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O'Reilly BA, Viereck V, Phillips C, Toozs-Hobson P, Kuhn A, Athanasiou S, Lukanović A, Palmer B, Dahly D, Daykan Y, Cardozo L. Vaginal erbium laser treatment for stress urinary incontinence: A multicenter randomized sham-controlled clinical trial. Int J Gynaecol Obstet 2024; 164:1184-1194. [PMID: 37927157 DOI: 10.1002/ijgo.15222] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/31/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of non-ablative vaginal Er:YAG laser device in stress urinary incontinence (SUI) treatment. METHODS We conducted a multicenter blinded randomized sham-controlled trial in which women with urodynamic SUI were randomization to active arm using Er:YAG laser therapy, and sham arm using sham handpiece. Patients received two treatments 1 month apart. The primary outcomes measure was 1 h pad weight test measured at 6 months. Secondary outcomes were durability of treatment success at 12 months, and questionnaires for assessment of SUI severity (ICIQ-UI SF), sexual function (PISQ-12) and HRQoL (KHQ), and incidence and severity of device related adverse events and pain (VAS). RESULTS A total of 110 participants with SUI were recruited; 73 in the active arm and 37 in the sham arm. Two participants were excluded; one was assigned the wrong treatment and one withdrew their consent. Treatment success was observed in 36% of the sham arm and 59% of the active arm; in the latter, odds of achieving treatment success were more than three-fold higher (OR 3.63, 95% CI: 1.3-11.2, P = 0.02). HRQoL by KHQ showed significant improvement in the active versus the sham arm (OR 0.36, 95% CI: 0.15-0.87, P = 0.003). Similarly, subjective patient assessment of general and sexual function improvement with PISQ-12 and PGI-I showed superior effect over sham (OR 2.8, 95% CI: 1.2-7.0, P = 0.02 and OR 0.13, 95% CI: 0.05-0.36, P < 0.001, respectively). CONCLUSION Non-ablative vaginal Er:YAG laser therapy significantly improves SUI symptoms versus sham treatment. Er:YAG laser therapy should be considered as a non-surgical treatment option for SUI patients.
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Affiliation(s)
- Barry A O'Reilly
- Department of Urogynecology, Cork University Maternity Hospital, Cork, Ireland
| | - Volker Viereck
- Bladder and Pelvic Floor Center/Urogynecology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland
| | - Christian Phillips
- Women's Health Unit, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Philip Toozs-Hobson
- Urogynecology Department, Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK
| | - Annette Kuhn
- Women's Clinic/Clinic for Gynecology, Universitätsspital Bern, Bern, Switzerland
| | - Stavros Athanasiou
- Department of Urogynecology and Pelvic Floor Surgery, Alexandra University Hospital, Athens, Greece
| | - Adolf Lukanović
- Division of Gynecology and Obstetrics, University Clinical Center Ljubljana, Ljubljana, Slovenia
| | - Brendan Palmer
- Clinical Research Facility, University College Cork, Cork, Ireland
| | - Darren Dahly
- Clinical Research Facility, University College Cork, Cork, Ireland
| | - Yair Daykan
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Cardozo
- Urogynecology Department, King's College Hospital NHS Foundation Trust, London, UK
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Liston M, Fuller C, Dahly D, Falla D, McLoughlin R, Yeomans C, van Dyk N, Falvey E. A Profile of Isometric Cervical Strength in Elite Professional Male Rugby Players. J Orthop Sports Phys Ther 2024; 54:1-8. [PMID: 38284387 DOI: 10.2519/jospt.2024.11830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVES: To (1) provide position-specific normative data for isometric cervical muscle strength and endurance in professional, male rugby players and (2) assess the relationship between age, height, weight, and playing position with cervical muscle strength and endurance. DESIGN: Cross-sectional study. METHODS: Professional rugby players completed peak isometric cervical strength testing followed by a test of cervical muscle endurance. Descriptive statistics for continuous variables with strength normalized to body weight were performed. Multiple linear regression was used to estimate associations between strength measurements. RESULTS: In total, 136 players participated including front-row forwards (27%), other forwards (28%), and backs (45%). Front-row forwards had significantly greater peak isometric cervical muscle strength than other position groups, with backs having the lowest strength. Extension produced the highest force for all 3 position groups (429 N ± 104 N), whereas flexion produced the least (275 N ± 65 N). Age was associated with increased isometric cervical muscle strength. There was a statistically significant relationship between peak flexion strength and flexion endurance (P = .003). The average time for the endurance tests were 55.7 (±17.1) seconds and 52.9 (±20.1) seconds for extension and flexion, respectively. Other forwards had lower cervical extension muscle endurance than backs and front-row forwards. CONCLUSIONS: Normative values for peak and endurance isometric strength in professional rugby players illustrate significant differences between playing position. Consider age, body weight, and intraindividual variability when interpreting cervical strength and endurance results. J Orthop Sports Phys Ther 2024;54(3):1-8. Epub 29 January 2024. doi:10.2519/jospt.2024.11830.
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Naughton C, de Foubert M, Cummins H, McCullagh R, Wills T, Skelton DA, Dahly D, O’Mahony D, Ahern E, Tedesco S, Sullivan BO. Implementation of a Frailty Care Bundle (FCB) Targeting Mobilisation, Nutrition and Cognitive Engagement to Reduce Hospital Associated Decline in Older Orthopaedic Trauma Patients: Pretest-Posttest Intervention Study. J Frailty Sarcopenia Falls 2024; 9:32-50. [PMID: 38444547 PMCID: PMC10910252 DOI: 10.22540/jfsf-09-032] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Objective To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models. Results We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count. Conclusion It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850).
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Affiliation(s)
- Corina Naughton
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | | | - Helen Cummins
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | - Ruth McCullagh
- School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Teresa Wills
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | - Dawn A. Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
| | - Denis O’Mahony
- Department of Medicine, University College Cork, Cork, Ireland
| | - Emer Ahern
- Department of Geriatric & Stroke Medicine, Cork University Hospital, Cork, Ireland
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McKenna DP, Price A, McAleese T, Dahly D, McKenna P, Cleary M. Acetabular cup size trends in total hip arthroplasty. World J Orthop 2024; 15:39-44. [PMID: 38293257 PMCID: PMC10824062 DOI: 10.5312/wjo.v15.i1.39] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is a common procedure for end stage osteoarthritis. The learning curve for THA is complex and challenging. One of the most difficult skills to master is acetabular reaming. We wish to identify if experience in arthroplasty leads to preservation of more bone stock. AIM To investigate if increasing surgeon experience will predict an ever decreasing acetabular cup size. METHODS A retrospective case series of four attending orthopaedic surgeons was completed. All uncemented elective total hip arthroplasties since appointment were selected for inclusion. The size of acetabular cup used was noted and logistic regression was used to identify if a trend to smaller cups existed. RESULTS A total of 1614 subjects were included with a mean age of 64 years. Overall cups were on average 0.18mm smaller per year (95% confidence interval -0.25 to -0.11, P < 0.001). Individual surgeon trends showed cup sizes to decrease 0.27 mm/year for surgeon A, 0.02 mm/year for surgeon B, 0.15 mm/year for surgeon C and 0.29 mm/year for surgeon D. Three of the four surgeons had a more pronounced trend to smaller cups for male subjects than their female counterparts. CONCLUSION We found increasing surgeon experience to be associated with an ever-decreasing acetabular cup size. Smaller acetabular cup size may act as a surrogate marker of surgical proficiency by virtue of decreased acetabular reaming.
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Affiliation(s)
- Daniel Patrick McKenna
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Alex Price
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Timothy McAleese
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Darren Dahly
- Department of Epidemiology and Public Health, University College Cork, Cork T12 XF62, Ireland
| | - Paul McKenna
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - May Cleary
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
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Saab MM, Davoren MP, Murphy A, Murphy D, Cooke E, Landers M, Fitzgerald S, Richardson N, Rovito MJ, Von Wagner C, Murphy M, Dahly D, Hegarty J. Promoting men's awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions. HRB Open Res 2023; 1:16. [PMID: 32002508 PMCID: PMC6973532 DOI: 10.12688/hrbopenres.12837.3] [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] [Accepted: 10/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background: Testicular cancer (TC) is among the most commonly diagnosed cancers in men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders, such as testicular torsion and epididymitis, can lead to testicular ischemia, sepsis, and infertility if left untreated. This updated systematic review aims to evaluate the effectiveness of studies promoting men's knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular disorder symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsycINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, and Clinicaltrials.gov were searched for studies published between April 2018 and August 2023. Methodological quality was assessed and results were synthesised meta-narratively. Results: Five studies were included. The majority of the reviewed interventions were successful in increasing men's awareness of TC and self-examination, including a PowerPoint presentation, an online educational brochure, video-assisted teaching, a motivational video, and a virtual reality game. Only one study addressed help-seeking for testicular symptoms and promoted men's awareness of benign as well as malignant testicular diseases. Conclusions: This review highlights the importance of evaluating innovative educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular disorder symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The protocol of the previous version of this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.
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Affiliation(s)
- Mohamad M. Saab
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martin P. Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, University College Cork, Cork, Ireland
| | - David Murphy
- School of Computer Science & Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
- Health Research Board National Clinical Trials Office, College of Medicine & Health, University College Cork, Cork, Ireland
| | - Margaret Landers
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Serena Fitzgerald
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Noel Richardson
- Department of Science and Health, South East Technological University, Carlow, Ireland
| | - Michael J. Rovito
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Christian Von Wagner
- Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, UK
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Frizelle P, Buckley A, Biancone T, Ceroni A, Dahly D, Fletcher P, Bishop DVM, McKean C. How reliable is assessment of children's sentence comprehension using a self-directed app? A comparison of supported versus independent use. J Child Lang 2023:1-29. [PMID: 37705428 DOI: 10.1017/s0305000923000545] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This study reports on the feasibility of using the Test of Complex Syntax- Electronic (TECS-E), as a self-directed app, to measure sentence comprehension in children aged 4 to 5 ½ years old; how testing apps might be adapted for effective independent use; and agreement levels between face-to-face supported computerized and independent computerized testing with this cohort. A pilot phase was completed with 4 to 4;06-year-old children, to determine the appropriate functional app features required to facilitate independent test completion. Following the integration of identified features, children completed the app independently or with adult support (4-4;05 (n = 22) 4;06-4;11 months (n = 55) and 5 to 5;05 (n = 113)) and test re-test reliability was examined. Independent test completion posed problems for children under 5 years but for those over 5, TECS-E is a reliable method to assess children's understanding of complex sentences, when used independently.
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Affiliation(s)
- Pauline Frizelle
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
| | - Ana Buckley
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
| | - Tricia Biancone
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
| | - Anna Ceroni
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
| | - Darren Dahly
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
| | - Paul Fletcher
- Department of Speech and Hearing Sciences, University College Cork, Republic of Ireland
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Vickers AJ, Assel M, Dunn RL, Zabor EC, Kattan MW, van Smeden M, Dahly D. Guidelines for Reporting Observational Research in Urology: The Importance of Clear Reference to Causality. Eur Urol 2023; 84:147-151. [PMID: 37286459 DOI: 10.1016/j.eururo.2023.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/05/2023] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Abstract
Observational studies often dance around the issue of causality. We propose guidelines to ensure that papers refer to whether or not the study aim is to investigate causality, and suggest language to use and language to avoid.
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Affiliation(s)
| | - Melissa Assel
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Vickers AJ, Assel M, Dunn RL, Zabor EC, Kattan MW, van Smeden M, Dahly D. Guidelines for Reporting Observational Research in Urology: The Importance of Clear Reference to Causality. J Urol 2023; 210:10-14. [PMID: 37209013 DOI: 10.1097/ju.0000000000003479] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Andrew J Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rodney L Dunn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Emily C Zabor
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Maarten van Smeden
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
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Vickers AJ, Assel M, Dunn RL, Zabor EC, Kattan MW, van Smeden M, Dahly D. Guidelines for Reporting Observational Research in Urology: The Importance of Clear Reference to Causality. Urology 2023; 177:1-5. [PMID: 37085050 PMCID: PMC10524387 DOI: 10.1016/j.urology.2023.04.007] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Affiliation(s)
- Andrew J Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rodney L Dunn
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Emily C Zabor
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - Mike W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - Maarten van Smeden
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, Netherlands
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
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Vickers AJ, Assel M, Dunn RL, Zabor EC, Kattan MW, van Smeden M, Dahly D. Guidelines for reporting observational research in urology: the importance of clear reference to causality. BJU Int 2023. [PMID: 37208953 DOI: 10.1111/bju.16028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
| | - Melissa Assel
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Martin NA, Gonzalez G, Reynolds LJ, Bennett C, Campbell C, Nolan TM, Byrne A, Fennema S, Holohan N, Kuntamukkula SR, Sarwar N, Sala-Comorera L, Dean J, Urtasun-Elizari JM, Hare D, Liddy E, Joyce E, O'Sullivan JJ, Cuddihy JM, McIntyre AM, Robinson EP, Dahly D, Fletcher NF, Cotter S, Fitzpatrick E, Carr MJ, De Gascun CF, Meijer WG. Adeno-Associated Virus 2 and Human Adenovirus F41 in Wastewater during Outbreak of Severe Acute Hepatitis in Children, Ireland. Emerg Infect Dis 2023; 29:751-760. [PMID: 36957994 PMCID: PMC10045691 DOI: 10.3201/eid2904.221878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
During April-July 2022, outbreaks of severe acute hepatitis of unknown etiology (SAHUE) were reported in 35 countries. Five percent of cases required liver transplantation, and 22 patients died. Viral metagenomic studies of clinical samples from SAHUE cases showed a correlation with human adenovirus F type 41 (HAdV-F41) and adeno-associated virus type 2 (AAV2). To explore the association between those DNA viruses and SAHUE in children in Ireland, we quantified HAdV-F41 and AAV2 in samples collected from a wastewater treatment plant serving 40% of Ireland's population. We noted a high correlation between HAdV-F41 and AAV2 circulation in the community and SAHUE clinical cases. Next-generation sequencing of the adenovirus hexon in wastewater demonstrated HAdV-F41 was the predominant HAdV type circulating. Our environmental analysis showed increased HAdV-F41 and AAV2 prevalence in the community during the SAHUE outbreak. Our findings highlight how wastewater sampling could aid in surveillance for respiratory adenovirus species.
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Richards T, Miles LF, Clevenger B, Keegan A, Abeysiri S, Rao Baikady R, Besser MW, Browne JP, Klein AA, Macdougall IC, Murphy GJ, Anker SD, Dahly D, Besser M, Browne J, Clevenger B, Kegan A, Klein A, Miles L, MacDougall I, Baikady RR, Dahly D, Bradbury A, Richards T, Burley T, Van Loen S, Anker S, Klein A, MacDougall I, Murphy G, Besser M, Unsworth I, Clayton T, Collier T, Potter K, Abeysiri S, Evans R, Knight R, Swinson R, Van Dyck L, Keidan J, Williamson L, Crook A, Pepper J, Dobson J, Newsome S, Godec T, Dodd M, Richards T, Van Dyck L, Evans R, Abeysiri S, Clevenger B, Butcher A, Swinson R, Collier T, Potter K, Anker S, Kelly J, Morris S, Browne J, Keidan J, Grocott M, Chau M, Knight R, Collier T, Baikady RR, Black E, Lawrence H, Kouthra M, Horner K, Jhanji S, Todman E, Keon‐Cohen Z, Rooms M, Tomlinson J, Bailes I, Walker S, Pirie K, Gerstman M, Kasivisvanathan R, Uren S, Magee D, Eeles A, Anker R, McCanny J, O'Mahony M, Reynolds T, Batley S, Hegarty A, Trundle S, Mazzola F, Tatham K, Balint A, Morrison B, Evans M, Pang CL, Smith L, Wilson C, Sjorin V, Khatri P, Wilson M, Parkinson D, Crosbie J, Dawas K, Smyth D, Bercades G, Ryu J, Reyes A, Martir G, Gallego L, Macklin A, Rocha M, Tam DK, Brealey DD, Dhesi J, Morrison C, Hardwick J, Partridge J, Braude P, Rogerson A, Jahangir N, Thomson C, Biswell L, Cross J, Pritchard F, Mohammed A, Wallace D, Galat MG, Okello J, Symes R, Leon J, Gibbs C, Sanghera S, Dennis A, Kibutu F, Fofie J, Bird S, Alli A, Jackson Y, Albuheissi S, Brain C, Shiridzinomwa C, Ralph C, Wroath B, Hammonds F, Adams B, Faulds J, Staddon S, Hughes T, Saha S, Finney C, Harris C, Mellis C, Johnson L, Riozzi P, Yarnold A, Buchanan F, Hopkins P, Greig L, Noble H, Edwards M, Grocott M, Plumb J, Harvie D, Dushianthan A, Wakatsuki M, Leggett S, Salmon K, Bolger C, Burnish R, Otto J, Rayat G, Golder K, Bartlett P, Bali S, Seaward L, Wadams B, Tyrell B, Collins H, Tantony N, Geale R, Wilson A, Ball D, Lindsey I, Barker D, Thyseen M, Chiam P, Hannaway C, Colling K, Messer C, Verma N, Nasseri M, Poonawala G, Sellars A, Mainali P, Hammond T, Hughes A, O'Hara D, McNeela F, Shillito L, Kotze A, Moriarty C, Wilson J, Davies S, Yates D, Carter J, Redman J, Ma S, Howard K, Redfearn H, Wilcock D, Lowe J, Alexander T, Jose J, Hornzee G, Akbar F, Rey S, Patel A, Coulson S, Saini R, Santipillai J, McCretton T, McCanny J, Chima K, Collins K, Pathmanathan B, Chattersingh A, McLeavy L, Al‐Saadi Z, Patel M, Skampardoni S, Chinnadurai R, Thomas V, Keen A, Pagett K, Keatley C, Howard J, Greenhalgh M, Jenkins S, Gidda R, Watts A, Breaton C, Parker J, Mallett S, James S, Penny L, Chan K, Reeves T, Catterall M, Williams S, Birch J, Hammerton K, Williamson N, Thomas A, Evans M, Mercer L, Horsfield G, Hughes C, Cupitt J, Stoddard E, McNamara H, Birt C, Hardy A, Dennis R, Butcher D, O'Sullivan S, Pope A, Elhanash S, Preston S, Officer H, Stoker A, Moss S, Walker A, Gipson A, Melville J, Bradley‐Potts J, McCormac R, Benson V, Melia K, Fielding J, Guest W, Ford S, Murdoch H, Beames S, Townshend P, Collins K, Glass J, Cartwright B, Altemimi B, Berresford L, Jones C, Kelliher L, de Silva S, Blightman K, Pendry K, Pinto L, Allard S, Taylor L, Chishti A, Scott J, O'Hare D, Lewis M, Hussain Z, Hallett K, Dermody S, Corbett C, Morby L, Hough M, Williams S, Williams P, Horton S, Ashcroft P, Homer A, Lang A, Dawson H, Harrison E, Thompson J, Hariharan V, Goss V, Ravi R, Butt G, Vertue M, Acheson A, Ng O, Bush D, Dickson E, Ward A, Morris S, Taylor A, Casey R, Wilson L, Vimalachandran D, Faulkner M, Jeffrey H, Gabrielle C, Martin S, Bracewell A, Ritzema J, Sproates D, Alexander‐Sefre F, Kubitzek C, Humphreys S, Curtis J, Oats P, Swann S, Holden A, Adam C, Flintoff L, Paoloni C, Bobruk K. The association between iron deficiency and outcomes: a secondary analysis of the intravenous iron therapy to treat iron deficiency anaemia in patients undergoing major abdominal surgery (PREVENTT) trial. Anaesthesia 2023; 78:320-329. [PMID: 36477695 PMCID: PMC10107684 DOI: 10.1111/anae.15926] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Abstract
In the intravenous iron therapy to treat iron deficiency anaemia in patients undergoing major abdominal surgery (PREVENTT) trial, the use of intravenous iron did not reduce the need for blood transfusion or reduce patient complications or length of hospital stay. As part of the trial protocol, serum was collected at randomisation and on the day of surgery. These samples were analysed in a central laboratory for markers of iron deficiency. We performed a secondary analysis to explore the potential interactions between pre-operative markers of iron deficiency and intervention status on the trial outcome measures. Absolute iron deficiency was defined as ferritin <30 μg.l-1 ; functional iron deficiency as ferritin 30-100 μg.l-1 or transferrin saturation < 20%; and the remainder as non-iron deficient. Interactions were estimated using generalised linear models that included different subgroup indicators of baseline iron status. Co-primary endpoints were blood transfusion or death and number of blood transfusions, from randomisation to 30 days postoperatively. Secondary endpoints included peri-operative change in haemoglobin, postoperative complications and length of hospital stay. Most patients had iron deficiency (369/452 [82%]) at randomisation; one-third had absolute iron deficiency (144/452 [32%]) and half had functional iron deficiency (225/452 [50%]). The change in pre-operative haemoglobin with intravenous iron compared with placebo was greatest in patients with absolute iron deficiency, mean difference 8.9 g.l-1 , 95%CI 5.3-12.5; moderate in functional iron deficiency, mean difference 2.8 g.l-1 , 95%CI -0.1 to 5.7; and with little change seen in those patients who were non-iron deficient. Subgroup analyses did not suggest that intravenous iron compared with placebo reduced the likelihood of death or blood transfusion at 30 days differentially across subgroups according to baseline ferritin (p = 0.33 for interaction), transferrin saturation (p = 0.13) or in combination (p = 0.45), or for the number of blood transfusions (p = 0.06, 0.29, and 0.39, respectively). There was no beneficial effect of the use of intravenous iron compared with placebo, regardless of the metrics to diagnose iron deficiency, on postoperative complications or length of hospital stay.
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Affiliation(s)
- T Richards
- Division of Surgery, University of Western Australia, Perkins South Building, Fiona Stanley Hospital, Murdoch, Perth, WA, Australia.,Institute of Clinical Trials and Methodology and Division of Surgery, University College London, UK
| | - L F Miles
- Department of Critical Care, Melbourne Medical School, The University of Melbourne, VIC, Australia.,Department of Anaesthesia, Austin Health, Melbourne, VIC, Australia
| | - B Clevenger
- Department of Anaesthesia, Royal National Orthopaedic Hospital, Stanmore, UK
| | - A Keegan
- Department of Haematology, PathWest Laboratory Medicine, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - S Abeysiri
- Division of Surgery, University of Western Australia, Perkins South Building, Fiona Stanley Hospital, Murdoch, Perth, WA, Australia
| | - R Rao Baikady
- Department of Anaesthesia, The Royal Marsden NHS Foundation Trust, London, UK
| | - M W Besser
- Department of Haematology, Addenbrooke's Hospital, Cambridge, UK
| | - J P Browne
- School of Public Health, University College Cork, Ireland
| | - A A Klein
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK
| | - I C Macdougall
- Department of Renal Medicine, King's College Hospital, London, UK
| | - G J Murphy
- Department of Cardiovascular Sciences, University of Leicester, UK
| | - S D Anker
- Department of Cardiology, Berlin Institute of Health Centre for Regenerative Therapies; German Centre for Cardiovascular Research partner site Berlin; Charité Universitätsmedizin Berlin, Germany
| | - D Dahly
- School of Public Health, University College Cork, Ireland.,Health Research Board Clinical Research Facility, University College Cork, Ireland
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Frizelle P, Allenby R, Hassett E, Holland O, Ryan E, Dahly D, O'Toole C. Embedding key word sign prompts in a shared book reading activity: The impact on communication between children with Down syndrome and their parents. Int J Lang Commun Disord 2022. [PMID: 36585887 DOI: 10.1111/1460-6984.12842] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children with Down syndrome have speech and language difficulties that are disproportionate to their overall intellectual ability and relative strengths in the use of gesture. Shared book reading between parents and their children provides an effective context in which language development can be facilitated. However, children with Down syndrome often take a passive role in shared book reading and the use of key word signing (KWS) as a shared book reading technique has never been investigated. AIMS This study aimed to compare children with Down syndrome's participation and use of KWS across two methods of shared book reading - one in which a book had key-word sign prompts embedded (signed condition) and the other in which a book was read as normal (unsigned condition). Measures of child and parent communicative behaviour were taken in each condition to establish if differences emerged. METHODS & PROCEDURES A total of 36 children with Down syndrome (aged between 18 and 61 months) and their mothers took part in the study. Parent-child dyads were videoed at home reading two books, one in a signed and one in an unsigned condition. Child measures included total number of signs produced in each condition and levels of attention and initiation as measured by the Pivotal Behaviour Rating Scale. Parent measures included total number of utterances, mean length of utterance (MLU) in morphemes and vocabulary diversity (VOCD). Parental measures were transcribed using the Codes for Human Analysis Transcripts (CHAT) software and analysed by the Computerised Language Analysis software (CLAN). Contrasts in outcomes between the signed and unsigned conditions were estimated using Poisson and linear mixed-effects models, determined by the type of data. OUTCOMES & RESULTS Results showed that children attempted to sign significantly more in the signed than unsigned condition, as well as showing significant increases in their levels of attention and initiation. There was also a significant increase in the total number of utterances used by parents in the signed versus unsigned condition and a decrease in MLU. VOCD was similar in both conditions. CONCLUSIONS & IMPLICATIONS This study shows that the simple act of embedding key word signs into commercially available books, during shared book reading between parents and young children with Down syndrome, positively affects children's participation (initiation and attention) and use of KWS. The use of KWS as a core shared book reading technique may therefore be a fruitful avenue to facilitate growth in the language abilities of young children with Down syndrome. WHAT THIS PAPER ADDS What is already known on this subject Most children with Down syndrome have significant speech and language difficulties, with relative strengths in the use of gesture. Shared book reading is an activity reported to positively affect language. However, children with Down syndrome are reported to take a passive role in shared book reading and are therefore more dependent on their parents to use techniques that facilitate their levels of participation, in order to maximise potential benefits. To the best of our knowledge, the communicative effects of embedding key word signing (KWS) in shared book reading have never been examined with children with Down syndrome. What this paper adds to existing knowledge This is the first study to investigate the communicative impact of parents embedding KWS in a shared book reading activity with their young children with Down syndrome. Our findings show that this relatively simple manipulation resulted in Increase in children's sign attempts. Increase in children's overall participation in shared book reading (indicated by levels of attention and initiation). Increase in the number of utterances produced by parents (primarily as a result of repetitions). Decrease in parental mean length of utterance. These findings suggest that embedding KWS in shared book reading is likely to facilitate increased language abilities in this cohort. What are the potential or actual clinical implications of this work? Shared book reading is part of the daily routine for many parents and their children with Down syndrome. Integrating KWS is a relatively simple adaptation to this activity which is likely to enhance children's language skills. Therapists can encourage parents to do this at home to support work carried out at school and in a clinical setting.
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Affiliation(s)
- Pauline Frizelle
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Rebecca Allenby
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Elizabeth Hassett
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Orlaith Holland
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Eimear Ryan
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Darren Dahly
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Ciara O'Toole
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
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Kearns N, Raigal-Aran L, O’Connell K, Davis A, Bermingham K, O’Reilly S, Collins DC, Corrigan M, Coulter J, Cleary V, Cushen S, Flavin A, Byrne F, O’Grady A, O’Neill D, Murphy A, Dahly D, Palmer B, Connolly RM, Hegarty J. Correction: The Women's Health Initiative cancer survivorship clinic incorporating electronic patient-reported outcomes: a study protocol for the Linking You to Support and Advice (LYSA) randomized controlled trial. Pilot Feasibility Stud 2022; 8:255. [PMID: 36510292 PMCID: PMC9743670 DOI: 10.1186/s40814-022-01219-5] [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: 12/14/2022] Open
Affiliation(s)
- Noreen Kearns
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Laia Raigal-Aran
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Kate O’Connell
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Andrea Davis
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Katie Bermingham
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Seamus O’Reilly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.412702.20000 0004 0617 8029Department of Medical Oncology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Dearbhaile C. Collins
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Mark Corrigan
- grid.411916.a0000 0004 0617 6269Department of Academic Surgery, Cork University Hospital, Cork, Ireland
| | - John Coulter
- grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Vicki Cleary
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Samantha Cushen
- grid.7872.a0000000123318773School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Aileen Flavin
- grid.411916.a0000 0004 0617 6269Department of Radiation Oncology, Cork University Hospital, Cork, Ireland
| | - Fiona Byrne
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aisling O’Grady
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Deirdre O’Neill
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aileen Murphy
- grid.7872.a0000000123318773Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Darren Dahly
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Brendan Palmer
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Roisin M. Connolly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
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Kearns N, Raigal-Aran L, O’Connell K, Davis A, Bermingham K, O’Reilly S, Collins DC, Corrigan M, Coulter J, Cleary V, Cushen S, Flavin A, Byrne F, O’Grady A, O’Neill D, Murphy A, Dahly D, Palmer B, Connolly RM, Hegarty J. The Women's Health Initiative cancer survivorship clinic incorporating electronic patient-reported outcomes: a study protocol for the Linking You to Support and Advice (LYSA) randomized controlled trial. Pilot Feasibility Stud 2022; 8:238. [PMID: 36357934 PMCID: PMC9648029 DOI: 10.1186/s40814-022-01186-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The improved survival rate for many cancers in high-income countries demands a coordinated multidisciplinary approach to survivorship care and service provision to ensure optimal patient outcomes and quality of life. This study assesses the feasibility of introducing a Women's Health Initiative cancer survivorship clinic in Ireland. METHODS The trial https://spcare.bmj.com/content/9/2/209.short comprises an intervention and control arm. Two hundred participants will be recruited. Key eligibility (1) women with early-stage hormone receptor-positive breast or gynecologic cancer (cervix or endometrial), within 12 months of completion of primary curative therapy, and (2) access to the Internet. The complex intervention comprises a nurse-led clinic targeting symptom management through a trigger alert system, utilizing electronic patient-reported outcome (ePRO) assessments at baseline, and 2, 4, 6, 8, 10, and 12 months. It also includes input from a dietitian monitoring diet and nutritional status. The control group will receive their usual care pathway standard of care and attend the cancer survivorship clinic and complete ePRO assessments at the start and end of the study. The primary endpoint (feasibility) includes the proportion of enrolled participants who complete baseline and follow-up ePRO surveys and partake in health professional consultations after ePRO data triggers. Secondary endpoints include changes in cancer-related symptom scores assessed by ePROs, health-related Quality of Life Questionnaire (QLQ) scores, Appraisal Self-Care Agency-R scores, and adjuvant endocrine therapy medication adherence. A process evaluation will capture the experiences of participation in the study, and the healthcare costs will be examined as part of the economic analysis. Ethical approval was granted in December 2020, with accrual commencing in March 2021. DISCUSSION This protocol describes the implementation of a parallel arm randomized controlled trial (RCT) which examines the feasibility of delivering a Cancer Survivorship Clinic. The ePRO is an innovative symptom monitoring system which detects the treatment-related effects and provides individualized support for cancer survivors. The findings will provide direction for the implementation of future survivorship care. TRIAL REGISTRATION ClinicalTrials.gov , NCT05035173 . Retrospectively registered on September 5, 2021.
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Affiliation(s)
- Noreen Kearns
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Laia Raigal-Aran
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Kate O’Connell
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Andrea Davis
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Katie Bermingham
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Seamus O’Reilly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.412702.20000 0004 0617 8029Department of Medical Oncology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Dearbhaile C. Collins
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Mark Corrigan
- grid.411916.a0000 0004 0617 6269Department of Academic Surgery, Cork University Hospital, Cork, Ireland
| | - John Coulter
- grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Vicki Cleary
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Gynaecology Oncology, Cork University Maternity Hospital, Cork, Ireland
| | - Samantha Cushen
- grid.7872.a0000000123318773School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Aileen Flavin
- grid.411916.a0000 0004 0617 6269Department of Radiation Oncology, Cork University Hospital, Cork, Ireland
| | - Fiona Byrne
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aisling O’Grady
- grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Deirdre O’Neill
- grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
| | - Aileen Murphy
- grid.7872.a0000000123318773Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
| | - Darren Dahly
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Brendan Palmer
- grid.7872.a0000000123318773HRB Clinical Research Facility, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773School of Public Health, University College Cork, Cork, Ireland
| | - Roisin M. Connolly
- grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland ,grid.411916.a0000 0004 0617 6269Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- grid.7872.a0000000123318773Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland ,grid.7872.a0000000123318773Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
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Baruch J, Rojek A, Kartsonaki C, Vijayaraghavan BKT, Gonçalves BP, Pritchard MG, Merson L, Dunning J, Hall M, Sigfrid L, Citarella BW, Murthy S, Yeabah TO, Olliaro P, Abdukahil SA, Abdulkadir NN, Abe R, Abel L, Absil L, Acharya S, Acker A, Adam E, Adrião D, Al Ageel S, Ahmed S, Ainscough K, Airlangga E, Aisa T, Hssain AA, Tamlihat YA, Akimoto T, Akmal E, Al Qasim E, Alalqam R, Alberti A, Al‐dabbous T, Alegesan S, Alegre C, Alessi M, Alex B, Alexandre K, Al‐Fares A, Alfoudri H, Ali I, Ali A, Shah NA, Alidjnou KE, Aliudin J, Alkhafajee Q, Allavena C, Allou N, Altaf A, Alves J, Alves R, Alves JM, Amaral M, Amira N, Ampaw P, Andini R, Andréjak C, Angheben A, Angoulvant F, Ansart S, Anthonidass S, Antonelli M, de Brito CAA, Apriyana A, Arabi Y, Aragao I, Araujo C, Arcadipane A, Archambault P, Arenz L, Arlet J, Arora L, Arora R, Artaud‐Macari E, Aryal D, Asensio A, Ashraf M, Asif N, Asim M, Assie JB, Asyraf A, Atique A, Attanyake AMUL, Auchabie J, Aumaitre H, Auvet A, Axelsen EW, Azemar L, Azoulay C, Bach B, Bachelet D, Badr C, Bævre‐Jensen R, Baig N, Baillie JK, Baird JK, McPartlan E, Meaney E, Mear‐Passard C, Mechlin M, Meher M, Mehkri O, Mele F, Melo L, Memon K, Mendes JJ, Bak E, Menkiti O, Menon K, Mentré F, Mentzer AJ, Mercier N, Mercier E, Merckx A, Mergeay‐Fabre M, Mergler B, Merson L, Bakakos A, Mesquita A, Meta R, Metwally O, Meybeck A, Meyer D, Meynert AM, Meysonnier V, Meziane A, Mezidi M, Michelanglei C, Bakar NA, Michelet I, Mihelis E, Mihnovit V, Miranda‐Maldonado H, Misnan NA, Mohamed TJ, Mohamed NNE, Moin A, Molina D, Molinos E, Bal A, Molloy B, Mone M, Monteiro A, Montes C, Montrucchio G, Moore SC, Moore S, Cely LM, Moro L, Morton B, Balakrishnan M, Motherway C, Motos A, Mouquet H, Perrot CM, Moyet J, Mudara C, Mufti AK, Muh NY, Muhamad D, Mullaert J, Balan V, Müller F, Müller KE, Munblit D, Muneeb S, Munir N, Munshi L, Murphy A, Murphy L, Murphy A, Murris M, Bani‐Sadr F, Murthy S, Musaab H, Muvindi H, Muyandy G, Myrodia DM, Mohd‐Hanafiah FN, Nagpal D, Nagrebetsky A, Narasimhan M, Narayanan N, Barbalho R, Khan RN, Nazerali‐Maitland A, Neant N, Neb H, Nekliudov N, Nelwan E, Neto R, Neumann E, Ng PY, Ng WY, Barbosa NY, Nghi A, Nguyen D, Choileain ON, Leathlobhair NN, Nichol A, Nitayavardhana P, Nonas S, Noordin NAM, Noret M, Norharizam NFI, Barclay WS, Norman L, Notari A, Noursadeghi M, Nowicka K, Nowinski A, Nseir S, Nunez JI, Nurnaningsih N, Nusantara DU, Nyamankolly E, Barnett SU, Nygaard AB, Brien FO, Callaghan AO, O'Callaghan A, Occhipinti G, OConnor D, O'Donnell M, Ogston T, Ogura T, Oh T, Barnikel M, O'Halloran S, O'Hearn K, Ohshimo S, Oldakowska A, Oliveira J, Oliveira L, Olliaro PL, Ong JY, Ong DSY, Oosthuyzen W, Barrasa H, Opavsky A, Openshaw P, Orakzai S, Orozco‐Chamorro CM, Ortoleva J, Osatnik J, O'Shea L, O'Sullivan M, Othman SZ, Ouamara N, Barrelet A, Ouissa R, Oziol E, Pagadoy M, Pages J, Palacios M, Palacios A, Palmarini M, Panarello G, Panda PK, Paneru H, Barrigoto C, Pang LH, Panigada M, Pansu N, Papadopoulos A, Parke R, Parker M, Parra B, Pasha T, Pasquier J, Pastene B, Bartoli M, Patauner F, Patel D, Pathmanathan MD, Patrão L, Patricio P, Patrier J, Patterson L, Pattnaik R, Paul M, Paul C, Baruch J, Paulos J, Paxton WA, Payen J, Peariasamy K, Jiménez MP, Peek GJ, Peelman F, Peiffer‐Smadja N, Peigne V, Pejkovska M, Bashir M, Pelosi P, Peltan ID, Pereira R, Perez D, Periel L, Perpoint T, Pesenti A, Pestre V, Petrou L, Petrovic M, Basmaci R, Petrov‐Sanchez V, Pettersen FO, Peytavin G, Pharand S, Picard W, Picone O, de Piero M, Pierobon C, Piersma D, Pimentel C, Basri MFH, Pinto R, Pires C, Pironneau I, Piroth L, Pitaloka A, Pius R, Plantier L, Png HS, Poissy J, Pokeerbux R, Battaglini D, Pokorska‐Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Porto DB, Post A, Postma DF, Povoa P, Póvoas D, Bauer J, Powis J, Prapa S, Preau S, Prebensen C, Preiser J, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Rincon DFB, Puéchal O, Semedi BP, Pulicken M, Purcell G, Quesada L, Quinones‐Cardona V, González VQ, Quist‐Paulsen E, Quraishi M, Rabaa M, Dow DB, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Rahardjani M, Rahman RA, Rahman AKHA, Rahutullah A, Rainieri F, Rajahram GS, Beane A, Ramachandran P, Ramakrishnan N, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Bedossa A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Bee KH, Reeve B, Rehman A, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Begum H, Resseguier A, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Ricchiuto A, Richardson D, Richardson D, Richier L, Behilill S, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Nuñez MAR, Rizer N, Robba C, Roberto A, Beishuizen A, Roberts S, Robertson DL, Robineau O, Roche‐Campo F, Rodari P, Rodeia S, Abreu JR, Roessler B, Roger P, Roger C, Beljantsev A, Roilides E, Rojek A, Romaru J, Roncon‐Albuquerque R, Roriz M, Rosa‐Calatrava M, Rose M, Rosenberger D, Roslan NHM, Rossanese A, Bellemare D, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Beltrame A, Ryckaert S, Holten AR, Saba I, Sadaf S, Sadat M, Sahraei V, Saint‐Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Beltrão BA, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sanchez‐Miralles A, Sancho‐Shimizu V, Sandhu G, Sandhu Z, Beluze M, Sandrine P, Sandulescu O, Santos M, Sarfo‐Mensah S, Banheiro BS, Sarmiento ICE, Sarton B, Satya A, Satyapriya S, Satyawati R, Benech N, Saviciute E, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Benjiman LE, Scott JT, Scott‐Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Benkerrou D, Sequeira F, Sequeira T, Neto AS, Balazote PS, Shadowitz E, Shahidan SA, Shamsah M, Shankar A, Sharjeel S, Sharma P, Bennett S, Shaw CA, Shaw V, Sheharyar A, Shetty R, Shetty RM, Shi H, Shiekh M, Shime N, Shimizu K, Shrapnel S, Bento L, Shrestha PS, Shrestha SK, Shum HP, Mohammed NS, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Berdal J, Silva R, Silva MJ, Heng BSL, Sin WC, Sinatti D, Singh P, Singh BC, Sitompul PA, Sivam K, Skogen V, Bergeaud D, Smith S, Smood B, Smyth C, Smyth M, Snacken M, So D, Soh TV, Solberg LB, Solomon J, Solomon T, Bergin H, Somers E, Sommet A, Song R, Song MJ, Song T, Chia JS, Sonntagbauer M, Soom AM, Søraas A, Søraas CL, Sobrino JLB, Sotto A, Soum E, Sousa M, Sousa AC, Uva MS, Souza‐Dantas V, Sperry A, Spinuzza E, Darshana BPSRS, Sriskandan S, Bertoli G, Stabler S, Staudinger T, Stecher S, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu‐Cercel A, Streinu‐Cercel A, Bertolino L, Stuart D, Stuart A, Subekti D, Suen G, Suen JY, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Bessis S, Suwarti S, Svistunov A, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Bevilcaqua S, Talarek E, Taleb S, Talsma J, Tamisier R, Tampubolon ML, Tan KK, Tan YC, Tanaka T, Tanaka H, Taniguchi H, Bezulier K, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Bhatt A, Tellier M, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier‐Grenier H, Tey A, Thabit AAM, Bhavsar K, Thakur A, Tham ZD, Thangavelu S, Thibault V, Thiberville S, Thill B, Thirumanickam J, Thompson S, Thomson EC, Thurai SRT, Bianco C, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit J, Vijayaraghavan BKT, Tissot N, Toh JZY, Toki M, Tonby K, Bidin FN, Tonnii SL, Torres M, Torres A, Santos‐Olmo RMT, Torres‐Zevallos H, Towers M, Trapani T, Treoux T, Tromeur C, Trontzas I, Singh MB, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel J, Turtle LCW, Tveita A, Twardowski P, Uchiyama M, Humaid FB, Udayanga PGI, Udy A, Ullrich R, Uribe A, Usman A, Uyeki TM, Vajdovics C, Valentini P, Val‐Flores L, Valran A, Kamarudin MNB, Van de Velde S, van den Berge M, Van der Feltz M, van der Palen J, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Gulik L, Van Hattem J, Bissuel F, van Netten C, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Veeran S, Veislinger A, Bitker L, Vencken S, Ventura S, Verbon A, Vickers J, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve P, Bitton J, Villoldo A, Vishwanathan G, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Blanco‐Schweizer P, Wainstein M, Shukeri WFWM, Wang C, Webb S, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Blier C, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils E, Wong XC, Bloos F, Wong C, Wong YS, Wong TF, Wright N, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yakop SRBM, Yamazaki M, Blot M, Yazdanpanah Y, Hing NYL, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Boccia F, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Bodenes L, Zoufaly A, Zucman D, Bogaarts A, Bogaert D, Boivin A, Bolze P, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho‐Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau A, Bourke J, Bouscambert M, Bousquet A, Bouziotis J, Boxma B, Boyer‐Besseyre M, Boylan M, Bozza FA, Braconnier A, Braga C, Brandenburger T, Monteiro FB, Brazzi L, Breen P, Breen D, Breen P, Brickell K, Browne S, Browne A, Brozzi N, Brunvoll SH, Brusse‐Keizer M, Buchtele N, Buesaquillo C, Bugaeva P, Buisson M, Buonsenso D, Burhan E, Burrell A, Bustos IG, Butnaru D, Cabie A, Cabral S, Caceres E, Cadoz C, Calligy K, Calvache JA, Camões J, Campana V, Campbell P, Campisi J, Canepa C, Cantero M, Caraux‐Paz P, Cárcel S, Cardellino CS, Cardoso S, Cardoso F, Cardoso F, Cardoso N, Carelli S, Carlier N, Carmoi T, Carney G, Carqueja I, Carret M, Carrier FM, Carroll I, Carson G, Casanova M, Cascão M, Casey S, Casimiro J, Cassandra B, Castañeda S, Castanheira N, Castor‐Alexandre G, Castrillón H, Castro I, Catarino A, Catherine F, Cattaneo P, Cavalin R, Cavalli GG, Cavayas A, Ceccato A, Cervantes‐Gonzalez M, Chair A, Chakveatze C, Chan A, Chand M, Auger CC, Chapplain J, Chas J, Chatterjee A, Chaudry M, Iñiguez JSC, Chen A, Chen Y, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Tho LC, Chirouze C, Chiumello D, Cho S, Cholley B, Chopin M, Chow TS, Chow YP, Chua J, Chua HJ, Cidade JP, Herreros JMC, Citarella BW, Ciullo A, Clarke J, Clarke E, Granado RC, Clohisey S, Cobb PJ, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin‐Cadiergues S, Courtois R, Cousse S, Cregan R, Croonen S, Crowl G, Crump J, Cruz C, Bermúdez JLC, Rojo JC, Csete M, Cullen A, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz A, Dagens A, Dahl JA, Dahly D, Dalton H, Dalton J, Daly S, Daneman N, Daniel C, Dankwa EA, Dantas J, D'Aragon F, de Loughry G, de Mendoza D, De Montmollin E, de Oliveira França RF, de Pinho Oliveira AI, De Rosa R, De Rose C, de Silva T, de Vries P, Deacon J, Dean D, Debard A, Debray M, DeCastro N, Dechert W, Deconninck L, Decours R, Defous E, Delacroix I, Delaveuve E, Delavigne K, Delfos NM, Deligiannis I, Dell'Amore A, Delmas C, Delobel P, Delsing C, Demonchy E, Denis E, Deplanque D, Depuydt P, Desai M, Descamps D, Desvallées M, Dewayanti S, Dhanger P, Diallo A, Diamantis S, Dias A, Diaz JJ, Diaz P, Diaz R, Didier K, Diehl J, Dieperink W, Dimet J, Dinot V, Diop F, Diouf A, Dishon Y, Djossou F, Docherty AB, Doherty H, Dondorp AM, Donnelly M, Donnelly CA, Donohue S, Donohue Y, Donohue C, Doran P, Dorival C, D'Ortenzio E, Douglas JJ, Douma R, Dournon N, Downer T, Downey J, Downing M, Drake T, Driscoll A, Dryden M, Fonseca CD, Dubee V, Dubos F, Ducancelle A, Duculan T, Dudman S, Duggal A, Dunand P, Dunning J, Duplaix M, Durante‐Mangoni E, Durham L, Dussol B, Duthoit J, Duval X, Dyrhol‐Riise AM, Ean SC, Echeverria‐Villalobos M, Egan S, Eggesbø LM, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Ellingjord‐Dale M, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito‐Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre M, Fabre I, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Fareed K, Faria P, Farooq A, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes MA, Fernandes S, Ferrand F, Devouge EF, Ferrão J, Ferraz M, Ferreira S, Ferreira I, Ferreira B, Ferrer‐Roca R, Ferriere N, Ficko C, Figueiredo‐Mello C, Finlayson W, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher M, Franch‐Llasat D, Fraser JF, Fraser C, Freire MV, Ribeiro AF, Friedrich C, Fry S, Fuentes N, Fukuda M, Argin G, Gaborieau V, Gaci R, Gagliardi M, Gagnard J, Gagneux‐Brunon A, Gaião S, Skeie LG, Gallagher P, Gamble C, Gani Y, Garan A, Garcia R, Barrio NG, Garcia‐Diaz J, Garcia‐Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Morlaes LG, Germano N, Ghisulal PK, Ghosn J, Giani M, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard J, Goh JY, Golob J, Gomez K, Gómez‐Junyent J, Gominet M, Gonçalves BP, Gonzalez A, Gordon P, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Lordemann AG, Gruner H, Gu Y, Guedj J, Guego M, Guellec D, Guerguerian A, Guerreiro D, Guery R, Guillaumot A, Guilleminault L, Guimarães de Castro M, Guimard T, Haalboom M, Haber D, Habraken H, Hachemi A, Hackmann A, Hadri N, Haidri F, Hakak S, Hall A, Hall M, Halpin S, Hameed J, Hamer A, Hamers RL, Hamidfar R, Hammarström B, Hammond T, Han LY, Haniffa R, Hao KW, Hardwick H, Harrison EM, Harrison J, Harrison SBE, Hartman A, Hasan MS, Hashmi J, Hayat M, Hayes A, Hays L, Heerman J, Heggelund L, Hendry R, Hennessy M, Henriquez‐Trujillo A, Hentzien M, Hernandez‐Montfort J, Hershey A, Hesstvedt L, Hidayah A, Higgins E, Higgins D, Higgins R, Hinchion R, Hinton S, Hiraiwa H, Hirkani H, Hitoto H, Ho YB, Ho A, Hoctin A, Hoffmann I, Hoh WH, Hoiting O, Holt R, Holter JC, Horby P, Horcajada JP, Hoshino K, Houas I, Hough CL, Houltham S, Hsu JM, Hulot J, Huo S, Hurd A, Hussain I, Ijaz S, Illes H, Imbert P, Imran M, Sikander RI, Imtiaz A, Inácio H, Dominguez CI, Ing YS, Iosifidis E, Ippolito M, Isgett S, Isidoro T, Ismail N, Isnard M, Istre MS, Itai J, Ivulich D, Jaafar D, Jaafoura S, Jabot J, Jackson C, Jamieson N, Jaquet P, Jaud‐Fischer C, Jaureguiberry S, Jaworsky D, Jego F, Jelani AM, Jenum S, Jimbo‐Sotomayor R, Joe OY, Jorge García RN, Jørgensen SB, Joseph C, Joseph M, Joshi S, Jourdain M, Jouvet P, Jung H, Jung A, Juzar D, Kafif O, Kaguelidou F, Kaisbain N, Kaleesvran T, Kali S, Kalicinska A, Kalleberg KT, Kalomoiri S, Kamaluddin MAA, Kamaruddin ZAC, Kamarudin N, Kamineni K, Kandamby DH, Kandel C, Kang KY, Kanwal D, Karpayah P, Kartsonaki C, Kasugai D, Kataria A, Katz K, Kaur A, Kay C, Keane H, Keating S, Kedia P, Kelly C, Kelly Y, Kelly A, Kelly N, Kelly A, Kelly S, Kelsey M, Kennedy R, Kennon K, Kernan M, Kerroumi Y, Keshav S, Khalid I, Khalid O, Khalil A, Khan C, Khan I, Khan QA, Khanal S, Khatak A, Khawaja A, Kherajani K, Kho ME, Khoo R, Khoo D, Khoo S, Khoso N, Kiat KH, Kida Y, Kiiza P, Granerud BK, Kildal AB, Kim JB, Kimmoun A, Kindgen‐Milles D, King A, Kitamura N, Kjetland EFK, Klenerman P, Klont R, Bekken GK, Knight SR, Kobbe R, Kodippily C, Vasconcelos MK, Koirala S, Komatsu M, Kosgei C, Kpangon A, Krawczyk K, Krishnan V, Krishnan S, Kruglova O, Kumar G, Kumar D, Kumar M, Vecham PK, Kuriakose D, Kurtzman E, Kutsogiannis D, Kutsyna G, Kyriakoulis K, Lachatre M, Lacoste M, Laffey JG, Lagrange M, Laine F, Lairez O, Lakhey S, Lalueza A, Lambert M, Lamontagne F, Langelot‐Richard M, Langlois V, Lantang EY, Lanza M, Laouénan C, Laribi S, Lariviere D, Lasry S, Lath S, Latif N, Launay O, Laureillard D, Lavie‐Badie Y, Law A, Lawrence T, Lawrence C, Le M, Le Bihan C, Le Bris C, Le Falher G, Le Fevre L, Le Hingrat Q, Le Maréchal M, Le Mestre S, Le Moal G, Le Moing V, Le Nagard H, Le Turnier P, Leal E, Santos ML, Lee HG, Lee BH, Lee YL, Lee TC, Lee J, Lee J, Lee SH, Leeming G, Lefebvre L, Lefebvre B, Lefèvre B, LeGac S, Lelievre J, Lellouche F, Lemaignen A, Lemee V, Lemeur A, Lemmink G, Lene HS, Lennon J, León R, Leone M, Leone M, Lepiller Q, Lescure F, Lesens O, Lesouhaitier M, Lester‐Grant A, Levy Y, Levy B, Levy‐Marchal C, Lewandowska K, L'Her E, Bassi GL, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina L, Lina B, Lind A, Lingad MK, Lingas G, Lion‐Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez‐Colon D, Lopez‐Revilla JW, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace‐Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Bermejo CL, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, Machado M, Macheda G, Madiha H, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandelbrot L, Manetta F, Mankikian J, Manning E, Manuel A, Sant'Ana Malaque CM, Marino F, Marino D, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, Martin D, Martin E, Martin‐Blondel G, Martin‐Loeches I, Martinot M, Martin‐Quiros A, Martins J, Martins A, Martins N, Rego CM, Martucci G, Martynenko O, Marwali EM, Marzukie M, Maslove D, Mason S, Masood S, Nor BM, Matan M, Mathew M, Mathieu D, Mattei M, Matulevics R, Maulin L, Maxwell M, Maynar J, Mazzoni T, Evoy NM, Sweeney LM, McArthur C, McArthur C, McCarthy A, McCarthy A, McCloskey C, McConnochie R, McDermott S, McDonald SE, McElroy A, McElwee S, McEneany V, McGeer A, McKay C, McKeown J, McLean KA, McNally P, McNicholas B. Symptom-based case definitions for COVID-19: Time and geographical variations for detection at hospital admission among 260,000 patients. Influenza Other Respir Viruses 2022; 16:1040-1050. [PMID: 36825252 PMCID: PMC9530510 DOI: 10.1111/irv.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/22/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Case definitions are used to guide clinical practice, surveillance and research protocols. However, how they identify COVID-19-hospitalised patients is not fully understood. We analysed the proportion of hospitalised patients with laboratory-confirmed COVID-19, in the ISARIC prospective cohort study database, meeting widely used case definitions. Methods Patients were assessed using the Centers for Disease Control (CDC), European Centre for Disease Prevention and Control (ECDC), World Health Organization (WHO) and UK Health Security Agency (UKHSA) case definitions by age, region and time. Case fatality ratios (CFRs) and symptoms of those who did and who did not meet the case definitions were evaluated. Patients with incomplete data and non-laboratory-confirmed test result were excluded. Results A total of 263,218 of the patients (42%) in the ISARIC database were included. Most patients (90.4%) were from Europe and Central Asia. The proportions of patients meeting the case definitions were 56.8% (WHO), 74.4% (UKHSA), 81.6% (ECDC) and 82.3% (CDC). For each case definition, patients at the extremes of age distribution met the criteria less frequently than those aged 30 to 70 years; geographical and time variations were also observed. Estimated CFRs were similar for the patients who met the case definitions. However, when more patients did not meet the case definition, the CFR increased. Conclusions The performance of case definitions might be different in different regions and may change over time. Similarly concerning is the fact that older patients often did not meet case definitions, risking delayed medical care. While epidemiologists must balance their analytics with field applicability, ongoing revision of case definitions is necessary to improve patient care through early diagnosis and limit potential nosocomial spread.
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Affiliation(s)
- Joaquin Baruch
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK
| | - Amanda Rojek
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK,Centre for Integrated Critical CareUniversity of MelbourneMelbourneAustralia
| | - Christiana Kartsonaki
- MRC Population Health Unit, Clinical Trials Service Unit and Epidemiological Studies UnitUniversity of OxfordOxfordUK
| | | | | | | | - Laura Merson
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK,Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK
| | - Jake Dunning
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK
| | | | - Louise Sigfrid
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK
| | | | - Srinivas Murthy
- Faculty of MedicineUniversity of British ColumbiaVancouverCanada
| | - Trokon O. Yeabah
- Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global HealthUniversity of OxfordOxfordUK,National Public Health Institute of LiberiaPaynesvilleLiberia
| | - Piero Olliaro
- ISARIC, Pandemic Sciences InstituteUniversity of OxfordOxfordUK
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Reynolds LJ, Gonzalez G, Sala-Comorera L, Martin NA, Byrne A, Fennema S, Holohan N, Kuntamukkula SR, Sarwar N, Nolan TM, Stephens JH, Whitty M, Bennett C, Luu Q, Morley U, Yandle Z, Dean J, Joyce E, O'Sullivan JJ, Cuddihy JM, McIntyre AM, Robinson EP, Dahly D, Fletcher NF, Carr M, De Gascun C, Meijer WG. SARS-CoV-2 variant trends in Ireland: Wastewater-based epidemiology and clinical surveillance. Sci Total Environ 2022; 838:155828. [PMID: 35588817 PMCID: PMC9110007 DOI: 10.1016/j.scitotenv.2022.155828] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 05/21/2023]
Abstract
SARS-CoV-2 RNA quantification in wastewater is an important tool for monitoring the prevalence of COVID-19 disease on a community scale which complements case-based surveillance systems. As novel variants of concern (VOCs) emerge there is also a need to identify the primary circulating variants in a community, accomplished to date by sequencing clinical samples. Quantifying variants in wastewater offers a cost-effective means to augment these sequencing efforts. In this study, SARS-CoV-2 N1 RNA concentrations and daily loadings were determined and compared to case-based data collected as part of a national surveillance programme to determine the validity of wastewater surveillance to monitor infection spread in the greater Dublin area. Further, sequencing of clinical samples was conducted to determine the primary SARS-CoV-2 lineages circulating in Dublin. Finally, digital PCR was employed to determine whether SARS-CoV-2 VOCs, Alpha and Delta, were quantifiable from wastewater. No lead or lag time was observed between SARS-CoV-2 wastewater and case-based data and SARS-CoV-2 trends in Dublin wastewater significantly correlated with the notification of confirmed cases through case-based surveillance preceding collection with a 5-day average. This demonstrates that viral RNA in Dublin's wastewater mirrors the spread of infection in the community. Clinical sequence data demonstrated that increased COVID-19 cases during Ireland's third wave coincided with the introduction of the Alpha variant, while the fourth wave coincided with increased prevalence of the Delta variant. Interestingly, the Alpha variant was detected in Dublin wastewater prior to the first genome being sequenced from clinical samples, while the Delta variant was identified at the same time in clinical and wastewater samples. This work demonstrates the validity of wastewater surveillance for monitoring SARS-CoV-2 infections and also highlights its effectiveness in identifying circulating variants which may prove useful when sequencing capacity is limited.
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Affiliation(s)
- Liam J Reynolds
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Gabriel Gonzalez
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, N20 W10 Kita-ku, Sapporo 001-0020, Japan
| | - Laura Sala-Comorera
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Niamh A Martin
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Alannah Byrne
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Sanne Fennema
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Niamh Holohan
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Sailusha Ratnam Kuntamukkula
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Natasha Sarwar
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Tristan M Nolan
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Jayne H Stephens
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Megan Whitty
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Charlene Bennett
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Quynh Luu
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Ursula Morley
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Zoe Yandle
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Jonathan Dean
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Eadaoin Joyce
- Irish Water, Colvill House, 24-26 Talbot Street, Dublin 1, Ireland
| | - John J O'Sullivan
- UCD School of Civil Engineering, UCD Dooge Centre for Water Resources Research and UCD Earth Institute, University College Dublin, Dublin 4, Ireland
| | - John M Cuddihy
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Eve P Robinson
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Nicola F Fletcher
- UCD School of Veterinary Medicine and UCD Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | - Michael Carr
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, N20 W10 Kita-ku, Sapporo 001-0020, Japan
| | - Cillian De Gascun
- National Virus Reference Laboratory (NVRL), School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Wim G Meijer
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, UCD Conway Institute, University College Dublin, Dublin, Ireland.
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McAloon CG, Dahly D, Walsh C, Wall P, Smyth B, More SJ, Teljeur C. Potential Application of SARS-CoV-2 Rapid Antigen Diagnostic Tests for the Detection of Infectious Individuals Attending Mass Gatherings - A Simulation Study. Front Epidemiol 2022; 2:862826. [PMID: 38455312 PMCID: PMC10911017 DOI: 10.3389/fepid.2022.862826] [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] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/17/2022] [Indexed: 03/09/2024]
Abstract
Rapid Antigen Diagnostic Tests (RADTs) for the detection of SARS-CoV-2 offer advantages in that they are cheaper and faster than currently used PCR tests but have reduced sensitivity and specificity. One potential application of RADTs is to facilitate gatherings of individuals, through testing of attendees at the point of, or immediately prior to entry at a venue. Understanding the baseline risk in the tested population is of particular importance when evaluating the utility of applying diagnostic tests for screening purposes. We used incidence data from January and from July-August 2021, periods of relatively high and low levels of infection, to estimate the prevalence of infectious individuals in the community at particular time points and simulated mass gatherings by sampling from a series of age cohorts. Nine different illustrative scenarios were simulated, small (n = 100), medium (n = 1,000) and large (n = 10,000) gatherings each with 3 possible age constructs: mostly younger, mostly older or a gathering with equal numbers from each age cohort. For each scenario, we estimated the prevalence of infectious attendees, then simulated the likely number of positive and negative test results, the proportion of cases detected and the corresponding positive and negative predictive values, and the cost per case identified. Our findings suggest that for each reported case on a given day, there are likely to be 13.8 additional infectious individuals also present in the community. Prevalence ranged from 0.26% for "mostly older" events in July-August, to 2.6% for "mostly younger" events in January. For small events (100 attendees) the expected number of infectious attendees ranged from <1 across all age constructs of attendees in July-August, to 2.6 for "mostly younger" events in January. For large events (10,000 attendees) the expected number of infectious attendees ranged from 27 (95% confidence intervals 12 to 45) for mostly older events in July-August, to 267 (95% confidence intervals 134 to 436) infectious attendees for mostly younger attendees in January. Given rapid changes in SARS-CoV-2 incidence over time, we developed an RShiny app to allow users to run updated simulations for specific events.
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Affiliation(s)
- Conor G. McAloon
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
| | - Cathal Walsh
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Patrick Wall
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Breda Smyth
- Department of Public Health, Health Service Executive West, Galway, Ireland
| | - Simon J. More
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
- Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Conor Teljeur
- Health Information and Quality Authority, George's Court, Dublin, Ireland
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Naughton C, Cummins H, de Foubert M, Barry F, McCullagh R, Wills T, Skelton DA, Dahly D, Palmer B, Murphy A, McHugh S, O'Mahony D, Tedesco S, O Sullivan B. Implementation of the Frailty Care Bundle (FCB) to promote mobilisation, nutrition and cognitive engagement in older people in acute care settings: protocol for an implementation science study. HRB Open Res 2022. [DOI: 10.12688/hrbopenres.13473.1] [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
Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD). Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty Care Bundle (FCB) intervention aims to implement and evaluate evidence-based principles on early mobilisation, enhanced nutrition and increased cognitive engagement to prevent functional decline and HAD in older patients. Methods: A hybrid implementation science study will use a pragmatic prospective cohort design with a pre-post mixed methods evaluation to test the effect of the FCB on patient, staff, and health service outcomes. The evaluation will include a description of the implementation process, intervention adaptations, and economic costs analysis. The protocol follows the Standards for Reporting Implementation Studies (StaRI). The intervention design and implementation strategy will utilise the behaviour change theory COM-B (capability, motivation, opportunity) and the Promoting Action on Research Implementation in Health Services (i-PARIHS). A clinical facilitator will use a co-production approach with staff. All patients will receive care as normal, the intervention is delivered at ward level and focuses on nurses and health care assistants (HCA) normative clinical practices. The intervention will be delivered in three hospitals on six wards including rehabilitation, acute trauma, medical and older adult wards. Evaluation: The evaluation will recruit a volunteer sample of 180 patients aged 65 years or older (pre 90; post 90 patients). The primary outcomes are measures of functional status (modified Barthel Index (MBI)) and mobilisation measured as average daily step count using accelerometers. Process data will include ward activity mapping, staff surveys and interviews and an economic cost-impact analysis. Conclusions: This is a complex intervention that involves ward and system level changes and has the potential to improve outcomes for older patients.
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Abbas A, Abdukahil SA, Abdulkadir NN, Abe R, Abel L, Absil L, Acharya S, Acker A, Adachi S, Adam E, Adrião D, Ageel SA, Ahmed S, Ain Q, Ainscough K, Aisa T, Ait Hssain A, Ait Tamlihat Y, Akimoto T, Akmal E, Al Qasim E, Alalqam R, Alam T, Al-dabbous T, Alegesan S, Alegre C, Alessi M, Alex B, Alexandre K, Al-Fares A, Alfoudri H, Ali I, Ali Shah N, Alidjnou KE, Aliudin J, Alkhafajee Q, Allavena C, Allou N, Altaf A, Alves J, Alves JM, Alves R, Amaral M, Amira N, Ammerlaan H, Ampaw P, Andini R, Andrejak C, Angheben A, Angoulvant F, Ansart S, Anthonidass S, Antonelli M, Antunes de Brito CA, Anwar KR, Apriyana A, Arabi Y, Aragao I, Arali R, Arancibia F, Araujo C, Arcadipane A, Archambault P, Arenz L, Arlet JB, Arnold-Day C, Aroca A, Arora L, Arora R, Artaud-Macari E, Aryal D, Asaki M, Asensio A, Ashley E, Ashraf M, Ashraf S, Asim M, Assie JB, Asyraf A, Atique A, Attanyake AMUL, Auchabie J, Aumaitre H, Auvet A, Azemar L, Azoulay C, Bach B, Bachelet D, Badr C, Baig N, Baillie JK, Baird JK, Bak E, Bakakos A, Bakar NA, Bal A, Balakrishnan M, Balan V, Bani-Sadr F, Barbalho R, Barbosa NY, Barclay WS, Barnett SU, Barnikel M, Barrasa H, Barrelet A, Barrigoto C, Bartoli M, Bartone C, Baruch J, Bashir M, Basmaci R, Basri MFH, Bastos D, Battaglini D, Bauer J, Bautista Rincon DF, Bazan Dow D, Bedossa A, Bee KH, Behilill S, Beishuizen A, Beljantsev A, Bellemare D, Beltrame A, Beltrão BA, Beluze M, Benech N, Benjiman LE, Benkerrou D, Bennett S, Bento L, Berdal JE, Bergeaud D, Bergin H, Bernal Sobrino JL, Bertoli G, Bertolino L, Bessis S, Betz A, Bevilcaqua S, Bezulier K, Bhatt A, Bhavsar K, Bianchi I, Bianco C, Bidin FN, Bikram Singh M, Bin Humaid F, Bin Kamarudin MN, Bissuel F, Biston P, Bitker L, Blanco-Schweizer P, Blier C, Bloos F, Blot M, Blumberg L, Boccia F, Bodenes L, Bogaarts A, Bogaert D, Boivin AH, Bolze PA, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho-Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau AS, Bourke J, Bouscambert M, Bousquet A, Bouziotis J, Boxma B, Boyer-Besseyre M, Boylan M, Bozza FA, Brack M, Braconnier A, Braga C, Brandenburger T, Brás Monteiro F, Brazzi L, Breen D, Breen P, Breen P, Brett S, Brickell K, Broadley T, Browne A, Browne S, Brozzi N, Brusse-Keizer M, Buchtele N, Buesaquillo C, Bugaeva P, Buisson M, Burhan E, Burrell A, Bustos IG, Butnaru D, Cabie A, Cabral S, Caceres E, Cadoz C, Callahan M, Calligy K, Calvache JA, Cam J, Campana V, Campbell P, Campisi J, Canepa C, Cantero M, Caraux-Paz P, Cárcel S, Cardellino CS, Cardoso F, Cardoso F, Cardoso N, Cardoso S, Carelli S, Carlier N, Carmoi T, Carney G, Carpenter C, Carqueja I, Carret MC, Carrier FM, Carroll I, Carson G, Carton E, Casanova ML, Cascão M, Casey S, Casimiro J, Cassandra B, Castañeda S, Castanheira N, Castor-Alexandre G, Castrillón H, Castro I, Catarino A, Catherine FX, Cattaneo P, Cavalin R, Cavalli GG, Cavayas A, Ceccato A, Cervantes-Gonzalez M, Chair A, Chakveatze C, Chan A, Chand M, Chantalat Auger C, Chapplain JM, Chas J, Chaudary M, Chávez Iñiguez JS, Chen A, Chen YS, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Chin-Tho L, Chirouze C, Chiumello D, Cho HJ, Cho SM, Cholley B, Chopin MC, Chow TS, Chow YP, Chua HJ, Chua J, Cidade JP, Cisneros Herreros JM, Citarella BW, Ciullo A, Clarke E, Clarke J, Claure Del Granado R, Clohisey S, Cobb JP, Coca N, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connolly J, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cormican S, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin-Cadiergues S, Courtois R, Cousse S, Cregan R, Crepy D'Orleans C, Croonen S, Crowl G, Crump J, Cruz C, Cruz Berm JL, Cruz Rojo J, Csete M, Cucino A, Cullen A, Cullen C, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz AA, Dagens A, Dahly D, Dalton H, Dalton J, Daly S, D'Amico F, Daneman N, Daniel C, Dankwa EA, Dantas J, D’Aragon F, de Boer M, de Loughry G, de Mendoza D, De Montmollin E, de Oliveira França RF, de Pinho Oliveira AI, De Rosa R, de Silva T, de Vries P, Deacon J, Dean D, Debard A, DeBenedictis B, Debray MP, DeCastro N, Dechert W, Deconninck L, Decours R, Defous E, Delacroix I, Delaveuve E, Delavigne K, Delfos NM, Deligiannis I, Dell'Amore A, Delmas C, Delobel P, Delsing C, Demonchy E, Denis E, Deplanque D, Depuydt P, Desai M, Descamps D, Desvallée M, Dewayanti S, Diallo A, Diamantis S, Dias A, Diaz P, Diaz R, Diaz Diaz JJ, Didier K, Diehl JL, Dieperink W, Dimet J, Dinot V, Diop F, Diouf A, Dishon Y, Dixit D, Djossou F, Docherty AB, Doherty H, Dondorp AM, Dong A, Donnelly CA, Donnelly M, Donohue C, Donohue S, Donohue Y, Doran C, Doran P, Dorival C, D'Ortenzio E, Douglas JJ, Douma R, Dournon N, Downer T, Downey J, Downing M, Drake T, Driscoll A, Dryden M, Duarte Fonseca C, Dubee V, Dubos F, Ducancelle A, Duculan T, Dudman S, Duggal A, Dunand P, Dunning J, Duplaix M, Durante-Mangoni E, Durham III L, Dussol B, Duthoit J, Duval X, Dyrhol-Riise AM, Ean SC, Echeverria-Villalobos M, Egan S, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito-Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre I, Fabre M, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Faria P, Farooq A, Farrar JJ, Farshait N, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes M, Fernandes S, Ferrand FX, Ferrand Devouge E, Ferrão J, Ferraz M, Ferreira B, Ferreira S, Ferrer-Roca R, Ferriere N, Ficko C, Figueiredo-Mello C, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn B, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher DM, Franch-Llasat D, Fraser C, Fraser JF, Freire MV, Freitas Ribeiro A, Friedrich C, Fritz R, Fry S, Fuentes N, Fukuda M, Gaborieau V, Gaci R, Gagliardi M, Gagnard JC, Gagné N, Gagneux-Brunon A, Gaião S, Gail Skeie L, Gallagher P, Gallego Curto E, Gamble C, Gani Y, Garan A, Garcia R, García Barrio N, Garcia-Diaz J, Garcia-Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Gerbaud Morlaes L, Germano N, ghisulal PK, Ghosn J, Giani M, Giaquinto C, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Gitahi J, Giwangkancana G, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard JC, Goh JY, Golob J, Gomes R, Gomez K, Gómez-Junyent J, Gominet M, Gonzalez A, Gordon P, Gordon A, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Grazioli L, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Grosse Lordemann A, Gruner H, Gu Y, Guarracino F, Guedj J, Guego M, Guellec D, Guerguerian AM, Guerreiro D, Guery R, Guillaumot A, Guilleminault L, Guimarães de Castro M, Guimard T, Haalboom M, Haber D, Habraken H, Hachemi A, Hadri N, Haidash O, Haider S, Haidri F, Hakak S, Hall A, Hall M, Halpin S, Hamer A, Hamers R, Hamidfar R, Hammond T, Han LY, Haniffa R, Hao KW, Hardwick H, Harrison EM, Harrison J, Harrison SBE, Hartman A, Hashmi J, Hashmi M, Hayat M, Hayes A, Hays L, Heerman J, Heggelund L, Hendry R, Hennessy M, Henriquez A, Hentzien M, Herekar F, Hernandez-Montfort J, Herr D, Hershey A, Hesstvedt L, Hidayah A, Higgins D, Higgins E, HigginsOKeeffe G, Hinchion R, Hinton S, Hiraiwa H, Hitoto H, Ho A, Ho YB, Hoctin A, Hoffmann I, Hoh WH, Hoiting O, Holt R, Holter JC, Horby P, Horcajada JP, Hoshino K, Hoshino K, Houas I, Hough CL, Houltham S, Hsu JMY, Hulot JS, Hussain I, Ijaz S, Illes HG, Imbert P, Imran M, Imran Sikander R, Inácio H, Infante Dominguez C, Ing YS, Iosifidis E, Ippolito M, Isgett S, Ishani PGPI, Isidoro T, Ismail N, Isnard M, Itai J, Ito A, Ivulich D, Jaafar D, Jaafoura S, Jabot J, Jackson C, Jamieson N, Jaquet P, Jassat W, Jaud-Fischer C, Jaureguiberry S, Javidfar J, Jawad I, Jaworsky D, Jayakumar D, Jego F, Jelani AM, Jenum S, Jimbo-Sotomayor R, Job VDP, Joe OY, Jorge García RN, Joseph C, Joseph M, Joshi S, Jourdain M, Jouvet P, June J, Jung A, Jung H, Juzar D, Kafif O, Kaguelidou F, Kaisbain N, Kaleesvran T, Kali S, Kalicinska A, Kalomoiri S, Kamal S, Kamaluddin MAA, Kamaruddin ZAC, Kamarudin N, Kandamby DH, Kandel C, Kang KY, Kant R, Kanwal D, Kanyawati D, Karki B, Karpayah P, Karsies T, Kartsonaki C, Kasugai D, Kataria A, Katz K, Kaur A, Kaur Johal S, Kawasaki T, Kay C, Keane H, Keating S, Kellam P, Kelly A, Kelly A, Kelly C, Kelly N, Kelly S, Kelly Y, Kelsey M, Kennedy R, Kennon K, Kernan M, Kerroumi Y, Keshav S, Kestelyn E, Khalid I, Khalid O, Khalil A, Khan C, Khan I, Khanal S, Kho ME, Khoo D, Khoo R, Khoo S, Khoso N, Kiat KH, Kida Y, Kiiza P, Kildal AB, Kim JB, Kimmoun A, Kindgen-Milles D, King A, Kitamura N, Klenerman P, Klont R, Kloumann Bekken G, Knight S, Kobbe R, Kodippily C, Kohns Vasconcelos M, Koirala S, Komatsu M, Korten V, Kosgei C, Kpangon A, Krawczyk K, Krishnan S, Krishnan V, Kruglova O, Kumar A, Kumar D, Kumar G, Kumar M, Kumar Vecham P, Kuriakose D, Kurtzman E, Kusumastuti NP, Kutsogiannis D, Kutsyna G, Kyriakoulis K, Lachatre M, Lacoste M, Laffey JG, Lagrange M, Laine F, Lairez O, Lakhey S, Lalueza A, Lambert M, Lamontagne F, Langelot-Richard M, Langlois V, Lantang EY, Lanza M, Laouénan C, Laribi S, Lariviere D, Lasry S, Latif N, Launay O, Laureillard D, Lavie-Badie Y, Law A, Lawrence C, Lawrence T, Le M, Le Bihan C, Le Bris C, Le Falher G, Le Fevre L, Le Hingrat Q, Le Maréchal M, Le Mestre S, Le Moal G, Le Moing V, Le Nagard H, Le Turnier P, Leal E, Leal Santos M, Lee BH, Lee HG, Lee J, Lee SH, Lee TC, Lee YL, Leeming G, Lefebvre B, Lefebvre L, Lefevre B, LeGac S, Lelievre JD, Lellouche F, Lemaignen A, Lemee V, Lemeur A, Lemmink G, Lene HS, Lennon J, León R, Leone M, Leone M, Lepiller Q, Lescure FX, Lesens O, Lesouhaitier M, Lester-Grant A, Levy B, Levy Y, Levy-Marchal C, Lewandowska K, L'Her E, Li Bassi G, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina B, Lina L, Lind A, Lingas G, Lion-Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez-Colon D, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace-Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Lumbreras Bermejo C, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, MacDonald S, MacDonald S, Machado M, Macheda G, Macias Sanchez J, Madhok J, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandei JM, Mandelbrot L, Manetta F, Mangal K, Mankikian J, Manning E, Manuel A, Maria Sant`Ana Malaque C, Marino D, Marino F, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, Martin DA, Martin E, Martin-Blondel G, Martinelli A, Martin-Loeches I, Martinot M, Martin-Quiros A, Martins A, Martins J, Martins N, Martins Rego C, Martucci G, Martynenko O, Marwali EM, Marzukie M, Masa Jimenez JF, Maslove D, Maslove D, Mason P, Mason S, Masood S, Masood S, Mat Nor B, Matan M, Mateus Fernandes H, Mathew M, Mathieu D, Mattei M, Matulevics R, Maulin L, Maxwell M, Maynar J, Mazzoni T, Mc Sweeney L, McAndrew L, McArthur C, McCarthy A, McCarthy A, McCloskey C, McConnochie R, McDermott S, McDonald SE, McElroy A, McElwee S, McEneany V, McEvoy N, McGeer A, McKay C, McKeown J, McLean KA, McNally P, McNicholas B, McPartlan E, Meaney E, Mear-Passard C, Mechlin M, Meher M, Mehkri O, Mele F, Melo L, Memon K, Mendes JJ, Menkiti O, Menon K, Mentré F, Mentzer AJ, Mercier E, Mercier N, Merckx A, Mergeay-Fabre M, Mergler B, Merson L, Mesquita A, Metwally O, Meybeck A, Meyer D, Meynert AM, Meysonnier V, Meziane A, Mezidi M, Michelagnoli G, Michelanglei C, Michelet I, Mihelis E, Mihnovit V, Miranda-Maldonado H, Misnan NA, Mohamed NNE, Mohamed TJ, Moin A, Molina D, Molinos E, Molloy B, Mone M, Monteiro A, Montes C, Montrucchio G, Moore S, Moore SC, Morales Cely L, Moro L, Morocho Tutillo DR, Morton B, Motherway C, Motos A, Mouquet H, Mouton Perrot C, Moyet J, Mudara C, Mufti AK, Muh NY, Muhamad D, Mullaert J, Muller F, Müller KE, Munblit D, Muneeb S, Munir N, Munshi L, Murphy A, Murphy A, Murphy L, Murris M, Murthy S, Musaab H, Muyandy G, Myrodia DM, N N, Nagpal D, Nagrebetsky A, Narasimhan M, Narayanan N, Nasim Khan R, Nazerali-Maitland A, Neant N, Neb H, Nekliudov NA, Nelwan E, Neto R, Neumann E, Neves B, Ng PY, Nghi A, Nguyen D, Ni Choileain O, Ni Leathlobhair N, Nichol A, Nitayavardhana P, Nonas S, Noordin NAM, Noret M, Norharizam NFI, Norman L, Notari A, Noursadeghi M, Nowicka K, Nowinski A, Nseir S, Nunez JI, Nurnaningsih N, Nyamankolly E, O Brien F, O'Callaghan A, Occhipinti G, OConnor D, O'Donnell M, Ogston T, Ogura T, Oh TH, O'Halloran S, O'Hearn K, Ohshimo S, Oldakowska A, Oliveira J, Oliveira L, Olliaro PL, O'Neil C, Ong DS, Ong JY, Oosthuyzen W, Opavsky A, Openshaw P, Orakzai S, Orozco-Chamorro CM, Orquera A, Ortoleva J, Osatnik J, O'Shea L, O'Sullivan M, Othman SZ, Ouamara N, Ouissa R, Owyang C, Oziol E, Pabasara HMU, Pagadoy M, Pages J, Palacios A, Palacios M, Palmarini M, Panarello G, Panda PK, Paneru H, Pang LH, Panigada M, Pansu N, Papadopoulos A, Parke R, Parker M, Parra B, Parrini V, Pasha T, Pasquier J, Pastene B, Patauner F, Patel J, Pathmanathan MD, Patrão L, Patricio P, Patrier J, Patterson L, Pattnaik R, Paul C, Paul M, Paulos J, Paxton WA, Payen JF, Peariasamy K, Pedrera Jiménez M, Peek GJ, Peelman F, Peiffer-Smadja N, Peigne V, Pejkovska M, Pelosi P, Peltan ID, Pereira R, Perez D, Periel L, Perpoint T, Pesenti A, Pestre V, Petrou L, Petrov-Sanchez V, Pettersen FO, Peytavin G, Pharand S, Piagnerelli M, Picard W, Picone O, Piero MD, Pierobon C, Piersma D, Pimentel C, Pinto R, Pires C, Pironneau I, Piroth L, Pius R, Piva S, Plantier L, Plotkin D, Png HS, Poissy J, Pokeerbux R, Pokorska-Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Post AM, Postma DF, Povoa P, Póvoas D, Powis J, Prapa S, Preau S, Prebensen C, Preiser JC, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Puéchal O, Pujo Semedi B, Pulicken M, Puntoni M, Purcell G, Quesada L, Quinones-Cardona V, Quirós González V, Quist-Paulsen E, Quraishi M, Rabaa M, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Ragazzo G, Rahman AKHA, Rahman RA, Rahutullah A, Rainieri F, Rajahram GS, Rajapakse N, Ralib A, Ramakrishnan N, Ramanathan K, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Reeve B, Rehan A, Rehman A, Reid L, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Resende L, Resseguier AS, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Richardson D, Richardson D, Richier L, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Rivera Nuñez MA, Rizer N, Robb D, Robba C, Roberto A, Roberts S, Robertson DL, Robineau O, Roche-Campo F, Rodari P, Rodeia S, Rodriguez Abreu J, Roessler B, Roger C, Roger PM, Roilides E, Rojek A, Romaru J, Roncon-Albuquerque Jr R, Roriz M, Rosa-Calatrava M, Rose M, Rosenberger D, Rossanese A, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Ryckaert S, Rygh Holten A, Saba I, Sadaf S, Sadat M, Sahraei V, Saint-Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Saleem J, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sánchez Choez X, Sanchez de Oliveira K, Sanchez-Miralles A, Sancho-Shimizu V, Sandhu G, Sandhu Z, Sandrine PF, Sandulescu O, Santos M, Sarfo-Mensah S, Sarmento Banheiro B, Sarmiento ICE, Sarton B, Satyapriya S, Satyawati R, Saviciute E, Savio R, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Scott JT, Scott-Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Sepulveda C, Sequeira F, Sequeira T, Serpa Neto A, Serrano Balazote P, Shadowitz E, Shahidan SA, Shahnaz Hasan M, Shamsah M, Shankar A, Sharjeel S, Sharma P, Shaw CA, Shaw V, Shi H, Shiban N, Shiekh M, Shiga T, Shime N, Shimizu H, Shimizu K, Shimizu N, Shindo N, Shrapnel S, Shum HP, Si Mohammed N, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Silva MJ, Silva R, Sim Lim Heng B, Sin WC, Singh BC, Singh P, Sitompul PA, Sivam K, Skogen V, Smith S, Smood B, Smyth C, Smyth M, Smyth M, Snacken M, So D, Soh TV, Solis M, Solomon J, Solomon T, Somers E, Sommet A, Song MJ, Song R, Song T, Song Chia J, Sonntagbauer M, Soom AM, Sotto A, Soum E, Sousa AC, Sousa M, Sousa Uva M, Souza-Dantas V, Sperry A, Spinuzza E, Sri Darshana BPSR, Sriskandan S, Stabler S, Staudinger T, Stecher SS, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu-Cercel A, Streinu-Cercel A, Strudwick S, Stuart A, Stuart D, Subekti D, Suen G, Suen JY, Sukumar P, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Suwarti S, Svistunov AA, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Talarek E, Taleb S, Talsma J, Tampubolon ML, Tan KK, Tan LV, Tan YC, Tanaka C, Tanaka H, Tanaka T, Taniguchi H, Tanveer H, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Tellier MC, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier-Grenier H, Tey A, Thabit AAM, Tham ZD, Thangavelu S, Thibault V, Thiberville SD, Thill B, Thirumanickam J, Thompson S, Thomson D, Thomson EC, Thurai SRT, Thuy DB, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit JF, Tirupakuzhi Vijayaraghavan BK, Tissot N, Toh JZY, Toki M, Tolppa T, Tonby K, Tonnii SL, Torres A, Torres M, Torres Santos-Olmo RM, Torres-Zevallos H, Towers M, Trapani T, Traynor D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
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O'Mahony D, Gudmundsson A, Soiza RL, Petrovic M, Jose Cruz-Jentoft A, Cherubini A, Fordham R, Byrne S, Dahly D, Gallagher P, Lavan A, Curtin D, Dalton K, Cullinan S, Flanagan E, Shiely F, Samuelsson O, Sverrisdottir A, Subbarayan S, Vandaele L, Meireson E, Montero-Errasquin B, Rexach-Cano A, Correa Perez A, Lozano-Montoya I, Vélez-Díaz-Pallarés M, Cerenzia A, Corradi S, Soledad Cotorruelo Ferreiro M, Dimitri F, Marinelli P, Martelli G, Fong Soe Khioe R, Eustace J. Corrigendum to: Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial. Age Ageing 2021; 50:e10-e11. [PMID: 34166483 DOI: 10.1093/ageing/afab120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Denis O'Mahony
- University College Cork School of Medicine-Medicine Cork Ireland, Cork University Hospital Group, Cork, Ireland
| | | | - Roy L Soiza
- NHS Grampian, University of Aberdeen Institute of Applied Health Sciences-Ageing Clinical and Experimental Research, Aberdeen, UK
| | - Mirko Petrovic
- University of Ghent-Medicine, University Hospital Ghent, Ghent, Belgium
| | | | - Antonio Cherubini
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Richard Fordham
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Stephen Byrne
- School of Pharmacy, University College Cork, Cork, Ireland
| | | | - Paul Gallagher
- Cork University Hospital-Geriatric Medicine, Cork, Ireland
| | - Amanda Lavan
- University College Cork, School of Medicine-Geriatrics, Cork, Ireland
| | - Denis Curtin
- University College Cork, School of Medicine-Geriatrics, Cork, Ireland
| | - Kieran Dalton
- University College Cork, National University of Ireland, Pharmaceutical Care Research Group, School of Pharmacy, Cork Ireland
| | - Shane Cullinan
- Royal College of Surgeons, School of Pharmacy, Dublin, Ireland
| | - Evelyn Flanagan
- University College Cork, Clinical Research Facility, Cork, Ireland
| | - Frances Shiely
- University College Cork, School of Epidemiology and Public Health, Cork, Ireland
| | - Olafur Samuelsson
- Landspitali University Hospital, Geriatric Medicine Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | - Annarita Cerenzia
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Samanta Corradi
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | | | - Federica Dimitri
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Paolo Marinelli
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Gaia Martelli
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | | | - Joseph Eustace
- University College Cork, National University of Ireland-Clinical Research Facility, Cork, Ireland
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Frizelle P, Mullane E, O'Shea A, Ceroni A, Dahly D, Horgan A, Levickis P, Mckean C. Happy Talk: A pilot effectiveness study of a targeted-selective speech-language and communication intervention for children from areas of social disadvantage. Int J Lang Commun Disord 2021; 56:954-974. [PMID: 34322955 DOI: 10.1111/1460-6984.12648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Despite the public health implications of language difficulties associated with social disadvantage, there is a dearth of effectiveness studies investigating the effects of targeted speech and language programmes in this area. AIMS To determine the effects of a targeted selective community-based child language intervention programme (Happy Talk), which simultaneously engaged with parents and early childhood educators, in the Republic of Ireland. METHODS & PROCEDURES A mixed methods methodology was applied with quantitative outcome and qualitative process data collected. Effectiveness was examined using a quasi-experimental single blind study design comparing Happy Talk with 'usual care' across four preschools. Qualitative process data were also gathered to examine the acceptability and feasibility of the Happy Talk approach in practice, and to identify factors to improve the probability of successful wider implementation. Child language (PLS-5) and quality-of-life measures were administered pre- and immediately post- the 11-week intervention. Responsiveness was assessed as the parental outcome, and the oral language environment of preschools was measured using the Communication Supporting Classroom Observation Tool (CSCOT). Retrospective acceptability was analysed with reference to the theoretical framework of acceptability (v 2). OUTCOMES & RESULTS Pre-/post-expressive and composite language scores were collected for 58 children, and receptive scores for 54 children. Multiple linear regression revealed significant intervention effects for comprehension and total language with large and moderate effect sizes, respectively (0.60 and 0.46 SD). No significant effect was shown for parental responsiveness. No effects were found for the preschool environment or children's quality of life. Preschool staff deemed the programme to be an acceptable method of enhancing children's speech and language skills and rated the intervention positively. CONCLUSIONS & IMPLICATIONS The Happy Talk pilot effectiveness trial shows that comprehension can be improved (with a large effect) in preschool children from areas of social disadvantage, following an 11-week intervention, in which parents and preschool staff are simultaneously engaged. The ecological validity of the programme, as well as feasibility and acceptability to staff, make it a suitable programme to be delivered at scale. WHAT THIS PAPER ADDS What is already known on the subject Up to 50% of children from socially disadvantaged areas enter preschool with speech and language difficulties. The majority of intervention studies are (1) researcher led; (2) efficacy trials carried out in ideal conditions; and (3) focus on working with parents or early childhood educators rather than engaging with both groups simultaneously. Many studies omit child language outcomes, and those that include them tend to show relatively modest effects for expressive language and negligible effects for receptive language. What this paper adds to existing knowledge This pilot study shows that the Happy Talk programme, which is embedded in the community and which simultaneously engages with parents and early childhood educators, is highly effective in improving children's receptive language skills. These findings are particularly important in the context of (1) the study taking place in real world conditions; and (2) the programme being designed and refined by speech and language therapy services, rather than one which is researcher led. What are the potential or actual clinical implications of this work? Implementing an 11-week targeted selective community-based language intervention can result in a large positive effect on receptive language for children from areas of social disadvantage. The study findings highlight the importance of embedding intervention programmes in the community and of simultaneously engaging with parents and preschool staff.
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Affiliation(s)
- Pauline Frizelle
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Elaine Mullane
- Speech and Language Therapy Department, North Lee, Cork, Ireland
| | - Aoife O'Shea
- Speech and Language Therapy Department, North Lee, Cork, Ireland
| | - Anna Ceroni
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Darren Dahly
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Anne Horgan
- Speech and Language Therapy Department, North Lee, Cork, Ireland
| | - Penny Levickis
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, VIC, Australia
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Naughton C, Simon R, White TJ, de Foubert M, Cummins H, Dahly D. Mealtime and patient factors associated with meal completion in hospitalised older patients: An exploratory observation study. J Clin Nurs 2021; 30:2935-2947. [PMID: 33945183 DOI: 10.1111/jocn.15800] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 01/15/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES To examine mealtime and patient factors associated with meal completion among hospitalised older patients. We also considered contextual factors such as staffing levels and ward communication. BACKGROUND Sub-optimum nutrition is a modifiable risk factor for hospital associated decline (HAD) in older patients. Yet, the quality of mealtime experiences can be overlooked within ward routinised practice. DESIGN Cross sectional, descriptive observation study. METHODS We undertook structured observation of mealtimes examining patient positioning, mealtime set-up and feeding assistance. The outcome was meal completion categorised as 0, 25%, 50%, 75% or 100%. Data were collected on patient characteristics and ward context. We used mixed-effects ordinal regression models to examine patient and mealtime factors associated with higher meal completion producing odds ratios (OR) and 95% confidence intervals (CI). The study was reported as per STROBE guidelines. RESULTS We included 60 patients with a median age of 82 years (IQR 76-87) and clinical frailty score of 5 IQR (4-6). Of the 279 meals, 51% were eaten completely, 6% three quarters, 15% half, 18% a quarter and 10% were not eaten at all. Mealtime predictors with a weak association with less-meal completion were requiring assistance, special diets, lying in bed, and red tray (indicator of nutrition risk), but were not statistically significant. Significant patient-level factors were higher values for frailty (OR 0.34 [0.11-1.04]) and Malnutrition Universal Screening Tool (OR 0.22 [0.08-0.62]). The average nurse-to-patient ratio was 1:5.5. CONCLUSION Patient factors were the strongest predictors for meal completion, but mealtime factors had a subtle influence. The nursing teams' capacity to prioritise mealtimes above competing demands is important as part of a comprehensive nutrition strategy. RELEVANCE TO CLINICAL PRACTISE Nurses are central to optimising nutrition for frail older patients. It requires ward leadership to instil a culture of prioritising assisted mealtimes, improved communication, greater autonomy to tailor nutrition strategies and safe staffing levels.
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Affiliation(s)
- Corina Naughton
- Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, Brookfield, University College Cork, Cork, Ireland
| | - Rachel Simon
- South Tipperary General Hospital, Clonmel, Ireland
| | - T J White
- South Tipperary General Hospital, Clonmel, Ireland
| | - Marguerite de Foubert
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Helen Cummins
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility Cork, School of Public Health, University College Cork, Cork, Ireland
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Affiliation(s)
- Toby Richards
- Division of Surgery, University of Western Australia, Fiona Stanley Hospital, Perth, Crawley WA 6009, Australia.
| | - Ben Clevenger
- Department of Anaesthesia, Royal National Orthopaedic Hospital, London, UK
| | - Darren Dahly
- HRB Clinical Research Facility, School of Public Health, University College Cork, Cork, UK
| | - Martin Besser
- Department of Haematology, Addenbrooke's Hospital, Cambridge, UK
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Galvin E, Wiese A, Dahly D, O'Farrell J, Cotter J, Bennett D. Maintenance of professional competence in Ireland: a national survey of doctors' attitudes and experiences. BMJ Open 2020; 10:e042183. [PMID: 33303465 PMCID: PMC7733195 DOI: 10.1136/bmjopen-2020-042183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Programmes to ensure doctors' maintenance of professional competence (MPC) have been established in many countries. Since 2011, doctors in Ireland have been legally required to participate in MPC. A significant minority has been slow to engage with MPC, mirroring the contested nature of such programmes internationally. This study aimed to describe doctors' attitudes and experiences of MPC in Ireland with a view to enhancing engagement. PARTICIPANTS All registered medical practitioners in Ireland required to undertake MPC in 2018 were surveyed using a 33-item cross-sectional mixed-methods survey designed to elicit attitudes, experiences and suggestions for improvement. RESULTS There were 5368 responses (response rate 42%). Attitudes to MPC were generally positive, but the time, effort and expense involved outweighed the benefit for half of doctors. Thirty-eight per cent agreed that MPC is a tick-box exercise. Heavy workload, travel, requirement to record continuing professional development activities and demands placed on personal time were difficulties cited. Additional support, as well as higher quality, more varied educational activities, were among suggested improvements. Thirteen per cent lacked confidence that they could meet requirements, citing employment status as the primary issue. MPC was particularly challenging for those working less than full-time, in locum or non-clinical roles, and taking maternity or sick leave. Seventy-seven per cent stated a definite intention to comply with MPC requirements. Being male, or having a basic medical qualification from outside Ireland, was associated with less firm intention to comply. CONCLUSIONS Doctors need to be convinced of the benefits of MPC to them and their patients. A combination of clear communication and improved relevance to practice would help. Addition of a facilitated element, for example, appraisal, and varied ways to meet requirements, would support participation. MPC should be adequately resourced, including provision of high-quality free educational activities. Systems should be established to continually evaluate doctors' perspectives.
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Affiliation(s)
- Emer Galvin
- Medical Education Unit, National University of Ireland, University College Cork, Cork, Ireland
| | - Anel Wiese
- Medical Education Unit, National University of Ireland, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility and School of Public Health, National University of Ireland, University College Cork, Cork, Ireland
| | | | | | - Deirdre Bennett
- Medical Education Unit, National University of Ireland, University College Cork, Cork, Ireland
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Egan S, Tobin M, Palmer B, Coffey A, Dahly D, Houghton C, Ó Carragáin E, Toomey E, Dockray S, Matvienko-Sikar K. Developing an open educational resource for open research: Protocol for the PaPOR TRAIL project. HRB Open Res 2020; 3:84. [PMID: 33364548 PMCID: PMC7737705 DOI: 10.12688/hrbopenres.13171.1] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Open research involves actions at all stages of the research cycle to make the research process and outputs more transparent and accessible. Though a number of initiatives exist for researchers at PhD, post-doctoral and more senior levels, there remains a critical need for educational resources for research students at earlier career stages and across disciplines. The aim of the Principles and Practices of Open Research: Teaching, Research, Impact, and Learning (PaPOR TRaIL) project is to develop an open educational resource (OER) on the principles and practice of open research for undergraduate and master's students. Methods: In stage 1, interviews and surveys of students and supervisors are being conducted to explore students' and supervisors' knowledge, attitudes, and experiences of open research, in addition to needs and preferences for the content and delivery of the OER. Stage 2 involves development of the OER content and delivery, based on Stage 1 engagement and national and international guidance on best practice in conducting and teaching open research. In Stage 3, students and supervisors will evaluate the developed OER and provide feedback in terms of OER usability, learning experience and learning outcomes. This feedback will guide revisions and finalisation of the OER content, format and learning activities. Discussion: The PaPOR TRaIL project will develop an evidence-based OER that provides a foundation in all aspects of open research theory & practice. Teaching undergraduate and master's students open research will promote development of core research values and equip them with transferable competencies and skills, including how to conduct and use research in a trustworthy and ethical manner within and beyond academia. Enhancing teaching and learning of open research will promote better teaching and research outcomes that will benefit individuals, universities, and science more broadly.
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Affiliation(s)
- Sophia Egan
- School of Public Health, University College Cork, Cork, Ireland
| | - Mary Tobin
- School of Public Health, University College Cork, Cork, Ireland
| | - Brendan Palmer
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Aoife Coffey
- UCC Library, University College Cork, Cork, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, Ireland
| | | | - Elaine Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
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Byrne FN, Gillman BA, Kiely M, Palmer B, Shiely F, Kearney PM, Earlie J, Bowles MB, Keohane FM, Connolly PP, Wade S, Rennick TA, Moore BL, Smith ON, Sands CM, Slevin O, McCarthy DC, Brennan KM, Mellett H, Dahly D, Bergin E, Casserly LF, Conlon PJ, Hannan K, Holian J, Lappin DW, O'Meara YM, Mellotte GJ, Reddan D, Watson A, Eustace J. Pilot Randomized Controlled Trial of a Standard Versus a Modified Low-Phosphorus Diet in Hemodialysis Patients. Kidney Int Rep 2020; 5:1945-1955. [PMID: 33163715 PMCID: PMC7609990 DOI: 10.1016/j.ekir.2020.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/09/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The standard low-phosphorus diet restricts pulses, nuts, and whole grains and other high phosphorus foods to control hyperphosphatemia. We conducted a randomized controlled trial to evaluate the effectiveness, safety, and tolerability of the modified diet, which introduced some pulses and nuts, increased the use of whole grains, increased focus on the avoidance of phosphate additives, and introduced the prescription of low-biological-value protein such as bread. METHODS We conducted a multicenter, pragmatic, parallel-arm, open-label, randomized controlled trial of modified versus standard diet in 74 adults on hemodialysis with hyperphosphatemia over 1 month. Biochemistry was assessed using monthly laboratory tests. Dietary intake was assessed using a 2-day record of weighed intake of food, and tolerability was assessed using a patient questionnaire. RESULTS There was no significant difference in the change in serum phosphate between the standard and modified diets. Although total dietary phosphorus intake was similar, phytate-bound phosphorus, found in pulses, nuts, and whole grains, was significantly higher in the modified diet (P < 0.001). Dietary fiber intake was also significantly higher (P < 0.003), as was the percentage of patients reporting an increase in bowel movements while following the modified diet (P = 0.008). There was no significant difference in the change in serum potassium or in reported protein intake between the 2 diets. Both diets were similarly well tolerated. CONCLUSION The modified low phosphorus diet was well tolerated and was associated with similar phosphate and potassium control but with a wider food choice and greater fiber intake than the standard diet.
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Affiliation(s)
- Fiona N. Byrne
- Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
- Department of Renal Medicine, Cork University Hospital, Cork, Ireland
- Health Research Board, Clinical Research Facility, Cork, Ireland
| | - Barbara A. Gillman
- Department of Nutrition and Dietetics, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Renal Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Mairead Kiely
- School of Food and Nutritional Sciences University College Cork, Cork, Ireland
| | - Brendan Palmer
- Health Research Board, Clinical Research Facility, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Frances Shiely
- Health Research Board, Clinical Research Facility, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Maria B. Bowles
- Department of Nutrition and Dietetics, University Hospital Limerick, Limerick, Ireland
- Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Ireland
| | - Fiona M. Keohane
- Department of Nutrition and Dietetics, Cork University Hospital, Cork, Ireland
- Department of Renal Medicine, Cork University Hospital, Cork, Ireland
| | - Pauline P. Connolly
- Department of Nutrition and Dietetics, Cavan General Hospital, Cavan, Ireland
- Department of Medicine, Cavan General Hospital, Cavan, Ireland
| | - Sarah Wade
- Department of Nutrition and Dietetics, St. Vincent’s University Hospital Dublin, Dublin, Ireland
- Department of Nephrology, St. Vincent’s University Hospital Dublin, Dublin, Ireland
| | - Theresa A. Rennick
- Department of Nutrition and Dietetics, Midland Regional Hospital, Tullamore, Ireland
- Department of Nephrology, Midland Regional Hospital, Tullamore, Ireland
| | - Bernice L. Moore
- Department of Nutrition and Dietetics, Beaumont Hospital, Dublin, Ireland
- Beaumont Hospital Kidney Center, Beaumont Hospital, Dublin, Ireland
| | - Oonagh N. Smith
- Department of Nutrition and Dietetics, Beaumont Hospital, Dublin, Ireland
- Beaumont Hospital Kidney Center, Beaumont Hospital, Dublin, Ireland
| | - Celene M. Sands
- Department of Nutrition and Dietetics, Mayo University Hospital, Mayo, Ireland
| | - Orla Slevin
- Department of Nutrition and Dietetics, Galway University Hospitals, Galway, Ireland
- Department of Nephrology, Galway University Hospitals, Galway, Ireland
| | | | | | - Halóg Mellett
- Department of Nutrition and Dietetics, Tallaght University Hospital, Dublin, Ireland
- Department of Nephrology, Tallaght University Hospital, Dublin, Ireland
| | - Darren Dahly
- Health Research Board, Clinical Research Facility, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Eoin Bergin
- Department of Nephrology, Midland Regional Hospital, Tullamore, Ireland
| | - Liam F. Casserly
- Departments of Nephrology and Internal Medicine, University Hospital Limerick, Limerick, Ireland
| | - Peter J. Conlon
- Beaumont Hospital Kidney Center, Beaumont Hospital, Dublin, Ireland
| | - Kieran Hannan
- Department of Medicine, Cavan General Hospital, Cavan, Ireland
| | - John Holian
- Department of Nephrology, St. Vincent’s University Hospital Dublin, Dublin, Ireland
| | - David W. Lappin
- Department of Nephrology, Galway University Hospitals, Galway, Ireland
| | - Yvonne M. O'Meara
- Department of Renal Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Donal Reddan
- Department of Nephrology, Galway University Hospitals, Galway, Ireland
| | - Alan Watson
- Department of Nephrology, St. Vincent’s University Hospital Dublin, Dublin, Ireland
| | - Joseph Eustace
- Department of Renal Medicine, Cork University Hospital, Cork, Ireland
- Health Research Board, Clinical Research Facility, Cork, Ireland
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O'Riordan F, Shiely F, Byrne S, O'Brien D, Palmer B, Dahly D, O'Connor TM, Curran D, Fleming A. An investigation of the effects of procalcitonin testing on antimicrobial prescribing in respiratory tract infections in an Irish university hospital setting: a feasibility study. J Antimicrob Chemother 2020; 74:3352-3361. [PMID: 31325313 DOI: 10.1093/jac/dkz313] [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] [Received: 04/11/2019] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Diagnostic uncertainty and a high prevalence of viral infections present unique challenges for antimicrobial prescribing for respiratory tract infections (RTIs). Procalcitonin (PCT) has been shown to support prescribing decisions and reduce antimicrobial use safely in patients with RTIs, but recent study results have been variable. METHODS We conducted a feasibility study of the introduction of PCT testing in patients admitted to hospital with a lower RTI to determine if PCT testing is an effective and worthwhile intervention to introduce to support the existing antimicrobial stewardship (AMS) programme and safely decrease antimicrobial prescribing in patients admitted with RTIs. RESULTS A total of 79 patients were randomized to the intervention PCT-guided treatment group and 40 patients to the standard care respiratory control group. The addition of PCT testing led to a significant decrease in duration of antimicrobial prescriptions (mean 6.8 versus 8.9 days, P = 0.012) and decreased length of hospital stay (median 7 versus 8 days, P = 0.009) between the PCT and respiratory control group. PCT did not demonstrate a significant reduction in antimicrobial consumption when measured as DDDs and days of therapy. CONCLUSIONS PCT testing had a positive effect on antimicrobial prescribing during this feasibility study. The successful implementation of PCT testing in a randomized controlled trial requires an ongoing comprehensive education programme, greater integration into the AMS programme and delivery of PCT results in a timely manner. This feasibility study has shown that a larger randomized controlled trial would be beneficial to further explore the positive aspects of these findings.
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Affiliation(s)
- F O'Riordan
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - F Shiely
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - S Byrne
- Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - D O'Brien
- Department of Microbiology, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - B Palmer
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - D Dahly
- HRB Clinical Research Facility Cork, Mercy University Hospital, Grenville Place, Cork, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | - T M O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - D Curran
- Department of Respiratory Medicine, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - A Fleming
- Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.,Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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Kahan BC, Morris TP, White IR, Tweed CD, Cro S, Dahly D, Pham TM, Esmail H, Babiker A, Carpenter JR. Treatment estimands in clinical trials of patients hospitalised for COVID-19: ensuring trials ask the right questions. BMC Med 2020; 18:286. [PMID: 32900372 PMCID: PMC7478913 DOI: 10.1186/s12916-020-01737-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022] Open
Abstract
When designing a clinical trial, explicitly defining the treatment estimands of interest (that which is to be estimated) can help to clarify trial objectives and ensure the questions being addressed by the trial are clinically meaningful. There are several challenges when defining estimands. Here, we discuss a number of these in the context of trials of treatments for patients hospitalised with COVID-19 and make suggestions for how estimands should be defined for key outcomes. We suggest that treatment effects should usually be measured as differences in proportions (or risk or odds ratios) for outcomes such as death and requirement for ventilation, and differences in means for outcomes such as the number of days ventilated. We further recommend that truncation due to death should be handled differently depending on whether a patient- or resource-focused perspective is taken; for the former, a composite approach should be used, while for the latter, a while-alive approach is preferred. Finally, we suggest that discontinuation of randomised treatment should be handled from a treatment policy perspective, where non-adherence is ignored in the analysis (i.e. intention to treat).
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Affiliation(s)
| | | | | | | | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Darren Dahly
- HRB Clinical Research Facility Cork, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Hanif Esmail
- MRC Clinical Trials Unit at UCL, London, UK
- Institute for Global Health, University College London, London, UK
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30
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O'Mahony D, Gudmundsson A, Soiza RL, Petrovic M, Cruz-Jentoft AJ, Cherubini A, Fordham R, Byrne S, Dahly D, Gallagher P, Lavan A, Curtin D, Dalton K, Cullinan S, Flanagan E, Shiely F, Samuelsson O, Sverrisdottir A, Subbarayan S, Vandaele L, Meireson E, Montero-Errasquin B, Rexach-Cano A, Correa Perez A, Lozano-Montoya I, Vélez-Díaz-Pallarés M, Cerenzia A, Corradi S, Soledad Cotorruelo Ferreiro M, Dimitri F, Marinelli P, Martelli G, Fong Soe Khioe R, Eustace J. Prevention of adverse drug reactions in hospitalized older patients with multi-morbidity and polypharmacy: the SENATOR* randomized controlled clinical trial. Age Ageing 2020; 49:605-614. [PMID: 32484850 DOI: 10.1093/ageing/afaa072] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Multi-morbidity and polypharmacy increase the risk of non-trivial adverse drug reactions (ADRs) in older people during hospitalization. Despite this, there are no established interventions for hospital-acquired ADR prevention. METHODS We undertook a pragmatic, multi-national, parallel arm prospective randomized open-label, blinded endpoint (PROBE) controlled trial enrolling patients at six European medical centres. We randomized 1,537 older medical and surgical patients with multi-morbidity and polypharmacy on admission in a 1:1 ratio to SENATOR software-guided medication optimization plus standard care (intervention, n = 772, mean number of daily medications = 9.34) or standard care alone (control, n = 765, mean number of daily medications = 9.23) using block randomization stratified by site and admission type. Attending clinicians in the intervention arm received SENATOR-generated advice at a single time point with recommendations they could choose to adopt or not. The primary endpoint was occurrence of probable or certain ADRs within 14 days of randomization. Secondary endpoints were primary endpoint derivatives; tertiary endpoints included all-cause mortality, re-hospitalization, composite healthcare utilization and health-related quality of life. RESULTS For the primary endpoint, there was no difference between the intervention and control groups (24.5 vs. 24.8%; OR 0.98; 95% CI 0.77-1.24; P = 0.88). Similarly, with secondary and tertiary endpoints, there were no significant differences. Among attending clinicians in the intervention group, implementation of SENATOR software-generated medication advice points was poor (~15%). CONCLUSIONS In this trial, uptake of software-generated medication advice to minimize ADRs was poor and did not reduce ADR incidence during index hospitalization.
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Affiliation(s)
- Denis O'Mahony
- University College Cork School of Medicine-Medicine Cork Ireland, Cork University Hospital Group, Cork, Ireland
| | | | - Roy L Soiza
- NHS Grampian, University of Aberdeen Institute of Applied Health Sciences-Ageing Clinical and Experimental Research, Aberdeen, UK
| | - Mirko Petrovic
- University of Ghent-Medicine, University Hospital Ghent, Ghent, Belgium
| | | | - Antonio Cherubini
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Richard Fordham
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Stephen Byrne
- School of Pharmacy, University College Cork, Cork, Ireland
| | | | - Paul Gallagher
- Cork University Hospital-Geriatric Medicine, Cork, Ireland
| | - Amanda Lavan
- University College Cork, School of Medicine-Geriatrics, Cork, Ireland
| | - Denis Curtin
- University College Cork, School of Medicine-Geriatrics, Cork, Ireland
| | - Kieran Dalton
- University College Cork, National University of Ireland, Pharmaceutical Care Research Group, School of Pharmacy, Cork Ireland
| | - Shane Cullinan
- Royal College of Surgeons, School of Pharmacy, Dublin, Ireland
| | - Evelyn Flanagan
- University College Cork, Clinical Research Facility, Cork, Ireland
| | - Frances Shiely
- University College Cork, School of Epidemiology and Public Health, Cork, Ireland
| | - Olafur Samuelsson
- Landspitali University Hospital, Geriatric Medicine Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | - Annarita Cerenzia
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Samanta Corradi
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | | | - Federica Dimitri
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Paolo Marinelli
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | - Gaia Martelli
- Italian National Research Center on Aging (IRCCS-INRCA), Geriatrics and Geriatrics Emergency Care, Ancona, Italy
| | | | - Joseph Eustace
- University College Cork, National University of Ireland-Clinical Research Facility, Cork, Ireland
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31
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Ní Cheallaigh S, Fleming A, Dahly D, Kehoe E, O'Byrne JM, McGrath B, O'Connell C, Sahm LJ. Aspirin compared to enoxaparin or rivaroxaban for thromboprophylaxis following hip and knee replacement. Int J Clin Pharm 2020; 42:853-860. [PMID: 32328957 DOI: 10.1007/s11096-020-01032-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/08/2020] [Indexed: 11/29/2022]
Abstract
Background The risk of venous thromboembolism following major orthopaedic surgery is among the highest for all surgical specialties. Our hospital guidelines for thromboprophylaxis following elective primary total hip or knee replacement are based on American College of Chest Physicians guidance. The most recent change to local guidelines was the introduction of the extended aspirin regimen as standard thromboprophylaxis. Objective To establish the appropriateness of this regimen by comparing venous thromboembolism rates in patients receiving extended aspirin to previous regimens. Setting The largest dedicated orthopaedic hospital in Ireland. Methods This was a retrospective cohort study. Data were collected from patient record software. All eligible patients undergoing primary total hip or knee replacement between 1st January 2010 and 30th June 2016 were included. Main outcome measure Venous thromboembolism up to 6 months post-operatively. Results Of the 6548 participants (55.3% female, mean age 65.4 years (± 11.8 years, 55.8% underwent total hip replacement), venous thromboembolism occurred in 65 (0.99%). Venous thromboembolism rate in both the inpatient enoxaparin group (n = 961) and extended aspirin group (n = 3460) was 1.04% and was 0.66% in the modified rivaroxaban group (n = 1212). Non-inferiority analysis showed the extended aspirin regimen to be equivalent to the modified rivaroxaban regimen. History of venous thromboembolism was the only significant demographic risk factor for post-operative venous thromboembolism (0.87% vs. 3.54%, p = 0.0002). Conclusion In daily clinical practice, extended aspirin regimen is at least as effective as modified rivaroxaban for preventing clinically important venous thromboembolism among patients undergoing hip or knee arthroplasty who are discharged from the hospital without complications. Aspirin can be considered a safe and effective agent in the prevention of venous thromboembolism after total hip or total knee replacement.
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Affiliation(s)
| | - Aoife Fleming
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility Cork, School of Public Health, University College Cork, Cork, Ireland
| | - Eimear Kehoe
- Pharmacy Department, Cappagh National Orthopaedic Hospital, Dublin 11, Ireland
| | - John M O'Byrne
- RCSI Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Dublin 11, Ireland
| | - Brid McGrath
- Department of Anaesthetics, Cappagh National Orthopaedic Hospital, Dublin 11, Ireland
| | - Charles O'Connell
- Pharmacy Department, Cappagh National Orthopaedic Hospital, Dublin 11, Ireland
| | - Laura J Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
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32
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McCullagh R, O'Connell E, O'Meara S, Dahly D, O'Reilly E, O'Connor K, Horgan NF, Timmons S. Augmented exercise in hospital improves physical performance and reduces negative post hospitalization events: a randomized controlled trial. BMC Geriatr 2020; 20:46. [PMID: 32033532 PMCID: PMC7007685 DOI: 10.1186/s12877-020-1436-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To measure the effects of an augmented prescribed exercise programme versus usual care, on physical performance, quality of life and healthcare utilisation for frail older medical patients in the acute setting. METHODS This was a parallel single-blinded randomised controlled trial. Within 2 days of admission, older medical inpatients with an anticipated length of stay ≥3 days, needing assistance/aid to walk, were blindly randomly allocated to the intervention or control group. Until discharge, both groups received twice daily, Monday-to-Friday half-hour assisted exercises, assisted by a staff physiotherapist. The intervention group completed tailored strengthening and balance exercises; the control group performed stretching and relaxation exercises. Length of stay was the primary outcome measure. Blindly assessed secondary measures included readmissions within 3 months, and physical performance (Short Physical Performance Battery) and quality of life (EuroQOL-5D-5 L) at discharge and at 3 months. Time-to-event analysis was used to measure differences in length of stay, and regression models were used to measure differences in physical performance, quality of life, adverse events (falls, deaths) and negative events (prolonged hospitalisation, institutionalisation). RESULTS Of the 199 patients allocated, 190 patients' (aged 80 ± 7.5 years) data were analysed. Groups were comparable at baseline. In intention-to-treat analysis, length of stay did not differ between groups (HR 1.09 (95% CI, 0.77-1.56) p = 0.6). Physical performance was better in the intervention group at discharge (difference 0.88 (95% CI, 0.20-1.57) p = 0.01), but lost at follow-up (difference 0.45 (95% CI, - 0.43 - 1.33) p = 0.3). An improvement in quality of life was detected at follow-up in the intervention group (difference 0.28 (95% CI, 0.9-0.47) p = 0.004). Overall, fewer negative events occurred in the intervention group (OR 0.46 (95% CI 0.23-0.92) p = 0.03). CONCLUSION Improvements in physical performance, quality of life and fewer negative events suggest that this intervention is of value to frail medical inpatients. Its effect on length of stay remains unclear. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02463864, registered prospectively 26.05.2015.
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Affiliation(s)
- Ruth McCullagh
- Centre for Gerontology & Rehabilitation, University College Cork, Cork, Ireland.
| | - Eimear O'Connell
- Physiotherapy Department, Mercy University Hospital, Cork, Ireland
| | - Sarah O'Meara
- Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland.,Clinical Research Facility, University College Cork, Cork, Ireland
| | - Eilis O'Reilly
- School of Public Health, University College Cork, Cork, Ireland
| | - Kieran O'Connor
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
| | - N Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Suzanne Timmons
- Centre for Gerontology & Rehabilitation, University College Cork, Cork, Ireland
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33
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Jennings E, Lavan A, Dahly D, Eustace J, Flanagan E, Gallagher P, Cullinane S, Petrovic M, Perehudoff K, Gudmondsson A, Samuelsson Ó, Sverrisdóttir Á, Cherubin A, Dimitri F, Rimland J, Cruz-Jentoft A, Vélez-Díaz-Pallarés M, Lozano Montoya I, L Soiza R, Subbarayan S, O’Mahony D. 91 A Descriptive Analysis of Causative Drgs/Drg Classes of Incident Adverse Drg Reactions in Acutely Hospitalized Older-Adults: SENATOR (Phase I). Age Ageing 2019. [DOI: 10.1093/ageing/afz103.53] [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: 11/12/2022] Open
Abstract
Abstract
Background
Adverse drug reactions (ADRs) are common and have serious repercussions for older-adults. This descriptive-analysis elucidates clinical presentations, severity and responsible drugs of incident ADRs in the SENATOR (Software ENgine for the Assessment & optimization of drug and non-drug Therapy in Older peRsons) phase I feasibility study.
Methods
SENATOR-phase-I was a European multicentre-prospective-observational study. Participants were ≥ 65 years, experiencing acute-hospitalisation and on pharmacological treatment for ≥ 3 conditions.
Adverse events (AEs) were identified by trigger list at recruitment, day-14/discharge and classified as ADRs when association with an administered drug was adjudicated as being probable/certain, according to the World Health Organization Uppsala Monitoring Centre ADR causality criteria.
Results
Of 644 participants recruited, 382 (59.1%) experienced 732 AEs, 363 AEs (49.6%) being incident. 139 participants (21.6%) experienced 177 (48.8%) ADRs. Full drug details were recorded in 156 patients (88%). Cardiovascular-system drugs accounted for one-third of ADRs (55, 35.3%).
Five drug classes caused three-quarters of ADRs (135, 76.3%); diuretics 28.2% (furosemide 24.4%), opioid analgesics 16.7%, anti-bacterials for systemic use 14.1%, anti-thrombotic agents 10.3%, and drugs used in diabetes 7%.
68 patients (10.6%) experienced 81 (45.8%) clinically significant moderate-severe ADRs. Significant serum electrolyte disturbance (32, 18.1%), acute kidney injury [AKI] (22, 12.4%), unspecified adverse event (UAE; 21, 11.9%), dyspepsia/nausea/vomiting (20, 11.3%), new-onset major constipation (19, 10.7%) were the most common presentations of ADRs, accounting for 114, (64.4%) of all ADRs. In moderate-severe ADRs; AKI (12, 14.8%), acute bleeding (11, 13.6%), new-onset major constipation (11, 13.6%), UAE (11, 13.6%), significant serum electrolyte disturbance (10, 12.4%) were the most common presentations.
Conclusion
This analysis highlights that;
1-in-5 older adults will experience an incident ADR during acute hospitalisation.
1-in-10 patients experience moderate-severe incident ADRs.
3-of-4 ADRs were caused by 5 drug classes (diuretics, opioids, anti-bacterials, anti-thrombotics and anti-diabetic agents).
This study allows for identification of potentially high risk medications which could be targeted for future ADR prevention.
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Affiliation(s)
- Emma Jennings
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Amanda Lavan
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Darren Dahly
- Department of Epidemiology, University College Cork National University of Ireland, Cork, Ireland
| | - Joseph Eustace
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Evelyn Flanagan
- Health Research Board Clinical Research Facility, Cork, Ireland
| | - Paul Gallagher
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Shane Cullinane
- School of Pharmacy, University College Cork National University of Ireland, Cork, Ireland
| | - Mirko Petrovic
- Department of Internal Medicine, Section of Geriatrics, Universiteit Gent, Gent, Belgium
| | | | | | - Ólafur Samuelsson
- Department of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Ástrós Sverrisdóttir
- Department of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Antonio Cherubin
- Geriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
| | - Frederica Dimitri
- Geriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
| | - Joe Rimland
- Geriatria ed Accettazione Geriatrica d’urgenza, IRCCS-INRCA, Ancona, Italy
| | | | | | | | | | - Selvarani Subbarayan
- University of Aberdeen School of Medicine and Dentistry, Aberdeen, United Kingdom
| | - Denis O’Mahony
- Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
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Sullivan E, Kelly T, Cushen S, Daly L, Ní Bhuachalla É, Howick K, Schellekens H, Cryan J, Griffin B, Dahly D, Ryan A. OR63: A Phase 1, Single-Blind, Placebo-Controlled, 3-Arm Crossover Trial of Food-Grade Peptides with Orexigenic Properties in Murine Models. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32535-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: 11/26/2022]
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Flannery C, Dahly D, Byrne M, Khashan A, McHugh S, Kenny LC, McAuliffe F, Kearney PM. Social, biological, behavioural and psychological factors related to physical activity during early pregnancy in the Screening for Pregnancy Endpoints (Cork, Ireland) cohort study. BMJ Open 2019; 9:e025003. [PMID: 31227527 PMCID: PMC6596951 DOI: 10.1136/bmjopen-2018-025003] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the social, biological, behavioural and psychological factors related to physical activity (PA) in early pregnancy. DESIGN This is a secondary analysis of data from a prospective cohort study. SETTING The study was conducted in Cork, Ireland. PARTICIPANTS Nulliparous women with singleton pregnancies were recruited and then interviewed at 15±1 weeks' gestation. PRIMARY AND SECONDARY OUTCOMES The biopsychosocial model identified factors including social (age), biological (body mass index), behavioural (diet) and psychological (anxiety) at 15±1 weeks' gestation. PA subgroups were identified based on a latent class analysis of their responses to a set of questions about the amount and intensity of activity they were engaging in during the pregnancy. Associations were estimated with multivariable multinomial logistic regression models. RESULTS From a total of 2579, 1774 (69%) women were recruited; ages ranged from 17 to 45 years. Based on a combination of model fit, theoretical interpretability and classification quality, the latent class analyses identified three PA subgroups: low PA (n=393), moderate PA (n=960) and high PA (n=413). The fully adjusted model suggests non-smokers, and consumers of fruit and vegetables were more likely to be in the high PA subgroup (vs low). Women with more than 12 years of schooling and a higher socioeconomic status were more likely to be in the moderate PA subgroup (vs low). CONCLUSION The findings highlight potential links between PA, a low education level and a low socioeconomic background. These factors should be considered for future interventions to improve low PA levels during pregnancy. TRIAL REGISTRATION NUMBER ACTRN 12607000551493.
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Affiliation(s)
- Caragh Flannery
- School of Psychology, Health Behaviour Change Research Group, National University of Ireland Galway, Galway, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
- Health Research Board, Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Molly Byrne
- School of Psychology, Health Behaviour Change Research Group, National University of Ireland Galway, Galway, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork, Cork, Ireland
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Sheena McHugh
- School of Public Health, University College Cork, Cork, Ireland
| | - Louise C Kenny
- Department of Women’s and Children’s Health, University of Liverpool School of Life Sciences, Liverpool, UK
| | - Fionnuala McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, Dublin, Ireland
- National Maternity Hospital, University College Dublin, Dublin, Ireland
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36
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Sweeney E, Dahly D, Seddiq N, Corcoran G, Horgan M, Sadlier C. Impact of BCG vaccination on incidence of tuberculosis disease in southern Ireland. BMC Infect Dis 2019; 19:397. [PMID: 31072396 PMCID: PMC6506945 DOI: 10.1186/s12879-019-4026-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 04/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background Tuberculosis (TB) is the ninth leading cause of death worldwide and the leading cause from a single infectious agent. Bacillus Calmette-Guerin (BCG) is the only licensed vaccine for TB, yet its efficacy remains debated with variations in vaccine sub-strains, policies, and practices observed across the world. Three BCG vaccination policies were implemented across adjoining regions in the South West of Ireland from 1972; neonatal vaccination (vaccinated Region-A), vaccination of children aged 10–12 years (vaccinated Region-B) and no vaccination (unvaccinated Region-C). The aim of this study is to examine the impact of different BCG vaccination policies on incidence of TB disease in the South of Ireland over a 13-year period. Methods Cases of active TB disease from 2003 to 2016 were identified through surveillance data. Residential addresses for each case were geocoded using the Google Maps API. Addresses were linked to 2011 census population data and to Local Health Offices BCG coverage data for study regions A-C. A steady-state population was assumed to calculate the 13-year incidence of TB disease. Using SatScan (v9.4.4), spatial clusters were identified at a small area level with the spatial scan statistic based on the discrete Poisson probability distribution. Results Of 621 TB disease cases identified, 510 could be linked to the study area based on the reported addresses. The median age was 42 years (range 4 months - 94 years), 65% male and 66% Irish born. The incidence of TB disease was higher in the unvaccinated population, region-C 132/100,000 (95% CI 116–150) versus vaccinated region-A 56/100,000 (95%CI 45–69) and region-B 44/100,000 (95%CI 29–63). A spatial cluster analysis identified a single high-risk cluster in region -C where the relative risk (vs. the areas outside of the cluster) was 4.94 (95% CI 4.03 to 5.96). Conclusion Our study demonstrates significant regional variation in the incidence of TB in demographically similar populations based on BCG vaccination policy. This observation is particularly noteworthy in a country with low TB disease incidence such as Ireland. These findings strengthen existing data demonstrating efficacy of BCG vaccination for primary prevention of TB disease. Electronic supplementary material The online version of this article (10.1186/s12879-019-4026-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eileen Sweeney
- Department of Infectious Diseases, Cork University Hospital, T12 DC4A, Cork, Ireland. .,Royal College of Physicians of Ireland, Dublin, Ireland.
| | - Darren Dahly
- Health Research Board Clinical Research Facility, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Nahed Seddiq
- Department of Infectious Diseases, Cork University Hospital, T12 DC4A, Cork, Ireland.,Royal College of Physicians of Ireland, Dublin, Ireland
| | - Gerard Corcoran
- Department of Microbiology, Cork University Hospital, Cork, Ireland
| | - Mary Horgan
- Department of Infectious Diseases, Cork University Hospital, T12 DC4A, Cork, Ireland.,School of Medicine, University College Cork, Cork, Ireland.,Royal College of Physicians of Ireland, Dublin, Ireland
| | - Corinna Sadlier
- Department of Infectious Diseases, Cork University Hospital, T12 DC4A, Cork, Ireland.,School of Medicine, University College Cork, Cork, Ireland
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37
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Lavan AH, O'Mahony D, Gallagher P, Fordham R, Flanagan E, Dahly D, Byrne S, Petrovic M, Gudmundsson A, Samuelsson O, Cherubini A, J Cruz-Jentoft A, Soiza RL, Eustace JA. The effect of SENATOR (Software ENgine for the Assessment and optimisation of drug and non-drug Therapy in Older peRsons) on incident adverse drug reactions (ADRs) in an older hospital cohort - Trial Protocol. BMC Geriatr 2019; 19:40. [PMID: 30760204 PMCID: PMC6375169 DOI: 10.1186/s12877-019-1047-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/24/2019] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this trial is to evaluate the effect of SENATOR software on incident, adverse drug reactions (ADRs) in older, multimorbid, hospitalized patients. The SENATOR software produces a report designed to optimize older patients’ current prescriptions by applying the published STOPP and START criteria, highlighting drug-drug and drug-disease interactions and providing non-pharmacological recommendations aimed at reducing the risk of incident delirium. Methods We will conduct a multinational, pragmatic, parallel arm Prospective Randomized Open-label, Blinded Endpoint (PROBE) controlled trial. Patients with acute illnesses are screened for recruitment within 48 h of arrival to hospital and enrolled if they meet the relevant entry criteria. Participants’ medical history, current prescriptions, select laboratory tests, electrocardiogram, cognitive status and functional status are collected and entered into a dedicated trial database. Patients are individually randomized with equal allocation ratio. Randomization is stratified by site and medical versus surgical admission, and uses random block sizes. Patients randomized to either arm receive standard routine pharmaceutical clinical care as it exists in each site. Additionally, in the intervention arm an individualized SENATOR-generated medication advice report based on the participant’s clinical and medication data is placed in their medical record and a senior medical staff member is requested to review it and adopt any of its recommendations that they judge appropriate. The trial’s primary outcome is the proportion of patients experiencing at least one adjudicated probable or certain, non-trivial ADR, during the index hospitalization, assessed at 14 days post-randomization or at index hospital discharge if it occurs earlier. Potential ADRs are identified retrospectively by the site researchers who complete a Potential Endpoint Form (one per type of event) that is adjudicated by a blinded, expert committee. All occurrences of 12 pre-specified events, which represent the majority of ADRs, are reported to the committee along with other suspected ADRs. Participants are followed up 12 (+/− 4) weeks post-index hospital discharge to assess medication quality and healthcare utilization. This is the first clinical trial to examine the effectiveness of a software intervention on incident ADRs and associated healthcare costs during hospitalization in older people with multi-morbidity and polypharmacy. Trial registration number Clinicaltrials.gov NCT02097654, 27 March 2014.
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Affiliation(s)
- Amanda H Lavan
- Department of Medicine (Geriatrics), University College Cork, Cork University Hospital, Cork, Ireland
| | - Denis O'Mahony
- Department of Medicine (Geriatrics), University College Cork, Cork University Hospital, Cork, Ireland
| | - Paul Gallagher
- Department of Medicine (Geriatrics), University College Cork, Cork University Hospital, Cork, Ireland
| | - Richard Fordham
- Health Economics, University of East Anglia Medical School, Norwich, England
| | - Evelyn Flanagan
- Health Research Board Clinical Research Facility-Cork, University College Cork, Cork University Hospital, Wilton, Cork, Ireland, T12 DC4A
| | - Darren Dahly
- Health Research Board Clinical Research Facility-Cork, University College Cork, Cork University Hospital, Wilton, Cork, Ireland, T12 DC4A
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Mirko Petrovic
- Vakgroep Inwendige Ziekten (Geriatrie), Universiteit Gent, UGent, Ghent, Belgium
| | | | | | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Roy L Soiza
- NHS Grampian and University of Aberdeen, Aberdeen, Scotland
| | - Joseph A Eustace
- Health Research Board Clinical Research Facility-Cork, University College Cork, Cork University Hospital, Wilton, Cork, Ireland, T12 DC4A.
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Sweeney E, Dahly D, Seddiq N, Horgan M, Corcoran D, Sadlier C. 761. Age-Related Incidence of TB Infection Supporting Efficacy of BCG Vaccination. Open Forum Infect Dis 2018. [PMCID: PMC6255141 DOI: 10.1093/ofid/ofy210.768] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Mycobacterium tuberculosis (MTB) is a major, and potentially preventable, cause of morbidity and mortality worldwide. Bacillus Calmette-Guerin (BCG) remains the only licensed vaccine for TB, and while efficacy has been demonstrated in some populations, many uncertainties remain. Three BCG vaccination policies were implemented across bordering geographical regions in the South West of Ireland from 1972; neonatal vaccination (vaccinated region-a), vaccination of children aged 10–12 years (vaccinated region-b) and no vaccination (unvaccinated region-c). The aim of this study was to investigate the impact of BCG vaccination on incidence of MTB during the study period. Methods Surveillance data were used to identify all M. tuberculosis complex (MTC) isolates from 2003 to 2016. Residential addresses for each case were geocoded using the Google Maps API. Case locations were spatially linked to 2011 census population data and to Local Health Offices (LHO) BCG coverage data for study regions a–c. The 13-year incidence of TB was calculated assuming a steady-state population. Using SatScan (v9.4.4), spatial clusters were identified at the small area level with the spatial scan statistic based on the discrete Poisson probability distribution. Results Of 638 MTC infections identified (621 MTB, 16 M. bovis, 1 M. africanum), 510 occurred in study regions a–c (median age 42 years (4 months–94 years), 65% male and 66% Irish born). The incidence of MTB was higher in the unvaccinated population, region-c 132/100,000 (95% CI 116–150) vs. vaccinated region-a 56/100,000 (95% CI 45–69) and region-b 44/100,000 (95% CI 29–63). A single high-risk cluster of 138 cases within a population of 46,000 was identified in unvaccinated region-c (relative risk 4.94 (95% CI 4–6). The year-on-year incidence rates in the 20- to 35-year-old age range suggested a decreasing risk consistent with a beneficial impact of vaccination policies. Conclusion Prevention and treatment of TB remains a significant challenge worldwide. Our study demonstrates significant differences in incidence of MTC infection in demographically similar populations based on BCG immunization policy and thus further supports efficacy of BCG for prevention of tuberculosis infection. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Eileen Sweeney
- Infectious Diseases, Cork University Hospital, Cork, Ireland
| | - Darren Dahly
- Epidemiology and Public Health, Health Research Board Clinical Research Facility, Cork, Ireland
| | - Nahed Seddiq
- Infectious Diseases, Cork University Hospital, Cork, Ireland
| | - Mary Horgan
- Infectious Diseases, Cork University Hospital, Cork, Ireland
- Royal College of Physicians of Ireland, Dublin 2, Ireland
| | - Dan Corcoran
- Microbiology, Cork University Hospital, Cork, Ireland
| | - Corinna Sadlier
- Infectious Diseases, Cork University Hospital, Cork, Ireland
- Medicine, University College Cork, Cork, Ireland
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Drennan J, Duffield C, Scott AP, Ball J, Brady NM, Murphy A, Dahly D, Savage E, Corcoran P, Hegarty J, Griffiths P. A protocol to measure the impact of intentional changes to nurse staffing and skill-mix in medical and surgical wards. J Adv Nurs 2018; 74:2912-2921. [PMID: 30019346 DOI: 10.1111/jan.13796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 04/06/2018] [Revised: 05/17/2018] [Accepted: 06/01/2018] [Indexed: 11/27/2022]
Abstract
AIM The aim of this research is to measure the impact that planned changes to nurse staffing and skill-mix have on patient, nurse, and organizational outcomes. BACKGROUND It has been highlighted that there are several design limitations in studies that explore the relationship between nurse staffing and patient, nurse and organizational outcomes; not least that the vast majority of research in this area emanates from studies that are predominantly observational in design. There are limited studies that measure nurse, patient, organizational, and economic outcomes using a longitudinal design following a planned change in nurse staffing. DESIGN The research will employ a longitudinal, multimethod approach to evaluate the impact that planned changes in nurse staffing and skill-mix have on wards in three pilot hospitals. METHODS Administrative data collection will take place on a shift-by-shift basis prospectively over a three-year period including the measurement of nursing sensitive outcomes: cross-sectional patient experience data and nurse outcomes (nursing work, job satisfaction, burnout, missed care) will be collected at intervals prior to, during and after the implementation of planned changes in nurse staffing and skill-mix. Data will be analysed using interrupted time-series models, adjusted for key hospital, ward and patient-level factors. An economic costing of the changes will further investigate the resources required for the intervention that can then be aggregated to a national level for future roll-out plans. DISCUSSION The study aims to provide evidence on the impact of planned changes to nurse staffing and skill-mix based on a systematic approach using a longitudinal design and to determine the extent to which the approach can be implemented at a national level.
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Affiliation(s)
- Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Christine Duffield
- University of Technology, Sydney, Centre for Health Services Management and Edith Cowan University, Nursing and Midwifery, Broadway, Australia
| | | | - Jane Ball
- Health Sciences, University of Southampton, Southampton, UK
| | - Noeleen M Brady
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Aileen Murphy
- Cork University Business School, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility Cork, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Paul Corcoran
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Ronan N, Bennett DM, Khan KA, McCarthy Y, Dahly D, Bourke L, Chelliah A, Cavazza A, O'Regan K, Moloney F, Plant BJ, Henry MT. Tissue and Bronchoalveolar Lavage Biomarkers in Idiopathic Pulmonary Fibrosis Patients on Pirfenidone. Lung 2018; 196:543-552. [PMID: 30066212 DOI: 10.1007/s00408-018-0140-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/06/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pirfenidone is a novel anti-fibrotic agent in idiopathic pulmonary fibrosis with proven clinical benefit. Better human tissue models to demonstrate the immunomodulatory and anti-fibrotic effect of pirfenidone are required. OBJECTIVES The purpose of the study was to use transbronchial lung cryobiopsy (TBLC), a novel technique which provides substantial tissue samples, and a large panel of biomarkers to temporally assess disease activity and response to pirfenidone therapy. METHODS Thirteen patients with confirmed idiopathic pulmonary fibrosis (IPF) underwent full physiological and radiological assessment at diagnosis and after 6-month pirfenidone therapy. They underwent assessment for a wide range of potential serum and bronchoalveolar lavage biomarkers of disease activity. Finally, they underwent TBLC before and after treatment. Tissue samples were assessed for numbers of fibroblast foci, for Ki-67, a marker of tissue proliferation and caspase-3, a marker of tissue apoptosis. RESULTS All patients completed treatment and investigations without significant incident. There was no significant fall in number of fibroblast foci per unit tissue volume after treatment (pre-treatment: 0.14/mm2 vs. post-treatment 0.08/mm2, p = 0.1). Likewise, there was no significant change in other markers of tissue proliferation, Ki-67 or Caspase-3 with pirfenidone treatment. We found an increase in three bronchoalveolar lavage angiogenesis cytokines, Placental Growth Factor, Vascular Endothelial Growth Factor-A, and basic Fibroblast Growth Factor, two anti-inflammatory cytokines Interleukin-10 and Interleukin-4 and Surfactant Protein-D. CONCLUSIONS TBLC offers a unique opportunity to potentially assess the course of disease activity and response to novel anti-fibrotic activity in IPF.
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Affiliation(s)
- Nicola Ronan
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland.,Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | | | - Kashif A Khan
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland.,Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - Yvonne McCarthy
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Louise Bourke
- Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Adeline Chelliah
- Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Alberto Cavazza
- Department of Pathology, Arcispedale S Maria Nuova, Istituti di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy
| | - Kevin O'Regan
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - Fiachra Moloney
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - Barry J Plant
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland.,Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - Michael T Henry
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland. .,Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.
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41
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Dahly D, Li X, Smith H, Khashan A, Deirdre M, Kiely M. Associations between maternal lifestyle factors and neonatal body composition in the screening for pregnancy endpoints (CORK) cohort study. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.044] [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] Open
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42
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Saab MM, Davoren MP, Murphy A, Murphy D, Cooke E, Landers M, Fitzgerald S, Richardson N, Rovito MJ, Von Wagner C, Murphy M, Dahly D, Hegarty J. Promoting men's awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions. HRB Open Res 2018; 1:16. [PMID: 32002508 PMCID: PMC6973532 DOI: 10.12688/hrbopenres.12837.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2018] [Indexed: 12/26/2022] Open
Abstract
Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men's knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men's awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.
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Affiliation(s)
- Mohamad M. Saab
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martin P. Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, University College Cork, Cork, Ireland
| | - David Murphy
- School of Computer Science & Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
- Health Research Board National Clinical Trials Office, College of Medicine & Health, University College Cork, Cork, Ireland
| | - Margaret Landers
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Serena Fitzgerald
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Noel Richardson
- Department of Science and Health, South East Technological University, Carlow, Ireland
| | - Michael J. Rovito
- College of Health Professions and Sciences, University of Central Florida, Orlando, Florida, USA
| | - Christian Von Wagner
- Behavioural Science and Health, Institute of Epidemiology & Health, University College London, London, UK
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Saab MM, Davoren M, Murphy A, Murphy D, Cooke E, Landers M, Fitzgerald S, Richardson N, Rovito M, Von Wagner C, Murphy M, Dahly D, Hegarty J. Promoting men's awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions. HRB Open Res 2018. [PMID: 32002508 DOI: 10.12688/hrbopenres.12837.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men's knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men's awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.
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Affiliation(s)
- Mohamad M Saab
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Martin Davoren
- School of Public Health, University College Cork, Cork, Ireland.,Sexual Health Centre, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, University College Cork, Cork, Ireland
| | - David Murphy
- Department of Computer Science, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- Department of Computer Science, University College Cork, Cork, Ireland
| | - Margaret Landers
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Serena Fitzgerald
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Noel Richardson
- Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
| | - Michael Rovito
- College of Health and Public Affairs, University of Central Florida, Orlando, Florida, USA
| | - Christian Von Wagner
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Darren Dahly
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Murray S, Plant W, Eustace J, Dahly D. SP308SURVIVAL WITH ESKD IN AN IRISH POPULATION 2002-2015. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp308] [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: 11/15/2022] Open
Affiliation(s)
| | - William Plant
- Renal Medicine, Cork University Hospital, Cork, Ireland
| | - Joseph Eustace
- Clinicl Research Facility, University College Cork, Cork, Ireland
| | - Darren Dahly
- Clinicl Research Facility, University College Cork, Cork, Ireland
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Lavan A, Eustace J, Dahly D, Flanagan E, Gallagher P, Cullinane S, Petrovic M, Perehudoff K, Gudmondsson A, Samuelsson Ó, Sverrisdóttir Á, Cherubin A, Dimitri F, Rimland J, Cruz-Jentoft A, Vélez-Díaz-Pallarés M, Lozano Montoya I, Soiza RL, Subbarayan S, O'Mahony D. Incident adverse drug reactions in geriatric inpatients: a multicentred observational study. Ther Adv Drug Saf 2017; 9:13-23. [PMID: 29318003 DOI: 10.1177/2042098617736191] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 08/27/2017] [Indexed: 11/16/2022] Open
Abstract
Background Adverse drug reactions (ADRs) are common in older adults and frequently have serious clinical and economic consequences. This study was conducted as a feasibility study for a randomized control trial (RCT) that will investigate the efficacy of a software engine to optimize medications and reduce incident (in-hospital) ADRs. This study's objectives were to (i) establish current incident ADR rates across the six sites participating in the forthcoming RCT and (ii) assess whether incident ADRs are predictable. Methods This was a multicentre, prospective observational study involving six European hospitals. Adults aged ⩾ 65 years, hospitalized with an acute illness and on pharmacological treatment for three or more conditions were eligible for inclusion. Adverse events (AEs) were captured using a trigger list of 12 common ADRs. An AE was deemed an ADR when its association with an administered drug was adjudicated as being probable/certain, according to the World Health Organization Uppsala Monitoring Centre causality assessment. The proportion of patients experiencing at least one, probable/certain, incident ADR within 14 days of enrolment/discharge was recorded. Results A total of 644 patients were recruited, evenly split by sex and overwhelmingly of White ethnicity. Over 80% of admissions were medical. The median number of chronic conditions was five (interquartile range 4-6), with eight or more conditions present in approximately 10%. The mean number of prescribed medications was 9.9 (standard deviation 3.8), which correlated strongly with the number of conditions (r = 0.54, p < 0.0001). A total of 732 AEs were recorded in 382 patients, of which 363 were incident. The majority of events were classified as probably or possibly drug related, with heterogeneity across sites (χ2 = 88.567, df = 20, p value < 0.001). Out of 644 patients, 139 (21.6%; 95% confidence interval 18.5-25.0%) experienced an ADR. Serum electrolyte abnormalities were the most common ADR. The ADRROP (ADR Risk in Older People) and GerontoNet ADR risk scales correctly predicted ADR occurrence in 61% and 60% of patients, respectively. Conclusion This feasibility study established the rates of incident ADRs across the six study sites. The ADR predictive power of ADRROP and GerontoNet ADR risk scales were limited in this population.
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Affiliation(s)
- Amanda Lavan
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Joseph Eustace
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Darren Dahly
- Department of Epidemiology, University College Cork National University of Ireland, Cork, Ireland
| | | | - Paul Gallagher
- Department of Medicine, University College Cork National University of Ireland, Cork, Ireland
| | - Shane Cullinane
- Department of Pharmacy, University College Cork National University of Ireland, Cork, Ireland
| | - Mirko Petrovic
- Department of Internal Medicine, Section of Geriatrics, Universiteit Gent, Gent, Belgium
| | | | | | - Ólafur Samuelsson
- Department of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Ástrós Sverrisdóttir
- Department of Geriatric Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Antonio Cherubin
- Geriatria ed Accettazione Geriatrica d'urgenza, IRCCS-INRCA, Ancona, Italy
| | - Frederica Dimitri
- Geriatria ed Accettazione Geriatrica d'urgenza, IRCCS-INRCA, Ancona, Italy
| | - Joe Rimland
- Geriatria ed Accettazione Geriatrica d'urgenza, IRCCS-INRCA, Ancona, Italy
| | | | | | | | | | | | - Denis O'Mahony
- Department of Medicine, University College Cork & Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland
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46
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McCullagh R, Dahly D, Horgan F, Timmons S. 010Barriers to Older Medical Patient Walking in Hospital. Age Ageing 2017. [DOI: 10.1093/ageing/afx145.1] [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: 11/13/2022] Open
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Abstract
OBJECTIVE To investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. METHOD We analysed baseline data from the Mitchelstown (Ireland) 2010-2011 cohort of 2047 men and women aged 50-69 years. Self-reported measures included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale) and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by ACE scores and ACE subtypes abuse, neglect and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors. We tested whether the estimated associations varied across levels of PSS (poor, moderate and strong). RESULTS 23.7% of participants reported at least one ACE (95% CI 21.9% to 25.6%). ACE exposures (overall, subtype or ACE scores) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. Exposure to any ACE (vs none) was associated with almost three times the odds of depressive symptoms (adjusted OR 2.85; 95% CI 1.64 to 4.95) among individuals reporting poor PSS, while among those reporting moderate and strong PSS, the adjusted ORs were 2.21 (95% CI 1.52 to 3.22) and 1.39 (95% CI 0.85 to 2.29), respectively. This pattern of results was similar when exposures were based on ACE subtype and ACE scores, though the interaction was clearly strongest among those reporting abuse. CONCLUSIONS ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms, particularly among those with poor PSS. Interventions that enhance social support, or possibly perceptions of social support, may help reduce the burden of depression in older populations with ACE exposure, particularly in those reporting abuse.
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Affiliation(s)
- E Von Cheong
- School of Medicine, University College Cork, Cork, Ireland
| | - Carol Sinnott
- Department of General Practice, University College Cork, Cork, Ireland
| | - Darren Dahly
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Caplice N, Devoe M, Choi J, Dahly D, Spitzer E, Van Guens R, Maher M, Tuite D, Kerins D, Kelly P, Kearney P, Curtin R, Vaughan C, Eustace J, McFadden E. P2125Randomised placebo controlled trial evaluating the safety and efficacy of intracoronary insulin like growth factor 1 post percutaneous intervention for acute myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2125] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kelly M, Sahm LJ, Shiely F, O’Sullivan R, de Bont EG, Mc Gillicuddy A, Herlihy R, Dahly D, McCarthy S. Parental knowledge, attitudes and beliefs on fever: a cross-sectional study in Ireland. BMJ Open 2017; 7:e015684. [PMID: 28694348 PMCID: PMC5541503 DOI: 10.1136/bmjopen-2016-015684] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Fever is a common symptom of mostly benign illness in young children, yet concerning for parents. The aim of this study was to describe parental knowledge, attitudes and beliefs regarding fever in children aged ≤5 years of age. DESIGN A cross-sectional study using a previously validated questionnaire. Results were analysed using descriptive statistics and multivariable logistic regression. SETTING Purposively selected primary schools (n=8) in Cork, Ireland, using a paper-based questionnaire. Data were collected from a cross-sectional internet-based questionnaire with a convenience sample of parents via websites and web pages (n=10) previously identified in an interview study. PARTICIPANTS Parents with at least one child aged ≤5 years were invited to participate in the study. MAIN OUTCOME MEASURES Parental knowledge, attitudes and beliefs when managing fever in children. RESULTS One thousand one hundred and four parents contributed to this research (121 parents from schools and 983 parents through an online questionnaire). Almost two-thirds of parents (63.1%) identified temperatures at which they define fever that were either below or above the recognised definition of temperature (38°C). Nearly two of every three parents (64.6%) alternate between two fever-reducing medications when managing a child's fever. Among parents, years of parenting experience, age, sex, educational status or marital status did not predict being able to correctly identify a fever, neither did they predict if the parent alternated between fever-reducing medications. CONCLUSIONS Parental knowledge of fever and fever management was found to be deficient which concurs with existing literature. Parental experience and other sociodemographic factors were generally not helpful in identifying parents with high or low levels of knowledge. Resources to help parents when managing a febrile illness need to be introduced to help all parents provide effective care.
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Affiliation(s)
- Maria Kelly
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - Laura J Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- Department of Pharmacy, Mercy University Hospital, Cork, Ireland
| | - Frances Shiely
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Ronan O’Sullivan
- School of Medicine, University College Cork, Cork, Ireland
- National Children’s Research Centre, Dublin, Ireland
| | - Eefje G de Bont
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Aoife Mc Gillicuddy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Roisin Herlihy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Suzanne McCarthy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- Department of Pharmacy, Cork University Hospital, Cork, Ireland
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Davoren MP, Dahly D, Shiely F, Perry IJ. Alcohol consumption among university students: A latent class analysis. Drugs: Education, Prevention and Policy 2017. [DOI: 10.1080/09687637.2017.1290787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Martin P. Davoren
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland and
| | - Darren Dahly
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland and
- Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Frances Shiely
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland and
- Clinical Research Facility Cork, University College Cork, Cork, Ireland
| | - Ivan J. Perry
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland and
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