Lisa Murphy

In vitro selection criteria for probiotic bacteria of human origin: correlation with in vivo findings

The enteric flora comprises approximately 95% of the total number of cells in the human body and can elicit immune responses while protecting against microbial pathogens. However, the resident bacterial flora of the gastrointestinal tract may also be implicated in the pathogenesis of diseases such as inflammatory bowel disease (ulcerative colitis and Crohn disease). The objectives of the Probiotic Research Group based at University College Cork were to isolate and identify lactic acid bacteria exhibiting beneficial probiotic traits, such as bile tolerance in the absence of deconjugation activity, acid resistance, adherence to host epithelial tissue, and in vitro antagonism of pathogenic microorganisms or those suspected of promoting inflammation. To isolate potentially effective probiotic bacteria, we screened the microbial population adhering to surgically resected segments of the gastrointestinal tract (the environment in which they may subsequently be reintroduced and required to function). In total, 1500 bacterial strains from resected human terminal ilea were assessed. From among these organisms, Lactobacillus salivarius subsp. salivarius strain UCC118 was selected for further study. In mouse feeding trials, milk-borne L. salivarius strain UCC118 could successfully colonize the murine gastrointestinal tract. A human feeding study conducted in 80 healthy volunteers showed that yogurt can be used as a vehicle for delivery of strain UCC118 to the human gastrointestinal tract with considerable efficacy in influencing gut flora and colonization. In summary, we developed criteria for in vitro selection of probiotic bacteria that may reflect certain in vivo effects on the host such as modulation of gastrointestinal tract microflora.

Probiotics: from myth to reality. Demonstration of functionality in animal models of disease and in human clinical trials

The enteric flora comprise approximately 95% of the total number of cells in the human body and are capable of eliciting immune responses while also protecting against microbial pathogens. However, the resident bacterial flora of the gastrointestinal tract (GIT) may also be implicated in the pathogenesis of several chronic conditions such as inflammatory bowel disease (IBD). The University College Cork-based Probiotic Research Group has successfully isolated and identified lactic acid bacteria (LAB) which exhibit beneficial probiotic traits. These characteristics include the demonstration of bile tolerance; acid resistance; adherence to host epithelial tissue; and in vitro antagonism of potentially-pathogenic micro-organisms or those which have been implicated in promoting inflammation. The primary objective of this report is to describe the strategy adopted for the selection of potentially effective probiotic bacteria. The study further describes the evaluation of two m embers of the resulting panel of micro-organisms (Lactobacillus salivarius subsp. salivarius UCC118 and Bifidobacterium longum infantis 35624) under in vitro conditions and throughout in vivo murine and human feeding trials. Specifically, an initial feeding study completed in Balb/c mice focused upon (i) effective delivery of the probiotic micro-organisms to the GIT and evaluation of the ability of the introduced strains to survive transit through, and possibly colonise, the murine GIT; (ii) accepting the complexity of the hostile GIT and faecal environments, development of a method of enumerating the introduced bacterial strains using conventional microbiological techniques; and (iii) assessment of the effects of administered bacterial strains on the numbers of specific recoverable indigenous bacteria in the murine GIT and faeces. Additional research, exploiting the availability of murine models of inflammatory bowel disease, demonstrated the beneficial effects of administering probi otic combinations of Lactobacillus salivarius UCC118 and Bifidobacterium longum infantis 35624 in prevention of illness-related weight loss. A further ethically-approved feeding trial, successfully conducted in 80 healthy volunteers, demonstrated that yoghurt can be used as a vehicle for delivery of Lactobacillus salivarius strain UCC118 to the human GIT with considerable efficacy in influencing gut flora and colonisation.

Probiotic impact on microbial flora, inflammation and tumour development in IL‐10 knockout mice

The enteric bacterial flora has been implicated in the pathogenesis of enterocolitis and colon cancer in C57BL/6 IL‐10 knockout mice. Probiotic Lactobacilli modify the enteric flora and are thought to have a beneficial effect on enterocolitis. We conducted a controlled feeding trial in IL‐10 knockout mice using the probiotic Lactobacillus salivarius ssp. salivarius UCC118.

Development and process evaluation of an educational intervention to support primary care of problem alcohol among drug users

Purpose – The purpose of this paper is to describe the development and process evaluation of an educational intervention, designed to help general practitioners (GPs) identify and manage problem alcohol use among problem drug users. Design/methodology/approach – The educational session was developed as part of a complex intervention which was informed by the Medical Research Council framework for complex interventions. A Cochrane review and a modified Delphi-facilitated consensus process formed the theoretical phase of the development. The modelling phase involved qualitative interviews with professionals and patients. The trainings learning outcomes included alcohol screening and delivery of brief psychosocial interventions and this was facilitated by demonstration of clinical guidelines, presentation, video, group discussion and/or role play. Findings – Participants (n=17) from three general practices and local medical school participated in four workshops. They perceived the training as most helpful i...

Outcomes of Irish graduate entry medical student engagement with self-directed learning of clinical skills.

BackgroundExisting literature is mixed as to whether self-directed learning (SDL) delivers improvements in knowledge, skills or attitudes of medical students compared with traditional learning methods. This study aimed to determine whether there is an association between engagement in SDL and student performance in clinical examinations, the factors that influence student engagement with SDL in clinical skills, and student perceptions of SDL.MethodsA retrospective analysis of electronic records of student bookings of SDL sessions from 2008 to 2010 was performed for students in the pre-clinical years of an Irish Graduate Entry Medical programme to assess their level of engagement with SDL. The extent to which this engagement influenced their performance in subsequent summative examinations was evaluated. A cross-sectional survey of students across the four years of the programme was also conducted to determine student perceptions of SDL and the factors that affect engagement.ResultsThe level of engagement with SDL decreased over time from 95% of first years in 2008 to 49% of first years in 2010. There was no significant difference between the median exam performance for any clinical skills tested by level of engagement (none, one or more sessions) except for basic life support in first year (p =0.024). The main reason for engaging with SDL was to practice a clinical skill prior to assessment and the majority of respondents agreed that SDL sessions had improved their performance of the specific clinical skills being practised.ConclusionStudents viewed SDL as an opportunity to practise skills prior to assessment but there were no significant differences in subsequent summative assessment by the level of engagement for most clinical skills.

The consideration of future consequences and health behaviour: a meta-analysis

ABSTRACT The aim of this meta-analysis was to quantify the direction and strength of associations between the Consideration of Future Consequences (CFC) scale and intended and actual engagement in three categories of health-related behaviour: health risk, health promotive, and illness preventative/detective behaviour. A systematic literature search was conducted to identify studies that measured CFC and health behaviour. In total, 64 effect sizes were extracted from 53 independent samples. Effect sizes were synthesised using a random-effects model. Aggregate effect sizes for all behaviour categories were significant, albeit small in magnitude. There were no significant moderating effects of the length of CFC scale (long vs. short), population type (college students vs. non-college students), mean age, or sex proportion of study samples. CFC reliability and study quality score significantly moderated the overall association between CFC and health risk behaviour only. The magnitude of effect sizes is comparable to associations between health behaviour and other individual difference variables, such as the Big Five personality traits. The findings indicate that CFC is an important construct to consider in research on engagement in health risk behaviour in particular. Future research is needed to examine the optimal approach by which to apply the findings to behavioural interventions.

Social evaluative stress in adolescence: Effects of changes in perceived social competence

two different days (5-point daily profiles). Measures of body composition includedweight, height, waist circumference and skinfold thickness. Parents were asked to complete a set of questionnaires on life events, daily hassles and conflicts. Results: Mixed model analyses revealed positive associations between stress exposure and stress responses after controlling for age, gender and parental socioeconomic status. However, stress exposure was not associatedwith body composition nor with daily profiles in these young children. Conclusion: In very young children, stress exposurewas related to a dysregulation of acute physiological stress responses but not chronic stress responses or body composition. The time frame and lack of free access to food to change body composition after stress exposure might have been too short to show an impact within the age group of preschool children.