Is pay for performance promoting inverse inequality in Irish general practice?

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.

Women's fertility decision-making with a diagnosis of breast cancer: A qualitative evidence synthesis.

Aim: To synthesize qualitative evidence of premenopausal women's experiences of fertility decision-making with a diagnosis of breast cancer.

Background: Breast cancer is increasingly more common in premenopausal women who may have not yet considered starting a family or have completed their families.

Design: Qualitative evidence synthesis guided by Thomas and Harden's three-stage approach to thematic analysis.

Communicating water availability to improve awareness and implementation of water conservation: A study of the 2018 and 2020 drought events in the Republic of Ireland.

Public communication on water availability is pivotal in highlighting water conservation needs as droughts impact water resources for critical use, such as drinking water quality and accessibility. This paper presents the results of research into public communication on water availability and the implementation of water conservation measures in the Republic of Ireland. The paper analyses social media (Twitter and Facebook) communication and newspaper publications from 2018 to 2020 on water conservation and drought events, in addition, to undertaking six key stakeholder interviews made up of journalists (n = 4), political representatives (n = 1), and a water and communication expert (n = 1).

COVID-19 water sector responses in Europe: A scoping review of preliminary governmental interventions.

The unprecedented scale and impact of COVID-19 pandemic, and the accompanying lockdown implemented across many countries, has exacerbated water scarcity and security globally. Many European governments have introduced policy interventions to mitigate and protect their economies. Yet, water resources, which are a potential enabler in revitalising Europe's economy, have received few of such policy interventions since the World Health Organization declared the COVID-19 outbreak as a public health emergency only in January 2020.

Water matters: An assessment of opinion on water management and community engagement in the Republic of Ireland and the United Kingdom.

Internationally, water management is moving from the traditional top-down approach to more integrated initiatives focussing on community-led action. With inadequacies in previous engagement initiatives undertaken through the first cycle of River Basin Management Planning for the EU Water Framework Directive (WFD), the Republic of Ireland has only recently embraced this bottom-up approach. The attempted introduction of national charging for domestic water use in 2015 has resulted in significant public disquiet and protest movements against the national government.

Randomized Phase III Trial of Standard Therapy Plus Low Molecular Weight Heparin in Patients With Lung Cancer: FRAGMATIC Trial.

Purpose: Venous thromboembolism (VTE) is common in cancer patients. Evidence has suggested that low molecular weight heparin (LMWH) might improve survival in patients with cancer by preventing both VTE and the progression of metastases. No trial in a single cancer type has been powered to demonstrate a clinically significant survival difference.

Bronchial dentures as a cause of airway actinomycosis.

A 65-year-old man was referred to the respiratory clinic with recurrent chest infections on a background of stage 3 chronic obstructive pulmonary disease. On examination, there was wheeze bilaterally more marked on the left lower lobe. Subsequent imaging revealed an obstruction of the left main bronchus that was concerning for malignancy.

Caloric restriction maintains OX40 agonist-mediated tumor immunity and CD4 T cell priming during aging.

Immune responses wane during aging, posing challenges to the potential effectiveness of cancer immunotherapies. We previously demonstrated that in the context of a promising immunotherapeutic, OX40 agonist (αOX40), older animals exhibited impaired anti-tumor immune responses and diminished CD4 T cell effector differentiation. In this study, we hypothesized that tumor immune responses could be maintained during aging through caloric restriction (CR) or dietary supplementation with resveratrol (RES), a CR mimetic.

The prediction of in-flight hypoxaemia using non-linear equations.

Background: Respiratory disease may cause profound hypoxaemia during flight. Previously derived linear equations poorly predict the need for supplemental oxygen during air travel. The current gold standard assessment is the hypoxic challenge test (HCT).

Overexpression and potential targeting of the oncofoetal antigen 5T4 in malignant pleural mesothelioma.

Malignant pleural mesothelioma (MPM) is resistant to conventional treatments. Novel, targeted treatments are hampered by the relative lack of MPM-associated tumour antigens. The aim of this study was to evaluate the level of expression and the relevance of 5T4 as a tumour-associated antigen in MPM.

Outcomes of patients presenting to a dedicated rapid access lung cancer clinic.

We examined the outcomes of the first 500 patients referred to a dedicated Rapid Access Lung Cancer Clinic. A total of 206 patients (41.2%) were diagnosed with a thoracic malignancy; 179 had primary lung cancer and 27 had secondary or other thoracic cancers.

The effects of hypoxia on markers of coagulation and systemic inflammation in patients with COPD.

Background: It has been demonstrated that there is an increased risk of venous thromboembolism (VTE) during air travel on flights of long duration. Patients with COPD are also at increased risk of VTE, particularly during exacerbations, possibly because of a hypercoagulable state secondary to hypoxia and/or heightened systemic inflammation. We investigated the effects of hypoxia on indices of coagulation and systemic inflammation in patients with COPD.

Human tumor-derived exosomes down-modulate NKG2D expression.

NKG2D is an activating receptor for NK, NKT, CD8(+), and gammadelta(+) T cells, whose aberrant loss in cancer is a key mechanism of immune evasion. Soluble NKG2D ligands and growth factors, such as TGFbeta1 emanating from tumors, are mechanisms for down-regulating NKG2D expression. Cancers thereby impair the capacity of lymphocytes to recognize and destroy them.

Responses to a questionnaire on networking between OIE Reference Laboratories and OIE Collaborating Centres.

Two separate questionnaires were distributed to 20 OIE Collaborating Centres and 160 OIE Reference Laboratories to assess the current status of networking and collaboration among OIE Reference Laboratories and between OIE Reference Laboratories and OIE Collaborating Centres. The questionnaire for the OIE Reference Laboratories contained 7 sections with questions on networking between laboratories, reporting of information, biosecurity quality control, and financing. Emphasis was placed in obtaining information on inter-laboratory relationships and exchange of expertise, training needs and sharing of data and information.

Small cell lung cancer treated in southeast Wales.

Aims: In small cell lung cancer (SCLC), consolidation thoracic irradiation (CTI) increases 3-year absolute survival by 5.4% in patients with limited disease and a complete response to chemotherapy. Early concurrent thoracic radiotherapy has been shown to improve local control and prolong survival compared with CTI in some trials.

Global detection and identification of Campylobacter fetus subsp. venerealis.

Bovine genital campylobacteriosis caused by Campylobacter fetus subsp. venerealis (Cfv) is a genital infection that threatens the cattle industry. Detection and identification of Cfv are key factors in control programmes.

Making do not attempt resuscitation decisions: do doctors follow the guidelines?

When do not attempt resuscitation orders are contemplated, guidelines exist to outline standards for planning patient care and decision making. These guidelines may not always be fully followed as ethical issues arise which may prevent doctors from doing so.

Gonococcal endocarditis: a rare complication of a common disease.

This report describes a case of gonococcal endocarditis in a 28 year old male patient with no history of previous valvular heart disease. More cases of gonococcal endocarditis (a rare complication of gonorrhoea) may occur with the increase in the incidence of gonorrhoea and the increase in resistance to ciprofloxacin, which is currently used as the first line agent for the treatment of gonorrhoea in 75% of genitourinary medicine clinics.

Use of the gas exchange threshold to noninvasively determine the lactate threshold in patients with cystic fibrosis.

Objective: The anaerobic threshold (AT) is a submaximal index related to endurance exercise performance, which is usually determined by the measurement of blood lactate concentration during an incremental exercise test (lactate threshold [LT]). The LT, and thus the AT, can also be detected noninvasively in normal subjects by means of the gas exchange threshold (GET). This study was undertaken to validate the use of GET in patients with cystic fibrosis (CF) with a wide range of disease severity, and to assess the reproducibility of this index.

Glucocorticoid treatment reduces exhaled nitric oxide in cystic fibrosis patients.

In cystic fibrosis (CF), low concentrations of exhaled nitric oxide (NO) and reduced expression of inducible nitric oxide synthase (iNOS) in airway epithelium have been reported. However, abundant iNOS expression has been found in the subepithelial tissues and elevated concentrations of NO metabolites in breath condensate and sputum. These conflicting results may be explained by increased scavenging of NO by superoxide radicals, resulting in rapid conversion to peroxynitrite, so that only a small proportion of the NO produced in the lung tissue reaches the airway lumen.