Medicine and Health Sciences Commons^™

The Challenges Of Leading Change In Health-Care Delivery From The Frontline, Vivienne Byers

Articles

Aim: The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change.

Background: Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person- centred policy, nurses can be seen to be doing the best they can within a constrained environment.

Method: A survey of nursing practice in person-centred health-policy …

Detection And Epidemiology Of Plasmid-Mediated Ampc B-Lactamase Producing Escherichia Coli In Two Irish Tertiary Care Hospitals, Celine Herra

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This study determined the prevalence and distribution of plasmid-mediated AmpC (pAmpC) b-lactamases in Irish Escherichia coli isolates. Clinical E. coli isolates (n = 95) that were intermediate or resistant to cefoxitin and/or flagged by VITEK 2 as potential AmpC-producers underwent confirmation using a MASTDISCST ESBL and AmpC Detection Kit. Multiplex PCR capable of detecting family-specific plasmid ampC genes was performed to detect the presence of these genes. Five PCR- negative isolates were selected for promoter analysis. PFGE and MLST were performed on E. coli isolates that harboured a plasmid ampC gene to determine their clonal relatedness. Plasmid ampC genes were …

Student Educational Background, Perceptions And Expectations Towards Optometry: An Emerging Eye Health Profession Mozambique., James Loughman, Ving Fai Chan, Vanessa Raquel Moodley, Luigi Bilotto, Kovin Naidoo

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Background: The University of Lurio, School of Optometry in Mozambique is a new program in Africa. The school, the first to serve Portuguese-speaking Africa, can act as a template for such initiatives in other African countries and other limited-resource settings around the world. A major challenge facing such programs is the lack of knowledge about the profession, which impacts the recruitment of students and their expectations of the program. This study was conducted to understand students’ pre-enrollment educational background, perceptions and career expectations as an optometrist in Mozambique so as to inform future enrollment and other similar initiatives. Methods: First-year …

15 Years On Sirna Delivery: Beyond The State-Of-The-Art On Inorganic Nanoparticles For Rnai Therapeutics, Joao Conde, Furong Tian, Alfredo Ambrosone, Yulán Hernandez, Mark Mccully, Catherine C. .Berry, Pedro Baptista, Claudia Tortiglione, Jesus M. De La Fuented

Articles

RNAi has always captivated scientists due to its tremendous power to modulate the phenotype of living organisms. This natural and powerful biological mechanism can now be harnessed to downregulate specific gene expression in diseased cells, opening up endless opportunities. Since most of the conventional siRNA delivery methods are limited by a narrow therapeutic index and significant side and off-target effects, we are now in the dawn of a new age in gene therapy driven by nanotechnology vehicles for RNAi therapeutics. Here, we outlook the “do's and dont's” of the inorganic RNAi nanomaterials developed in the last 15 years and the …

Bioresponsive Antisense Dna Gold Nanobeacons As A Hybrid In Vivo Theranostics Platform For The Inhibition Of Cancer Cells And Metastasis, Chenchen Bao, Joao Conde, James Curtin, Daxiang Cui, Furong Tian, Natalie Artzi

Articles

Gold nanobeacons can be used as a powerful tool for cancer theranostics. Here, we proposed a nanomaterial platform based on gold nanobeacons to detect, target and inhibit the expression of a mutant Kras gene in an in vivo murine gastric cancer model. The conjugation of fluorescently-labeled antisense DNA hairpin oligonucleotides to the surface of gold nanoparticles enables using their localized surface plasmon resonance properties to directly track the delivery to the primary gastric tumor and to lung metastatic sites. The fluorescently labeled nanobeacons reports on the interaction with the target as the fluorescent Cy3 signal is quenched by the gold …

Diary Of A Cataract Surgeon 2045, Claire E. Mcdonnell

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No abstract provided.

Lower Macular Pigment Optical Density In Foveal-Involved Glaucoma., James Loughman

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Purpose: To evaluate the relationship between macular pigment optical density (MPOD) and structural parameters of the macula and optic nerve head in glaucomatous eyes.

Vitamin D As An Adjunctive Therapy In Asthma. Part 1: A Review Of Potential Mechanisms, Conor Kerley, Basil Elnazir, John Faul, Liam Cormican

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Vitamin D deficiency (VDD) is highly prevalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease. Further, VDD and asthma share several common risk factors including high latitude, winter season, industrialization, poor diet, obesity, and dark skin pigmentation. Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production …

Vitamin D As An Adjunctive Therapy In Asthma. Part 2: A Review Of Human Studies, Conor Kerley, Basil Elnazir, John Faul, Liam Cormican

Articles

Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25- dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to …

Rnai-Based Glyconanoparticles Trigger Apoptotic Pathways For In Vitro And In Vivo Enhanced Cancer-Cell Killing, Joao Conde, Furong Tian, Yulan Hernandez, Chenchen Bao, Pedro Baptista, Daxiang Cui, Tobias Stoeger, Jesus M. De La Fuentec

Articles

biotechnology and material science due to their amazing physical, chemical and biological properties. Here, siRNA GlycoNPs (AuNP@PEG@Glucose@siRNA) in comparison to PEGylated GlycoNPs (AuNP@PEG@Glucose) were applied in vitro to a luciferase-CMT/167 adenocarcinoma cancer cell line and in vivo via intratracheal instillation directly into the lung of B6 albino mice grafted with luciferase-CMT/167 adenocarcinoma cells. siRNA GlycoNPs but not PEGylated GlycoNPs induced the expression of pro-apoptotic proteins such as Fas/CD95 and caspases 3 and 9 in CMT/167 adenocarcinoma cells in a dose dependent manner, independent from the inflammatory response, evaluated by bronchoalveolar lavage cell counting. Moreover, in vivo pulmonary delivered siRNA GlycoNPs …

Insole Antenna For On-Body Telemetry, Domenico Gaetano, Patrick Mcevoy, Max Ammann, Matthias John, Colm Brannigan, Louise Keating, Frances Horgan

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A 433 MHz antenna is proposed for integration with the insole of footwear for a body area network. The folded dipole design with an asymmetric groundplane radiates from its edges and considers the close proximity of the human foot and ground surfaces. It functions for different ground conductivity conditions and an on-body communication link with an Inverted F Antenna in the upper body area was evaluated on a static and dynamic human subject. The antenna solution was compliant with Specific Absorption Rate requirements, remains matched and links with upper-body nodes regardless of the body posture and node location.

Evaluations Of Refraction Competencies Of Ophthalmic Technicians In Mozambique., James Loughman, Kajal Shah, Kovin Naidoo, Margarida Chagunda

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Purpose: Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Methods: Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills.

Raman Micro Spectroscopy For In Vitro Drug Screening: Subcellular Localisation And Interactions Of Doxorubicin, Zeineb Farhane, Franck Bonnier, Alan Casey, Hugh Byrne

Articles

Vibrational spectroscopy, including Raman spectroscopy, has been widely used over the last few years to explore potential biomedical applications. Indeed, Raman spectroscopy has been demonstrated to be a powerful non-invasive tool in cancer diagnosis and monitoring. In confocal microscopic mode, the technique is also a molecularly specific analytical tool with optical resolution which has potential applications in subcellular analysis of biochemical processes, and therefore as an in vitro screening tool of the efficacy and mode of action of, for example, chemotherapeutic agents.

In order to demonstrate and explore the potential in this field, established, model chemotherapeutic agents can be valuable. …

Optical Diagnostics – Spectropathology For The Next Generation, Malgorzata Baranska, Hugh Byrne

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Spectropathology For The Next Generation: Quo Vadis?, Hugh Byrne, Malgorzata Baranska, Gerwin J. Pupples, Nick Stone, Bayden Wood, Kathleen M. Gough, Peter Lasch, Phil Heraud, Josep Sulé-Suso, Ganesh Sockalingum

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Although the potential of vibrational spectroscopy for biomedical applications has been well demonstrated, translation into clinical practice has been relatively slow. This Editorial assesses the challenges facing the field and the potential way forward. While many technological challenges have been addressed to date, considerable effort is still required to gain acceptance of the techniques among the medical community, standardise protocols, extend to a clinically relevant scale, and ultimately assess the health economics underlying clinical deployment. National and international research networks can contribute much to technology development and standardisation. Ultimately, large-scale funding is required to engage in clinical trials and instrument …

Macular Pigment Optical Density Is Lower In Type 2 Diabetes, Compared With Type 1 Diabetes And Normal Controls., James Loughman, Grainne Scanlon, Paul Connell, Audrey Murphy, Karen O'Conner, Mathew Ratzlaff, Brittany Foerg

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Purpose: This study was designed to investigate the optical density of macular pigment in Type 1 and Type 2 diabetes subjects relative to normal controls

Vibrational Microspectroscopy For Cancer Screening, Fiona Lyng, Ines Ramos, Ola Ibrahim, Hugh Byrne

Articles

Vibrational spectroscopy analyses vibrations within a molecule and can be used to characterise a molecular structure. Raman spectroscopy is one of the vibrational spectroscopic techniques, in which incident radiation is used to induce vibrations in the molecules of a sample, and the scattered radiation may be used to characterise the sample in a rapid and non-destructive manner. Infrared (IR) spectroscopy is a complementary vibrational spectroscopic technique based on the absorption of IR radiation by the sample. Molecules absorb specific frequencies of the incident light which are characteristic of their structure. IR and Raman spectroscopy are sensitive to subtle biochemical changes …

Multivariate Statistical Methodologies Applied In Biomedical Raman Spectroscopy: Assessing The Validity Of Partial Least Squares Regression Using Simulated Model Datasets, Mark E. Keating, Haq Nawaz, Franck Bonnier, Hugh Byrne

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Raman spectroscopy is fast becoming a valuable analytical tool in a number of biomedical scenarios, most notably disease diagnostics. Importantly, the technique has also shown increasing promise in the assessment of drug interactions on a cellular and subcellular level, particularly when coupled with multivariate statistical analysis. However, an important consideration, both with Raman spectroscopy and the associated statistical methodologies, is the accuracy of these techniques and more specifically the sensitivities which can be achieved and ultimately the limits of detection of the various methods. The purpose of this study is thus the construction of a model simulated data set with …

Analyses Of Ionizing Radiation Effects In – Vitro In Peripheral Blood 1 Lymphocytes With Raman Spectroscopy, Adrian Maguire, Isabel Vegacarrascal, Lisa White, B. Mcclean, Orla L. Howe, Fiona Lyng, Aidan Meade

Articles

The use of Raman spectroscopy to measure the biochemical profile of healthy and diseased cells and tissues may be a potential solution to many diagnostic problems in the clinic. Although extensively used to identify changes in the biochemical profiles of cancerous cells and tissue, Raman spectroscopy has been used less often for analyzing changes to the cellular environment by external factors such as ionizing radiation. In tandem with this, the biological impact of low doses of ionizing radiation remains poorly understood. Extensive studies have been performed on the radiobiological effects associated with radiation doses above 0.1 Gy, and are well …

Barriers To Utilisation Of Refractive Services In Mozambique., James Loughman, Stephen Thompson, Carmen Gonzalez-Alvarez, Kovin Naidoo, Farai Chinanayi, Geoff Harris

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Mozambique has a population of more than 25 million people.1 Nampula Province has just fewer than 4 million people.2 Although Mozambique is currently experiencing unprecedented economic growth rates, buoyed by the discovery of natural resources, significant challenges remain for the population, such as adequate health care, including eye health services. VISION 2020 is a global initiative to eliminate avoidable blindness by the year 2020. Its core strategies are focused on human resource development, infrastructure development, and disease control.3 The Mozambique Eyecare Project delivered a regional optometry model for Lusophone Africa, based on the VISION 2020 core strategies. A key output …

Rapid Assessment Of Refractive Error, Presbyopia, And Visual Impairment And Associated Quality Of Life In Nampula, Mozambique, James Loughman, Lindelwa Nxele, Cesar Faria, Stephen Thompson, Prasidh Ramson, Farai Chinanyi, Kovin S. Naidoo

Articles

Introduction: Uncorrected refractive error is the leading cause of visual impairment worldwide and leads to an impaired quality of life. This study was designed to determine the prevalence of uncorrected refractive error and presbyopia, to assess spectacle coverage, and to evaluate visual health-related quality of life among persons aged 15–50 years old in Nampula, Mozambique.

Methods: Participants were assessed using a validated rapid assessment of refractive error protocol, comprised of a demographic questionnaire, a standardized ophthalmic assessment to determine refractive status and spectacle coverage, and a modified vision-related quality of life questionnaire to assess the impact of uncorrected refractive error …

Photonic Hydrogel Sensors, Ali K. Yetisen, Haider Butt, Lisa R Volpatti, Ida Pavlichenko, Matjaž Humar, Sheldon J.J.Kwok Sheldon J.J.Kwok, Heebeom Koo, Ki Su Kim, Izabela Naydenova, Ali Khademhosseini, Sei Kwang Hahnk, Seok Hyun Yunaf

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Analyte-sensitive hydrogels that incorporate optical structures have emerged as sensing platforms for point-of-care diagnostics. The optical properties of the hydrogel sensors can be rationally designed and fabricated through self-assembly, microfabrication or laser writing. The advantages of photonic hydrogel sensors over conventional assay formats include label-free, quantitative, reusable, and continuous measurement capability that can be integrated with equipment-free text or image display. This Review explains the operation principles of photonic hydrogel sensors, presents syntheses of stimuli-responsive polymers, and provides an overview of qualitative and quantitative readout technologies. Applications in clinical samples are discussed, and potential future directions are identified.

Visual Function And Its Relationship With Severity Of Early, And Activity Of Neovascular, Age-Related Macular Degeneration, James Loughman, Sarah Sabour-Pickett, John M. Nolan, Barbara Klein, Ron Klein, Stephen Beatty

Articles

Purpose: To investigate the relationship between visual function and severity of early age-related macular degeneration (AMD) and activity of neovascular (nv-) AMD.

Methods: The following data was collected from 66 eyes of 66 subjects with early AMD and 47 eyes of 47 subjects with active nv-AMD: corrected distance visual acuity (CDVA); contrast sensitivity (CS); glare disability (GD); and retinotopic ocular sensitivity (ROS) of the central 5° of the retina, by microperimetry. Fundus photographic grading of early AMD was performed in a masked fashion. Mean foveal thickness (MFT) was measured by spectral domain optical coherence tomography in patients with nv-AMD.

Results: …

The Relationship Between Tooth Size Discrepancy And Archform Classification In Orthodontic Patients, Gerard O'Mahony, Declan T. Millett, Michael S. Cronin, Mark K. Barry, Grant T. Mcintyre

Articles

Background

To determine the relationship between clinically significant tooth size discrepancies (TSD) and archform classification in orthodontic patients.

Material and Methods

Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win.

Results

Reproducibility of the classification of archform was very good (unweighted Kappa statistic of 0.83 with a 95% …

Binding Of Dna By A Dinitro-Diester Calix[4]Arene: Denaturation And Condensation Of Dna, Mary Deasy, Pilar Lopez-Cornejo, F J. Ostos, J A. Lebron, M L. Moya

Articles

A study of a dinitro-diester calix[4]arene (5,17-(3-nitrobenzylideneamino)-11,23-di-tert-butyl- 25,27-diethoxycarbonyl methyleneoxy-26,28-dihydroxycalix[4]arene) interaction with calf-thymus DNA was carried out using several techniques. The measurements were done at various molar ratios X=[calixarene]/[DNA]. Results show diverse changes in the DNA conformation depending on the X value. Thus, at low macrocycle concentration, the calixarene binds to the polynucleotide. This interaction, mainly in groove mode, weakens the hydrogen bonds between the base pairs of the helix inducing the denaturation of the double strands, as well as the condensation of the macromolecule, from an extended coil state to a globular state. An opposite effect is observed …

Inverse Relationship Between Physical Activity, Adiposity And Arterial Stiffness In Healthy Middle-Aged Subjects, Oscar Mac Ananey, B Mc Loughlin, A Leonard, L Maher, P Gaffney, G Boran, V Maher

Articles

BACKGROUND:

Several obesity related factors are reported to exacerbate premature arterial stiffening, including inactivity and metabolic disarray. The aim of the present study was to investigate the relationship between physical activity, arterial stiffness and adiposity using objective methods. To further explore the role of adiposity in this complex process, obesity associated anthropometric and humoral biomarkers were measured.

METHODS:

Seventy-nine healthy, lifelong non-smoking, subjects were recruited. Habitual physical activity was measured using accelerometry. Arterial stiffness (augmentation index; AIx & pulse wave velocity; PWV), was measured using tonometry. Body composition was estimated using bioimpedence. Adipose associated biomarkers, leptin and adiponectin, were also …

Functional Conservation Of An Ancestral Pellino Protein In Helminth Species, Christopher Cluxton, Brian Caffrey, Gemma Kinsella, Paul Moynagh, Mario Fares, Padraic Fallon

Articles

The immune system of H. sapiens has innate signaling pathways that arose in ancestral species. This is exemplified by the discovery of the Toll-like receptor (TLR) pathway using free-living model organisms such as Drosophila melanogaster. The TLR pathway is ubiquitous and controls sensitivity to pathogen-associated molecular patterns (PAMPs) in eukaryotes. There is, however, a marked absence of this pathway from the plathyhelminthes, with the exception of the Pellino protein family, which is present in a number of species from this phylum. Helminth Pellino proteins are conserved having high similarity, both at the sequence and predicted structural protein level, with that …

A Quantum Theory Of Consciousness May Require A Paradigm Shift In Biology, Maurice Goodman

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It is often assumed that the known physical laws form a closed system and are complete. It is also assumed that biological theories require no additional principles that are fundamental other than those we already know. Assumptions such as these are acting as a barrier to progress in biological theories and an understanding of consciousness. This paper examines the unexplained inconsistencies among fundamental particles and forces and the fundamental gaps in our knowledge of biology and the cell in particular that may impact on such progress. Also, the laws of quantum mechanics are examined and found to be grossly incomplete. …

Trailmaking Test Performance Contributes To Subjective Judgment Of Visual Efficiency In Older Adults, Annalisa Setti, James Loughman, George Savva, Rose Anne Kenny

Articles

Introduction.

The determinant factors that influence self-reported quality of vision have yet to be fully elucidated. This study evaluated a range of contextual information, established psychophysical tests, and in particular, a series of cognitive tests as potentially novel determinant factors.

Materials &Methods. Community dwelling adults (aged 50+) recruited to Wave 1 of The Irish Longitudinal Study on Ageing, excluding those registered blind, participated in this study (N = 5,021). Self-reports of vision were analysed in relation to visual acuity and contrast sensitivity, ocular pathology, visual (Choice Response Time task; TrailMaking Test) and global cognition. Contextual factors such as having visited …

Breast-Feeding And Postpartum Maternal Weight Trajectories, Laura Mullaney, Amy O'Higgins, Shona Cawley, Rachel Kennedy, Daniel Mccartney, Michael J. Turner

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We examined whether breast-feeding, and in particular exclusive breast-feeding, was associated with maternal weight and body composition changes at 4 months postpartum independently of other maternal variables.