Naas Co.

Kildare, Ireland
Kildare, Ireland

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Horan L.,National University of Ireland | Horan L.,Naas Co. | Fox J.,National University of Ireland
International Journal of Psychosocial Rehabilitation | Year: 2016

Objective: This study explored the experience of individuals with mental health difficulties who completed the Wellness Recovery Action Plan (W.R.A.P.) intervention. Participant perspectives on the therapeutic elements of the WRAP, its role in recovery and constructive feedback are presented. Methods: Using descriptive phenomenological methods, in-depth semi-structured interviews were conducted with four individuals with mental health difficulties who attended a WRAP programme in a community mental health centre in Ireland. Results: Overall, participants felt that completing the WRAP was a therapeutic group experience. The identification of early warning signs and crisis planning proved particularly valuable by individuals who felt more empowered to actively manage their own mental health. Qualitative perspectives from this study point to the importance of introducing the WRAP early in an individual’s recovery journey, and providing multiple opportunities to repeat and review the process. Conclusions and Implications for Practice: Results support the findings of earlier studies in which the WRAP was found to be a self-management programme that contributes to the recovery of individuals with mental health difficulties. Group peer support was valued by participants, but future research should study the effectiveness of the WRAP in comparison to other peer support programmes. © 2016 ADG, SA. All Rights Reserved.


Ward M.,University College Dublin | McAuliffe E.,University College Dublin | Wakai A.,Royal College of Surgeons in Ireland | Wakai A.,Beaumont Hospital | And 8 more authors.
BMC Health Services Research | Year: 2017

Background: Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). Methods: A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of ‘Plan Do Study Act’ (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Discussion: Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration. © 2017 The Author(s).


PubMed | Cork University Hospital, University College Dublin, Institute for Clinical Evaluative science, Naas Co and 3 more.
Type: Journal Article | Journal: BMC health services research | Year: 2017

Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED).A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of Plan Do Study Act (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed.Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration.


Gildea S.,Naas Co. | Arkins S.,University of Limerick | Walsh C.,Trinity College Dublin | Cullinane A.,Naas Co.
Vaccine | Year: 2011

Many racing authorities, sales companies and equestrian bodies have mandatory vaccination policies for equine influenza (EI). The consequences of lack of vaccine efficacy include clinical disease, disruption to training programmes, the cancellation of equestrian events and the introduction of virus to susceptible populations. The correlation between antibody against the virus haemagglutinin and protection against influenza has been well established. The objective of this study was to compare the antibody responses of 66 unvaccinated Thoroughbred weanlings on four different stud farms, following primary vaccination (V1, V2 and V3) with the five EI vaccines commercially available in Ireland (Duvaxyn IET Plus, Equilis Resequin, Equip FT, Equilis Prequenza Te, ProteqFlu Te). Antibody responses were monitored for 6 months post V3 by single radial haemolysis. The pattern of antibody response was similar for all vaccines and for all antigens tested. A rapid decline of antibody level was observed by 3 months post V2 for all vaccines. The antibody response of the horses vaccinated with the whole virus vaccine Duvaxyn IET Plus was significantly higher than that of the horses vaccinated with the other four products. Five weanlings had maternally derived antibodies (MDA) at the time of V1. The canary pox recombinant vaccine, subunit vaccine and whole virus inactivated vaccines administered to these weanlings did not induce a detectable antibody response against the background of MDA but effectively primed the animals as revaccination resulted in a strong antibody response. In this study 43% of the weanlings failed to seroconvert after V1. This high incidence of poor responders has not been reported in previous experimental studies relating to these products. The poor responders were observed in all vaccine groups except those vaccinated with Duvaxyn IET Plus. Post V2 the incidence of poor responders was reduced to 7% and all horses responded to V3. The study demonstrates that independent evaluation of influenza vaccine performance in the field is critical to add to the body of knowledge gained from experimental challenge experiments carried out for regulatory or marketing purposes. © 2011 .


Khan S.A.,Naas Co. | Stephens L.R.,Naas Co. | O'Riordan D.,Naas Co. | Rothwell J J.,Naas Co.
Surgical Chronicles | Year: 2011

Background: For day case laparoscopic surgery to be successful, patient selection is of the utmost importance. Factors that lead to overstay and readmission must be identified at an early stage. This study aims to identify patient-related factors that predis-pose to readmission or overstay following day case laparoscopic inguinal hernia repair surgery. Methods: A cohort study of patients undergoing elective day case laparoscopic hernia repair (TEP) from 2004 to 2009 was un-dertaken. A total number of 163 patients were included in this study. Patient age, social circumstances, co morbidities and ASA (American Society of Anesthesiologists) score were recorded. Reasons documented for overstay and readmission and duration were also recorded. Results: 21 patients (12.8%) following the procedure overstayed, or were readmitted at a later date. 3.7% (n=6) (p=0.05, CI 95%) of patients were readmitted and 9.2% (n=15) (p=0.05, CI 95%) overstayed. 23 of the 163 patients included in this study were classified as ASA III, and 60.87% (14/23) of these patients were readmitted or overstayed, as compared to 8.77% (5/57) of ASA II patients and 2.41% (2/83) of ASA I patients. Post-operative pain 19% (4/21) and urinary retention 52.3% (11/21) were the lead-ing causes for readmission/overstay. Conclusions: Day case laparoscopic inguinal hernia repair is a feasible and safe option and should be performed in the main. Me-ticulous pre-assessment and identification of risk factors for overstay and readmission is a fundamental component of delivery of ambulatory day surgery. The authors conclude that ASA score of III or more and increasing age correlate with an increasing incidence of overstay and readmission and therefore we would recommend that these factors are taken into consideration when planning a day case procedure.


Gildea S.,Naas Co. | Quinlivan M.,Naas Co. | Murphy B.A.,University College Dublin | Cullinane A.,Naas Co.
Vaccine | Year: 2013

Previous studies in experimental ponies using interferon gamma (IFN-. γ) as a marker for cell mediated immune (CMI) response demonstrated an increase in IFN-. γ gene expression following vaccination with an ISCOM subunit, a canarypox recombinant and more recently, an inactivated whole virus vaccine. The objective of this study was to carry out an independent comparison of both humoral antibody and CMI responses elicited following vaccination with all these vaccine presentation systems. Antibody response of 44 Thoroughbred weanlings was monitored for three weeks following the second dose of primary vaccination (V2) by single radial haemolysis (SRH). The pattern of antibody response was similar for all vaccines. The antibody response of horses vaccinated with the inactivated whole virus vaccine (Duvaxyn IE-T Plus) was superior to that of the horses vaccinated with the ISCOM-matrix subunit (Equilis Prequenza Te) and canarypox recombinant (ProteqFlu-Te) vaccine. In this study 39% of weanlings failed to seroconvert following their first dose of primary vaccination (V1). Poor response to vaccination (H3N8) was observed among weanlings vaccinated with Equilis Prequenza Te and ProteqFlu-Te but not among those vaccinated with Duvaxyn IE-T Plus. PAXgene bloods were collected on days 0, 2, 7 and 14 following V1. Gene expression levels of IFN-. γ, IL-1β (proinflammatory cytokine) and IL-4 (B cell stimulating cytokine) were measured using RT-PCR. Mean gene expression levels of IL-1β and IL-4 peaked on day 14 post vaccination. The increase in IL-4 gene expression by horses vaccinated with Equilis Prequenza Te was significantly greater to those vaccinated with the other two products. Vaccination with all three vaccines resulted in a significant increase in IFN-. γ gene expression which peaked at 7 days post V1. Overall, there was no significant difference in IFN-. γ gene expression by the horses vaccinated with the whole inactivated, the subunit and the canarypox recombinant vaccines included in this study. © 2013.


PubMed | Naas Co
Type: Journal Article | Journal: Irish veterinary journal | Year: 2011

This study sought to determine whether an increase in resistance of Rhodococcus equi to the antibiotics rifampin and erythromycin occurred over a 10-year period. This was carried out by the use of E test strips for rifampin and erythromycin to determine the MIC (minimum inhibitory concentration) values of Rhodococcus equi to this combination of antibiotics.The findings of this study indicated that there was an increase in resistance of Rhodococcus equi to rifampin and erythromycin over the 10-year period. The MIC for rifampin increased from 0.081 g/ml in 1996 to 0.187 g/ml in 2006 and from 0.258 g/ml for erythromycin during the years prior to 2000 to 0.583 g/ml in 2006.This finding suggests that there may be a problem in the treatment of Rhodococcus equi infections in foals in the future, particularly as the number of drugs available for treatment of Rhodococcus equi infection is limited because of the intracellular capabilities of this bacterium. Antibiotics used in its treatment have to be able to penetrate the polysaccharide cell wall of Rhodococcus equi as well as the alveolar macrophages in which the bacterium is capable of surviving.


PubMed | Naas Co
Type: Journal Article | Journal: Irish veterinary journal | Year: 2011

Respiratory infections, recurrent airway obstruction (RAO) and exercise induced pulmonary haemorrhage (EIPH) are major causes of poor performance in horses. Fungi and mycotoxins are now recognised as a major cause of these conditions. The most notable fungi are Aspergillus and Fusarium. Fungal spores can originate from forage, bedding and feed and, in turn, these fungal spores can produce a series of mycotoxins as secondary metabolites.This study set out to ascertain the degree of fungal and mycotoxin contamination in feed and fodder used in Irish racing yards over a one-year period. Weather conditions in forage producing areas were sampled by Met Eireann and the Canadian Meteorological Service.Fifty per cent of Irish hay, 37% of haylage and 13% of Canadian hay contained pathogenic fungi. Of the mycotoxins, T2 and zearalenone were most prominent. Twenty-one per cent of Irish hay and 16% of pelleted feed contained zearalenone. Forty per cent of oats and 54% of pelleted feed contained T2 toxins.


Many racing authorities, sales companies and equestrian bodies have mandatory vaccination policies for equine influenza (EI). The consequences of lack of vaccine efficacy include clinical disease, disruption to training programmes, the cancellation of equestrian events and the introduction of virus to susceptible populations. The correlation between antibody against the virus haemagglutinin and protection against influenza has been well established. The objective of this study was to compare the antibody responses of 66 unvaccinated Thoroughbred weanlings on four different stud farms, following primary vaccination (V1, V2 and V3) with the five EI vaccines commercially available in Ireland (Duvaxyn IET Plus, Equilis Resequin, Equip FT, Equilis Prequenza Te, ProteqFlu Te). Antibody responses were monitored for 6 months post V3 by single radial haemolysis. The pattern of antibody response was similar for all vaccines and for all antigens tested. A rapid decline of antibody level was observed by 3 months post V2 for all vaccines. The antibody response of the horses vaccinated with the whole virus vaccine Duvaxyn IET Plus was significantly higher than that of the horses vaccinated with the other four products. Five weanlings had maternally derived antibodies (MDA) at the time of V1. The canary pox recombinant vaccine, subunit vaccine and whole virus inactivated vaccines administered to these weanlings did not induce a detectable antibody response against the background of MDA but effectively primed the animals as revaccination resulted in a strong antibody response. In this study 43% of the weanlings failed to seroconvert after V1. This high incidence of poor responders has not been reported in previous experimental studies relating to these products. The poor responders were observed in all vaccine groups except those vaccinated with Duvaxyn IET Plus. Post V2 the incidence of poor responders was reduced to 7% and all horses responded to V3. The study demonstrates that independent evaluation of influenza vaccine performance in the field is critical to add to the body of knowledge gained from experimental challenge experiments carried out for regulatory or marketing purposes.


Previous studies in experimental ponies using interferon gamma (IFN-) as a marker for cell mediated immune (CMI) response demonstrated an increase in IFN- gene expression following vaccination with an ISCOM subunit, a canarypox recombinant and more recently, an inactivated whole virus vaccine. The objective of this study was to carry out an independent comparison of both humoral antibody and CMI responses elicited following vaccination with all these vaccine presentation systems. Antibody response of 44 Thoroughbred weanlings was monitored for three weeks following the second dose of primary vaccination (V2) by single radial haemolysis (SRH). The pattern of antibody response was similar for all vaccines. The antibody response of horses vaccinated with the inactivated whole virus vaccine (Duvaxyn IE-T Plus) was superior to that of the horses vaccinated with the ISCOM-matrix subunit (Equilis Prequenza Te) and canarypox recombinant (ProteqFlu-Te) vaccine. In this study 39% of weanlings failed to seroconvert following their first dose of primary vaccination (V1). Poor response to vaccination (H3N8) was observed among weanlings vaccinated with Equilis Prequenza Te and ProteqFlu-Te but not among those vaccinated with Duvaxyn IE-T Plus. PAXgene bloods were collected on days 0, 2, 7 and 14 following V1. Gene expression levels of IFN-, IL-1 (proinflammatory cytokine) and IL-4 (B cell stimulating cytokine) were measured using RT-PCR. Mean gene expression levels of IL-1 and IL-4 peaked on day 14 post vaccination. The increase in IL-4 gene expression by horses vaccinated with Equilis Prequenza Te was significantly greater to those vaccinated with the other two products. Vaccination with all three vaccines resulted in a significant increase in IFN- gene expression which peaked at 7 days post V1. Overall, there was no significant difference in IFN- gene expression by the horses vaccinated with the whole inactivated, the subunit and the canarypox recombinant vaccines included in this study.

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