CORA
Cork Open Research Archive (CORA) is UCC’s Open Access institutional repository which enables UCC researchers to make their research outputs freely available and accessible.
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Comparison of a novel methadone rotation method with other commonly used methods
(BMJ Publishing Group, 2024) Cunningham, Elaine; DiBiagio, Nicole; O’Connell, Florry; Flannery, Maedhbh; Cronin, Michael; Murphy, Marie; O’Leary, Mary Jane; Kiely, Fiona; Lowney, Aoife C.
Objectives To compare a novel method of methadone rotation used in a specialist palliative care inpatient unit (SPCU) in Cork, Ireland, with rapid titration methods using Perth and Brisbane Protocols as well as the Edmonton method of methadone rotation.
Methods A retrospective chart review was performed in March–June 2022. All patients who completed rotation to methadone during 2018–2019 in the SPCU were included. 2018–2019 was selected to study a population not affected by the coronavirus pandemic. Oral morphine equivalent (OME) was calculated using the opioid conversion chart. From the OME, the expected daily methadone dose was calculated using the Perth, Brisbane and Edmonton methods. These figures were then compared directly with the actual methadone doses achieved using our dosing schedule.
Results A comparison of the expected doses using the Perth and Brisbane rapid titration protocols and stable daily dose achieved revealed that the stable methadone dose was significantly lower than both rapid titration protocols (p=<0.0001) and (p=0.0035, respectively). However, a comparison of the expected dose using the Edmonton method and the dose achieved did not determine any significant difference (p=0.7602).
Conclusions This is the first evaluation of a novel Irish method of methadone rotation and demonstrates a lower overall daily methadone dose compared with established protocols.
Opinions of visually impaired adults on the care provided at community pharmacies: a qualitative interview study
(Springer Nature Switzerland AG, 2025-03-13) Roche Ryan, Ellen; Bennett-Lenane, Harriet
Background: Adults who are Visually Impaired (VI) often experience challenges in taking medications and interacting with healthcare settings.
Aim: The aims of this study were to (1) explore the opinions of VI adults regarding care provided at community pharmacies in Ireland and (2) identify patient recommendations for improved care.
Method: Semi-structured interviews were conducted using a topic guide via telephone or videoconference with VI adults who visit community pharmacies in Ireland. Interviewees were recruited on a voluntary basis using a mix of purposive, convenience and snowball sampling. Interviews were recorded, transcribed and carried out until theoretical data saturation. The Braun and Clarke approach was used for thematic data analysis using NVivo software.
Results: Four major themes emerged from eighteen interviews. These were staff awareness, medicines information accessibility, physical inaccessibility and positive supports. Interviewees identified how open communication and close professional relationships between staff and VI adults could be influential in overcoming a perceived lack of independence and privacy currently experienced. Need for staff awareness training, improved provision of medicines information, improved physical accessibility of pharmacy layouts and use of mobile application as assistive technologies were also recommended.
Conclusion: This study provides the first qualitative exploration of care provided to VI adults by community pharmacies in Ireland. Based on personal experiences, interviewees recommended mostly minor adjustments to pharmacy practice to increase accessibility and help provide improved care for this cohort when visiting a pharmacy. This work represents a springboard for future research involving bespoke interventions and tailored guidance for pharmacy teams.
The association between body image and psychological outcomes in multiple sclerosis. A systematic review
(Elsevier B.V., 2024-12-24) McCormack, Derval; O'Keeffe, Fiadhnait; Seery, Christina; Eccles, Fiona
Background: Multiple sclerosis (MS) is a demyelinating autoimmune condition, in which body image may be altered due to a range of biopsychosocial factors. The aim of this review was to examine whether there is a relationship between body image and psychological outcomes in MS, in order to guide clinical intervention development. Methods: PsycINFO, Medline, CINAHL and Scopus databases were searched systematically in November 2023 for eligible studies, using terms relating to MS and body image. Quantitative studies, published in English, that examined the relationship between body image and psychological outcomes in adults with MS were included. The QualSyst tool was used to assess risk of bias across studies. Screening and quality appraisal was verified by the third author. A narrative synthesis was used to report patterns in findings. Results: Thirteen studies (ten cross-sectional and three intervention studies) met inclusion criteria and were included in the final review. The sample size across all included studies totalled 1533. The results suggested that positive body image was associated with improved mood, lower anxiety, increased self-esteem, and better quality of life. However, the causal nature of these relationships was unclear. Conclusion: The findings offer preliminary evidence to suggest that a more negative body image is associated with higher levels of psychological distress in MS, indicating that body image may be a target for intervention. Further research is necessary to provide a greater understanding of this association, and to inform future clinical practice.
Child and adult perspectives on implementing a quality improvement strategy in ECEC settings
(OMEP Ireland, 2021) Martin, Shirley; Buckley, Lynn; Harford, Katherine
This article presents findings from a mixed methods research project which sought to include the voices of young children in an ongoing evaluation of a government funded community-based prevention and early intervention programme in Ireland. The main objective of the intervention programme is to measurably improve the lives of children (pre-birth to six years) and their families through universal and targeted services in an urban community which experiences high levels of socio-economic deprivation. A key aspect of the programme is an Early Childhood Education and Care (ECEC) strategy which involves the delivery of a suite of Early Years quality improvement measures to seven ECEC centres (both crèche and preschool rooms) in the catchment area. The core elements of the quality improvement strategy focused on language supports for practitioners (Hanen Learning Language and Loving It™training), curriculum enhancement (HighScope™ curriculum training),
onsite mentoring for practitioners, and an Environment Enhancement Fund for each centre. The project evaluation utilised a mixed methods approach including pre and post programme Environmental Rating Scale (ERS) assessments (ECERS-3) at seven early years centres. Post programme implementation ERS results show significant improvements in many areas, in particular scores related to adult-child interactions. Using participatory research guided by a children’s rights framework and informed by UNCRC Article 12, children’s voices are being included in the project evaluation through participatory research methods including photo-voice and talk and draw methods. The article presents findings from post-intervention ECERS-3
assessments and qualitative interviews with early years’ practitioners which were merged with the findings in the children’s data to improve the overall implementation of the programme.
Designing and evaluating an accessible smartphone-based app for blind and visually impaired students for learning mathematics
(International Academy of Technology, Education and Development (IATED), 2025) Shoaib, Muhammad; Minghim, Rosane; Pitt, Ian; Science Foundation Ireland
The design and development of educational applications to enhance the learning experiences of blind and visually impaired people have improved considerably in recent years, but research suggests there is a need for further improvement. Despite the increasing prominence of accessibility features in mobile devices, barriers remain in providing efficient learning resources for these students, especially in STEM topics like mathematics. This paper discusses the design and usability evaluation of AccessMath, a mobile application designed to help blind and visually impaired primary school pupils learn mathematics. The application was developed using accessibility design guidelines, offering adjustable intrinsic brightness, multimodal feedback, a comprehensive settings panel, and intuitive swipe control functions. A usability test was carried out with five blind and visually impaired students employing a variety of metrics, such as task completion time, Usability Metric for User Experience (UMUX), NASA Task Load Index (NASA-TLX), and the System Usability Scale (SUS). The results revealed improved usability, lower cognitive load, and satisfactory user experiences, highlighting the usefulness of the implemented guidelines for designing and developing accessible mobile applications for blind and visually impaired users. Methodology: a) Design and Development of AccessMath (Shoaib, M. et al., 2024) The AccessMath app was designed to focus on four essential accessibility features: changeable intrinsic brightness, multimodal feedback, user settings panel, and swipe controls. These features enable them to better use their visual skills by changing brightness and contrast to minimize dependency on visual information by audio cues. Auditory, vibro, and gestural inputs help them navigate the app easily. With the help of a user-controlled setting panel, users can customize the app extensively to their preferences. b) Usability. Evaluation: A usability test was conducted with five blind and visually impaired users to examine the app's usability, cognitive load, and user experience. The study utilized measurements, i.e., task completion time to measure efficiency, the UMUX for perceived usability, NASA-TLX to evaluate cognitive workload, and the SUS for overall user satisfaction. Participants interacted with the app to perform the task and access the mathematical information. Later, they provided valuable feedback on the effectiveness and accessible features of the application. c) Participant Information: Five blind and visually impaired students were involved in this study, two males and three females. Their ages ranged from 9 to 12 years. All students had experience using mobile applications with assistive features. Ethical considerations were observed carefully, and all students were given informed consent before the study. This study has two phases (named "Design and Development of AccessMath" and "Usability Evaluation"). First, it expands existing accessibility guidelines to better suit the mobile context for blind and visually impaired users. Second, it presents empirical information on the usability and user experience of AccessMath, giving valuable insights for developers and researchers in accessible educational technology.