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Almutairi M, McKenna G, Alsumaih I, Alhazzaa R, O’Neill C. Factors influencing the likelihood of dental service checkup: results from a survey in Saudi Arabia. Front Oral Health 2023; 4:1208929. [PMID: 38161345 PMCID: PMC10755011 DOI: 10.3389/froh.2023.1208929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Background The funding and delivery of healthcare including dental care in the Kingdom of Saudi Arabia (KSA, or Saudi Arabia) is undergoing a process of reform. To inform this process, it is important that policymakers are aware of the relationships between service use, specific types of use, and the factors that influence this. Currently, there is a paucity of research in this area in KSA that examines dental service use for checkups at a national level and none that examines differences in this use across regions or that examines explicitly the role of income. Aims This study uses the most recent version of the Saudi Health Interview Survey (SHIS) to examine the relationships between the use of dental services for a checkup and socio-demographic characteristics of respondents. Particular focus is given to the differences between regions in service use and the role of socio-demographics within regions. Methods Data were taken from SHIS 2013. Descriptive statistics (means and standard errors) were used to characterize the sample. Logistic regression analyses were used to examine the relationship between checkups in the past 12 months and a range of covariates including income and region. The analysis was repeated for sub-samples based on specific regions. No attempt was made to impute missing values. Results A sample of 7603 respondents provided complete data for analysis. Fifty-one per cent of the respondents were male, 29% were educated at least to degree level, 25% reported that they floss at least once per day, 69% reported that they brushed their teeth at least once per day, and 11% reported that they had visited the dentist for a checkup in the preceding 12 months. Logistic regression analyses revealed income, region, and oral hygiene habits to be among the significant determinants of the likelihood of dental checkup in the preceding 12 months. In logistic regression analyses at the regional level, different relationships were evident between checkups and socio-demographic characteristics across regions. Conclusion Region and income are significant determinants of dental service use for checkups. Differences exist between regions in the relationship between socio-demographic characteristics and the likelihood of getting checkups. Policy changes should reflect the potential differences they might have across regions for which the role of socio-demographic characteristics varies.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Gerry McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ibrahim Alsumaih
- Department of Medical Support Services, King Fahad Hofuf Hospital, Ministry of Health, Hofuf, Saudi Arabia
| | - Rasha Alhazzaa
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Health Informatics Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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Ngan TT, Tien TH, Donnelly M, O’Neill C. Financial toxicity among cancer patients, survivors and their families in the United Kingdom: a scoping review. J Public Health (Oxf) 2023; 45:e702-e713. [PMID: 37541834 PMCID: PMC10687873 DOI: 10.1093/pubmed/fdad143] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/17/2022] [Revised: 07/04/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND The aim of this scoping review was to identify key research gaps and priorities in order to advance policy and practice for people living with cancer in the UK. METHODS The review adhered to PRISMA guidelines for scoping review. We searched MEDLINE, EMBASE, Scopus, Web of Science and Google Scholar on 16 July 2022. There were no restrictions in terms of study design and publication time; gray literature was included. The key words, 'financial' or 'economic', were combined with each of the following words 'hardship/stress/burden/distress/strain/toxicity/catastrophe/consequence/impact.' RESULTS 29/629 studies/reports published during 1982-2022 were eligible to be included in the review. No study conducted a comprehensive inquiry and reported all aspects of financial toxicity (FT) or used a validated measure of FT. The most three commonly reported outcomes related to financial hardship were financial well-being (24/29), benefit/welfare (17/29) and mental health status (16/29). CONCLUSIONS It is evident that FT is experienced by UK cancer patients/survivors and that the issue is under-researched. There is an urgent need for further research including rigorous studies which contribute to a comprehensive understanding about the nature and extent of FT, disparities in experience, the impacts of FT on outcomes and potential solutions to alleviate FT and related problems.
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Affiliation(s)
- Tran T Ngan
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Tran H Tien
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea
- Department of Pharmacy, University Medical Center Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
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Barry LE, Kee F, Woodside J, Cawley J, Doherty E, Clarke M, Crealey GE, Duggan J, O’Neill C. An umbrella review of the acceptability of fiscal and pricing policies to reduce diet-related noncommunicable disease. Nutr Rev 2023; 81:1351-1372. [PMID: 36857083 PMCID: PMC10494142 DOI: 10.1093/nutrit/nuad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
CONTEXT Poor diet has been implicated in a range of noncommunicable diseases. Fiscal and pricing policies (FPs) may offer a means by which consumption of food and non-alcoholic beverages with links to such diseases can be influenced to improve public health. OBJECTIVE To examine the acceptability of FPs to reduce diet-related noncommunicable disease, based on systematic review evidence. DATA SOURCES MEDLINE, EMBASE, PsychInfo, SCI, SSCI, Web of Science, Scopus, EconLit, the Cochrane Library, Epistemonikos, and the Campbell Collaboration Library were searched for relevant studies published between January 1, 1990 and June 2021. DATA EXTRACTION The studies included systematic reviews of diet-related FPs and: used real-world evidence; examined real or perceived barriers/facilitators; targeted the price of food or non-alcoholic beverages; and applied to entire populations within a jurisdiction. A total of 9996 unique relevant records were identified, which were augmented by a search of bibliographies and recommendations from an external expert advisory panel. Following screening, 4 systematic reviews remained. DATA ANALYSIS Quality appraisal was conducted using the AMSTAR 2 tool. A narrative synthesis was undertaken, with outcomes grouped according to the WHO-INTEGRATE criteria. The findings indicated a paucity of high-quality systematic review evidence and limited public support for the use of FPs to change dietary habits. This lack of support was related to a number of factors that included: their perceived potential to be regressive; a lack of transparency, ie, there was mistrust around the use of revenues raised; a paucity of evidence around health benefits; the deliberate choice of rates that were lower than those considered necessary to affect diet; and concerns about the potential of such FPs to harm economic outcomes such as employment. CONCLUSION The findings underscore the need for high-quality systematic review evidence on this topic, and the importance of responding to public concerns and putting in place mechanisms to address these when implementing FPs. This study was funded by Safefood [02A-2020]. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021274454.
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Affiliation(s)
- Luke E Barry
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Frank Kee
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Jayne Woodside
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - John Cawley
- Brooks School of Public Policy, Cornell University, Ithaca, New York, USA
| | - Edel Doherty
- John E. Cairnes School of Business and Economics, National University of Ireland, Galway, County Galway, Ireland
| | - Mike Clarke
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Grainne E Crealey
- John E. Cairnes School of Business and Economics, National University of Ireland, Galway, County Galway, Ireland
| | - Jim Duggan
- John E. Cairnes School of Business and Economics, National University of Ireland, Galway, County Galway, Ireland
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
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Fleville S, O’Neill C, Mcadam A, Macleod A, Safar D, Mulholland C, Subin F. Freehand cognitive registration transperineal prostate biopsies – A single centre experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00231-2] [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: 02/12/2023]
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Almutairi M, McKenna G, O’Neill C. A comparative examination of the role of need in the relationship between dental service use and socio-economic status across respondents with distinct needs using data from the Scottish Health Survey. BMC Public Health 2023; 23:159. [PMID: 36694144 PMCID: PMC9872289 DOI: 10.1186/s12889-023-15078-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Disparities in oral health and distinct patterns in service use related to socio-economic status have been shown to exist in the United Kingdom. A number of studies have used the Andersen behavioural model to better understand the factors that influence utilization and thereby inform policies aimed at improving service uptake. As the nature of need may differ across distinct types of patients, however, so too may the distribution of enabling and pre-disposing factors and observed relationships between need, other factors and service use. In this study we compare samples with distinct self-assessed needs in terms of their characteristics and patterns of service use to compare application of the Andersen model to dental services among respondents to a population based survey. MATERIALS AND METHODS Data were taken from the Scottish Health Survey, for 2019. Data on service use, oral hygiene habits, perceived treatment need, and socio-demographic characteristics were extracted. Data were analysed using descriptive statistics, t-tests and ordered logistic regression analyses. RESULTS Two thousand one hundred forty-eight usable responses were obtained from the survey, 74.95% of the sample had visited the dentist less than a year ago, 11.82% between 1 year and up to 2 years ago, 7.12% between 2 and 5 years ago and 6.10% more than 5 years. Descriptive statistics, t-tests and ordered logistic regression analyses revealed distinct patterns of service use when the sample was partitioned based on perceived treatment need. Specifically those with self-assessed treatment need were older, more likely to smoke, be male and be less likely to have a degree than those who did not. While service use was positively related to age (predisposing) among those who did not have self-assessed treatment need, it was negatively related for those with perceived treatment need. Distinct patterns were also evident with respect to sugar exposure (need) and ease with which time off work could be organised (enabling). DISCUSSION The study shows common and distinct patterns of service use related to enabling and predisposing factors across groups differentiated by self-perceived treatment need. If inequalities in health and healthcare use are to be addressed, it is important to understand their origins. Conflation of distinct types of need that may correlate with predisposing and enabling factors complicates this. CONCLUSION In applying the Andersen model, it is important to take account of potential differences in the types of need expressed where possible to understand the role of other variables in service use.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. .,Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
| | - Gerry McKenna
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Ciaran O’Neill
- grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
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Aljohani M, Donnelly M, O’Neill C. Changes in public satisfaction with GP services in Britain between 1998 and 2019: a repeated cross-sectional analysis of attitudinal data. BMC Prim Care 2022; 23:83. [PMID: 35436843 PMCID: PMC9014779 DOI: 10.1186/s12875-022-01696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop.
Methods
Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend.
Results
Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education.
Conclusion
While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction.
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Barry LE, Crealey GE, Cockwell P, Elliman SJ, Griffin MD, Maxwell AP, O’Brien T, Perico N, O’Neill C. Mesenchymal stromal cell therapy compared to SGLT2-inhibitors and usual care in treating diabetic kidney disease: A cost-effectiveness analysis. PLoS One 2022; 17:e0274136. [PMID: 36331936 PMCID: PMC9635741 DOI: 10.1371/journal.pone.0274136] [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: 05/10/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To simulate the cost-effectiveness of Mesenchymal Stromal Cell (MSC) therapy compared to sodium/glucose co-transporter 2 inhibitors (SGLT2i) or usual care (UC) in treating patients with Diabetic Kidney Disease (DKD). DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS This Markov-chain Monte Carlo model adopted a societal perspective and simulated 10,000 patients with DKD eligible for MSC therapy alongside UC using a lifetime horizon. This cohort was compared with an SGLT2i alongside UC arm and a UC only arm. Model input data were extracted from the literature. A threshold of $47,000 per quality-adjusted life year and a discount rate of 3% were used. The primary outcome measure was incremental net monetary benefit (INMB). Sensitivity analysis was conducted to examine: parameter uncertainty; threshold effects regarding MSC effectiveness and cost; and INMB according to patient age (71 vs 40 years), sex, and jurisdiction (UK, Italy and Ireland). RESULTS While MSC was more cost-effective than UC, both the UC and MSC arms were dominated by SLGT2i. Relative to SGLT2i, the INMB's for MSC and UC were -$4,158 and -$10,085 respectively indicating that SGLT2i, MSC and UC had a 64%, 34% and 1% probability of being cost-effective at the given threshold, respectively. This pattern was consistent across most scenarios; driven by the relatively low cost of SGLT2i and demonstrated class-effect in delaying kidney failure and all-cause mortality. When examining younger patients at baseline, SGLT2i was still the most cost-effective but MSC performed better against UC given the increased lifetime benefit from delaying progression to ESRD. CONCLUSIONS The evidence base regarding the effectiveness of MSC therapy continues to evolve. The potential for these therapies to reverse kidney damage would see large improvements in their cost-effectiveness as would targeting such therapies at younger patients and/or those for whom SGLT2i is contra-indicated.
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Affiliation(s)
- Luke E. Barry
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Grainne E. Crealey
- John E. Cairnes School of Business and Economics, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Paul Cockwell
- Queen Elizabeth Hospital, University Hospitals Birmingham and Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | | | - Matthew D. Griffin
- Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Centre For Research in Medical Devices, School of Medicine, National University of Ireland, Galway (NUIG), Galway, Ireland
| | | | - Timothy O’Brien
- Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Centre For Research in Medical Devices, School of Medicine, National University of Ireland, Galway (NUIG), Galway, Ireland
| | - Norberto Perico
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
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Yong AC, Chuluunkhuu C, Chan VF, Stephan T, Congdon N, O’Neill C. A pilot cost-benefit analysis of a children’s spectacle reimbursement scheme: Evidence for Including children’s spectacles in Mongolia’s Social Health Insurance. PLoS One 2022; 17:e0273032. [PMID: 35969626 PMCID: PMC9377584 DOI: 10.1371/journal.pone.0273032] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background and aim Globally, 12.8 million children have vision impairment due to uncorrected refractive error (URE). In Mongolia, one in five children needs but do not have access to spectacles. This pilot cost-benefit analysis aims to estimate the net benefits of a children’s spectacles reimbursement scheme in Mongolia. Methods A willingness-to-pay (WTP) survey using the contingent valuation method was administered to rural and urban Mongolia respondents. The survey assessed WTP in additional annual taxes for any child with refractive error to be provided government-subsidised spectacles. Net benefits were then calculated based on mean WTP (i.e. benefit) and cost of spectacles. Results The survey recruited 50 respondents (mean age 40.2 ± 9.86 years; 78.0% women; 100% response rate) from rural and urban Mongolia. Mean WTP was US$24.00 ± 5.15 (95% CI US$22.55 to 25.35). The average cost of a pair of spectacles in Mongolia is US$15.00. Subtracting the average cost of spectacles from mean WTP yielded a mean positive net benefit of US$9.00. Conclusion A spectacle reimbursement scheme is potentially a cost-effective intervention to address childhood vision impairment due to URE in Mongolia. These preliminary findings support the proposal of the inclusion of children’s spectacles into existing Social Health Insurance. A much larger random sample could be employed in future research to increase the precision and generalisability of findings.
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Affiliation(s)
- Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | | | - Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa
- * E-mail:
| | - Tai Stephan
- Orbis International, New York City, New York, United States of America
| | - Nathan Congdon
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Orbis International, New York City, New York, United States of America
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biological Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
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Abstract
IMPORTANCE Estimates of the total economic cost of firearm violence are important in drawing attention to this public health issue; however, studies that consider violence more broadly are needed to further the understanding of the extent to which such costs can be avoided. OBJECTIVES To estimate the association of firearm assaults with US hospital costs and deaths compared with other assault types. DESIGN, SETTING, AND PARTICIPANTS The 2016-2018 US Nationwide Emergency Department Sample and National Inpatient Sample, Healthcare Cost and Utilization Project were used in this cross-sectional study of emergency department (ED) and inpatient admissions for assaults involving a firearm, sharp object, blunt object, or bodily force identified using International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes. Differences in ED and inpatient costs (2020 US dollars) across mechanisms were estimated using ordinary least-squares regression with and without adjustments for year and hospital, patient, and injury characteristics. The Centers for Disease Control and Prevention underlying cause of death data were used to estimate national death rates and hospital case-fatality rates across mechanisms. Cost analysis used a weighted sample. National death rates and hospital case-fatality rates used US resident death certificates, covering 976 million person-years. Hospital case-fatality rates also used nationally weighted ED records covering 2.7 million admissions. Data analysis was conducted from March 1, 2021, to March 31, 2022. EXPOSURE The primary exposure was the mechanism used in the assault. MAIN OUTCOMES AND MEASURES Emergency department and inpatient costs per record. National death rates and hospital case-fatality rates. RESULTS Overall, 2.4 million ED visits and 184 040 inpatient admissions for assault were included. Across all mechanisms, the mean age of the population was 32.7 (95% CI, 32.6-32.9) years in the ED and 36.4 (95% CI, 36.2-36.7) years in the inpatient setting; 41.9% (95% CI, 41.2%-42.5%) were female in the ED, and 19.1% (95% CI, 18.6%-19.6%) of inpatients were female. Most assaults recorded in the ED involved publicly insured or uninsured patients and hospitals in the Southern US. Emergency department costs were $678 (95% CI, $657-$699) for bodily force, $861 (95% CI, $813-$910) for blunt object, $996 (95% CI, $925-$1067) for sharp object, and $1388 (95% CI, $1254-$1522) for firearm assaults. Corresponding inpatient costs were $14 702 (95% CI, $14 178-$15 227) for bodily force, $17 906 (95% CI, $16 888-$18 923) for blunt object, $19 265 (95% CI, $18 475-$20 055) for sharp object, and $34 949 (95% CI, $33 654-$36 244) for firearm assaults. National death rates per 100 000 were 0.04 (95% CI, 0.03-0.04) for bodily force, 0.03 (95% CI, 0.03-0.03) for blunt object, 0.54 (95% CI, 0.52-0.55) for sharp object, and 4.40 (95% CI, 4.36-4.44) for firearm assaults. Hospital case fatality rates were 0.01% (95% CI, 0.009%-0.012%) for bodily force, 0.05% (95% CI, 0.04%-0.06%) for blunt object, 1.05% (95% CI, 1.00%-1.09%) for sharp object, and 15.26% (95% CI, 15.04%-15.49%) for firearm assaults. In regression analysis, ED costs for firearm assaults were 59% to 99% higher than costs for nonfirearm assaults, and inpatient costs were 67% to 118% higher. CONCLUSIONS AND RELEVANCE The findings of this study suggest that it may be useful for policies aimed at reducing the costs of firearm violence to consider violence more broadly to understand the extent to which costs can be avoided.
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Affiliation(s)
- Luke E. Barry
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Grainne E. Crealey
- John E. Cairnes School of Business and Economics, National University of Ireland, Galway, Ireland
| | - Nga T. Q. Nguyen
- Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Thomas G. Weiser
- Department of Surgery, Stanford University, Stanford, California
| | | | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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Ngan TT, Jenkins C, Minh HV, Donnelly M, O’Neill C. Breast cancer screening practices among Vietnamese women and factors associated with clinical breast examination uptake. PLoS One 2022; 17:e0269228. [PMID: 35622840 PMCID: PMC9140272 DOI: 10.1371/journal.pone.0269228] [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: 05/23/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
This study examined current breast cancer (BC) screening practices among Vietnamese women and the factors associated with the uptake of clinical breast examination (CBE).
Methods
A total of 508 women aged 30–74 years in Hanoi completed a knowledge-attitude-practice (KAP) survey in 2019 including validated measures of breast cancer awareness (Breast-CAM) and health beliefs (Champion’s Health Belief Model Scale). Descriptive statistics, χ2, and ANOVA tests were used to analyse KAP responses across groups with different sociodemographic characteristics. A logistic regression model assessed the associations of knowledge, beliefs, and sociodemographic characteristics with CBE uptake.
Results
Only 18% of respondents were aware of BC signs, risk factors, and screening modalities although 63% had previously received BC screening. CBE was the most common screening modality with an uptake of 51%. A significantly higher proportion of urban residents compared with rural residents (32% vs 18%, Chi-square test, p = 0.04) received mammography. Unlike mammography, CBE uptake was not associated with sociodemographic characteristics (i.e., residence area/education level/occupation/household monthly income/possession of health insurance). CBE uptake was associated with BC knowledge (OR = 2.44, 95%CI: 1.37–4.32), perceived susceptibility to BC (OR = 1.15, 95%CI: 1.05–1.25), and perceived barriers to accessing CBE (OR = 0.88, 95%CI: 0.84–0.92).
Conclusion
The study points to the need for public health education and promotion interventions to address low levels of awareness about BC and to increase uptake of BC screening in Vietnam in advance of screening programme planning and implementation. It also suggests that screening programmes using CBE are promising given current engagement and the absence of socio-demographic disparities.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- * E-mail:
| | - Chris Jenkins
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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11
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Kelleher D, Kharroubi S, Doherty E, Baio G, O’Neill C. Examining the Association between Polish Migrant Status and Health Preferences Using a Novel Application of a Smaller Design EQ-5D-5L Valuation Study. Pharmacoecon Open 2022; 6:425-435. [PMID: 35080756 PMCID: PMC9043148 DOI: 10.1007/s41669-021-00314-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Migrants have different utilisation of healthcare services and health-related behaviours than host populations. A potential factor that may contribute to the notable differences in healthcare use and health-related behaviours between migrants and host populations is how these groups value health. Those who place a high value on health have greater healthcare-seeking practices than those who do not. OBJECTIVE The aim of this study was to examine how Polish migrants and native Irish differ in health state utility valuations using a novel application of a smaller design EQ-5D-5L valuation study. METHODS This study uses health preferences as a predictor of how one values health. We examined the EQ-5D-5L health preferences of 119 Polish migrants and 123 native Irish, both residing full-time in Ireland. To do so, we used a novel application of a smaller design EQ-5D-5L valuation study that consisted of 30 health states and a targeted sampling strategy coupled with a Bayesian statistical nonparametric model. We collected data from June 2018 to September 2019. RESULTS Our results highlight that Polish migrants and native Irish differ in their health preferences for and valuation of severe health states. Polish migrants place meaningfully higher utility valuations of 0.1 or more on the three most severe health states compared with the native Irish. CONCLUSION This study can provide an understanding of a potential new factor underpinning some of the disparities in healthcare utilisation and health-related behaviours among migrants and host populations in Europe. This study also provides proof of principle for using a smaller design EQ-5D-5L valuation study to explore differences in health preferences among other minority subgroups, which can otherwise be hard to uncover when using the secondary analysis of national EQ-5D-5L valuation studies.
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Affiliation(s)
- Dan Kelleher
- The Institute for Lifecourse and Society, NUI Galway, Room 2007, Upper Newcastle, Galway, H91C7DK Ireland
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El Solh, PO Box 11-0236, Beirut, Lebanon
| | - Edel Doherty
- Health Economics and Policy Analysis Centre, The Institute for Lifecourse and Society, Upper Newcastle, NUI Galway, National University of Ireland, Galway, H91C7DK Ireland
| | - Gianluca Baio
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT UK
| | - Ciaran O’Neill
- Institute of Clinical Sciences, Centre for Public Health, Queen’s University Belfast, Royal Victoria Hospital, Block B, Belfast, BT12 6BA Northern Ireland, UK
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Al-Sumaih I, Donnelly M, O’Neill C. The use of finite mixture models to examine the serum 25(OH)D levels among Saudis. PLoS One 2021; 16:e0260748. [PMID: 34847185 PMCID: PMC8631613 DOI: 10.1371/journal.pone.0260748] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recorded serum 25(OH)D in survey data varies with observed and unobserved respondent characteristics. The aim of this study was to expose latent population sub-groups and examine variation across groups regarding relationships between serum 25(OH)D and observable characteristics. METHODS This study explored the role of unobserved heterogeneity on associations between surveyed 25(OH)D and various factors using a sample (n = 2,641) extracted from the Saudi Health Interview Survey (2013). Linear regression and finite mixture models (FMM) were estimated and compared. The number of latent classes in the FMM was chosen based on BIC score. RESULT Three latent classes were identified. Class I (39.82%), class II (41.03%), and class III (19.15%) with mean 25(OH)D levels of 22.79, 34.88, and 57.45 ng/ml respectively. Distinct patterns of associations with nutrition, behaviour and socio-demographic variables were recorded across classes that were not revealed in pooled linear regression. CONCLUSION FMM has the potential to provide additional insights on the relationship between 25(OH)D levels and observable characteristics. It should be more widely considered as a method of investigation in this area.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
- Ministry of Health, Riyadh, Saudi Arabia
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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Chan VF, Yong AC, O’Neill C, Graham C, Congdon N, Lohfeld L, Stephan T, Ebri AE. Factors affecting guardians' decision making on clinic-based purchase of children's spectacles in Nigeria. PLoS One 2021; 16:e0254517. [PMID: 34252145 PMCID: PMC8274875 DOI: 10.1371/journal.pone.0254517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/19/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aims to understand the key factors influencing guardians' decisions when purchasing spectacles for their children in semi-urban and urban areas of Cross River State, Nigeria, where a spectacle cross-subsidisation scheme will be implemented. METHODS This cross-sectional study was conducted among all consecutive guardians visiting the Calabar (urban), Ugep, Ikom and Ogoja (semi-urban) public eye clinics in Cross River State, southern Nigeria, from August 1 to October 31 2019, and whose children had significant refractive errors (myopia ≤-0.50D, hyperopia ≥1.50D, astigmatism >0.75D) and received spectacles. Guardians were interviewed using a questionnaire which included i) close-ended questions on reasons guardians choose to purchase spectacles for their children in eye clinics, ii) guardians' perceptions of the quality and design of children's current spectacle, iii) factors most heavily influencing their choice of spectacles for children, and iv) open-ended questions to seek guardians' suggestions on how to improve the current spectacle range. RESULTS All 137 eligible guardians (67.2% women [n = 92]) who visited the selected eye clinics participated in the study (response rate = 100%), with 109 (79.6%) from semi-urban and 28 (20.4%) attending urban clinics. Guardians from both urban and semi-urban clinics prioritised frame design, quality, and material as the main factors affecting their decision when purchasing spectacles for their children. Female guardians and those with higher incomes were both 1.5 times more likely to emphasise frame quality when describing selection criteria for purchasing spectacles for their children than male guardians (p = 0.01) or guardians earning less (p = 0.03). CONCLUSION Design, material, and frame quality are key factors influencing guardians when purchasing spectacles for their children in these setting and female guardians or those with higher income prioritise frame quality. This study could guide the planning and implementation of a novel cross-subsidisation scheme in Cross River State.
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Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- College of Health Sciences, University KwaZulu Natal, Durban, South Africa
| | - Ai Chee Yong
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Christine Graham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
| | - Nathan Congdon
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
- Orbis International, New York, New York, United States of America
| | - Lynne Lohfeld
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Northern Ireland, United Kingdom
- Clinical and Epidemiological Eye Research Center, Wenzhou Medical University, Wenzhou, China
| | - Tai Stephan
- Orbis International, New York, New York, United States of America
| | - Anne Effiom Ebri
- Brien Holden Vision Institute Foundation (Africa) Trust, Durban, South Africa
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Abstract
Background: This paper presents detailed unit costs for 16 healthcare professionals in community-based non-acute services in Ireland for the years 2016—2019. Unit costs are important data inputs for assessments of health service performance and value for money. Internationally, while some countries have an established database of unit costs for healthcare, there is need for a more coordinated approach to calculating healthcare unit costs. In Ireland, detailed cost analysis of acute care is undertaken by the Healthcare Pricing Office but to date there has been no central database of unit costs for community-based non-acute healthcare services. Methods: Unit costs for publicly employed allied healthcare professionals, Public Health Nurses and Health Care Assistant staff are calculated using a bottom-up micro-costing approach, drawing on methods outlined by the Personal Social Services Research Unit in the UK, and on available Irish and international costing guidelines. Data on salaries, working hours and other parameters are drawn from secondary datasets available from Department of Health, Health Service Executive and other public sources. Unit costs for public and private General Practitioner, dental, and long-term residential care (LTRC) are estimated drawing on available administrative and survey data. Results: The unit costs for the publicly employed non-acute healthcare professionals have changed by 2–6% over the timeframe 2016–2019 while larger percentage changes are observed in the unit costs for public GP visits and public LTRC (14-15%). Conclusions: The costs presented here are a first step towards establishing a central database of unit costs for non-acute healthcare services in Ireland. The database will help ensure consistency across Irish health costing studies and facilitate cross-study and cross-country comparisons. Future work will be required to update and expand on the range of services covered and to incorporate new data and methodological developments in cost estimation as they become available.
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Affiliation(s)
- Samantha Smith
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Jingjing Jiang
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
- Cicely Saunders Institute, London, SE5 9PJ, UK
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, BT12 6BA, Ireland
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Elshahat S, Cockwell P, Maxwell AP, Griffin M, O’Brien T, O’Neill C. The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review. PLoS One 2020; 15:e0230512. [PMID: 32208435 PMCID: PMC7092970 DOI: 10.1371/journal.pone.0230512] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [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: 08/21/2019] [Accepted: 03/02/2020] [Indexed: 11/18/2022] Open
Abstract
Chronic kidney disease (CKD) affects over 10% of the global population and poses significant challenges for societies and health care systems worldwide. To illustrate these challenges and inform cost-effectiveness analyses, we undertook a comprehensive systematic scoping review that explored costs, health-related quality of life (HRQoL) and life expectancy (LE) amongst individuals with CKD. Costs were examined from a health system and societal perspective, and HRQoL was assessed from a societal and patient perspective. Papers published in English from 2015 onward found through a systematic search strategy formed the basis of the review. All costs were adjusted for inflation and expressed in US$ after correcting for purchasing power parity. From the health system perspective, progression from CKD stages 1-2 to CKD stages 3a-3b was associated with a 1.1-1.7 fold increase in per patient mean annual health care cost. The progression from CKD stage 3 to CKD stages 4-5 was associated with a 1.3-4.2 fold increase in costs, with the highest costs associated with end-stage renal disease at $20,110 to $100,593 per patient. Mean EuroQol-5D index scores ranged from 0.80 to 0.86 for CKD stages 1-3, and decreased to 0.73-0.79 for CKD stages 4-5. For treatment with renal replacement therapy, transplant recipients incurred lower costs and demonstrated higher HRQoL scores with longer LE compared to dialysis patients. The study has provided a comprehensive updated overview of the burden associated with different CKD stages and renal replacement therapy modalities across developed countries. These data will be useful for the assessment of new renal services/therapies in terms of cost-effectiveness.
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Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Paul Cockwell
- University Hospitals Birmingham, Birmingham, England, United Kingdom
| | - Alexander P. Maxwell
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | | | | | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
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16
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Charm SE, Chi RK, Bryant H, Carson M, Chu WS, Fraser A, Gruetmacher CF, Hostetler O, Jones K, Kenell L, McQuattie R, O’Neill C, Richwine D, Salimbene J, Smith S, Wallace C, Yokote R. Rapid Screening Assay for Beta-Lactam Antibiotics in Milk: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/65.5.1186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A 15 min assay for beta-lactam antibiotics has been used by dairies for several years as a screening procedure for testing milk tankers before they unload. The test is based on a competition between 14C-penicillin and beta-lactam antibiotics in the milk samples for sites on a microbial cell wall that specifically binds beta-lactam. In a collaborative study, 11 laboratories correctly distinguished 10 coded zero penicillin G samples and 10 coded 0.01 IU/mL samples. The proposed test is qualitative, positive or negative, and can detect the presence of beta-lactam antibiotics at the 0.01 IU/mL level. The control point for determining positive or negative samples is more than 3 standard deviations from the mean of 0.01 IU/mL. The method has been adopted official first action.
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Affiliation(s)
- Stanley E Charm
- New England Enzyme Center, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
| | - Ruey K Chi
- New England Enzyme Center, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
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17
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Nguyen HQ, Nguyen NTQ, Hughes CM, O’Neill C. Trends and impact of antimicrobial resistance on older inpatients with urinary tract infections (UTIs): A national retrospective observational study. PLoS One 2019; 14:e0223409. [PMID: 31581222 PMCID: PMC6776395 DOI: 10.1371/journal.pone.0223409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/19/2019] [Accepted: 09/21/2019] [Indexed: 12/19/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the most common infections in older people and are associated with increased morbidity and mortality. UTIs are also associated with increased risk of antimicrobial resistance (AR). This study examined changes in AR among older inpatients with a primary diagnosis of UTIs in the United States over an 8-year period and the impact of AR on clinical outcomes and hospital costs. Data were obtained from the longitudinal hospital HCUP-NIS database from 2009 to 2016 for inpatient episodes that involved those aged 65+ years. The ICD-9 and ICD-10 codes were used to identify episodes with a primary diagnosis of UTIs, comorbidities, AR status and age-adjusted Deyo-Charlson comorbidity index (ACCI) for the patient concerned. Weighted multivariable regression was used to examine the impact of AR on all-cause inpatient mortality, discharge destination, length of stay and hospital expenditures, adjusted for socio-demographic and clinical covariates. The proportion of admissions with AR increased, from 3.64% in 2009 to 6.88% in 2016 (p<0.001), with distinct patterns for different types of resistance. The likelihood of AR was higher in admissions with high ACCI scores and admissions to hospitals in urban areas. Admissions with AR were more likely to be discharged to healthcare facilities (e.g. care homes) compared to routine discharge (OR 1.81; 95%CI, 1.75–1.86), had increased length of stay (1.12 days; 95%CI, 1.06–1.18) and hospital costs (1259 USD; 95%CI, 1178–1340). Resistance due to MRSA was specifically associated with increased hospital mortality (OR 1.33; 95%CI, 1.15–1.53). Our findings suggest that the prevalence of AR has increased among older inpatients with UTIs in the USA. The study highlights the impact of AR among older inpatients with a primary diagnosis of UTIs on clinical outcomes and hospital costs. These relationships and their implications for the care homes to which patients are frequently discharged warrant further research.
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Affiliation(s)
- Hoa Q. Nguyen
- School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom
| | - Nga T. Q. Nguyen
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
- * E-mail:
| | - Carmel M. Hughes
- School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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18
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Lemoine A, Aroulandom J, O’Neill C, Lemale J, Tounian P. Les suspicions d’allergies au lait de vache non IgE-médiée sont rarement confirmées. NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.399] [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: 10/27/2022]
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19
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Balfe J, Curtis E, O’Neill C. Permanent Childhood Hearing Loss in Ireland: Diagnostic Yield from Aetiological Evaluation in a Paediatric Clinic. Ir Med J 2019; 112:862. [PMID: 30719903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- J Balfe
- Dept of Neurodisability and Developmental Paediatrics , Tallaght University Hospital, Dublin 24
- Discipline of Paediatrics, Trinity College Dublin
| | - E Curtis
- Dept of Neurodisability and Developmental Paediatrics , Tallaght University Hospital, Dublin 24
- Discipline of Paediatrics, Trinity College Dublin
| | - C O’Neill
- Discipline of Paediatrics, Trinity College Dublin
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20
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McLister C, Donnelly M, Cardwell CR, Moore C, O’Neill C, Brocklehurst P, McKenna G. Effectiveness of prosthodontic interventions and survival of remaining teeth in adult patients with shortened dental arches—A systematic review. J Dent 2018; 78:31-39. [DOI: 10.1016/j.jdent.2018.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/09/2018] [Accepted: 02/19/2018] [Indexed: 11/29/2022] Open
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21
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Furlong M, McGilloway S, Stokes A, Hickey G, Leckey Y, Bywater T, O’Neill C, Cardwell C, Taylor B, Donnelly M. A community-based parent-support programme to prevent child maltreatment: Protocol for a randomised controlled trial. HRB Open Res 2018. [DOI: 10.12688/hrbopenres.12812.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The prevention of child abuse and neglect is a global public health priority due to its serious, long-lasting effects on personal, social, and economic outcomes. The Children At Risk Model (ChARM) is a wraparound-inspired intervention that coordinates evidence-based parenting- and home-visiting programmes, along with community-based supports, in order to address the multiple and complex needs of families at risk of child abuse or neglect. The study comprises a multi-centre, randomised controlled trial, with embedded economic and process evaluations. The study is being conducted in two child-welfare agencies within socially disadvantaged settings in Ireland. Families with children aged 3-11 years who are at risk of maltreatment (n = 50) will be randomised to either the 20-week ChARM programme (n = 25) or to standard care (n = 25) using a 1:1 allocation ratio. The primary outcomes are incidences of child maltreatment and child behaviour and wellbeing. Secondary outcomes include quality of parent-child relationships, parental stress, mental health, substance use, recorded incidences of substantiated abuse, and out-of-home placements. Assessments will take place at pre-intervention, and at 6- and 12-month follow-up periods. The study is the first evaluation of a wraparound-inspired intervention, incorporating evidence-based programmes, designed to prevent child abuse and neglect within intact families. The findings offer a unique contribution to the development, implementation and evaluation of effective interventions in the prevention of child abuse and neglect. The trial is registered with the International Standard Randomised Controlled Trial Number Register (DOI 10.1186/ISRCTN13644600, Date of registration: 3rd June 2015).
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22
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Irani M, Zaninovic N, Canon C, O’Neill C, Gunnala V, Zhan Q, Palermo G, Reichman D, Rosenwaks Z. A rationale for biopsying embryos reaching the morula stage on Day 6 in women undergoing preimplantation genetic testing for aneuploidy. Hum Reprod 2018; 33:935-941. [DOI: 10.1093/humrep/dey053] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 02/20/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- M Irani
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - N Zaninovic
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - C Canon
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065, USA
| | - C O’Neill
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - V Gunnala
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - Q Zhan
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - G Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - D Reichman
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
| | - Z Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021, USA
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23
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Carney P, O’Neill C. Income inequality in uptake of voluntary versus organised breast cancer screening: evidence from the British Household Panel Survey. BMC Public Health 2018; 18:252. [PMID: 29444642 PMCID: PMC5813398 DOI: 10.1186/s12889-018-5139-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 09/13/2016] [Accepted: 02/01/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This paper measures income-related inequality in uptake of breast cancer screening among women before and after a policy change to extend the screening programme to women aged 65 to 70. Prior to programme expansion women aged 50 to 64 were invited for screening under the national cancer screening programme in England and Wales whereas women in the 65 to 70 age cohort could elect to be screened by personally organising a screen. This will give a deeper insight into the nature of inequality in screening and the impact of policies aimed at widening the access related to age on inequality of uptake. METHODS Taking advantage of this natural experiment, inequality is quantified across the different age cohorts and time periods with the use of concentration indices (CI). Using data from the British Household Panel Survey, information on screening attendance, equivalised household income and age was taken for the three years prior to the programme expansion and the three years immediately following the policy change. RESULTS Results show that following the expansion, inequality significantly reduced for the 50-64 age group, prior to the expansion there was a pro-rich inequality in screening uptake. There is also evidence of a reduction in income inequality in screening uptake among those aged 65 to 70 and an increase in the number of women attending screening from this older age cohort. CONCLUSIONS This indicates that an organised breast screening programme is likely to reduce income related inequality over a screening programme where women must organise their own screen. This is important when breast screening is one of the main methods used to detect breast cancer at an earlier stage which improves outcomes for women and reduces treatment costs.
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Affiliation(s)
- Patricia Carney
- Centre for Economic and Social Research on Dementia, National University of Ireland Galway, Galway, Ireland
| | - Ciaran O’Neill
- Centre for Public Health, Queens University Belfast, Belfast, UK
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24
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Xiao M, O’Neill C. A comparative examination of healthcare use related to hearing impairment in Europe. Global & Regional Health Technology Assessment 2018. [DOI: 10.1177/2284240318757938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mimi Xiao
- School of Business and Economics, National University of Ireland, Galway, Ireland
| | - Ciaran O’Neill
- Centre for Public Health, Queens University Belfast, Northern Ireland, UK
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25
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Yap S, O’Donnell KA, O’Neill C, Mayne PD, Thornton P, Naughten E. Factor V Leiden (Arg506Gln), a Confounding Genetic Risk Factor but not Mandatory for the Occurrence of Venous Thromboembolism in Homozygotes and Obligate Heterozygotes for Cystathionine β-synthase Deficiency. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
SummaryThrombosis is the major cause of morbidity and mortality in individuals with untreated classical homocystinuria (HCU) due to cystathionine β-synthase deficiency and characterised by severe hyperhomocysteinaemia. In addition, mild and moderate hyperhomocysteinaemia and Factor V Leiden (FVL; Arg506Gln) have recently been identified as thrombotic risk factors. FVL, which renders resistance to activated Protein C, is the most common inherited genetic risk factor for thrombosis with a high allelic frequency amongst Caucasians. As thrombophilia is a multigenic disorder, 26 individuals with HCU (median age 17.6 years, range 3.5-32.8 years) and 36 obligate heterozygotes (median age 51.5 years, range 34-74 years) were screened for FVL. All the HCU individuals received treatment, except one, within 6 weeks of birth for those who were diagnosed at birth through the national newborn screening programme (n = 20) and at the time of diagnosis for those late detected (n = 5, mean age of starting treatment 4.9 years, range 1.4-11 years). All had been free from venous thrombosis, except one HCU individual and one HCU obligate heterozygote. Neither of the two individuals with venous thrombosis carried FVL. Two independent individuals with HCU (male 14.8 years; female 18.2 years) were heterozygous for FVL (allelic frequency 3.8%) and three independent HCU obligate heterozygotes (males 40 and 45.8 years; female 45.6 years) were also heterozygous for FVL (allelic frequency 4.16%). The findings in this small group suggest that FVL is not a mandatory but a significant confounding risk factor for the occurrence of thrombosis in HCU individuals and additional contributing factors may be required for thrombosis to occur in HCU obligate heterozygotes with FVL heterozygosity. Our data also suggest that treatment of HCU not only reduces the thrombotic risk in patients with isolated HCU but also in those with the additional FVL heterozygosity.
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Foster A, El Chami C, O’Neill C, Watson R. 158 Taurine transporter, TAUT, is significantly down-regulated in photoexposed human skin. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.468] [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: 11/28/2022]
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Alhubail M, Cruickshank S, McBain A, O’Neill C. 700 Lactobacillus rhamnosus GG and its lysate protects human epidermal keratinocytes from the toxic effect of specific wound pathogens. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.377] [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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Reid G, Abrahamsson T, Bailey M, Bindels L, Bubnov R, Ganguli K, Martoni C, O’Neill C, Savignac H, Stanton C, Ship N, Surette M, Tuohy K, van Hemert S. How do probiotics and prebiotics function at distant sites? Benef Microbes 2017; 8:521-533. [DOI: 10.3920/bm2016.0222] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The realisation that microbes regarded as beneficial to the host can impart effects at sites distant from their habitat, has raised many possibilities for treatment of diseases. The objective of a workshop hosted in Turku, Finland, by the International Scientific Association for Probiotics and Prebiotics, was to assess the evidence for these effects and the extent to which early life microbiome programming influences how the gut microbiota communicates with distant sites. In addition, we examined how probiotics and prebiotics might affect the skin, airways, heart, brain and metabolism. The growing levels of scientific and clinical evidence showing how microbes influence the physiology of many body sites, leads us to call for more funding to advance a potentially exciting avenue for novel therapies for many chronic diseases.
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Affiliation(s)
- G. Reid
- Lawson Health Research Institute, F3-106, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada
- Departments of Microbiology & Immunology and Surgery, The University of Western Ontario, London, Canada
| | - T. Abrahamsson
- Department of Clinical and Experimental Medicine, Division of Paediatrics, Linköping University, Linköping, Sweden
| | - M. Bailey
- Department of Pediatrics, Ohio State University, College of Medicine, Columbus, OH, USA
- Center for Microbial Pathogenesis, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - L.B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Avenue Mounier 73, P.O. Box B1.73.11, 1200 Brussels, Belgium
| | - R. Bubnov
- Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - K. Ganguli
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital for Children and Harvard Medical School, Charlestown, MA, 02114, USA
| | - C. Martoni
- UAS Laboratories, 4027 Owl Creek Drive, Madison, WI 53718, USA
| | - C. O’Neill
- Centre for Dermatology, Faculty of Biology Medicine and Health, The University of Manchester, UK
| | - H.M. Savignac
- Former (during ISAPP): Clasado Research Services Ltd, Reading, United Kingdom; present: 4D Pharma PLC, Life Sciences Innovation Building, Cornhill Road, Aberdeen, AB25 2ZS, United Kingdom
| | - C. Stanton
- APC Microbiome Institute, Biosciences Building, University College Cork, Ireland
| | - N. Ship
- Bio-K+ Pharma Inc., 495 Boulevard Armand-Frappier, Laval QC, H7V 4B3 Canada
| | - M. Surette
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton ON, L8S 4K1 Canada
| | - K. Tuohy
- Nutrition and Nutrigenomics Unit, Department of Food Quality and Nutrition, Fondazione Edmund Mach, San Michele all’Adige, Trento, 38010, Italy
| | - S. van Hemert
- Winclove Probiotics, Hulstweg 11, 1032 LB Amsterdam, the Netherlands
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O’Neill C, Worthington H, Donaldson M, Birch S, Noble S, Killough S, Murphy L, Greer M, Brodison J, Verghis R, Tickle M. Cost-Effectiveness of Caries Prevention in Practice: A Randomized Controlled Trial. J Dent Res 2017; 96:875-880. [DOI: 10.1177/0022034517708968] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 2-arm parallel-group randomized controlled trial measured the cost-effectiveness of caries prevention in caries-free children aged 2 to 3 y attending general practice. The setting was 22 dental practices in Northern Ireland. Participants were centrally randomized into intervention (22,600 ppm fluoride varnish, toothbrush, a 50-mL tube of 1,450 ppm fluoride toothpaste, and standardized prevention advice) and control (advice only), both provided at 6-monthly intervals during a 3-y follow-up. The primary outcome measure was conversion from caries-free to caries-active states assessed by calibrated and blinded examiners; secondary outcome measures included decayed, missing, or filled teeth surfaces (dmfs); pain; and extraction. Cumulative costs were related to each of the trial’s outcomes in a series of incremental cost effectiveness ratios (ICERs). Sensitivity analyses examined the impact of using dentist’s time as measured by observation rather than that reported by the dentist. The costs of applying topical fluoride were also estimated assuming the work was undertaken by dental nurses or hygienists rather than dentists. A total of 1,248 children (624 randomized to each group) were recruited, and 1,096 (549 in the intervention group and 547 in the control group) were included in the final analyses. The mean difference in direct health care costs between groups was £107.53 (£155.74 intervention, £48.21 control, P < 0.05) per child. When all health care costs were compared, the intervention group’s mean cost was £212.56 more than the control group (£987.53 intervention, £774.97 control, P < 0.05). Statistically significant differences in outcomes were only detected with respect to carious surfaces. The mean cost per carious surface avoided was estimated at £251 (95% confidence interval, £454.39–£79.52). Sensitivity analyses did not materially affect the study’s findings. This trial raises concerns about the cost-effectiveness of a fluoride-based intervention delivered at the practice level in the context of a state-funded dental service (EudraCT No: 2009-010725-39; ISRCTN: ISRCTN36180119).
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Affiliation(s)
- C. O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - H.V. Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - M. Donaldson
- Health & Social Care Board of Northern Ireland, Belfast, UK
| | - S. Birch
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Centre for Health Economics and Policy Analysis, McMaster University, Ontario, Canada
| | - S. Noble
- Northern Health & Social Care Trust, Antrim, UK
| | | | - L. Murphy
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
| | - M. Greer
- hVIVO, Queen Mary BioEnterprises Innovation Centre, London, UK
| | - J. Brodison
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
| | - R. Verghis
- Northern Ireland Clinical Trials Unit, Belfast Health & Social Care Trust, Belfast, UK
| | - M. Tickle
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Barry LB, Sweeney JS, O’Neill C, Patterson CP, Price DP, Heaney LH. P124 An investigation into comorbidity accumulation in asthma patients with systemic steroid exposure. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.267] [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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31
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Haslam I, Hiippala K, O’Neill C. 116 Probiotic regulation of ABCA1 and cholesterol efflux in primary human keratinocytes. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.134] [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: 11/25/2022]
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32
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Walsh B, Doherty E, O’Neill C. Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased. Health Aff (Millwood) 2016; 35:356-64. [DOI: 10.1377/hlthaff.2015.1019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Brendan Walsh
- Brendan Walsh is a research fellow at the School of Health Sciences and City Health Economics Centre at City University London, in the United Kingdom
| | - Edel Doherty
- Edel Doherty is a lecturer in the Department of Economics at the J.E. Cairnes School of Business and Economics, National University of Ireland Galway
| | - Ciaran O’Neill
- Ciaran O’Neill is a professor in the Department of Economics at the J.E. Cairnes School of Business and Economics, National University of Ireland Galway, and a honorary professor at Queens University Belfast
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Barry L, Sweeney J, O’Neill C, Patterson C, Price D, Heaney L. P158 The cost of steroid induced morbidity among severe asthma patients in the UK: Abstract P158 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.295] [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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O’Neill C, Li Y, Jin X. Survival Signalling in the Preimplantation Embryo. Advances in Experimental Medicine and Biology 2015; 843:129-49. [DOI: 10.1007/978-1-4939-2480-6_5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Moylan EC, Harold S, O’Neill C, Kowalczuk MK. Open, single-blind, double-blind: which peer review process do you prefer? BMC Pharmacol Toxicol 2014; 15:55. [PMID: 25266119 PMCID: PMC4191873 DOI: 10.1186/2050-6511-15-55] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 09/04/2014] [Accepted: 09/10/2014] [Indexed: 11/21/2022] Open
Abstract
BMC Pharmacology and Toxicology was created from the merger of two journals within the BMC series published by BioMed Central: BMC Pharmacology and BMC Clinical Pharmacology. BMC Pharmacology operated anonymous peer review whereas BMC Clinical Pharmacology operated a fully open peer review policy where the identity of the reviewers was known to the editors, authors and readers. The merged journal also adopted a fully open peer review policy. Two years on we discuss the views and experiences of our Editorial Board Members towards open peer review on this biomedical journal.
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Affiliation(s)
| | - Simon Harold
- Present Address: Nature Communications, The Macmillan Campus, 4 Crinan Street, London N1 9XW, UK
| | - Ciaran O’Neill
- BioMed Central Ltd, 236 Gray’s Inn Road, London WC1X 8HL, UK
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O’Donoghue M, Corrigan G, Connolly N, Deeney O, Fanning E, Guiden H, Hannon R, O’Hanlon C, McElligott K, McMahon S, Moreau C, Shaw A, O’Neill C. PP199-MON: An Audit of Meal Service and Provision in a Large Teaching Hospital in Dublin. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50533-x] [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: 10/24/2022]
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37
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Le Roux E, O’Neill C, Ait Aissa T, Shroedt J, Alberti C. Comparaison du flux et du refus de participation des patients dans les essais contrôlés randomisés en population adulte et pédiatrique : une revue. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.05.105] [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: 10/25/2022] Open
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Infanti JJ, O’Dea A, Gibson I, McGuire BE, Newell J, Glynn LG, O’Neill C, Connolly SB, Dunne FP. Reasons for participation and non-participation in a diabetes prevention trial among women with prior gestational diabetes mellitus (GDM). BMC Med Res Methodol 2014; 14:13. [PMID: 24461045 PMCID: PMC3913964 DOI: 10.1186/1471-2288-14-13] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 09/03/2013] [Accepted: 01/20/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a risk factor for the development of type 2 diabetes. Lifestyle intervention can prevent progression to type 2 diabetes in high risk populations. We designed a randomised controlled trial (RCT) to evaluate the effectiveness of an established lifestyle intervention compared to standard care for delaying diabetes onset in European women with recent GDM. Recruitment into the RCT was more challenging than anticipated with only 89 of 410 (22%) women agreeing to participate. This paper identifies factors that could enhance participation of the target population in future interventions. METHODS We hypothesised that women who agreed to participate would have higher diabetes risk profiles than those who declined, and secondly that it would be possible to predict participation on the bases of those risk factors. To test our hypothesis, we identified the subset of women for whom we had comprehensive data on diabetes risks factors 3-5 years following GDM, reducing the sample to 43 participants and 73 decliners. We considered established diabetes risk factors: smoking, daily fruit and vegetable intake, participation in exercise, family history of diabetes, glucose values and BMI scores on post-partum re-screens, use of insulin during pregnancy, and age at delivery. We also analysed narrative data from 156 decliners to further understand barriers to and facilitators of participation. RESULTS Two factors differentiated participants and decliners: age at delivery (with women older than 34 years being more likely to participate) and insulin use during pregnancy (with women requiring the use of insulin in pregnancy less likely to participate). Binary logistic regression confirmed that insulin use negatively affected the odds of participation. The most significant barriers to participation included the accessibility, affordability and practicality of the intervention. CONCLUSIONS Women with recent GDM face multiple barriers to lifestyle change. Intervention designers should consider: (i) the practicalities of participation for this population, (ii) research designs that capitalise on motivational differences between participants, (iii) alleviating concerns about long-term diabetes management. We hope this work will support future researchers in developing interventions that are more relevant, effective and successful in recruiting the desired population. TRIAL REGISTRATION Current Controlled Trials ISRCTN41202110.
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Affiliation(s)
- Jennifer J Infanti
- School of Medicine, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Angela O’Dea
- School of Medicine, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Irene Gibson
- Croí–The West of Ireland Cardiac Foundation, Croí Heart and Stroke Centre, Moyola Lane, Newcastle, Galway, Ireland
| | - Brian E McGuire
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland
| | - John Newell
- HRB Clinical Research Facility, National University of Ireland Galway, University Road, Galway, Ireland
| | - Liam G Glynn
- Discipline of General Practice, National University of Ireland Galway, 1 Distillery Road, Galway, Ireland
| | - Ciaran O’Neill
- J.E. Cairnes School of Business & Economics, Cairnes Building, National University of Ireland Galway, Galway, Ireland
| | - Susan B Connolly
- Division of Cardiology Cardiothoracic and Thoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Fidelma P Dunne
- School of Medicine, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
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Abstract
AbstractPeaks in the Precambrian preserved crustal record are associated with major volcanic, tectonic and climatic events. These include addition of juvenile continental crust, voluminous high-temperature volcanism, massive mantle depletion, widespread orogeny and mineralization, large apparent polar wander velocity spikes, and subsequent palaeomagnetic intensity increases. These events impinge on the glaciation record, atmospheric and ocean chemistry, and on the rise of oxygen. Here we summarize and assess a number of geodynamic models that have been proposed to explain the observed episodicity in the Precambrian record. We find that episodic behaviour from nonlinear slab-driven models best explains the observed record. Examples of such slab-driven systems include mantle avalanches or episodic subduction. In these cases, rapid descent of slabs into the mantle drives fast plate motions and convergence at the surface. This is accompanied by large-scale upwellings of deep hot mantle, which contribute to voluminous volcanism. Further modelling will determine the relative importance of each mechanism, and reinforce the fundamental contribution of the mantle to the evolution of Earth's surface systems.
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Affiliation(s)
- C. O’Neill
- CCFS ARC Centre of Excellence, GEMOC, Macquarie University, Sydney, Australia
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Dee AP, Perry IJ, O’Neill C, Doherty E, Callan A, Kearns K, O’Dwyer V, Staines A, McVeigh T, Sweeney MR, Sharp L, Balanda K, Hughes J, Kee F. PP47 The Cost of Overweight and Obesity on the Island of Ireland. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.144] [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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Fardal Ø, O’Neill C, Gjermo P, Fardal E, Sandvik L, Hansen BF, Linden GJ. The Lifetime Direct Cost of Periodontal Treatment: A Case Study From a Norwegian Specialist Practice. J Periodontol 2012; 83:1455-62. [DOI: 10.1902/jop.2012.110689] [Citation(s) in RCA: 26] [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: 11/13/2022]
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42
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Telford C, Murray L, Donaldson M, O’Neill C. An analysis examining socio-economic variations in the provision of NHS general dental practitioner care under a fee for service contract among adolescents: Northern Ireland Longitudinal Study. Community Dent Oral Epidemiol 2011; 40:70-9. [DOI: 10.1111/j.1600-0528.2011.00649.x] [Citation(s) in RCA: 4] [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: 11/28/2022]
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44
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O’Neill C. How can the risk that orphan drugs present to budgets be managed better? Clin Ther 2010; 32:1640-1. [DOI: 10.1016/j.clinthera.2010.08.007] [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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45
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Harrison C, Park RM, O’Neill C, McManus D, Hughes S, Carey D, Kennedy A, McGuigan J, McManus K, Eatock M. Assessment of 18FDG PET and pathological response following neoadjuvant chemotherapy for oesophageal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14026 Background: Response to chemoradiation for oesophageal carcinoma on PET scanning is associated with pathological response and survival. Recent trials suggest that neoadjuvant chemotherapy for oesophageal cancer improves disease free and overall survival. We have examined the relationship between PET and histopathological response in those who have undergone surgical resection following preoperative chemotherapy in Northern Ireland. Methods: We assessed 20 consecutive patients with resectable oesophageal cancer. Staging in all patients included an endoscopic ultrasound scan and PET scan before and after preoperative chemotherapy and a PET scan after pre-operative chemotherapy. PET response (≥50% decrease in SUVmax) and pathological response were assessed independently by a Nuclear Medicine specialist and two histopathologists. Evidence of histopathological response was assessed using the Mandard criteria and by determining the proportion of the total blocks of tumour with evidence of viable disease. Results: 20 have been treated, 15 males and 5 females with a median age of 68 (range 39–76). Clinical staging suggested stage III disease in 12 patients (60%), stage IIa in 6 (30%), stage IIb and IVa disease 1 in each group. 16 patients with adenocarcinoma received 3 cycles of ECF chemotherapy and 4 with squamous cell carcinoma received 2 cycles of Cisplatin/5FU chemotherapy. The median time to surgery from first chemotherapy was 101 days (range 84–165). Final pathological stage was less than predicted by pre-treatment staging in 9 patients (45%). PET response was seen in 10 patients (50%), of these, 9 had a Mandard score of ≤3. With median followup of 8 months (range 3–21 months), 18 patients (81.9%) are alive disease free, 3 (13.6%) have died from disease, 1 (4.5%) died postoperatively. Conclusions: In this small series evidence of response to pre-operative chemotherapy assessed by reduction in SUVmax on 18FDG PET scanning is associated with pathological response. We suggest that this association is worthy of further evaluation and prospective investigation. No significant financial relationships to disclose.
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Affiliation(s)
- C. Harrison
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - R. M. Park
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - C. O’Neill
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - D. McManus
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - S. Hughes
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - D. Carey
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - A. Kennedy
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - J. McGuigan
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - K. McManus
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
| | - M. Eatock
- Belfast City Hospital, Belfast, United Kingdom; Royal Victoria Hospital, Belfast, United Kingdom; Northern Ireland Cancer Centre, Belfast, United Kingdom
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O’Neill C, Li A, Chandrakanthan V. IVF or Culture of Embryos in Vitro Causes Increased p53 Expression Which Compromises Their Developmental Competence. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.1009] [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: 11/27/2022]
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Willison HJ, Lastovica AJ, Prendergast MM, Moran AP, Walsh C, Flitcroft I, Eustace P, McMahon C, Smith J, Smith OP, Lakshmandass G, Taylor MRH, Holland CV, Cox D, Good B, Kearns GM, Gaffney P, Shark K, Frauenshuh M, Ortmann W, Messner R, King R, Rich S, Behrens T, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Walsh KM, Thorburn D, Mills P, Morris AJ, Good T, Cameron S, McCruden EAB, Bennett MW, O’Connell J, Brady C, Roche D, Collins JK, Shanahan F, O’Sullivant GC, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, McGonagle D, Gibbon W, O’Connor P, Emery P, Murphy M, Watson R, Casey E, Naidu E, Murphy M, Watson R, Barnes L, McCann S, Murphy M, Watson R, Barnes L, Sweeney E, Barrett EJ, Graham H, Cunningham RT, Johnston CF, Curry WJ, Buchanan KD, Courtney CH, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Kilbane MT, Smith DF, Murray MJ, Shering SG, McDermott EWM, O’Higgins NJ, Smyth PPA, McEneny J, Trimble ER, Young IS, Sharpe P, Mercer C, McMaster D, Young IS, Evans AE, Young IS, Cundick J, Hasselwander O, McMaster D, McGeough J, Savage D, Maxwell AP, Evans AE, Kee F, Larkin CJ, Watson RGP, Johnston C, Ardill JES, Buchanan KD, McNamara DA, Walsh TN, Bouchier-Hayes DJ, Madden C, Timon C, Gardiner N, Lawler M, O’Riordan J, Duggan C, McCann SR, Gowing H, Braakman E, Lawler M, Byrne C, Martens ACM, Hagenbeek A, McCann SR, Kinsella N, Cusack S, Lawler M, Baker H, White B, Smith OP, Lawler M, Gardiner N, Molloy K, Gowing H, Wogan A, McCann SR, McElwaine S, Lawler M, Hollywood D, McCann SR, Mcmahon C, Merry C, Ryan M, Smith O, Mulcahy FM, Murphy C, Briones J, Gardiner N, McCann SR, Lawler M, White B, Lawler M, Cusack S, Kinsella N, Smith OP, Lavin P, McCaffrey M, Gillen P, White B, Smith OP, Thompson L, Lalloz M, Layton M, Barnes L, Corish C, Kennedy NP, Flood P, Mulligan S, McNamara E, Kennedy NP, Flood P, Mathias PM, Ball E, Duiculescu D, Calistru P, O’Gorman N, Kennedy NP, Abuzakouk M, Feighery C, Brannigan M, Pender S, Keeling F, Varghese J, Lee M, Colreavy M, Gaffney R, Hone S, Herzig M, Walsh M, Dolan C, Wogan A, Lawler M, McCann SR, Hollywood D, Donovan D, Harmey J, Bouchier-Hayes DJ, Haverty A, Wang JH, Harmey JH, Redmond HP, Bouchier-Hayes DJ, McGreal G, Shering SG, Moriarty MJ, Shortt A, Kilbane MT, Smith DF, McDermott EWM, O’Higgins NJ, Smyth PPA, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Pidgeon G, Harmey J, McNamara DA, Bouchier-Hayes DJ, Dunne P, Lambkin H, Russell JM, O’Neill AJ, Dunne BM, O’Donovan M, Lawler M, Gaffney EF, Gillan JE, Cotter TG, Horan J, Jones D, Biswas SK, Mulkerrin EC, Brady H, O’Donnell J, Neary J, Healy E, Watson A, Keogh B, Ryan M, Cassidy C, Ward S, Stokes E, Keoghan F, Barrett A, O’Connell P, Ryall N, O’Connell PA, Jenkinson A, O’Brien T, O’Connell PG, Harrison R, Barrett T, Bailey DMD, Butler A, Barton DE, Byrne C, McElwaine S, McCann SR, Lawler M, Cusack S, Lawler M, White B, Smith OP, Daly G, Gill M, Heron S, Hawi Z, 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National scientific medical meeting 1997 abstracts. Ir J Med Sci 1998. [DOI: 10.1007/bf02937234] [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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