Dorothy Leahy

Can general practice help address youth mental health? A retrospective cross-sectional study in Dublin's south inner city

Aims: With general practice potentially having an important role in early intervention of mental and substance use disorders among young people, we aim to explore this issue by determining the prevalence of psychological problems and general practice/health service utilization among young people attending general practice.

Role of the general practitioner in providing early intervention for youth mental health: a mixed methods investigation.

Youth suicide in Ireland is now the second highest in the European Union. General practitioners (GPs), as the health‐care professional most often consulted by young people, have a central role in early detection of youth mental health problems. However, evidence regarding the perspectives of young people and health‐care workers towards screening and treatment for such issues in primary care in Ireland is lacking.

Stroke in young women: An interpretative phenomenological analysis

Stroke among adults of working age is increasing. We aimed to explore the experience of stroke among young women in Ireland. In total, 12 women (aged between 18 and 50 years) participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis. Four super-ordinate themes were identified: stroke as an illness of later life (‘obviously it’s for older people’), post-stroke selves, a desire for peer support and the impact of stroke on relationships. Findings indicate the importance of addressing the specific needs of younger stroke patients from admission to recovery through provision of inclusive all-age acute stroke services with tailored rehabilitation.

Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention

BackgroundGPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas.AimsTo inform a complex intervention to support GPs in this important role, we aim to identify the key areas in which general practice can help address youth mental health and strategies to enhance implementation.MethodsWe conducted a modified Delphi study which involved establishing an expert panel involving key stakeholders/service providers at two deprived urban areas. The group reviewed emerging literature on the topic at a series of meetings and consensus was facilitated by iterative surveys.ResultsWe identified 20 individual roles in which GPs could help address youth mental health, across five domains: (1) prevention, health promotion and access, (2) assessment and identification, (3) treatment strategies, (4) interaction with other agencies/referral, and (5) ongoing support. With regard to strategies to enhance implementation, we identified a further 19 interventions, across five domains: (1) training, (2) consultation improvements, (3) service-level changes, (4) collaboration, and (5) healthcare-system changes.ConclusionsGPs have a key role in addressing youth mental health and this study highlights the key domains of this role and the key components of a complex intervention to support this role.

‘Nobody really gets it’: a qualitative exploration of youth mental health in deprived urban areas

To examine the experience of developing and living with mental health and substance use disorders among young people living in urban‐deprived areas in Ireland to inform primary care interventions.

Commentary on Zeremski et al. (2016): Improvements in Hcv-related Knowledge Among Substance Users on Opioid Agonist Therapy After an Educational Intervention

Letter to editor: Zeremski et al., (2016) highlight how improving patients’ knowledge about hepatitis C virus (HCV) care can enhance adherence to treatment plans and improved treatment outcomes. In this regard we believe that patients’ knowledge of HCV care can best be optimized through community-based approaches to HCV treatment as supported by recent findings from (Wade et al., 2015; Grebely et al., 2016). The advent of such models of care provide an opportunity to embed HCV treatment within a holistic approach that also addresses related issues, especially alcohol use disorders. This is especially the case in Ireland, where alcohol use disorders are common among people who inject drugs (Ryder et al., 2009). This increases the risk of complications related to chronic HCV infection as alcohol can exacerbate HCV infection and the associated liver damage by causing oxidative stress and promoting fibrosis, thereby accelerating disease progression to cirrhosis (Batchelder et al., 2015).......

Towards early intervention for youth mental health in primary care: a mixed methods investigation

Objective: Stress and burnout are commonly reported among millennial medical students. A medical student’s perception and response to stress can affect their health, delivery of quality care and practice of patient safety. The purpose of this study is to explore the prevalence and gender differences in burnout and coping mechanisms used in a sample of third-year, millennial medical students rotating at a Southern California hospital.T rates of obesity are rapidly rising worldwide. Obesity is now a leading cause of cancer incidence and mortality. One in five female and one in seven male cancer deaths are attributable to obesity. My research program is focused on the development of precision medicine-driven interventions to prevent obesity-related cancers and improve outcomes. Our team was the first to demonstrate that inflammation of breast white adipose tissue (WAT) occurs in association with obesity and is detected by the presence of crown-like structures (CLS). Consisting of a dead or dying adipocyte surrounded by macrophages, CLS are associated with increased levels of proinflammatory mediators and locally enhanced estrogen signaling, which directly promotes tumorigenesis. Additionally, we have discovered WAT inflammation at other organ sites, including the tongue and prostate, suggesting that adipose inflammation and its systemic effects have a role in the development of several cancers. Alarmingly, we have also identified WAT inflammation and its associated metabolic alterations in one third of lean women. It is particularly important to develop tools that identify this cohort of at-risk individuals, given their healthy appearance. The identification of these biologic processes underlying the obesity-cancer link has allowed us to begin developing novel and exciting interventions to combat the ill effects of obesity. This new mechanism-based understanding of the ways by which obesity promotes cancer is poised to transform the way we prevent and treat cancer.Method: In this cross-sectional study, 622 women (aged 20-74 years) were recruited from a general population. Ultrasound with saline contrast sono-hysterography (SCSH) was performed. The shape of the uterus was dynamically evaluated and classified in accordance with American Fertility Society as normal, arcuate, septate (partial, complete), bicorn (partial, complete), or unicorn. History of previous miscarriage and menstrual cycle was obtained by a questionnaire.Introduction: The youth suicide rate in Ireland is now the second highest in the European Union, for 0-19 year olds. Early intervention in youth mental health is increasingly viewed as being more effective than traditional approaches to care. General Practitioners (GPs), as the healthcare professional most often consulted by young people, have a central role in early detection of youth mental health problems. However, there is a dearth of evidence regarding the experiences and attitudes of young people and health care workers towards screening and treatment for such issues.