Artigos de revistas sobre o tema "Moths – ireland – identification"
Siga este link para ver outros tipos de publicações sobre o tema: Moths – ireland – identification.
Crie uma referência precisa em APA, MLA, Chicago, Harvard, e outros estilos
Veja os 25 melhores artigos de revistas para estudos sobre o assunto "Moths – ireland – identification".
Ao lado de cada fonte na lista de referências, há um botão "Adicionar à bibliografia". Clique e geraremos automaticamente a citação bibliográfica do trabalho escolhido no estilo de citação de que você precisa: APA, MLA, Harvard, Chicago, Vancouver, etc.
Você também pode baixar o texto completo da publicação científica em formato .pdf e ler o resumo do trabalho online se estiver presente nos metadados.
Veja os artigos de revistas das mais diversas áreas científicas e compile uma bibliografia correta.
1
Frankis, Jamie, Paul Flowers, Lisa McDaid e Adam Bourne. "Low levels of chemsex among men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries". Sexual Health 15, n.º 2 (2018): 144. http://dx.doi.org/10.1071/sh17159.
Texto completo da fonteResumo:
Background This paper establishes the prevalence of chemsex drug use among men who have sex with men (MSM), the extent to which these drugs are used in a sexual context, as well as their associated behaviours and circumstances of use. Methods: Data from a cross-sectional, online survey of 2328 MSM recruited via gay sociosexual media in Scotland, Wales, Northern Ireland and the Republic of Ireland were analysed. Results: While almost half (48.8%) of participants had ever taken illicit drugs, lifetime chemsex drug use was less common (18.0%) and far fewer reported chemsex drug use in the last year (8.2%) or last 4 weeks (3.0%). Just over one-quarter (27.1%) of men who used chemsex drugs in the last year reported no sexualised drug use, but almost three-quarters (72.9%) did. Only 6.1% of the whole sample reported sexualised chemsex drug use in the last year. The odds of reporting chemsex in the last year were significantly higher for men aged 36–45 years (AOR = 1.96), single men (AOR = 1.83), men who were HIV positive (AOR = 4.01), men who report high-risk sex (AOR = 4.46), being fisted (AOR = 7.77) or had sex in exchange for goods other than money (AOR = 4.7) in the last year and men who reported an HIV test in the last 3 months (AOR = 1.53). Discussion: Only a small proportion of MSM in Scotland, Wales, Northern Ireland and the Republic of Ireland reported chemsex, and, for the first time, it is demonstrated that not all chemsex drug use was sexualised. Nevertheless, MSM who engage in chemsex (MWEC) reported substantial sexual risk inequalities. These novel findings highlight several opportunities for intervention, particularly around the multiple vulnerabilities of MWEC, opportunities for early identification of those most vulnerable to chemsex-related harm and the potential to develop a specialised responsive patient pathway.
2
Beresford, Robert M., e Kwang Soo Kim. "Identification of Regional Climatic Conditions Favorable for Development of European Canker of Apple". Phytopathology® 101, n.º 1 (janeiro de 2011): 135–46. http://dx.doi.org/10.1094/phyto-05-10-0137.
Texto completo da fonteResumo:
Months of the year with high risk of European canker (Neonectria galligena) development in areas of the United States, Chile, England, and Northern Ireland were determined from published data. Moving-window analysis of long-term climatic data was used to classify disease risk in these areas in relation to rainfall and temperature conditions using the degree of agreement statistic. Greatest agreement occurred when it both rained on >30% of days/month and there was an average of >8 h/day with temperature of 11 to 16°C. When these thresholds were applied in eight validation areas in New Zealand, Australia, the United States, The Netherlands, and Denmark, areas with reported higher risk of disease tended to be areas where the thresholds were exceeded more often and by greater amounts. Areas at higher latitudes (>52°) with frequent summer rainfall appeared to be most prone to European canker, including the fruit rot phase of the disease, probably because summer temperatures were more favorable than at lower latitudes. The climatic thresholds derived for European canker could be useful for studies of disease establishment risk, surveillance, eradication, climate change impact assessment, and, possibly, for disease risk forecasting. The methods used in this study allowed conditions favorable for disease development to be identified even though quantitative regional disease data were lacking, and they could be useful for similar geoclimatic studies of other diseases.
3
Garry, P., P. Collins e JG Devlin. "An open 36-month study of lipid changes with growth hormone in adults: lipid changes following replacement of growth hormone in adult acquired growth hormone deficiency". European Journal of Endocrinology 134, n.º 1 (janeiro de 1996): 61–66. http://dx.doi.org/10.1530/eje.0.1340061.
Texto completo da fonteResumo:
Garry P. Collins P. Devlin JG. An open 36 month study of lipid changes with growth hormone in adults: lipid changes following replacement of growth hormone in adult acquired growth hormone deficiency. Eur J Endocrinol 1996:134:61–6. ISSN 0804–4643 Interest in adult growth hormone replacement has increased since identification of the associated vascular morbidity and mortality. Although total cholesterol and low density lipoprotein reduction and high density lipoprotein increases are anticipated, reports are conflicting and there is no uniformity in lipoprotein(a) changes. In 1990 we commenced an open trial of therapy with human recombinant GH and now have results to 36 months for 21 patients. Deficiency status was confirmed by insulin stress test with flat GH response <2.0 ng/ml, mean insulin-like growth factor-I value 122 ng/ml (±69 SD). Lipoprotein(a) was measured by monoclonal assay. Lipid analysis yields two subgroups: baseline cholesterol levels of greater or less than 6.22 mmol/l, with hypercholesterolaemic patients showing an enhanced hypolipaemic response. ANOVA was utilized, with 95% confidence limits. The most significant changes are of reductions in cholesterol and low density lipoprotein: the rate of change is greatest at 6 and 12 months but not sustained to 36 months. High density lipoprotein rises as expected, not to full significance. Lipoprotein(a) levels rose significantly in six patients of the cohort, and the increase was sustained over 36 months. JG Devlin, Department of Endocrinology, Beaumont Hospital. Dublin 9. Ireland
4
Flynn, Maureen A., Thora Burgess e Philip Crowley. "Supporting and activating clinical governance development in Ireland: sharing our learning". Journal of Health Organization and Management 29, n.º 4 (15 de junho de 2015): 455–81. http://dx.doi.org/10.1108/jhom-03-2014-0046.
Texto completo da fonteResumo:
Purpose – The purpose of this paper is to present a description of the Irish national clinical governance development initiative and an evaluation of the initiative with the purpose of sharing the learning and proposing actions to activate structures and processes for quality and safety. The Quality and Patient Safety Division of the Health Service Executive established the initiative to counterbalance a possible focus on finances during the economic crisis in Ireland and bring attention to the quality of clinical care. Design/methodology/approach – A clinical governance framework for quality in healthcare in Ireland was developed to clearly articulate the fundamentals of clinical governance. The project plan involved three overlapping phases. The first was designing resources for practice; the second testing the implementation of the national resources in practice; and the third phase focused on gathering feedback and learning. Findings – Staff responded positively to the clinical governance framework. At a time when there are a lot of demands (measurement and scrutiny) the health services leads and responds well to focused support as they improve the quality and safety of services. Promoting the use of the term “governance for quality and safety” assisted in gaining an understanding of the more traditional term “clinical governance”. The experience and outcome of the initiative informed the identification of 12 key learning points and a series of recommendations Research limitations/implications – The initial evaluation was conducted at 24 months so at this stage it is not possible to assess the broader impact of the clinical governance framework beyond the action project hospitals. Practical implications – The single most important obligation for any health system is patient safety and improving the quality of care. The easily accessible, practical resources assisted project teams to lead changes in structures and processes within their services. This paper describes the fundamentals of the clinical governance framework which might serve as a guide for more integrative research endeavours on governance for quality and safety. Originality/value – Experience was gained in both the development of national guidance and their practical use in targeted action projects activating structures and processes that are a prerequisite to delivering safe quality services.
5
Williams, Scott, Ian D. Davis, Christopher Sweeney, Martin R. Stockler, Andrew James Martin, Wendy Hague, Xanthi Coskinas et al. "Randomised phase 3 trial of enzalutamide in androgen deprivation therapy (ADT) with radiation therapy for high risk, clinically localized prostate cancer: ENZARAD (ANZUP 1303)." Journal of Clinical Oncology 36, n.º 6_suppl (20 de fevereiro de 2018): TPS156. http://dx.doi.org/10.1200/jco.2018.36.6_suppl.tps156.
Texto completo da fonteResumo:
TPS156 Background: Adjuvant ADT with an LHRH analog (LHRHA) given before, during and after radiotherapy (RT) is standard of care for high risk localised prostate cancer (PC). Enzalutamide improves overall survival (OS) in castration-resistant, metastatic prostate cancer. We hypothesized that the addition of enzalutamide to adjuvant ADT and RT will improve outcomes. The aim is to determine the effects of enzalutamide versus a conventional non-steroidal anti-androgen (NSAA) as part of neoadjuvant and adjuvant ADT in men undergoing RT for high risk, localized PC. Methods: DESIGN: Open label, randomised, phase 3 trial including ANZ, USA, UK, Ireland and Europe. ENDPOINTS: OS (primary), cause-specific survival, PSA progression free survival (PFS), clinical PFS, time to subsequent hormonal therapy, time to castration-resistant disease (PCWG2 criteria), metastasis free survival (MFS), adverse events and health-related quality of life (HRQOL). CORRELATIVE OBJECTIVES: identification of prognostic/predictive biomarkers from archival tumour tissue and serial blood samples. SAMPLE SIZE: 800 participants with a minimum follow-up of 5.5 yrs is designed to give 80% power to detect 33% reduction in the hazard of death assuming 5-year survival rate of 76% amongst controls. TREATMENT: Enzalutamide 160mg daily for 24 months versus conventional NSAA for 6 months. All participants receive LHRHA for 24 months, and RT starting about week 16 delivered as 78Gy in 39#, or 46Gy in 23# plus brachytherapy (nodal RT optional for N0, mandatory for N1). ASSESSMENTS: Baseline, then every 8 weeks until year 2, then 3-4 monthly until year 5, 6-monthly until year 7, then annually. Imaging with CT/MRI and bone scan at baseline, PSA progression, then 6 monthly until re-initiation of ADT, when PCWG2 criteria for CRPC are met and then 3 monthly until evidence of metastases. 623 participants recruited from 61 sites as of 16 October 2017. ENZARAD is an investigator-initiated cooperative group trial led by ANZUP Cancer Trials Group with funds and product from Astellas. Clinical trial information: NCT02446444.
6
Williams, Scott, Ian D. Davis, Christopher Sweeney, Martin R. Stockler, Andrew James Martin, Wendy Hague, Xanthi Coskinas et al. "Randomised phase III trial of enzalutamide in androgen deprivation therapy (ADT) with radiation therapy for clinically localised, high risk, or node-positive prostate cancer: ENZARAD (ANZUP 1303)." Journal of Clinical Oncology 35, n.º 15_suppl (20 de maio de 2017): TPS5096. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.tps5096.
Texto completo da fonteResumo:
TPS5096 Background: Adjuvant ADT with an LHRH analog (LHRHA) given before, during and after radiotherapy (RT) is standard of care for high risk localised prostate cancer (PC). Enzalutamide is more effective in metastatic disease than conventional non-steroidal anti-androgens (NSAA). We hypothesize that addition of enzalutamide to adjuvant ADT and RT will improve outcomes. The aim is to determine the efficacy of enzalutamide compared with NSAA as part of adjuvant ADT with LHRHA in men planned for RT for localized high risk or node-positive PC. Methods: DESIGN: Open label, randomised, phase 3 trial including ANZ, USA, UK, Ireland and Europe. ENDPOINTS: OS (primary), cause-specific survival, PSA PFS, clinical PFS, time to subsequent hormonal therapy, time to castration-resistant disease (PCWG2 criteria), metastasis free survival, adverse events and HRQOL. Tertiary objectives: identification of prognostic/predictive biomarkers from archival tumour tissue and 4 serial fasting bloods. 800 target participants with 5.5 yrs minimum follow-up. 80% power to detect 33% reduction in the hazard of death assuming 5-year survival rate of 76% amongst controls. TREATMENT: Participants are randomised 1:1 to enzalutamide 160mg daily for 24 months versus conventional NSAA for 6 months. All participants receive LHRHA for 24 months and RT starting after week 16. RT delivered as 78Gy in 39 Fx or 46Gy in 23 Fx plus brachytherapy (nodal RT optional for N0, mandatory for N1). ASSESSMENTS: Baseline, then every 8 weeks until year 2, then 3-4 monthly until year 5, 6-monthly until year 7, then annually. CT/MRI and bone scan at baseline, PSA progression, 6 monthly until re-initiation of ADT, when PCWG2 criteria for CRPC are met and then 3 monthly until evidence of metastases. As of 1st February 2017, 55 of 67 sites open with 398 patients recruited. EORTC sites expected to open from Quarter 1 2017. ENZARAD is an investigator-initiated cooperative group trial led by ANZUP Cancer Trials Group with funds and product from Astellas. ANZUP is supported by Cancer Australia and previously CI NSW. ClinicalTrials.gov: NCT02446444, ANZCTR: ACTRN12614000126617 Clinical trial information: NCT02446444.
7
Codd, Y., R. Mullan, D. Kane, A. Coe e T. Stapleton. "POS0156-HPR ‘THE RIGHT ADVICE, IN THE RIGHT WAY AND AT THE RIGHT TIME’: AN INNOVATIVE MULTIDISCIPLINARY APPROACH TO ADDRESS CLIENT-IDENTIFIED PARTICIPATION NEEDS IN EARLY INFLAMMATORY ARTHRITIS". Annals of the Rheumatic Diseases 80, Suppl 1 (19 de maio de 2021): 291.3–291. http://dx.doi.org/10.1136/annrheumdis-2021-eular.583.
Texto completo da fonteResumo:
Background:Inflammatory arthritis (IA) is a complex life-long disease with negative consequences on occupational performance and significant impact on meaningful life roles. International guidelines for the clinical management of IA consistently recommend early intervention and a multidisciplinary (MDT) approach as the optimum method to address the medical, symptom and broader life impacts, however, barriers to timely access to the MDT is a common issue in clinical practice. Limited research has explored how clinical services support broader life impacts and participation restrictions associated with early disease as part of routine healthcare. Four rheumatology services in Ireland have recently reconfigured to provide an MDT-led early arthritis service which operates in parallel to traditional medical clinics. Staffed by nurses, occupational therapists, and physiotherapists this service provides assessment and management to clients with a new diagnosis of IA along a model of care within four to six weeks of diagnosis with mechanisms to follow the client over their first year of diagnosis.Objectives:To explore how a novel MDT-led early arthritis service addresses client-identified participation restrictions associated with early IA.Methods:A qualitative description (QD) study was used to explore the perspectives of service providers and service users of this MDT-led early arthritis service. Data were gathered using one-off focus groups with service providers, and individual interviews with service users.Results:All staff (n=15) currently working in these services participated in the focus groups. Forty-three service users with IA participated in individual interviews (males n=12: females n=31); diagnosis duration ranged from 5 to 24 months. QD principles and thematic analysis were used in data analysis.Extensive limitations in everyday activity and restriction in participation in meaningful, age-appropriate life roles in early IA were outlined by service users and service providers. Participants described how the MDT-led model provided automatic and immediate access to services focussed on identification and management of occupation-based participation restrictions early in the disease. Participants described how the model used a flexible approach that ensured; ease of early access to a full MDT, prolonged support from the MDT, and a person-centred approach incorporating social prescribing and self-management principles. Service users emphasised the strength of the MDT approach of providing ‘the right advice, in the right way and at the right time’ as the most influential feature that assisted them to address participation restrictions and support positive health outcomes. This was accomplished by the service providers acting in a coordinated and interdisciplinary manner with a clear remit to address participation restrictions alongside the traditional symptom management approach. Findings highlight the feasibility of the MDT-led early arthritis model as an approach to address participation-based restrictions as part of routine healthcare that delivers on the rheumatology guidelines and was positively regarded by both service users and service providers.Conclusion:Findings provide important insights into the role of an innovative early MDT intervention approach in addressing client-identified participation needs in early IA. This model maps onto the Irish rheumatology model of care (HSE, 2018), ‘right place, right time’ approach but importantly includes a ‘right way’ approach which is identified as influential in the effective delivery of client-focussed and client-centred care.References:[1]HSE. (2018). Model of care for rheumatology in Ireland. Retrieved 15/09/2019, https://www.hse.ie/eng/about/who/cspd/ncps/rheumatology/achievements/model-of-care-for-rheumatology-in-ireland.pdfAcknowledgements:The authors, thank you to the research sites who facilitated this study & the service providers and service users who partook in the research. Thank you to Kildare Branch of Arthritis Ireland who provided funding support for the researchDisclosure of Interests:None declared
8
Andrieu, Charlotte, Dalal Al-Sultan, Laura Ivers, Jose Javier Berenguer Pina, Darko Skrobo, Josephine Ballot, Alex J. Eustace et al. "The association of centromere amplification and response to trastuzumab in HER2+ metastatic breast cancer." Journal of Clinical Oncology 41, n.º 16_suppl (1 de junho de 2023): 1016. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.1016.
Texto completo da fonteResumo:
1016 Background: Chromosomal instability and copy number aberration (CNA) burden can be associated with patients' survival in some cancers. Centromeres, chromosomal regions crucial for genomic stability, can be found altered by CNA in tumours but remain largely unexplored due to sequencing technologies. Using whole-genome sequencing (WGS) data from cases of long term, never relapsed HER2+ metastatic breast cancer (MBC) patients, also referred as exceptional responders (ExRs), we aim to better characterise the CNA profiles and underlying long-term survival of this “exceptional” cohort and investigate the centromeric and pericentromeric association with prognosis and treatment response. Methods: Two hundred and forty-three HER2+ MBC patients were enrolled in the HER2 Patients Project Database from St Vincent University Hospital, Dublin, Ireland. Eighty-five HER2+ MBC patients were identified as exceptional survivors (ExS) with an OS > 60 months (range 60-248 months), of which 28 never-relapsed and responded exceptionally (ExR) to trastuzumab. Patients with an OS < 60 months (N=158, range 0.2-59 months) were identified as non responders (NR). WGS was performed on 13 ExR tumours (primary or metastases) and matching control at a mean depth of 60X and 30X, respectively. Control-FREEC and CNVkit were used to characterise the CNA profiles and estimate the CNA burden. Samples from 10 NR patients were used for comparison with the ExR. Results: WGS analysis revealed that ExR samples are more impacted by gain rather than loss of copy overall, with a median fraction altered by gain of 0.24. No significant difference was observed between the ExR and NR in terms of CNA burden. However, a large fragment on chromosome 9 was amplified in 92% of ExR (12/13) which corresponded to the centromere (chr9q11) and a large heterochromatic block (chr9q12). A higher copy number status of this centromeric region was detected in the ExR, with a gain of at least 1 additional copy compared to the NR tumoral samples (P<0.001). The dichotomisation into high versus low copy number of the centromeric region of chromosome 9 was also observed in centromeres of chromosome 17 (P=0.009) and chromosome 19 (P<0.001). No case of polysomy was detected in our cohort and genes located near the centromeres, such as ERBB2 (amplified in both ExR and NR), were independent of the centromeres copy-number status. Conclusions: The identification of the genomic aberrations of these metastatic patients, treated with trastuzumab who never relapsed, increases our understanding of the mechanisms involved in MBC progression. Our results suggest that the centromere co-amplification of chr9q11-q12, chr17p11.1-q11.1 and chr19p11-q11 stratifies patients according to their OS. CNA status of the centromeric regions of chromosomes 9, 17 and 19 may therefore represent a novel prognostic predictor to trastuzumab response and new outcomes for patients.
9
Imtiaz, Nafiz, e John McLaughlin. "Reducing the Pressure on Mental Health Team by Improving Post-Discharge Follow-Up of Self-Harm or Suicidal Patients in Primary Care". BJPsych Open 8, S1 (junho de 2022): S99. http://dx.doi.org/10.1192/bjo.2022.307.
Texto completo da fonteResumo:
AimsNorthern Ireland has had the highest suicide and self-harm rate in the UK since 2012 according to National Statistics Office with 12.5 deaths per 100,000 population compared to 10.5 in the rest of the country. Evidence shows that the risk of suicide hugely increases following self-harm, and the greatest risk is immediately after the self-harm episode. Better access to health care, especially to primary care, in this period, can actively reduce the risk to this vulnerable patient group. Patients assessed for self-harm in the emergency department are often followed up by the mental health/crisis team. Due to lack of resources and staff shortages this is often not possible in a timely fashion. NICE suggests that patients should be offered a follow-up appointment in primary care within 48 hours of discharge. We aimed to ensure 70% of patients discharged from secondary care following an episode of suicidal ideation or self-harm are contacted proactively by mental health practitioner (MHP) or GP within 48 hours of communication from secondary care.MethodsThe project underwent two PDSA cycles. An electronic workflow was created to provide easy patient identification, assessment and follow-up. A process mapping was done after discussion with the GPs, administrative team, practice nurses and MHP. Outcome was measured by finding out percentage of patients: 1) Contacted within 48 hours of communication following an episode of self-harm 2) Appropriately coded 3) Comprehensively assessed 4) Risk stratified and minimized following each cycle.ResultsOver a period of three months, following two PDSA cycles, the frequency of these contacts increased from 0 to 80% (median) with an average 3.8 (83%) patients reviewed per week. The patient experience and satisfaction also improved significantly.ConclusionGeneral practice (GP) has long been known as the next of kin for patients in the health care system. As GP is mostly the first point of contact for the patients, it can contribute significantly to ease the rising pressure on the mental health team. Also, a small number of weekly contacts from each GP can make a huge difference in nationwide patient safety and experience. We hope this intervention will significantly improve patient safety and reduce further self-harm presentation to ED in the long run.
10
McKenna, Julie. "Evidence based research activities, interests and opportunities exist for practitioners in all library sectors in the British Isles". Evidence Based Library and Information Practice 1, n.º 1 (15 de março de 2006): 107. http://dx.doi.org/10.18438/b8kw2r.
Texto completo da fonteResumo:
A review of:
McNicol, Sarah. “Is Research an Untapped Resource in the Library and Information Profession?” Journal of Librarianship and Information Science 36.3 (September 2004):119-26.
Objective – To scope the range, nature and challenges of present, planned and future research by practitioners within libraries in the British Isles.
Design – A series of survey questionnaires sent by mail.
Setting – Public, academic, health, special and school libraries of the British Isles.
Subjects – A total of 2384 questionnaires were sent out and 334 responses were received. 62 academic libraries, 83 health libraries, 78 public libraries, 63 school libraries and 48 special libraries participated in the study.
Methods – This study was undertaken in 2003 by a research team at the University of Central England. Survey questionnaires were sent by mail to library directors in all public library authorities, academic libraries, health libraries and special libraries in England, Wales, Scotland, Northern Ireland and the Republic of Ireland. In addition, questionnaires were sent to the librarians in all state and independent schools within a sample of nine local education authorities.
Each participant was asked to identify past and future research issues of interest and the barriers to research practice within their library. Research was defined to include work on both externally funded and in-house projects and examples of the types of activities that this might include were provided.
Main results – Half the respondents reported that they had been involved in some form of research in the past two years, with the lowest level of involvement from school libraries and the highest in public libraries. Generally, only the library directly involved in conducting the research made use of the findings and a gap in the dissemination of results was identified across sectors. User surveys were the most common form of research undertaken across libraries and slightly fewer respondents intended to carry out research in the coming twelve months than had in the past (the area most commonly mentioned was user surveys). Information and communications technology (ICT) was an area of planned future research in all libraries, as were user needs and user behaviour. The most frequently cited barriers to research activity across all sectors were lack of time and financial resources. Staff skills and the lack of focus on practical problems to solve were indicated as a barrier in health, public and academic libraries.
Libraries reported a range of common uses for the research findings including: informing strategic and service planning; providing benchmarking data and measuring the effectiveness of services; identification of marketing and public relations opportunities; discovery of staff training needs; and use of the results to demonstrate the value of libraries to funding bodies.
Conclusion – This study provides insight into practitioner-focused areas of research interest and possible areas for future investigation. As the author reports in her conclusion, the survey results cannot be considered representative of the wider population.
Since research interests often overlap, a sector wide or cross-sectoral research approach should be considered to allow library staff to identify and resolve common problems. Wide dissemination of research results within the practitioner community would be of benefit to all. Greater communication between practitioner and information science communities is also encouraged, as these communities’ work is mutually beneficial.
11
Iveson, Timothy, Kathleen A. Boyd, Rachel S. Kerr, Jose Robles-Zurita, Mark P. Saunders, Andrew H. Briggs, Jim Cassidy et al. "3-month versus 6-month adjuvant chemotherapy for patients with high-risk stage II and III colorectal cancer: 3-year follow-up of the SCOT non-inferiority RCT". Health Technology Assessment 23, n.º 64 (dezembro de 2019): 1–88. http://dx.doi.org/10.3310/hta23640.
Texto completo da fonteResumo:
Background Oxaliplatin and fluoropyrimidine chemotherapy administered over 6 months is the standard adjuvant regimen for patients with high-risk stage II or III colorectal cancer. However, the regimen is associated with cumulative toxicity, characterised by chronic and often irreversible neuropathy. Objectives To assess the efficacy of 3-month versus 6-month adjuvant chemotherapy for colorectal cancer and to compare the toxicity, health-related quality of life and cost-effectiveness of the durations. Design An international, randomised, open-label, non-inferiority, Phase III, parallel-group trial. Setting A total of 244 oncology clinics from six countries: UK (England, Scotland, Wales and Northern Ireland), Denmark, Spain, Sweden, Australia and New Zealand. Participants Adults aged ≥ 18 years who had undergone curative resection for high-risk stage II or III adenocarcinoma of the colon or rectum. Interventions The adjuvant treatment regimen was either oxaliplatin and 5-fluorouracil or oxaliplatin and capecitabine, randomised to be administered over 3 or 6 months. Main outcome measures The primary outcome was disease-free survival. Overall survival, adverse events, neuropathy and health-related quality of life were also assessed. The main cost categories were chemotherapy treatment and hospitalisation. Cost-effectiveness was assessed through incremental cost comparisons and quality-adjusted life-year gains between the options and was reported as net monetary benefit using a willingness-to-pay threshold of £30,000 per quality-adjusted life-year per patient. Results Recruitment is closed. In total, 6088 patients were randomised (3044 per group) between 27 March 2008 and 29 November 2013, with 6065 included in the intention-to-treat analyses (3-month analysis, n = 3035; 6-month analysis, n = 3030). Follow-up for the primary analysis is complete. The 3-year disease-free survival rate in the 3-month treatment group was 76.7% (standard error 0.8%) and in the 6-month treatment group was 77.1% (standard error 0.8%), equating to a hazard ratio of 1.006 (95% confidence interval 0.909 to 1.114; p-value for non-inferiority = 0.012), confirming non-inferiority for 3-month adjuvant chemotherapy. Frequent adverse events (alopecia, anaemia, anorexia, diarrhoea, fatigue, hand–foot syndrome, mucositis, sensory neuropathy, neutropenia, pain, rash, altered taste, thrombocytopenia and watery eye) showed a significant increase in grade with 6-month duration; the greatest difference was for sensory neuropathy (grade ≥ 3 was 4% for 3-month vs.16% for 6-month duration), for which a higher rate of neuropathy was seen for the 6-month treatment group from month 4 to ≥ 5 years (p < 0.001). Quality-of-life scores were better in the 3-month treatment group over months 4–6. A cost-effectiveness analysis showed 3-month treatment to cost £4881 less over the 8-year analysis period, with an incremental net monetary benefit of £7246 per patient. Conclusions The study achieved its primary end point, showing that 3-month oxaliplatin-containing adjuvant chemotherapy is non-inferior to 6 months of the same regimen; 3-month treatment showed a better safety profile and cost less. For future work, further follow-up will refine long-term estimates of the duration effect on disease-free survival and overall survival. The health economic analysis will be updated to include long-term extrapolation for subgroups. We expect these analyses to be available in 2019–20. The Short Course Oncology Therapy (SCOT) study translational samples may allow the identification of patients who would benefit from longer treatment based on the molecular characteristics of their disease. Trial registration Current Controlled Trials ISRCTN59757862 and EudraCT 2007-003957-10. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 64. See the NIHR Journals Library website for further project information. This research was supported by the Medical Research Council (transferred to NIHR Evaluation, Trials and Studies Coordinating Centre – Efficacy and Mechanism Evaluation; grant reference G0601705), the Swedish Cancer Society and Cancer Research UK Core Clinical Trials Unit Funding (funding reference C6716/A9894).
12
Sellar, Rob S., Clare Rowntree, Ajay J. Vora, Caroline L. Furness, Nicholas Goulden, Chris Mitchell, Anthony V. Moorman e Rachael Hough. "Relapse in Teenage and Young Adult (TYA) Patients Treated on a Pediatric Minimal Residual Disease (MRD) Stratified Protocol Is Associated with a Poor Outcome: Results from UKALL2003". Blood 126, n.º 23 (3 de dezembro de 2015): 2493. http://dx.doi.org/10.1182/blood.v126.23.2493.2493.
Texto completo da fonteResumo:
Abstract The superior outcomes of teenage and young adult (TYA) patients with acute lymphoblastic leukemia (ALL) treated on contemporary pediatric minimal residual disease (MRD) directed chemotherapy regimens compared to adult ALL protocols are well established. However, there are limited data on the outcome of relapse following such regimens and consequently no consensus on optimal salvage strategies. UKALL 2003 was a prospective, randomised controlled trial investigating treatment modification according to MRD status at the end of induction in consecutively diagnosed children and young people with ALL recruited from the UK and Republic of Ireland between October 2003 and June 2011. The trial was initially open to children up to the age of 18 years but the upper age limit was increased to 20th birthday in 2006 and 25th birthday in 2007. Here we report the relapse outcomes of 16 - 24 year old TYA patients recruited to the trial. All TYA patients recruited to UKALL 2003 who subsequently relapsed were identified using the trial database, which also provided data regarding prognostic factors at presentation, MRD risk group, treatment allocation, site of and time to relapse and overall outcome. Individual centers were then contacted for follow up information including salvage chemotherapy, disease response, use of transplantation, subsequent outcome and cause of death. Of a total of 229 TYA patients recruited, 42 (18.3%) relapsed. The immunophenotype in those who subsequently relapsed was precursor B cell (B-ALL) in 30 patients and T cell (T-ALL) in 12. The median white cell count at diagnosis was 22x109/l and 1 patient had central nervous system (CNS) involvement. In B-ALL, 4 had good risk cytogenetics (all high hyperdiploid), 13 had intermediate risk, 6 had high risk (3 with MLL rearrangements), and 7 had unknown cytogenetics. End of induction MRD risk group was low risk in 2, intermediate risk in 11 and high risk in 29. The median time from diagnosis to relapse was 17 months (17.5 months for B-ALL and 14 months for T-ALL, p=0.1). The site of relapse was isolated bone marrow (BM) in 30 patients, combined BM and CNS in 4, combined BM and testicular in 1, and isolated CNS in 6 (T-ALL; 8 BM, 3 BM+CNS, 1 isolated CNS) (B-ALL; 23 BM, 1 BM+CNS, 1 BM + testicular, 5 isolated CNS). 36 of the 42 relapsed patients were given salvage chemotherapy, using a variety of regimens including R3 (n=9), Fludarabine/Cytarabine/Idarubicin based (n=16), and Clofarabine based (n=4). One patient received Blinatumamab and one entered the MARALL study (a Phase I/II study of the combination of Veltuzumab (anti-CD20) and Epratuzumab (anti-CD22) with intensive chemotherapy in patients with relapsed B-cell ALL). A second complete remission rate was achieved in 22 patients (61%) and a further 2 had an empty marrow without count recovery. 23 patients proceeded to an allogeneic hemopoietic stem cell transplant. The median overall survival (OS) from relapse was 213 days (actuarial 5 year OS of 18%). 9 patients remain alive; 8 in remission (1 unconfirmed) and 1 undergoing active treatment. The cause of death in the 33 patients who died was relapsed/refractory disease in 20, complications of re-induction treatment in 4, transplant related complications in 6 and unknown in 2. 1 further patient died of sepsis post transplant in the context of pancytopenia and suspected (though unproven) relapse. Those relapsing earlier than the median of 17 months had a shorter median survival and 5 year OS from relapse compared to those relapsing at >17 months (median 113.5 v 400 days, and OS 10% v 37%, p=0.0075). When this analysis was restricted to only the B-ALL cohort the effect was even more marked (median 151 v 595 days, OS 0% v 45%). No patient with B-ALL relapsing ≤24 months was salvageable. There were no differences in salvage approach between the early and late relapsing cohorts, nor differences in MRD risk. The late relapsing cohort did have more patients with good risk cytogenetics, and fewer with high risk cytogenetics. TYA patients with ALL who relapse despite intensive, contemporary MRD directed chemotherapy have an extremely poor outcome. Patients with B-ALL relapsing at 24 months from diagnosis or earlier are unsalvageable. Improving the outcomes of TYA ALL patients will depend on a) more accurate early identification of those destined to relapse and b) use of innovative therapies in those at high risk of relapse or with overt relapse. Disclosures No relevant conflicts of interest to declare.
13
McDermott, H., D. Morris, E. McArdle, G. O'Mahony, S. Kelly, M. Cormican e R. Cunney. "Isolation of NDM-1-producing Klebsiella pnemoniae in Ireland, July 2011". Eurosurveillance 17, n.º 7 (16 de fevereiro de 2012). http://dx.doi.org/10.2807/ese.17.07.20087-en.
Texto completo da fonteResumo:
We report the identification of New Delhi metallo-beta-lactamase 1 (NDM-1)-producing Klebsiella pnemoniae in Ireland. The organism was resistant to multiple antibiotic classes, including carbapenems, and PCR and sequencing confirmed the presence of the blaNDM-1 gene, carried on a 98kb plasmid. The organism was isolated from an infant, who was born in India and moved to Ireland at the age of four months. This is the first reported isolation of an NDM-1-producing Enterobacteriaceae strain in Ireland.
14
McWilliams, Gerry, Julian C. Leslie e Claire McDowell. "Evaluation of a School-Based Headsprout Intervention for Improving Literacy". Journal of Behavioral Education, 9 de setembro de 2022. http://dx.doi.org/10.1007/s10864-022-09489-y.
Texto completo da fonteResumo:
AbstractHeadsprout Early Reading is a computer-based program designed on behavioral principles to enhance the basic skills that underpin the initial development of reading. In a within and between groups design, and using primary schools within Northern Ireland that had a currently high proportion of disadvantaged pupils, children who were behind their peers in progress with reading were randomly allocated to an intervention group (n = 79), where the target was to work through 80 reading training episodes within a school year, or a teaching as usual group (n = 44). Reading skills were assessed in all children before, at the midpoint, and after the intervention using a flashcard-based phonics identification test with three levels of difficulty, and before and after intervention using a standardized reading assessment, which generated a sentence reading age and a phonics reading age. Both groups showed increased scores on all measures over the 6 months of the study, but the intervention group showed markedly greater improvement. Importantly, the mean scores on sentence reading age and phonics reading age for the intervention group increased by over 17 months and 12.1 months, respectively, as opposed to 7.6 months and 7.8 months with the control group. These findings also validated the use of the flashcard-based phonics identification test with this population. This study indicates that widespread use of Headsprout Early Reading in mainstream education could be highly effective.
15
Kelleher, Dan, Luke Barry, Bernie McGowan, Edel Doherty, John J. Carey e David Kane. "Budget impact analysis of an early identification and referral model for diagnosing patients with suspected rheumatoid arthritis in Ireland". Rheumatology Advances in Practice 4, n.º 2 (2020). http://dx.doi.org/10.1093/rap/rkaa059.
Texto completo da fonteResumo:
Abstract Objective To estimate the budget impact from the perspective of the Irish health-care system attributable to a reconfiguration in the diagnostic care pathway for patients with suspected RA by adopting an early identification and referral model (EIM). Methods The budget impact model evaluated the total health-care use and costs attributable to an EIM to diagnose patients with suspected RA relative to the reference scenario of current practice. The modelling also assessed a primary outcome of effect, which examined how many patients can be diagnosed by a rheumatologist within 3 months of symptom onset. The budget impact analysis model was estimated over a 5-year time frame. Results The EIM generated a cost saving for the Irish health-care system of €237 547 over the time frame relative to current practice. The cost savings were realized owing to a reduction in the number of general practitioner (GP) visits of 18 790 and a reduction in diagnostic tests carried out by GPs. The results showed that 1027 (510%) more patients were diagnosed within 3 months of symptom onset in the EIM compared with current practice. Conclusion This paper has presented an alternative rheumatologist-led service design that can be used in diagnosing patients with suspected RA. The rheumatologist-led service provision detailed in this study has the potential simultaneously to reduce demand for primary care services and to improve the health outcomes of patients. The use of an EIM sees rheumatologist activity incorporate patient demand.
16
Wooding, Eva Louise, Michael John Stuart Morton, Ming Lim, Oana Mitrofan, Nadine Mushet, Adrian Sie, Brodie Knight, Tamsin Ford e Tamsin Newlove-Delgado. "Childhood/adolescent Sydenham’s chorea in the UK and Ireland: a BPSU/CAPSS surveillance study". Archives of Disease in Childhood, 24 de maio de 2023, archdischild—2023–325399. http://dx.doi.org/10.1136/archdischild-2023-325399.
Texto completo da fonteResumo:
ObjectiveTo conduct the first prospective surveillance study of Sydenham’s chorea (SC) in the UK and Ireland, and to describe the current paediatric and child psychiatric service-related incidence, presentation and management of SC in children and young people aged 0–16 years.DesignSurveillance study of first presentations of SC reported by paediatricians via the British Paediatric Surveillance Unit (BPSU) and all presentations of SC reported by child and adolescent psychiatrists through the Child and Adolescent Psychiatry Surveillance System (CAPSS).ResultsOver 24 months from November 2018, 72 reports were made via BPSU, of which 43 met the surveillance case definition of being eligible cases of suspected or confirmed SC. This translates to an estimated paediatric service-related incidence rate of new SC cases of 0.16 per 100 000 children aged 0–16 per year in the UK. No reports were made via CAPSS over the 18-month reporting period, although over 75% of BPSU cases presented with emotional and/or behavioural symptoms. Almost all cases were prescribed courses of antibiotics of varying duration, and around a quarter of cases (22%) received immunomodulatory treatment.ConclusionsSC remains a rare condition in the UK and Ireland but has not disappeared. Our findings emphasise the impact that the condition can have on children’s functioning and confirm that paediatricians and child psychiatrists should remain vigilant to its presenting features, which commonly include emotional and behavioural symptoms. There is a further need for development of consensus around identification, diagnosis and management across child health settings.
17
McDonnell, M. W., N. Kelly, T. O'Malley, S. Coleman, H. Kavanagh, C. Prendergast, K. Joksaite et al. "176 The AVERT DOSE international trial: an update on the Irish experience". Age and Ageing 52, Supplement_3 (setembro de 2023). http://dx.doi.org/10.1093/ageing/afad156.155.
Texto completo da fonteResumo:
Abstract Background Mobility training is a complex intervention and recovery post-stroke is multidimensional. AVERT DOSE aims to define optimal early intervention regimens for people with mild to moderate ischaemic stroke. Methods AVERT DOSE (ACTRN:12619000557134) is an international randomised trial that will recruit >2,500 patients. Randomisation is to two groups according to stroke severity. Patients are then randomised to one of four mobility training regimens in each strata and the intervention is delivered for up to 14-days. Primary Outcome: Identification of the intervention regimen that results in higher proportion of favourable outcome at 3-months post-stroke. Results In Ireland, 4 sites are actively recruiting (1,2,3 and 7), one completing training (4) and two finalising ethical approval and contracts (5,6). Eighteen patients have been recruited to date in Ireland, and over 400 internationally. Trial set-up has proven complex with processes and requirements differing significantly across Irish sites. Time to ethics approval has ranged from 10-months to over 3-years. The novel status of this trial as a non-drug/medical device trial, but rather rehabilitation trial, had led to discussion in relation to the need for a trial EU representative. Staff recruitment and retention challenges have proven to be a significant barrier to recruitment in recent months. The development of an Irish Avert Dose group to collaboratively address challenges and provide peer support has proven very successful in both supporting sites to reach recruitment stage and throughout the stages of screening, recruitment, intervention and blind assessment. Conclusion Undertaking rehabilitation research against the backdrop of a global pandemic and increasing staffing challenges requires a determined, problem-solving approach. Irish sites have embraced this opportunity to answer an important stroke research question. Health and social care professionals have displayed innovation and competence in steering clinical research and this should improve future rehabilitation trial readiness. Trial recruitment is expected to gain pace as more Irish and international sites are approved.
18
Fitzgerald, Brendan, Keelin O'Donoghue, Noel McEntagart, John E. Gillan, Peter Kelehan, John O'Leary, Paul Downey et al. "Fetal deaths in Ireland due to SARS-CoV-2 placentitis caused by SARS-CoV-2 Alpha". Archives of Pathology & Laboratory Medicine, 12 de janeiro de 2022. http://dx.doi.org/10.5858/arpa.2021-0586-sa.
Texto completo da fonteResumo:
ABSTRACT Context.- A severe third wave of COVID-19 disease affected Ireland in the first 3 months of 2021. In this wave, 1 second trimester miscarriage and 6 stillbirths were observed in the Irish population due to placental insufficiency as a result of SARS-CoV-2 placentitis. This observation was at odds with the country's previous experience with COVID-19 disease in pregnant mothers. Objective.- To describe the clinical and pathological features of these pregnancy losses. Design.- Retrospective review of clinical and pathological data of cases of second trimester miscarriage, stillbirth or neonatal death identified by perinatal pathologists as being due to SARS-CoV-2 placentitis during the third wave of COVID-19 in Ireland. Results.- Clinical and pathological data was available for review in 6 pregnancies. Sequencing or genotyping of the virus identified SARS-CoV-2 Alpha (B.1.1.7) in all cases. Three of the 6 cases had maternal thrombocytopenia, while fetal growth restriction was not prominent suggesting a rapidly progressive placental disease. Conclusions.- The identification of SARS-CoV-2 Alpha in all these cases suggests that the emergence of the variant was associated with an increased risk of fetal death due to SARSCoV-2 placentitis when compared to the original virus. Maternal thrombocytopenia, may have potential as a clinical marker of placentitis but other inflammatory markers need investigation. Three of the 6 women had been assessed for reduced fetal movements in hospital some days before the fetal deaths actually occurred; this could suggest that there may be a window for intervention in some cases.
19
Bluett‐Duncan, Matthew, Philip Bullen, Ellen Campbell, Jill Clayton‐Smith, John Craig, Marta García‐Fiñana, David M. Hughes et al. "The use of parent‐completed questionnaires to investigate developmental outcomes in large populations of children exposed to antiseizure medications in pregnancy". Epilepsia, 22 de maio de 2024. http://dx.doi.org/10.1111/epi.18001.
Texto completo da fonteResumo:
AbstractObjectiveThis study was undertaken to assess the utility of the Ages and Stages Questionnaire–3rd Edition (ASQ‐3) and the Vineland Adaptive Behavior Scales–2nd Edition (VABS‐II) as neurodevelopmental screening tools for infants exposed to antiseizure medications in utero, and to examine their suitability for use in large‐population signal generation initiatives.MethodsParticipants were women with epilepsy who were recruited from 21 hospitals in England and Northern Ireland during pregnancy between 2014 and 2016. Offspring were assessed at 24 months old using the Bayley Scales of Infant Development–3rd Edition (BSID‐III), the VABS‐II, and the ASQ‐3 (n = 223). The sensitivity and specificity of the ASQ‐3 and VABS‐II to identify developmental delay at 24 months were examined, using the BSID‐III to define cases.ResultsThe ASQ‐3 identified 65 children (29.1%) as at risk of developmental delay at 24 months using standard referral criteria. Using a categorical approach and standard referral criteria to identify delay in the ASQ‐3 and BSID‐III at 24 months, the ASQ‐3 showed excellent sensitivity (90.9%) and moderate specificity (74.1%). Utilizing different cut‐points resulted in improved properties and may be preferred in certain contexts. The VABS‐II exhibited the strongest psychometric properties when borderline impairment (>1 SD below the mean) was compared to BSID‐III referral data (sensitivity = 100.0%, specificity = 96.6%).SignificanceBoth the ASQ‐3 and VABS‐II have good psychometric properties in a sample of children exposed to antiseizure medications when the purpose is the identification of at‐risk groups. These findings identify the ASQ‐3 as a measure that could be used effectively as part of a tiered surveillance system for teratogenic exposure by identifying a subset of individuals for more detailed investigations. Although the VABS‐II has excellent psychometric properties, it is more labor‐intensive for both the research team and participants and is available in fewer languages than the ASQ‐3.
20
Basu, Rumia, Owen Fenton, Eve Daly e Patrick Tuohy. "Identifying favourable conditions for farm scale trafficability and grass growth using a combined Sentinel-2 and soil moisture deficit approach". Frontiers in Environmental Science 12 (27 de fevereiro de 2024). http://dx.doi.org/10.3389/fenvs.2024.1331659.
Texto completo da fonteResumo:
In Atlantic Europe, on poorly drained grasslands soils, compaction negatively affects soil health when trafficked in wet conditions, while optimum grass growth cannot be achieved in excessively dry conditions. In Ireland, daily soil moisture deficit (SMD) information is forecasted at regional scale for all soil drainage classes. Optimal paddock conditions can occur between trafficking (10 mm) and optimum grass growth (50 mm) SMD thresholds for an identified drainage class. The objective of this farm scale study is to improve the identification of optimum conditions in time and space by combining high resolution spatial soil moisture estimates with soil drainage class specific SMD data. For that purpose, Sentinel- 2 (S-2) data was used in a modified Optical Trapezoid Model (OPTRAM) to derive normalised surface soil moisture (nSSM) estimates at farm level. In-situ soil moisture sensors providing daily estimates of volumetric soil moisture were used for validation of OPTRAM with an RMSE of 0.05. Cumulative 7-day SMD prior to the date of each S-2 image was analysed for each year from 2017-2021 to select nSSM maps corresponding to negative, 0 or −0 and positive SMD. Results established a relationship between nSSM and SMD indicating optimal conditions changed spatially and temporally. The months of April, May, August and September always presented at least 35% of the farm area available for optimum management operations. Future refinement of this methodology utilising daily high resolution remote sensing data could provide near real-time information for farmers.
21
Abutheraa, Nouf, Emma-Louise Tarburn, Charlene M. McShane, Andrew Duncombe, Mary Frances McMullin e Lesley Ann Anderson. "The aetiology and burden of myeloproliferative neoplasms in the United Kingdom: the MyelOproliferative neoplasmS: an In-depth case-control (MOSAICC) study protocol". BMC Cancer 23, n.º 1 (7 de dezembro de 2023). http://dx.doi.org/10.1186/s12885-023-11483-0.
Texto completo da fonteResumo:
Abstract Background Myeloproliferative neoplasms (MPNs) are a group of haematological malignancies that affect approximately 8 people in every 100,000 individuals in the UK. Little is known about the aetiology of MPNs, as previous studies have been hampered by small sample sizes, thus it is important to understand the cause of MPNs in a larger study to identify prevention strategies and improve treatment strategies. This study aims to determine environmental, lifestyle, genetic and medical causes of MPNs and to assess the relevance of occupational carcinogen exposures and quality of life impacts. Methods A UK-wide case-control study of 610 recently diagnosed MPN patients (within 24 months) receiving clinical care at 21 NHS study sites in Scotland, England, Wales and Northern Ireland and 610 non-blood relative/friend controls is underway. Data on occupational and residential history, medical and environmental factors, and quality of life are being collected from the participants via a structured interview and self-complete questionnaires. Clinical data is being provided by the clinical team. Blood, saliva and toenail samples are also being collected for genetic and elemental analysis. Adjusted odds ratios (ORs) and 95% confidence intervals (95%CI) will be calculated using a p < 0.05 to investigate potential risk factors for the MPN clinical and genetic subtypes, and further analyses will be conducted based on the type of data and outcome of interest at a later stage. Discussion The study design is most effective for investigating the aetiology of rare diseases. The study will enable identification of potential causes of MPNs through in-depth assessment of potential risk factors with potential for longer follow-up of a number of outcomes.
22
Barry, Shane. "Finding lost words: The ‘savings effect’ in the Irish language context". International Journal of Bilingualism, 7 de junho de 2022, 136700692211015. http://dx.doi.org/10.1177/13670069221101512.
Texto completo da fonteResumo:
Aims: By applying the savings paradigm to determine the presence of residual Irish language knowledge, this study seeks to investigate the relearning advantage for the acquisition of words likely to have been acquired during the second language acquisition of Irish compared with newly acquired Irish words. Furthermore, self-efficacy will be assessed as a robust self-assessed predictor of performance. Methodology: Using a corpus of Irish language, low- and high-frequency nouns were used to create a list of ‘old’ and ‘new’ words. Thirty-six participants were tested over 2 months, across three phases. Each participant was provided with a relearning session before being tested on their individualised list of 40 words. Participants were asked to rate their self-efficacy confidence levels before each testing session. Data and analysis: An online survey platform was used at each phase to test residual knowledge and to gather self-efficacy and attitudinal data. Correlation analyses and independent t-tests were carried out to measure the effect sizes over the 2-month time period of testing. Findings: The data provide evidence that Irish nouns likely to have been previously encountered, but since forgotten, are recalled more efficiently than newly encountered Irish nouns. Furthermore, evidence of cognateness as a retrieval strategy reveals an active Irish language residual knowledge base. Originality: This paper is the first effort in applying the savings paradigm methodology, as demonstrated in de Bot et al., to the Irish language context, and is the first attempt at measuring perceived pre-test Irish language abilities using self-efficacy. Implications: With Irish language as a compulsory school subject in Ireland, and so few daily users of the language, the identification of residual Irish knowledge in a population that has not used the language in decades may encourage reactivation of a language presumed to be forgotten.
23
Steen, G., N. Maher, N. Fallon, C. O'Carroll, J. Carragher, K. McCarroll e R. Lannon. "299 Impact of a dedicated fracture liaison service candidate ANP on wait times in a geriatrician-led specialist bone health service". Age and Ageing 52, Supplement_3 (setembro de 2023). http://dx.doi.org/10.1093/ageing/afad156.296.
Texto completo da fonteResumo:
Abstract Background A specialist osteoporosis and bone health service was founded in 2003 in our institution. It sees a range of patients—providing DXA alone to giving specialist opinion on complex cases from all Ireland. Dedicated flow for hip fractures is well established however the advent of the fracture liaison database audit brought challenges providing DXA and reviewing specific acute fractures within the 12 week standard. Fracture liaison services target those who’ve just fractured with the aim of reducing risk of further imminent fracture by screening for osteoporosis and initiating bone protection measures. Methods Wait times for unselected direct review in the nurse led pre-assessment clinic with DXA were compared to the direct identification, review of DXA and subsequent follow up if indicated by a newly appointed candidate ANP (cANP). Results Average wait time for initial review of acute Colles/vertebral/humeral fractures prior to the cANP appointment was 10 months with further waits for consultant led bone clinic. Following the cANP appointment 318 relevant fractures were identified from September 2022 to May 2023. A 3 month lag was applied. Initial DXA took place on average 10 weeks post fracture (range 2–24). After this 169 patients were discharged back to GP with recommendations as scores above −2.0 on DXA as per locally agreed protocol for fractures and osteopenia; 111 seen in FLS by cANP for detailed assessment including bloods and risk factor review under supervision of their clinical mentor. 6 have not attended; the remainder await review. Average time from fracture to review by cANP is already 18 weeks. Conclusion Appointment of a dedicated cANP for fracture liaison has already streamlined bone health assessment for acute fractures attending our hospital as well as freed appointments in the specialist bone service. As the FLS service establishes we expect to reach the 12 week target consistently.
24
Lehane, Elaine, Catherine Buckley, Helen Mulcahy, Elizabeth McCarthy, Liz Cogan, Rhona O’Connell, Margaret Murphy e Patricia Leahy-Warren. "Evaluating the process of practice enhancement for exclusive breastfeeding (PEEB): a participatory action research approach for clinical innovation". International Breastfeeding Journal 19, n.º 1 (31 de maio de 2024). http://dx.doi.org/10.1186/s13006-024-00648-7.
Texto completo da fonteResumo:
Abstract Background Despite the known benefits of exclusive breastfeeding, global rates remain below recommended targets, with Ireland having one of the lowest rates in the world. This study explores the efficacy of Participatory Action Research (PAR) and Work-Based Learning Groups (WBLGs) to enhance breastfeeding practices within Irish healthcare settings from the perspective of WBLG participants and facilitators. Methods Employing a PAR approach, interdisciplinary healthcare professionals across maternity, primary, and community care settings (n = 94) participated in monthly WBLGs facilitated by three research and practice experts. These sessions, conducted over nine months (November 2021 – July 2022), focused on critical reflective and experiential learning to identify and understand existing breastfeeding culture and practices. Data were collected through participant feedback, facilitator notes, and reflective exercises, with analysis centered on participant engagement and the effectiveness of WBLGs. This approach facilitated a comprehensive understanding of breastfeeding support challenges and opportunities, leading to the development of actionable themes and strategies for practice improvement. Results Data analysis from WBLG participants led to the identification of five key themes: Empowerment, Ethos, Journey, Vision, and Personal Experience. These themes shaped the participants’ meta-narrative, emphasising a journey of knowledge-building and empowerment for breastfeeding women and supporting staff, underlining the importance of teamwork and multidisciplinary approaches. The project team’s evaluation highlighted four additional themes: Building Momentum, Balancing, Space Matters, and Being Present. These themes reflect the dynamics of the PAR process, highlighting the significance of creating a conducive environment for discussion, ensuring diverse engagement, and maintaining energy and focus to foster meaningful practice changes in breastfeeding support. Conclusion This study highlights the potential of WBLGs and PAR to enhance the understanding and approach of healthcare professionals towards breastfeeding support. By fostering reflective and collaborative learning environments, the study has contributed to a deeper understanding of the challenges in breastfeeding support and identified key areas for improvement. The methodologies and themes identified hold promise to inform future practice and policy development in maternal and child health.
25
Bowe, A., A. Staines e D. Murray. "Predictive utility of the ages and stages questionnaire for below average cognitive ability at age 5". European Journal of Public Health 31, Supplement_3 (1 de outubro de 2021). http://dx.doi.org/10.1093/eurpub/ckab165.498.
Texto completo da fonteResumo:
Abstract Background The first 1000 days of life are a period of unique sensitivity and plasticity during which critical cognitive abilities are formed. For children at risk of later cognitive difficulties, this period is the ideal target for early intervention initiatives. Routine developmental screening tools aim to identify infants who would benefit from early intervention. While these tools have been validated for detecting children with more severe neurodevelopmental disorders, their ability to identify the larger proportion with below average cognitive ability has not been sufficiently explored. The aim of this study was to examine the predictive utility of the Ages and Stages Questionnaire (ASQ), for identifying children with later below average cognitive function. Methods The study population (n = 8260) is formed from two national cohort studies, the Growing Up in Ireland Infant cohort (n = 7,444) and the Cork BASELINE cohort (n = 816). The ASQ was completed at 8- and 24-months respectively. Cognitive assessments were performed at age 5. Those scoring <1 standard deviation below the mean were categorised as below average cognitive ability. Applying the currently used onward referral criterion (one fail in any domain) the sensitivity, specificity, positive and negative predictive values of the 8- and 24-month ASQ for detecting children with later below average cognitive function were calculated. Results The sensitivities of the 8-month and 24-month ASQ for detecting children with below average cognitive ability were 16.4% (95% CI 14.0-19.0) and 20.8% (95% CI 13.6-30.2) respectively, with specificity of 92.0% (95% CI 91.3-92.6) and 91.1% (95% CI 88.6-93.2). Conclusions The ASQ has a low sensitivity for identifying children with below average cognitive ability at age 5. The findings of this study suggest that if we are to intervene early in the developmental trajectory for children with below average cognitive ability alternative methods of identifying high risk infants are needed. Key messages The ages and stages questionnaire, a widely used routine infant developmental screening tool, has a low sensitivity between 16%-21% for detecting later below average cognitive ability. To enable intervention in the first 1000 days of life for children at risk of later below average cognitive ability alternative methods of screening and risk identification require investigation.