Research by staff affiliated to Cavan/Monaghan Hospital

Recent Submissions

  • New-onset lone maternal atrial fibrillation: A case report.

    Janjua, Nusrat Batool; Birmani, Suhaib Akhtar; McDonagh, Thomas; Hameed, Abdul; McKernan, Matthew (2020-02)
    Rationale: Atrial fibrillation (AF) is encountered rarely in pregnancy. Management of maternal AF is challenging as it poses a threat to both maternal and fetal well-being. Patient concerns: We report a case of a 35 weeks pregnant woman who presented in emergency with sudden-onset palpitations and mild shortness of breath with no personal/family history of cardiac diseases. Diagnoses: Patient's pulse was irregularly irregular with an average rate of 179 beats per minute. The obstetric examination was normal. Diagnosis: High-sensitive cardiac troponin T (hs-cTnT) was elevated. The 12 lead electrocardiogram (ECG) confirmed AF. The obstetric ultrasound, electronic fetal heart rate (EFHR) trace, and maternal echocardiography were normal. Interventions: The patient was admitted under joint cardiology and obstetric care and monitored with continuous telemetry. She was commenced on a therapeutic dose of low-molecular weight heparin (LMWH) and intravenous fluid. She received a single 200 Joule synchronized direct current (DC) shock under general anesthesia in operation theater, which reverted the rhythm back to normal. EFHR monitoring was normal pre- and post-DC cardioversion. We acknowledge the unwise use of therapeutic dose of LMWH before DC cardioversion (DCCV) because of a potential need for emergency cesarean delivery for maternal and/or fetal compromise. Outcome: The patient remained well and in sinus rhythm after cardioversion. She was discharged home the following day on Flecainide (anti-arrhythmic) and therapeutic dose of low molecular weight heparin (LMWH) and followed up in outpatient clinics frequently. She had a baby at term and received prophylactic LMWH for 10 days post-cesarean. She was discharged from cardiology clinic when she was 10 weeks postnatal, and Flecainide was discontinued. Lessons: We are reporting this case because of the rarity of the condition and successful use of DCCV for treating maternal AF. High-sensitive cardiac troponin T (hs-cTnT) level is a useful laboratory indicator to gauge the severity of AF in pregnancy. We emphasize to make the arrangements for EFHR monitoring and potential cesarean delivery and advocate cautious use of thromboprophylaxis while planning for electrical cardioversion (ECV) for maternal AF.
  • Bird fancier's lung in mushroom workers

    J Hayes,; M Barrett (Irish Medical Journal, 2015-04)
    Hypersensitivity pneumonitis has been described in mushrooms workers caused by exposure to mushroom or fungal spores in the compost used to grow mushrooms. We describe two mushroom workers who developed hypersensitivity pneumonitis due to exposure to avian proteins found in poultry manure which was used in producing mushroom compost. Both workers were employed in the compost production area. Both presented with typical features of HP. Both workers had negative serological and precipitin studies to Apergillus fumigatus, Saccarhopolyspora rectivirgula and thermophilic actinomycetes but had positive responses to poultry antibodies. Neither was exposed to mushroom spores. Both workers required initial therapy with corticosteroids. Relocation with avoidance of further exposure resulted in complete cure in one worker and change in work practice with the use of personal protections equipment resulted in the second worker clinical stabilisation. These are the first reported cases of bird fanciers lung in mushroom workers.
  • Improving stroke care for patients at Cavan hospital [poster]

    Murugasu, G Dr.; O’Callaghan, Su-Zann; Smith, Collette; Young, Maeve; Cavan General Hospital (Health Service Executive, 2013-07)
    Under the Quality and Continuing Care Directorate (QCCD) in stroke care Cavan General Hospital was identified as a hospital that received a large number of stroke and TIA patients. A programme was established to improve services to this population.
  • Evidence based road safety? The Driving Standards Agency's schools programme

    Cochrane Injuries Group Driver Education Reviewers; Achara, Shirley; Adeyemi, Bola; Dosekun, Efunbo; Kelleher, Suzanne; Lansley, Marilyn; Male, Ian; Muhialdin, Nermin; Reynolds, Lucy; Roberts, Ian; et al. (2001-07)
    Presentation at the third Interdisciplinary Evidence Based Policies and Indicator Systems Conference, July 2001
  • Revesz syndrome masquerading as bilateral cicatricial retinopathy of prematurity

    van der Spek, Nick; McElnea, E; Smith, O; Fitzsimons, S; Patel, C; O’Marcaigh, A (European Society of Ophthalmology, 2013-06-11)
  • Evaluation of an innovative recruitment initiative on the attitudes of medical students

    O’Connor, K; Thekiso, T; Douglas, L; Barry, H; Flynn, D; McCarthy, A; Swanwick, G (Irish Medical Journal, 2013-05)
  • Social and occupational engagement of staff in two Irish nursing homes for people

    Morgan-Brown, M; Ormerod, M; Newton, R; Manley, D; Fitzpatrick, M (Irish Journal of Occupational Therapy, 2011)
  • An exploration of occupation in nursing home residents with dementia

    Morgan-Brown, M; Manley, D (National Institute of Health Sciences Research Bulletin, 2011)
  • Engaging life in two Irish nursing home units for people with dementia: Quantitative comparisons before and after implementing household environments.

    Morgan-Brown, Mark; Newton, Rita; Ormerod, Marcus; a SURFACE Inclusive Design Research Centre, School of the Built Environment, The University of Salford , Salford , UK. (Aging & mental health, 2012-09-03)
    Objectives: This study compares the Social Engagement and Interactive Occupation of residents with dementia in two Irish nursing homes, before and after conversion to a household model environment. The changes were an open plan design and a functioning unit kitchen, supported by a homemaker role and operational policies which reduced task-based work in favour of person-centred care offering choice. Method: A snapshot observation method was used to obtain quantitative data of resident activity using the Assessment Tool for Occupation and Social Engagement (ATOSE). Residents were assessed for four hours, on seven different weekdays, over a six-week period both pre- and post-renovation. The exception to this was the assessment of the traditional model unit (TMU) for Nursing Home 1 which was reduced to four days due to the early start of the building work. Results: The results were consistent for both nursing homes and data were aggregated. Residents spent more time in the communal living spaces and were more likely to be active and engaged in the household model units (HMUs) compared to the TMUs. Using the independent t-test, these changes were found to be highly significant (p < 0.001). Conclusion: Creating an HMU increased the Interactive Occupation and Social Engagement of residents in the communal areas of the two nursing homes. The physical environment change, in conjunction with supportive staff procedures and organizational initiatives, improved the well-being of residents with dementia. The outcomes must be viewed in context with financial implications.
  • An exploration of occupation in nursing home residents with dementia

    Morgan-Brown, Mark; Ormerod, Marcus; Newton, Rita; Manley, Dympna (2011-05)
    Objectives: This study evaluated the sitting room environment of two nursing homes in Ireland, using interactive occupation and social engagement as outcome measures and defining these rooms as occupational spaces. Method: Snapshot observational recordings were made in the main sitting rooms during the periods of time when the rooms were in most active use. Narrative information was also recorded. Results: Residents were more likely to occupy their time in the main sitting room passively, rather than in interactive occupation and social engagement. The nursing home residents with dementia spent approximately 70% of their daily time in the main sitting room areas in states of occupational disengagement. Discussion: Additional insight is provided through pragmatic narrative descriptions of the functioning of the main sitting room environment in terms of interactive occupation and social engagement. Relevance: The research study demonstrates a methodology for evaluating the sitting room areas of a care environment, using interactive occupation and social engagement as outcome measures, which can be used for descriptive and comparative insights into the performance of care environments.
  • Social and occupational engagement of staff in two Irish nursing homes for people with dementia

    Morgan-Brown, M; Omerod, M; Newton, R; Manley, D; Fitzpatrick, M; Cavan General Hospital (2011)
    This observational study evaluated the amounts of social and occupational engagement of staff (nurses, care workers, activity coordinators) in two traditional style Irish residential nursing homes for people with dementia. A snapshot observational technique was used to obtain daily quantitative data. Approximately 65% of the time that staff were in communal sitting rooms during the observational periods was spent in work and care tasks, with approximately 25% of the time spent in social engagement and 10% spent in interactive occupational activities with the residents. Staff were absent from the room for over one-third of the observed time. Environmental and operational observations are discussed using narrative descriptions to give a context to the quantitative outcome measures.
  • A consultant paediatrician led and public health nurse (PHN) provided Community Enuresis Clinic as a model of care.

    Noone, D; van der Spek, N; Waldron, M; Cavan General Hospital, Cavan Town, Co Cavan. (2011-02)
    A dedicated Community Enuresis Clinic was established in 2004 in Cavan and Monaghan. The service was audited using ERIC (Education and Resources for Improving Childhood Continence) guidelines. There were 106 males and 47 females, giving an M: F ratio of 2.3:1. Monosymptomatic Nocturnal Enuresis (MNE) accounted for 127 (83%). Adequate follow-up was available for 108 children with MNE and in this group Initial Success was 49% (ERIC target 50%). 71% were dry at 1 year. There was a dropout rate of 20% in the MNE group (ERIC minimum standard < 25%). We believe the structure of this community based clinic and its approach to MNE management has been successful.
  • Take care caring for ourselves as we care for patients at the end of life a reflective guide for health care staff at Cavan General Hospital

    Marron, Martina; Cavan General Hospital (Health Service Executive (HSE), Cavan General Hospital, 2011)
  • An exploration of occupation in nursing home residents with dementia

    Morgan-Brown, Mark; Ormerod, Marcus; Newton, Rita; Manley, Dympna; Cavan General Hospital,University of Salford,Monaghan General Hospital (The College of Occupational Therapists Ltd., 2011-05)