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Circular RNAs are differentially expressed in cystic fibrosis bronchial epithelium and regulate ion conductance
No full textCircular RNAs (circRNAs) are a class of non-coding RNAs (ncRNAs) that regulate gene expression at post-transcriptional or transcriptional levels through interacting with ribonucleoproteins and microRNAs (miRNAs)1 . Their differential expression has been studied in various disease contexts, however very limited information is available in chronic lung diseases, especially cystic fibrosis (CF). In the CF lung, absent or dysfunctional Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) leads to impaired mucociliary clearance, chronic infection and inflammation. In addition to the direct effects of dysfunctional CFTR protein in the lung, there is emerging evidence for important roles of ncRNAs in the pathophysiology of CF. We first reported that miRNA2 and long-non-coding RNA3 expression is impaired in CF. A recent study has shown that circRNAs are differentially expressed in CF whole blood4 , however a study of the biological role of circRNAs in bronchial epithelial cells (BECs) in the CF lung is lacking and could highlight new mechanisms underpinning CF pathology.</p
45th Annual International Nursing and Midwifery Research and Education Conference: Nursing and Midwifery: transforming traditions, evolving systems, redefining healthcare – conference proceedings
No full textAt its heart, this year’s conference is about the transformative role of nursing and midwifery in shaping the future of healthcare – whether it is challenging existing systems, breaking down traditional silos, embracing technology, working across disciplines, or finding ways to provide more effective, accessible, and sustainable care. By questioning old practices and delivering new solutions, we can lead efforts to improve the working environment for healthcare professionals, and the care patients receive. Working together, we can build a healthcare system fit for the future – and fit for all.</p
Investigating the effects of a short narratology module on empathy and patient-centred communication in early-stage medical students: an empirical mixed-methods pilot study
No full textBackground: Effective communication is a fundamental skill in clinical medicine; however, traditional approaches often fail to equip learners with an ability to authentically and empathically engage with the complexities of real patients' experiences. Narratology has been proposed as a pedagogical framework for augmenting empathy and patient-centred communication in medical students.Methods: In April 2025, we undertook a mixed-methods pilot study to evaluate the impact of a one-week narratology module on second-year undergraduate medical students at the Royal College of Surgeons in Ireland (RCSI), Dublin. The module involved close reading, group viewings, facilitated small-group workshops, and whole-group discussions in response to narrative works by Irish writers and storytellers, followed by written personal reflections. At the outset and conclusion of the module, each student undertook a clinical history with a simulated patient (SP) portraying early-stage dementia. SPs assessed each student's empathy and communication using the Consultation and Relational Empathy (CARE) Measure.Results: Overall, 30 medical students (age 20 ± 1.1 yrs, 59.1% female) were included; of these, 22 completed both SP encounters. Total CARE Measure score significantly increased post-intervention: median within-subject difference = 3.00 (-0.25, 10.00) [P = 0.0035]. Analysis of individual CARE Measure items revealed significant improvement post-intervention in "Q2: Letting you tell your story" (P = 0.0131), "Q3: Really listening" (P = 0.0474), "Q4: Being interested in you as a whole person" (P = 0.0474), "Q5: Fully understanding your concerns" (P = 0.0369), and "Q6: Showing care and compassion" (P = 0.0054). Qualitative analysis of students' written reflections (n = 30) identified three themes: (i) developing a safe and respectful communication environment; (ii) recognising the patient as a whole individual; and, (iii) growing in empathy and emotional connection.Conclusion: Our results show that empathy and communication in early-stage medical students can improve following a short narratology module. Further prospective studies are now required to explore the longer-term effects of narratology on patient-centred healthcare.Trial registration: ClinicalTrials.gov Identifier: NCT07084077 (Retrospective registration).</p
Expect the unexpected: a rare case of bilateral lymphoepithelial carcinoma of the parotid gland
No full textLymphoepithelial carcinoma (LEC) of the salivary glands is a rare and aggressive malignancy strongly associated with Epstein–Barr virus (EBV) infection and more frequently reported in endemic regions such as Greenland and Southeast Asia. Bilateral involvement is exceptionally uncommon, particularly in non-endemic populations. We report the case of a 62-year-old male with bilateral, asymptomatic parotid swellings persisting for five years. Initial clinical assessment suggested a benign etiology, with no pain, facial nerve involvement, or other red flag symptoms. However, ultrasound, fine needle aspiration, and contrast-enhanced computed tomography of the left parotid revealed atypical features suspicious for malignancy, and histopathology confirmed LEC. The patient underwent left superficial parotidectomy with clear margins, followed by right superficial parotidectomy, which also confirmed LEC. This case represents a rare presentation of bilateral LEC in a non-endemic region. The indolent course and absence of classic malignant features highlight the diagnostic challenges of this entity. Early multidisciplinary evaluation is essential for persistent or atypical parotid swellings, and further research is warranted into the role of EBV in tumorigenesis outside endemic areas.</p
Identifying core teamwork competencies for community-based health and social care professionals: an e-Delphi study
No full textBackground: Due to the increasing burden of chronic diseases, the European Recovery Plan aims to enhance community-based healthcare services across Europe by 2026. Therefore, healthcare professionals will need to be prepared to work effectively in teams to ensure effective patient-centred care. However, few courses specifically designed for developing teamwork competencies are available. The aim of this study was to identify core teamwork competencies for in Community-Based Interprofessional Team specialists for person-centred care. Methods: Guided by the European Skills, Competences, Qualifications and Occupations framework of the European Centre for the Development of Vocational Training for transversal skills and competencies, a 3-round e-Delphi study was conducted between March-May 2024. The experts were identified by the project partners. Following a literature review, focus groups, and interviews with service users and healthcare professionals from four different countries, an initial list of 63 competencies was identified. In Rounds 1 and 2, experts were asked to ‘agree’, ‘disagree’ or ‘amend’ the competencies. An agreement threshold of 70% was established for the inclusion of the competencies. In Round 3, experts rated the priority of each competency on a Likert scale from 1 (low) to 10 (high).Results: Nineteen experts from 6 European countries responded to all rounds. Consensus was achieved for 58 core competencies grouped into: ‘Interprofessional Teamwork’; ‘Interprofessional Communication, Roles and Professional Conduct’; ‘Shared Vision and Approach to Healthcare’; ‘Digital Health’; and ‘Planning and Coordination of Integrated Care Services’.Conclusions: The competencies identified through this study covered a wide range of areas, such as conflict management, collaborative leadership, respect and dignity, cultural sensitivity, digital skills, data management, artificial intelligence, and green skills. The competencies were developed in line with European skills classification and crediting systems to ensure transferability across Europe. These competencies will subsequently be used to develop an EU Curriculum to adequately prepare a new cohort of healthcare professionals specialised in Community-Based Interprofessional Teamwork.</p
Trends in psychological distress among adolescents in Ireland: survey data from 2018 to 2023 & lived experience perspective
No full textPurpose: This study aimed to estimate the prevalence of poor mental health, repetitive self-harm, and suicide attempts among adolescents in Ireland between 2018 and 2023; to identify demographic groups at elevated risk; and to assess changes in these outcomes across the time period.Methods: The Planet Youth survey is a repeated cross-sectional study in which 21,340 secondary school students aged 15–19 years and 588 early school leavers were surveyed across seven local authorities in Ireland. Participants anonymously self-reported mental health status, lifetime repetitive self-harm, and suicide attempts. We used multilevel logistic regression, accounting for school and regional clustering, to estimate population prevalence rates, identify risk groups, and assess temporal trends. Young people with lived experience of adolescent mental health problems provided their insights on survey methodology and findings.Results: Averaged across the 5-year period, 19.6% reported poor mental health, 12.1% repetitive self-harm, and 8.4% a lifetime suicide attempt. Transgender/gender-diverse adolescents and early school leavers were most likely to report these outcomes. By 2022/23, rates of poor mental health and suicide attempt had returned to pre-COVID levels, however, rates of repetitive self-harm continued to rise. Lived experience reflections highlighted the contributions of service inaccessibility and the role of cultural trends.Conclusion: Findings highlight high levels of psychological distress among Irish youth. There was significant heterogeneity of risk across subgroups, with implications for both universal and targeted interventions. Continued surveillance of adolescent mental health and the expansion of accessible youth mental health services remain key priorities.</p
The Gift Of Life: An Analysis Of How The Principle Of Altruism Influences Kidney Donation
No full textIf people are inherently altruistic, why is there a waiting list for donated kidneys? The aim of this dissertation is to assess whether the focus on the principle of altruism within kidney donation legislation is ethically sound and practically effective. To achieve this objective, a literature review is undertaken to analyse how the principle of altruism influences kidney donation. The concept of altruism is explored and the development of altruism into a key principle in kidney donation is examined. Given the need to increase kidney donation rates to save lives, other potential models of donation which do not limit donor motivations to pure altruism are assessed. These potential models include a regulated commercial market model, a model which incorporates non-financial incentives, and an incentivised altruism model that focuses on the development of kidney exchange programmes. Given that models which focus solely on altruism are proving insufficient to meet the demand for donated kidneys, there is a moral obligation to consider alternative approaches which could save the lives of those on waiting lists.</p
The health economics of social prescribing systematic review of the international evidence
No full textBackground: Social prescribing is an approach to improving health and wellbeing that links individuals to community-based supports, such as arts programs, physical activity initiatives, financial or housing advice, volunteering opportunities, and social groups. Although evidence supporting its effects on physical, functional, and mental health outcomes is expanding, no systematic review of the international evidence has yet assessed the health economics of social prescribing.Aim: To systematically review evidence on the health economic methods and tools that have been used to evaluate social prescribing initiatives internationally.Methods: A systematic search of seven electronic databases (PubMed, Embase, Cochrane Trials, APA PsycINFO, CINAHL, Web of Science, and Ovid Global Health) was conducted alongside gray literature and citation searching. Two reviewers independently screened titles, abstracts, and full texts using Covidence, with disagreements resolved with a third researcher. Data extraction followed a structured protocol, and thematic analysis informed a narrative synthesis of findings.Results: Eighteen studies met the inclusion criteria: 5 randomized controlled trials, one quasi-experimental study, and 12 mixed-methods studies. Interventions reflected four main categories: exercise-based or loneliness-prevention initiatives (n= 10), coaching programs (n= 3), nature-based interventions (n= 3), and dance or movement-based programs (n= 2). Use of standard economic methods and tools was limited. Social Return on Investment analyses reported positive returns for interventions targeting mental health and loneliness.Conclusion: Robust economic evidence on social prescribing remains limited. Despite the availability of established health economic methods and tools, these are rarely applied to social prescribing, limiting the usefulness of existing studies for healthcare planning and commissioning.</p
Fellowships across Europe: insights from the European Board of Ophthalmology survey
No full textPurpose: Analyse the results of a European Board of Ophthalmology (EBO) survey on post-residency training (fellowship) opportunities across Europe, providing insights from ophthalmic educators on the current landscape.Methods: A cross-sectional study was conducted using an anonymous 31-question online survey distributed to educators in all EBO-affiliated countries.Results: The response rate was 61% with participation of 392 ophthalmic educators. Despite broad participation, outhwestern Europe was overrepresented, while Northern and Central Europe were underrepresented, affecting regional balance. Respondents had a mean age of 51 ± 11 years, with 37.8% as professors and 46.6% as department heads. Most (54.1%) were affiliated with university hospitals. The reported median percentage of residents pursuing post-residency training was 25%, varying between 15% and 100%, with 15.3% of respondents uncertain about their existence, especially in non-university hospitals. Post-residency training durations were predominantly 1 or 2 years. National diplomas were highly valued except in the United Kingdom; language proficiency was required in 84.2% of countries. Respondents reported a median of three positions per department, with 60% filled by local residents. Surgical activity accounted for 65%, with regional variations, whereas 40% of positions involved research. Observerships remained rare (10%). Financial compensation was provided in 67% of cases. A national medical licence was deemed essential, whereas the EBO diploma and letters of recommendation were moderately valued, especially in Northern Europe. Fellowships were highly recommended by 76.2%, while 63% believed that grants would improve access to positions.Conlusion: This survey represents the largest data set on post-residency training in Europe. Results highlight a lack of cohesion in fellowship opportunities, with many respondents uncertain about national programmes. A national medical licence remains the primary requirement, while language proficiency and financial support are key factors influencing access. Institutional support for medical educators is increasing, yet challenges persist regarding time, resources and funding. Focusing on subspecialty training and research, fellowships are crucial for career progression. Expanding training opportunities through international initiatives could further enhance accessibility and standardisation across Europe.</p
Patterns of drug and polydrug detection in drivers suspected of driving under the influence of an intoxicant in Ireland 2019–2020: a latent class analysis
No full textIntroduction: Driving under the influence of drugs is a major risk factor for road traffic collisions. While increasing harms are observed in relation to polydrug use, evidence is needed about this issue in the context of road safety. We examined polydrug use patterns in drivers providing samples for toxicological analysis in Ireland between 2019 and 2020.Methods: A cross-sectional study using LC-MS toxicology results from the Medical Bureau of Road Safety, which is responsible for the chemical testing of intoxicants in all drivers arrested under the Road Traffic Acts 1968-2024 in Ireland. Latent class analysis was performed on all samples with at least one drug detected (N = 4856). Descriptive statistics for age, gender and number of drug groups detected were calculated for each class identified.Results: We identified six latent classes based on drug detection patterns. The cannabis only class (46.5%) is characterised by the detection of cannabis with no other drug involved, a high proportion of men and young age. The cocaine class (31.1%), which combines cocaine and cannabis use, and the stimulant class (2.5%), characterised by amphetamine/methamphetamine detection, have a similar demographic profile to the cannabis class. The polydrug non-opioid (11.8%), polydrug opioid (5.5%) and heroin (2.6%) classes are older, with lower male:female ratios.Discussion and conclusions: By identifying profiles of people driving under the influence of drugs, this study contributes to enhancing knowledge of drug and polydrug use in motor vehicle drivers in Ireland. Further work is needed to examine risks and develop interventions to address polydrug driving.</p