Journal articles: 'Irish occupational therapy'

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O’Mahony, Rachel, Emma Connolly, and Patrick Hynes. "A qualitative study of Irish parents’ views on hippotherapy, including its influence on their children’s home-based occupations." Irish Journal of Occupational Therapy 47, no. 1 (May 7, 2019): 42–57. http://dx.doi.org/10.1108/ijot-11-2018-0018.

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Purpose Hippotherapy is an emerging area of paediatric occupational therapy practice in Ireland. It is a treatment strategy used by specially trained occupational therapy practitioners, physical therapists and speech language pathologists as part of the intervention programme to facilitate functional gains. This paper aims to explore parents’ perspectives on children’s participation in home-based occupations following hippotherapy treatment. Design/methodology/approach Qualitative, semi-structured interviews were conducted with eight participants. Interviews were audio-recorded and transcribed verbatim. In accordance with thematic analysis, line-by-line coding was completed to identify codes. Codes were organised into categories, which were grouped to develop themes. Findings Three core themes were identified: lack of knowledge regarding hippotherapy as an occupational therapy intervention; children’s increased participation in home-based occupations secondary to improved physical, psychological, communication and social skills; and the unique hippotherapy environment as a motivating factor for children to engage in occupational therapy intervention. Originality/value Findings from this study support the growing body of evidence that hippotherapy is an effective means of intervention for increasing physical, psychological, social and communication skills. The participants report positive effects following hippotherapy on their children’s participation in home-based occupations. It highlights a link between the unique hippotherapy environment and children’s increased engagement in occupational therapy. Given that no published hippotherapy-specific literature related to occupational therapy exists in the Irish context, and given that hippotherapy is an emerging area of practice in Ireland, this paper contributes to the knowledge base.

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Mulholland, Fiona, and Jeanne Jackson. "The experience of older adults with anxiety and depression living in the community: Aging, occupation and mental wellbeing." British Journal of Occupational Therapy 81, no. 11 (May 31, 2018): 657–66. http://dx.doi.org/10.1177/0308022618777200.

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Introduction As life expectancy grows so does the need for mental health services for older people. Occupational science and therapy literature demonstrates how occupation supports older adults' wellbeing, but there has been little research into the relationship between occupation and health for those with anxiety and depression. The aim of this study was to understand the occupational experience of Irish older adults with anxiety and depression so as to inform therapeutic programmes. Method A qualitative research design with a phenomenological framework was adopted. A total of five community-dwelling people with diagnoses of anxiety and/or depression were purposively selected to participate in semi-structured interviews. The interviews were analysed using thematic analysis. Findings The themes which emerged – ‘Occupation as a marker for wellness’ and ‘Sustaining a sense of occupational identity’ – support existing literature and reveal new information about interactions between occupational identity crisis and mental health. Personally meaningful occupation which connects a person to their life worlds and sense of self has the potential to consolidate recovery from anxiety and depression. Conclusion The study contributes to knowledge on how occupation supports an older person's wellbeing and identity in the face of life changes, and has implications for occupational therapists working with older adults.

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Pettigrew, Judith, Aisling Shalvey, Bríd Dunne, and Katie Robinson. "Eamon O’Sullivan: 20th-century Irish psychiatrist and occupational therapy patron." History of Psychiatry 31, no. 4 (September 3, 2020): 470–82. http://dx.doi.org/10.1177/0957154x20948326.

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The profession of occupational therapy was formalized in the USA in 1917. Many of its earliest proponents were psychiatrists, yet their role in the development of the profession has received limited attention. This paper addresses this gap by considering one of the earliest Irish psychiatrist patrons of occupational therapy: Dr Eamon O’Sullivan (1897–1966) of Killarney Mental Hospital, Co Kerry, who developed an occupational therapy department in 1934. A textbook written by O’Sullivan reflects core philosophies articulated by occupational therapy’s founders, and these philosophies were evident in practice at his hospital. Some inconsistencies between O’Sullivan’s writings and practice are identified. In the absence of patient testimonies, it is not possible to resolve questions about the potential exploitation of patients through work as therapy.

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Verdonck, Michele, Cathy McCormack, and Gill Chard. "Irish Occupational Therapists' Views of Electronic Assistive Technology." British Journal of Occupational Therapy 74, no. 4 (April 2011): 185–90. http://dx.doi.org/10.4276/030802211x13021048723291.

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Pettigrew, Judith, Katie Robinson, Brid Dunne, and Jennifer O' Mahoney. "Major trends in the use of occupation as therapy in Ireland 1863-1963." Irish Journal of Occupational Therapy 45, no. 1 (April 3, 2017): 4–14. http://dx.doi.org/10.1108/ijot-02-2017-0007.

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Purpose Major gaps exist in the documented history of occupational therapy in Ireland. The purpose of this paper is to contribute to filling these gaps by providing an overview of three major transitions in Irish occupational therapy in the century preceding the opening of St. Joseph?s College of Occupational Therapy in 1963. Research on occupational therapy’s past is valuable not only for recording and commemorating key events and individuals but also for allowing reflection on and questioning of contemporary practice and assumptions. Design/methodology/approach This descriptive paper draws on multiple documentary sources to present an overview of the first 100 years of the use of occupation as therapy/occupational therapy in Ireland from 1863 to 1963. Findings Three major transitions in occupational therapy in Ireland are presented: from moral treatment and the use of occupation as therapy to medical patronage of occupational therapy, from medical patronage to the early/pre-professional era and finally from the pre-professional era to the era of professionally qualified occupational therapists. To illustrate these transitions, a small number of individuals and their contributions are discussed including Dr Eamon O’Sullivan, Dr Ada English, Donal Kelly, Olga Gale and Ann Beckett. Originality/value This paper charts the foundations upon which the currently thriving profession of occupational therapy are built. The Association of Occupational Therapists of Ireland recently celebrated their 50th anniversary (AOTI, 2015a), and in 2017, it is 100 years since occupational therapy was formalised in Clifton Springs, New York, USA. Occupational therapy is a relatively young profession, and great opportunities exist to research its history in Ireland to capture the memories and experiences of the pioneers who laid the foundation of the profession as well as to situate the development of the profession in the broader social, cultural and scientific contexts within which it developed.

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Tyrrell, Jeanne, and Howard Smith. "Levels of Psychological Distress among Occupational Therapy Students." British Journal of Occupational Therapy 59, no. 8 (August 1996): 365–71. http://dx.doi.org/10.1177/030802269605900805.

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This study measured levels of psychological distress among a sample of Irish occupational therapy students. Students from all four undergraduate classes (n=102) were surveyed, using the General Health Questionnaire (GHQ-28). Over 40% of the students scored as having a ‘just significant clinical disturbance’ on the GHQ-28. Mean GHQ scores (or symptom levels) varied throughout the 4-year course and were highest just before examinations and during fieldwork placements. Students who had unhealthy diets or who smoked had significantly higher levels of psychiatric symptomatology. The prevalence of psychological distress among occupational therapy students was similar to that found in students from four other disciplines; however, the university students had much higher levels of symptomatology than the non-university peer group. The article concludes with some suggestions for dealing with stressful aspects of professional education and some recommendations for further research.

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Lombard, Kim, Laura Desmond, Ciara Phelan, and Joan Brangan. "Irish occupational therapists use of evidenced-based falls prevention programmes." Irish Journal of Occupational Therapy 48, no. 1 (November 13, 2019): 17–30. http://dx.doi.org/10.1108/ijot-02-2019-0002.

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Purpose As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland. Design/methodology/approach A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively. Findings In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland. Originality/value In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

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O’Donoghue, Carol, Jennifer O’Leary, and Helen Lynch. "Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from Ireland." Occupational Therapy International 2021 (June 16, 2021): 1–11. http://dx.doi.org/10.1155/2021/6636478.

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Purpose. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. Methods. This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. Results. The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.

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Cahill, Rebecca, and Judith Pettigrew. "Development of occupational therapy in Grangegorman hospital, Dublin: 1934-1954." Irish Journal of Occupational Therapy 48, no. 1 (April 1, 2020): 69–87. http://dx.doi.org/10.1108/ijot-10-2019-0013.

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Purpose In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954. Design/methodology/approach Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach. Findings The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”. Originality/value This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.

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Davoren, Mary, Eugene G. Breen, and Brendan D. Kelly. "Dr Ada English: patriot and psychiatrist in early 20th century Ireland." Irish Journal of Psychological Medicine 28, no. 2 (June 2011): 91–96. http://dx.doi.org/10.1017/s0790966700011514.

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AbstractDr Adeline (Ada) English (1875-1944) was a pioneering Irish psychiatrist. She qualified in medicine in 1903 and spent four decades working at Ballinasloe District Lunatic Asylum, during which time there were significant therapeutic innovations (eg. occupational therapy, convulsive treatment). Dr English was deeply involved in Irish politics. She participated in the Easter Rising (1916); spent six months in Galway jail for possessing nationalistic literature (1921); was elected as a Teachta Dála (member of Parliament; 1921); and participated in the Civil War (1922). She made significant contributions to Irish political life and development of psychiatric services during an exceptionally challenging period of history. Additional research would help contextualise her contributions further.

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Hynes, Patrick Joseph, and Alia Harb. "Practices and roles of Irish occupational therapists’ with adults with intellectual disabilities who access supported employment services." Irish Journal of Occupational Therapy 45, no. 2 (September 4, 2017): 78–91. http://dx.doi.org/10.1108/ijot-06-2017-0016.

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Purpose Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services. Design/methodology/approach Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis. Findings Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles. Originality/value This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.

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Linnane, Esther, and Alison Warren. "Apprehension and interest." Irish Journal of Occupational Therapy 45, no. 1 (April 3, 2017): 40–51. http://dx.doi.org/10.1108/ijot-01-2017-0002.

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Purpose Role-emerging placements have been used internationally within occupational therapy education but are relatively new to Ireland. At times, there has been a debate in the profession regarding the use of this placement model. This paper aims to generate views from both occupational therapists and occupational therapy students on the use of role-emerging placements in the Republic of Ireland. Design/methodology/approach Electronic surveys were administered to occupational therapy students and occupational therapists in Ireland. Quantitative data were analysed using the SPSS Statistics software package and the content of the open question responses were analysed into themes. Findings Occupational therapists (n = 60) and occupational therapy students (n = 45) indicated that there were inconsistent views surrounding role-emerging placements. It is deemed as an effective method for student learning, but apprehension exists around inclusion within occupational therapy programmes in the Republic of Ireland. Preference was indicated towards inclusion of role-emerging placements on a part-time basis within formal occupational therapy education. Originality/value Both respondent groups viewed that role-emerging placements can positively influence new areas of occupational therapy practice and concern over the use of the placement model requires further exploration and debate. This study is from an Irish context, although there are similarities with other countries’ use of the placement model. There is a need for research through an in-depth exploration of the learning experience of undertaking role-emerging placements from the students’ perspective and identification of supports required to promote an optimal learning experience.

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Davis, Aisling Jane, and Patricia Mc Clure. "An exploratory study of discharge planning home visits within an Irish context – investigating nationwide practice and nationwide perspectives." Irish Journal of Occupational Therapy 47, no. 2 (November 4, 2019): 95–113. http://dx.doi.org/10.1108/ijot-10-2018-0015.

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Purpose Discharge planning home visits (DPHVs) are a routine part of occupational therapy clinical practice. However, there is a dearth of evidence to support or refute their efficacy and limited policies or standards to guide clinical practice. This study aims to investigate current clinical practice during home visits and the value that occupational therapists’ attribute to home visits within an Irish context. Design/methodology/approach Data collection was carried out by using a survey questionnaire (postal and electronic options). The study population comprised occupational therapists across 52 sites including acute, rehabilitation and convalescence settings within the Republic of Ireland. In total, 122 occupational therapists that completed the survey questionnaire were recruited for the study. Findings Quantitative data identified time spent per visit, departmental size, hospital size, number of visits and report writing times. Information was gathered regarding clinical areas assessed during visits in a Likert scale format. Qualitative data identified benefits, risks, recommendations to improve home visit practice and clinical criteria for home visits. Findings conclude that DPHVs are routinely carried out by occupational therapists and that there is consistency in clinical practice within an Irish setting. Occupational therapists value home visits as clinical assessments and have identified risks during practice, benefits of visits and ways to improve practice. Originality/value This study has provided a reflection of clinical practice in the Republic of Ireland. It is the only study of its kind in an Irish setting, and it could be used as a knowledge base regarding current practice on DPHV and occupational therapists’ clinical reasoning regarding home visits. The information gathered in this study could influence policies regarding DPHV and could serve as a comparison to standardise practice and justify the need for DPHV.

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Moloney, Laura, and Daniela Rohde. "Experiences of men with psychosis participating in a community-based football programme." Irish Journal of Occupational Therapy 45, no. 2 (September 4, 2017): 100–111. http://dx.doi.org/10.1108/ijot-06-2017-0015.

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Purpose Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme. Design/methodology/approach Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health. Originality/value This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.

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Hynes, Sinéad, and Agnes Shiel. "Validating an Irish-Language Version of the Rivermead Behavioural Memory Test — Second Edition." British Journal of Occupational Therapy 77, no. 4 (April 2014): 198–204. http://dx.doi.org/10.4276/030802214x13968769798836.

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Noonan Walsh, Patricia, and Christine Linehan. "Factors influencing the integration of Irish employees with disabilities in the workplace." Journal of Vocational Rehabilitation 8, no. 1 (1997): 55–64. http://dx.doi.org/10.3233/jvr-1997-8107.

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Whelehan, Dale F., Maria Baily-Scanlan, and Paul F. Ridgway. "Is your physio tired? Exploring sleep deprivation in Irish physiotherapists." Physiotherapy Practice and Research 41, no. 2 (January 11, 2021): 201–11. http://dx.doi.org/10.3233/ppr-200400.

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INTRODUCTION: Health professionals have been subject to increased levels fatigue when compared to population norms. It remains unknown if physiotherapists report high levels of sleep deprivation. This paper explores levels of sleep deprivation, and its potential impact on professional performance. METHODS: A survey was distributed through the Irish Society of Chartered Physiotherapists. The survey explored work characteristics, sleep quality using the Pittsburgh Sleep Quality Index, daytime sleepiness using the Epworth Sleepiness Scale, and the professional and non-professional causes of sleep deprivation in the profession. Pearson correlation and independent t-tests were used on SPSS to explore relationship between variables. RESULTS: There was a total of 559 valid respondents. Females accounted for 82% and public sector employees accounted for 63% of respondents. Over half (50.1%) of respondents said they felt sleep deprivation impacted on their practice. Most physiotherapists (63.3%) of respondents said they did not feel that their practice impacted sleep. The PSQI global score was 5.6 indicating “poor” quality of sleep. The ESS global score was 6.0 indicating ‘higher normal daytime sleepiness’. Potential causes of sleep deprivation included professional issues relating to burnout and work-life balance, and non-professional reasons such as parenthood. DISCUSSION AND CONCLUSION: A mismatch exists between self-reported sleep deprivation and validated measurements of sleep indicating poor self-awareness of the impact of sleep in optimising professional performance. A work-life balance is needed to facilitate a safe and efficient workforce. Individual and organizational efforts should be made to improve sleep quantity and quality to reduce personnel fatigue and enhance physiotherapists professional performance.

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Cahalan, Roisin, and Kieran O'Sullivan. "Musculoskeletal pain and injury in Irish dancing: A systematic review." Physiotherapy Practice and Research 34, no. 2 (2013): 83–92. http://dx.doi.org/10.3233/ppr-130018.

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Creaner, Brian, and Clodagh Nolan. "How do we know we do what it says on the tin? Ensuring adherence to a person centered approach within Occupational Therapy Mental Health Services in Higher Education." European Journal for Person Centered Healthcare 4, no. 2 (July 26, 2016): 271. http://dx.doi.org/10.5750/ejpch.v4i2.1079.

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Current Irish mental health policy demands a shift towards person centred service delivery. Occupational therapy is well placed to implement and develop services in line with this policy as it has person centred care at the core of its theoretical constructs. This study examines the use of person centred models in an occupational therapy service for students with mental health disabilities in higher education that is, the Person Environment Occupation (PEO) and Recovery models. As documentation offers the best insight into the integration of theory to practice, the aim of this study was to examine if documentation adhered to its theoretical underpinnings. Thus 195 Electronic case files were reviewed and 47 in a re-assessment process. Results demonstrated adherence to the recovery model was an area of strength for the service as was alignment to international best practice standards. However, recording of goals and interventions in line with the PEO model was lacking. Following a period on consultation with senior therapists and the clinical director changes were made to further embed the models into the documentation processes. Following this consultation re-assessment demonstrated greater adherence to person centred models in all interactions with the students with mental health disabilities. This research demonstrates that it is necessary not only to examine ones practice but to develop context specific tools to ensure person centred care signifying integration of theory to practice.

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Van Hout, Marie Claire, and Tim Bingham. "Methadone maintenance and Special Community Employment schemes: A study of Irish participants' views." Journal of Vocational Rehabilitation 37, no. 1 (2012): 63–73. http://dx.doi.org/10.3233/jvr-2012-0600.

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Suibhne, Orla Nic, and Karen Finnerty. "The Irish Association of Supported Employment Job Shadow Initiative: A tool for supported employment." Journal of Vocational Rehabilitation 41, no. 1 (2014): 3–11. http://dx.doi.org/10.3233/jvr-140693.

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O'Neill, Geraldine. "The Development of a Standardised Assessment of Hand Function." British Journal of Occupational Therapy 58, no. 11 (November 1995): 477–80. http://dx.doi.org/10.1177/030802269505801110.

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A new assessment of hand function, the O'Neill Hand Function Assessment, has recently been developed on an Irish adult population. The assessment is based on a commonly used grip classification of the hand and it also contains a non-prehensive section. There are eight tasks In the final version of the assessment. The instructions allow for a description of both the manner of performance (criterion-referenced section) and the speed of performance (norm-referenced section) of the tasks in the assessment. Reliability studies have been performed on the tasks in the assessment, with high inter-rater reliability (0.96–0.99) and moderate test re-test reliability (0.54–0.79). There is also a description of the validity of the assessment and the total score in the assessment appears to correlate highly with the Nine Hole Peg Test (0.98). The normative data for the speed section are based on 140 non-disabled adults. The assessment has also been applied to 38 orthopaedic and rheumatology patients. The O'Neill Hand Function Assessment appears to fulfil the basic criteria for a standardised assessment.

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Kavannagh, Jane, Aine Kearns, and Tanya McGarry. "The benefits and challenges of student-led clinics within an Irish context." Journal of Practice Teaching and Learning 13, no. 2-3 (October 22, 2015): 58–72. http://dx.doi.org/10.1921/jpts.v13i2-3.858.

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Student-led clinics are being established internationally as a means of practice education within a variety of disciplines. These clinics can provide opportunities for students in health care professions to have ‘real life’ clinic experiences while also providing beneficial outcomes for service users. This paper reviews the preliminary experiences from thirteen uni-disciplinary student-led clinics (thirty two students in total) in the disciplines of Occupational Therapy (OT), Speech and Language Therapy (SLT) and Physiotherapy (PT). These clinics were part of the placement experience of the students in an Irish University between 2011 and 2013. Clinical Education Quality Audit (CEQA) questionnaires (Ladyshewsky & Barrie, 1996) were used to explore the student experience of these placements, and practice educators were given an opportunity to discuss the benefits and challenges of the placements with the University Practice Education team. The data collected was analysed using thematic analysis. A number of themes emerged from the data: Environment, Organisational issues, Professional development / growth, and Relationships. These themes highlighted both positive and challenging features of the placement experiences. This paper will discuss the benefits and challenges of these student-led clinics and outline that overcoming challenges may be an additional important aspect of learning in innovative clinical experiences

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Spirtos, Michelle, Mary Naughton, Emma Carr, Tadhg Stapleton, and Michelle O'Donnell. "Post-operative management of flexor tendon injuries at zone II and flexor pollicis longus – a survey of Irish practice." Irish Journal of Occupational Therapy 49, no. 2 (October 18, 2021): 70–76. http://dx.doi.org/10.1108/ijot-01-2021-0001.

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Purpose The post-operative management of flexor tendon injuries has been the focus of considerable exploration and there continues to be variation in approaches and methods of mobilisation. The purpose of this paper is to explore therapy management following repair to flexor tendons at zone II and flexor pollicis longus (FPL) (all zones) in Ireland. Design/methodology/approach A descriptive survey questionnaire design through an online format was used. Therapists were recruited through the Irish Association of Hand Therapists, the national bodies for occupational therapy and physiotherapy, and therapy managers in acute hospitals, with 29 therapists participating in the study. Descriptive statistics were used to analyse the survey data. Findings Patients were generally seen three to five days following surgery. Early active mobilisation approaches were favoured by all but one therapist, with 62% using the Belfast protocol and 34% the Manchester Short Splint (MSS) protocol. Each early active protocol exercise session commences with passive motion followed by graded active flexion. Tenodesis is incorporated by the majority of respondents within the first four weeks. Therapy programme and splints are modified based on patient presentation. Resistance exercises are commenced from week seven. Patient compliance was identified as the most influential factor in the post-operative intervention approach taken. Originality/value This study provides the first Irish profile of current practice in the post-operative management of flexor tendon repairs at zone II and FPL which has not previously been reported. Further research should explore the reasoning behind the interventions chosen and also the implications for practice of changes to surgical techniques.

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Rooney, M. "Professional Managers' Perceptions on Managing the Impact of Flexible Working Practices in Irish Healthcare." Physiotherapy Practice and Research 30, no. 1 (2009): 45–49. http://dx.doi.org/10.3233/ppr-2009-30110.

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Coe, Áine, Mary Martin, and Tadhg Stapleton. "Effects of An Occupational Therapy Memory Strategy Education Group Intervention on Irish Older Adults’ Self-Management of Everyday Memory Difficulties." Occupational Therapy In Health Care 33, no. 1 (January 2, 2019): 37–63. http://dx.doi.org/10.1080/07380577.2018.1543911.

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Stapleton, Tadhg, and Deirdre Connelly. "Occupational Therapy Practice in Predriving Assessment Post Stroke in the Irish Context: Findings From a Nominal Group Technique Meeting." Topics in Stroke Rehabilitation 17, no. 1 (January 2010): 58–68. http://dx.doi.org/10.1310/tsr1701-58.

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Maher, A., M. Mc Alister, and J. Gallagher. "PCN160 Potential Impact of Advanced Therapy Medicinal Products on Irish Hematology-Oncology Care Pathway." Value in Health 24 (June 2021): S49. http://dx.doi.org/10.1016/j.jval.2021.04.252.

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McLoughlin, Petra, Eleanor Murphy, Fiona O'Sullivan, and Ciara Connellan. "331 Implementation of Community Based Comprehensive Geriatric Assessment and Intervention in a Rural Irish Setting." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.214.

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Abstract Background The Integrated Care Team for Older People (ICTOP) in Sligo formed in 2018 to provide home based rehabilitation for acutely frail older adults to enable them to continue to live independently. It serves a predominantly rural catchment area with 14.5% aged >65 years versus the national average of 11%.1 An in-home person-centred multi-disciplinary approach is utilized based on the principles of comprehensive geriatric assessment (CGA). This observational study aims to describe the typical user of this service, interventions and outcomes to date. Methods An Excel database was compiled and analysed from CGA of consecutive referrals from June to December 2018. Results Of the 70 referrals studied, 69% resided in rural Sligo, two thirds were female and there was a mean age of 82.3 (range 68-95). The median Rockwood Clinical Frailty Scale level was 6 and the median Timed Up and Go was 28seconds. Hospital in-patients accounted for 58% of referrals with functional deterioration (74%), mobility decline (72%) and cognitive decline (28%) the most frequent referral reasons. Gait imbalance was the most prevalent co-morbidity (77%). There was an average of 4.5 home visits per person. Over 80% of referrals received combined physiotherapy and occupational therapy input, with Clinical Nurse Specialist (CNS) in Dementia involvement in 40%, speech and language therapy in 26% and social work in 15%. CGA identified additional clinical and social needs in 100%, and the team made 217 onward referrals to available community health and social supports. ICTOP referral decreased length of stay by 2.6days and only one patient required long term care. Conclusion The use of a multidisciplinary team providing domiciliary assessments decreased hospital stay, facilitated maintenance of independent living and addressed both identified and un-identified needs in a frail older person’s population. Further evaluation over time is needed to indicate impact on readmission rate.

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Hegarty, Josephine M., Meredith Wallace, and Harry Comber. "Uncertainty and Quality of Life Among Men Undergoing Active Surveillance for Prostate Cancer in the United States and Ireland." American Journal of Men's Health 2, no. 2 (May 23, 2007): 133–42. http://dx.doi.org/10.1177/1557988307300467.

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Background. Prostate cancer continues to be the most common site of male cancers, particularly among older men in Europe and the United States, and the second most common male cancer worldwide. Active surveillance involves the use of no local or systemic therapy once prostate cancer has been diagnosed. A description of uncertainty and quality of life among men undergoing active surveillance in samples from both the United States and Ireland has the potential to enhance global health care delivery. Methods. The specific aim of this study is to enhance the understanding of the experience of active surveillance for prostate cancer among Irish and American men by measuring quality of life and levels of uncertainty among men over the age of 65 in receipt of the active surveillance management option for prostate cancer. A quantitative, descriptive survey design was used. Results. Twenty-nine men completed questionnaires. The results reveal that men undergoing active surveillance in the United States have slightly higher levels of uncertainty. Primary appraisal, opportunity, and danger appraisal were consistent between samples from both countries. Total affective and health-related quality-of-life scores were similar among active surveillance participants in both countries, but subscale scores identified both similarities and differences. Irish men had lower mean role and social function than U.S. men, and higher general health and energy. Irish men reported more urine bother and less sexual bother than U.S. men. Conclusion. To assist men with prostate cancer who are treated with the active surveillance management option, health care professionals must develop an awareness of how prostate cancer affects the man's physical and psychological health care outcomes.

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McGinty, Ronan N., Delphine M. Goulding, Marie J. McCarthy, Sandra M. Moloney, Daniel J. Costello, and Barry J. Plant. "Clinical Effectiveness of Dual Nicotine Replacement Therapy in Planned Hospital Admissions to an Epilepsy Monitoring Unit: An Irish Perspective." Nicotine & Tobacco Research 20, no. 5 (February 9, 2017): 656–58. http://dx.doi.org/10.1093/ntr/ntx029.

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Harmon, Deirdre, and Michelle Spirtos. "An investigation of the acute management of closed intra-articular fractures of the proximal interphalangeal joint in Ireland." Irish Journal of Occupational Therapy 48, no. 1 (March 27, 2020): 55–68. http://dx.doi.org/10.1108/ijot-09-2019-0011.

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Purpose Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy. Design/methodology/approach A cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results. Findings Buddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time. Originality/value To the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.

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O’Connor, Anne, and Arlene McCurtin. "A profile of physiotherapy practice educators and practice tutors in the Republic of Ireland." Physiotherapy Practice and Research 41, no. 2 (January 11, 2021): 193–99. http://dx.doi.org/10.3233/ppr-200427.

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BACKGROUND: Limited evidence exists regarding practice educators’ and practice tutors’ experience of, and training in, student supervision in the physiotherapy workplace. This knowledge would inform universities of their learning needs and help to enhance the practice-based experience for physiotherapy students. OBJECTIVE: The aim of this study was to create a profile of physiotherapy practice educators’ and practice tutors’ student supervision experience, university support available to them during practice placement and training undertaken by them. This study was undertaken in the Republic of Ireland. METHODS: An online survey was designed and circulated via the Irish Society of Chartered Physiotherapists’ database of physiotherapy members. RESULTS: One hundred and ninety-two practice educators and 71 practice tutors participated. Findings indicate that the 1:1 model of practice education is the predominant model of practice education employed in the Republic of Ireland. 70% of practice educators currently receive support from a practice tutor. Fifty-five percent of practice educators undertake student supervision 2-3 times per year. However, 56% of practice educators and 48% of practice tutors had not undertaken training in student supervision in the year prior to the study. A decline was also noted in the uptake of student supervision among clinicians with 16–25 years clinical experience. CONCLUSION: This study provides an insightful profile of physiotherapy practice education in the Republic of Ireland. Findings are encouraging, with data highlighting that most practice educators are supported by practice tutors. Recommendations include the need for further investigation of the apparent decline in student supervision among experienced clinicians. Consideration of the learning needs of practice educators and practice tutors is encouraged as well as a review of the accessibility and flexibility of training resources provided.

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O’Connell, Sarah, Anna O’Rourke, Eileen Sweeney, Almida Lynam, Corinna Sadlier, and Colm Bergin. "Factors associated with non-retention in HIV care in an era of widespread antiretroviral therapy." International Journal of STD & AIDS 28, no. 7 (August 5, 2016): 679–84. http://dx.doi.org/10.1177/0956462416663868.

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In an era of antiretroviral therapy (ART) for all HIV-1-infected patients, our primary aim was to describe prevalence and characteristics of patients disengaged from care at an urban ambulatory HIV clinic. We conducted a nested case–control study. All patients who disengaged from care (defined as being lost to follow-up for at least one year) from 2007 to 2014 inclusive were identified. Cases were matched to controls in a 1:4 ratio. A total of 1250 cases were included; 250/2289 (10.9%) of patients attending our HIV clinic disengaged from 2007 to 2014. One hundred and twenty-six (50.4%) were heterosexual, 81 (32.4%) were men who have sex with men and 40 (16%) were intravenous drug users. On univariate analysis only, patients with heterosexual risk were more likely to disengage from care (50.4% vs. 33.7%, p: <0.001). Those who disengaged were younger, mean age of 39 (p: <0.001). A higher proportion of patients who disengaged from care was not receiving ART and did not have a suppressed HIV-1 viral load (p: <0.001). On multivariable analysis, Irish patients were less likely to disengage from HIV care (odds ratio: 0.567, p: 0.002). Factors associated with non-retention in HIV care have been identified. A semi-structured interview of those patients who re-engaged will take place to further examine reasons for disengagement from care.

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Mc Carthy, Paul M., and David O'Sullivan. "Efficacy of a Brief Cognitive Behavioral Therapy Program to Reduce Excessive Drinking Behavior Among New Recruits Entering the Irish Navy: A Pilot Evaluation." Military Medicine 175, no. 11 (November 2010): 841–46. http://dx.doi.org/10.7205/milmed-d-09-00251.

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Murphy, Con, Stephen Byrne, Gul Ahmed, Andrew Kenny, James Gallagher, Harry Harvey, Eoin O’Farrell, and Brian Bird. "Cost Implications of Reactive Versus Prospective Testing for Dihydropyrimidine Dehydrogenase Deficiency in Patients With Colorectal Cancer: A Single-Institution Experience." Dose-Response 16, no. 4 (October 1, 2018): 155932581880304. http://dx.doi.org/10.1177/1559325818803042.

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Background: Severe toxicity is experienced by a substantial minority of patients receiving fluoropyrimidine-based chemotherapy, with approximately 20% of these severe toxicities attributable to polymorphisms in the DPYD gene. The DPYD codes for the enzyme dihydropyrimidine dehydrogenase (DPD) important in the metabolism of fluoropyrimidine-based chemotherapy. We questioned whether prospective DPYD mutation analysis in all patients commencing such therapy would prove more cost-effective than reactive testing of patients experiencing severe toxicity. Methods: All patients experiencing severe toxicity from fluoropyrimidine-based chemotherapy for colorectal cancer in an Irish private hospital over a 3-year period were tested for 4 DPYD polymorphisms previously associated with toxicity. The costs associated with an index admission for toxicity in DPD-deficient patients were examined. A cost analysis was undertaken comparing the anticipated cost of implementing screening for DPYD mutations versus current usual care. One-way sensitivity analysis was conducted on known input variables. An alternative scenario analysis from the perspective of the Irish health-care payer (responsible for public hospitals) was also performed. Results: Of 134 patients commencing first-line fluoropyrimidine chemotherapy over 3 years, 30 (23%) patients developed grade 3/4 toxicity. Of these, 17% revealed heterozygote DPYD mutations. The cost of hospitalization for the DPYD-mutated patients was €232 061, while prospectively testing all 134 patients would have cost €23 718. Prospective testing would result in cost savings across all scenarios. Conclusions: The cost of hospital admission for severe chemotherapy-related toxicity is significantly higher than the cost of prospective DPYD testing of each patient commencing fluoropyrimidine chemotherapy.

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Lalevic, G., M. Scriven, and S. O’Brien. "Early intervention in psychosis in the North Lee Mental Health Services programme: a 5-year review." Irish Journal of Psychological Medicine 36, no. 4 (June 21, 2019): 271–77. http://dx.doi.org/10.1017/ipm.2019.17.

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ObjectivesAn Early Intervention in Psychosis (EIP) programme aims to engage patients in early assessment and phase-specific interventions which are the key elements of the Irish National Clinical Programme for psychosis. This study aims to describe and review the EIP programme offered by Cork’s North Lee Mental Health Services over a 5-year period.MethodsA retrospective descriptive study design was adopted to describe and review the EIP programme, patient demographics and treatments offered in the service over a 5-year period.ResultsA total of 139 patients were accepted into the programme over the 5-year period. The mean age of onset was 30 years (median = 28, SD = 9.9), and the mean duration of untreated psychosis was 8 months (median = 2.5, SD = 15.3). Two-thirds of patients were single on initial assessment, had a history of substance misuse and were unemployed. The majority of the cohort engaged with the keyworkers and occupational therapy but did not complete the full psychological or family programmes offered. Hospital admission was required for 12% of the cohort.ConclusionsPatients experiencing their first episode of psychosis can successfully be treated in the community with appropriate professional and family support. However, deficiencies were noted in physical health monitoring, as well as in the availability and engagement with family and psychological therapies. Properly resourced early interventions in psychosis teams are necessary to deliver services at internationally recognised standards.

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Teeling, SeÁn Paul, Heather Coetzee, Maeve Phillips, Mary McKiernan, ÉidÍn NÍ ShÉ, and Aileen Igoe. "Reducing risk of development or exacerbation of nutritional deficits by optimizing patient access to mealtime assistance." International Journal for Quality in Health Care 31, Supplement_1 (December 2019): 6–13. http://dx.doi.org/10.1093/intqhc/mzz060.

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Abstract Objective Optimize patient access to mealtime assistance, decrease missed meal incidence, risk of malnutrition, reduce food waste and staff rework. Design Lean Six Sigma methodology informed a pre/post intervention design. Setting 31 bed ward including Specialist Geriatric services and Acute Stroke Unit within an Irish University teaching hospital. Participants Clinical and non-clinical staff including catering, nursing, speech and language therapy, dietetics and nutrition; patients, relatives. Interventions An interdisciplinary team used the structured Define/Measure/Analyse/Improve/Control (DMAIC) framework to introduce visual aids and materials to improve the access of patients to assistance at mealtimes. Main outcome measures Pre and post outcomes measures were taken for the number and cost of uneaten meals, rework for staff, staff and patient satisfaction, patient outcomes. Results Following a 1-month pilot of a co-designed process for ensuring access to assistance at mealtimes, average wasted meals due to staff not being available to assist patients requiring mealtime assistance went from 3 per day to 0 corresponding to an average reduction of 0.43 kg per participating patient in food waste per day. Patients receiving assistance did not require additional oral therapeutic nutritional supplements, evidenced no new incidences of aspiration pneumonia or swallowing difficulties and were discharged without requirement for ongoing Dietetics and Nutrition support. Following a 6 month Control period comprising repeated PDCA cycles, the initiative was incrementally introduced to a further 10 wards/units, with positive feedback from patients and staff alike. Conclusion The co-designed new process highlights the importance of staff and patient collaboration, inclusion and participation in designing quality improvement projects.

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Lin, Andrew Y., Victor Chun, Anish Dhamija, Talya Bordin-Wosk, and Ankita Kadakia. "Immune reconstitution inflammatory syndrome in an HIV-infected patient with disseminated coccidioidomycosis." International Journal of STD & AIDS 30, no. 9 (June 3, 2019): 923–26. http://dx.doi.org/10.1177/0956462419844415.

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Immune reconstitution inflammatory syndrome (IRIS) is a condition characterized by excessive inflammatory response to an underlying pathogen following immune recovery. IRIS associated with coccidioidomycosis infection is rare, with only a few cases reported to date. Unfortunately, the mortality rate for disseminated coccidioidomycosis-related IRIS in the available literature is extremely high. We present a case of paradoxical IRIS associated with disseminated coccidioidomycosis in an HIV-infected patient following initiation of antiretroviral therapy, who was successfully treated with steroid therapy.

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Kwon, Hea Yoon, Ye Jeong Han, Jae Hyoung Im, Ji Hyeon Baek, and Jin-Soo Lee. "Two cases of immune reconstitution inflammatory syndrome in HIV patients treated with thalidomide." International Journal of STD & AIDS 30, no. 11 (September 19, 2019): 1131–35. http://dx.doi.org/10.1177/0956462419847297.

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Immune reconstitution inflammatory syndrome (IRIS) is a clinical manifestation that accompanies paradoxical deterioration of symptoms in human immunodeficiency virus (HIV)-infected patients after commencement of antiretroviral treatment. This disease is caused by immune dysregulation, resulting in a cytokine storm and limited effector T-cell function. IRIS treatment involves supportive care and corticosteroid therapy to regulate the immune response. However, prolonged steroid therapy may increase the risk of opportunistic infections. Previous studies have highlighted the use of thalidomide to shorten the duration of steroid use. Herein, we report two cases of IRIS in HIV-infected patients whose symptoms were successfully controlled with thalidomide therapy. Both patients had opportunistic infections involving the central nervous system; one patient had cryptococcal meningitis and the other had progressive multifocal leukoencephalopathy.

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Okazaki, Masafumi, Miho Nakamura, Akiko Imai, Tadashi Asagiri, and Seisho Takeuchi. "Sequential occurrence of Graves’ disease and immune thrombocytopenic purpura as manifestations of immune reconstitution inflammatory syndrome in an HIV-infected patient." International Journal of STD & AIDS 29, no. 8 (January 23, 2018): 834–36. http://dx.doi.org/10.1177/0956462417752824.

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Immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients after initiating antiretroviral therapy usually involves worsening manifestations of overt infectious disease. Here, we describe a sporadic case of a late-diagnosed HIV-positive man who developed Graves’ disease as the first noninfectious IRIS followed by immune thrombocytopenic purpura as the second noninfectious IRIS.

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Hu, Zhiliang, Chuanjun Xu, Duxian Liu, Fanqing Meng, Yun Chi, and Wei Chen. "Pulmonary cryptococcal immune reconstitution syndrome in a person living with HIV: a case report." International Journal of STD & AIDS 31, no. 3 (January 30, 2020): 280–84. http://dx.doi.org/10.1177/0956462419893545.

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Cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) in human immunodeficiency virus (HIV)-1 infection manifests as a clinical worsening or new presentation of cryptococcal disease after initiating antiretroviral therapy (ART). C-IRIS involving the respiratory system has been scarcely reported. Here, we report a case of pulmonary C-IRIS in a person living with HIV after initiating ART, characterized by an exacerbation of a pulmonary nodule and new occurrence of pleural effusions, which responded well to corticosteroid treatment.

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Keeley, Alexander J., Vivak Parkash, Anne Tunbridge, Julia Greig, Paul Collini, William McKane, and Rachel S. Tattersall. "Anakinra in the treatment of protracted paradoxical inflammatory reactions in HIV-associated tuberculosis in the United Kingdom: a report of two cases." International Journal of STD & AIDS 31, no. 8 (July 2020): 808–12. http://dx.doi.org/10.1177/0956462420915394.

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Paradoxical reactions, including immune reconstitution inflammatory syndrome (IRIS), are common in patients co-infected with human immunodeficiency virus (HIV) and tuberculosis (TB). Paradoxical reactions may confer substantial morbidity and mortality, especially in cases of central nervous system (CNS) TB, or through protracted usage of corticosteroids. No high-quality evidence is available to guide management in this scenario. Interleukin-1-mediated inflammation has been implicated in the pathophysiology of TB–IRIS. We describe two cases where anakinra (human recombinant interleukin-1 receptor antagonist) was used as steroid-sparing therapy for life-threatening protracted paradoxical inflammation in HIV-associated TB. In the first case of disseminated TB with lymphadenitis, protracted TB–IRIS led to amyloid A amyloidosis and nephrotic syndrome. In the second case of disseminated TB with cerebral tuberculomata, paradoxical inflammation caused unstable tuberculomata leading to profound neuro-disability. In both cases, paradoxical inflammation persisted for over a year. Protracted high-dose corticosteroid use led to adverse events yet failed to control inflammatory pathology. In both patients, anakinra successfully controlled paradoxical inflammation and facilitated withdrawal of corticosteroid therapy. Following anakinra therapy, nephrotic syndrome and neuro-disability resolved, respectively. Anakinra therapy for protracted paradoxical inflammation in HIV-associated TB may be a viable therapeutic option and warrants further research.

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Salas, Natalie Mariam, and Thomas F. Byrd. "Granulomatous interstitial nephritis in the setting of disseminated Mycobacterium simiae: a rare presentation of immune reconstitution inflammatory syndrome." International Journal of STD & AIDS 31, no. 9 (July 1, 2020): 911–13. http://dx.doi.org/10.1177/0956462420926881.

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Disseminated Mycobacterium simiae is a rare opportunistic infection reported most commonly in advanced human immunodeficiency virus (HIV) infection. Treatment can be further complicated by the occurrence of severe immune reconstitution inflammatory syndrome (IRIS). We present the first case of disseminated multi-drug-resistant M. simiae in the setting of advanced HIV, complicated by IRIS in the form of granulomatous interstitial nephritis causing acute renal failure. This case highlights the importance of recognizing rare complications of IRIS, as delays in therapy can be life threatening.

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Taeb, Abdalsamih M., Joshua M. Sill, Catherine J. Derber, and Michael H. Hooper. "Nodular granulomatous Pneumocystis jiroveci pneumonia consequent to delayed immune reconstitution inflammatory syndrome." International Journal of STD & AIDS 29, no. 14 (August 16, 2018): 1451–53. http://dx.doi.org/10.1177/0956462418787603.

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Although Pneumocystis jiroveci pneumonia (PCP) is a frequent manifestation of acquired immune deficiency syndrome (AIDS), the granulomatous form is uncommon. Here, we present an unusual case of granulomatous PCP consequent to immune reconstitution inflammatory syndrome (IRIS) after highly active antiretroviral therapy. A 36-year-old woman with human immunodeficiency virus (HIV) presented with cough and dyspnea that were attributed to typical PCP associated with AIDS. She was successfully treated with antibiotic, steroid, and antiretroviral therapies. After six months, however, she presented with consolidating lung lesions caused by bronchial obstruction from PCP granulomatous disease. Although antibiotics were ineffective, the effectiveness of steroid therapy suggested a diagnosis of granulomatous IRIS caused by persistent PCP antigens. Physicians should strongly suspect PCP in HIV-positive patients with nodular lung lesions and must remain aware that these lesions, if immune in origin, might not respond to antimicrobial therapy.

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Frunza-Stefan, Simona, Gyanendra Acharya, Viktoryia Kazlouskaya, Paunel Vukasinov, Yushan Chiou, and Zeyar Thet. "Immune reconstitution inflammatory syndrome associated with secondary syphilis." International Journal of STD & AIDS 28, no. 3 (September 27, 2016): 302–5. http://dx.doi.org/10.1177/0956462416664469.

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Immune reconstitution inflammatory syndrome (IRIS) is a condition associated with paradoxical worsening and/or new onset of an opportunistic infection in HIV patients following the initiation of anti-retroviral therapy or switching to more potent antiretroviral therapy (ART) regimen. Although IRIS associated with many opportunistic infections (OIs) has been well reported, syphilis has very rarely been mentioned in this regard. A 52-year-old male, diagnosed with AIDS six weeks ago, presented with the disseminated non-pruritic painless skin rash. He denied any fever, cough, shortness of breath, and joint pain or swelling. The patient had no similar symptoms, genital ulcers, or any medical illness in the past. CD4 cell count and viral load were 40 cells/mm3 and 280,000 copies/ml, respectively, while screening tests for OIs including rapid plasma reagin test, quantiferon, cryptococcal antigen, and toxoplasma tests were negative at the time of HIV diagnosis. After three days of initiation of anti-retroviral therapy, he developed the above-mentioned skin rash. Repeat rapid plasma regain (RPR) test at this time was also negative. Punch biopsy of the skin lesion demonstrated findings suggestive of secondary syphilitic lesions, which was confirmed by immunostain. The repeat RPR, CD4 cell count, and viral load showed a titer of 1:256, 257 cells/mm3, and 5000 copies/ml, respectively. His skin rashes faded away, and RPR titer trended down on treatment with benzathine penicillin without discontinuation of ART. The presence of an IRIS response does not predict overall HIV or OI treatment responses, and discontinuation of ART is not generally recommended as the benefits of treating HIV infection outweighs the risk associated with IRIS.

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Mori, S., S. Polatino, and R. M. Estrada-Y-Martin. "Pneumocystis-associated organizing pneumonia as a manifestation of immune reconstitution inflammatory syndrome in an HIV-infected individual with a normal CD4+ T-cell count following antiretroviral therapy." International Journal of STD & AIDS 20, no. 9 (September 2009): 662–65. http://dx.doi.org/10.1258/ijsa.2008.008428.

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We describe a rare case of Pneumocystic jirovecii-associated organizing pneumonia (PJP) in an HIV-infected individual on highly active antiretroviral therapy (HAART) with a CD4+ T-cell count of 835 × 103 cells/mL and a low viral load. PJP was confirmed using transbronchial biopsies and bronchoalveolar lavage. The presentation in this patient suggests immune reconstitution inflammatory syndrome (IRIS) after institution of antiretroviral therapy (ART). This case report, however, is the first documented presentation of PJP in a patient with CD4 count greater than 300 prior to the induction of HAART who developed PJP and organizing pneumonia as a manifestation of IRIS. This suggests that there is continuing immune dysfunction in the face of re-expansion of CD4+ T-cells and low viral load in HIV patients despite ART.

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Lynch, B. "OP0308-PARE PREGNANCY AND ARTHRITIS - A PATIENT EDUCATION PROGRAMME IN IRELAND." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 191.1–191. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1214.

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Background:The relationship between pregnancy and arthritis is a complex one. Because of the variability of arthritic conditions, it is important for patients to get advice from their doctor or a specialist nurse before trying for a baby. There can be implications for medication regimes, while the pregnancy itself can also affect the inflammatory arthritis. In the postpartum period, other considerations include breastfeeding and the frequent return of flares.Through this education programme, Arthritis Ireland developed information resources primarily targeting women of child-bearing age. The multichannel campaign provided information about the wide range of issues of concern to women with inflammatory arthritis who are planning a family or are pregnant.Objectives:•To provide information and increase awareness around inflammatory arthritis and pregnancy;•To support women living with inflammatory arthritis through their illness and life journey;•To increase awareness of the work of Arthritis Ireland as a patient organisation.Methods:In developing and executing this education programme, Arthritis Ireland worked extensively with a team of healthcare professionals, who are regarded internationally as leaders in this field.A multi-channel approach was taken to the development, production and dissemination of information, with public information events, literature and a suite of videos developedUp to this point, there had not been any Irish-produced material on this subject. he topic was seen to be an important one and an issue of significant public health interest.The series of information talks on pregnancy and inflammatory arthritis was delivered by consultant rheumatologists and were held in cities around Ireland. The information booklet covered topics such as planning for a baby, medication and pregnancy, the role of the father, fertility, genetics, during the pregnancy, after the pregnancy and breastfeeding.Video was seen to be central to the success of the campaign. Working with the expert healthcare team, six information videos were developed around obstetrics, rheumatology, physiotherapy and occupational therapy. The videos were published and promoted across Arthritis Ireland’s social media channels and website.The capstone video featured a young mother who was diagnosed with JIA when she was two. Her story was an incredibly powerful testimony of overcoming and dealing with adversity and complex health issues.Results:This educational campaign was developed to meet a significant need in the health information landscape. While there are no little resources produced focusing on pregnancy and parenting, there wasn’t anything in Ireland which specifically addressed the needs of women and men with inflammatory arthritis who are looking to have a family. The materials produced are a valuable part of Arthritis Ireland’s canon of patient education materials.Conclusion:It is anticipated that the materials developed will have a long lifespan and will support prospective parents for several years to come. Central to the success of the project was the involvement of the expert healthcare teams. Their commitment to the project spoke volumes of its importance and the considerable need for the clearly communicated information, which the project provided.Ultimately, Arthritis Ireland has produced a suite of resources which will be referenced and used by patients, and will hopefully make a considerable impact on their quality of life.Acknowledgments:This patient education programme was supported by a grant from UCB.Disclosure of Interests:Brian Lynch Grant/research support from: Arthritis Ireland received a grant from MSD to develop this patient education programme. Brian Lynch has not benefited personally in any way.

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Sandhu, Mani Ratnesh, Ronnye Rutledge, Matthew Grant, Amit Mahajan, and Serena Spudich. "Slowly progressive fatal PML-IRIS following antiretroviral initiation at CD4+ nadir of 350 cells/mm3 despite CD4+ cell count rise to 900 cells/mm3." International Journal of STD & AIDS 30, no. 8 (May 2, 2019): 810–13. http://dx.doi.org/10.1177/0956462419835966.

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AIDS-related progressive multifocal leukoencephalopathy (PML)-immune reconstitution inflammatory syndrome (IRIS) is a central nervous system inflammatory syndrome where immune response to John Cunningham (JC) virus antigen following antiretroviral therapy (ART) causes breakdown of the blood–brain barrier. We report a unique case of PML-IRIS, which presented with dystonic choreoathetosis after initiation of ART at a CD4+ cell count of 350 cells/mm3. This report shows continuous progression of the disease over a period of two years, despite robust immune reconstitution. The worsening of neurological symptoms, persistent positivity of JC virus in CSF, and progressive inflammatory picture on MR scans in the setting of a CD4+ cell count of 900 cells/mm3 highlight a different variant of PML-IRIS, and challenge the role of CD4+ cell count in diagnosing opportunistic infections in HIV/AIDS patients.

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Mouchard, Alice, Romain Blaizot, Jenna Graille, Pierre Couppié, and Chloé Bertin. "Leprosy as immune reconstitution inflammatory syndrome in patients living with HIV: Description of French Guiana’s cases over 20 years and systematic review of the literature." PLOS Neglected Tropical Diseases 16, no. 3 (March 4, 2022): e0010239. http://dx.doi.org/10.1371/journal.pntd.0010239.

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Background HIV infection is highly prevalent in French Guiana, a territory where leprosy is also endemic. Since the introduction of Highly Active Antiretroviral Treatment (HAART) in the management of HIV, leprosy has been reported as part of the immune reconstitution inflammatory syndrome (IRIS). Methodology/Principal findings We aimed to present a general description of these forms of leprosy as IRIS, highlighting clinical and therapeutic specificities. A retrospective study was conducted in French Guiana, including patients living with HIV (PLHIV) with advanced infection (CD4 < 200/mm3) and developing leprosy or a leprosy reaction within six months of HAART initiation, from 2000 to 2020. Clinical, histological and biological data were collected for all these patients. Six patients were reported in French Guiana. A systematic review of the literature was conducted, and its results were added to an overall analysis. Overall, seventy-three PLHIV were included. They were mainly men (74%), aged 22–54 years (median 36 years), mainly from Brazil (46.5%) and India (32.8%). Most leprosy cases (56.2%) were borderline tuberculoid (BT). Leprosy reactions were frequent (74%), mainly type 1 reaction (T1R) (68.5%), sometimes intense with ulceration of skin lesions (22%). Neuritis was observed in 30.1% of patients. The outcome was always favorable under multidrug therapy (MDT), continuation of HAART and additional corticosteroid therapy in case of neuritis or ulceration. There was no relapse. Conclusion Leprosy as IRIS in PLHIV mainly presents as a BT leprosy in a T1R state, sometimes with ulcerated skin lesions. Response to MDT is usually good. Systemic corticosteroids are necessary and efficient in case of neuritis.

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Journal articles on the topic 'Irish occupational therapy'

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