University of Limerick Research Repository

Recent Submissions

  • PublicationOpen Access
    The Descriptive and Psychometric Properties of QoLTEN
    (2026) O'Reilly, Pauline; Savarimalai, Rajamanikandan; Fortune, Donal; Walsh, Sarah; Bunker, Christopher; Ingen-Housz-Oro, Saskia; Dodiuk-Gad, Roni P.; Ramsay, Bart; Phillips, Elizabeth J; Martin-Pozo, Michelle; O’Connor, April; Peter, Jonny; Hoenck, Helen; Lehloenya, Rannakoe; Chapman, Anna B; Meskell, Pauline; Ryan, Sheila; Griffin , Laoise; Ahearne, Robert; Morrissey, Philomena; Coffey, Alice; Hanson, Anita; Carr, Daniel F; Hannigan, Ailish
    QoLTEN is a recently developed bespoke health related quality of life (HRQoL) outcome measure for adults with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). As part of QoLTEN item development, an umbrella review, a systematic mixed method review, [1] a qualitative study, [2] and a Delphi study [3] were undertaken. Evolution of QoLTEN through the different stages are reported in the attached document. The report provides an overview of the descriptive and psychometric tests of the test-retest study on QoLTEN.
  • PublicationOpen Access
    The feasibility of the COMMUNICATE toolkit to support the communication of physical activity messages with adolescents in Irish schools
    (Oxford University Press, 2026-08-06) Grady, Caera L.; Murtagh, Elaine; Ng, Kwok; Garcaí Bengoechea, Enrique; Woods, Catherine B.
    The Active School Flag (ASF) is a peer-led whole-of-school physical activity (PA) programme in Irish secondary schools. This study assessed the feasibility of implementing the COMMUNICATE toolkit for ASF programme implementers (peer leaders and coordinating teachers). A pre-post, quasi-experimental, mixed-methods design was employed and guided by the Orsmond and Cohn feasibility objectives. Online surveys, semi-structured interviews, and focus groups were collected from six secondary schools (40% recruitment rate), 170 peer leaders, and three coordinating teachers. Survey data were analysed using descriptive statistics and independent and paired samples t-tests. Interview and focus group data were analysed using a combined inductive–deductive reflexive thematic analysis. Data were integrated during the writing-up stage. The toolkit was acceptable and appropriate; however, full implementation was hindered by time constraints within the busy school schedule and short implementation period. Methodological refinements regarding data collection timing and instrument validity and reliability were identified as necessary. Despite no differences between the intervention and control groups’ communication skills or health knowledge at follow-up, the toolkit positively impacted peer leaders’ personal development and knowledge and the PA and knowledge levels of their peers. While a real-world implementation design, led by programme implementers, may improve intervention sustainability and cost efficiency, implementation support and flexibility in delivery are essential. The COMMUNICATE toolkit was a valuable resource for whole-of-school programme implementers. Nevertheless, changes to the intervention and study procedures are required before proceeding to a definitive trial. Future research should consider an internal pilot within a definitive trial to ensure the changes are sufficient.
  • PublicationOpen Access
    Examining electronic medical record migration in a team- based primary care clinic: Case study
    (JMIR Publications, 2026-08-10) Moloney, Max; Sundareswaran, Madura
    Background: Electronic medical record (EMR) systems are now ubiquitous in Ontario primary care, with near-universal adoption among family physicians. EMRs have become critical pieces of clinic infrastructure that can affect nearly every aspect of clinical and administrative work. As EMR vendors consolidate and functionality evolves, some clinics undertake EMR migrations—complex transitions that require data conversion, workflow redesign, training, and change management. Despite their importance and wide adoption, there is a gap in understanding how community-based primary care organizations in Canadian settings navigate migration in practice, particularly from the perspective of frontline clinicians and staff. Objective: The project aimed to describe a single case of EMR migration within an 11-physician, team-based Family Health Organization (FHO) in Peterborough, Ontario, from the perspective of frontline clinicians and staff. This included assessing the factors influencing the decision to migrate, the operational and human factors that shaped implementation, and practical lessons for supporting and evaluating future EMR transitions. Methods: A single-site, physician-led quality improvement project was conducted in collaboration with the Peterborough Ontario Health Team using an exploratory case study approach. This approach was used to examine a complex, real-world health IT transition in its local organizational context. This project examined one FHO’s migration between EMR providers using purposive sampling of individuals directly involved in the transition, including a lead physician (n=1), a lead administrator (n=1), family physicians (n=9), interprofessional health care providers (n=12), and medical office assistants (n=9). Data sources included 2 semi-structured interviews, 2 focus groups, and 1 comprehensive document review. Data collection spanned the planning, implementation, and stabilization phases of the migration from February 2022 to November 2024. Sessions were recorded, transcribed, and deidentified. Documents included emails, meeting minutes, training communications, project planning materials, and troubleshooting records. Interview and focus group transcripts were analyzed thematically. Study documents were reviewed separately to construct a narrative chronology of the migration. Results: Four interrelated themes emerged: (1) burden of invisible labor, (2) cost and uncertainty as a catalyst, (3) importance of physician leadership, and (4) engage stakeholders early. Participants described migration as a resource-intensive organizational transition shaped by unpaid preparation work, cost pressures, clinical governance, quality assurance, and the responsiveness of internal and external stakeholders, particularly the vendor. Conclusions: This study illuminates the process of an EMR migration within one team-based FHO. Effective transitions depend on resourcing the often-invisible work of change, sustaining physician-led governance, and securing early, collaborative engagement with vendors and external partners. These findings complement provincial migration guidance by emphasizing protected time for training and quality assurance, local workflow adaptation, staged validation to shorten the transition period (“gray zone”), and explicit assessment of vendor responsiveness. Lessons are readily actionable for similar group practices and clinics planning future migrations or optimizations.
  • PublicationOpen Access
    Case Report: Eosinophilic fasciitis with PM-Scl antibody positivity: expanding the serological spectrum
    (frontiersin.org, 2026-07-27) Zanib, Alvina; Manicom, Brandon; O'Rourke, Anna; Murray, Kieran
    Eosinophilic fasciitis (EF) is a rare connective tissue disorder characterized by symmetrical or asymmetrical skin induration, fascial inflammation, and peripheral eosinophilia. We report the case of a middle-aged man presenting with left knee pain and swelling, progressive skin induration and pigmentation changes on the thigh and trunk. Blood workup showed peripheral eosinophilia and weakly positive PM-Scl-100 antibodies. MRI demonstrated fascial thickening with subcutaneous edema and fluid tracking along fascial planes, as well as a moderate knee effusion. Muscle biopsy confirmed eosinophilic fasciitis without muscle involvement. He was treated with high-dose prednisolone, methotrexate as a steroid-sparing agent, and adjunctive bone and infection prophylaxis, with marked clinical improvement at follow-up. This case highlights the diagnostic challenges in atypical presentation of eosinophilic fasciitis in the presence of overlap autoantibodies. Careful clinicopathological correlation is critical to exclude other differentials as EF can mimic systemic sclerosis or myositis. Biopsy can improve diagnostic certainty particularly when encountering auto-antibodies that have some association with other diagnoses.
  • PublicationOpen Access
    Drone-measured canopy spectra can be a complementary predictor of belowground arbuscular mycorrhizal fungi variations in urban community gardens
    (Elsevier, 2026-09-01) Afrasiabian, Yasamin; Andrade-Linares, Diana Rocio; Schulz, Stefanie; Schloter, Michael; Van Cleemput, Elisa; Egerer, Monika; Yu, Kang
    Arbuscular mycorrhizal fungi (AMF) form essential symbioses with plant roots, improving nutrient uptake, plant health, and soil function. However, assessing AMF abundance in urban ecosystems remains challenging. Drone-based multispectral imaging can estimate canopy functional traits, raising the question of whether variation in aboveground canopy metrics can serve as an ecological indicator of belowground AMF abundance. We sampled five community gardens over two growing seasons, combining quadrat-level plant surveys, soil sampling for AMF abundance, Unmanned Aerial Vehicle (UAV) multispectral imagery, and point clouds. From the UAV, we derived vegetation indices, spectral diversity and texture metrics, and from the point clouds we extracted canopy height metrics. We related these traits to log AMF abundance using LASSO cross-validated regression and piecewise structural equation modelling (SEM). Our analyses showed that drone-derived canopy traits captured part of the aboveground variation associated with belowground AMF abundance, particularly through canopy greenness and image texture patterns. Higher AMF abundance was associated with greener and more vertically heterogeneous canopies. UAV-derived canopy texture features explained up to ~38% of the variance in AMF abundance. Piecewise SEM indicated that AMF abundance was associated with a non-linear climate response, represented by the quadratic climate term (β = 0.25) and a positive vegetation-index pathway (β = 0.21). The AMF abundance SEM model had a marginal R2 of 0.62, suggesting that seasonal climatic conditions and canopy greenness jointly structured AMF variation. Overall, UAV-derived canopy traits represent a scalable ecological indicator of relative AMF abundance in urban gardens, supporting non-destructive assessment of relative AMF variation and spatial targeting of field sampling. Establishing this link provides a baseline for developing stronger urban ecological indicators by integrating UAV data with soil measurements, garden management, and higher resolution remote-sensing approaches.