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Item Identifying educational interventions aimed at improving communication with older adults with age-related hearing loss: a scoping review and thematic analysis(Taylor and Francis Ltd., 2025) Maher, Aisling; Lyons, Imogen; Fleming, Joanne; Smith, Simon; Lennon, Brendan; Müller, Nicole; Timmons, Suzanne; El Refaie, Amr; O’Tuathaigh, ColmObjective: This scoping review summarises existing interventions aimed at educating individuals without hearing loss to enhance their communication with older adults experiencing age-related hearing loss (ARHL). Design: Data collection employed a systematic search approach as per the guidelines of Arksey & O’Malley, and followed the PRISMA-ScR guidelines. Study selection: A structured search was conducted involving four research databases from 2000 to 2023, with additional grey literature searching. Original papers written in English, reporting the design and implementation of educational interventions targeting communication with older adults with ARHL, were included. Reflexive thematic analysis was used to identify themes related to intervention type and methodology, and key findings. Results: 13 eligible intervention studies were identified and summarised. Four main themes were described: (1) education and communication skills training; (2) mode of intervention delivery; (3) appropriateness of the intervention and satisfaction among participants; (4) transforming attitudes on hearing loss for better relationships and emotional well-being. Conclusions: The link between hearing loss and diminished quality of life in older adults with ARHL highlights the importance of ongoing development of innovative educational programmes targeting effective communication in diverse settings, including clinical environments.Item Oxysterols, age-related-diseases and nutritherapy: Focus on 7-ketocholesterol and 7β-hydroxycholesterol(Elsevier Inc., 2025) Vejux, Anne; Ghzaiel, Imen; Mackrill, John J.; Dias, Irundika H.K.; Rezig, Leila; Ksila, Mohamed; Zarrouk, Amira; Nury, Thomas; Brahmi, Fatiha; El Midaoui, Adil; Meziane, Smail; Atanasov, Atanas G.; Hammami, Sonia; Latruffe, Norbert; Jouanny, Pierre; Lizard, Gérard; INPST; Mediterranean Association of Biogerontology; Université de Bourgogne Europe; Association Bourguignonne pour les Applications des Sciences de l’Information en Médecine; ABASIM; ENOR; Université de Tunis El Manar, UTM; PHC Utique; Association Bourguignonne pour les Applications des Sciences de l'Information en Médecine; Université de MonastirAge-related diseases are often associated with a disruption of RedOx balance that can lead to lipid peroxidation with the formation of oxysterols, especially those oxidized on carbon-7: 7-ketocholesterol (also known as 7-oxo-cholesterol) and 7β-hydroxycholesterol. Like cholesterol, these oxysterols have 27 carbons, they are composed of a sterane nucleus and have a hydroxyl function in position 3. The oxysterols 7-ketocholesterol and 7β-hydroxycholesterol are mainly formed by cholesterol autoxidation and are biomarkers of oxidative stress. These two oxysterols are frequently found at increased levels in the biological fluids (plasma, cerebrospinal fluid), tissues and/or organs (arterial wall, retina, brain) of patients with age-related diseases, especially cardiovascular diseases, neurodegenerative diseases (mainly Alzheimer's disease), ocular diseases (cataract, age-related macular degeneration), and sarcopenia. Depending on the cell type considered, 7-ketocholesterol and 7β-hydroxycholesterol induce either caspase- dependent or -independent types of cell death associated with mitochondrial and peroxisomal dysfunctions, autophagy and oxidative stress. The caspase dependent type of cell death associated with oxidative stress and autophagy is defined as oxiapoptophagy. These two oxysterols are also inducers of inflammation. These biological features associated with the toxicity of 7-ketocholesterol, and 7β-hydroxycholesterol are often observed in patients with age-related diseases, suggesting an involvement of these oxysterols in the pathophysiology of these disorders. The cytotoxic effects of 7-ketocholesterol and 7β-hydroxycholesterol are counteracted on different cell models by representative nutrients of the Mediterranean diet: ω3 and ω9 fatty acids, polyphenols, and tocopherols. There are also evidences, mainly in cardiovascular diseases, of the benefits of α-tocopherol and phenolic compounds. These in vitro and in vivo observations on 7-ketocholesterol and 7β-hydroxycholesterol, which are frequently increased in age-related diseases, reinforce the interest of nutritherapeutic treatments to prevent and/or cure age-related diseases currently without effective therapies.Item The long-term general practice healthcare of women with a history of gestational diabetes: A scoping review protocol [version 2; peer review: 2 approved](F1000 Research Ltd, 2025) O'Flynn, James; McMorrow, Rita; Foley, Tony; Forde, Rita; McHugh, Sheena; Newman, Christine; Jennings, Aisling A.; Irish College of General PractitionersIntroduction: Gestational Diabetes Mellitus (GDM) is a hyperglycaemic condition diagnosed during pregnancy. GDM is strongly associated with future development of type 2 diabetes and cardiovascular disease. Lifestyle and pharmacological interventions can reduce the risk of developing type 2 diabetes. General practice is the recommended setting for long-term follow-up of women with a history of GDM. However, rates of follow-up are suboptimal. The evidence around long-term general practice healthcare for women with a history of GDM has not previously been reviewed. Aims: The aim of this scoping review is to explore the current evidence base for the long-term care of women with a history of GDM in general practice. Study Design: The study described by this protocol is a scoping review. The study design was informed by Joanna Briggs Institute methodology. Methods: Empirical qualitative and quantitative research studies published since 2014 will be identified from a search of the following databases: MEDLINE (Ovid), EMBASE (Elsevier), CINAHL, PsycINFO, Academic Search Complete and SocIndex. The review will identify key characteristics of the literature. Framework analysis will be used to map the findings against the Chronic Care Model, a primary care-based framework that sets out the core components for optimal long-term healthcare. Results: A numerical descriptive summary (using frequencies) will describe the overall extent of literature, and the range and distribution of its component parts, including the geographical and economic settings, research methods, interventions, outcomes and findings. The qualitative analysis will map interventions and descriptions of care to components of the chronic care model. Research gaps will be reported, and research needs and priorities will be suggested. Conclusion: The findings of this scoping review will have the potential to inform future research efforts in the area. Registration: This protocol has been registered in Open Science Framework (https://osf.io/bz2vh).Item ‘At a tipping point’: a comparative analysis of oral health coverage for children across six European countries: Denmark, Germany, Hungary, Ireland, Scotland, and Spain(BioMed Central Ltd, 2025) McAuliffe, Úna; Eaton, Kenneth; Harding, Máiréad; Whelton, Helen; Cronin, Jodi; Burke, Sara; Health Research BoardBackground: Dental caries remains a significant public health problem for children with continuing calls to incorporate oral health under the Universal Healthcare domain (UHC). However, there is little knowledge on the variations in the coverage, financing, and access to child oral healthcare across Europe. Methods: This inter-country comparative analysis provides a detailed description and mapping of publicly funded child oral health coverage across six European countries: Denmark, Germany, Hungary, Ireland, Scotland, and Spain. A multiple case study approach was adopted encompassing two strands of data collection: a documentary analysis and in-depth interviews with experts from each country. The WHO Universal Health Coverage Cube was used to guide data collection and analysis. Results: Two broad models of child oral health coverage were found: those systems adopting ‘universal’ approaches (Denmark, Germany, Hungary, and Scotland) and those restricting coverage by ‘targeting’ children by age or where they live (Ireland and Spain). In countries without universal coverage (Ireland and Spain), the private sector assumed a significant role, leading to substantial out-of-pocket expenses for families. This was also evident in Hungary owing to barriers in accessing its publicly funded oral healthcare system. Preventive oral healthcare was also attributed a lower priority in these countries, however a prominent observation across all countries was the necessity for a stronger focus on prevention. Each country with universal oral health coverage (Denmark, Germany, and Scotland) except for Hungary, demonstrated a trend of expanded coverage and regulatory reform achieved using oral health data, political support and engaging the dental profession. While a failure to implement policy and system reform was evident in the remaining countries with the impact of the 2008 economic crisis particularly evident in Ireland and Spain. Conclusions: This research finds that child oral health coverage in some European countries is ‘at a tipping point’, with recognition of the need for reform evident in Hungary, Spain and Ireland while most ‘universal’ systems remain on alert to maintaining the broad coverage in place. To maintain and progress UHC for oral health there must be an emphasis on prevention, on addressing inequalities faced by children excluded from care and on advocacy using quality oral health data to engage both dental professionals and political will.Item Transperineal prostate biopsy under local vs general anaesthesia: a cost-effectiveness analysis(John Wiley and Sons Inc, 2025) Roberts, Matthew J.; Arora, Shiksha; Yao, Henry H.; Hogan, Donnacha; Dias, Brendan; O'Connell, Helen E.; Wetherell, David; Zargar, Homayoun; Kwok, Michael; McGeorge, Stephen P.; Pearce, Adam; Yaxley, John; Tuffaha, Haitham; Metro North Office of Research, Queensland Health; The University of Queensland; Sylvia and Charles Viertel Charitable Foundation; Royal Brisbane and Women's Hospital; Royal Brisbane and Women's Hospital FoundationObjectives: To estimate the cost effectiveness of local anaesthetic (LA) transperineal prostate biopsy (TPB) compared to general anaesthetic (GA) TPB, considering both hospital/health system and societal perspectives. Patients and Methods: Individual-patient data from a prospective pilot study of 80 patients who underwent LA (n = 40) or GA (n = 40) TPB according to patient preference was used. A cost-effectiveness analysis was conducted using a decision tree model considering cancer detection rates, perioperative and return to work considerations between LA and GA TPB. The economic model included costs associated with consumables, device (capital, maintenance) and personnel for each approach. Cost-effectiveness was evaluated in terms of the incremental cost/quality-adjusted life-years (QALYs) and incremental net monetary benefit. Probabilistic and one-way sensitivity analyses were performed. Results: Clinical parameters were generally similar between groups, including overall (55%) and significant (35% vs 23%; P = 0.32) cancer detection and procedure-specific duration (20 vs 21 min; P = 0.53). Total procedure and recovery durations were longer in the GA group by 8 min (P < 0.001) and 32.5 min (P < 0.001), respectively. Participants in the LA group returned to work earlier than the GA group (2 vs 4 days; P = 0.046). There was a marginal gain in QALYs between the LA and GA groups (0.82385 vs 0.82383), but LA TPB had lower costs (Australian dollars [AU$]715.80 vs AU$1673.58), with an estimated average cost savings of ~AU$959. From the societal perspective, driven by the reduction in productivity loss, the average cost savings with LA TPB were ~AU$1639. Sensitivity analyses showed the probability of LA being cost effective was 100%, while utilisation of operating theatre for GA TPB was the main driver of cost difference. Conclusion: Performing TPB via the LA approach would be cost-saving from both hospital and societal perspectives without reducing the accuracy of the biopsy.