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Article ; Online: Doctor Retention in a COVID-World: An Opportunity to Reconfigure the Health Workforce, or "Plus ça change plus c'est la meme chose"? A Response to the Recent Commentaries.

Brugha, Ruairí

International journal of health policy and management

2022 Volume 11, Issue 6, Page(s) 865–868

MeSH term(s)	COVID-19 ; Health Workforce ; Humans ; Physicians
Language	English
Publishing date	2022-06-01
Publishing country	Iran
Document type	Journal Article ; Comment
ZDB-ID	2724317-5
ISSN	2322-5939 ; 2322-5939
ISSN (online)	2322-5939
ISSN	2322-5939
DOI	10.34172/ijhpm.2021.60
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Comparison of the CIS-R and CIDI lay diagnostic interviews for anxiety and depressive disorders.

Brugha, T S / Meltzer, H / Jenkins, R / Bebbington, P E / Taub, N A

Psychological medicine

2005 Volume 35, Issue 7, Page(s) 1089–1091

MeSH term(s)	Anxiety Disorders/diagnosis ; Depressive Disorder/diagnosis ; Epidemiologic Studies ; Health Surveys ; Humans ; Interview, Psychological/standards ; Reproducibility of Results ; Research Design
Language	English
Publishing date	2005-06-02
Publishing country	England
Document type	Comment ; Comparative Study ; Letter
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/s0033291705005180
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Article: Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories.

Brugha, T S / Bebbington, P E / Jenkins, R / Meltzer, H / Taub, N A / Janas, M / Vernon, J

Psychological medicine

1999 Volume 29, Issue 5, Page(s) 1029–1042

Abstract: ... in general population samples show marked discrepancies. In order to validate the CIS-R, a fully structured diagnostic ... addresses from the Postcode Address File yielded 1157 eligible adults: of these 860 completed the CIS-R; 387 ... adults scores > or = 8 on the CIS-R and 205 of these completed a SCAN reference examination. Neurotic ...

Abstract	Background: Comparisons of structured diagnostic interviews with clinical assessments in general population samples show marked discrepancies. In order to validate the CIS-R, a fully structured diagnostic interview used for the National Survey of Psychiatric Morbidity in Great Britain, it was compared with SCAN, a standard, semi-structured, clinical assessment. Methods: A random sample of 1882 Leicestershire addresses from the Postcode Address File yielded 1157 eligible adults: of these 860 completed the CIS-R; 387 adults scores > or = 8 on the CIS-R and 205 of these completed a SCAN reference examination. Neurotic symptoms, in the previous week and month only, were enquired about. Concordance was estimated for ICD-10 neurotic and depressive disorders, F32 to F42 and for depression symptom score. Results: Sociodemographic characteristics closely resembled National Survey and 1991 census profiles. Concordance was poor for any ICD-10 neurotic disorder (kappa = 0.25 (95% CI, 0.1-0.4)) and for depressive disorder (kappa = 0.23 (95% CI, 0-0.46)). Sensitivity to the SCAN reference classification was also poor. Specificity ranged from 0.8 to 0.9. Rank order correlation for total depression symptoms was 0.43 (Kendall's tau b; P < 0.001; N = 205). Discussion: High specificity indicates that the CIS-R and SCAN agree that prevalence rates for specific disorders are low compared with estimates in some community surveys. We have revealed substantial discrepancies in case finding. Therefore, published data on service utilization designed to estimate unmet need in populations requires re-interpretation. The value of large-scale CIS-R survey data can be enhanced considerably by the incorporation of concurrent semi-structured clinical assessments.
MeSH term(s)	Adult ; Female ; Humans ; Interviews as Topic/methods ; Male ; Mass Screening ; Mental Disorders/diagnosis ; Psychiatric Status Rating Scales/standards ; Reproducibility of Results ; Sensitivity and Specificity
Language	English
Publishing date	1999-09
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/s0033291799008892
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Article ; Online: Disparities in lung transplantation in children.

Brugha, Rossa / Wu, Diana / Spencer, Helen / Marson, Lorna

Pediatric pulmonology

2023

Abstract: Lung transplantation is a recognized therapy for end-stage respiratory failure in children and young people. It is only available in selected countries and is limited by access to suitable organs. Data on disparities in access and outcomes for children ... ...

Abstract	Lung transplantation is a recognized therapy for end-stage respiratory failure in children and young people. It is only available in selected countries and is limited by access to suitable organs. Data on disparities in access and outcomes for children undergoing lung transplantation are limited. It is clear from data from studies in adults, and from studies in other solid organ transplants in children, that systemic inequities exist in this field. While data relating specifically to pediatric lung transplantation are relatively sparse, professionals should be aware of the risk that healthcare systems may result in disparities in access and outcomes following lung transplantation in children.
Language	English
Publishing date	2023-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.26813
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Zs.A 2143: Show issues

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Article: Diagnosis and management of pulmonary hypertension in infants with bronchopulmonary dysplasia: a guide for paediatric respiratory specialists.

Chan, Sarah / Brugha, Rossa / Quyam, Sadia / Moledina, Shahin

Breathe (Sheffield, England)

2023 Volume 18, Issue 4, Page(s) 220209

Abstract: Pulmonary hypertension (PH) can develop in babies with bronchopulmonary dysplasia (BPD). PH is common in those with severe BPD and is associated with a high mortality rate. However, in babies surviving beyond 6 months, resolution of PH is likely. There ... ...

Abstract	Pulmonary hypertension (PH) can develop in babies with bronchopulmonary dysplasia (BPD). PH is common in those with severe BPD and is associated with a high mortality rate. However, in babies surviving beyond 6 months, resolution of PH is likely. There is currently no standardised screening protocol for PH in BPD patients. Diagnosis in this group relies heavily on transthoracic echocardiography. Management of BPD-PH should be led by a multidisciplinary team and focus on optimal medical management of the BPD and associated conditions that may contribute to PH. PH-targeted pharmacotherapies have been used in BPD-PH. To date, these have not been investigated in clinical trials and evidence of their efficacy and safety is absent. Educational aims: To identify those BPD patients most at risk of developing PH.To be aware of detection, multidisciplinary management, pharmacological treatment and monitoring strategies for BPD-PH patients.To understand the potential clinical course for patients with BPD-PH and that evidence on efficacy and safety of PH-targeted pharmacotherapy in BPD-PH is limited.
Language	English
Publishing date	2023-02-14
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2562899-9
ISSN	2073-4735 ; 1810-6838
ISSN (online)	2073-4735
ISSN	1810-6838
DOI	10.1183/20734735.0209-2022
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Article ; Online: Mycobacterium abscessus

Brugha, Rossa / Spencer, Helen

Science (New York, N.Y.)

2021 Volume 372, Issue 6541, Page(s) 465–466

MeSH term(s)	Cystic Fibrosis ; Humans ; Microbial Sensitivity Tests ; Mycobacterium Infections, Nontuberculous/drug therapy ; Mycobacterium Infections, Nontuberculous/epidemiology ; Mycobacterium abscessus
Language	English
Publishing date	2021-04-17
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
DOI	10.1126/science.abi5695
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Zs.A 27: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with Cystic Fibrosis following liver transplantation: A systematic review.

Testa, Ilaria / Indolfi, Giuseppe / Brugha, Rossa / Verkade, Henkjan J / Terlizzi, Vito

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

2024

Abstract: Background & aims: Cystic Fibrosis (CF) liver disease progresses to liver failure requiring transplantation in about 3 % of patients, 0.7 % of CF patients are post liver transplant. The prognosis of CF has improved with the introduction of elexacaftor/ ... ...

Abstract	Background & aims: Cystic Fibrosis (CF) liver disease progresses to liver failure requiring transplantation in about 3 % of patients, 0.7 % of CF patients are post liver transplant. The prognosis of CF has improved with the introduction of elexacaftor/tezacaftor/ivacaftor (ETI). Due to the paucity of data and concerns regarding interactions with immunosuppressive drug regimens, there is no general consensus on use of ETI post liver transplantation. The aim of this review is to report the safety and efficacy of ETI in CF patients who underwent liver transplantation. Methods: A systematic review was conducted through MEDLINE/Pubmed and EMBASE databases. English-written articles reporting clinical data on liver transplanted CF patients treated with ETI were included. Article quality was evaluated using the Critical Appraisal Checklist for Case Reports. Results: Twenty cases were retrieved from 6 reports. Temporary discontinuation and/or dose reduction due to elevated transaminases was required in 5 cases. ETI restarted on a reduced dose was tolerated in 3 out of 5 patients, 1 patient tolerated full dose. Tacrolimus dose change was required in 14 cases, in 1 case ETI was discontinued due to tacrolimus toxicity. Improvement in percentage predicted FEV1 was noted in 15/19 patients (median +17 %, range 8 %-38 %). Conclusions: In the majority of liver transplanted patients ETI is well tolerated, although adverse events and liver function abnormalities may occur. Close monitoring of liver function and tacrolimus level is warranted. Significant improvement in lung function after ETI initiation is confirmed, highlighting the importance of accessing this medication for this group of patients.
Language	English
Publishing date	2024-04-13
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2084724-5
ISSN	1873-5010 ; 1569-1993
ISSN (online)	1873-5010
ISSN	1569-1993
DOI	10.1016/j.jcf.2024.04.006
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Zs.A 6028: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Dimensions of patient-centred care from the perspective of patients and healthcare workers in hospital settings in sub-Saharan Africa: A qualitative evidence synthesis.

Okeny, Paul K / Pittalis, Chiara / Monaghan, Celina Flocks / Brugha, Ruairi / Gajewski, Jakub

PloS one

2024 Volume 19, Issue 4, Page(s) e0299627

Abstract: Introduction: The United States Institute of Medicine defines patient centred care (PCC), a core element of healthcare quality, as care that is holistic and responsive to individual needs. PCC is associated with better patient satisfaction and improved ... ...

Abstract	Introduction: The United States Institute of Medicine defines patient centred care (PCC), a core element of healthcare quality, as care that is holistic and responsive to individual needs. PCC is associated with better patient satisfaction and improved clinical outcomes. Current conceptualizations of PCC are mainly from Europe and North America. This systematic review summarises the perceived dimensions of PCC among patients and healthcare workers within hospitals in sub-Saharan Africa (SSA). Methods: Without date restrictions, searches were done on databases of the Web of Science, Cochrane Library, PubMed, Embase, Global Health, and grey literature, from their inception up to 11th August 2022. Only qualitative studies exploring dimensions or perceptions of PCC among patients, doctors and/or nurses in hospitals in (SSA) were included. Review articles and editorials were excluded. Two independent reviewers screened titles and abstracts, and conducted full-text reviews with conflicts resolved by a third reviewer. The CASP (critical appraisal skills program) checklist was utilised to assess the quality of included studies. The framework synthesis method was employed for data synthesis. Results: 5507 articles were retrieved. Thirty-eight studies met the inclusion criteria, of which 17 were in the specialty of obstetrics, while the rest were spread across different fields. The perceived dimensions reported in the studies included privacy and confidentiality, communication, shared decision making, dignity and respect, continuity of care, access to care, adequate infrastructure and empowerment. Separate analysis of patients' and providers' perspective revealed a difference in the practical understanding of shared-decision making. These dimensions were summarised into a framework consisting of patient-as-person, access to care, and integrated care. Conclusion: The conceptualization of PCC within SSA was largely similar to findings from other parts of the world, although with a stronger emphasis on access to care. In SSA, both relational and structural aspects of care were significant elements of PCC. Healthcare providers mostly perceived structural aspects such as infrastructure as key dimensions of PCC. Trial registration: PROSPERO Registration number CRD42021238411.
MeSH term(s)	Pregnancy ; Female ; Humans ; Hospitals ; Health Personnel ; Africa South of the Sahara ; Patient-Centered Care/methods ; Obstetrics
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0299627
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Article ; Online: "We're not there to protect ourselves, we're there to talk about workforce planning": A qualitative study of policy dialogues as a mechanism to inform medical workforce planning.

Bruen, Carlos / Brugha, Ruairi

Health policy (Amsterdam, Netherlands)

2020 Volume 124, Issue 7, Page(s) 736–742

Abstract: Introduction: To address a disjuncture between medical workforce research and policy activities in Ireland, a series of national level policy dialogues were held between policy stakeholders and researchers to promote the use of research evidence in ... ...

Abstract	Introduction: To address a disjuncture between medical workforce research and policy activities in Ireland, a series of national level policy dialogues were held between policy stakeholders and researchers to promote the use of research evidence in medical workforce planning. This article reports on findings from a qualitative study of four policy dialogues (2013-2016), the aim of which was to analyse policy dialogues as a mechanism for knowledge-sharing and interaction to support medical workforce planning. Methods: Descriptive qualitative study design involving in-depth interviews with policy stakeholders and researchers (n = 13) who participated in the policy dialogues; thematic analysis of interview transcripts. Findings: Periodic policy dialogues, with discussion focused on research evidence, provided an enabling environment for exchange and interaction between policy stakeholders and researchers, and between policy stakeholders themselves. Findings foreground the significance of the policy-making context, in terms of how people interact during policy dialogues, and how research can potentially (or not) inform medical workforce planning. Conclusion: Policy dialogues provide a mechanism for improving knowledge exchange and interaction between policy stakeholders and researchers. Situated within the policy context, policy dialogues also add value to: a) policy-making processes by facilitating interactions between policy stakeholders outside the day-to-day business of formal and sometimes adversarial negotiation; b) research processes, including exposing researchers to the complexity of health workforce planning, and health policy more generally.
MeSH term(s)	Health Planning ; Health Policy ; Humans ; Ireland ; Policy Making ; Workforce
Language	English
Publishing date	2020-05-19
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605805-x
ISSN	1872-6054 ; 0168-8510
ISSN (online)	1872-6054
ISSN	0168-8510
DOI	10.1016/j.healthpol.2020.04.001
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Article ; Online: Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle.

Brugha, Ruairi / Clarke, Nicholas / Hendrick, Louise / Sweeney, James

International journal of health policy and management

2021 Volume 10, Issue 6, Page(s) 299–309

Abstract: Background: The failure of some high-income countries to retain their medical graduates is one driver of doctor immigration from low- and middle-income countries. Ireland, which attracts many international medical graduates, implemented a doctor ... ...

Abstract	Background: The failure of some high-income countries to retain their medical graduates is one driver of doctor immigration from low- and middle-income countries. Ireland, which attracts many international medical graduates, implemented a doctor retention strategy from early 2015. This study measures junior doctors' migration intentions, the reasons they leave and likelihood of them returning. The aim is to identify the characteristics and patterns of doctors who plan to emigrate to inform targeted measures to retain these doctors. Methods: A national sample of 1148 junior hospital doctors completed an online survey in early 2018, eliciting their experiences of training and working conditions. Respondents were asked to choose between the following career options: remain in Ireland, go and return, go and stay away, or quit medicine. Bivariate analyses and a two-stage multivariable analysis were used to model the factors associated with these outcomes. Results: 45% of respondents planned to remain in Ireland, 35% leave but return later, 17% leave and not return; and 3% to quit medicine. An intention to go abroad versus remain in Ireland was independently associated ( Conclusion: Ireland's doctor retention strategy has not addressed the root causes of poor training and working experiences in Irish hospitals. It needs a more diversified retention strategy that addresses under-staffing, facilitates circular migration by younger trainees who choose to train abroad, identifies and addresses specialty-specific factors, and builds mentoring linkages between trainees and senior specialists.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Emigration and Immigration ; Humans ; Ireland ; Physicians ; Professional Practice Location ; Surveys and Questionnaires
Keywords	covid19
Language	English
Publishing date	2021-06-01
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2724317-5
ISSN	2322-5939 ; 2322-5939
ISSN (online)	2322-5939
ISSN	2322-5939
DOI	10.34172/ijhpm.2020.54
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