• Psychosocial Interventions for Problem Alcohol Use in Primary Care Settings (PINTA): Baseline Feasibility Data

      Klimas, Jan; Henihan, Anne Marie; McCombe, Geoff; Swan, Davina; Anderson, Rolande; Bury, Gerard; Dunne, Colum; Keenan, Eamon; Saunders, Jean; Shorter, Gillian Williams; et al. (2015-05-18)
    • Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users

      Klimas, J.; Tobin, H.; Field, C.A.; O'Gorman, C.; Glynn, L.; Keenan, E.; Saunders, J.; Bury, G.; Dunne, C.; Cullen, W. (Wiley Online Library, 2014-12-03)
    • Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users.

      Klimas, Jan; Fairgrieve, Christopher; Tobin, Helen; Field, Catherine-Anne; O'Gorman, Clodagh SM; Glynn, Liam G; Keenan, Eamon; Saunders, Jean; Bury, Gerard; Dunne, Colum; et al. (2018-12-05)
      Problem alcohol use is common among people who use illicit drugs (PWID) and is associated with adverse health outcomes. It is also an important factor contributing to a poor prognosis among drug users with hepatitis C virus (HCV) as it impacts on progression to hepatic cirrhosis or opioid overdose in PWID. To assess the effectiveness of psychosocial interventions to reduce alcohol consumption in PWID (users of opioids and stimulants). We searched the Cochrane Drugs and Alcohol Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO, from inception up to August 2017, and the reference lists of eligible articles. We also searched: 1) conference proceedings (online archives only) of the Society for the Study of Addiction, International Harm Reduction Association, International Conference on Alcohol Harm Reduction and American Association for the Treatment of Opioid Dependence; and 2) online registers of clinical trials: Current Controlled Trials, ClinicalTrials.gov, Center Watch and the World Health Organization International Clinical Trials Registry Platform. We included randomised controlled trials comparing psychosocial interventions with other psychosocial treatment, or treatment as usual, in adult PWIDs (aged at least 18 years) with concurrent problem alcohol use.
    • Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: Cochrane Reviewa

      Klimas, Jan; Field, Catherine-Anne; Cullen, Walter; O’Gorman, Clodagh S; Glynn, Liam G; Keenan, Eamon; Saunders, Jean; Bury, Gerard; Dunne, Colum (2013-01-12)
      Abstract Background Problem alcohol use is common among illicit drug users and is associated with adverse health outcomes. It is also an important factor in poor prognosis among drug users with hepatitis C virus (HCV) as it impacts progression to hepatic cirrhosis or opiate overdose in opioid users. The aim of this systematic review was to assess the effects of psychosocial interventions for problem alcohol use in adult illicit drug users with concurrent problem alcohol use (principally, problem drug users of opiates and stimulants). Methods We searched the following databases (November 2011): Cochrane Library, PUBMED, EMBASE, CINAHL, PsycINFO and reference list of articles. We also searched conference proceedings and online registers of clinical trials. Two reviewers independently assessed risk of bias and extracted data from included randomized controlled trials. Results Four studies (594 participants) were included in this review. Half of the trials were rated as having a high or unclear risk of bias. The four studies considered six different psychosocial interventions grouped into four comparisons: 1) cognitive-behavioral coping skills training versus 12-step facilitation (N = 41), 2) brief intervention versus treatment as usual (N = 110), 3) hepatitis health promotion versus motivational interviewing (N = 256), and 4) brief motivational intervention versus assessment-only group (N = 187). Differences between studies precluded any pooling of data. Findings are described for each trial individually. Most findings were not statistically significant except for comparison 2: decreased alcohol use at three months (risk ratio (RR) 0.32; 95% confidence interval (CI) 0.19 to 0.54) and nine months (RR 0.16; 95% CI 0.08 to 0.33) in the treatment-as-usual group and comparison 4: reduced alcohol use in the brief motivational intervention (RR 1.67; 95% CI 1.08 to 2.60). Conclusions No conclusion can be made because of the paucity of the data and the low quality of the retrieved studies.
    • Psychotic symptoms, functioning and coping in adolescents with mental illness

      Wigman, Johanna TW; Devlin, Nina; Kelleher, Ian; Murtagh, Aileen; Harley, Michelle; Kehoe, Anne; Fitzpatrick, Carol; Cannon, Mary (2014-04-01)
      Abstract Background Psychotic symptoms in the context of psychiatric disorders are associated with poor functional outcomes. Environmental stressors are important in the development of psychosis; however, distress may only be pathogenic when it exceeds an individual’s ability to cope with it. Therefore, one interesting factor regarding poor functional outcomes in patients with psychotic symptoms may be poor coping. This paper aimed to address the question whether 1) psychotic symptoms are associated with poorer functioning and 2) whether poor coping moderated the association. Methods In a clinical case-clinical control study of 106 newly-referred adolescent patients with non-psychotic psychiatric disorders, coping was investigated using the Adolescents Coping Scale. Severity of impairment in socio-occupational functioning was assessed with the Children’s Global Assessment Scale. Results Patients with non-psychotic psychiatric disorders and additional psychotic symptoms (N = 50) had poorer functioning and were more likely to use avoidance-oriented coping compared to patients with non-psychotic psychiatric disorders without psychotic symptoms (N = 56). No differences were found with respect to approach-oriented coping. When stratifying for poor/good coping, only those adolescent patients with psychotic symptoms who applied poor coping (i.e. less use of approach-oriented coping styles [OR 0.24, p < 0.015] and more use of avoidance-oriented coping [OR 0.23, p < 0.034]) had poorer functioning. However, these interactions were not significant. Conclusions Non-adaptive coping and poorer functioning were more often present in adolescents with non-psychotic psychiatric disorders and additional psychotic symptoms. Due to small subgroups, our analyses could not give definitive conclusions about the question whether coping moderated the association between psychotic symptoms and functioning. Improvement of coping skills may form an important target for intervention that may contribute to better clinical and functional outcomes in patients with psychotic symptoms.
    • Public awareness of mouth, head and neck cancer.

      MacCarthy, D; O'Sullivan, E (2010-11)
    • Public knowledge of head and neck cancer.

      O'Connor, T E; Papanikolaou, V; Keogh, I J; Department of Otolaryngology, Galway University Hospitals, Newcastle Rd, Galway. antoconnor@ireland.com (2010-04)
      Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.
    • The publication of medical images.

      McNeill, G; Torregianni, W C (2010-05)
    • Pulmonary blastoma: a case report and review of the literature

      Smyth, Robert J; Fabre, Aurelie; Dodd, Johnathan D; Bartosik, Waldemar; Gallagher, Charles G; McKone, Edward F (2014-05-13)
      Abstract Background Pulmonary blastomas are a rare aggressive neoplasm comprising 0.25-0.5% of all primary lung tumors and portend a poor prognosis. They display a biphasic histology with mesenchymal and epithelial components. Historically, the term pulmonary blastoma had included both pure fetal adenocarcinomas, pleuropulmonary blastomas as well as the classic biphasic blastomas. However recent World Health Organisation re-classifications separated well-differentiated fetal adenocarcinomas and pleuropulmonary blastomas from the biphasic tumours. Case presentation We present a case of a systemically well 67-year-old Caucasian male who presented with haemoptysis. Investigations confirmed the presence of a large right-sided lung mass and biopsy identified non-small cell carcinoma. The resected tumour was markedly necrotic revealing a biphasic pattern. It was composed of malignant glandular tissue with sub-nuclear vacuoles, associated with a pleomorphic stromal malignant blastematous component, characteristic of classic biphasic pulmonary blastoma. Conclusion We present a case of a classic biphasic pulmonary blastoma, a rare lung cancer occurring at an earlier age and portending to poorer prognosis than other more common lung cancers. Given the small number of cases and recent re-classification, interpreting the published epidemiology and clinical features of this disease is difficult. Many earlier reports may have included fetal adenocarcinomas (in particular high grade variant), which need to be considered when discussing treatment and prognosis with newly-diagnosed patients. Much could be gained from a central registry of individual experiences to improve our understanding of this rare lung cancer.
    • Purinergic receptor antagonists inhibit odorant-mediated CREB phosphorylation in sustentacular cells of mouse olfactory epithelium

      Dooley, Ruth; Mashukova, Anastasia; Toetter, Bastian; Hatt, Hanns; Neuhaus, Eva M (2011-08-22)
      Abstract Background Extracellular nucleotides have long been known to play neuromodulatory roles and to be involved in intercellular signalling. In the olfactory system, ATP is released by olfactory neurons, and exogenous ATP can evoke an increase in intracellular calcium concentration in sustentacular cells, the nonneuronal supporting cells of the olfactory epithelium. Here we investigate the hypothesis that olfactory neurons communicate with sustentacular cells via extracellular ATP and purinergic receptor activation. Results Here we show that exposure of mice to a mixture of odorants induced a significant increase in the levels of the transcription factor CREB phosphorylated at Ser-133 in the nuclei of both olfactory sensory neurons and sustentacular cells. This activation was dependent on adenylyl cyclase III-mediated olfactory signaling and on activation of P2Y purinergic receptors on sustentacular cells. Purinergic receptor antagonists inhibited odorant-dependent CREB phosphorylation specifically in the nuclei of the sustentacular cells. Conclusion Our results point to a possible role for extracellular nucleotides in mediating intercellular communication between the neurons and sustentacular cells of the olfactory epithelium in response to odorant exposure. Maintenance of extracellular ionic gradients and metabolism of noxious chemicals by sustentacular cells may therefore be regulated in an odorant-dependent manner by olfactory sensory neurons.
    • QTrim: a novel tool for the quality trimming of sequence reads generated using the Roche/454 sequencing platform

      Shrestha, Ram K; Lubinsky, Baruch; Bansode, Vijay B; Moinz, Mónica BJ; McCormack, Grace P; Travers, Simon A (2014-01-30)
      Abstract Background Many high throughput sequencing (HTS) approaches, such as the Roche/454 platform, produce sequences in which the quality of the sequence (as measured by a Phred-like quality scores) decreases linearly across a sequence read. Undertaking quality trimming of this data is essential to enable confidence in the results of subsequent downstream analysis. Here, we have developed a novel, highly sensitive and accurate approach (QTrim) for the quality trimming of sequence reads generated using the Roche/454 sequencing platform (or any platform with long reads that outputs Phred-like quality scores). Results The performance of QTrim was evaluated against all other available quality trimming approaches on both poor and high quality 454 sequence data. In all cases, QTrim appears to perform equally as well as the best other approach (PRINSEQ) with these two methods significantly outperforming all other methods. Further analysis of the trimmed data revealed that the novel trimming approach implemented in QTrim ensures that the prevalence of low quality bases in the resulting trimmed data is substantially lower than PRINSEQ or any of the other approaches tested. Conclusions QTrim is a novel, highly sensitive and accurate algorithm for the quality trimming of Roche/454 sequence reads. It is implemented both as an executable program that can be integrated with standalone sequence analysis pipelines and as a web-based application to enable individuals with little or no bioinformatics experience to quality trim their sequence data.
    • A qualitative systematic review of studies using the normalization process theory to research implementation processes

      McEvoy, Rachel; Ballini, Luciana; Maltoni, Susanna; O’Donnell, Catherine A; Mair, Frances S; MacFarlane, Anne (2014-01-02)
      Abstract Background There is a well-recognized need for greater use of theory to address research translational gaps. Normalization Process Theory (NPT) provides a set of sociological tools to understand and explain the social processes through which new or modified practices of thinking, enacting, and organizing work are implemented, embedded, and integrated in healthcare and other organizational settings. This review of NPT offers readers the opportunity to observe how, and in what areas, a particular theoretical approach to implementation is being used. In this article we review the literature on NPT in order to understand what interventions NPT is being used to analyze, how NPT is being operationalized, and the reported benefits, if any, of using NPT. Methods Using a framework analysis approach, we conducted a qualitative systematic review of peer-reviewed literature using NPT. We searched 12 electronic databases and all citations linked to six key NPT development papers. Grey literature/unpublished studies were not sought. Limitations of English language, healthcare setting and year of publication 2006 to June 2012 were set. Results Twenty-nine articles met the inclusion criteria; in the main, NPT is being applied to qualitatively analyze a diverse range of complex interventions, many beyond its original field of e-health and telehealth. The NPT constructs have high stability across settings and, notwithstanding challenges in applying NPT in terms of managing overlaps between constructs, there is evidence that it is a beneficial heuristic device to explain and guide implementation processes. Conclusions NPT offers a generalizable framework that can be applied across contexts with opportunities for incremental knowledge gain over time and an explicit framework for analysis, which can explain and potentially shape implementation processes. This is the first review of NPT in use and it generates an impetus for further and extended use of NPT. We recommend that in future NPT research, authors should explicate their rationale for choosing NPT as their theoretical framework and, where possible, involve multiple stakeholders including service users to enable analysis of implementation from a range of perspectives.
    • A quality framework for health services developed through an inclusive approach

      Markham, Trish; Butler, Michelle; McNamara, Martin; Health Service Executive (HSE) (Journal of Nursing Education and Practice, 2015-03-18)
    • A quality improvement initiative in community mental health in the Republic of Ireland

      Murphy, Lorraine; Wells, John Stephen; Lachman, Peter; Bergin, Michael; Health Service Executive (HSE), Waterford Institute of Technology(WIT), Royal College of Physicians Ireland (RCPI) (Insight Medical Publishing (Imed), 2015)
    • Quality of life of palliative chemotherapy naive patients with advanced adenocarcinoma of the stomach or esophagogastric junction treated with irinotecan combined with 5-fluorouracil and folinic acid: results of a randomised phase III trial.

      Curran, Desmond; Pozzo, Carmelo; Zaluski, Jerzy; Dank, Magdalena; Barone, Carlo; Valvere, Vahur; Yalcin, Suayib; Peschel, Christian; Wenczl, Miklós; Goker, Erdem; et al. (2009-09)
      PURPOSE: The quality of life (QL) of advanced gastric cancer patients receiving irinotecan, folinic acid and 5-fluorouracil (5-FU) (IF arm) or cisplatin with 5-FU (CF arm) is presented. METHODS: Patients with measurable or evaluable advanced gastric cancer received IF weekly for 6/7 weeks or CF q4 weeks. QL was assessed using the EORTC QLQ-C30 at baseline, subsequently every 8 weeks until progression and thereafter every 3 months until death. The QL data were analysed using several statistical methods including summary measures and pattern-mixture modelling. RESULTS: A total of 333 patients were randomised and treated (IF 170, CF 163). The time-to-progression for IF and CF was 5.0 and 4.2 months (P = 0.088), respectively. The overall compliance rates for QL questionnaire completion were 60 and 56% in the IF and CF arms, respectively. Significant treatment differences were observed for the physical functioning scale (P = 0.024), nausea\vomiting (P = 0.001) and EQ-5D thermometer (P = 0.020) in favour of the IF treatment arm. CONCLUSION: There was a trend in favour of IF over CF in time-to-progression. The IF group also demonstrated a better safety profile than CF and a better QL on a number of multi-item scales, suggesting that IF offers an alternative first-line platinum-free treatment option for advanced gastric cancer.
    • Quantifying size-dependent interactions between fluorescently labeled polystyrene nanoparticles and mammalian cells

      Varela, Juan A; Bexiga, Mariana G; Åberg, Christoffer; Simpson, Jeremy C; Dawson, Kenneth A (2012-09-24)
      Abstract Background Nanoparticles (NPs) are currently used in a wide variety of fields such as technology, medicine and industry. Due to the novelty of these applications and to ensure their success, a precise characterization of the interactions between NPs and cells is essential. Findings The current study explores the uptake of polystyrene NPs by 1321N1 human astrocytoma and A549 human lung carcinoma cell lines. In this work we show for the first time a comparison of the uptake rates of fluorescently labeled carboxylated polystyrene (PS) NPs of different sizes (20, 40 and 100 nm) in two different cell types, keeping the number of NPs per unit volume constant for all sizes. We propose a reliable methodology to control the dose of fluorescently labeled NPs, by counting individual NPs using automated particle detection from 3D confocal microscopy images. The possibility of detecting individual NPs also allowed us to calculate the size of each nanoparticle and compare the fluorescence of single NPs across different sizes, thereby providing a robust platform for normalization of NP internalization experiments as measured by flow cytometry. Conclusions Our findings show that 40 nm NPs are internalized faster than 20 nm or 100 nm particles in both cell lines studied, suggesting that there is a privileged size gap in which the internalization of NPs is higher.
    • Quantifying uncertainty, variability and likelihood for ordinary differential equation models

      Weisse, Andrea Y; Middleton, Richard H; Huisinga, Wilhelm (2010-10-28)
      Abstract Background In many applications, ordinary differential equation (ODE) models are subject to uncertainty or variability in initial conditions and parameters. Both, uncertainty and variability can be quantified in terms of a probability density function on the state and parameter space. Results The partial differential equation that describes the evolution of this probability density function has a form that is particularly amenable to application of the well-known method of characteristics. The value of the density at some point in time is directly accessible by the solution of the original ODE extended by a single extra dimension (for the value of the density). This leads to simple methods for studying uncertainty, variability and likelihood, with significant advantages over more traditional Monte Carlo and related approaches especially when studying regions with low probability. Conclusions While such approaches based on the method of characteristics are common practice in other disciplines, their advantages for the study of biological systems have so far remained unrecognized. Several examples illustrate performance and accuracy of the approach and its limitations.
    • Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: a cross-sectional nationwide study.

      Burke, Éilish; Carroll, Rachael; O'Dwyer, Máire; Walsh, James Bernard; McCallion, Philip; McCarron, Mary (BMJ Open, 2019-04-15)
    • A quest for health: Creating a world of difference in Clondalkin

      Cosgrove, Sharon; Clondalkin Partnership (Clondalkin Partnership, 2003-04)