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Journal Article	Journal Article		2020	Using systematic data categorisation to quantify the types of data collected in clinical trials: the DataCat project	Data collection consumes a large proportion of clinical trial resources. Each data item requires time and effort for collection, processing and quality control procedures. In general, more data equals a heavier burden for trial staff and participants. It is also likely to increase costs. Knowing the types of data being collected, and in what proportion, will be helpful to ensure that limited trial resources and participant goodwill are used wisely.	More details Read publication
Journal Article	Journal Article		2018	Screening for cognitive impairment in an Australian aged care assessment team as part of comprehensive geriatric assessment	Accurate detection of mild cognitive impairment (MCI) is important to stratify and address risk. Yet, few short cognitive screening instruments are validated for this. In Australia, all clients referred to an Aged Care Assessment Team (ACAT) receive comprehensive geriatric assessment (CGA) including the Standardized Mini-Mental State Examination (SMMSE). We compared the accuracy of the quick mild cognitive impairment (Qmci) screen to the SMMSE in 283 participants: 195 with dementia, 47 with MCI, and 41 with subjective cognitive decline (SCD) in an Australian community-based ACAT. Both had similar accuracy in identifying dementia, AUC of 0.86 for the Qmci versus 0.93 for the SMMSE (p = 0.10), but the Qmci was more accurate than the SMMSE in differentiating MCI from SCD, AUC of 0.84 versus 0.71, respectively, p = 0.046. These suggest that the new, short (3–5 min) Qmci screenis appropriate for use in an ACAT or other units conducting CGA.	More details Read publication
Journal Article	Journal Article		2018	Associations between maternal lifestyle factors and neonatal body composition in the Screening for Pregnancy Endpoints (Cork) cohort study	Neonatal body composition likely mediates fetal influences on life long chronic disease risk. A better understanding of how maternal lifestyle is related to newborn body composition could thus inform intervention efforts.	More details Read publication
Journal Article	Journal Article	Reflux, Medicine, Inflammation, Lung Injury, Epithelium, Cytokines	2018	Gastric Aspiration and Its Role in Airway Inflammation	Gastro-Oesophageal Reflux (GOR) has been associated with chronic airway diseases while the passage of foreign matter into airways and lungs through aspiration has the potential to initiate a wide spectrum of pulmonary disorders. The clinical syndrome resulting from such aspiration will depend both on the quantity and nature of the aspirate as well as the individual host response. Aspiration of gastric fluids may cause damage to airway epithelium, not only because acidity is toxic to bronchial epithelial cells but also due to the effect of digestive enzymes such as pepsin and bile salts. Experimental models have shown that direct instillation of these factors to airways epithelia cause damage with a consequential inflammatory response. The pathophysiology of these responses is gradually being dissected, with better understanding of acute gastric aspiration injury, a major cause of acute lung injury, providing opportunities for therapeutic intervention and potentially, ultimately, improved understanding of the chronic airway response to aspiration. Ultimately, clarification of the inflammatory pathways which are related to micro-aspiration via pepsin and bile acid salts may eventually progress to pharmacological intervention and surgical studies to assess the clinical benefits of such therapies in driving symptom improvement or reducing disease progression.	More details Read publication
Journal Article	Journal Article		2018	Body composition determinants of radiation dose during abdominopelvic CT	We designed a prospective study to investigate the in-vivo relationship between abdominal body composition and radiation exposure to determine the strongest body composition predictor of dose length product (DLP) at CT.	More details Read publication
Journal Article	Journal Article		2018	CORK Study in Cystic Fibrosis: Sustained Improvements in Ultra-Low-Dose Chest CT Scores After CFTR Modulation With Ivacaftor	Ivacaftor produces significant clinical benefit in patients with cystic fibrosis (CF) with the G551D mutation. Prevalence of this mutation at the Cork CF Centre is 23%. This study assessed the impact of cystic fibrosis transmembrane conductance regulator modulation on multiple modalities of patient assessment.	More details Read publication
Journal Article	Journal Article		2018	A randomised clinical trial of feedback on inhaler compliance in difficult asthma – a case study	In severe asthma, poor control could reflect issues of medication adherence or inhaler technique, or that the condition is refractory. This study aimed to determine if an intervention with (bio)feedback on the features of inhaler use would identify refractory asthma and enhance inhaler technique and adherence. Patients with severe uncontrolled asthma were subjected to a stratified-by-site random block design. The intensive education group received repeated training in inhaler use, adherence and disease management. The intervention group received the same intervention, enhanced by (bio)feedback-guided training. The primary outcome was rate of actual inhaler adherence. Secondary outcomes included a pre-defined assessment of clinical outcome. Outcome assessors were blinded to group allocation. Data were analysed on an intention-to-treat and per-protocol basis. The mean rate of adherence during the third month in the (bio)feedback group (n=111) was higher than that in the enhanced education group (intention-to-treat, n=107; 73% versus 63%; 95% CI 2.8%–17.6%; p=0.02). By the end of the study, asthma was either stable or improved in 54 patients (38%); uncontrolled, but poorly adherent in 52 (35%); and uncontrolled, but adherent in 40 (27%). Repeated feedback significantly improved inhaler adherence. After a programme of adherence and inhaler technique assessment, only 40 patients (27%) were refractory and adherent, and might therefore need add-on therapy.	More details Read publication
Journal Article	Journal Article		2017	The altered gut microbiota in adults with cystic fibrosis	Cystic Fibrosis (CF) is an autosomal recessive disease that affects the function of a number of organs, principally the lungs, but also the gastrointestinal tract. The manifestations of cystic fibrosis transmembrane conductance regulator (CFTR) dysfunction in the gastrointestinal tract, as well as frequent antibiotic exposure, undoubtedly disrupts the gut microbiota. To analyse the effects of CF and its management on the microbiome, we compared the gut microbiota of 43 individuals with CF during a period of stability, to that of 69 non-CF controls using 454-pyrosequencing of the 16S rRNA gene. The impact of clinical parameters, including antibiotic therapy, on the results was also assessed.	More details Read publication
Journal Article	Journal Article	Clostridium difficile, Cystic fibrosis,Transmission, Nosocomial infection	2017	Clostridium difficile carriage in adult cystic fibrosis (CF); implications for patients with CF and the potential for transmission of nosocomial infection	Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal–oral route. Despite increasing carriage rates and the presence of C. difficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. difficile infection (CDI). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant. C. difficile was detected in 50% (30/60) of patients with CF by culturing for the bacteria. C. difficile toxin was detected in 63% (19/30) of C. difficile-positive stool samples. All toxin-positive stool samples contained toxigenic C. difficile strains harbouring toxin genes, tcdA and tcdB. Despite the presence of C. difficile and its toxin in patient stool, no acute gastrointestinal symptoms were reported. Ribotyping of C. difficile strains revealed 16 distinct ribotypes (RT), 11 of which are known to be disease-causing including the hyper-virulent RT078. Additionally, strains RT002, RT014, and RT015, which are common in non-CF nosocomial infection were described. All strains were susceptible to vancomycin, metronidazole, fusidic acid and rifampicin. No correlation was observed between carriage of C. difficile or any characteristics of isolated strains and any recorded clinical parameters or treatment received. We demonstrate a high prevalence of hypervirulent, toxigenic strains of C. difficile in asymptomatic patients with CF. This highlights the potential role of asymptomatic patients with CF in nosocomial transmission of C. difficile.	More details Read publication
Journal Article	Journal Article		2017	A pilot study demonstrating the altered gut microbiota functionality in stable adults with Cystic Fibrosis	Cystic Fibrosis (CF) and its treatment result in an altered gut microbiota composition compared to non-CF controls. However, the impact of this on gut microbiota functionality has not been extensively characterised. Our aim was to conduct a proof-of-principle study to investigate if measurable changes in gut microbiota functionality occur in adult CF patients compared to controls. Metagenomic DNA was extracted from faecal samples from six CF patients and six non-CF controls and shotgun metagenomic sequencing was performed on the MiSeq platform. Metabolomic analysis using gas chromatography-mass spectrometry was conducted on faecal water. The gut microbiota of the CF group was significantly different compared to the non-CF controls, with significantly increased Firmicutes and decreased Bacteroidetes. Functionality was altered, with higher pathway abundances and gene families involved in lipid (e.g. PWY 6284 unsaturated fatty acid biosynthesis (p = 0.016)) and xenobiotic metabolism (e.g. PWY-5430 meta-cleavage pathway of aromatic compounds (p = 0.004)) in CF patients compared to the controls. Significant differences in metabolites occurred between the two groups. This proof-of-principle study demonstrates that measurable changes in gut microbiota functionality occur in CF patients compared to controls. Larger studies are thus needed to interrogate this further.	More details Read publication
Journal Article	Journal Article	House dust allergen , Immunoglobulin E , Lactic acid , Adult , Article , Asthma , Athletic performance , Bronchoconstriction , Clinical article , Exercise , Exercise test , Forced expiratory volume , Heart rate , Human , Lung function test , Prevalence , Provocation test , Questionnaire , Radioallergosorbent test , Spirometry , Valsalva maneuver	2017	A Study to Assess the Prevalence of Exercise-Induced Bronchoconstriction in Inter-County Hurling	Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB.	More details Read publication
Journal Article	Journal Article		2017	The Potential Role of Aspiration in the Asthmatic Airway	Many people with asthma remain suboptimally controlled despite current treatments. Reasons include comorbidities that could aggravate asthma, including gastroesophageal reflux. We aimed to investigate whether aspiration occurs in patients with asthma and, if so, does it correlate with asthma control?	More details Read publication
Journal Article	Journal Article		2017	Perceived barriers and facilitators to Risk Based Monitoring in academic-led clinical trials: a mixed methods study.	In November 2016, the ICH published a requirement for sponsors to develop a systematic, prioritised, risk-based approach to monitoring clinical trials. This approach is more commonly known as risk-based monitoring (RBM). However, recent evidence suggests that a ‘gold standard’, validated approach to RBM does not exist and it is unclear how sponsors will introduce RBM into their organisations. A first step needed to inform the implementation of RBM is to explore academic trialists’ readiness and ability to perform RBM. The aim of this paper is to identify the attitudes and perceived barriers and facilitators to the implementation of RBM in academic-led clinical trials in Ireland.	More details Read publication
Journal Article	Journal Article	Cardiovascular system, Thrombosis, Hospital	2017	Hospital Acquired Thrombosis (HAT) Preention in an Acute Hospital; A Single Centre Cross-Sectional Study	Evidence based guidelines are effective in reducing incidence of venous thromboembolism (VTE) which is associated with morbidly, mortality and economic burden. This study aimed to identify the proportion of inpatients who had a VTE risk assessment (RA) performed and who received thromboprophylaxis (TP), in Cork University Hospital. There was no structured RA tool at the time; information was obtained from medical and drug charts to ascertain if a RA was performed. Patients were then RA by researchers and stratified as per NICE guidelines and the proportion who received TP was calculated. One thousand and nineteen inpatients were screened. Risk was documented in 24% of cases. TP was prescribed in 43.2% of inpatients. Following application of a RA tool >80% were at high risk of VTE with low risk of bleeding with TP prescription in 46.3% of inpatients. A national collaborative effort should be encouraged to develop a standardized approach for safe RA of inpatients and prescription of TP for prevention of HAT.	More details Read publication
Journal Article	Journal Article	Venous thromboembolism, VTE risk assessment, Thromboprophylaxis	2017	Incidence of Hospital Acquired Thrombosis (HAT) in a Teritary Care Hospital	Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. In spite of guidelines, VTE prophylaxis continues to be underutilised, and hospital acquired thrombosis (HAT) continues to be a problem. This study was conducted to estimate the incidence of HAT in a tertiary referral centre and to examine whether VTE risk assessment and thromboprophylaxis (TP) were implemented. Patients 18 years and above, with a radiologically-confirmed acute VTE during the study period of 15 weeks were included. Acute VTE was diagnosed in 100 patients and HAT was diagnosed in 48. There were 12,024 admissions over the study period, therefore the incidence of HAT was 0.4%. TP was prescribed in only 35% of patients, and 65% did not receive any or appropriate TP. Hospitals without active implementation of a formal risk assessment tool and TP policy are likely to continue to have increased incidence of HAT.	More details Read publication
Journal Article	Journal Article		2017	In patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial	Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes.	More details Read publication
Journal Article	Journal Article		2017	Comparing Approaches to Optimize Cut-off Scores for Short Cognitive Screening Instruments in Mild Cognitive Impairment and Dementia	Although required to improve the usability of cognitive screening instruments (CSIs), the use of cut-off scores is controversial yet poorly researched.	More details Read publication
Journal Article	Journal Article		2017	Current and emerging comorbidities in cystic fibrosis	Cystic fibrosis transmembrane conductance regulator (CFTR) is expressed ubiquitously throughout the body. Thus, while respiratory manifestations dominate much of cystic fibrosis (CF) care, there are prominent multi-organ manifestations and comorbidities. In the general population, the number of comorbidities increases with aging. Few illnesses have experienced such a dramatic improvement in survival as CF, which has been transformed from an illness of childhood death to one of adult survival. Hence, as longevity increases in CF, it is paralleled by an increasing number of patients with multicomplex comorbidities availing of care from adult CF multi-disciplinary teams. This review gives an overview of the traditional CF associated comorbidities and those emerging in an aging adult cohort. While historically the treatment of CF focused on the consequences of CFTR dysfunction, the recent advent of CFTR modulators with the potential to enhance CFTR function represents an opportunity to potentially reverse or delay the development of some of the comorbidities associated with CF. Where evidence is available for the impact of CFTR modulatory therapy, namely ivacaftor on comorbidities in CF, this is highlighted.	More details Read publication
Journal Article	Journal Article		2017	The association between weight perception and BMI: report and measurement data from the growing up in Ireland Cohort Study of 9-year olds	The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies.	More details Read publication
Journal Article	Journal Article		2016	Plasma Thrombin Generation and Sensitivity to Activated Protein C Among Patients With Myeloma and Monoclonal Gammopathy of Undetermined Significance	The etiology of the prothrombotic state in myeloma has yet to be definitively characterized. Similarly, while recent evidence suggests that patients with monoclonal gammopathy of undetermined significance (MGUS) may also be at increased risk of thrombosis, the magnitude and the etiology of this risk have also yet to be defined. The present study aims to characterize patterns of plasma thrombin generation and sensitivity to the anticoagulant activity of activated protein C (APC) at the time of initial diagnosis of myeloma and in response to therapy in comparison to that observed among patients with MGUS and matched, healthy volunteers. Patients presenting with newly diagnosed/newly relapsed myeloma (n = 8), MGUS (n = 8), and matched healthy volunteers (n = 8) were recruited. Plasma thrombin generation was determined by calibrated automated thrombography. Peak thrombin generation was significantly higher in patients with myeloma (383.4 ± 33.4 nmol/L) and MGUS (353.4 ± 16.5 nmol/L) compared to healthy volunteers (276.7 ± 20.8 nmol/L; P < .05). In the presence of APC, endogenous thrombin potential was significantly lower in control plasma (228.6 ± 44.5 nmol/L × min) than in either myeloma (866.2 ± 241.3 nmol/L × min, P = .01) or MGUS plasma (627 ± 91.5 nmol/L × min, P = .003). Within the myeloma cohort, peak thrombin generation was significantly higher at diagnosis (353.2 ± 15.9 nmol/L) than following completion of the third cycle of therapy (282.1 ± 15.2 nmol/L; P < .005). Moreover, sensitivity to APC increased progressively with each cycle of chemotherapy. Further study of the etiology and evolving patterns of hypercoagulability among patients with these conditions is warranted and may have future implications for thromboprophylaxis strategies.	More details Read publication
Journal Article	Journal Article	Clinical trial, Risk based monitoring	2016	Risk based monitoring (RBM) tools for clinical trials: A systematic review	In November 2016, the Integrated Addendum to ICH-GCP E6 (R2) will advise trial sponsors to develop a risk-based approach to clinical trial monitoring. This new process is commonly known as risk based monitoring (RBM). To date, a variety of tools have been developed to guide RBM. However, a gold standard approach does not exist. This review aims to identify and examine RBM tools.	More details Read publication
Journal Article	Journal Article		2016	Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review	The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.	More details Read publication
Journal Article	Journal Article		2016	Drivers for inappropriate fever management in children: a systematic review	Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported.	More details Read publication
Journal Article	Journal Article		2016	Parental knowledge, attitudes and beliefs regarding fever in children: an interview study	Fever is one of the most common childhood symptoms. It causes significant worry and concern for parents. Every year there are numerous cases of over- and under-dosing with antipyretics. Caregivers seek reassurance from a variety of sources including healthcare practitioners. The aim of this study was to describe parental knowledge, attitudes and beliefs regarding management of childhood fever in children aged 5 years and under.	More details Read publication
Journal Article	Journal Article		2016	Walking in hospital is associated with a shorter length of stay in older medical inpatients	Evidence suggests that inactivity during a hospital stay is associated with poor health outcomes in older medical inpatients. We aimed to estimate the associations of average daily step-count (walking) in hospital with physical performance and length of stay in this population. Medical in-patients aged ⩾65 years, premorbidly mobile, with an anticipated length of stay ⩾3 d, were recruited. Measurements included average daily step-count, continuously recorded until discharge, or for a maximum of 7 d (Stepwatch Activity Monitor); co-morbidity (CIRS-G); frailty (SHARE F-I); and baseline and end-of-study physical performance (short physical performance battery). Linear regression models were used to estimate associations between step-count and end-of-study physical performance or length of stay. Length of stay was log transformed in the first model, and step-count was log transformed in both models. Similar models were used to adjust for potential confounders. Data from 154 patients (mean 77 years, SD 7.4) were analysed. The unadjusted models estimated for each unit increase in the natural log of step-count, the natural log of length of stay decreased by 0.18 (95% CI −0.27 to −0.09). After adjustment of potential confounders, while the strength of the inverse association was attenuated, it remained significant (βlog(steps) = −0.15, 95%CI −0.26 to −0.03). The back-transformed result suggested that a 50% increase in step-count was associated with a 6% shorter length of stay. There was no apparent association between step-count and end-of-study physical performance once baseline physical performance was adjusted for. The results indicate that step-count is independently associated with hospital length of stay, and merits further investigation.	More details Read publication
Journal Article	Journal Article		2016	Step-Count Accuracy of 3 Motion Sensors for Older and Frail Medical Inpatients	To measure the step-count accuracy of an ankle-worn accelerometer, a thigh-worn accelerometer, and a pedometer in older and frail inpatients.	More details Read publication
Journal Article	Journal Article		2016	A study protocol of a randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) for frail older medical patients in the acute setting	Older adults experience functional decline in hospital leading to increased healthcare burden and morbidity. The benefits of augmented exercise in hospital remain uncertain. The aim of this trial is to measure the short and longer-term effects of augmented exercise for older medical in-patients on their physical performance, quality of life and health care utilisation.	More details Read publication
Journal Article	Journal Article		2016	Prevention of Hospital-Acquired Adverse Drug Reactions in Older People Using Screening Tool of Older Persons’ Prescriptions and Screening Tool to Alert to Right Treatment Criteria: A Cluster Randomized Controlled Trial	To determine whether use of the Screening Tool of Older Persons' Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START) criteria reduces incident hospital-acquired adverse drug reactions (ADRs), 28-day medication costs, and median length of hospital stay in older adults admitted with acute illness.	More details Read publication
Journal Article	Journal Article		2016	Positive lifestyle changes around the time of pregnancy: a cross-sectional study	To examine the prevalence of positive lifestyle behaviours before and during pregnancy in Ireland.	More details Read publication
Journal Article	Journal Article		2016	Knowledge, attitudes and beliefs of parents regarding fever in children: a Danish interview study	Fever and febrile illness are some of the most common conditions managed by parents. The aim of this study was to examine the knowledge, attitudes and beliefs of parents around fever in children under five years of age.	More details Read publication
Journal Article	Journal Article		2016	Correlates of self-reported weekday sleep duration in adolescents: the 18-year follow-up of the 1993 Pelotas (Brazil) Birth Cohort Study	To investigate factors associated with sleep duration in adolescence.	More details Read publication
Journal Article	Journal Article		2016	Do patient-reported measures of symptoms and health status predict mortality in hemodialysis? An assessment of POS-S Renal and EQ-5D	Experience with the use of patient-reported outcome measures such as EQ-5D and the symptom module of the Palliative care Outcome Scale—Renal Version (POS-S Renal) as mortality prediction tools in hemodialysis is limited.	More details Read publication
Journal Article	Journal Article		2016	Trial of a novel plasma gas disinfection system (Radica) to reduce mattress residual bacterial contamination in the acute hospital setting: a preliminary study	In routine clinical practice, mattresses are manually cleaned using specialised cleaning and high-level disinfecting fluids. While effective against a wide range of organisms, the success of this approach is dependent on a thorough and complete application and is likely to be susceptible to human error and thus variable. The efficacy of available infection control measures to reduce such mattress contamination is unknown as it is not subject to quality control measures. There is a pressing need to identify more effective methods to prevent cross contamination within the medical environment, given the lack of available treatment strategies.	More details Read publication
Journal Article	Journal Article		2016	The association between weight perception and BMI: Report and measurement data from the Growing Up in Ireland Study of 9-year olds	The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies.	More details Read publication
Journal Article	Journal Article		2016	The Microbiome and the Pathophysiology of Asthma	Asthma is a chronic respiratory disease whose prevalence is increasing in the western world. Recently research has begun to focus on the role the microbiome plays in asthma pathogenesis in the hope of further understanding this respiratory disorder. Considered sterile until recently, the lungs have revealed themselves to contain a unique microbiota. A shift towards molecular methods for the quantification and sequencing of microbial DNA has revealed that the airways harbour a unique microbiota with apparent, reproducible differences present between healthy and diseased lungs. There is a hope that in classifying the microbial load of the asthmatic airway an insight may be afforded as to the possible role pulmonary microbes may have in propagating an asthmatic airway response. This could potentially pave the way for new therapeutic strategies for the treatment of chronic lung conditions such as asthma.	More details Read publication
Journal Article	Journal Article		2016	The safety of salt pipes in asthmatic patients	Salt pipes are commercially available products which are advertised for use in a wide range of respiratory conditions, including asthma. They use micronized salt crystals which are inspired into the lungs. Advocats of the device propose that they enhance sputum clearance from the lungs with resultant improvement in breathing.1, 2 However, there is a lack of robust clinical efficacy and safety data available to support this claim. Airway hyperresponsiveness is a characteristic feature of asthma and results in an exaggerated bronchoconstrictive reaction of the airways to nonspecific stimuli. Only a small volume of hypertonic saline is needed to provoke airway narrowing in patients with asthma.3 Hence, concern remains that salt pipes may provoke a bronchoconstrictive response particularly in potentially susceptible asthmatic subjects.	More details Read publication
Journal Article	Journal Article		2015	Ionizing radiation exposure as a result of diagnostic imaging in patients with lymphoma	Survival rates among patients with lymphoma continue to improve. Strategies aimed at reducing potential treatment-related toxicity are increasingly prioritized. While radiological procedures play an important role, ionizing radiation exposure has been linked to an increased risk of malignancy, particularly among individuals whose cumulative radiation exposure exceeds a specific threshold (75 millisieverts).	More details Read publication
Journal Article	Journal Article		2015	Differing coagulation profiles of patients with monoclonal gammopathy of undetermined significance and multiple myeloma	The link between myeloma and thrombosis is well established. Monoclonal gammopathy of undetermined significance (MGUS) has also been associated with an increased risk of thrombosis. It was recently demonstrated that patients with myeloma display changes in thromboelastometry that may indicate a prothrombotic state. There is little data with regard to changes in thromboelastography in patients with myeloma or MGUS. The aim of this study was to investigate the differing coagulation profiles of patients of patients with myeloma and MGUS by means of conventional coagulation tests and thromboelastography. Blood was taken by direct venepuncture from patients with myeloma, MGUS and normal controls. Routine coagulation tests were performed in an accredited hospital laboratory. Thromboelastography (TEG®) was performed as per the manufacturer’s protocol. Eight patients were recruited in each group. Patients with myeloma had a significantly lower mean haemoglobin level than patients with MGUS or normal controls (p < 0.001). Pateints with myeloma had a significantly more prolonged mean prothrombin time than normal controls (p = 0.018) but not patients with MGUS. Patients with myeloma had significantly higher median D-dimer levels than normal controls (p = 0.025), as did patients with MGUS (p = 0.017). Patients with myeloma had a significantly higher mean factor VIII level than normal controls (p = 0.009) and there was a non-significant trend towards patients with MGUS having higher factor VIII levels than normal controls (p = 0.059). There was no significant difference in thromboelastographic parameters between the three groups. Patients with MGUS appear to have a distinct coagulation profile which is intermediate between patients with myeloma and normal controls.	More details Read publication
Journal Article	Journal Article		2015	The effects of freezing on faecal microbiota as determined using MiSeq sequencing and culture-based investigations	High-throughput sequencing has enabled detailed insights into complex microbial environments, including the human gut microbiota. The accuracy of the sequencing data however, is reliant upon appropriate storage of the samples prior to DNA extraction. The aim of this study was to conduct the first MiSeq sequencing investigation into the effects of faecal storage on the microbiota, compared to fresh samples. Culture-based analysis was also completed.	More details Read publication
Journal Article	Journal Article		2015	The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: protocol for a qualitative systematic review	Many parents consider fever a disease in itself and feel disempowered when their child is ill. Numerous guidelines have been produced; however, their target audience remains healthcare professionals and not carers of children in general. A reliable source of information will decrease worry in parents and carers when managing a febrile child.	More details Read publication
Journal Article	Journal Article		2015	Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART study	Despite limitations of routine methods, Clinical Practice Guidelines support the assessment of bone mineral density (BMD) and vascular calcification in renal transplant recipients. Changes in fat mass also occur post-transplantation, although they are traditionally difficult to measure accurately. We report the feasibility, convenience and accuracy of measuring the above 3 parameters using a novel CT protocol.	More details Read publication
Journal Article	Journal Article		2015	Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland	The international cohort of hemodialysis patients is aging and increasing in number. Nephrologists have a therapeutic relationship with their patients that may span decades. Often overlooked components of chronic disease management include symptom control and assessment of health-related quality of life (HRQoL).	More details Read publication
Journal Article	Journal Article		2014	Venous Thromboembolism in Patients with Myeloma: Incidence and Risk Factors in a “Real-World” Population	Myeloma has a well-described association with venous thromboembolism (VTE). There are few dedicated studies investigating the incidence and risk factors. Many assessment scores have been suggested to estimate the risk of VTE in patients with cancer but these have been validated in solid organ tumors. The records of patients with myeloma attending a university hospital between January 2007 and December 2012 were reviewed to investigate the incidence of VTE and the associated risk factors. In all, 217 patients with a mean (standard deviation) age at diagnosis of 65 (12) years were included. Of 217 patients, 12% had an episode of VTE, 69% received at least 1 immunomodulatory agent, and 95% had low or intermediate risk of VTE according to the Khorana score. Venous thromboembolism was a frequent occurrence in this cohort. Patients had many risk factors for VTE but no one was predictive. As myeloma outcomes continue to improve, a dedicated prospective study is warranted to investigate the most appropriate thromboprophylaxis strategy.	More details Read publication
Journal Article	Journal Article		2014	Sexually transmitted infection incidence among adolescents in Ireland	The burden of sexually transmitted infections (STIs) rests with young people, yet in Ireland there has been very little research into this population. The purpose of this study was to determine the incidence rate and establish risk factors that predict STI occurrence among adolescents in Ireland.	More details Read publication
Journal Article	Journal Article		2014	Inhaled versus nebulised tobramycin: a real world comparison in adult cystic fibrosis (CF)	There are no published data on real-life clinical experience comparing inhaled antibiotic therapy via new rapid delivery systems with nebulised antibiotic therapy in CF. This real world study compares safety, effectiveness and tolerability using tobramycin inhaled powder (TIP) versus tobramycin inhaled solution (TIS).	More details Read publication
Journal Article	Journal Article		2014	Effects of centrally acting angiotensis converting enzyme inhibitors on functional decline in patients with Alzheimer’s disease	Centrally acting angiotensin converting enzyme inhibitors (CACE-Is) are associated with reduced rates of cognitive decline in patients with dementia. CACE-Is may also improve exercise tolerance in functionally impaired older adults with normal cognition, suggesting that CACE-Is may positively influence activities of daily living (ADL) in dementia.	More details Read publication
Journal Article	Journal Article		2014	Attention! A good bedside test for delirium?	Routine delirium screening could improve delirium detection, but it remains unclear as to which screening tool is most suitable. We tested the diagnostic accuracy of the following screening methods (either individually or in combination) in the detection of delirium: MOTYB (months of the year backwards); SSF (Spatial Span Forwards); evidence of subjective or objective ‘confusion’.	More details Read publication
Journal Article	Journal Article		2014	Insulin resistance in primary nephrotic syndrome; is kidney function truly normal?	We read with great interest the article by Jin et al. which examined the association between the nephrotic syndrome and insulin resistance. We have recently conducted a cross-sectional study of arterial stiffness in adult patients with primary nephrotic syndrome without diabetes mellitus. We have also gathered information on glycosylated haemoglobin levels (HBA1c) in adult patients with the nephrotic syndrome, the findings of which are relevant to the study by Jin et al..	More details Read publication
Journal Article	Journal Article		2014	Comparison of risk factors for prevalent sexually transmitted infections based on attendees at two genitourinary medicine clinics in Ireland	Little has changed in sexually transmitted infection (STI) epidemiology in Ireland since 2000. Three STIs comprise approximately 90% of notifications; ano-genital warts, Chlamydia trachomatis and non-specific urethritis. Our objective was to compare the risk factors for prevalent STIs in attendees at two genitourinary medicine clinics and examine the incidence of coinfection. Diagnostic, demographic and behavioural information on attendees at two clinics in southwest Ireland were collected from January 1999 to July 2009. Risk factors associated with first episodes of ano-genital warts, genital herpes simplex viral infection, non-specific urethritis and C. trachomatis were investigated. In all, 22,705 STI patients (mean age 27 years) received 26,824 diagnoses; 1628 had more than one infection. Ano-genital warts was most likely to be diagnosed with a coinfection. Having multiple partners was positively associated with a diagnosis of bacterial infection but not viral infection. Our large cohort outlines those at risk in the region, showing age and gender influences the risk and type of infection. Smoking, alcohol and drug use is also common, all regarded as markers of risk-taking behaviour. The younger the age, the higher the risk of acquiring infection, regardless of infection type. Prevention strategies that target youth, bacterial STIs and high-risk behaviour, including sexual, alcohol and drugs, may be effective in reducing STI incidence in Ireland.	More details Read publication

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Using systematic data categorisation to quantify the types of data collected in clinical trials: the DataCat project

Screening for cognitive impairment in an Australian aged care assessment team as part of comprehensive geriatric assessment

Associations between maternal lifestyle factors and neonatal body composition in the Screening for Pregnancy Endpoints (Cork) cohort study

Gastric Aspiration and Its Role in Airway Inflammation

Body composition determinants of radiation dose during abdominopelvic CT

CORK Study in Cystic Fibrosis: Sustained Improvements in Ultra-Low-Dose Chest CT Scores After CFTR Modulation With Ivacaftor

A randomised clinical trial of feedback on inhaler compliance in difficult asthma – a case study

The altered gut microbiota in adults with cystic fibrosis

Clostridium difficile carriage in adult cystic fibrosis (CF); implications for patients with CF and the potential for transmission of nosocomial infection

A pilot study demonstrating the altered gut microbiota functionality in stable adults with Cystic Fibrosis

A Study to Assess the Prevalence of Exercise-Induced Bronchoconstriction in Inter-County Hurling

The Potential Role of Aspiration in the Asthmatic Airway

Perceived barriers and facilitators to Risk Based Monitoring in academic-led clinical trials: a mixed methods study.

Hospital Acquired Thrombosis (HAT) Preention in an Acute Hospital; A Single Centre Cross-Sectional Study

Incidence of Hospital Acquired Thrombosis (HAT) in a Teritary Care Hospital

In patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial

Comparing Approaches to Optimize Cut-off Scores for Short Cognitive Screening Instruments in Mild Cognitive Impairment and Dementia

Current and emerging comorbidities in cystic fibrosis

The association between weight perception and BMI: report and measurement data from the growing up in Ireland Cohort Study of 9-year olds

Plasma Thrombin Generation and Sensitivity to Activated Protein C Among Patients With Myeloma and Monoclonal Gammopathy of Undetermined Significance

Risk based monitoring (RBM) tools for clinical trials: A systematic review

Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review

Drivers for inappropriate fever management in children: a systematic review

Parental knowledge, attitudes and beliefs regarding fever in children: an interview study

Walking in hospital is associated with a shorter length of stay in older medical inpatients

Step-Count Accuracy of 3 Motion Sensors for Older and Frail Medical Inpatients

A study protocol of a randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) for frail older medical patients in the acute setting

Prevention of Hospital-Acquired Adverse Drug Reactions in Older People Using Screening Tool of Older Persons’ Prescriptions and Screening Tool to Alert to Right Treatment Criteria: A Cluster Randomized Controlled Trial

Positive lifestyle changes around the time of pregnancy: a cross-sectional study

Knowledge, attitudes and beliefs of parents regarding fever in children: a Danish interview study

Correlates of self-reported weekday sleep duration in adolescents: the 18-year follow-up of the 1993 Pelotas (Brazil) Birth Cohort Study

Do patient-reported measures of symptoms and health status predict mortality in hemodialysis? An assessment of POS-S Renal and EQ-5D

Trial of a novel plasma gas disinfection system (Radica) to reduce mattress residual bacterial contamination in the acute hospital setting: a preliminary study

The association between weight perception and BMI: Report and measurement data from the Growing Up in Ireland Study of 9-year olds

The Microbiome and the Pathophysiology of Asthma

The safety of salt pipes in asthmatic patients

Ionizing radiation exposure as a result of diagnostic imaging in patients with lymphoma

Differing coagulation profiles of patients with monoclonal gammopathy of undetermined significance and multiple myeloma

The effects of freezing on faecal microbiota as determined using MiSeq sequencing and culture-based investigations

The knowledge, attitudes and beliefs of carers (parents, guardians, healthcare practitioners, crèche workers) around fever and febrile illness in children aged 5 years and under: protocol for a qualitative systematic review

Comparison of single CT scan assessment of bone mineral density, vascular calcification and fat mass with standard clinical measurements in renal transplant subjects: the ABC HeART study

Understanding What Influences the Health-Related Quality of Life of Hemodialysis Patients: A Collaborative Study in England and Ireland

Venous Thromboembolism in Patients with Myeloma: Incidence and Risk Factors in a “Real-World” Population

Sexually transmitted infection incidence among adolescents in Ireland

Inhaled versus nebulised tobramycin: a real world comparison in adult cystic fibrosis (CF)

Effects of centrally acting angiotensis converting enzyme inhibitors on functional decline in patients with Alzheimer’s disease

Attention! A good bedside test for delirium?

Insulin resistance in primary nephrotic syndrome; is kidney function truly normal?

Comparison of risk factors for prevalent sexually transmitted infections based on attendees at two genitourinary medicine clinics in Ireland

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