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O’Neill B, Green N, Blackwood B, McAuley D, Moran F, MacCormac N, Johnston P, McNamee JJ, Shevlin C, Bradley J. Recovery following discharge from intensive care: What do patients think is helpful and what services are missing? PLoS One 2024; 19:e0297012. [PMID: 38498470 PMCID: PMC10947670 DOI: 10.1371/journal.pone.0297012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/26/2023] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Recovery following critical illness is complex due to the many challenges patients face which influence their long-term outcomes. We explored patients' views about facilitators of recovery after critical illness which could be used to inform the components and timing of specific rehabilitation interventions. AIMS To explore the views of patients after discharge from an intensive care unit (ICU) about their recovery and factors that facilitated recovery, and to determine additional services that patients felt were missing during their recovery. METHODS Qualitative study involving individual face-to-face semi-structured interviews at six months (n = 11) and twelve months (n = 10). Written, informed consent was obtained. [Ethics approval 17/NI/0115]. Interviews were audiotaped, transcribed and analysed using template analysis. FINDINGS Template analysis revealed four core themes: (1) Physical activity and function; (2) Recovery of cognitive and emotional function; (3) Facilitators to recovery; and (4) Gaps in healthcare services. CONCLUSION Patient reported facilitators to recovery include support and guidance from others and self-motivation and goal setting, equipment for mobility and use of technology. Barriers include a lack of follow up services, exercise rehabilitation, peer support and personal feedback. Patients perceived that access to specific healthcare services was fragmented and where services were unavailable this contributed to slower or poorer quality of recovery. ICU patient recover could be facilitated by a comprehensive rehabilitation intervention that includes patient-directed strategies and health care services.
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Affiliation(s)
- Brenda O’Neill
- Centre for Health and Rehabilitation Technologies, INHR, Ulster University, Belfast, United Kingdom
| | - Natasha Green
- School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute of Experimental Medicine, Belfast, United Kingdom
| | - Bronagh Blackwood
- School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute of Experimental Medicine, Belfast, United Kingdom
| | - Danny McAuley
- School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute of Experimental Medicine, Belfast, United Kingdom
| | - Fidelma Moran
- Centre for Health and Rehabilitation Technologies, INHR, Ulster University, Belfast, United Kingdom
| | - Niamh MacCormac
- Centre for Health and Rehabilitation Technologies, INHR, Ulster University, Belfast, United Kingdom
| | | | | | - Claire Shevlin
- Craigavon Area Hospital, SHSCT, Craigavon, United Kingdom
| | - Judy Bradley
- School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute of Experimental Medicine, Belfast, United Kingdom
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Daly Lynn J, Ramsey L, Marley J, Rohde J, McGuigan TM, Reaney A, O’Neill B, Jones A, Kerr D, Hughes C, McFadden S. Participatory peer research exploring the experience of learning during Covid-19 for allied health and healthcare science students. PLoS One 2022; 17:e0276180. [PMID: 36301988 PMCID: PMC9612578 DOI: 10.1371/journal.pone.0276180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The teaching and learning experience of allied health and healthcare science students has altered because of the Covid-19 pandemic. Limited research has explored the experience on the future healthcare workforce using participatory research design. The aim of this study was to explore the impact of a global pandemic on the clinical and academic experiences of healthcare student using a co-production approach with student peer researchers. METHODS A participatory research approach adopting online focus groups facilitated by students trained as peer researchers was adopted. First, second and final year students from occupational therapy, physiotherapy, podiatry, healthcare science, diagnostic radiography and imaging, radiotherapy and oncology, and speech and language therapy were recruited to six focus groups. Data generated through focus groups were analysed thematically using the DEPICT model to support a partnership approach. RESULTS Twenty-three participants took part in six focus groups. The themes identified were: rapid changes to learning; living alongside Covid-19 and psychological impact. Students preferred blended learning approaches when available, as reduced peer interaction, studying and sleeping in the same space, and technology fatigue decreased motivation. CONCLUSION Due to rapid changes in learning and the stress, anxiety and isolation created by the pandemic, managing study, personal life and placement resulted in a gap in confidence in clinical skills development for students. Students took their professional identity seriously, engaged in behaviours to reduce transmission of Covid-19 and employed a range of coping strategies to protect wellbeing. A challenge with the move to online delivery was the absence of informal peer learning and students indicated that moving forward they would value a hybrid approach to delivery. Higher Education should capitalise on innovative learning experiences developed during the pandemic however it is important to research the impact this has on student skill acquisition and learning experience.
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Affiliation(s)
- Jean Daly Lynn
- Lecturer in Psychology, School of Health Science, Ulster University, Ulster, Northern Ireland
- * E-mail:
| | - Lucia Ramsey
- Lecturer in Occupational Therapy, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Joanne Marley
- Lecturer in Physiotherapy, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Johanna Rohde
- Peer Researcher, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Toni-Marie McGuigan
- Peer Researcher, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Adam Reaney
- Peer Researcher, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Brenda O’Neill
- Lecturer in Physiotherapy, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Andrea Jones
- Lecturer in Podiatry, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Danny Kerr
- Lecturer in Physiotherapy, School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Ciara Hughes
- Associate Research Director, School of Nursing and School of Health Science, Ulster University, Ulster, Northern Ireland
| | - Sonyia McFadden
- Senior Lecturer in Diagnostic Radiography, School of Health Science, Ulster University, Ulster, Northern Ireland
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McFadden S, Guille S, Daly-Lynn J, O’Neill B, Marley J, Hanratty C, Shepherd P, Ramsey L, Breen C, Duffy O, Jones A, Kerr D, Hughes C. Academic, clinical and personal experiences of undergraduate healthcare students during the COVID-19 pandemic: A prospective cohort study. PLoS One 2022; 17:e0271873. [PMID: 35895730 PMCID: PMC9328508 DOI: 10.1371/journal.pone.0271873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 07/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Coronavirus disease 2019 has impacted upon the role and safety of healthcare workers, with the potential to have a lasting effect on their wellbeing. Limited research has been conducted during previous pandemics exploring how student healthcare workers are impacted as they study and train for their professional careers.
Objective
The aim of the current study was to examine the specific impact of COVID-19 on the academic, clinical and personal experiences of healthcare students.
Method
Undergraduate students across three year groups within the School of Health Sciences at Ulster University completed online Qualtrics surveys at three timepoints during one academic year (2020/2021). Quantitative survey data was downloaded from Qualtrics into SPSS Version 25 for descriptive analysis of each cross-sectional sample. Qualitative survey data was downloaded into text format, which was thematically analysed using content analysis.
Results
412 students completed the survey at Time 1 (October 2020), n = 309 at Time 2 (December 2020) and n = 259 at Time 3 (April 2021). Academically, the pandemic had mostly a negative impact on the learning environment, the development of practical skills, the assessment process and opportunities for peer learning and support. Students reported increased stress and challenges managing their workload and maintaining a sense of motivation and routine. Clinically, they felt unprepared by the university for placement where the pandemic had an increasingly negative impact over time on learning and skill development. In terms of personal experiences, despite the majority of students taking steps to keep physically and mentally well, negative impacts on friendships, mental wellbeing and concerns for family were reported. The pandemic had not impacted upon career choice for most students.
Conclusion
Consideration must be given to the development of practical skills so students feel prepared for their professional careers given the practical nature of their roles. Programme coordinators should adopt a holistic approach to student wellbeing.
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Affiliation(s)
- Sonyia McFadden
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
- * E-mail:
| | - Sharon Guille
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Jean Daly-Lynn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Brenda O’Neill
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Joanne Marley
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Catherine Hanratty
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Paul Shepherd
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Lucia Ramsey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Cathal Breen
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Orla Duffy
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Andrea Jones
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Daniel Kerr
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
| | - Ciara Hughes
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, County Antrim, Northern Ireland
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Abstract
This paper is a survey of standards being used in the domain of digital cultural heritage with focus on the Metadata Encoding and Transmission Standard (METS) created by the Library of Congress in the United States of America. The process of digitization of cultural heritage requires silo breaking in a number of areas-one area is that of academic disciplines to enable the performance of rich interdisciplinary work. This lays the foundation for the emancipation of the second form of silo which are the silos of knowledge, both traditional and born digital, held in individual institutions, such as galleries, libraries, archives and museums. Disciplinary silo breaking is the key to unlocking these institutional knowledge silos. Interdisciplinary teams, such as developers and librarians, work together to make the data accessible as open data on the "semantic web". Description logic is the area of mathematics which underpins many ontology building applications today. Creating these ontologies requires a human-machine symbiosis. Currently in the cultural heritage domain, the institutions' role is that of provider of this open data to the national aggregator which in turn can make the data available to the trans-European aggregator known as Europeana. Current ingests to the aggregators are in the form of machine readable cataloguing metadata which is limited in the richness it provides to disparate object descriptions. METS can provide this richness.
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Affiliation(s)
- Brenda O’Neill
- Department of Computing and Mathematics, INSYTE Centre, Waterford Institute of Technology, Waterford, Ireland
| | - Larry Stapleton
- Department of Computing and Mathematics, INSYTE Centre, Waterford Institute of Technology, Waterford, Ireland
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Lee C, Toomey S, O’Neill B, Hennessy B. 430P Serial ctDNA (circulating tumour DNA) for detection of genomic changes during neoadjuvant chemoradiotherapy (NACRT) in locally advanced rectal cancer (LARC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Bradley JM, Anand R, O’Neill B, Ferguson K, Clarke M, Carroll M, Chalmers J, De Soyza A, Duckers J, Hill AT, Loebinger MR, Copeland F, Gardner E, Campbell C, Agus A, McGuire A, Boyle R, McKinney F, Dickson N, McAuley DF, Elborn S. A 2 × 2 factorial, randomised, open-label trial to determine the clinical and cost-effectiveness of hypertonic saline (HTS 6%) and carbocisteine for airway clearance versus usual care over 52 weeks in adults with bronchiectasis: a protocol for the CLEAR clinical trial. Trials 2019; 20:747. [PMID: 31856887 PMCID: PMC6921594 DOI: 10.1186/s13063-019-3766-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 09/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current guidelines for the management of bronchiectasis (BE) highlight the lack of evidence to recommend mucoactive agents, such as hypertonic saline (HTS) and carbocisteine, to aid sputum removal as part of standard care. We hypothesise that mucoactive agents (HTS or carbocisteine, or a combination) are effective in reducing exacerbations over a 52-week period, compared to usual care. METHODS This is a 52-week, 2 × 2 factorial, randomized, open-label trial to determine the clinical effectiveness and cost effectiveness of HTS 6% and carbocisteine for airway clearance versus usual care - the Clinical and cost-effectiveness of hypertonic saline (HTS 6%) and carbocisteine for airway clearance versus usual care (CLEAR) trial. Patients will be randomised to (1) standard care and twice-daily nebulised HTS (6%), (2) standard care and carbocisteine (750 mg three times per day until visit 3, reducing to 750 mg twice per day), (3) standard care and combination of twice-daily nebulised HTS and carbocisteine, or (4) standard care. The primary outcome is the mean number of exacerbations over 52 weeks. Key inclusion criteria are as follows: adults with a diagnosis of BE on computed tomography, BE as the primary respiratory diagnosis, and two or more pulmonary exacerbations in the last year requiring antibiotics and production of daily sputum. DISCUSSION This trial's pragmatic research design avoids the significant costs associated with double-blind trials whilst optimising rigour in other areas of trial delivery. The CLEAR trial will provide evidence as to whether HTS, carbocisteine or both are effective and cost effective for patients with BE. TRIAL REGISTRATION EudraCT number: 2017-000664-14 (first entered in the database on 20 October 2017). ISRCTN.com, ISRCTN89040295. Registered on 6 July/2018. Funder: National Institute for Health Research, Health Technology Assessment Programme (15/100/01). SPONSOR Belfast Health and Social Care Trust. Ethics Reference Number: 17/NE/0339. Protocol version: v3.0 Final_14052018.
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Affiliation(s)
- Judy Martina Bradley
- Wellcome-Wolfson Institute For Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Rohan Anand
- Wellcome-Wolfson Institute For Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Brenda O’Neill
- Centre for Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK
| | - Kathryn Ferguson
- Northern Ireland Clinical Research Network, Belfast Health and Social Care Trust, Belfast, UK
| | - Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Mary Carroll
- Southampton University Hospitals NHS Trust, Southampton, UK
| | | | - Anthony De Soyza
- NIHR Biomedical research centre (BRC) for Aging, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Jamie Duckers
- Cardiff and Vale University Health Board, University Hospital Llandough, Penarth, UK
| | - Adam T. Hill
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Michael R. Loebinger
- Faculty of Medicine, National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, UK
| | - Fiona Copeland
- PCD Family Support Group, Ciliopathy Alliance, London, UK
| | - Evie Gardner
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Christina Campbell
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Ashley Agus
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Alistair McGuire
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Roisin Boyle
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Fionnuala McKinney
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Naomi Dickson
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK
| | - Danny F. McAuley
- Wellcome-Wolfson Institute For Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Stuart Elborn
- Wellcome-Wolfson Institute For Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
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Stapleton L, O’Neill B, Cronin K, Kendrick M. Announcing the Professor Cooley archive at Waterford Institute of Technology, Ireland: a celebration of the legacy of Mike Cooley. AI & Soc 2019. [DOI: 10.1007/s00146-019-00878-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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King J, O’Neill B, Ramsay P, Linden MA, Darweish Medniuk A, Outtrim J, Blackwood B. Identifying patients' support needs following critical illness: a scoping review of the qualitative literature. Crit Care 2019; 23:187. [PMID: 31126335 PMCID: PMC6533750 DOI: 10.1186/s13054-019-2441-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Intensive care survivors suffer chronic and potentially life-changing physical, psychosocial and cognitive sequelae, and supporting recovery is an international priority. As survivors' transition from the intensive care unit to home, their support needs develop and change. METHODS In this scoping review, we categorised patients' support needs using House's Social Support Needs framework (informational, emotional, instrumental, appraisal) and mapped these against the Timing it Right framework reflecting the patient's transition from intensive care (event/diagnosis) to ward (stabilisation/preparation) and discharge home (implementation/adaptation). We searched electronic databases from 2000 to 2017 for qualitative research studies reporting adult critical care survivors' experiences of care. Two reviewers independently screened, extracted and coded data. Data were analysed using a thematic framework approach. RESULTS From 3035 references, we included 32 studies involving 702 patients. Studies were conducted in UK and Europe (n = 17, 53%), Canada and the USA (n = 6, 19%), Australasia (n = 6, 19%), Hong Kong (n = 1, 3%), Jordan (n = 1, 3%) and multi-country (n = 1, 3%). Across the recovery trajectory, informational, emotional, instrumental, appraisal and spiritual support needs were evident, and the nature and intensity of need differed when mapped against the Timing it Right framework. Informational needs changed from needing basic facts about admission, to detail about progress and treatments and coping with long-term sequelae. The nature of emotional needs changed from needing to cope with confusion, anxiety and comfort, to a need for security and family presence, coping with flashbacks, and needing counselling and community support. Early instrumental needs ranged from managing sleep, fatigue, pain and needing nursing care and transitioned to needing physical and cognitive ability support, strength training and personal hygiene; and at home, regaining independence, strength and return to work. Appraisal needs related to obtaining feedback on progress, and after discharge, needing reassurance from others who had been through the ICU experience. CONCLUSIONS This review is the first to identify the change in social support needs among intensive care survivors as they transition from intensive care to the home environment. An understanding of needs at different transition periods would help inform health service provision and support for survivors.
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Affiliation(s)
- J. King
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - B. O’Neill
- Centre for Health and Rehabilitation Technologies, INHR, Ulster University, Newtownabbey, Northern Ireland, UK
| | - P. Ramsay
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK
| | - M. A. Linden
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - A. Darweish Medniuk
- Department of Anaesthesia, Southmead Hospital, North Bristol NHS Trust, Bristol, England, UK
| | - J. Outtrim
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, England, UK
| | - B. Blackwood
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast, BT9 7BL Northern Ireland, UK
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Toomey S, Sartori A, Irwin D, Hummel S, Carr A, Lee C, Armstrong P, Farrelly A, El-Masry S, McNamara D, Morris P, Grogan L, Breathnach O, O’Sullivan L, Bradshaw S, Rashed A, Smyth R, Workman J, O’Neill B, Hennessy B. Non-invasive genotyping and monitoring of tumor evolution in locally advanced rectal cancer (LARC) patients using circulating tumor DNA (ctDNA). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Le D, Kavan P, Kim T, Burge M, Van Cutsem E, Hara H, Boland P, Van Laethem J, Geva R, Taniguchi H, Crocenzi T, Sharma M, Atreya C, Diaz L, Liang L, Marinello P, Dai T, O’Neill B. Safety and antitumor activity of pembrolizumab in patients with advanced microsatellite instability–high (MSI-H) colorectal cancer: KEYNOTE-164. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Reynolds JV, Preston SR, O’Neill B, Baeksgaard L, Griffin SM, Mariette C, Cuffe S, Cunningham M, Crosby T, Parker I, Hofland K, Hanna G, Svendsen LB, Donohoe CL, Muldoon C, O’Toole D, Johnson C, Ravi N, Jones G, Corkhill AK, Illsley M, Mellor J, Lee K, Dib M, Marchesin V, Cunnane M, Scott K, Lawner P, Warren S, O’Reilly S, O’Dowd G, Leonard G, Hennessy B, Dermott RM. ICORG 10-14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). BMC Cancer 2017; 17:401. [PMID: 28578652 PMCID: PMC5457631 DOI: 10.1186/s12885-017-3386-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/25/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Neoadjuvant therapy is increasingly the standard of care in the management of locally advanced adenocarcinoma of the oesophagus and junction (AEG). In randomised controlled trials (RCTs), the MAGIC regimen of pre- and postoperative chemotherapy, and the CROSS regimen of preoperative chemotherapy combined with radiation, were superior to surgery only in RCTs that included AEG but were not powered on this cohort. No completed RCT has directly compared neoadjuvant or perioperative chemotherapy and neoadjuvant chemoradiation. The Neo-AEGIS trial, uniquely powered on AEG, and including comprehensive modern staging, compares both these regimens. METHODS This open label, multicentre, phase III RCT randomises patients (cT2-3, N0-3, M0) in a 1:1 fashion to receive CROSS protocol (Carboplatin and Paclitaxel with concurrent radiotherapy, 41.4Gy/23Fr, over 5 weeks). The power calculation is a 10% difference in favour of CROSS, powered at 80%, two-sided alpha level of 0.05, requiring 540 patients to be evaluable, 594 to be recruited if a 10% dropout is included (297 in each group). The primary endpoint is overall survival, with a minimum 3-year follow up. Secondary endpoints include: disease free survival, recurrence rates, clinical and pathological response rates, toxicities of induction regimens, post-operative pathology and tumour regression grade, operative in-hospital complications, and health-related quality of life. The trial also affords opportunities for establishing a bio-resource of pre-treatment and resected tumour, and translational research. DISCUSSION This RCT directly compares two established treatment regimens, and addresses whether radiation therapy positively impacts on overall survival compared with a standard perioperative chemotherapy regimen Sponsor: Irish Clinical Research Group (ICORG). TRIAL REGISTRATION NCT01726452 . Protocol 10-14. Date of registration 06/11/2012.
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Affiliation(s)
- JV Reynolds
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - SR Preston
- Royal Surrey County Hospital, Guildford, UK
| | | | | | | | - C Mariette
- University Hospital C. Huriez Place de Verdun, Lille, France
| | - S Cuffe
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - M Cunningham
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - T Crosby
- Velindre Cancer Centre, Cardiff, Wales UK
| | - I Parker
- St Mary’s Hospital and Imperial College London, London, UK
| | | | - G Hanna
- St Mary’s Hospital and Imperial College London, London, UK
| | | | - CL Donohoe
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - C Muldoon
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - D O’Toole
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - C Johnson
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - N Ravi
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - G Jones
- Velindre Cancer Centre, Cardiff, Wales UK
| | - AK Corkhill
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - M Illsley
- Royal Surrey County Hospital, Guildford, UK
| | - J Mellor
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - K Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - M Dib
- University Hospital C. Huriez Place de Verdun, Lille, France
| | - V Marchesin
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - M Cunnane
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - K Scott
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - P Lawner
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - S Warren
- St. James’s Hospital and Trinity College Dublin, Dublin, Ireland
| | - S O’Reilly
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - G O’Dowd
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - G Leonard
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - B Hennessy
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
| | - R Mc Dermott
- Irish Clinical Oncology Research Group (ICORG), Dublin, Ireland
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O’Shea O, McCormick R, Bradley JM, O’Neill B. Fidelity review: a scoping review of the methods used to evaluate treatment fidelity in behavioural change interventions. Physical Therapy Reviews 2016. [DOI: 10.1080/10833196.2016.1261237] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Orlagh O’Shea
- Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
| | - Rosemary McCormick
- Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
| | - Judy M. Bradley
- NI Clinical Research Facility, School of Medicine, Dentistry and Biomedical Sciences, The Queen’s University of Belfast, Belfast, Northern Ireland, UK
| | - Brenda O’Neill
- Centre for Health and Rehabilitation Technologies, Institute for Nursing and Health Research, Ulster University, Jordanstown, Northern Ireland, UK
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O’Neill B, O’Shea OM, McDonough SM, McGarvey L, Bradbury I, Arden MA, Troosters T, Cosgrove D, McManus T, McDonnell TJ, Bradley JM. S33 Physical activity intervention versus pulmonary rehabilitation in copd: the lively copd project. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McDowell K, Bradley JM, McAuley DF, Blackwood B, O’Neill B. S14 Patients’ perceptions of an exercise programme delivered following discharge from hospital after critical illness (the revive trial). Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Zukas AM, Bennani N, Chou C, Johnston P, O’Neill B, Nijland M, Batchelor T, Nayak L, Mrugala M, Schiff D. OS5.8 Intravascular lymphoma affecting the central nervous system: features and outcomes in a case series of the Primary CNS Lymphoma Collaborative Group (IPCG). Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bales M, Alarcon R, Bass C, Beise E, Breuer H, Byrne J, Chupp T, Coakley K, Cooper R, Dewey M, Gardner S, Gentile T, He D, Mumm H, Nico J, O’Neill B, Thompson A, Wietfeldt F. Precision Measurement of the Radiative β Decay of the Free Neutron. Phys Rev Lett 2016; 116:242501. [PMID: 27367385 PMCID: PMC6058315 DOI: 10.1103/physrevlett.116.242501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Indexed: 06/06/2023]
Abstract
The standard model predicts that, in addition to a proton, an electron, and an antineutrino, a continuous spectrum of photons is emitted in the β decay of the free neutron. We report on the RDK II experiment which measured the photon spectrum using two different detector arrays. An annular array of bismuth germanium oxide scintillators detected photons from 14 to 782 keV. The spectral shape was consistent with theory, and we determined a branching ratio of 0.00335±0.00005[stat]±0.00015[syst]. A second detector array of large area avalanche photodiodes directly detected photons from 0.4 to 14 keV. For this array, the spectral shape was consistent with theory, and the branching ratio was determined to be 0.00582±0.00023[stat]±0.00062[syst]. We report the first precision test of the shape of the photon energy spectrum from neutron radiative decay and a substantially improved determination of the branching ratio over a broad range of photon energies.
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Affiliation(s)
- M.J. Bales
- University of Michigan, Ann Arbor, MI 48104, USA
- Physikdepartment, Technische Universität München, D-85748, Germany
| | - R. Alarcon
- Arizona State University, Tempe, AZ 85287, USA
| | - C.D. Bass
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - E.J. Beise
- University of Maryland, College Park, MD 20742, USA
| | - H. Breuer
- University of Maryland, College Park, MD 20742, USA
| | - J. Byrne
- University of Sussex, Brighton, BN1 9QH, UK
| | - T.E. Chupp
- University of Michigan, Ann Arbor, MI 48104, USA
| | - K.J. Coakley
- National Institute of Standards and Technology, Boulder, CO 80305, USA
| | - R.L. Cooper
- Indiana University, Bloomington, IN 47408, USA
| | - M.S. Dewey
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - S. Gardner
- University of Kentucky, Lexington, KY 40506 USA
| | - T.R. Gentile
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - D. He
- University of Kentucky, Lexington, KY 40506 USA
| | - H.P. Mumm
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - J.S. Nico
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
| | - B O’Neill
- Arizona State University, Tempe, AZ 85287, USA
| | - A.K. Thompson
- National Institute of Standards and Technology, Gaithersburg, MD 20899, USA
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Dillane C, Bove A, Cohen H, Bashir R, O’Murchu B, O’Neill B, Gomez-Abraham J, Shiose A, Schwartz D, Dries D, Punnoose L, Toyoda Y, Alvarez R, Hamad E. A Shock Team Improves Survival in Cardiogenic Shock by Decreasing Time to Intervention. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Wilson JJ, O’Neill B, Collins EG, Bradley J. Interventions to Increase Physical Activity in Patients with COPD: A Comprehensive Review. COPD 2014; 12:332-43. [DOI: 10.3109/15412555.2014.948992] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cosgrove D, MacMahon J, Bourbeau J, Bradley JM, O’Neill B. Facilitating education in pulmonary rehabilitation using the living well with COPD programme for pulmonary rehabilitation: a process evaluation. BMC Pulm Med 2013; 13:50. [PMID: 23915179 PMCID: PMC3751129 DOI: 10.1186/1471-2466-13-50] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 07/31/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Standardised evidenced-based materials and mechanisms to facilitate the delivery of the education component of pulmonary rehabilitation are not widely available. The aims of this study were: 1) to adapt the self-management programme Living Well with COPD (LWWCOPD) programme, for embedding in pulmonary rehabilitation; and, 2) to conduct a process evaluation of the adapted programme. METHODS The adaptations to the LWWCOPD programme were informed by focus groups, current practice, relevant research and guideline documents. Pulmonary rehabilitation sites used the adapted programme, the LWWCOPD programme for pulmonary rehabilitation, to deliver the education component of pulmonary rehabilitation. A process evaluation was conducted: elements included reach (patients' attendance rates), dose delivered (amount of programme delivered), dose received (health professional and patient satisfaction) and fidelity (impact on patients' knowledge, understanding and self-efficacy on the Understanding COPD questionnaire). Descriptive statistics (mean, SD) were used to summarise demographics and key data from the feedback questionnaires. Qualitative feedback on the programme was collated and categorised. Changes in the Understanding COPD questionnaire were examined using paired t-tests. RESULTS The LWWCOPD programme for pulmonary rehabilitation was delivered in eleven hospital- and community-based programmes (n=25 health professionals, n=57 patients with COPD). It consisted of six weekly 30-45 minute sessions. The process evaluation showed positive results: 62.3% of patients attended ≥ 4 education sessions (reach); mean (SD) 90 (10)% of the session content were delivered (dose delivered); the majority of sessions were rated as excellent or good by health professionals and patients. Patients' satisfaction was high: mean (SD) Section B of the Understanding COPD questionnaire: 91.67 (9.55)% (dose received). Knowledge, understanding and self-efficacy improved significantly: mean change (95% CI): Section A of the Understanding COPD questionnaire: 26.75 (21.74 to 31.76)%, BCKQ 10.64 (6.92 to 14.37)% (fidelity). CONCLUSION This rigorous process evaluation has demonstrated that the LWWCOPD programme for pulmonary rehabilitation can be used to deliver high quality, consistent and equitable education sessions during hospital and community-based pulmonary rehabilitation. This programme is now available worldwide (http://www.livingwellwithcopd.com/living-well-and-pulmonary-rehabilitation.html). TRIAL REGISTRATION This study was registered with clinicaltrials.gov (reference number: NCT01226836).
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Affiliation(s)
- Denise Cosgrove
- Centre of Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health research, School of Health Sciences, University of Ulster, Newtownabbey, BT37 OQB, Northern Ireland
- (Current affiliation) Northern Ireland Clinical Research Network (Respiratory Health), Belfast City Hospital, Belfast, BT9 7AB, Northern Ireland
| | - Joseph MacMahon
- Department of Respiratory Medicine, Belfast City Hospital, Belfast, BT9 7AB, Northern Ireland
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Centre, Montreal, H2X 2P4, Canada
| | - Judy M Bradley
- Centre of Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health research, School of Health Sciences, University of Ulster, Newtownabbey, BT37 OQB, Northern Ireland
- Department of Respiratory Medicine, Belfast City Hospital, Belfast, BT9 7AB, Northern Ireland
| | - Brenda O’Neill
- Centre of Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health research, School of Health Sciences, University of Ulster, Newtownabbey, BT37 OQB, Northern Ireland
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Leung S, Croft R, McKenzie R, Iskra S, Silber B, Cooper N, O’Neill B, Cropley V, Diaz-Trujillo A, Hamblin D, Simpson D. Effects of 2G and 3G mobile phones on performance and electrophysiology in adolescents, young adults and older adults. Clin Neurophysiol 2011; 122:2203-16. [DOI: 10.1016/j.clinph.2011.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 02/24/2011] [Accepted: 04/10/2011] [Indexed: 10/18/2022]
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Abstract
There should be a clear pathway through pulmonary rehabilitation and follow-on services. The aim of this survey was to determine the characteristics of the different components of the patient pathway, that is, pulmonary rehabilitation programs, ongoing exercise facilities, and support networks in Northern Ireland. Questionnaires were sent to current providers of pulmonary rehabilitation, providers of ongoing exercise, and support groups in Northern Ireland. Findings relating to the current status of pulmonary rehabilitation in Northern Ireland up to January 2007 are reported. There are currently 23 pulmonary rehabilitation programs in Northern Ireland. There appears to be a pathway through the short-term pulmonary rehabilitation program (6–8 weeks). Programs met standards for structure and format, except for the frequency of supervised exercise. Not all programs have links for the provision of ongoing exercise, but a range of exercise programs are available in leisure centers in Northern Ireland that include people with respiratory disease. There are 13 support groups for patients with respiratory disease in Northern Ireland and their function is diverse. Pulmonary rehabilitation is established in Northern Ireland, although not all patients are able to access these. Facilities for ongoing exercise and support groups are less developed. Improvements could be facilitated by better communication within the patient pathway and a strategic coordinated approach.
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Affiliation(s)
- B O’Neill
- Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland
| | - JS Elborn
- Respiratory Medicine Research Group, Queens University Belfast
| | - J MacMahon
- Regional Respiratory Centre, Belfast Trust, City Hospital, Belfast, Northern Ireland
| | - JM Bradley
- Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland; Regional Respiratory Centre, Belfast Trust, City Hospital, Belfast, Northern Ireland
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Zbaeda M, Egan E, Loftus BG, Cairns P, Jenkins J, Wilson DC, Baird T, Scrimgeour CM, McClure G, Halliday HL, Reid M, Rennie MJ, Dornan JC, Fogarty P, Dornan J, Fogarty P, Hepper PG, Shahidullah S, Halligan A, Connolly M, Gleeson RP, Holohan M, Clarke T, Matthews T, King M, Darling MRN, Daly SF, Pooley AS, Philbin M, McCreery M, Lillie EW, Byrne BM, Keane D, Boylan P, Stronge JM, Pillai M, James D, Parker M, O’Dwyer P, O’Neill B, Gleeson R, Gillan JE, Crowley P, Elbourne D, Ashurst H, Garcia J, Murphy D, Duignan N, Burke G, Donnelly V, O'Herlihy C, Gorman W, Gormally SM, Matthews TG, Condell D, O’Neill B, Campbell R, O’Hara MD, McNamara H, Johnson N, Lilford R, Teoh TG, Gleeson RP, Hickey K, Magee AC, Priest FJ, Nevin NC, Stewart FJ, Magee AC, Nevin J, Armstrong MJ, Robinson K, Stuart B, Graham I, Refsum H. Irish perinatal society. Ir J Med Sci 1992. [DOI: 10.1007/bf02996211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bill KM, Gallagher M, Dempsey M, Pratt IS, O’Connor CM, FitzGerald MX, Murray AM, Waddington JL, McKeating K, Bali IM, Dundee JW, Laird CRD, Gallagher M, Larkin S, Martin F, Schuster W, Dwyer R, Flynn RJ, McMurray T, Moore J, O’Neill M, Andrews JF, Al-Arabi A, Houlden M, Paterson A, Kirkpatrick CT, Crotty TP, McCarron JG, Allen JM, McHale NG, Thornbury KD, McGeown JG, McMurray TJ, Wright J, Phillips SA, Peyton M, O’Toole DP, Keeling F, Bouchier-Hayes D, Cunningham AJ, Jande MB, Sharma SC, Anwyl R, Mulkeen D, Rowan M, O’Connor JJ, Rowan MJ, Anwyl R, Jamison JP, Mercer CG, Victory R, O’Sullivan K, Furness G, McCollum JC, Fee JPH, Collier PS, Boyhan C, Claffey LP, Blunnie WP, Dunphy JA, O’Connell DP, Cooney D, Keenan AK, Treacy M, Martin F, Daly L, Bonnar J, Blurnie WP, McShane AJ, Synnott A, Gilmore JE, Allen JA, Hayes JR, Stevens AB, McKane WR, Bell PM, Bell P, King DJ, Ennis S, O’Regan RG, Kennedy M, Bannigan J, Cottell D, Ennis S, O’Neill B, Fitzpatrick KTJ, Ghaly RG, McGrath LT, Elliott RJ, Biggart DJ, Regan MB, Milligan KR, Howe JP, McKay AC. Royal Academy of Medicine in Ireland Section of Biological Sciences Proceedings of Summer Meeting held on Tuesday and Wednesday, 22nd and 23rd June, 1987. Ir J Med Sci 1988. [DOI: 10.1007/bf02953680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McCormick D, Wallace I, Thompson A, Hutchinson M, Hawkins SA, Connolly JH, Lyttle JA, Montgomery EA, McClelland RJ, Houston G, Fenton GW, Millar H, Martin EA, Galway JE, Sawhney BB, Forsythe I, Sills M, Callaghan N, Kenny RA, O’Neill B, Crowley M, Goggin T, McDonald K, Bresnihan B, Behan WMH, Behan PO, O’Laoire S, Hutchinson R, Nevin NC, Finucane P, Murphy SF, Morrow J, McDowell H, Ritchie C, Patterson V, Brown DA, McClure BG, Lawless V, O’Donnell L. Irish neurological association. Ir J Med Sci 1984. [DOI: 10.1007/bf02939881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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