1
|
O’Donoghue B, Roche E, Lyne J, Renwick L, Clarke M. Outcomes 1 year after a first episode of psychosis in migrants to the Republic of Ireland. Int J Soc Psychiatry 2023; 69:1617-1625. [PMID: 37211684 PMCID: PMC10657506 DOI: 10.1177/00207640231174360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Migration is a robust risk factor for developing a psychotic disorder, yet there is a paucity of research on the outcomes of migrants who develop a psychotic disorder. Identifying sub-groups within FEP cohorts who have a poorer outcome, could assist in the development and delivery of more targeted interventions. AIMS There is a paucity of research on the outcomes of migrants who develop a psychotic disorder. This study aimed to evaluate a broad range of outcomes for those with a FEP who migrated to the Republic of Ireland, including: (i) symptomatic; (ii) functional; (iii) hospitalisation and (iv) engagement with psychosocial services. METHODS All individuals with a FEP aged 18 to 65 who presented between 01.02.2006 and 01.07.2014 were included. Structured and validated instruments were used to measure positive, negative, depressive symptoms and insight. RESULTS Of the 573 individuals with a FEP, 22.3% were first-generation migrants and 63.4% (n = 363) were followed up at 1 year. At this time, 72.4% of migrants were in remission of positive psychotic symptoms compared to 78.5% of the Irish born (OR = 0.84, 95% CI [0.50-1.41], p = .51). In relation to negative symptoms, 60.5% of migrants were in remission compared to 67.2% of the Irish born (OR = 0.75, 95% CI [0.44-1.27], p = .283). There was no difference in the severity of positive, negative or depressive symptoms between groups and there was a trend for the Irish born to have better insight (p = .056). The functional outcomes were similar across groups. One third of migrants were admitted to hospital compared to 28.7% of the Irish born (OR = 1.24, 95% CI [0.73-2.13], p = .426). Just over half of both groups attended CBT and 46.2% of caregivers for migrants attended the psychoeducation programme, compared to 39.7% for the Irish born (OR = 1.30, 95% CI [0.79-2.16], p = .306). CONCLUSIONS These findings demonstrate that migrants have broadly similar outcomes to the native-born populations, however there is still considerable scope for the outcomes for all individuals affected by psychotic disorders to be improved.
Collapse
Affiliation(s)
- Brian O’Donoghue
- Department of Psychiatry, University College Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Centre for Youth Mental Health, University of Melbourne, Parkville VIC, Australia
| | - Eric Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
| | - John Lyne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Mary Clarke
- Department of Psychiatry, University College Dublin, Ireland
- DETECT Early Intervention for Psychosis Service, Blackrock, Co. Dublin, Ireland
| |
Collapse
|
2
|
O'Donoghue B, Sexton S, Lyne JP, Roche E, Mifsud N, Brown E, Renwick L, Behan C, Clarke M. Socio-demographic and clinical characteristics of migrants to Ireland presenting with a first episode of psychosis. Ir J Psychol Med 2023; 40:336-342. [PMID: 33632349 DOI: 10.1017/ipm.2020.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service. METHODS All cases of treated FEP from three local mental health services within a defined catchment area were included. Psychotic disorder diagnoses were determined using the SCID and symptom and functioning domains were measured using validated and reliable measures. RESULTS From a cohort of 612 people, 21.1% were first-generation migrants and there was no difference in the demographic characteristics, diagnoses, symptoms or functioning between migrants and those born in the Republic of Ireland, except that migrants from Africa presented with less insight. Of those admitted, 48.6% of admissions for migrants were involuntary compared to 37.7% for the native-born population (p = 0.09). CONCLUSIONS First-generation migrants now make up a significant proportion of people presenting with a FEP to an Irish EI for psychosis service. Broadly the demographic and clinical characteristics of migrants and those born in the Republic of Ireland are similar, except for less insight in migrants from Africa and a trend for a higher proportion of involuntary admissions in the total migrant group.
Collapse
Affiliation(s)
- B O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - S Sexton
- Linndara, Child and Adolescent Mental Health Services, Health Service Executive, Kildare, Ireland
| | - J P Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
| | - E Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - N Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - E Brown
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, England, UK
| | - C Behan
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - M Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
| |
Collapse
|
3
|
Crowley P, Casey S, Kelleher E, Roche E, Behan C, Cannon M, Lyne J. Survey of consultant psychiatrists about the draft heads of a bill to amend the mental health act. Ir J Med Sci 2023; 192:1769-1770. [PMID: 37032395 DOI: 10.1007/s11845-023-03355-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Paul Crowley
- Health Service Executive, Newcastle Hospital, Greystones, Co. Wicklow, Ireland.
| | - Sarah Casey
- St Patrick's University Hospital, Dublin 8, Ireland
- Trinity College Dublin, Dublin 2, Ireland
| | - Eric Kelleher
- Liaison Psychiatry Service, Cork University Hospital, Cork, Ireland
- Liaison Psychiatry Service, Mercy University Hospital, Cork, Ireland
- Department of Psychiatry, School of Medicine, University College Cork, Cork, Ireland
| | - Eric Roche
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
- Cluain Mhuire Community Mental Health Service, Blackrock, Dublin, Ireland
| | - Caragh Behan
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - John Lyne
- Health Service Executive, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
| |
Collapse
|
4
|
Boix-Castejón M, Roche E, Olivares-Vicente M, Álvarez-Martínez FJ, Herranz-López M, Micol V. Plant compounds for obesity treatment through neuroendocrine regulation of hunger: A systematic review. Phytomedicine 2023; 113:154735. [PMID: 36921427 DOI: 10.1016/j.phymed.2023.154735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Food intake behavior is influenced by both physiological and psychological complex processes, such as appetite, satiety, and hunger. The neuroendocrine regulation of food intake integrates short- and long-term acting signals that modulate the moment of intake and energy storage/expenditure, respectively. These signals are classified as orexigenic, those that activate anabolic pathways and the desire of eating, and anorexigenic, those that activate the catabolic pathways and a sensation of satiety. Appetite control by natural vegetal compounds is an intense area of research and new pharmacological interventions have been emerging based on an understanding of appetite regulation pathways. Several validated psychometric tools are used to assess the efficacy of these plant ingredients. However, these data are not conclusive if they are not complemented with physiological parameters, such as anthropometric evaluations (body weight and composition) and the analysis of hormones related to adipose tissue and appetite in blood. PURPOSE The purpose of this manuscript is the critical analysis of the plant compounds studied to date in the literature with potential for the neuroendocrine regulation of hunger in order to determine if the use of phytochemicals for the treatment of obesity constitutes an effective and/or promising therapeutic tool. METHODS Relevant information on neuroendocrine regulation of hunger and satiety for the treatment of obesity by plant compounds up to 2022 in English and/or Spanish were derived from online databases using the PubMed search engine and Google Scholar with relevant keywords and operators. RESULTS Accordingly, the comparison performed in this review between previous studies showed a high degree of experimental heterogeneity. Among the studies reviewed here, only a few of them establish comprehensively a potential correlation between the effect of the ingredient on hunger or satiety, body changes and a physiological response. CONCLUSIONS More systematic clinical studies are required in future research. The first approach should be to decode the pattern of circulating hormones regulating hunger, satiety, and appetite in overweight/obese subjects. Thereafter, studies should correlate brain connectivity at the level of the hypothalamus, gut and adipose tissue with the hormone patterns modulating appetite and satiety. Extracts whose mode of action have been well characterized and that are safe, can be used clinically to perform a moderate, but continuous, caloric restriction in overweight patients to lose weight excess into a controlled protocol.
Collapse
Affiliation(s)
- M Boix-Castejón
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - E Roche
- Institute of Bioengineering, Applied Biology Department-Nutrition, University Miguel-Hernández, 03202, Elche, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010, Alicante, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - M Olivares-Vicente
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - F J Álvarez-Martínez
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain
| | - M Herranz-López
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain.
| | - V Micol
- Institute of Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universitas Miguel Hernández (UMH), 03202, Elche, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| |
Collapse
|
5
|
Abstract
BACKGROUND Migration is an established risk factor for developing a psychotic disorder in countries with a long history of migration. Less is known for countries with only a recent history of migration. This study aimed to determine the risk for developing a psychotic disorder in migrants to the Republic of Ireland. METHODS We included all presentations of first-episode psychosis over 8.5 years to the DETECT Early Intervention for psychosis service in the Republic of Ireland (573 individuals aged 18-65, of whom 22% were first-generation migrants). Psychotic disorder diagnosis relied on SCID. The at-risk population was calculated using census data, and negative binomial regression was used to estimate incidence rate ratios. RESULTS The annual crude incidence rate for a first-episode psychotic disorder in the total cohort was 25.62 per 100000 population at risk. Migrants from Africa had a nearly twofold increased risk for developing a psychotic disorder compared to those born in the Republic of Ireland (IRR = 1.83, 95% CI 1.11-3.02, p = 0.02). In contrast, migrants from certain Asian countries had a reduced risk, specifically those from China, India, Philippines, Pakistan, Malaysia, Bangladesh and Hong Kong (aIRR = 0.36, 95% CI 0.16-0.81, p = 0.01). CONCLUSIONS Further research into the reasons for this inflated risk in specific migrant groups could produce insights into the aetiology of psychotic disorders. This information should also be used, alongside other data on environmental risk factors that can be determined from census data, to predict the incidence of psychotic disorders and thereby resource services appropriately.
Collapse
Affiliation(s)
- Brian O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - John Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Eric Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - Nathan Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, England
| | - Caragh Behan
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
| |
Collapse
|
6
|
Griffith V, Murphy R, Sheil O, Roche E, Devaney T, Geoghegan J, Robinson S, Waters R, O'Donnell M, Canavan M. 311 FROM ONE FRONT DOOR TO ANOTHER: OUTCOMES OF PATIENTS DIRECTLY DISCHARGED FROM THE FRAILTY AT THE FRONT DOOR SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.273] [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: 11/14/2022] Open
Abstract
Abstract
Background
The Frailty at the Front Door service is a novel service that provides comprehensive geriatric assessment in the emergency department for older adults who have an unplanned emergency presentation to hospital. It is important to monitor outcomes of patients discharged by the service to ensure appropriate patient selection.
Methods
Patients over the age of 75 with a Manchester Triage Score of between three and five and a possible frailty syndrome are eligible for review by the service. After initial review patients are either discharged directly or recommended for admission. We reviewed the outcomes of patients who were discharged directly after Emergency Department (ED) assessment by the service.
Results
Discharge disposition was available for review in 413 (95%) of patients since initiation of the service in October 2021. 30% (n= 122) of patients were discharged directly after initial ED review. Elevated 4AT score (p = 0.002) but not frailty (p = 0.80) was associated with decreased chances of direct discharge. Of patients discharged directly from ED 13% were reviewed post discharge by the community integrated care team (GICOP), with 43% of these reviews taking place within 30 days. Overall, 16% of patients discharged directly represented to ED within 30 days. There was a trend towards lower rates of representation to ED among patients who were seen by GICOP after discharge from ED (p = 0.12).
Conclusion
There was a high rate of direct discharge after review by the service, with low rates of representation to hospital. While limited by low numbers there was a trend towards lower representation rates in patients reviewed post-discharge by the integrated care team. Future quality improvement initiatives will aim to improve the integration between the services and highlighting patients who would benefit from more timely reviews.
Collapse
Affiliation(s)
- V Griffith
- Galway University Hospital , Galway, Ireland
| | - R Murphy
- Galway University Hospital , Galway, Ireland
| | - O Sheil
- Galway University Hospital , Galway, Ireland
| | - E Roche
- Galway University Hospital , Galway, Ireland
| | - T Devaney
- Galway University Hospital , Galway, Ireland
| | - J Geoghegan
- Galway University Hospital , Galway, Ireland
| | - S Robinson
- Galway University Hospital , Galway, Ireland
| | - R Waters
- Galway University Hospital , Galway, Ireland
| | - M O'Donnell
- Galway University Hospital , Galway, Ireland
| | - M Canavan
- Galway University Hospital , Galway, Ireland
| |
Collapse
|
7
|
Cox R, Roche E. Gastrointestinal: Inflammatory bowel disease therapy-induced triple-hit lymphoma. J Gastroenterol Hepatol 2020; 35:1856. [PMID: 32424816 DOI: 10.1111/jgh.15083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/17/2020] [Accepted: 04/27/2020] [Indexed: 12/09/2022]
Affiliation(s)
- R Cox
- The Townsville University Hospital, Douglas, Queensland, Australia
| | - E Roche
- The Townsville University Hospital, Douglas, Queensland, Australia
| |
Collapse
|
8
|
Norton S, Kaur S, Roche E, O’Beirn E, Daly K, Considine S, Dowling C, Jaffry S, O’Malley P, Durkan G, Walsh K, Rogers E, D’Arcy F. The Effect of a JJ Stent on Sexual Function and Satisfaction. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35276-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
9
|
Behan C, Kennelly B, Roche E, Renwick L, Masterson S, Lyne J, O'Donoghue B, Waddington J, McDonough C, McCrone P, Clarke M. Early intervention in psychosis: health economic evaluation using the net benefit approach in a real-world setting. Br J Psychiatry 2020; 217:484-490. [PMID: 31339083 DOI: 10.1192/bjp.2019.126] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Early intervention in psychosis is a complex intervention, usually delivered in a specialist stand-alone setting, which aims to improve outcomes for people with psychosis. Previous studies have been criticised because the control used did not accurately reflect actual practice. AIMS To evaluate the cost-effectiveness of early intervention by estimating the incremental net benefit (INB) of an early-intervention programme, delivered in a real-world setting. INB measures the difference in monetary terms between alternative interventions. METHOD Two contemporaneous incidence-based cohorts presenting with first-episode psychosis, aged 18-65 years, were compared. Costs and outcomes were measured over 1 year. The main outcome was avoidance of a relapse that required admission to hospital or home-based treatment. RESULTS From the health sector perspective, the probability that early intervention was cost-effective was 0.77. The INB was €2465 per person (95% CI - €4418 to €9347) when society placed a value of €6000, the cost of an in-patient relapse, on preventing a relapse requiring admission or home care. Following adjustment, the probability that early intervention was cost-effective was 1, and the INB to the health sector was €3105 per person (95% CI -€8453 to €14 663). From a societal perspective, the adjusted probability that early intervention was cost-effective was 1, and the INB was €19 928 per person (95% CI - €2075 to €41 931). CONCLUSIONS Early intervention has a modest INB from the health sector perspective and a large INB from the societal perspective. The perspective chosen is critical when presenting results of an economic evaluation of a complex intervention.
Collapse
Affiliation(s)
- Caragh Behan
- Clinical Research Fellow, Dublin and East Treatment and Early Care Team (DETECT); and Clinical Research Fellow, School of Medicine, University College Dublin, Ireland
| | - Brendan Kennelly
- Lecturer and Programme Director (Health Economics MSc), Department of Economics, National University of Ireland Galway, Ireland
| | - Eric Roche
- Clinical Research Fellow, DETECT; and Clinical Research Fellow, School of Medicine, University College Dublin, Ireland
| | - Laoise Renwick
- Clinical Nurse Specialist, HRB Nursing and Midwifery Fellow, DETECT, Ireland
| | | | - John Lyne
- Consultant Psychiatrist, Beaumont Hospital, Dublin; and Honorary Senior Lecturer, Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland
| | - Brian O'Donoghue
- Senior Research Fellow, Orygen National Centre of Excellence in Youth Mental Health; and Senior Research Fellow, University of Melbourne, Australia
| | - John Waddington
- Professor of Neuroscience, Faculty of Medicine and Health Sciences, Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Ireland
| | - Catherine McDonough
- Consultant Psychiatrist and Clinical Lead, COPE Early Intervention Service, Cavan and Monaghan Mental Health Services, Ireland
| | - Paul McCrone
- Professor of Health Economics, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mary Clarke
- Clinical Lead, DETECT; and Associate Clinical Professor of Psychiatry, Department of Psychiatry, School of Medicine, University College Dublin, Ireland
| |
Collapse
|
10
|
Roche E, O'Sullivan R, Gunawardena S, Cannon M, Lyne JP. Higher rates of disengagement among young adults attending a general adult community mental health team: Time to consider a youth-specific service? Early Interv Psychiatry 2020; 14:330-335. [PMID: 31368245 DOI: 10.1111/eip.12860] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 01/01/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022]
Abstract
AIM The initial onset of mental illness occurs most frequently in adolescence or early adulthood. In order to inform the development of mental health services tailored for youth, we sought to compare the characteristics of young (18-25 years old) and older (over 25 years old) adults following referral to a general adult community mental health team. METHODS All individuals referred to a Dublin-based community mental health team and offered an appointment between January 1 and December 31, 2016 were included in the study. Information in relation to engagement patterns, demographic characteristics and clinical characteristics was collected. RESULTS A total of 298 appointments were offered during the study period among which 94 (31.6%) were for young adults. Significant differences in demographic and clinical characteristics between the two age groups were evident. Young adults were significantly less likely to have been prescribed psychotropic medication at the point of referral (63% vs. 82% respectively, χ2 = 12.30, p < .001). Older adults were four times more likely to demonstrate a good level of early engagement in treatment than young adults (AOR 4.00, 95% CI 1.11-14.37, p = .03). CONCLUSIONS Young adults had distinct clinical needs and a lower level of engagement in the early stage of treatment compared with their older counterparts in this community team. Further research and stakeholder consultation is needed to more clearly identify the issues in relation to patient engagement. These insights will help to inform the development of youth-specific community mental health services.
Collapse
Affiliation(s)
- Eric Roche
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Swords Community Adult Mental Health Service, Dublin, Ireland
| | | | | | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Paul Lyne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Swords Community Adult Mental Health Service, Dublin, Ireland
| |
Collapse
|
11
|
Feighan SM, Hughes M, Maunder K, Roche E, Gallagher L. A profile of mental health and behaviour in Prader-Willi syndrome. J Intellect Disabil Res 2020; 64:158-169. [PMID: 31849130 DOI: 10.1111/jir.12707] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 07/18/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a neurogenetic syndrome with an associated behavioural phenotype and a high incidence of behaviours of concern and psychiatric co-morbidity. These associated behaviours and co-morbidities are not well addressed by existing interventions, and they impact significantly on affected individuals and their caregivers. METHODS We undertook a national survey of the needs of individuals with PWS and their families in Ireland. In this paper, we report on the parent/caregiver-reported mental health, behavioural and access to services. RESULTS Over 50% of individuals with PWS in this survey had at least one reported psychiatric diagnosis, the most common diagnosis was anxiety. The most commonly reported behaviours in children were skin picking, repetitive questioning, difficulty transitioning and non-compliance. The same four behaviours were reported by caregivers as being the most commonly occurring in adolescents and adults in addition to food-seeking behaviours. Increased needs for mental health services were also reported by caregivers. Individuals with PWS had an average wait of 22 months for an appointment with a psychologist and 4 months for an appointment with a psychiatrist. CONCLUSION This study highlighted high levels of psychiatric co-morbidities and behavioural concerns in individuals with PWS in Ireland. The findings of this study suggest that there is an urgent need to provide specialist psychiatric and behavioural interventions to manage complex mental health and behavioural needs to better support individuals with PWS and reduce caregiver burden.
Collapse
Affiliation(s)
- S-M Feighan
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - M Hughes
- Prader-Willi Syndrome Association of Ireland, Dublin, Ireland
| | - K Maunder
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - E Roche
- Department of Paediatrics, Trinity College Dublin, Dublin, Ireland
| | - L Gallagher
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
12
|
Pacaud R, Thomas S, Roche E, Pawlowska N, Munster P. Abstract P6-21-10: Not presented. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-21-10] [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: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the conference.
Citation Format: Pacaud R, Thomas S, Roche E, Pawlowska N, Munster P. Not presented [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-21-10.
Collapse
Affiliation(s)
- R Pacaud
- University of California San Francisco, San Francisco, CA
| | - S Thomas
- University of California San Francisco, San Francisco, CA
| | - E Roche
- University of California San Francisco, San Francisco, CA
| | - N Pawlowska
- University of California San Francisco, San Francisco, CA
| | - P Munster
- University of California San Francisco, San Francisco, CA
| |
Collapse
|
13
|
Lyne J, O'Donoghue B, Roche E, Renwick L, Cannon M, Clarke M. Negative symptoms of psychosis: A life course approach and implications for prevention and treatment. Early Interv Psychiatry 2018; 12:561-571. [PMID: 29076240 DOI: 10.1111/eip.12501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/29/2017] [Accepted: 08/20/2017] [Indexed: 01/09/2023]
Abstract
AIM Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development. METHODS A literature search was conducted for life course approach of negative symptoms using PubMed. Further articles were included following manual checking of reference lists and other search strategies. The paper contains a theoretical synthesis of the literature, summarized using conceptual models. RESULTS Negative symptom definitions are compared and considered within a context of the life course. Previous studies suggest that several illness phases may contribute to negative symptoms, highlighting our uncertainty in relation to the origin of negative symptoms. CONCLUSIONS Similar to other aspects of schizophrenia, negative symptoms likely involve a complex interplay of several risk and protective factors at different life phases. Concepts suggested in this article, such as "negative symptom reserve" theory, require further research, which may inform future prevention and treatment strategies.
Collapse
Affiliation(s)
- John Lyne
- Royal College of Surgeons in Ireland, North Dublin Mental Health Service, Ashlin Centre, Dublin, Ireland.,Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre of Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.,Saint John of God Community Services Ltd, Blackrock, Co., Dublin, Ireland
| |
Collapse
|
14
|
Sutton M, O'Keeffe D, Frawley T, Madigan K, Fanning F, Lawlor E, Roche E, Kelly A, Turner N, Horenstein A, O'Callaghan E, Clarke M. Feasibility of a psychosis information intervention to improve mental health literacy for professional groups in contact with young people. Early Interv Psychiatry 2018; 12:234-239. [PMID: 28102617 DOI: 10.1111/eip.12410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/20/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess the feasibility of a psychosis information intervention for professionals in contact with young people in Ireland. A quasi-experimental pre- and post-intervention design was used. One thousand and thirty-two professionals received an information intervention designed to improve mental health literacy (MHL) and confidence in providing help to people with psychosis. Seven hundred and fifty-five participants completed the Psychosis Information and Confidence Questionnaire pre- and post-intervention. The information intervention significantly improved participants': (1) knowledge of psychosis; (2) ability to recognize signs and symptoms of psychosis; (3) awareness of how to access services; and (4) confidence in providing help to people experiencing psychosis. Findings provide promising support for the intervention's feasibility and acceptability. The intervention enhanced MHL regarding psychosis among professionals in contact with young people. Further research assessing if such improvements translate to the facilitation of appropriate help seeking, the enhanced early detection of psychosis and a reduction of the duration of untreated psychosis is required.
Collapse
Affiliation(s)
- Marie Sutton
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Donal O'Keeffe
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Timothy Frawley
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Kevin Madigan
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,Royal College of Surgeons in Ireland, Institute of Leadership, Dublin, Ireland
| | | | | | - Eric Roche
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Aine Kelly
- Saint John of God Hospitaller Services, Research Department, Dublin, Ireland
| | - Niall Turner
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Arielle Horenstein
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,Department of Psychology, Boston University, Boston, Massachusetts
| | - Eadbhard O'Callaghan
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
15
|
Das A, Datta S, Roche E, Chaffee S, Jose E, Shi L, Grover K, Khanna S, Sen CK, Roy S. Novel mechanisms of Collagenase Santyl Ointment (CSO) in wound macrophage polarization and resolution of wound inflammation. Sci Rep 2018; 8:1696. [PMID: 29374192 PMCID: PMC5786052 DOI: 10.1038/s41598-018-19879-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022] Open
Abstract
Collagenases are useful in enzymatic wound debridement. Clostridial collagenase, marketed as Collagenase Santyl Ointment (CSO), is FDA approved for such use. Building on the scientific premise that collagenases as well as collagen degradation products may regulate immune cell function, we sought to investigate the potential role of CSO in wound inflammation. We tested the hypothesis that in addition to enacting debridement, CSO contributes to the resolution of persistent wound inflammation. Wound macrophages were isolated from PVA sponges loaded with CSO or petrolatum and implanted in mice. Significant increase in pro-reparative and decrease in pro-inflammatory polarization was noted in macrophages of acute as well as diabetic wounds. Wound macrophages from CSO-treated group displayed increased production of anti-inflammatory cytokines IL-10 and TGF-β, and decreased levels of pro-inflammatory cytokines TNF-α and IL-1β. The active ingredient of CSO, CS-API, induced the expression of mϕheal /M(IL-4) polarization markers ex vivo. CS-API treatment attenuated transactivation of NF-κB and significantly induced STAT6 phosphorylation. A significant role of a novel PGE2-EP4 pathway in CS-API induced STAT6 activation and the mϕheal /M(IL-4) polarization was identified. Taken together, findings of this work reposition CSO as a potential agent that may be effective in resolving wound inflammation, including diabetic wounds.
Collapse
Affiliation(s)
- Amitava Das
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Soma Datta
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Eric Roche
- Research & Development, Smith & Nephew, Inc., Fort Worth, Texas, USA
| | - Scott Chaffee
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Elizabeth Jose
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lei Shi
- Research & Development, Smith & Nephew, Inc., Fort Worth, Texas, USA
| | - Komel Grover
- Research & Development, Smith & Nephew, Inc., Fort Worth, Texas, USA
| | - Savita Khanna
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Chandan K Sen
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sashwati Roy
- Department of Surgery, Center for Regenerative Medicine and Cell Based Therapies and Comprehensive Wound Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| |
Collapse
|
16
|
Harnoss B, Akkersdijk G, Braithwaite B, Hnatek L, Roche E, Santoro P, Sarlija M, Sezgin Y, Nio D, Ajduk M, Koios D, Camci M. Effectivness and tolerability of bipolar radiofrequency-induced thermotherapy for the treatment of incompetent saphenous veins. Phlebologie 2018. [DOI: 10.1055/s-0037-1622251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryEndoluminal techniques such as laser therapy, radiofrequency therapy and sclerotherapy are increasingly replacing classic stripping for the treatment of incompetent saphenous veins. Interim results of the ongoing international, multicentre BRITTIV study to investigate the effectiveness and tolerability of the minimally invasive bipolar radiofrequency-induced thermal therapy (RFITT) are presented. Patients, methods: A flexible bipolar RFITT applicator is passed under ultrasound control into the affected vein of patients with varicosis of the great saphenous vein (GSV) or small saphenous vein (SSV). The vein is occluded by impedance-controlled release of radiofrequency energy as the RFITT applicator is slowly and smoothly withdrawn. The effectivness and tolerability of RFITT is checked over a one-year period by regular follow-ups. Results: To date a total of 345 saphenous veins (90% GSV, 10% SSV) in 271 patients (average age 50 years, 63% women, mean CEAP score 2.8) have been treated with RFITT in eight European hospitals. 72% of patients underwent general anaesthesia (18% spinal, 11% local) and tumescent anaesthesia was also used in 83% of the veins (mean length 45 cm). The average application time was 1.4 s/cm with a mean power output of 24 Watt. At the interim analysis after an average follow-up of 103 days, 90% of 335 treated veins were occluded. Differential analysis showed that partial (P) and complete (C) recurrences occurred significantly less often when longer application times had been used, whereby complete recurrences showed a greater reduction in frequency than partial. The total recurrence rate with an application time < 1 s/cm was 22% (P = 10%, C = 12%); with an application time between 1.0 and 1.4 s/cm it had already fallen to 9% (P = 6%, C = 3%) and with a time greater than 1.4 s/cm it was only 4% (P = 3%, C = 1%). According to subjective pain assessment on a visual analogue scale (VAS) of 0 to 10 (corresponding to no pain up to the strongest conceivable pain), by the first day after treatment already 74% of those questioned had only slight remaining pain or none at all (VAS 0–2). This generally low subjective pain sensation continued to fall at subsequent followups and at the 6-month follow-up, 99% of patients reported a VAS score of 0. Nearly all patients (99%) were satisfied with the treatment and would recommend it to others. Conclusions: With the same power output, even a minor increase in the application time to more than 1.4 s/cm can markedly reduce recurrence rate. In summary, the ongoing BRITTIV study illustrates the potential of RFITT for use in phlebology as it combines a spatially-defined obliteration of incompetent saphenous veins with overall moderate side effects and impressive results.
Collapse
|
17
|
Baglan N, Cossonnet C, Roche E, Kim SB, Croudace I, Warwick P. Feedback of the third interlaboratory exercise organised on wheat in the framework of the OBT working group. J Environ Radioact 2018; 181:52-61. [PMID: 29100110 DOI: 10.1016/j.jenvrad.2017.09.009] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 06/07/2023]
Abstract
Organically bound tritium (OBT) has become of increasing interest within the last decade, with a focus on its behaviour and also its analysis, which are both important to assess tritium distribution in the environment and dose consequences. After the first OBT International Workshop which was held in France in May 2012, an international working group was created. The expected benefits are the following: remove or reduce uncertainty in OBT analysis results, provide better OBT model validation data and better public dose results, increase the number of potential measuring OBT laboratories, validate all of the stages of the procedures based on a larger population and more statistically significant results, and investigate the feasibility of CRM's and RM's production. In this framework, three OBT exercises were organised; the 1st one on potatoes was conducted in 2013 by the Canadian National Laboratories (former AECL) with about 20 participating labs from around the world, the 2nd one on a sediment was organised in 2014 by GAU Radioanalytical (University of Southampton) on a sediment with again about 20 participating labs and the third one on wheat was organised in 2015 by the Commissariat à l'énergie atomique (CEA) with about 25 participating labs.
Collapse
Affiliation(s)
- N Baglan
- CEA/DAM/DIF, F91297 Arpajon, France.
| | - C Cossonnet
- IRSN/PRP-ENV/STEME/LMRE, Bât 501, Bois des Rames, 91400 Orsay, France
| | - E Roche
- CEA/DAM/DIF, F91297 Arpajon, France
| | - S B Kim
- Environmental Technologies Branch, Nuclear Science Division, Chalk River Laboratories, CNL, Canada
| | - I Croudace
- GAU-Radioanalytical, University of Southampton, NOCS, European way, SO14 6HT Southampton, UK
| | - P Warwick
- GAU-Radioanalytical, University of Southampton, NOCS, European way, SO14 6HT Southampton, UK
| |
Collapse
|
18
|
Cox R, Roche E, Fairley S. Novel oral anticoagulant drugs and severe oesophagitis dissecans. Intern Med J 2017; 46:1456-1457. [PMID: 27981772 DOI: 10.1111/imj.13275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- R Cox
- Department of Gastroenterology, The Townsville Hospital, Townsville, Queensland, Australia
| | - E Roche
- Department of Gastroenterology, The Townsville Hospital, Townsville, Queensland, Australia
| | - S Fairley
- Department of Gastroenterology, The Townsville Hospital, Townsville, Queensland, Australia
| |
Collapse
|
19
|
Renwick L, Owens L, Lyne J, O'Donoghue B, Roche E, Drennan J, Sheridan A, Pilling M, O'Callaghan E, Clarke M. Predictors of change in social networks, support and satisfaction following a first episode psychosis: A cohort study. Int J Nurs Stud 2017; 76:28-35. [PMID: 28910597 DOI: 10.1016/j.ijnurstu.2017.08.015] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 07/04/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Diminished social networks are common in psychosis but few studies have measured these comprehensively and prospectively to determine how networks and support evolve during the early phase. There is little information regarding perceived support in the early phase of illness. The aim of this study was to describe social support, networks and perceived satisfaction, explore the clinical correlates of these outcomes and examine whether phases of untreated psychosis are linked with social network variables to determine potential opportunities for intervention. METHODS During the study period, we assessed 222 people with first-episode psychosis at entry into treatment using valid and reliable measures of diagnosis, positive and negative symptoms, periods of untreated psychosis and prodrome and premorbid adjustment. For follow-up we contacted participants to conduct a second assessment (n=158). There were 97 people who participated which represented 61% of those eligible. Social network and support information obtained at both time points included the number of friends, self-reported satisfaction with support and social network size and clinician's evaluation of the degree of support received through networks. Mixed effects modelling determined the contribution of potential explanatory variables to social support measured. RESULTS A number of clinical variables were linked with social networks, support and perceived support and satisfaction. The size of networks did not change over time but those with no friends and duration of untreated psychosis was significantly longer for those with no friends at entry into treatment (n=129, Median=24.5mths, IQR=7.25-69.25; Mann-Whitney U=11.78, p=0.008). Social support at baseline and at one year was predicted by homelessness (t=-2.98, p=0.001, CI -4.74 to -1.21), duration of untreated psychosis (t=-0.86, p=0.031, CI -1.65 to -0.08) and premorbid adjustment (t=-2.26, p=0.017, CI -4.11 to -0.42). Social support improved over time but the duration of untreated psychosis was not linked with the rate of improvement in this outcome. CONCLUSIONS Improved social support could indicate greater reliance on social support or becoming more adept at mobilising resources to meet social needs. Particularly vulnerable groups with very long duration of untreated psychosis confirm the need for earlier intervention or targeted social network interventions to preserve social connectedness.
Collapse
Affiliation(s)
- Laoise Renwick
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.
| | - Liz Owens
- DETECT Early Psychosis Service, Dublin, Ireland
| | - John Lyne
- DETECT Early Psychosis Service, Dublin, Ireland; North Dublin Mental Health Services, Dublin, Ireland
| | - Brian O'Donoghue
- DETECT Early Psychosis Service, Dublin, Ireland; Orygen, the National Centre for Excellence in Youth Mental Health, Melbourne, Australia
| | - Eric Roche
- DETECT Early Psychosis Service, Dublin, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Ann Sheridan
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland
| | - Mark Pilling
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Eadbhard O'Callaghan
- DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland
| |
Collapse
|
20
|
Ranieri V, Madigan K, Roche E, McGuinness D, Bainbridge E, Feeney L, Hallahan B, McDonald C, O'Donoghue B. Caregiver burden and distress following the patient's discharge from psychiatric hospital. BJPsych Bull 2017; 41:87-91. [PMID: 28400966 PMCID: PMC5376724 DOI: 10.1192/pb.bp.115.053074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aims and method Caring for someone with a mental illness is increasingly occurring within the community. As a result, family members who fulfil a caregiving role may experience substantial levels of burden and psychological distress. This study investigates the level of burden and psychological distress reported by caregivers after the patient's admission. Results This study found that the overall level of burden and psychological distress experienced by caregivers did not differ according to the patient's legal status. However, the caregivers of those who were voluntarily admitted supervised the person to a significantly greater extent than the caregivers of those who were involuntarily admitted. Approximately 15% of caregivers revealed high levels of psychological distress. Clinical implications This study may emphasise a need for mental health professionals to examine the circumstances of caregivers, particularly of those caring for patients who are voluntarily admitted, a year after the patient's admission.
Collapse
Affiliation(s)
| | - Kevin Madigan
- Cluain Mhuire Community Mental Health Service, Blackrock, Co Dublin, Ireland
| | - Eric Roche
- DETECT, Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - David McGuinness
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Emma Bainbridge
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Larkin Feeney
- Cluain Mhuire Community Mental Health Service, Blackrock, Co Dublin, Ireland
| | - Brian Hallahan
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Colm McDonald
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia; Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| |
Collapse
|
21
|
Cox R, Welch C, Cameron D, Roche E. Gastrointestinal: Verrucous cell carcinoma (VCC) of the esophagus: A rare variant of esophageal squamous cell carcinoma (SCC). J Gastroenterol Hepatol 2017; 32:544. [PMID: 28320062 DOI: 10.1111/jgh.13513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/09/2022]
Affiliation(s)
- R Cox
- Department of Gastroenterology, The Townsville Hospital, Douglas, Queensland, Australia
| | - C Welch
- Department of Gastroenterology, The Townsville Hospital, Douglas, Queensland, Australia
| | - D Cameron
- Department of General Surgery, The Townsville Hospital, Douglas, Queensland, Australia
| | - E Roche
- Department of Gastroenterology, The Townsville Hospital, Douglas, Queensland, Australia
| |
Collapse
|
22
|
Roche E, Lyne J, O'Donoghue B, Segurado R, Behan C, Renwick L, Fanning F, Madigan K, Clarke M. The prognostic value of formal thought disorder following first episode psychosis. Schizophr Res 2016; 178:29-34. [PMID: 27639419 DOI: 10.1016/j.schres.2016.09.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/09/2016] [Accepted: 09/09/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Formal thought disorder (FTD) is associated with poor outcome in established psychotic illnesses and it can be assessed as a categorical or dimensional variable. However, its influence on functional outcome and hospitalisation patterns in early psychosis has not been investigated. We evaluated the relationship between FTD and these outcomes in a first episode psychosis (FEP) sample. MATERIALS AND METHODS A mixed diagnostic FEP cohort was recruited through an Early Intervention in Psychosis Service in Ireland. Participants were assessed at initial presentation and one year later with the MIRECC GAF to evaluate social and occupational functioning domains. Disorganisation (disFTD), verbosity (verFTD) and poverty (povFTD) dimensions of FTD were examined at both time points, as well as a unitary FTD construct. Analyses were controlled for demographic, clinical and treatment variables. RESULTS DisFTD was the only FTD dimension associated with functional outcome, specifically social functioning, on multivariate analysis (beta=0.13, P<0.05). The unitary FTD construct was not associated with functional outcome. DisFTD at FEP presentation predicted a greater number of hospitalisations (adjusted beta=0.24, P<0.001) and prolonged inpatient admission (adjusted OR=1.08, 95% CI 1.02-1.15, P<0.05) following FEP. CONCLUSIONS Longitudinal and dimensional evaluation of FTD has a clinical utility that is distinct from a cross-sectional or unitary assessment. Dimensions of FTD may map onto different domains of functioning. These findings are supportive of some of the changes in DSM-V with an emphasis on longitudinal and dimensional appraisal of psychopathology. Communication disorders may be considered a potential target for intervention in psychotic disorders.
Collapse
Affiliation(s)
- Eric Roche
- DETECT Early Intervention in Psychosis Service, Blackrock Business Park, Blackrock, Dublin, Ireland.
| | - John Lyne
- Royal College of Surgeons in Ireland and North Dublin Mental Health Services, Ashlin Centre, Beaumont Road, Dublin 9, Ireland
| | - Brian O'Donoghue
- Orygen, National Centre for Excellence in Youth Mental Health, Melbourne, Australia
| | - Ricardo Segurado
- Centre for Support and Training in Analysis and Research, University College Dublin, Ireland
| | - Caragh Behan
- DETECT Early Intervention in Psychosis Service, Blackrock Business Park, Blackrock, Dublin, Ireland
| | - Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, UK
| | - Felicity Fanning
- DETECT Early Intervention in Psychosis Service, Blackrock Business Park, Blackrock, Dublin, Ireland
| | - Kevin Madigan
- DETECT Early Intervention in Psychosis Service, Blackrock Business Park, Blackrock, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Blackrock Business Park, Blackrock, Dublin, Ireland
| |
Collapse
|
23
|
Roche E. Opciones terapéuticas de las varices. Angiología 2016. [DOI: 10.1016/j.angio.2016.05.008] [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]
|
24
|
Forestier-Jouve C, Neree M, de-Cornulier J, Romanet M, Blot S, Intrup J, Roche E, Ageron S, Bouyanzer K, Martineau E. Délégation médicale de compétence pour la radiothérapie guidée par l’image : compagnonnage médecin/manipulatrice référente/manipulatrice. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.096] [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: 11/30/2022]
|
25
|
Roche E. En referencia al artículo: «Reclamaciones médico-legales y cirugía de varices. Peritajes de un cirujano vascular durante 25 años y revisión de la literatura». Angiología 2016. [DOI: 10.1016/j.angio.2016.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
26
|
O'Donoghue B, Roche E, Lane A. Neighbourhood level social deprivation and the risk of psychotic disorders: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2016; 51:941-50. [PMID: 27178430 DOI: 10.1007/s00127-016-1233-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 05/04/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE The incidence of psychotic disorders varies according to the geographical area, and it has been investigated whether neighbourhood level factors may be associated with this variation. The aim of this systematic review is to collate and appraise the literature on the association between social deprivation and the incidence or risk for psychotic disorders. METHOD A systematic review was conducted, and studies were included if they were in English, provided a measure of social deprivation for more than one geographically defined area and examined either the correlation, rate ratio or risk of psychotic disorder. A defined search strategy was undertaken with Medline, CINAHL Plus and PsychInfo databases. RESULTS A total of 409 studies were identified in the search, of which 28 fulfilled the inclusion criteria. Of these, four examined the association between social deprivation at the time of birth, three examined the putative prodrome of psychosis or those at ultra-high risk (UHR) for psychosis, and 23 examined the time at presentation with a first episode of psychosis (FEP) (one study examined two time points and one study included both UHR and FEP). Three of the studies that examined the level of social deprivation at birth found an association with a higher risk for psychotic disorders and increased social deprivation. Seventeen of the 23 studies found that there was a higher risk or rate of psychotic disorders in more deprived neighbourhoods at the time of presentation; however, adjusting for individual factors tended to weaken this association. Limited research has been conducted in the putative prodromal stage and has resulted in conflicting findings. CONCLUSIONS Research conducted to date has not definitively identified whether the association is a result of social causation or social drift; however, the findings do have significant implications for service provision, such as the location and access of services.
Collapse
Affiliation(s)
- Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar rd, Parkville, VIC, 3052, Australia.
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Eric Roche
- University College Dublin, Belfield, Dublin 4, Ireland
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Abbie Lane
- University College Dublin, Belfield, Dublin 4, Ireland
| |
Collapse
|
27
|
Roche E, Segurado R, Renwick L, McClenaghan A, Sexton S, Frawley T, Chan CK, Bonar M, Clarke M. Language disturbance and functioning in first episode psychosis. Psychiatry Res 2016; 235:29-37. [PMID: 26699880 DOI: 10.1016/j.psychres.2015.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/19/2015] [Accepted: 12/08/2015] [Indexed: 12/11/2022]
Abstract
Language disturbance has a central role in the presentation of psychotic disorders however its relationship with functioning requires further clarification, particularly in first episode psychosis (FEP). Both language disturbance and functioning can be evaluated with clinician-rated and performance-based measures. We aimed to investigate the concurrent association between clinician-rated and performance-based measures of language disturbance and functioning in FEP. We assessed 108 individuals presenting to an Early Intervention in Psychosis Service in Ireland. Formal thought disorder (FTD) dimensions and bizarre idiosyncratic thinking (BIT) were rated with structured assessment tools. Functioning was evaluated with a performance-based instrument, a clinician-rated measure and indicators of real-world functioning. The disorganisation dimension of FTD was significantly associated with clinician-rated measures of occupational and social functioning (Beta=-0.19, P<0.05 and Beta=-0.31, P<0.01, respectively). BIT was significantly associated with the performance-based measure of functioning (Beta=-0.22, P<0.05). Language disturbance was of less value in predicting real-world measures of functioning. Clinician-rated and performance-based assessments of language disturbance are complementary and each has differential associations with functioning. Communication disorders should be considered as a potential target for intervention in FEP, although further evaluation of the longitudinal relationship between language disturbance and functioning should be undertaken.
Collapse
Affiliation(s)
- Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| | - Ricardo Segurado
- UCD CSTAR, School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin, Ireland.
| | - Laoise Renwick
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Nursing, Midwifery and Social Work, University of Manchester, UK.
| | - Aisling McClenaghan
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland.
| | - Sarah Sexton
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland.
| | - Timothy Frawley
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland.
| | - Carol K Chan
- School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| | - Maurice Bonar
- School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| |
Collapse
|
28
|
Fuster-Muñoz E, Roche E, Funes L, Martínez-Peinado P, Sempere JM, Vicente-Salar N. Effects of pomegranate juice in circulating parameters, cytokines, and oxidative stress markers in endurance-based athletes: A randomized controlled trial. Nutrition 2015; 32:539-45. [PMID: 26778544 DOI: 10.1016/j.nut.2015.11.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of the present study was to assess the effects of pomegranate juice on the level of oxidative stress in the blood of endurance-based athletes. Pomegranate juice is rich in polyphenols, conferring it a higher antioxidant capacity than other beverages with polyphenolic antioxidants. METHODS A randomized double-blind, multicenter trial was performed in athletes from three different sport clubs located in southeastern of Spain. Plasma oxidative stress markers (protein carbonyls and malondialdehyde [MDA]) as well as C-reactive protein and sE-selectin were measured. Thirty-one athletes participated in the study. Participants were divided into three groups. The first group was supplemented with 200 mL/d pomegranate juice (PJ; n = 10) over a 21-d period, the second with 200 mL/d pomegranate juice diluted 1:1 with water (PJD; n = 11), and a control group that did not consume pomegranate juice (C; n = 10). Nine athletes were excluded due to protocol violations (n = 4 in the PJ group and n = 5 in the PJD group) because they did not observe the 24 h of rest before the last blood test. RESULTS The control group increased levels of carbonyls (+0.7 ± 0.3 nmols/mg protein) and MDA (+3.2 ± 1.0 nmols/g protein), whereas the PJ and PJD groups maintained or decreased their levels, respectively. On the other hand, lactate levels increased in the PJ group (from 10.3 at day 0 to 21.2 mg/dL at day 22). A nonsignificant decrease was detected in sE-selectin and C-reactive protein in the groups consuming pomegranate juice. CONCLUSION Consumption of pomegranate juice over a 21-d period improved MDA levels and carbonyls, and thus decreased the oxidative damage caused by exercise.
Collapse
Affiliation(s)
- E Fuster-Muñoz
- Toxicology Unit, Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante), Spain
| | - E Roche
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante), Spain
| | - L Funes
- Quality and Innovation Department, Vitalgrana Pomegranate SL. Polígono Industrial de Poniente, Catral (Alicante), Spain
| | - P Martínez-Peinado
- Immunology Division, Biotechnology Department, University of Alicante, San Vicente del Raspeig (Alicant), Spain
| | - J M Sempere
- Immunology Division, Biotechnology Department, University of Alicante, San Vicente del Raspeig (Alicant), Spain
| | - N Vicente-Salar
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante), Spain.
| |
Collapse
|
29
|
Doblas A, Roche E, Ampudia-Blasco FJ, Martínez-Corral M, Saavedra G, Garcia-Sucerquia J. Diabetes screening by telecentric digital holographic microscopy. J Microsc 2015; 261:285-90. [PMID: 26501512 DOI: 10.1111/jmi.12331] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 07/14/2015] [Accepted: 09/15/2015] [Indexed: 02/04/2023]
Abstract
Diabetes is currently the world's fastest growing chronic disease and it is caused by deficient production of insulin by the endocrine pancreas or by abnormal insulin action in peripheral tissues. This results in persistent hyperglycaemia that over time may produce chronic diabetic complications. Determination of glycated haemoglobin level is currently the gold standard method to evaluate and control sustained hyperglycaemia in diabetic people. This measurement is currently made by high-performance liquid chromatography, which is a complex chemical process that requires the extraction of blood from the antecubital vein. To reduce the complexity of that measurement, we propose a fully-optical technique that is based in the fact that there are changes in the optical properties of erythrocytes due to the presence of glucose-derived adducts in the haemoglobin molecule. To evaluate these changes, we propose to perform quantitative phase maps of erythrocytes by using telecentric digital holographic microscopy. Our experiments show that telecentric digital holographic microscopy allows detecting, almost in real time and from a single drop of blood, significant differences between erythrocytes of diabetic patients and healthy patients. Besides, our phase measurements are well correlated with the values of glycated haemoglobin and the blood glucose values.
Collapse
Affiliation(s)
- A Doblas
- 3D Imaging and Display Laboratory, Department of Optics, University of Valencia, E-46100 Burjassot, Spain
| | - E Roche
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University of Miguel Hernandez, E-03203 Elche, Spain
| | - F J Ampudia-Blasco
- Diabetes Reference Unit, Department of Endocrinology and Nutrition, Valencia Clinic University Hospital, E-46010 Valencia, Spain
| | - M Martínez-Corral
- 3D Imaging and Display Laboratory, Department of Optics, University of Valencia, E-46100 Burjassot, Spain
| | - G Saavedra
- 3D Imaging and Display Laboratory, Department of Optics, University of Valencia, E-46100 Burjassot, Spain
| | - J Garcia-Sucerquia
- School of Physics, Universidad Nacional de Colombia Sede Medellin, A.A: 3840-Medellin-050034-, Colombia
| |
Collapse
|
30
|
Abstract
BACKGROUND Sickness certification poses significant challenges to most general practitioners (GPs). As an alternative form of certification, in 2010, the UK implemented the 'fit note', which focuses on returning to work after illness. It has been well received in the UK but little is known of non-UK GP attitudes towards the fit note. AIMS To evaluate the challenges Irish GPs experience with the current sickness certification system and their attitudes towards the fit note. METHODS A questionnaire assessing attitudes, practices and preferences regarding the fit note was developed, piloted and posted to a representative sample of Irish GPs selected by systematic sampling. Descriptive statistics, chi-square tests and binary logistic regression were used to analyse the results. RESULTS Of 305 GPs surveyed, 64% (196) completed the survey. Ninety per cent (177) of responders reported a lack of available rehabilitation services for patients on sick leave and 66% (124) reported adverse effects of sickness certification on therapeutic relationships with patients. Those who indicated a preference for introducing the fit note (53%; 104) were significantly more likely to endorse both an excessive focus on disability [odds ratio (OR) = 3.16] and lack of GP training (OR = 2.04) in the sickness certification process. CONCLUSIONS Difficulties associated with sickness certification are apparent at GP-patient, GP-employer and GP-health service levels. Addressing these will require intervention at each of these levels and may be facilitated by challenging the assumption that illness equates to disability.
Collapse
Affiliation(s)
- R King
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland,
| | - R Murphy
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - A Wyse
- School of Medicine, Royal College of Surgeons of Ireland, 123 St Stephen's Green, Dublin 2, Ireland
| | - E Roche
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland
| |
Collapse
|
31
|
Roche E, Lyne JP, O'Donoghue B, Segurado R, Kinsella A, Hannigan A, Kelly BD, Malone K, Clarke M. The factor structure and clinical utility of formal thought disorder in first episode psychosis. Schizophr Res 2015; 168:92-8. [PMID: 26260080 DOI: 10.1016/j.schres.2015.07.049] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 07/28/2015] [Accepted: 07/28/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Formal thought disorder (FTD) is a core feature of psychosis, however there are gaps in our knowledge about its prevalence and factor structure. We had two aims: first, to establish the factor structure of FTD; second, to explore the clinical utility of dimensions of FTD in order to further the understanding of its nosology. METHODS A cross-validation study was undertaken to establish the factor structure of FTD in first episode psychosis (FEP). The relative utility of FTD categories vs. dimensions across diagnostic categories was investigated. RESULTS The prevalence of clinically significant FTD in this FEP sample was 21%, although 41% showed evidence of disorganised speech, 20% displayed verbosity and 24% displayed impoverished speech. A 3-factor model was identified as the best fit for FTD, with disorganisation, poverty and verbosity dimensions (GFI=0.99, RMR=0.07). These dimensions of FTD accurately distinguished affective from non-affective diagnostic categories. A categorical approach to FTD assessment was useful in identifying markers of clinical acuteness, as identified by short duration of untreated psychosis (OR=2.94, P<0.01) and inpatient treatment status (OR=3.98, P<0.01). CONCLUSION FTD is moderately prevalent and multi-dimensional in FEP. Employing both a dimensional and categorical assessment of FTD gives valuable clinical information, however there may be a need to revise our conceptualisation of the nosology of FTD. The prognostic value of FTD, as well as its neural basis, requires elucidation.
Collapse
Affiliation(s)
- Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| | - John Paul Lyne
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; North Dublin Mental Health Services, Beaumont Hospital, Dublin 9, Ireland.
| | - Brian O'Donoghue
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.
| | - Ricardo Segurado
- UCD CSTAR, School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin, Ireland.
| | - Anthony Kinsella
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland.
| | - Ailish Hannigan
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
| | - Brendan D Kelly
- School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland; Mater Misericordiae University Hospital, Dublin, Ireland.
| | - Kevin Malone
- School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland; St Vincent's University Hospital, Dublin, Ireland.
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT) Service, Blackrock, Co Dublin, Ireland; School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland.
| |
Collapse
|
32
|
O'Donoghue B, Roche E, Shannon S, Creed L, Lyne J, Madigan K, Feeney L. Longer term outcomes of voluntarily admitted service users with high levels of perceived coercion. Psychiatry Res 2015; 229:602-5. [PMID: 26189340 DOI: 10.1016/j.psychres.2015.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/20/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
Abstract
Voluntarily admitted service users can report levels of perceived coercion comparable to those admitted involuntarily, yet little is known of this groups longer term outcome. The 'coerced voluntary' had a score of 4 or above on the MacArthur perceived coercion scale and one year after discharge, they had a better therapeutic relationship compared to involuntarily admitted service users. There was no difference between the coerced voluntary, uncoerced voluntary and involuntary groups in engagement, satisfaction and functioning.
Collapse
Affiliation(s)
| | - Eric Roche
- Cluain Mhuire Mental Health Services, Blackrock, CO Dublin
| | - Stephen Shannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Mental Health Commission, Ireland
| | - Lisa Creed
- St John of God Hospitaller Service, Stillorgan, CO Dublin, Ireland
| | - John Lyne
- Department of Psychiatry, St Vincents University Hospital, Dublin, Ireland
| | - Kevin Madigan
- Cluain Mhuire Mental Health Services, Blackrock, CO Dublin; Institute of Leadership, Royal College of Surgeons in Ireland, Dublin , Ireland
| | - Larkin Feeney
- Cluain Mhuire Mental Health Services, Blackrock, CO Dublin
| |
Collapse
|
33
|
Ranieri V, Madigan K, Roche E, Bainbridge E, McGuinness D, Tierney K, Feeney L, Hallahan B, McDonald C, O'Donoghue B. Caregivers' perceptions of coercion in psychiatric hospital admission. Psychiatry Res 2015; 228:380-5. [PMID: 26163727 DOI: 10.1016/j.psychres.2015.05.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 04/28/2015] [Accepted: 05/25/2015] [Indexed: 11/20/2022]
Abstract
While knowledge on service users' perspective on their admissions to psychiatric wards has improved substantially in the last decade, there is a paucity of knowledge of the perspectives of caregivers. This study aimed to determine caregiver's perception of the levels of perceived coercion, perceived pressures and procedural justice experienced by service users during their admission to acute psychiatric in-patient units. The perspective of caregivers were then compared to the perspectives of their related service users, who had been admitted to five psychiatric units in Ireland. Caregivers were interviewed using an adapted version of the MacArthur admission experience interview. Sixty-six caregivers participated in this study and the majority were parents. Seventy one percent of service users were admitted involuntarily and nearly half had a diagnosis of schizophrenia or schizoaffective disorder. Caregivers of involuntarily admitted individuals perceived the service users' admission as less coercive than reported by the service users. Caregivers also perceived a higher level of procedural justice in comparison to the level reported by service users. Reducing the disparity of perceptions between caregivers and service users could result in caregivers having a greater understanding of the admission process and why some service users may be reluctant to be admitted.
Collapse
Affiliation(s)
- Veronica Ranieri
- Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Kevin Madigan
- Cluain Mhuire Mental Health Service, Blackrock, Co Dublin, Ireland
| | - Eric Roche
- DETECT, Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - Emma Bainbridge
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - David McGuinness
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Kevin Tierney
- Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Larkin Feeney
- Cluain Mhuire Mental Health Service, Blackrock, Co Dublin, Ireland
| | - Brian Hallahan
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Colm McDonald
- Clinical Science Institute, National University of Ireland, Galway, Ireland
| | - Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
| |
Collapse
|
34
|
Shannon S, Roche E, Madigan K, Renwick LJ, Dolan C, Devitt P, Feeney L, Murphy KC, O'Donoghue B. Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission. Psychiatr Serv 2015; 66:883-7. [PMID: 25873025 DOI: 10.1176/appi.ps.201400212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The study aimed to determine the number of accumulated coercive events experienced by patients during inpatient admission, the patients' functioning and quality of life (QOL) one year after discharge, and associations between these variables and patient characteristics and between follow-up outcomes and number of accumulated coercive events. METHODS A prospective cohort study was undertaken at three community services and an independent hospital in Ireland (N=162). Accumulated coercive events scores were based on patients' legal status, perceived coercion, and exposure to physical restraint, seclusion, or forced medication. RESULTS Most (68%) experienced at least one coercive event. Lower functioning predicted more coercive events. At follow-up, the mean subjective QOL score was 63% of the highest possible score, objective QOL improved for 15% of participants, and functioning improved for 70%. Accumulated coercive events did not predict these outcomes. CONCLUSIONS Coercive events during psychiatric admission appeared unrelated to functioning and QOL at follow-up.
Collapse
Affiliation(s)
- Stephen Shannon
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Eric Roche
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Kevin Madigan
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Laoise J Renwick
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Catherine Dolan
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Patrick Devitt
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Larkin Feeney
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Kieran C Murphy
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| | - Brian O'Donoghue
- Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014
| |
Collapse
|
35
|
Abstract
BACKGROUND Authors of the Diagnostic and Statistical Manual, Fifth Edition (DSM-V) have recommended to "integrate dimensions into clinical practice." The epidemiology and associated phenomenology of formal thought disorder (FTD) have been described but not reviewed. We aimed to carry out a systematic review of FTD to this end. METHODS A systematic review of FTD literature, from 1978 to 2013, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS A total of 881 abstracts were reviewed and 120 articles met inclusion criteria; articles describing FTD factor structure (n = 15), prevalence and longitudinal course (n = 41), role in diagnosis (n = 22), associated clinical variables (n = 56), and influence on outcome (n = 35) were included. Prevalence estimates for FTD in psychosis range from 5% to 91%. Dividing FTD into domains, by factor analysis, can accurately identify 91% of psychotic diagnoses. FTD is associated with increased clinical severity. Poorer outcomes are predicted by negative thought disorder, more so than the typical construct of "disorganized speech." CONCLUSION FTD is a common symptom of psychosis and may be considered a marker of illness severity. Detailed dimensional assessment of FTD can clarify diagnosis and may help predict prognosis.
Collapse
Affiliation(s)
- Eric Roche
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland;
| | - Lisa Creed
- Cluain Mhuire Community Mental Health Service, Dublin, Ireland
| | | | | | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| |
Collapse
|
36
|
Affiliation(s)
- G Rich
- Department of Gastroenterology, The Townsville Hospital, Queensland, Australia
| | | | | |
Collapse
|
37
|
Sittler C, Schuler M, Caratini C, Chateauneuf JJ, Gruas-Cavagnetto C, Jardine S, Ollivier MF, Roche E, Tissot C. Extension stratigraphique, répartition géographique et écologie de deux genres polliniques paléogènes observés en Europe occidentale:AglaoreidiaetBoehlensipollis. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/00378941.1975.10835657] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
38
|
Gibson C, Roche E. A survey of general practitioners' knowledge and perceived confidence with clinical ophthalmology. Ir Med J 2014; 107:173-175. [PMID: 24988833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The quality of general practitioner (GP) ophthalmology referrals to emergency departments has been reported to be sub-optimal. It is possible that a lack of adequate formal training in ophthalmology for GPs contributes to this situation. Data in this study was obtained from a postal survey of GPs to ascertain their knowledge of, and confidence with, clinical ophthalmology skills as well as their training in this speciality. Undergraduate ophthalmology training was rated as inadequate by 35/50 (70%) respondents. 28 (56%) respondents reported to be confident with their clinical ophthalmology skills. 19 (38%) GPs reported to have good knowledge of ophthalmology, and this was strongly associated with a positive appraisal of their undergraduate ophthalmology training (92%, P < 0.01), having experience working in an ophthalmology department (80%, p = 0.14) and having received GP training abroad (52%, p = 0.16). Regarding ophthalmology equipment, 47 (94%) GPs reported to have an ophthalmoscope but only 33 (66%) were confident with its use and just 20 (40%) could confidently distinguish an abnormal optic disc. Lack of knowledge of ophthalmology may have a significant impact on patient care and could be addressed by including clinical skills training in GP specialist training or continuing professional development schemes.
Collapse
|
39
|
Martínez-Ramonde T, Alonso N, Cordido F, Cervelló E, Cañizares A, Martínez-Peinado P, Sempere J, Roche E. Importance of Exercise in the Control of Metabolic and Inflammatory Parameters at the Moment of Onset in Type 1 Diabetic Subjects. Exp Clin Endocrinol Diabetes 2014; 122:334-40. [DOI: 10.1055/s-0034-1372581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - N. Alonso
- Applied Biology Department and Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante) Spain
| | - F. Cordido
- Endocrinology Service, University Hospital A Coruña (Spain)
| | - E. Cervelló
- Sport Research Centre, University Miguel Hernandez, Elche (Alicante) Spain
| | - A. Cañizares
- Microbiology Department, University Hospital Complex, A Coruña (Spain)
| | | | - J. Sempere
- Biotechnology Department, University of Alicante (Spain)
| | - E. Roche
- Applied Biology Department and Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante) Spain
| |
Collapse
|
40
|
Sempere JM, Martinez-Peinado P, Arribas MI, Reig JA, De La Sen ML, Zubcoff JJ, Fraga MF, Fernández AF, Santana A, Roche E. Single cell-derived clones from human adipose stem cells present different immunomodulatory properties. Clin Exp Immunol 2014; 176:255-65. [PMID: 24666184 PMCID: PMC3992038 DOI: 10.1111/cei.12270] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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] [Accepted: 01/07/2014] [Indexed: 12/18/2022] Open
Abstract
Human adipose mesenchymal stem cells are a heterogeneous population, where cell cultures derived from single-cell-expanded clones present varying degrees of differential plasticity. This work focuses on the immunomodulatory/anti-inflammatory properties of these cells. To this end, five single-cell clones were isolated (generally called 1.X and 3.X) from two volunteers. Regarding the expression level of the lineage-characteristic surface antigens, clones 1·10 and 1·22 expressed the lowest amounts, while clones 3·10 and 3·5 expressed more CD105 than the rest and clone 1·7 expressed higher amounts of CD73 and CD44. Regarding cytokine secretion, all clones were capable of spontaneously releasing high levels of interleukin (IL)-6 and low to moderate levels of IL-8. These differences can be explained in part by the distinct methylation profile exhibited by the clones. Furthermore, and after lipopolysaccharide stimulation, clone 3.X produced the highest amounts of proinflammatory cytokines such as IL-1β, while clones 1·10 and 1·22 highly expressed IL-4 and IL-5. In co-culture experiments, clones 1.X are, together, more potent inhibitors than clones 3.X for proliferation of total, CD3(+) T, CD4(+) T and CD8(+) T lymphocytes and natural killer (NK) cells. The results of this work indicate that the adipose stem cell population is heterogeneous in cytokine production profile, and that isolation, characterization and selection of the appropriate cell clone is a more exact method for the possible treatment of different patients or pathologies.
Collapse
Affiliation(s)
- J M Sempere
- Immunology Division, Biotechnology Department, University of AlicanteSan Vicente del Raspeig, Alicante, Spain
| | - P Martinez-Peinado
- Immunology Division, Biotechnology Department, University of AlicanteSan Vicente del Raspeig, Alicante, Spain
| | - M I Arribas
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, University Miguel HernandezElche, Alicante, Spain
| | - J A Reig
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, University Miguel HernandezElche, Alicante, Spain
| | - M L De La Sen
- Immunology Division, Biotechnology Department, University of AlicanteSan Vicente del Raspeig, Alicante, Spain
| | - J J Zubcoff
- Department of Statistics, University of AlicanteSan Vicente del Raspeig, Alicante, Spain
| | - M F Fraga
- Department of Immunology and Oncology, National Center for Biotechnology, CNB-CSICCantoblanco, Madrid, Spain
- Cancer Epigenetics Laboratory, Institute of Oncology of Asturias (IUOPA), HUCA, University of OviedoOviedo, Asturias, Spain
| | - A F Fernández
- Cancer Epigenetics Laboratory, Institute of Oncology of Asturias (IUOPA), HUCA, University of OviedoOviedo, Asturias, Spain
| | - A Santana
- Research Unit, Gran Canaria Hospital Dr Negrin and Genetic Unit, Childhood Hospital ComplexLas Palmas, Canary Islands, Spain
| | - E Roche
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, University Miguel HernandezElche, Alicante, Spain
- CIBERobn (Fisiopatología de la Obesidad y la Nutrición CB12/03/30038), Instituto de Salud Carlos IIIMajadahonda, Madrid, Spain
| |
Collapse
|
41
|
Smith D, Roche E, O’Loughlin K, Brennan D, Madigan K, Lyne J, Feeney L, O’Donoghue B. Satisfaction with services following voluntary and involuntary admission. J Ment Health 2014; 23:38-45. [DOI: 10.3109/09638237.2013.841864] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
42
|
O'Donoghue B, Roche E, Shannon S, Lyne J, Madigan K, Feeney L. Perceived coercion in voluntary hospital admission. Psychiatry Res 2014; 215:120-6. [PMID: 24210740 DOI: 10.1016/j.psychres.2013.10.016] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 08/27/2013] [Accepted: 10/16/2013] [Indexed: 11/24/2022]
Abstract
The legal status of service users admitted to psychiatric wards is not synonymous with the level of coercion that they can perceive during the admission. This study aimed to identify and describe the proportion of individuals who were admitted voluntarily but experienced levels of perceived coercion comparable to those admitted involuntarily. Individuals admitted voluntarily and involuntarily to three psychiatric hospitals were interviewed using the MacArthur Admission Experience Interview and the Structured Clinical Interview for DSM-IV diagnoses. One hundered sixty-one individuals were interviewed and 22% of the voluntarily admitted service users had levels of perceived coercion similar to that of the majority of involuntarily admitted service users. Voluntarily admitted service users who experienced high levels of perceived coercion were more likely to have more severe psychotic symptoms, have experienced more negative pressures and less procedural justices on admission. Individuals brought to hospital under mental health legislation but who subsequently agreed to be admitted voluntarily and those treated on a secure ward also reported higher levels of perceived coercion. It needs to be ensured that if any service user, whether voluntary or involuntary, experiences treatment pressures or coercion that there is sufficient oversight of the practice, to ensure that individual's rights are respected.
Collapse
Affiliation(s)
- Brian O'Donoghue
- Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland.
| | - Eric Roche
- Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland
| | - Stephen Shannon
- Mental Health Commission, Waterloo Road, Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons, Ireland
| | - John Lyne
- St Vincents University Hospital, Elm Park, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - Kevin Madigan
- Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland; DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - Larkin Feeney
- Department of General Adult Psychiatry, Cluain Mhuire Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons, Ireland
| |
Collapse
|
43
|
García-Hernández VM, Gallar M, Sánchez-Soriano J, Micol V, Roche E, García-García E. Effect of omega-3 dietary supplements with different oxidation levels in the lipidic profile of women: a randomized controlled trial. Int J Food Sci Nutr 2013; 64:993-1000. [DOI: 10.3109/09637486.2013.812619] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
44
|
Estrada JC, Torres Y, Benguría A, Dopazo A, Roche E, Carrera-Quintanar L, Pérez RA, Enríquez JA, Torres R, Ramírez JC, Samper E, Bernad A. Human mesenchymal stem cell-replicative senescence and oxidative stress are closely linked to aneuploidy. Cell Death Dis 2013; 4:e691. [PMID: 23807220 PMCID: PMC3702285 DOI: 10.1038/cddis.2013.211] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In most clinical trials, human mesenchymal stem cells (hMSCs) are expanded in vitro before implantation. The genetic stability of human stem cells is critical for their clinical use. However, the relationship between stem-cell expansion and genetic stability is poorly understood. Here, we demonstrate that within the normal expansion period, hMSC cultures show a high percentage of aneuploid cells that progressively increases until senescence. Despite this accumulation, we show that in a heterogeneous culture the senescence-prone hMSC subpopulation has a lower proliferation potential and a higher incidence of aneuploidy than the non-senescent subpopulation. We further show that senescence is linked to a novel transcriptional signature that includes a set of genes implicated in ploidy control. Overexpression of the telomerase catalytic subunit (human telomerase reverse transcriptase, hTERT) inhibited senescence, markedly reducing the levels of aneuploidy and preventing the dysregulation of ploidy-controlling genes. hMSC-replicative senescence was accompanied by an increase in oxygen consumption rate (OCR) and oxidative stress, but in long-term cultures that overexpress hTERT, these parameters were maintained at basal levels, comparable to unmodified hMSCs at initial passages. We therefore propose that hTERT contributes to genetic stability through its classical telomere maintenance function and also by reducing the levels of oxidative stress, possibly, by controlling mitochondrial physiology. Finally, we propose that aneuploidy is a relevant factor in the induction of senescence and should be assessed in hMSCs before their clinical use.
Collapse
Affiliation(s)
- J C Estrada
- Department of Cardiovascular Development and Repair, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro 3, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
O'Donoghue B, Roche E, Ranieri VF, Shannon S, Crummey C, Murray J, Smith DG, O'Loughlin K, Lyne JP, Madigan K, Feeney L. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians. Psychiatr Serv 2013; 64:416-22, 416.e1-3. [PMID: 23318707 DOI: 10.1176/appi.ps.001912012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.
Collapse
Affiliation(s)
- Brian O'Donoghue
- Cluain Mhuire Mental Health Service, Newtownpark Ave., Blackrock, Co. Dublin, Ireland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Lau DP, Roche E, Chui CK, Goh CH. Transnasal oesophagoscopy-guided tracheoesophageal puncture. A novel method using the mini-tracheostomy kit. Clin Otolaryngol 2013; 38:182-3. [PMID: 23577886 DOI: 10.1111/coa.12093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2012] [Indexed: 11/27/2022]
|
47
|
Abstract
OBJECTIVES The Mental Health Act 2001 (MHA 2001) was implemented in November 2006. Since that time, there has been considerable research into its impact, including the impact on service provision, use of coercive practices and the perceptions by key stakeholders. Our objective is to present a summary of research into the MHA 2001 since its implementation in the Irish state in the context of international standards and practice. METHODS We reviewed the literature presented on Medline and Google Scholar, directly assessed relevant journals and sought abstract information from the College of Psychiatry of Ireland. RESULTS There has been a small decrease in the rate of involuntary admission since implementation but there has been no change in the representativeness of diagnoses of individuals admitted involuntarily. Mental Health Tribunals were held for 57% of those admitted involuntarily and 46% of service users found that the Mental Health Tribunal made the involuntary admission easier to accept. One year after discharge, 60% of service users reflected that their involuntary admission had been necessary. Professional groups have expressed concerns regarding workload, training time for junior doctors and paperwork. CONCLUSIONS The MHA 2001 has brought the practice of involuntary admission further into line with international standards. However, five years after the implementation of the Act international guidelines and practice have highlighted areas in need of further reform, including capacity legislation and consideration of advance directives and community treatment orders. Further research is also lacking on caregivers' or family members' perceptions of the MHA 2001.
Collapse
Affiliation(s)
- Hugh Ramsay
- Lucena Clinic, Orwell Road, Rathgar, Dublin 6, Ireland.
| | | | | |
Collapse
|
48
|
Braithwaite B, Hnatek L, Zierau U, Camci M, Akkersdijk G, Nio D, Sarlija M, Ajduk M, Santoro P, Roche E. Radiofrequency-induced thermal therapy: results of a European multicentre study of resistive ablation of incompetent truncal varicose veins. Phlebology 2012; 28:38-46. [PMID: 22865420 DOI: 10.1258/phleb.2012.012013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To investigate the effectiveness of bipolar radiofrequency-induced thermal therapy (RFITT) in a multicentre non-randomized study. METHODS Some 672 incompetent saphenous veins (85% great saphenous varicose vein, 15% short saphenous vein) in 462 patients (56.5% CEAP [clinical, aetiological, anatomical and pathological elements] class 3 or worse) were treated in eight European centres. Patients were assessed between 180 and 360 days postoperatively. Occlusion rates were determined by duplex ultrasound and compared with the power used for treatment, pull back rate and experience of the operating surgeon. RESULTS Complete occlusion rates of 98.4% were achieved when treatments were performed by an experienced operator (more than 20 cases), when the maximum power setting on the RFITT generator was between 18 and 20 W and the applicator was withdrawn at a rate slower than 1.5 second/cm CONCLUSIONS RFITT is efficacious, well tolerated by patients and has a low incidence of procedure-related post-operative complications.
Collapse
Affiliation(s)
- B Braithwaite
- Queens Medical Centre - Vascular Surgery, Nottingham, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
|
50
|
Montero D, Walther G, Perez-Martin A, Roche E, Vinet A. Endothelial dysfunction, inflammation, and oxidative stress in obese children and adolescents: markers and effect of lifestyle intervention. Obes Rev 2012; 13:441-55. [PMID: 22133012 DOI: 10.1111/j.1467-789x.2011.00956.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
With an increasing prevalence, pediatric obesity is often a prelude to adulthood obesity, and represents a major public health issue. Comorbidities are very common and severe in obese adults, justifying the search for earlier markers or risk factors for cardiovascular diseases in obese children. Endothelial dysfunction has been found to be present in the early stages of atherosclerosis, and can be non-invasively assessed with widely accepted and well-standardized techniques at the macrocirculation level. Endothelial dysfunction at the microcirculation level is less documented in obese children. Obesity in children has been repeatedly and independently correlated to endothelial dysfunction, inflammation and oxidative stress markers, although the relationship between these factors remains to be investigated. However, this would not only allow substantial improvements in risk stratification, but also provide essential data regarding the evolution of endothelial dysfunction in childhood obesity, especially during puberty when pro-inflammatory and pro-oxidative changes, with relative insulin resistance, occur. Therapeutic strategies such as lifestyle interventions in early childhood obesity appear all the more necessary, optimally including both exercise and diet because of their known effects on inflammatory and oxidative stress markers, potentially reversing endothelial dysfunction.
Collapse
Affiliation(s)
- D Montero
- Pharm-Ecology Cardiovascular Laboratory, Faculty of Sciences, Avignon, France
| | | | | | | | | |
Collapse
|