Publications by authors named "Hannigan A"

Both residential and day programs for eating disorders provide options for a step-up from standard outpatient care. However, there have not been any direct comparisons of their effectiveness and limited research on predictors of better outcomes from either setting. This study aimed to compare clinical outcomes and predictors from a transdiagnostic residential and day program for eating disorders.

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Objectives: Medico-legal and regulatory culture has a significant impact on medical practitioners, including the decision of graduates to enter high-risk specialties. This study explores the impact of the current medico-legal and regulatory culture in Ireland on the decision of graduate entry medical students to enter one high risk specialty, obstetrics and gynecology.

Study Design: We conducted a survey of 146 final-year, graduate-entry medical students pre- and post- a 6-week rotation in obstetrics and gynecology in Ireland.

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Article Synopsis
  • Tonsillectomy and adenoidectomy (AT) are common ENT procedures for children, performed over 500,000 times a year in the U.S., and while generally safe, they carry risks like bleeding and pain.
  • Tranexamic acid (TXA) has been shown to reduce bleeding in various surgical settings, but its effectiveness and safety in pediatric AT haven't been thoroughly reviewed until now.
  • A systematic review of existing literature was conducted, analyzing eight studies involving 1,315 pediatric patients to assess the efficacy and safety of using TXA for reducing bleeding during tonsillectomy and adenoidectomy.
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Preclinical studies suggest that simultaneous HER2/VEGF blockade may have cooperative effects in gastroesophageal adenocarcinomas. In a single-arm investigator initiated clinical trial for patients with untreated advanced HER2+ gastroesophageal adenocarcinoma, bevacizumab was added to standard of care capecitabine, oxaliplatin, and trastuzumab in 36 patients (NCT01191697). Primary endpoint was objective response rate and secondary endpoints included safety, duration of response, progression free survival, and overall survival.

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Background: In 2020, the Chronic Disease Management (CDM) programme was introduced in Ireland. This programme resources GPs to review public (GMS) patients, diagnosed with eight named chronic diseases, twice yearly according to a structured protocol. This pay for performance initiative has been widely adopted by GPs.

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Background: One in five people living in Ireland is a migrant. Understanding the distinctive health needs of this diverse population is essential to provide evidence-based, culturally sensitive primary care services. The aim of this review is to systematically examine changes in migrant health research in Ireland and to inform research, policy and practice in the field.

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Article Synopsis
  • The study investigates the prevalence of complex PTSD (CPTSD) and its symptoms in individuals seeking treatment for eating disorders, focusing on the new ICD-11 criteria that includes disturbances in self-organization (DSO).
  • Findings indicate that about one-third of participants experienced PTSD symptoms, while over half reported DSO symptoms, with a higher prevalence of CPTSD (28.4%) compared to PTSD (3.8%).
  • The research highlights a significant correlation between CPTSD symptoms and the severity of eating disorder symptoms, suggesting a need for integrated treatment approaches targeting both eating disorders and trauma-related issues. !*
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Purpose: ERBB2-amplified colorectal cancer is a distinct molecular subtype with expanding treatments. Implications of concurrent oncogenic RAS/RAF alterations are not known.

Experimental Design: Dana-Farber and Foundation Medicine Inc.

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Background: Given the complementary roles of health professionals and journalists in communicating health risks to patients and the public, there have been calls for physicians to work with journalists to improve the quality of health information received by the public. Understanding the preferences of medical and journalism students for the way in which health risks are communicated and their understanding of words used to describe risk is an important first step to inform interdisciplinary learning.

Methods: Medical and journalism students (n = 203) completed an online survey where they were given qualitative descriptors of risk such as 'a chance', 'probably' and 'unlikely', and asked to assign a number that represents what the word means to them.

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Background: Analysis of general practice records can address the information gap on the epidemiology of type 2 diabetes (T2DM) in Ireland, informing practice and the development of interventions in primary care. The aim of this study was to identify patients with poor glycaemic control, risk factors for complications and evidence of end organ damage in a large multi-practice study and to profile their characteristics.

Methods: Patients with T2DM were identified using disease coding in Health One practice management software in 41 general practices.

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Background: Pain is a prevalent, debilitating condition among older adults. Much evidence on this topic comes from cohort studies, which may be affected by attrition and measurement bias. Little is known about the impact of these biases on pain estimates for European older adults.

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Unlabelled: Coverage of migrant and refugee data is incomplete and of insufficient quality in European health information systems. This is not because we lack the knowledge or technology. Rather, it is due to various political factors at local, national and European levels, which hinder the implementation of existing knowledge and guidelines.

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Purpose: Combining gemcitabine with CHK1 inhibition has shown promise in preclinical models of pancreatic ductal adenocarcinoma (PDAC). Here, we report the findings from a phase I expansion cohort study (NCT02632448) investigating low-dose gemcitabine combined with the CHK1 inhibitor LY2880070 in patients with previously treated advanced PDAC.

Patients And Methods: Patients with metastatic PDAC were treated with gemcitabine intravenously at 100 mg/m2 on days 1, 8, and 15, and LY2880070 50 mg orally twice daily on days 2-6, 9-13, and 16-20 of each 21-day cycle.

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Information graphics or infographics combine visual representations of information or data with text. They have been used in health research to disseminate research findings, translate knowledge and address challenges in health communication to lay audiences. There is emerging evidence of the design of infographics with the involvement of patients and the public in health research.

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We report a case of a perineal fibroadenoma initially diagnosed on ultrasound and magnetic resonance imaging as a soft tissue sarcoma in a 35-year-old female. Following wide local excision, histopathology revealed the lesion as a vulval fibroadenoma. We provide an overview of the literature and highlight the need to consider fibroadenoma, arising from ectopic breast tissue, as an important differential for general surgeons and gynaecologists caring for patients with perineal masses.

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Background: Challenges in recruiting appropriately trained obstetricians and gynaecologists have been identified across the world. Given well documented staff shortages within obstetrics and gynaecology in Ireland, it is increasingly important to understand the factors which influence medical students to choose or reject a career in the speciality. The aim of this study was to ascertain the perceptions of final year graduate entry medical students of obstetrics and gynaecology, including the factors which may influence a student's decision to pursue in a career in the speciality.

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Background: As prevalence of multimorbidity and polypharmacy rise, healthcare systems must respond to these challenges. Data are needed from general practice on specific metrics of healthcare utilisation. This research aims to establish the rates of attendance to general practice and referral to hospital; and how age, multi-morbidity and polypharmacy affect them.

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Data literacy has been defined as "the ability to read, work with, analyze and argue with data". The United Nations has highlighted a growing risk of inequality for people excluded from the new world of data by lack of education, language, poverty, and discrimination and has called for the development of data literacy at all levels of society. Responses to data are shaped by personal, social and cultural influences, as well as by trust in the source.

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Migration is a longstanding, growing global phenomenon. As a social determinant of health, migration can lead to health inequities between people on the move and host populations. Thus, it is imperative that there is a coordinated effort to advance migration- and health-related goals.

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What can we learn from the history of Public and Patient Involvement (PPI) in healthcare and research across global jurisdictions? Depending on region and context, the terminology and heritage of involvement in research vary. In this paper, we draw on global traditions to explore dominant themes and key considerations and critiques pertaining to PPI in order to inform a PPI culture shift in Ireland. We then describe the heritage of PPI in Ireland and present the case for combining methodological imperatives with policy drivers to support and encourage involvement.

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Background: Direct observation of hand hygiene compliance is the gold standard despite limitations and potential for bias. Previous literature highlights poorer hand hygiene compliance among physicians than nurses and suggests that covert monitoring may give better compliance estimates than overt monitoring.

Aim: To explore differences in compliance between physicians and nurses further, and to determine whether compliance estimates differed when observations were covert rather than overt.

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Background: The recently published Australia and New Zealand Academy of Eating Disorders (ANZAED) practice and training standards for dietitians providing eating disorder treatment recommended dietitians working in eating disorders (EDs) seek further clinical experience, training, and supervision to provide effective evidence-informed treatment. Access to dietetic clinical supervision is problematic, secondary to limited trained supervisors, location, cost, and lack of organizational support. Demand for clinical supervision increased with the 2022 introduction of ANZAED credentialing for eating disorder (ED) clinicians in Australia and addition of the Eating Disorder Management Plan to the Medicare Benefits Scheme.

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Background: Social exclusion is a complex concept that is recognised as a key determinant of health. Many measurement tools developed looked at people from single excluded groups in isolation. We know from experience and literature that exclusion is often intersectional and multi-layered.

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Background: As prevalence of multimorbidity and polypharmacy rise, health care systems must respond to these challenges. Data is needed from general practice regarding the impact of age, number of chronic illnesses and medications on specific metrics of healthcare utilisation.

Methods: This was a retrospective study of general practices in a university-affiliated education and research network, consisting of 72 practices.

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