HRB open research最新文献

Background: Sleep disturbance is common among those with cognitive impairment, potentially contributing to negative outcomes. Furthermore, growing evidence suggests that sleep disturbance is associated with the onset and progression of cognitive decline. There is therefore increasing interest in treating sleep disturbance in people with cognitive impairment.Non-pharmacological treatments for sleep disturbance are unhindered by many of the adverse effects associated with pharmacological treatments, yet evidence supporting their use in clinical practice is often lacking. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia and has demonstrated effectiveness in people with cognitive impairment in a small number of trials. Digital CBT-I (dCBT-I) overcomes many of the obstacles associated with accessing CBT-I (such as limited availability of therapists and transportation) whilst presenting others (such as internet access and digital literacy).

Aim: To undertake a mixed-methods analysis of the usability and acceptability of a dCBT-I intervention ( Sleepio) among people with cognitive impairment.

Methods: Participants will be community-dwelling adults aged ≥50 years with cognitive decline and probable insomnia. Study partners (being caregivers, family or friends of participants) will be recruited, if available, to examine how their involvement influences usability and acceptability.Participants will be given access to Sleepio, a fully automated and personalised dCBT-I programme delivered over the course of six weekly sessions. Usability and acceptability will be assessed by a bespoke questionnaire incorporating the System Usability Scale and the Usability Metric for User Experience - Lite (UMUX-Lite). Semi-structured interviews will explore participants' experience of using the intervention.

Conclusion: By examining barriers and facilitators to the usability and acceptability of Sleepio among people with cognitive impairment, this study will provide insight into the potential efficacy of the intervention in this population whilst informing the design of a future definitive clinical trial.

Background: Molecular diagnostics are critical for informing cancer patient care. In Ireland, the National Cancer Control Programme (NCCP) develops cancer therapy regimens, which include relevant information on molecular indications. Here, we present a collated overview of the current molecular indications of all NCCP systemic anti-cancer therapy regimens and the funding statuses of their associated drugs. Furthermore, we also provide estimates for the scale of required molecular testing in cancer therapy and for the clinical genetic sequencing capacity of Ireland, and provide a summary of current cancer clinical trials in Ireland which have molecular components.

Methods: Through a combination of web scraping, keyword search, and manual review, we performed a full review of all 856 indications included in the 533 therapy regimens published to date by the NCCP to identify therapy indications with explicit molecular criteria. For all cancer types identified in these indications, we obtained incidence rates in Ireland from National Cancer Registry Ireland to predict the number of patients yearly who stand to benefit from a molecular test. We then applied molecular subtype rates from published literature to estimate the number of patients who would then qualify for a relevant molecularly guided therapy.

Results: We identified 246 indications for 175 NCCP therapy regimens that include molecular criteria. These 246 molecular indications encompassed 101 genetic criteria, 161 cellular biomarker criteria, 63 molecularly informed drugs, and over 20 cancer types. We estimated that up to approximately 55% of cancer patients in Ireland could qualify for a molecular test and that the majority of tested patients would qualify for a treatment informed by a molecular test.

Conclusions: As personalised cancer medicine continues to develop in Ireland, this study will provide a baseline understanding of current practices. We anticipate that work such as this will help to inform planning in the healthcare system.

Background: People with cancer are at a higher risk of suicide than the general population. Access to means of suicide is an important volitional risk factor, that if targeted at a population level can reduce incidence of suicide deaths. People with cancer are often prescribed multiple medications that have a high case fatality when taken in overdose and therefore have increased access to specific means of high lethality self-harm. The aim of this review is to examine the methods of suicide used by people with cancer, the study designs used to explore these and what, if any, comparisons have been made to the general population.

Methods: This scoping review will follow JBI scoping review methodology guidelines and be reported according to PRISMA-ScR checklist; a systematic search will be conducted of Embase (Elsevier), CINAHL Plus (EBSCO), PsycINFO (EBSCO), PsychARTICLES(EBSCO), and PubMed (NCBI) databases and grey literature sources. A data collection tool will be specifically designed and piloted independently by two reviewers. Findings will be presented descriptively, graphically, and narratively.

Results: The results of this review will identify the breadth of evidence in relation to methods of suicide used by people with cancer, explore how different methods are defined and categorised, how the topic has been studied, and ascertain if a systematic review is possible.

Background: BioBANC Symposium has become a key forum for the Irish biobanking community. The third annual event focused on networking and quality, featuring a workshop to explore the role and value of networked biobanking for Ireland. The Director General of BBMRI-ERIC advanced these discussions by addressing an audience of interdisciplinary experts, high-level stakeholders, and policymakers from the Irish biobanking community, as well as representatives from the Health Research Charities Ireland (HRCI), the National Clinical Trials Office (NCTO), the European Clinical Research Infrastructure Network (ECRIN-ERIC) research infrastructure, and the Department of Health.

Methods: A panel discussion brought together an array of experts from patient advocacy, clinical trials, pharmaceutical industry, government, healthcare policy and BBMRI-ERIC representation to explore the integration of Ireland into the BBMRI-ERIC network. This diverse panel discussed strategies to enhance Ireland's biobanking capabilities and leverage international collaborations. Themes explored included the benefits, gaps and changes needed if Ireland was to consider membership of BBMRI-ERIC. VEVOX live polling was used to gauge audience views and questions on posed topics, enabling interactive audience participation and capturing real-time feedback to enrich the discussion.

Results: Substantial benefits that BBMRI-ERIC membership would bring for Ireland were highlighted, including enhanced infrastructure, standardised practices, and greater economic opportunities. Attendees also delved into how Ireland could address current gaps and align its biobanking operations with broader European standards. The discussion identified several critical themes and recommendations to address the need for funding, legislative support, education, public engagement, and strategic planning.

Conclusion: This article aims to encapsulate the discussions and outcomes of BioBANC Symposium III, focusing on the strategic moves Ireland must consider harnessing the full potential of its biobanking community. It serves not just as a record of proceedings but as a guide for action, urging stakeholders at all levels to collaborate towards a unified goal.

Background: Despite high reported prevalence of pelvic organ prolapse (POP), women report difficulties accessing evidence-based and reliable information about the condition. Many rely on social media and other popular and highly visible internet platforms which have been found to contain poor quality information that is difficult for the average patient to understand. The aim of the study is to co-design an information website for premenopausal women with POP. The website design will be based on the Website Developmental Model for the Healthcare Consumer (WDMHC) framework.

Methods: A four phase process will be utilised as per the WDMHC framework: 1) User, task and environmental analysis; 2) Functional and representational analysis; 3) Cognitive walkthrough, keystroke level model, heuristic testing; 4) Content based testing, expert testing and user-based testing.Ethics approval has been obtained (LS-23-19-Carroll-Ful). Two groups of stakeholders will be recruited (i) patient group (ii) healthcare professional (HCP) group. Patient participants will be recruited from an online pelvic floor dysfunction (PFD) support group (n=950 members). A website designer and HCP stakeholders involved in the multidisciplinary team caring for women with POP will be invited to participate.Both groups will participate in separate co-design online workshops. Focus group workshops will be video-recorded, transcribed and imported into NVivo. Themes and subthemes will be developed.The website will be designed and disseminated to all participants for feedback. Cognitive walkthrough and heuristic testing will be undertaken. Following this, necessary modifications will be made to the website. Participants will then complete a modified System Usability Scale (SUS) and the eHealth Impact Questionnaire, while five HCPs will complete the DISCERN instrument.

Conclusion: This study will inform the design and testing of an information website for women with POP. The website design and content will be informed by patient and HCP stakeholder voices and the health literacy literature.

Introduction: Measuring patient experience has become standard practice in many countries. However, despite the widespread awareness of the impact of health inequalities on various aspects of health, including patient experience, a comprehensive examination of whether and how health inequalities are measured in patient experience surveys has yet to be completed. The ways in which these surveys conceptualise health inequalities may have important implications for how information about inequalities in patient experience is reported and used to allocate resources and plan quality improvement in health services.

Objective: The objective of this scoping review is to map measured and overlooked health inequalities in patient experience surveys in acute care and explore what factors potentially explain current conceptualisations and measurement practices of these health inequalities. Inclusion criteria: Papers and survey programmes that contain survey materials relating to adult patient experience measurement in any acute care context will be included. No limits will be placed the personal characteristics of people who completes the survey.

Inclusion criteria: Papers and survey programmes that contain survey materials relating to adult patient experience measurement in any acute care context will be included. No limits will be placed the personal characteristics of people who completes the survey.

Methods: A search strategy was developed with an information specialist. The database search will be limited to after September 2021. Reviews, opinion pieces, letters, editorials, conference proceedings and other such sources will be excluded as a publication source. Grey literature searches will be completed, and relevant experts will also be contacted to identify any patient experience surveys not captured through database or grey literature searches. Non-English papers will be included only if resources allow. Two independent reviewers will complete title and abstract, and full-text screening. Additional reviewers will resolve any conflicts. A data extraction form developed by the review team is being used. The extracted data will be analysed using Critical Discourse Analysis, a qualitative method used to examine how power, dominance and inequality are enacted in text.

Background: The Health Service Executive (HSE) in Ireland releases monthly reports on prescription dispensing claims and payments relating to community drug schemes. This paper describes the implementation of an R-based Shiny application that facilitates interactive visualisation and analysis of trends in medication prescribing and improves the data's practical value, and presents use cases focused on drug utilisation and medication policy questions.

Methods: Using Primary Care Reimbursement Service (PCRS) data provided by the HSE relating to the means-tested General Medical Services (GMS) scheme covering approximately one-third of the population, an R-based Shiny application was developed. This application uses monthly prescribing and cost data from 2016 up to the most recent data available (currently October 2024) relating to the 100 most commonly prescribed medications (by frequency and cost) and all therapeutic groups. The application leverages a range of R packages to enable users to select medications, therapeutic groups, and physiological systems to explore and compare prescribing and cost trends over time.

Results: The RxTrends Shiny application effectively integrates PCRS data, providing multiple functionalities that allow for visualisation of dispensing trends of multiple medications, therapeutic groups and physiological systems. Graphs are available across multiple prescribing frequency and cost metrics and can be restricted to a selected time period. The 'compare' function visualises the proportion of prescribing/cost a selected medication or therapeutic group accounts for within a therapeutic group or physiological system. Use cases relating to Ireland's Preferred Drug Initiative, availability of generic products and reference pricing, and seasonality of drug utilisation are presented.

Conclusion: The application provides an interactive interface for stakeholders to visualise and monitor prescribing patterns using data from monthly PCRS reports. The application increases access to and usability of PCRS data for various audiences for whom it may be of interest, including researchers, healthcare professionals, policymakers and the general public.

Background: Approximately one in eight people live with mental health difficulties, with onset commonly occurring in youth. It is critical to ensure care addresses all aspects of health, including physical health and sexual wellbeing needs, to achieve positive recovery outcomes. Connecting primary and secondary healthcare providers and service users through shared models of care is a critical aspect of this. The objectives of this scoping review will be to 1) identify and describe the implementation of shared models of care which address the mental health of young people and their physical health and/or sexual wellbeing needs, and 2) identify the determinants of implementing these models of care.

Protocol: Following Joanna Briggs Institute guidelines, studies will be included if they describe shared models of care for young people (aged 10-25) in any healthcare setting, specifically addressing mental health and physical health or sexual wellbeing needs. The review will employ the Consolidated Framework for Implementation Research (CFIR) to organise and assess findings. A librarian developed the search strategy, which will be applied to Web of Science, Medline, Embase, CINAHL, and PsycINFO databases. Two independent reviewers will screen titles, abstracts and full texts, followed by data extraction and critical appraisal of included studies. Discrepancies at all stages will be resolved through discussion or by a third reviewer. Screening results will be summarised in a PRISMA flow diagram. Narrative summaries, supported by tables and figures where applicable, will address the review's objectives. Findings will undergo thematic analysis, with implementation determinants mapped deductively to CFIR.

Discussion: Findings will inform the adaptation of implementation strategies to support the implementation of policy for improving healthcare delivery to young people with mental health difficulties.

Registration: Open Science Framework ( osf.io/rj783).

Background: Despite the wealth of evidence demonstrating the health benefits of physical activity (PA), people with arthritis commonly do not meet recommended PA levels. Whilst various programmes support people with arthritis to become active, most individuals reduce their level of PA after completion of a structured exercise programme. This research aims to co-develop and feasibility test a PA maintenance intervention for those living with arthritis, after exit from a structured exercise programme.

Methods: Intervention development was guided by the INDEX framework for developing complex interventions.Phase 1, Evidence Synthesis: Bring together existing evidence, clinical guidelines and behavior change theories for PA maintenance in arthritis, to develop an intervention logic model.Phase 2, Observation and qualitative study: Conduct an observational analysis of a physiotherapy led structured exercise programme for those living with arthritis, to understand what behaviour change components are used and what might support PA maintenance. Followed by a qualitative exploration of PA maintenance barriers, facilitators and strategies for those who have participated in the classes, their family members/friends and the delivering physiotherapist.Phase 3, Finalise intervention prototype: Results from phases 1 and 2, will be triangulated to inform potential intervention options. Those living with arthritis/key stakeholders will be invited to participatory workshops to refine intervention content and delivery modes.Phase 4, Feasibility Study: The final phase is a pre-post, mixed methods feasibility evaluation of the newly developed multicomponent PA maintenance intervention for people living with arthritis, after completion of a physiotherapy led structured exercise programme.

Discussion: Intervention development will bring together PA maintenance theory and evidence with user input and other key contextual factors. User input will be achieved by collaboration with two embedded patient researchers and a wider Public Patient Involvement (PPI) panel to ensure diverse patient experiences and perspectives are heard and inform programme design.

Introduction: Gestational Diabetes Mellitus (GDM) is a hyperglycaemic condition diagnosed during pregnancy. GDM is strongly associated with future development of type 2 diabetes and cardiovascular disease. Lifestyle and pharmacological interventions can reduce the risk of developing type 2 diabetes. General practice is the recommended setting for long-term follow-up of women with a history of GDM. However, rates of follow-up are suboptimal. The evidence around long-term general practice healthcare for women with a history of GDM has not previously been reviewed.

Aims: The aim of this scoping review is to explore the current evidence base for the long-term care of women with a history of GDM in general practice.

Study design: The study described by this protocol is a scoping review. The study design was informed by Joanna Briggs Institute methodology.

Methods: Empirical qualitative and quantitative research studies published since 2014 will be identified from a search of the following databases: MEDLINE (Ovid), EMBASE (Elsevier), CINAHL, PsycINFO, Academic Search Complete and SocIndex. The review will identify key characteristics of the literature. Framework analysis will be used to map the findings against the Chronic Care Model, a primary care-based framework that sets out the core components for optimal long-term healthcare.

Results: A numerical descriptive summary (using frequencies) will describe the overall extent of literature, and the range and distribution of its component parts, including the geographical and economic settings, research methods, interventions, outcomes and findings. The qualitative analysis will map interventions and descriptions of care to components of the chronic care model. Research gaps will be reported, and research needs and priorities will be suggested.

Conclusion: The findings of this scoping review will have the potential to inform future research efforts in the area.

Registration: This protocol has been registered in Open Science Framework ( https://osf.io/bz2vh).