Mercy University Hospital (Irish: Ospidéal Ollscoile na Trócaire) is a general hospital located in Cork, Ireland. It is managed by South/Southwest Hospital Group.
To compare perioperative, oncological, and survival outcomes of total gastrectomy (TG) versus subtotal gastrectomy (SG) in patients with locally advanced distal diffuse gastric adenocarcinoma treated with perioperative 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) chemotherapy. Diffuse distal gastric cancer is characterized by infiltrative growth patterns and early nodal metastasis. Whilst radical resection remains the cornerstone of curative treatment, the optimal extent of surgery with TG or SG, remains debated. This international multicenter cohort study analyzed data from patients with histologically confirmed diffuse gastric adenocarcinoma, located > 5 cm from the gastroesophageal junction. Endpoints included surgical margin status, nodal yield, perioperative morbidity, recurrence patterns, time-to-recurrence (TTR), and overall survival (OS). Outcomes were compared using multivariate analyses. In total, 188 (39.0
Mental disorders are estimated to affect one in seven people globally and are often linked to premature mortality. Psychotropic medicines play an important role in the management of many mental health conditions particularly where symptoms are moderate to severe, persistent, or complex. Pharmacists are increasingly recognised as key members of multidisciplinary mental health teams, with their role focusing on safe and effective use of psychotropic medicines. Mental healthcare is increasingly delivered in outpatient settings, however, the impact of pharmacists on these services remains underexplored. To systematically review and evaluate the impact of pharmacist-led or pharmacist-involved interventions specifically within outpatient mental health settings globally, across the full spectrum of mental disorders. A systematic search of five electronic databases (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) was conducted from inception to October 2025. Grey literature sources including ClinicalTrials.gov and Google Scholar were also searched. Inclusion criteria were: (i) evaluation of a pharmacist-led or pharmacist-involved intervention with a measurable outcome; (ii) conducted in an outpatient mental health setting involving adults with a diagnosed mental disorder classified according to ICD (up to and including ICD-11) or DSM criteria (up to and including DSM-5), excluding dementia; and (iii) inclusion of a comparator or control group. Study screening, data extraction, and quality appraisal, were performed independently by two reviewers. Due to heterogeneity in study design and outcomes, a narrative synthesis was conducted. Twenty-three studies met the inclusion criteria: 11 randomised controlled trials and 12 non-randomised studies. Pharmacist interventions varied, but most commonly included medication reviews, psychoeducation, adherence support and monitoring for side effects or drug interactions. Outcomes were grouped into seven domains: patient-reported, symptom-related, treatment-related, medication adherence, cost, monitoring and hospitalisations. Pharmacist impact was associated with improvements across multiple domains, particularly in medication adherence, treatment-related and symptom-related outcomes. While outcome measures varied between studies, a majority (82.6
BACKGROUND:Biologically based complementary and alternative medicine (BBCAM) includes special diets, dietary supplement and herbal remedies, not prescribed by a doctor or dietitian. The use of BBCAM is common among cancer survivors. BBCAM can interact with conventional treatments and unregulated products may cause harm. This study aimed to determine the prevalence, types, and motivations for BBCAM use among cancer survivors. METHODS:A survey assessed clinical characteristics and BBCAM use in participants >18 yrs who had received cancer treatment in Ireland from 2018 to 2022. RESULTS:Amongst 295 respondents (77% female, mean age 53 yrs), BBCAM use increased from 28% pre-diagnosis to 34% post-diagnosis (p < 0.001). For BBCAM users (n = 97, 33%), "daily-use" increased from 38% to 72% (p < 0.001) post-diagnosis. Common types included: mineral/vitamin supplements (84%), dietary supplements (e.g. turmeric, coenzyme-Q10) (78%), herbal remedies/botanicals (e.g. mistletoe, St. John's Wort, echinacea, ginseng) (50%), cannabis (21%), and other natural products (laetrile, shark cartilage, apricot kernels) (19%). Biological medicines (GcMAF, immuno-augmentative therapy) were used by 12% of BBCAM users. Special diets including dairy free (32%), gluten-free (19%), intermittent fasting (17%), ketogenic diet (15%), juicing/detox (10%) were also common. Perceived benefits included: improved well-being (63%) and reduced psychological stress (59%). CONCLUSION:BBCAM use increases after a cancer diagnosis. Patient perceived benefits highlight potential gaps in the current healthcare model, indicating a need for greater emphasis on safe survivorship care.
Background Transition from paediatric to adult healthcare is particularly challenging for youth and their caregivers with complex health conditions, in part due to loss of paediatric supports and fragmentation of care, contributing to adverse outcomes. To date, transition research and policy has been largely driven by paediatric providers. Adult provider insights are critical to inform gaps in care, transition planning and enable innovative and sustainable interventions.Objective To describe adult subspecialist perspectives on barriers, facilitators and opportunities to improve the transition from paediatric to adult care for youth with complex health conditions.Methods An adult subspecialty advisory panel was convened as part of a quality improvement initiative, with physicians from the University of Toronto’s Department of Medicine who participated in three virtual meetings through nomination and stakeholder mapping. The first meeting focused on identifying current challenges and opportunities in transition to adult care; the second generated recommendations based on experiential knowledge and the third reviewed case studies to identify gaps and potential solutions. Discussions were recorded, transcribed and analysed using thematic qualitative analysis.Results Adult subspecialists identified five key areas for improvement: (1) preparing patients and families for the realities of adult care; (2) bridging communication gaps between paediatric and adult systems; (3) moving beyond age-based transition toward flexible, readiness-informed care; (4) strengthening collaboration among adult providers caring for young adults; and (5) addressing structural and infrastructure barriers within adult care systems.Conclusion Adult care physicians expressed and validated that young adults have unique care needs during their transition to adult care. They highlighted the need for stronger cross-system collaboration, resources and investment to ensure effective transition. These findings highlight barriers in implementing current paediatric-led transition standards and provide a foundation for system-level, disease-agnostic approaches to improve continuity of care across the paediatric–adult divide.
