    • Older people - experience and issues

      Walsh, Kathy; Harvey, Brian (St Vincent de Paul, 2011-10)
    • Older women workers' access to pensions: vulnerabilities, perspectives and strategies

      Duvvury, Nata; Ni Leime, Aine; Callan, Aoife; Price, Linda; Simpson, Mark; NUI Galway, Queen's University Belfast (NUI Galway, 2012-02)
    • The open abdomen in trauma and non-trauma patients: WSES guidelines

      Coccolini, Federico; Roberts, Derek; Ansaloni, Luca; Ivatury, Rao; Gamberini, Emiliano; Kluger, Yoram; Moore, Ernest E; Coimbra, Raul; Kirkpatrick, Andrew W; Pereira, Bruno M; Montori, Giulia; Ceresoli, Marco; Abu-Zidan, Fikri M; Sartelli, Massimo; Velmahos, George; Fraga, Gustavo P; Leppaniemi, Ari; Tolonen, Matti; Galante, Joseph; Razek, Tarek; Maier, Ron; Bala, Miklosh; Sakakushev, Boris; Khokha, Vladimir; Malbrain, Manu; Agnoletti, Vanni; Peitzman, Andrew; Demetrashvili, Zaza; Sugrue, Michael; Di Saverio, Salomone; Martzi, Ingo; Soreide, Kjetil; Biffl, Walter; Ferrada, Paula; Parry, Neil; Montravers, Philippe; Melotti, Rita M; Salvetti, Francesco; Valetti, Tino M; Scalea, Thomas; Chiara, Osvaldo; Cimbanassi, Stefania; Kashuk, Jeffry L; Larrea, Martha; Hernandez, Juan A M; Lin, Heng-Fu; Chirica, Mircea; Arvieux, Catherine; Bing, Camilla; Horer, Tal; De Simone, Belinda; Masiakos, Peter; Reva, Viktor; DeAngelis, Nicola; Kike, Kaoru; Balogh, Zsolt J; Fugazzola, Paola; Tomasoni, Matteo; Latifi, Rifat; Naidoo, Noel; Weber, Dieter; Handolin, Lauri; Inaba, Kenji; Hecker, Andreas; Kuo-Ching, Yuan; Ordoñez, Carlos A; Rizoli, Sandro; Gomes, Carlos A; De Moya, Marc; Wani, Imtiaz; Mefire, Alain C; Boffard, Ken; Napolitano, Lena; Catena, Fausto (2018-02-02)
      Abstract Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
    • The open abdomen, indications, management and definitive closure

      Coccolini, Federico; Biffl, Walter; Catena, Fausto; Ceresoli, Marco; Chiara, Osvaldo; Cimbanassi, Stefania; Fattori, Luca; Leppaniemi, Ari; Manfredi, Roberto; Montori, Giulia; Pesenti, Giovanni; Sugrue, Michael; Ansaloni, Luca (2015-07-25)
      Abstract The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal directed therapy to achieve early opening and early closure is the key: paradigm of closure shifts to combination of therapies including negative pressure wound therapy and dynamic closure, in order to reduce complications and avoid incisional hernia. There have been huge studies and progress in survival of critically ill trauma and septic surgical patients: this in part has been through the great work of pioneers, scientific societies and their guidelines; however future studies and continued innovation are needed to better understand optimal treatment strategies and to define more clearly the indications, because OA by itself is still a morbid procedure.
    • Open Access [Presentation]

      Desmond, Yvonne; DIT Library Services (2015-10-23)
    • An open-data-driven agent-based model to simulate infectious disease outbreaks.

      Hunter, Elizabeth; Mac Namee, Brian; Kelleher, John (Plos One, 2018-01-01)
      Agent-based models are a tool that can be used to better understand the dynamics of an infectious disease outbreak. An infectious disease outbreak is influenced by many factors including vaccination or immunity levels, population density, and the age structure of the population. We hypothesize that these factors along with interactions of factors and the actions of individuals would lead to outbreaks of different size and severity even in two towns that appear similar on paper. Thus, it is necessary to implement a model that is able to capture these interactions and the actions of individuals. Using openly available data we create a data-driven agent-based model to simulate the spread of an airborne infectious disease in an Irish town. Agent-based models have been known to produce results that include the emergence of patterns and behaviours that are not directly programmed into the model. Our model is tested by simulating an outbreak of measles that occurred in Schull, Ireland in 2012. We simulate the same outbreak in 33 different towns and look at the correlations between the model results and the town characteristics (population, area, vaccination rates, age structure) to determine if the results of the model are affected by interactions of those town characteristics and the decisions on the agents in the model. As expected our results show that the outbreaks are not strongly correlated with any of the main characteristics of the towns and thus the model is most likely capturing such interactions and the agent-based model is successful in capturing the differences in the outbreaks.
    • Operational Research during the Ebola Emergency.

      Fitzpatrick, Gabriel; Decroo, Tom; Draguez, Bertrand; Crestani, Rosa; Ronsse, Axelle; Van den Bergh, Rafael; Van Herp, Michel (Centers for Disease Control and Prevention, 2017-07)
      Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare. Importantly, operational research questions were decided to a large extent by returning volunteers who had first-hand knowledge of the immediate issues facing teams in the field. Such a method is appropriate for an emergency medical organization. Many challenges were also identified while carrying out operational research across 3 different countries, including the basic need for collecting data in standardized format to enable comparison of findings among treatment centers.
    • Opiate addiction and overdose: experiences, attitudes, and appetite for community naloxone provision.

      Barry, Tomás; Klimas, Jan; Tobin, Helen; Egan, Mairead; Bury, Gerard (2017-02-28)
      GPs report extensive contact with people who have opiate use disorders but provide limited opiate agonist treatment. They support wider availability of naloxone and would participate in its expansion. Development and evaluation of an implementation strategy to support GP-based distribution is urgently needed.
    • Opioid substitution treatment and heroin dependent adolescents: reductions in heroin use and treatment retention over twelve months.

      Smyth, Bobby P; Elmusharaf, Khalifa; Cullen, Walter (2018-05-04)
      We found that heroin dependent adolescent patients achieved significant reductions in heroin use within three months of starting OST and this improved further after a year of treatment, about half being heroin abstinent at that stage. Patient drop out from treatment remains a challenge, as it is in adults. Cocaine use before and during treatment may be a negative prognostic factor.
    • Opt-out as an acceptable method of obtaining consent in medical research: a short report.

      Vellinga, Akke; Cormican, Martin; Hanahoe, Belinda; Bennett, Kathleen; Murphy, Andrew W (2011-04-06)
      Abstract Background A prospective cohort study was set up to investigate a possible association between antibiotic prescribing and antibiotic resistance of E. coli urinary tract infection in the community. Participation of patients with urinary tract infection was obtained through an opt-out methodology. This short paper reports on the acceptability of the opt-out recruitment approach. Methods Participating practices (22) were requested to send a urine sample from all patients presenting with symptoms of urinary tract infection. Upon receipt of the sample in the laboratory, a letter explaining the study, an opt-out form and a freepost envelope were sent to all adult patients. A website with additional information and including an 'opt-out' button was set up for the study. Results A total of 1362 urine samples were submitted by the 22 participating practices representing 1178 adult patients of whom 193 actively responded to the letter: 142 opted out by letter, 15 through the website, 2 by phone and 12 sent the letter back without indication, making a total of 171 patients or 14.5% opt-out; the remaining 22 patients (1.9%) explicitly opted in. The total group consisted of 80% women and the mean age was 50.9 years (sd 20.8). No significant differences were found between patients who participated and those who opted out in terms of age, gender or whether the urine sample was positive or not. Conclusions Overall the opt-out method was well received and participation in the study reached 85.5%. The low number of complaints (2) indicates that this is a generally acceptable method of patient recruitment. The 14.5% opt-out shows that it effectively empowers patients to decline participation. The similarity between patients opting out and the rest of the patients is reassuring for extrapolation of the results of the study.
    • Optimised electroporation mediated DNA vaccination for treatment of prostate cancer.

      Ahmad, Sarfraz; Casey, Garrett; Sweeney, Paul; Tangney, Mark; O'Sullivan, Gerald C; Cork Cancer Research Centre, Mercy University Hospital, Cork, Ireland. m.tangney@ucc.ie. (2010)
      ABSTRACT: BACKGROUND: Immunological therapies enhance the ability of the immune system to recognise and destroy cancer cells via selective killing mechanisms. DNA vaccines have potential to activate the immune system against specific antigens, with accompanying potent immunological adjuvant effects from unmethylated CpG motifs as on prokaryotic DNA. We investigated an electroporation driven plasmid DNA vaccination strategy in animal models for treatment of prostate cancer. METHODS: Plasmid expressing human PSA gene (phPSA) was delivered in vivo by intra-muscular electroporation, to induce effective anti-tumour immune responses against prostate antigen expressing tumours. Groups of male C57 BL/6 mice received intra-muscular injections of phPSA plasmid. For phPSA delivery, quadriceps muscle was injected with 50 mug plasmid. After 80 seconds, square-wave pulses were administered in sequence using a custom designed pulse generator and acustom-designed applicator with 2 needles placed through the skin central to the muscle. To determine an optimum treatment regimen, three different vaccination schedules were investigated. In a separate experiment, the immune potential of the phPSA vaccine was further enhanced with co- administration of synthetic CpG rich oligonucleotides. One week after last vaccination, the mice were challenged subcutaneously with TRAMPC1/hPSA (prostate cancer cell line stably expressing human PSA) and tumour growth was monitored. Serum from animals was examined by ELISA for anti-hPSA antibodies and for IFNgamma. Histological assessment of the tumours was also carried out. In vivo and in vitro cytotoxicity assays were performed with splenocytes from treated mice. RESULTS: The phPSA vaccine therapy significantly delayed the appearance of tumours and resulted in prolonged survival of the animals. Four-dose vaccination regimen provided optimal immunological effects. Co - administration of the synthetic CpG with phPSA increased anti-tumour responses, preventing tumour occurrence in 54% of treated animals. Vaccination with phPSA resulted in anti-hPSA Abs production and a significant production of IFNgamma was observed in immunised animals (p < 0.05). Immune responses were tumour specific and were transferable in adoptive T cell transfer experiments. CONCLUSIONS: This phPSA plasmid electroporation vaccination strategy can effectively activate tumour specific immune responses. Optimisation of the approach indicated that a four-dose regimen provided highest tumour protection. In vivo electroporation mediated vaccination is a safe and effective modality for the treatment of prostate cancer and has a potential to be used as a neo-adjuvant or adjuvant therapy.
    • Optimising parameters for the differentiation of SH-SY5Y cells to study cell adhesion and cell migration

      Dwane, Susan; Durack, Edel; Kiely, Patrick A (2013-09-11)
      Abstract Background Cell migration is a fundamental biological process and has an important role in the developing brain by regulating a highly specific pattern of connections between nerve cells. Cell migration is required for axonal guidance and neurite outgrowth and involves a series of highly co-ordinated and overlapping signalling pathways. The non-receptor tyrosine kinase, Focal Adhesion Kinase (FAK) has an essential role in development and is the most highly expressed kinase in the developing CNS. FAK activity is essential for neuronal cell adhesion and migration. Results The objective of this study was to optimise a protocol for the differentiation of the neuroblastoma cell line, SH-SY5Y. We determined the optimal extracellular matrix proteins and growth factor combinations required for the optimal differentiation of SH-SY5Y cells into neuronal-like cells and determined those conditions that induce the expression of FAK. It was confirmed that the cells were morphologically and biochemically differentiated when compared to undifferentiated cells. This is in direct contrast to commonly used differentiation methods that induce morphological differentiation but not biochemical differentiation. Conclusions We conclude that we have optimised a protocol for the differentiation of SH-SY5Y cells that results in a cell population that is both morphologically and biochemically distinct from undifferentiated SH-SY5Y cells and has a distinct adhesion and spreading pattern and display extensive neurite outgrowth. This protocol will provide a neuronal model system for studying FAK activity during cell adhesion and migration events.
    • Optimizing parameters of an open-source airway segmentation algorithm using different CT images

      Nardelli, Pietro; Khan, Kashif A; Corvò, Alberto; Moore, Niamh; Murphy, Mary J; Twomey, Maria; O’Connor, Owen J; Kennedy, Marcus P; Estépar, Raúl S J; Maher, Michael M; Cantillon-Murphy, Pádraig (2015-06-26)
      Abstract Background Computed tomography (CT) helps physicians locate and diagnose pathological conditions. In some conditions, having an airway segmentation method which facilitates reconstruction of the airway from chest CT images can help hugely in the assessment of lung diseases. Many efforts have been made to develop airway segmentation algorithms, but methods are usually not optimized to be reliable across different CT scan parameters. Methods In this paper, we present a simple and reliable semi-automatic algorithm which can segment tracheal and bronchial anatomy using the open-source 3D Slicer platform. The method is based on a region growing approach where trachea, right and left bronchi are cropped and segmented independently using three different thresholds. The algorithm and its parameters have been optimized to be efficient across different CT scan acquisition parameters. The performance of the proposed method has been evaluated on EXACT’09 cases and local clinical cases as well as on a breathing pig lung phantom using multiple scans and changing parameters. In particular, to investigate multiple scan parameters reconstruction kernel, radiation dose and slice thickness have been considered. Volume, branch count, branch length and leakage presence have been evaluated. A new method for leakage evaluation has been developed and correlation between segmentation metrics and CT acquisition parameters has been considered. Results All the considered cases have been segmented successfully with good results in terms of leakage presence. Results on clinical data are comparable to other teams’ methods, as obtained by evaluation against the EXACT09 challenge, whereas results obtained from the phantom prove the reliability of the method across multiple CT platforms and acquisition parameters. As expected, slice thickness is the parameter affecting the results the most, whereas reconstruction kernel and radiation dose seem not to particularly affect airway segmentation. Conclusion The system represents the first open-source airway segmentation platform. The quantitative evaluation approach presented represents the first repeatable system evaluation tool for like-for-like comparison between different airway segmentation platforms. Results suggest that the algorithm can be considered stable across multiple CT platforms and acquisition parameters and can be considered as a starting point for the development of a complete airway segmentation algorithm.