117 research outputs found
To Olga : an appreciation in verse.
No full textPoetic appreciation of Mrs. Olga Hunter, wife of the author. Bound in cream card covers with applied cover label
State of the art review: atrial fibrillation in athletes
No full textExercise has substantial health benefits with pleomorphic vascular, metabolic, psychological and anti-neoplastic actions resulting in improved quality of life and longevity. Despite these many benefits, numerous studies have shown that endurance athletes are more likely to develop atrial fibrillation (AF) than non-athletes. The type, intensity and amount of sport appears to influence the risk of developing AF. Several endurance sport activities have been shown to increase the risk of developing AF but an excess in AF has not been shown in non-endurance sports. Furthermore, lifetime hours of participation appear to increase the risk of developing AF. Intriguingly, women appear relatively protected and an association between endurance sport and AF has not been clearly demonstrated amongst female endurance athletes. The mechanisms by which endurance sport promotes the development of AF are unclear. There are, however, a number of pathophysiological mechanisms which are known to increase the risk of AF in non-athletes which have correlates in athletes. These include structural remodelling of the left atrium, elevated left atrial pressure, inflammation, myocardial fibrosis, vagal tone, sinus bradycardia and genetic predisposition. In this article, we explore how some of these mechanisms may contribute to the development of AF in endurance athletes.M. Darragh Flannery, Jonathan M. Kalman, Prashanthan Sanders, André La Gerch
Electrophysiologic remodelling and arrhythmias in endurance athletes: prevalence and mechanisms
No full text© 2024 Michael Darragh FlanneryIntroduction
Endurance sport participation has many health benefits including improved cardiovascular fitness and longer life expectancy. It is a paradox that endurance sport participation is also associated with cardiac arrhythmias. The true prevalence and incidence of arrhythmias in endurance athletes is difficult to define due to variable definitions of endurance sport participation and identifying athletes with arrhythmias. There are several proposed mechanisms by which endurance sport may predispose athletes to arrhythmias.
Aims
The aim of this thesis is to characterise what electrophysiologic changes are normal in endurance athletes, define the risk of arrhythmias attributable to endurance sport participation and investigate the mechanistic causes for an increased burden of arrhythmias.
Results
To characterise normal electrophysiologic changes in endurance athletes we recruited 223 current and former athletes as well as fifty-two nonathletic control participants. We found that bradycardia and notably ventricular pauses are very common in athletes and rare in non-athletes. We found no significant association of ectopic burden with endurance sport.
To investigate the mechanisms by which endurance sport leads to bradycardia in athletes we performed an experimental study in thirty volunteers split equally between nonathletes, endurance athletes and endurance athletes with extreme bradycardia. By administering autonomic blockade, we confirmed that bradycardia in athletes is not due to autonomic influence. Furthermore, this is the first study which has shown high vagal tone does not explain extreme resting bradycardia in athletes.
To better define the risk of atrial fibrillation attributable to endurance sport, we performed a case control study which strictly defined past endurance sport participation. We recruited 121 former elite rowers who competed at a national, world championship or Olympic level and compared them to an age, gender and ethnicity matched cohort from the UK Biobank at a ratio of 100:1. Despite less traditional risk factors we found the prevalence of atrial fibrillation 6.7 times higher in the athlete cohort and incidence was 2.8 times higher over two years of follow up. Using a polygenic risk score we were able to show that genetic risk plays a role in which athletes develop atrial fibrillation in a similar manner to non-athletes.
In our last study we attempted to identify why some athletes develop atrial fibrillation. In our previous study we demonstrated that genetic risk plays a role in which athletes develop atrial fibrillation but does not appear to explain the excess burden of atrial fibrillation in endurance athletes. For this study we performed a case control study with fifty-three current and former endurance athletes with atrial fibrillation age and gender matched to fifty-three athletes without atrial fibrillation. We found that endurance sports athletes with atrial fibrillation have similar risk factor profiles, body composition, training history, physical fitness and electrophysiologic remodelling to endurance athletes without atrial fibrillation.
Conclusion
Endurance sport training leads to profound electrophysiologic remodelling which is not explained by autonomic tone. The risk of atrial fibrillation in markedly increased in endurance athletes but the mechanisms which lead to the excess burden of atrial fibrillation in endurance athletes remain elusive
Supports and Barriers to Effective Job Matching for Persons With Intellectual Disabilities
No full textAbstract
Date Presented 3/31/2017
Several practices act as barriers, as supports, or as both to the job-matching process. Future research should focus on integrating these factors into a systematic procedure for matching persons with disabilities to long-term, competitive community employment.
Primary Author and Speaker: Andrew Persch
Additional Authors and Speakers: Beth Pfeiffer, Rebecca Weisshaar, Amy Darragh, Dennis Cleary</jats:p
Lifecycle Impact of Alternative Higher Education Finance Systems in Ireland
No full textWith increasing numbers of young people participating in higher education in Ireland and a heavy reliance of higher education institutions on state funding, the introduction of an alternative finance system for Ireland has been muted over the past number of years. However, no study has been conducted to gauge the potential impact of such measures. In this chapter we utilize a dynamic microsimulation model developed for Ireland to simulate the impact of both an income contingent loan system (ICL) and a graduate tax system from a fiscal and redistributional viewpoint and to analyze the repayment length under the former system. Our results suggest that an ICL system would is more equitable, while the graduate tax system would be a better alternative from a fiscal viewpoint. The results also illustrate the important of the interest rate attached to any future student loan system within Ireland from a fiscal viewpoint.graduate tax, income contingent loan, dynamic microsimulation, higher education financing
Participation in Higher Education: A Random Parameter Logit Approach with Policy Simulations
No full textIn this paper we present a theoretical model of higher education participation. We assume that young people that complete upper secondary education are faced with three choices, go to higher education, not go to higher education or go to higher education and work part time. Utilizing the Living in Ireland survey data 1994-2001 we model this choice in an Irish context by variation in costs (direct and indirect), the estimated lifecycle returns and household credit constraints. Using a random parameters logit choice model we find that simulated lifecycle earnings positively impact the educational/labour choices of young individuals in Ireland. This positive relationship is also found to be true for a choice-specific household income variable constructed in the paper. From the random parameters logit estimations we also find that preferences for choices with higher simulated lifecycle earnings and household income vary across individuals. We conduct policy simulations from our estimations and found that increasing student financial aid levels by 10% combined with a slight widening of the income limits for these aids can lead to significant movement away from the decision to not enter higher education.higher education participation, random parameters logit model, lifecycle simulated earnings, higher education policy
The Life-cycle Impact of Alternative Higher Education Finance Systems in Ireland
No full textWith increasing numbers of young people participating in higher education in Ireland and a heavy reliance of higher education institutions on State funding, the introduction of an alternative finance system for Ireland has been muted over the past number of years. However, no study has been conducted to gauge the potential impact of such measures. In this paper we utilise a dynamic microsimulation model developed for Ireland to simulate the impact of both an income contingent loan system (ICL) and a graduate tax system from a fiscal and redistributional viewpoint and to analyse the repayment length under the former system. Our results suggest that an ICL system could be more equitable, while the graduate tax system could be a better alternative from a fiscal viewpoint. The results also illustrate the importance of the interest rate attached to any future student loan system within Ireland from a fiscal viewpoint
Home-Based Intervention for Chemotherapy-Induced Peripheral Neuropathy
No full textAbstract
Date Presented 3/31/2017
Peripheral neuropathy is a side effect of neurotoxic chemotherapy, resulting in pain and declines in function and quality of life. This pilot study assessed effects of a sensorimotor intervention on pain, function, and quality of life in individuals with breast cancer.
Primary Author and Speaker: Amy Darragh
Additional Authors and Speakers: Karli Vicary
Contributing Authors: Karen Hock, LeAnn Gaerke, Sharon Flinn</jats:p
The economics of higher education participation in Ireland: Essays on geographic accessibility and student preferences
No full textHigher education has a range of important benefits for individuals and societies. As a result, increased participation in higher education is a stated policy goal in many countries. Understanding the economics of higher education is valuable in attempting to address issues related to higher education participation. In this context, the objective of this thesis is to expand our understanding of the economics of higher education participation in Ireland, with a particular focus on issues relating to geographic accessibility and student preferences.
Empirical studies investigating the factors influencing progression to higher education have identified geographic accessibility to higher education institutions (HEIs), through the associated transaction costs, as one important factor. Moreover, evidence from Ireland of ‘localised’ patterns of progression to higher education implies that proximity to a specific HEI is a key factor in a student’s decision to study there. Despite this, no comprehensive measure of geographic accessibility to higher education has been developed for Ireland to date. Thus, the first aim of this thesis is to present an analysis of the extent and nature of geographic accessibility to higher education in Ireland. To this end, a range of GIS techniques are employed, while enrolment and mobility rates are also analysed to explore the association between proximity to different types of HEIs and the type of education pursued by individuals. Spatially-based accessibility Gini indices are calculated to explore the likely implications of any inequalities in accessibility, while a detailed analysis of the impact of a recent proposed higher education reform on geographic accessibility to universities in Ireland is also presented.
Other non-spatial factors are of course also likely to be important, both in the decision to progress to higher education and in a student’s choice of HEI. In order to understand what attributes of higher education provision are valued by students, the second aim of this thesis is to elicit student preferences for HEIs in Ireland using a discrete choice experiment methodology. To this end, a survey of 1,105 students in their final year of secondary school was conducted across 34 schools. In the analysis, a latent class model is first employed to model heterogeneity in preferences and willingness-to-pay (WTP) across both the attributes of HEIs and across socio-economic groups. Compensating surplus for bundles of HEI attributes is also estimated, which has not been done previously in the literature. This allows the welfare gain or loss from alternative HEIs to be isolated. To further the analysis of heterogeneity in preferences, this thesis also employs mixed logit and generalised multinomial logit (GMNL) models to provide an in-depth analysis of the scale and variation in WTP by region, academic ability and socio-economic status. In fact, this thesis makes a methodological contribution to the education economics literature as it represents the first empirical application of the GMNL model in the area. Examining this variation in WTP is useful to both policymakers and HEI managers, as it provides them with interpretable information on how much different students value the attributes of HEIs
The economics of higher education participation in Ireland: Essays on geographic accessibility and student preferences
No full textHigher education has a range of important benefits for individuals and societies. As a result, increased participation in higher education is a stated policy goal in many countries. Understanding the economics of higher education is valuable in attempting to address issues related to higher education participation. In this context, the objective of this thesis is to expand our understanding of the economics of higher education participation in Ireland, with a particular focus on issues relating to geographic accessibility and student preferences. Empirical studies investigating the factors influencing progression to higher education have identified geographic accessibility to higher education institutions (HEIs), through the associated transaction costs, as one important factor. Moreover, evidence from Ireland of ‘localised’ patterns of progression to higher education implies that proximity to a specific HEI is a key factor in a student’s decision to study there. Despite this, no comprehensive measure of geographic accessibility to higher education has been developed for Ireland to date. Thus, the first aim of this thesis is to present an analysis of the extent and nature of geographic accessibility to higher education in Ireland. To this end, a range of GIS techniques are employed, while enrolment and mobility rates are also analysed to explore the association between proximity to different types of HEIs and the type of education pursued by individuals. Spatially-based accessibility Gini indices are calculated to explore the likely implications of any inequalities in accessibility, while a detailed analysis of the impact of a recent proposed higher education reform on geographic accessibility to universities in Ireland is also presented. Other non-spatial factors are of course also likely to be important, both in the decision to progress to higher education and in a student’s choice of HEI. In order to understand what attributes of higher education provision are valued by students, the second aim of this thesis is to elicit student preferences for HEIs in Ireland using a discrete choice experiment methodology. To this end, a survey of 1,105 students in their final year of secondary school was conducted across 34 schools. In the analysis, a latent class model is first employed to model heterogeneity in preferences and willingness-to-pay (WTP) across both the attributes of HEIs and across socio-economic groups. Compensating surplus for bundles of HEI attributes is also estimated, which has not been done previously in the literature. This allows the welfare gain or loss from alternative HEIs to be isolated. To further the analysis of heterogeneity in preferences, this thesis also employs mixed logit and generalised multinomial logit (GMNL) models to provide an in-depth analysis of the scale and variation in WTP by region, academic ability and socio-economic status. In fact, this thesis makes a methodological contribution to the education economics literature as it represents the first empirical application of the GMNL model in the area. Examining this variation in WTP is useful to both policymakers and HEI managers, as it provides them with interpretable information on how much different students value the attributes of HEIs
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