http://hdl.handle.net/10147/76176 Thu, 20 Jun 2013 10:23:58 GMT 2013-06-20T10:23:58Z http://hdl.handle.net/10147/293374 Title: Surgical checklists: the human factor Authors: O’Connor, Paul; Reddin, Catriona; O’Sullivan, Michael; O’Duffy, Fergal; Keogh, Ivan Abstract: Abstract Background Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. Methods Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. Results Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. Conclusion In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed. Tue, 14 May 2013 00:00:00 GMT http://hdl.handle.net/10147/293374 2013-05-14T00:00:00Z http://hdl.handle.net/10147/293370 Title: Bacteria and tumours: causative agents or opportunistic inhabitants? Authors: Cummins, Joanne; Tangney, Mark Abstract: Abstract Associations between different bacteria and various tumours have been reported in patients for decades. Studies involving characterisation of bacteria within tumour tissues have traditionally been in the context of tumourigenesis as a result of bacterial presence within healthy tissues, and in general, dogma holds that such bacteria are causative agents of malignancy (directly or indirectly). While evidence suggests that this may be the case for certain tumour types and bacterial species, it is plausible that in many cases, clinical observations of bacteria within tumours arise from spontaneous infection of established tumours. Indeed, growth of bacteria specifically within tumours following deliberate systemic administration has been demonstrated for numerous bacterial species at preclinical and clinical levels. We present the available data on links between bacteria and tumours, and propose that besides the few instances in which pathogens are playing a pathogenic role in cancer, in many instances, the prevalent relationship between solid tumours and bacteria is opportunistic rather than causative, and discuss opportunities for exploiting tumour-specific bacterial growth for cancer treatment. Thu, 28 Mar 2013 00:00:00 GMT http://hdl.handle.net/10147/293370 2013-03-28T00:00:00Z http://hdl.handle.net/10147/293019 Title: To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? ¿ An observational cohort study Authors: Kelly, Maureen E; Regan, Daniel; Dunne, Fidelma; Henn, Patrick; Newell, John; O’Flynn, Siun Abstract: Abstract Background Internationally, tests of general mental ability are used in the selection of medical students. Examples include the Medical College Admission Test, Undergraduate Medicine and Health Sciences Admission Test and the UK Clinical Aptitude Test. The most widely used measure of their efficacy is predictive validity.A new tool, the Health Professions Admission Test- Ireland (HPAT-Ireland), was introduced in 2009. Traditionally, selection to Irish undergraduate medical schools relied on academic achievement. Since 2009, Irish and EU applicants are selected on a combination of their secondary school academic record (measured predominately by the Leaving Certificate Examination) and HPAT-Ireland score. This is the first study to report on the predictive validity of the HPAT-Ireland for early undergraduate assessments of communication and clinical skills. Method Students enrolled at two Irish medical schools in 2009 were followed up for two years. Data collected were gender, HPAT-Ireland total and subsection scores; Leaving Certificate Examination plus HPAT-Ireland combined score, Year 1 Objective Structured Clinical Examination (OSCE) scores (Total score, communication and clinical subtest scores), Year 1 Multiple Choice Questions and Year 2 OSCE and subset scores. We report descriptive statistics, Pearson correlation coefficients and Multiple linear regression models. Results Data were available for 312 students. In Year 1 none of the selection criteria were significantly related to student OSCE performance. The Leaving Certificate Examination and Leaving Certificate plus HPAT-Ireland combined scores correlated with MCQ marks.In Year 2 a series of significant correlations emerged between the HPAT-Ireland and subsections thereof with OSCE Communication Z-scores; OSCE Clinical Z-scores; and Total OSCE Z-scores. However on multiple regression only the relationship between Total OSCE Score and the Total HPAT-Ireland score remained significant; albeit the predictive power was modest. Conclusion We found that none of our selection criteria strongly predict clinical and communication skills. The HPAT- Ireland appears to measures ability in domains different to those assessed by the Leaving Certificate Examination. While some significant associations did emerge in Year 2 between HPAT Ireland and total OSCE scores further evaluation is required to establish if this pattern continues during the senior years of the medical course. Fri, 10 May 2013 00:00:00 GMT http://hdl.handle.net/10147/293019 2013-05-10T00:00:00Z http://hdl.handle.net/10147/293012 Title: Promoting consumption at school: health threats associated with schoolhouse commercialism — the fifteenth annual report on schoolhouse commercializing trends: 2011 - 2012 Authors: Molnar, A.; Boninger, F.; Harris, M.D.; Libby, K.M.; Fogarty, J. Description: Many states and communities are in chronic fiscal crisis. So it is no surprise that beleaguered educators are ever more open to offers of corporate “partnerships” that might bring in additional money for their schools. Unfortunately, many school - business partnerships are little more than marketing arrangements that have few benefits for schools while carrying with them the potential to harm children in a variety of ways. The 2011 - 2012 Annual Report on Schoolhouse Commercializing Trends is the third in a series of annual reports to examine how commercializing activities in schools threaten children’s well - being. Prior reports examined psychological threats (2010) and educational threats (2011). The focus of this report is the health threats posed by the marketing of food and beverage products in school. Tue, 01 Jan 2013 00:00:00 GMT http://hdl.handle.net/10147/293012 2013-01-01T00:00:00Z