Informing Implementation of a National Integrated Clinical Pathway for Low Back Pain in Ireland: A Pre-Implementation Qualitative Study With General Practitioners.

Introduction: Ireland's Health Service Executive is developing a new national integrated low back pain (LBP) pathway spanning primary and secondary care to improve LBP healthcare. Clinical pathways are frequently employed to optimise clinical outcomes and resource use but are challenging to implement. Context-specific implementation planning, leveraging implementation science and its conceptual frameworks, should inform successful implementation.

Barriers and enablers to the management of osteoarthritis in primary care in Ireland from the perspective of healthcare professionals and individuals with osteoarthritis: a qualitative study using the Theoretical Domains Framework.

Objectives: To explore the barriers and enablers to providing and receiving primary care for osteoarthritis (OA) in Ireland from the perspectives of primary care healthcare professionals (HCPs) and individuals with OA.

Design: Descriptive qualitative study incorporating an inductive thematic analysis to identify key barrier and enabler themes and subsequent deductive mapping to the Theoretical Domains Framework (TDF).

Setting: Primary care in Ireland.

Influenza A virus transcription generates capped cRNAs that activate RIG-I.

During influenza A virus (IAV) infection, host pathogen receptor retinoic acid-inducible gene I (RIG-I) detects the partially complementary, 5'-triphosphorylated ends of the viral genome segments and non-canonical replication products. However, it has also been suggested that innate immune responses may be triggered by viral transcription. In this study, we investigated whether an immunostimulatory RNA is produced during IAV transcription.

Longitudinal relationship between hip displacement and hip function in children and adolescents with cerebral palsy: A scoping review.

Aim: To identify, describe, and synthesize available evidence on the longitudinal relationship between hip displacement and hip function, using the International Classification of Functioning, Disability and Health (ICF) framework, in children and adolescents with cerebral palsy (CP) aged up to 18 years.

Method: Five databases were searched systematically from inception to May 2022. Study and sample characteristics, and hip displacement and hip function measures, mapped to the ICF domains, were extracted for narrative synthesis.

Structured Intervention of Early Term Preclinical Veterinary Students Experiencing Academic Peril Improves Academic Performance.

Veterinary medical students experiencing curricular challenges naturally look to their institution for resources to facilitate improvement in academic productivity. Academic remediation programs tend to be institution-specific, and their impact on student success is uncommonly interrogated using rigorous objective assessment. This study investigated the deployment of an academic development program (ADP) in the second semester of the Doctor of Veterinary Medicine (DVM) Program.

One size does not fit all for URiM applicants: a comparison of NPM program size on URiM applications.

Neonatal-perinatal medicine (NPM) lacks a racially and ethnically diverse physician workforce. Fewer trainees from groups underrepresented in medicine (URiM) are entering NPM due to declining match rates in general pediatrics, financial burdens from delaying workforce entry, and ineffective recruitment into NPM. Annual surveys from the Organization of Neonatology Training Program Directors (ONTPD) were analyzed to assess URiM recruitment trends between 2021 and 2023.

Patterns of pain medication usage and self-reported pain in older Irish adults with osteoarthritis: A latent class analysis of data from the Irish Longitudinal Study on Ageing.

Background: This study aimed to identify and describe links between pain medication use and self-reported pain among people aged ≥ 50 years with osteoarthritis (OA) in an Irish population, and to examine the relationships between pain, medication usage and socioeconomic and clinical characteristics.

Methods: Secondary data analysis of wave 1 cross-sectional data from The Irish Longitudinal Study on Ageing (TILDA) was undertaken of 1042 people with self-reported doctor-diagnosed OA. We examined use of medications typically included in OA clinical guidelines, including non-opioid analgesics (e.

Cost Comparison of a Traditional Didactic versus National Flipped Classroom Curriculum.

Objective:  We compared the cost of faculty time preparing educational materials for traditional didactic (TD) education provided at local institutions with that of faculty time preparing National Neonatology Curriculum (NNC) flipped classroom (FC) educational materials shared among institutions for fellow education across the United States.

Study Design:  Using survey data and the national average for faculty educators' salaries, we calculated the cost of developing TD versus FC materials. Wilcoxon rank-sum test and comparison of two Poisson rates were utilized to evaluate the time to create versus update TD materials and the cost to create new TD versus FC materials, respectively.

An EDucation and eXercise intervention for gluteal tendinopathy in an Irish setting: a protocol for a feasibility randomised clinical trial (LEAP-Ireland RCT).

Background: Gluteal tendinopathy (GT) is a degenerative tendon condition characterised by pain over the greater trochanter of the hip. A randomised controlled trial (RCT) in Australia found that 14 sessions of EDucation on load management plus eXercise (EDX) delivered over 8 weeks resulted in greater improvements in global rating of change and pain outcomes at 8 and 52 weeks, compared with corticosteroid injection or 'wait and see'. Typically, 5-6 physiotherapy sessions are provided in public and private physiotherapy settings in Ireland, therefore, the aim of this study is to examine the feasibility of conducting a future definitive RCT to investigate effectiveness of 6 sessions of the EDX programme compared to usual care.

Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial.

Objectives: To investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo ointment and eccentric exercise.

Methods: This was a single-site randomised double-blind placebo-controlled trial at an acute hospital, Dublin, Ireland. Patients with chronic mid-portion Achilles tendinopathy were randomised to either 24 weeks of daily GTN ointment or placebo ointment.

The Evolving Role of Artificial Intelligence in Radiotherapy Treatment Planning-A Literature Review.

This paper examines the integration of artificial intelligence (AI) in radiotherapy for cancer treatment. The importance of radiotherapy in cancer management and its time-intensive planning process make AI adoption appealing especially with the escalating demand for radiotherapy. This review highlights the efficacy of AI across medical domains, where it surpasses human capabilities in areas such as cardiology and dermatology.

Informing low back pain care from the ground up: Survey of national musculoskeletal triage physiotherapists in Ireland.

Background: Healthcare is changing to meet the challenge of a rising musculoskeletal burden associated with the expanding, aging population. Clinicians, important stakeholders in healthcare provision, have crucial insights into service improvement, but clinician consultation is a shortcoming in healthcare development. In Ireland, specialist physiotherapist-led musculoskeletal (MSK) triage services operate at the primary-secondary care interface to expedite patient care.

A national virtual job search series for neonatal-perinatal medicine fellows.

Background: A standardized approach to prepare trainees for the job search has not been described. The objective of this study was to describe and evaluate an educational series on the job search for Neonatal-Perinatal Medicine (NPM) fellows and identify participants' job search knowledge gaps.

Methods: During the 2020-2021 academic year, we created a virtual, seven-part job search series for NPM fellows that required no funding.

An evaluation of the West of Scotland in-programme Chief Resident role.

Background: Postgraduate leadership education is an evolving field. Locally we have an established 'Chief Residency' programme where centres have two to four senior trainees completing leadership duties alongside clinical workload, supported by local directors of medical education. This is twinned with a 4-day central training programme and peer-support network.

Adjunctive electrophysical therapies used in addition to land-based exercise therapy for osteoarthritis of the hip or knee: A systematic review and meta-analysis.

Objectives: To review evidence for effectiveness of electrophysical therapies (EPTs), used adjunctively with land-based exercise therapy, for hip or knee osteoarthritis (OA), compared with 1) placebo EPTs delivered with land-based exercise therapy or 2) land-based exercise therapy only.

Methods: Six databases were searched up to October 2023 for randomised controlled trials (RCTs)/quasi-RCTs comparing adjunctive EPTs alongside land-based exercise therapy versus 1) placebo EPTs alongside land-based exercise, or 2) land-based exercise in hip or knee OA. Outcomes included pain, function, quality of life, global assessment and adverse events.

A retrospective comparison of postoperative outcomes in ovariectomised jennies (Equus asinus) treated with phenylbutazone or flunixin meglumine.

Background: Clinically, flunixin meglumine (FM) and phenylbutazone (PBZ) are preferentially selected for the treatment of visceral and musculoskeletal pain, respectively, in horses. In donkeys, there is no information to support or refute this conventional conjecture.

Objectives: To compare postoperative outcomes in a group of jennies treated with intravenous FM or oral PBZ.

'Look up from the waiting list and see the bigger picture': a qualitative analysis of clinical specialist physiotherapist perspectives on low back pain care in Ireland.

Introduction: Healthcare systems are struggling to deliver high-quality low back pain (LBP) care. In 2012 specialist physiotherapist-led musculoskeletal (MSK) triage services were introduced in Irish hospitals to expedite patient care and alleviate pressure on elective orthopaedic/ rheumatology consultant clinics. Specialist physiotherapists have expertise to inform health service improvement and reform, but their perspectives of LBP healthcare delivery have received scant attention.

ADvAnced PhysioTherapy in MuSculosKeletal Triage: Investigating prognostic factors, healthcare utilisation and clinical outcomes (ADAPT MSK) - a cohort study protocol.

Background: Clinical specialist physiotherapist-led musculoskeletal triage clinics were introduced nationally in Ireland in 2011 to improve patient care and reduce waiting times for secondary care orthopaedics and rheumatology. Evidence has shown them to be effective in reducing waiting lists, however there are currently no data on longitudinal patient outcomes following clinic attendance. The primary aim of this cohort study is to identify predictors of pain and function outcomes up to one year following musculoskeletal triage review.

Narrowing the diagnostic gap: Genomes, episignatures, long-read sequencing, and health economic analyses in an exome-negative intellectual disability cohort.

Purpose: Genome sequencing (GS)-specific diagnostic rates in prospective tightly ascertained exome sequencing (ES)-negative intellectual disability (ID) cohorts have not been reported extensively.

Methods: ES, GS, epigenetic signatures, and long-read sequencing diagnoses were assessed in 74 trios with at least moderate ID.

Results: The ES diagnostic yield was 42 of 74 (57%).

Implicit Bias and Health Disparities Education in the Neonatal Intensive Care Unit.

Objective:  This study aimed to characterize implicit bias (IB) and health disparities (HD) education in neonatal-perinatal medicine (NPM), including current educational opportunities, resources, and barriers.

Study Design:  A national web-based survey was sent to NPM fellows, neonatologists, and frontline providers after iterative review by education experts from the National Neonatology Curriculum Committee. Quantitative data were analyzed with chi-square and Fisher's exact tests.

Determination of minimum individual cow colostral immunoglobulin G concentration required to provide adequate total immunoglobulin G mass in pooled colostrum fed to Jersey calves.

Objective: Quantify the minimum individual cow colostral immunoglobulin G (IgG) concentration required for pooling to achieve adequate transfer of passive immunity in calves.

Animals: 201 Jersey cows.

Methods: Colostrum was collected from 28 pools and heat treated before being fed to calves or stored.

Veterinary Students' Sense of Belonging: Growing Community with Small Group Academic Enhancement.

A student's sense of belonging to a university is associated with success in academic setting, happiness, and satisfaction. It is therefore unsurprising that universities commonly strive to improve student measures of belonging especially considering its negative correlation with attrition rates. This study documents the implementation and assessment of a new curricular intervention at Ross University School of Veterinary Medicine (RUSVM) and measures associated changes in students' feeling of belonging to the university and accountability for their success.

The Neonatal-Perinatal Medicine fellowship application webinar series: a novel approach to helping applicants succeed.

Background: In 2022, 13,586 candidates applied to subspecialty fellowships. Formal resources to inform candidates on subspecialty-specific fellowship application are limited. Candidates rely on residency application experience, informal advice, and online research for navigating the application process.