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Panda S, Begley C, Daly D. Correction: Clinicians' views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies. PLoS One 2018; 13:e0202688. [PMID: 30110379 PMCID: PMC6093691 DOI: 10.1371/journal.pone.0202688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0200941.].
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Panda S, Begley C, Daly D. Clinicians' views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies. PLoS One 2018; 13:e0200941. [PMID: 30052666 PMCID: PMC6063415 DOI: 10.1371/journal.pone.0200941] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 06/26/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Caesarean section rates are increasing worldwide and are a growing concern with limited explanation of the factors that influence the rising trend. Understanding obstetricians' and midwives' views can give insight to the problem. This systematic review aimed to offer insight and understanding, through aggregation, summary, synthesis and interpretation of findings from studies that report obstetricians' and midwives' views on the factors that influence the decision to perform caesarean section. METHODS The electronic databases of PubMed (1958-2016), CINAHL (1988-2016), Maternity and Infant Care (1971-2016), PsycINFO (1980-2016) and Web of Science (1991-2016) were searched in September 2016. All quantitative, qualitative and mixed methods studies, published in English, whose aim was to explore obstetricians' and/or midwives' views of factors influencing decision-making for caesarean section were included. Papers were independently reviewed by two authors for selection by title, abstract and full text. Thomas et al's 12 assessment criteria checklist (2003) was used to assess methodological quality of the included studies. RESULT The review included 34 studies: 19 quantitative, 14 qualitative, and one using mixed methods, involving 7785 obstetricians and 1197 midwives from 20 countries. Three main themes, each with several subthemes, emerged. Theme 1: "clinicians' personal beliefs"-('Professional philosophies'; 'beliefs in relation to women's request for CS'; 'ambiguous versus clear clinical reasons'); Theme 2: "health care systems"-('litigation'; 'resources'; 'private versus public/insurance/payments'; 'guidelines and management policy'). Theme 3: "clinicians' characteristics" ('personal convenience'; 'clinicians' demographics'; 'confidence and skills'). CONCLUSION This systematic review and metasynthesis identified clinicians' personal beliefs as a major factor that influenced the decision to perform caesarean section, further contributed by the influence of factors related to the health care system and clinicians' characteristics. Obstetricians and midwives are directly involved in the decision to perform a caesarean section, hence their perspectives are vital in understanding various factors that have influence on decision-making for caesarean section. These results can help clinicians identify and acknowledge their role as crucial members in the decision-making process for caesarean section within their organisation, and to develop intervention studies to reduce caesarean section rates in future.
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O’Malley D, Higgins A, Begley C, Daly D, Smith V. Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy Childbirth 2018; 18:196. [PMID: 29855357 PMCID: PMC5984394 DOI: 10.1186/s12884-018-1838-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/21/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Many women are not prepared for changes to their sexual health after childbirth. The aim of this paper is to report on the prevalence of and the potential risk factors (pre-pregnancy dyspareunia, mode of birth, perineal trauma and breastfeeding) for sexual health issues (dyspareunia, lack of vaginal lubrication and a loss of interest in sexual activity) at 6 and 12 months postpartum. METHODS A longitudinal cohort study of 832 first-time mothers who were recruited in early pregnancy and returned postnatal surveys at 3, 6, 9 and 12 months postpartum were assessed for sexual health issues and associated risk factors. RESULTS Nearly half of the women (46.3%) reported a lack of interest in sexual activity, 43% experienced a lack of vaginal lubrication and 37.5% of included women had dyspareunia 6 months after birth. On univariate analysis, vacuum-assisted birth, 2nd degree perineal tears, 3rd degree perineal tears and episiotomy were all associated with dyspareunia 6 months postpartum, but, of these only 3rd degree tears, in association with breastfeeding and pre-existing dyspareunia, remained significant on multivariable analysis. Breastfeeding, in combination, with other significant factors, was associated with dyspareunia, a lack of vaginal lubrication and a loss of interest in sexual activity 6 months postpartum, and, dissatisfaction with body image emerged as a significant factor associated with lack of interest in sexual activity at 12 months postpartum. Pre-pregnancy dyspareunia and breastfeeding emerged as common factors associated with all three outcomes of dyspareunia, a lack of vaginal lubrication and a loss of interest in sexual activity at 6 months postpartum. CONCLUSION Breastfeeding and pre-existing dyspareunia are associated with sexual health issues at 6 months postpartum. Pre-existing dyspareunia is associated with a lack of vaginal lubrication at 12 months postpartum and breastfeeding is associated with dissatisfaction with body image. Preparing women and their partners during the antenatal period and advising on simple measures, such as use of lubrication to avoid or minimise sexual health issues, could potentially remove stress, anxiety and fears regarding intimacy after birth. Introducing the topic of pre-existing sexual health issues antenatally may facilitate appropriate support, treatment or counselling for women.
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Seijmonsbergen-Schermers A, van den Akker T, Beeckman K, Bogaerts A, Barros M, Janssen P, Binfa L, Rydahl E, Frith L, Gross MM, Hálfdánsdóttir B, Daly D, Calleja-Agius J, Gillen P, Vika Nilsen AB, Declercq E, de Jonge A. Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study. BMJ Open 2018; 8:e017993. [PMID: 29326182 PMCID: PMC5780680 DOI: 10.1136/bmjopen-2017-017993] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. METHODS AND ANALYSIS This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. ETHICS AND DISSEMINATION The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that an official approval of this study was not required. Results will be disseminated at national and international conferences and published in peer-reviewed journals.
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Healy P, Smith V, Savage G, Clarke M, Devane D, Gross MM, Morano S, Daly D, Grylka-Baeschlin S, Nicoletti J, Sinclair M, Maguire R, Carroll M, Begley C. Process evaluation for OptiBIRTH, a randomised controlled trial of a complex intervention designed to increase rates of vaginal birth after caesarean section. Trials 2018; 19:9. [PMID: 29304837 PMCID: PMC5756437 DOI: 10.1186/s13063-017-2401-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 12/10/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Complex interventions encompassing several interconnecting and interacting components can be challenging to evaluate. Examining the underlying trial processes while an intervention is being tested can assist in explaining why an intervention was effective (or not). This paper describes a process evaluation of a pan-European cluster randomised controlled trial, OptiBIRTH (undertaken in Ireland, Italy and Germany), that successfully used both quantitative and qualitative methods to enhance understanding of the underlying trial mechanisms and their effect on the trial outcome. METHODS We carried out a mixed methods process evaluation. Quantitative and qualitative data were collected from observation of the implementation of the intervention in practice to determine whether it was delivered according to the original protocol. Data were examined to assess the delivery of the various components of the intervention and the receipt of the intervention by key stakeholders (pregnant women, midwives, obstetricians). Using ethnography, an exploration of perceived experiences from a range of recipients was conducted to understand the perspective of both those delivering and those receiving the intervention. RESULTS Engagement by stakeholders with the different components of the intervention varied from minimal intensity of women's engagement with antenatal classes, to moderate intensity of engagement with online resources, to high intensity of clinicians' exposure to the education sessions provided. The ethnography determined that, although the overall culture in the intervention site did not change, smaller, more individual cultural changes were observed. The fidelity of the delivery of the intervention scored average quality marks of 80% and above on repeat assessments. CONCLUSION Nesting a process evaluation within the trial enabled the observation of the mode of action of the intervention in its practice context and ensured that the intervention was delivered with a good level of consistency. Implementation problems were identified as they arose and were addressed accordingly. When dealing with a complex intervention, collecting and analysing both quantitative and qualitative data, as we did, can greatly enhance the process evaluation. TRIAL REGISTRATION Current Controlled Trials Register, ISRCTN10612254 . Registered on 3 April 2013.
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Fleming P, Daly D. In memoriam: Billy Fenlon. Eur Arch Paediatr Dent 2017. [DOI: 10.1007/s40368-017-0319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Smith V, Daly D, Lundgren I, Eri T, Begley C, Gross MM, Downe S, Alfirevic Z, Devane D. Protocol for the development of a salutogenic intrapartum core outcome set (SIPCOS). BMC Med Res Methodol 2017; 17:61. [PMID: 28420339 PMCID: PMC5395745 DOI: 10.1186/s12874-017-0341-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 04/07/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Maternity intrapartum care research and clinical care more often focus on outcomes that minimise or prevent adverse health rather than on what constitutes positive health and wellbeing (salutogenesis). This was highlighted recently in a systematic review of reviews of intrapartum reported outcomes where only 8% of 1648 individual outcomes, from 102 systematic reviews, were agreed as being salutogenically-focused. Added to this is variation in the outcomes measured in individual studies rendering it very difficult for researchers to synthesise, fully, the evidence from studies on a particular topic. One of the suggested ways to address this is to develop and apply an agreed standardised set of outcomes, known as a 'core outcome set' (COS). In this paper we present a protocol for the development of a salutogenic intrapartum COS (SIPCOS) for use in maternity care research and a SIPCOS for measuring in daily intrapartum clinical care. METHODS The study proposes three phases in developing the final SIPCOSs. Phase one, which is complete, involved the conduct of a systematic review of reviews to identify a preliminary list of salutogenically-focused outcomes that had previously been reported in systematic reviews of intrapartum interventions. Sixteen unique salutogenically-focused outcome categories were identified. Phase two will involve prioritising these outcomes, from the perspective of key stakeholders (users of maternity services, clinicians and researchers) by asking them to rate the importance of each outcome for inclusion in the SIPCOSs. A final consensus meeting (phase three) will be held, bringing international stakeholders together to review the preliminary SIPCOSs resulting from the survey and to agree and finalise the final SIPCOSs for use in future maternity care research and daily clinical care. DISCUSSION The expectation in developing the SIPCOSs is that they will be collected and reported in all future studies evaluating intrapartum interventions and measured/recorded in future intrapartum clinical care, as routine, alongside other outcomes also deemed important in the context of the study or clinical scenario. Using the SIPCOSs in this way, will promote and encourage standardised measurements of positive health outcomes in maternity care, into the future.
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Levis C, Costa FRC, Bongers F, Peña-Claros M, Clement CR, Junqueira AB, Neves EG, Tamanaha EK, Figueiredo FOG, Salomão RP, Castilho CV, Magnusson WE, Phillips OL, Guevara JE, Sabatier D, Molino JF, López DC, Mendoza AM, Pitman NCA, Duque A, Vargas PN, Zartman CE, Vasquez R, Andrade A, Camargo JL, Feldpausch TR, Laurance SGW, Laurance WF, Killeen TJ, Nascimento HEM, Montero JC, Mostacedo B, Amaral IL, Guimarães Vieira IC, Brienen R, Castellanos H, Terborgh J, Carim MDJV, Guimarães JRDS, Coelho LDS, Matos FDDA, Wittmann F, Mogollón HF, Damasco G, Dávila N, García-Villacorta R, Coronado ENH, Emilio T, Filho DDAL, Schietti J, Souza P, Targhetta N, Comiskey JA, Marimon BS, Marimon BH, Neill D, Alonso A, Arroyo L, Carvalho FA, de Souza FC, Dallmeier F, Pansonato MP, Duivenvoorden JF, Fine PVA, Stevenson PR, Araujo-Murakami A, Aymard C. GA, Baraloto C, do Amaral DD, Engel J, Henkel TW, Maas P, Petronelli P, Revilla JDC, Stropp J, Daly D, Gribel R, Paredes MR, Silveira M, Thomas-Caesar R, Baker TR, da Silva NF, Ferreira LV, Peres CA, Silman MR, Cerón C, Valverde FC, Di Fiore A, Jimenez EM, Mora MCP, Toledo M, Barbosa EM, Bonates LCDM, Arboleda NC, Farias EDS, Fuentes A, Guillaumet JL, Jørgensen PM, Malhi Y, de Andrade Miranda IP, Phillips JF, Prieto A, Rudas A, Ruschel AR, Silva N, von Hildebrand P, Vos VA, Zent EL, Zent S, Cintra BBL, Nascimento MT, Oliveira AA, Ramirez-Angulo H, Ramos JF, Rivas G, Schöngart J, Sierra R, Tirado M, van der Heijden G, Torre EV, Wang O, Young KR, Baider C, Cano A, Farfan-Rios W, Ferreira C, Hoffman B, Mendoza C, Mesones I, Torres-Lezama A, Medina MNU, van Andel TR, Villarroel D, Zagt R, Alexiades MN, Balslev H, Garcia-Cabrera K, Gonzales T, Hernandez L, Huamantupa-Chuquimaco I, Manzatto AG, Milliken W, Cuenca WP, Pansini S, Pauletto D, Arevalo FR, Reis NFC, Sampaio AF, Giraldo LEU, Sandoval EHV, Gamarra LV, Vela CIA, ter Steege H. Persistent effects of pre-Columbian plant domestication on Amazonian forest composition. Science 2017; 355:925-931. [DOI: 10.1126/science.aal0157] [Citation(s) in RCA: 306] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/20/2017] [Indexed: 11/02/2022]
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Carroll M, Daly D, Begley CM. The prevalence of women's emotional and physical health problems following a postpartum haemorrhage: a systematic review. BMC Pregnancy Childbirth 2016; 16:261. [PMID: 27596720 PMCID: PMC5011962 DOI: 10.1186/s12884-016-1054-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/22/2016] [Indexed: 11/23/2022] Open
Abstract
Background Postpartum Haemorrhage (PPH) is a leading cause of maternal mortality with approximately 225 women dying as a result of it each day especially in low income countries. However, much less is known about morbidity after a PPH. This systematic review aimed to determine the overall prevalence of emotional and physical health problems experienced by women following a postpartum haemorrhage. Methods Eight databases were searched for published non-randomised, observational, including cohort, primary research studies that reported on the prevalence of emotional and/or physical health problems following a PPH. Intervention studies were included and data, if available, were abstracted on the control group. All authors independently screened the papers for inclusion. Of the 2210 papers retrieved, six met the inclusion criteria. Data were extracted independently by two authors. The methodological quality of the included studies was assessed using a modified Newcastle Ottawa Scale (NOS). The primary outcome measure reported was emotional and physical health problems up to 12 months postpartum following a postpartum haemorrhage. Results Two thousand two hundred ten citations were identified and screened with 2089 excluded by title and abstract. Following full-text review of 121 papers, 115 were excluded. The remaining 6 studies were included. All included studies were judged as having strong or moderate methodological quality. Five studies had the sequelae of PPH as their primary focus, and one study focused on morbidity postnatally, from which we could extract data on PPH. Persistent morbidities following PPH (at ≥ 3 and < 6 months postpartum) included postnatal depression (13 %), post-traumatic stress disorder (3 %), and health status ‘much worse than one year ago’ (6 %). Due to the different types of health outcomes reported in the individual studies, it was possible to pool results from only four studies, and only then by accepting the slightly differing definitions of PPH. Those that could be pooled reported rates of acute renal failure (0.33 %), coagulopathy (1.74 %) and re-admission to hospital following a PPH between 1 and 3 months postpartum (3.6 %), an appreciable indication of underlying physical problems. Conclusion This systematic review demonstrates that the existence and type of physical and emotional health problems post PPH, regardless of the volume of blood lost, are largely unknown. Further large cohort or case control studies are necessary to obtain better knowledge of the sequelae of this debilitating morbidity. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1054-1) contains supplementary material, which is available to authorized users.
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Daly D, Hutley MC, Hunt RA, Khand K, Stevens RF, Wilsoni R. The Use of a Series of Lens Arrays to Match Optical Arrays of Different Pitch. IMAGING SCIENCE JOURNAL 2016. [DOI: 10.1080/13682199.1997.11736371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Panda S, Begley C, Daly D. Readmission following caesarean section: Outcomes for women in an Irish maternity hospital. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjom.2016.24.5.322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Boyle RJ, Tang ML, Chiang WC, Chua MC, Ismail I, Nauta A, Hourihane JO, Smith P, Gold M, Ziegler J, Peake J, Quinn P, Rao R, Brown N, Rijnierse A, Garssen J, Warner JO, Axelrad C, Jeffries S, Donald Y, Barham H, Brown J, Wickenden R, Barnes T, Taylor S, Smith S, Thomas N, Goh A, Anng WA, Hua CCY, Daly D, Lafford S, Cullinane C, Bindels J, Merwe L, Klaassen D, Swinkels S, Knipping K. Prebiotic-supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high-risk infants: a randomized controlled trial. Allergy 2016; 71:701-10. [PMID: 27111273 PMCID: PMC4996326 DOI: 10.1111/all.12848] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 12/14/2022]
Abstract
Background Prevention guidelines for infants at high risk of allergic disease recommend hydrolysed formula if formula is introduced before 6 months, but evidence is mixed. Adding specific oligosaccharides may improve outcomes. Objective To evaluate whether partially hydrolysed whey formula containing oligosaccharides (0.8 g/100 ml) (pHF‐OS) can prevent eczema in high‐risk infants [ISRCTN65195597]. Methods We conducted a parallel‐group, multicentre, randomized double‐blind controlled trial of pHF‐OS vs standard cow's milk formula. Infants with a family history of allergic disease were randomized (stratified by centre/maternal allergy) to active (n = 432) or control (n = 431) formula until 6 months of age if formula was introduced before 18 weeks. Primary outcome was cumulative incidence of eczema by 12 months in infants randomized at 0–4 weeks (375 pHF‐OS, 383 control). Secondary outcomes were cumulative incidence of eczema by 12 or 18 months in all infants randomized, immune markers at 6 months and adverse events. Results Eczema occurred by 12 months in 84/293 (28.7%) infants allocated to pHF‐OS at 0‐4 weeks of age, vs 93/324 (28.7%) control (OR 0.98 95% CI 0.68, 1.40; P = 0.90), and 107/347 (30.8%) pHF‐OS vs 112/370 (30.3%) control in all infants randomized (OR 0.99 95% CI 0.71, 1.37; P = 0.94). pHF‐OS did not change most immune markers including total/specific IgE; however, pHF‐OS reduced cow's milk‐specific IgG1 (P < 0.0001) and increased regulatory T‐cell and plasmacytoid dendritic cell percentages. There was no group difference in adverse events. Conclusion pHF‐OS does not prevent eczema in the first year in high‐risk infants. The immunological changes found require confirmation in a separate cohort.
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Clarke M, Savage G, Smith V, Daly D, Devane D, Gross MM, Grylka-Baeschlin S, Healy P, Morano S, Nicoletti J, Begley C. Improving the organisation of maternal health service delivery and optimising childbirth by increasing vaginal birth after caesarean section through enhanced women-centred care (OptiBIRTH trial): study protocol for a randomised controlled trial (ISRCTN10612254). Trials 2015; 16:542. [PMID: 26620402 PMCID: PMC4666170 DOI: 10.1186/s13063-015-1061-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/16/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The proportion of pregnant women who have a caesarean section shows a wide variation across Europe, and concern exists that these proportions are increasing. Much of the increase in caesarean sections in recent years is due to a cascade effect in which a woman who has had one caesarean section is much more likely to have one again if she has another baby. In some places, it has become common practice for a woman who has had a caesarean section to have this procedure again as a matter of routine. The alternative, vaginal birth after caesarean (VBAC), which has been widely recommended, results in fewer undesired results or complications and is the preferred option for most women. However, VBAC rates in some countries are much lower than in other countries. METHODS/DESIGN The OptiBIRTH trial uses a cluster randomised design to test a specially developed approach to try to improve the VBAC rate. It will attempt to increase VBAC rates from 25 % to 40 % through increased women-centred care and women's involvement in their care. Sixteen hospitals in Germany, Ireland and Italy agreed to join the study, and each hospital was randomly allocated to be either an intervention or a control site. DISCUSSION If the OptiBIRTH intervention succeeds in increasing VBAC rates, its application across Europe might avoid the 160,000 unnecessary caesarean sections that occur every year at an extra direct annual cost of more than €150 million. TRIAL REGISTRATION Current Controlled Trials ISRCTN10612254 , registered 3 April 2013.
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Stenke E, Cullinane C, Daly D, Hourihane JO. A pragmatic and safe way of inducing immunotolerance in selected peanut allergic children: a single centre experience. Clin Transl Allergy 2015. [PMCID: PMC4412438 DOI: 10.1186/2045-7022-5-s3-p150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Daly D, Al-Sabi A, Kinsella GK, Nolan K, Dolly JO. Porphyrin derivatives as potent and selective blockers of neuronal Kv1 channels. Chem Commun (Camb) 2015; 51:1066-9. [DOI: 10.1039/c4cc05639f] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Docking model of compound12into the homology model of Kv1.1.
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Anthonissen M, Daly D, Peeters R, Van Brussel M, Fieuws S, Moortgat P, Flour M, Van den Kerckhove E. Reliability of Repeated Measurements on Post-Burn Scars with Corneometer CM 825(®). Skin Res Technol 2014; 21:302-12. [PMID: 25382262 DOI: 10.1111/srt.12193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND/PURPOSE The water content in burn scars, the parameter of stratum corneum water holding capacity, is an important feature in evaluation of biophysical properties of scars. Nevertheless, quantifiying this parameter is a challenge. In this study, the reliability of repeated water content measurements with Corneometer CM825(®) on (burn) scars was investigated. METHODS Intra-observer reliability, inter-observer reliability and day-by-day variability were examined on 30 scars by means of intra-class correlation coefficient (ICC) and within-subject coefficient of variation (WSCV). Bland-Altman plots with '95% limits of agreement' were constructed. RESULTS Results revealed excellent ICC values (ICCintra = 0.985; ICCinter = 0.984) with relatively low WSCV (WSCVintra = 6.3%; WSCVinter = 10.6%) for respectively intra- and inter-observer reliability. However, the Bland-Altman plot showed that more than 5% of differences were expected to exceed 4 a.u., the limit of what has been defined as a clinically acceptable difference. Results for day-by-day variability showed good ICC value (ICCday-by-day = 0.849) and higher WSCV (WSCVday-by-day = 20.5%). CONCLUSION The Corneometer CM825(®) is an objective and sensitive instrument for water content measurements. On the basis of our results, we concluded that the instrument can be used in clinical trials, but only under very strict conditions with standardized test protocol, preferably in combination with the evaluation of other physiological parameters.
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Tedd KM, Coxon CE, Misstear BDR, Daly D, Craig M, Mannix A, Williams NHH. An integrated pressure and pathway approach to the spatial analysis of groundwater nitrate: a case study from the southeast of Ireland. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 476-477:460-476. [PMID: 24486501 DOI: 10.1016/j.scitotenv.2013.12.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 06/03/2023]
Abstract
Excess nitrogen in soil, aquatic and atmospheric environments is an escalating global problem. Eutrophication is the principal threat to surface water quality in the Republic of Ireland. European Union Water Framework Directive (2000/60/EC) water quality status assessments found that 16% of Irish groundwater bodies were 'at risk' of poor status due to the potential deterioration of associated estuarine and coastal water quality by nitrate from groundwater. This paper presents a methodology for evaluating pressure and pathway parameters affecting the spatial distribution of groundwater nitrate, investigated at a regional scale using existing national spatial datasets. The potential for nitrate transfer to groundwater was rated based on the introduced concepts of Pressure Loading and Pathway Connectivity Rating, each based on a combination of selected pressure and pathway parameters respectively. In the region studied, the South Eastern River Basin District of Ireland, this methodology identified that pathway parameters were more important than pressure parameters in understanding the spatial distribution of groundwater nitrate. Statistical analyses supported these findings and further demonstrated that the proportion of poorly drained soils, arable land, karstic flow regimes, regionally important bedrock aquifers and high vulnerability groundwater within the zones of contribution of the monitoring points are statistically significantly related to groundwater nitrate concentrations. Soil type was found to be the most important parameter. Analysis of variance showed that a number of the pressure and pathway parameters are interrelated. The parameters identified by the presented methodology may provide useful insights into the best way to manage and mitigate the influence of nitrate contamination of groundwater in this region. It is suggested that the identification of critical source areas based on the identified parameters would be an appropriate management tool, enabling planning and enforcement resources to be focussed on areas which will yield most benefit.
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Smith V, Daly D, Lundgren I, Eri T, Benstoem C, Devane D. Salutogenically focused outcomes in systematic reviews of intrapartum interventions: a systematic review of systematic reviews. Midwifery 2013; 30:e151-6. [PMID: 24290422 DOI: 10.1016/j.midw.2013.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION research on intrapartum interventions in maternity care has focused traditionally on the identification of risk factors' and on the reduction of adverse outcomes with less attention given to the measurement of factors that contribute to well-being and positive health outcomes. We conducted a systematic review of reviews to determine the type and number of salutogenically-focused reported outcomes in current maternity care intrapartum intervention-based research. For the conduct of this review, we interpreted salutogenic outcomes as those relating to optimum and/or positive maternal and neonatal health and well-being. OBJECTIVES to identify salutogenically-focused outcomes reported in systematic reviews of randomised trials of intrapartum interventions. REVIEW METHODS we searched Issue 9 (September) 2011 of the Cochrane Database of Systematic Reviews for all reviews of intrapartum interventions published by the Cochrane Pregnancy and Childbirth Group using the group filter "hm-preg". Systematic reviews of randomised trials of intrapartum interventions were eligible for inclusion. We excluded protocols for systematic reviews and systematic reviews that had been withdrawn. Outcome data were extracted independently from each included review by at least two review authors. Unique lists of salutogenically and non-salutogenically focused outcomes were established. RESULTS 16 salutogenically-focused outcome categories were identified in 102 included reviews. Maternal satisfaction and breast feeding were reported most frequently. 49 non-salutogenically-focused outcome categories were identified in the 102 included reviews. Measures of neonatal morbidity were reported most frequently. CONCLUSION there is an absence of salutogenically-focused outcomes reported in intrapartum intervention-based research. We recommend the development of a core outcome data set of salutogenically-focused outcomes for intrapartum research.
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Lutomski J, Greene R, Meaney S, Forgeard N, Devane D, Daly D. 815: Trial of labor after cesarean delivery in Ireland. Am J Obstet Gynecol 2013. [DOI: 10.1016/j.ajog.2012.10.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Juhel G, Batisse E, Hugues Q, Daly D, van Pelt FNAM, O'Halloran J, Jansen MAK. Alumina nanoparticles enhance growth of Lemna minor. AQUATIC TOXICOLOGY (AMSTERDAM, NETHERLANDS) 2011; 105:328-36. [PMID: 21813085 DOI: 10.1016/j.aquatox.2011.06.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 06/10/2011] [Accepted: 06/21/2011] [Indexed: 05/21/2023]
Abstract
The industrial use of nanoparticles is rapidly increasing, and this has given rise to concerns about potential biological impacts of engineered particles released into the environment. So far, relatively little is known about uptake, accumulation and responses to engineered nanoparticles by plants. In this study, the effects of alumina nanoparticles on growth, morphology and photosynthesis of Lemna minor were quantified. It was found that alumina nanoparticles substantially increase biomass accumulation of L. minor. Such a stimulatory effect of alumina nanoparticles on growth has not been reported previously. Enhanced biomass accumulation was paralleled by morphological adjustments such as increased root length and number of fronds per colony, and by increased photosynthetic efficiency. Metal nanoparticles have previously been shown to enhance the energy transfer efficiency of isolated reaction centres; therefore it is proposed that the mechanism underlying the alumina mediated enhancement of biomass accumulation in L. minor is associated with increased efficiencies in the light reactions of photosynthesis.
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DunnGalvin A, Daly D, Cullinane C, Stenke E, Keeton D, Erlewyn-Lajeunesse M, Roberts GC, Lucas J, Hourihane JO. Highly accurate prediction of food challenge outcome using routinely available clinical data. J Allergy Clin Immunol 2011; 127:633-9.e1-3. [PMID: 21377032 DOI: 10.1016/j.jaci.2010.12.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 11/26/2010] [Accepted: 12/02/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Serum specific IgE or skin prick tests are less useful at levels below accepted decision points. OBJECTIVES We sought to develop and validate a model to predict food challenge outcome by using routinely collected data in a diverse sample of children considered suitable for food challenge. METHODS The proto-algorithm was generated by using a limited data set from 1 service (phase 1). We retrospectively applied, evaluated, and modified the initial model by using an extended data set in another center (phase 2). Finally, we prospectively validated the model in a blind study in a further group of children undergoing food challenge for peanut, milk, or egg in the second center (phase 3). Allergen-specific models were developed for peanut, egg, and milk. RESULTS Phase 1 (N = 429) identified 5 clinical factors associated with diagnosis of food allergy by food challenge. In phase 2 (N = 289), we examined the predictive ability of 6 clinical factors: skin prick test, serum specific IgE, total IgE minus serum specific IgE, symptoms, sex, and age. In phase 3 (N = 70), 97% of cases were accurately predicted as positive and 94% as negative. Our model showed an advantage in clinical prediction compared with serum specific IgE only, skin prick test only, and serum specific IgE and skin prick test (92% accuracy vs 57%, and 81%, respectively). CONCLUSION Our findings have implications for the improved delivery of food allergy-related health care, enhanced food allergy-related quality of life, and economized use of health service resources by decreasing the number of food challenges performed.
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Fraser J, Caine D, Daly D, Manning E. Back to basics. THE PRACTISING MIDWIFE 2011; 14:13-15. [PMID: 21560942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Yanishevsky Y, Daly D, Cullinane C, O'B Hourihane J. Differences in treatment of food challenge–induced reactions reflect physicians' protocols more than reaction severity. J Allergy Clin Immunol 2010; 126:182; author reply 182-3. [DOI: 10.1016/j.jaci.2010.03.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 03/18/2010] [Indexed: 11/30/2022]
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Millar S, Daly D, Mhurchú PN. Home birth in Ireland: changing times. THE PRACTISING MIDWIFE 2008; 11:40-43. [PMID: 19054956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Finger R, Sommerfelt C, Freeman M, Wilson C, Wade A, Daly D. Embryo donation is cost-effective compared to oocyte donation. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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