241 Works

Effects of the global fund HIV/AIDS programmes in Ukraine

Ukraine has one of the highest and most rapidly growing rates of HIV/AIDS in Europe with estimated numbers of people living with HIV/AIDS (PLWHA) reaching 400,000 in 2008. Since 2003 several Global Health Initiatives (GHIs) have committed to providing over US$ 300 million towards the control of HIV/AIDS in Ukraine. These funding mechanisms have had a significant impact on the availability of services for PLWHA and populations at risk of being infected. GHIs have also...

Retaining Migrant Nurses in Ireland II. Nurse Migration Project Policy Brief 3

Niamh Humphries, Ruairi Brugha & Hannah McGee
Active overseas recruitment efforts have attracted large numbers of migrant nurses into the Irish health system [1]. However, it will be Ireland’s ability to retain these nurses that will determine the long-term effectiveness of this workforce strategy. This is a key consideration both for individual employers and at national policy level [2], given the extent of Ireland’s reliance upon migrant nurses [1]. There is recognition internationally that poor support structures in the host country may...

A Profile of Migrant Nurses in Ireland. Nurse Migration Project Policy Brief 4

Niamh Humphries, Ruairi Brugha & Hannah McGee
Migrant nurses, mainly from outside of the EU, are now an essential component of the Irish nursing workforce. This is the result of almost a decade of active overseas nurse recruitment from countries such as India and the Philippines. Between 2000 and 2008, non-EU migrant nurses accounted for 40% of nurses newly registered with the Irish Nursing Board [2] (see Fig. 1). According to the INO, "It is a reality, not readily acknowledged by Irish...

Tracking Global HIV/AIDS Initiatives and their Impact on the Health System in Ukraine

Tetyana Semigina &
This report presents results from the final stage of the study based on fieldwork carried out in Ukraine from January – June 2008. It aims to assess the effects of GHIs in Ukraine at national and sub-national levels including the effects on scale-up of HIV/AIDS services, coordination of HIV/AIDS programs, health systems capacity and equitable access to HIV/AIDS services. The study focuses largely on the Global Fund to Fight AIDS, TB and Malaria (Global Fund)...

Retaining our Doctors Medical Workforce Evidence, 2013-18. Challenges and Responses

Ruairi F. Brugha, Frances Cronin, Nicholas Clarke &
The RCSI Health Workforce Research Group held a policy dialogue in November 2017 at the Royal College of Surgeons in Ireland. The event was attended by senior staff of the Department of Health, the Health Service Executive, postgraduate medical training bodies, NCHD representatives and other national stakeholders with an interest in, or remit for, medical workforce strategy. Copies of the evidence pack, Retaining our Doctors, Medical Workforce Evidence, 2013-17, which forms the body of this...

Chlamydia Screening in Ireland: a pilot study of opportunistic screening for genital Chlamydia trachomatis infection in Ireland (2007-2009). Pre-screening Report

Myles Balfe, Ruairi Brugha, Emer O'Connell, Deirdre Vaughan, Diarmuid O'Donovan, Claire Coleman, , Martin Cormican, Margaret Fitzgerald, Catherine Fleming, Hannah McGee, Andrew Murphy, , Ciaran O'Neill & Paddy Gillespie
Summary A series of background studies in 18 to 29 year olds were conducted in a range of primary care settings in Dublin and Galway, 2007-09, to assess the acceptability and feasibility of opportunistic screening for chlamydia: - semi-structured interviews with 35 women who had never been tested for a sexually transmitted infection (STI) - similar interviews with 30 men and women who had had a STI test - a questionnaire survey of 5685 students...

Chlamydia Screening in Ireland: a pilot study of opportunistic screening for genital Chlamydia trachomatis infection in Ireland (2007-2009). Screening Intervention Report

Myles Balfe, Ruairi Brugha, Emer O'Connell, Deirdre Vaughan, Diarmuid O'Donovan, Claire Coleman, , Martin Cormican, Margaret Fitzgerald, Catherine Fleming, Hannah McGee, Andrew Murphy, , Ciaran O'Neill & Paddy Gillespie
This report summarises the findings of the Pilot Screening Intervention conducted in Ireland between 2008 and 2009 as part of the Chlamydia Screening in Ireland Pilot study. The studies aimed to pilot screening models and to evaluate their feasibility and effectiveness. The study was commissioned by the Health Protection Surveillance Centre (HPSC) and overseen by the Health Research Board (HRB). It was carried out by a team from the Division of Population Health Sciences at...

Making end-of-life care central to hospital care: quality standards for end-of-life care in hospitals

Each year almost 30,000 people die in Ireland. While surveys suggest that the great majority of people would like to die at home the reality is that the great majority currently die outside the home. Three-quarters (75%) of all deaths now take place in hospitals and long-stay facilities and almost half (48%) of deaths occur in acute hospitals. End-of-life care in our hospitals is therefore everybody’s business. The Standards have been developed as part of...

Making end-of-life care central to hospital care: quality standards for end-of-life care in hospitals

Each year almost 30,000 people die in Ireland. While surveys suggest that the great majority of people would like to die at home the reality is that the great majority currently die outside the home. Three-quarters (75%) of all deaths now take place in hospitals and long-stay facilities and almost half (48%) of deaths occur in acute hospitals. End-of-life care in our hospitals is therefore everybody’s business. The Standards have been developed as part of...

Action-oriented research for master’s level dissertations: an opportunity to improve practice

Pauline Joyce & Maha Al Fahim
As academic staff become familiar with the qualifications framework of the UAE and work towards demonstrating alignment between learning outcomes, teaching/learning strategies and assessment, this is an opportune time to revisit traditional masters’ dissertation guidelines and methodologies to ensure students demonstrate mastery of a topic via achievement of a capstone project. Such a project is an opportunity to demonstrate both a contribution to knowledge and an improvement in practice. This discussion document takes the view...

Dublin Fire Brigade: Violence In The Workplace And Occupational Stress In The Control Room

Paul Harris, John F. Connolly & Ciaran O'Boyle
This study was designed to (i) identify the nature, incidence and prevalence of work-related violence (ii) examine sources and frequency of stress, and (iii) evaluate psychological distress in operational and control-room personnel. The measures used were the Survey of Violence Experienced by Staff, the Sources of Occupational Stress Questionnaire and the General Health Questionnaire. 96% of operational personnel had experienced some form of work-related violence in their careers. Primary sources of occupational stress in control...

Sustaining Academic Leadership in Higher Education

Pauline Joyce & Ciaran O'Boyle
This chapter draws on a recent case study from the healthcare sector which we argue contributes to the thinking on leadership not only in the healthcare sector, but also in the context of higher education. The chapter concludes with key messages for academic staff making a case for building capacity of leaders in education at all levels.

Platelet-bacterial interactions in the pathogenesis of infective endocarditis. Part I: The Streptococcus

Dorothea Tilley & Steven W. Kerrigan
Infective endocarditis (IE) is a life threatening disease caused by a bacterial infection of the endocardial surfaces of the heart. It is typified by the formation of septic thrombi or vegetative growth on the heart valve. Typically, both platelets and fibrin are deposited on exposed extracellular matrix proteins as part of the normal response to damage of the endocardium [1]. However, this sterile platelet-fibrin nidus facilitates colonisation of the endocardium by bacteria in the bloodstream...

The Cystic Fibrosis ‘Gender Gap’: Past Observations Present Understanding and Future Directions

Sanjay H. Chotirmall, Catherine M. Greene, Brian J. Harvey & Noel G. McElvaney
Cystic Fibrosis (CF) is a systemic disease impacting upon several organ systems. These include gastrointestinal, reproductive, endocrine and pulmonary manifestations of which the latter contributes the heaviest burden of disease morbidity, mortality and impact on quality of life. The defective protein in the disease state is the Cystic Fibrosis Transmembrane Regulator (CFTR) that normally functions as an ion channel permitting intracellular chloride escape. Regulated by cyclic adenosine monophosphate (cAMP) and localized to the apical membrane...

Tissue Engineered Solutions for Intracardiac Septal Defects: A Large Step Forward in an Unmet Clinical Need.

Aamir Hameed, Garry P. Duffy, Babar Hasan &
Congenital heart disease (CHD) is the occurrence of an anomaly in the heart structure during fetal development. The incidence of CHD is estimated to be 8 per 1000 live births in the United States, 6.9 per 1000 live births in Europe and 9.3 per 1000 live births in Asia.1 CHD varies in severity and timing of emergence of symptoms, hence they differ in ways of management.

Mineralocorticoid Receptor and Leptin: A Dangerous Liaison in the Obese Heart

Gema Marin-Royo, María Luaces, Victoria Cachofeiro & Ernesto Martínez-Martínez
Multiple factors have been proposed as being responsible for cardiac damage in the context of obesity, including aldosterone/mineralocorticoid receptor and leptin. Aldosterone exerts proinflammatory, prooxidant and profibrotic actions, which can play a key role in the development of cardiac damage associated with different pathologies, through binding of mineralocorticoid receptor (MR). Moreover, its pharmacological blockade has demonstrated to improve these situations. Different studies have demonstrated that aldosterone is inappropriately elevated in obesity and MR antagonism improves...

Aldosterone/Mineralocorticoid Receptor Downstream Targets as Novel Therapeutic Targets to Prevent Cardiovascular Remodeling

Jaime Ibarrola, Frederic Jaisser & Natalia López-Andrés
The incidence of heart failure (HF) is increasing because of aging of the population. Despite optimal therapy, patients with HF experience disease progression associated with high mortality rates. HF is still the first cause of hospital admission in subjects aged >65 years. The obvious solution for HF epidemics is to prevent new-onset HF with therapies directed specifically to mechanistic targets that are involved in the transition to HF. The mineralocorticoid receptor (MR) and its natural...

Advances in the Development of Non-steroidal Mineralocorticoidreceptor Antagonists

Felipe L. Pérez-Gordillo, & Mercedes Martín-Martínez
Aldosterone plays an important role in the regulation of blood pressure, body fluid, and electrolyte homeostasis. Overactivation of aldosterone/mineralocorticoid receptor (MR) pathway leads to hypertension, atherosclerosis, vascular damage, heart failure, and chronic kidney disease and is involved in many other diseases associated with endothelial dysfunction, inflammation, fibrosis, and metabolic disorders. Aldosterone is a final product of the renin-angiotensin-aldosterone system (RAAS), and its production is activated by angiotensin II, while angiotensin-(1–7) negatively regulates angiotensin II-mediated aldosterone...

Investigating the Role of Mineralocorticoid Receptor Signaling in Cancer Biology in the Genomic Era

&
In the last decades, advances that take place in the next-generation sequencing and bioinformatics research have helped reveal tissue- and cancer-specific gene expression patterns and mutation landscapes. Indeed, such data are now easily accessible via online genome browsers and different types and levels of public data compendia. Appropriate use of these tools eventually can lead to better patient stratification for diagnosis, prognosis, and therapy of cancers. Mineralocorticoid receptor (MR), encoded by NR3C2 gene, has long...

Investigating the Role of Mineralocorticoid Receptor Signaling in Cancer Biology in the Genomic Era

&
In the last decades, advances that take place in the next-generation sequencing and bioinformatics research have helped reveal tissue- and cancer-specific gene expression patterns and mutation landscapes. Indeed, such data are now easily accessible via online genome browsers and different types and levels of public data compendia. Appropriate use of these tools eventually can lead to better patient stratification for diagnosis, prognosis, and therapy of cancers. Mineralocorticoid receptor (MR), encoded by NR3C2 gene, has long...

View on Aldosterone and the Brain Revisited

&
The mineralocorticoid hormone aldosterone has been investigated almost exclusively with respect to cardiovascular function, as the main effects of aldosterone are related to water-electrolyte balance and the control of the blood pressure. This overview is focused on less traditional and long-time neglected effects of aldosterone on the brain and behavior. Preclinical studies by our research group brought evidence on causal relationships between aldosterone and anxiety as well as aldosterone and depression-like behavior. Aldosterone was found...

Transcriptional Regulation and Epigenetics in Cardiovascular Cells: Role of the Mineralocorticoid Receptor

Lisa Deng, Lutz Hein & Achim Lother
The mineralocorticoid receptor (MR), a ligand-activated transcription factor, plays an important role in the pathophysiology of cardiovascular disease. Epigenetic mechanisms such as DNA methylation or histone modifications in addition to the DNA sequence are decisive regulators of cell type-specific transcriptional activity and gene expression by controlling chromatin accessibility. In this review, we summarise the current knowledge about the impact of MR on gene expression in cardiovascular cells. We discuss studies investigating the interaction of MR...

Aldosterone Regulation of Protein Kinase Signaling Pathways and Renal Na+ Transport by Non-genomic Mechanisms

Warren Thomas & Brian Harvey
Aldosterone is the key regulating hormone of whole-body fluid and electrolyte homeostasis. Perturbations in aldosterone synthesis and over-activation of the mineralocorticoid receptor (MR) can lead to excess salt reabsorption and hypertension. The cortical collecting duct (CCD) is the main site of action in the kidney for aldosterone regulation of whole-body sodium homeostasis through actions on the epithelial sodium channel (ENaC) and the Na/K-ATPase (Na/K pump). Aldosterone stimulates ENaC trafficking into the apical cell membranes in...

COLT: A New Weapon to Disseminate Knowledge

Bernard C. Rossier, Michelle Rossier & Jean-Pierre Kraehenbühl
Too few researchers receive adequate pre- or postgraduate training to conduct a rigorous scientific study. In the digital age, new tools are emerging, and the development of distance education could improve this worrying situation. In this context, Health Science e-Training (HSeT), a nonprofit Swiss foundation, has developed new pedagogical concepts and tools under customized online training (COLT). For the ADMIRE Cost network, we have used an article-based e-learning (ABL) tool that allowed the students to...

The Mental Health of Young People in Ireland: A report of the Psychiatric Epidemology Research across the Lifespan (PERL) Group

Mary Cannon, Helen Coughlan, Mary Clarke, Michelle Harley & Ian Kelleher
There is increasing concern about the mental health of young people in Ireland. Reports of psychological distress, substance abuse and suicide among Irish youths have become common. While we know that many young people in Ireland are experiencing mental distress, little research has been done to determine the actual number of young people who are experiencing a diagnosable mental disorder. This report goes some way towards addressing this issue by presenting findings from two research...

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