Now showing items 1-20 of 29179

    • Combined Patients and Medical Related Cosmetic Breast Cancer Outcomes—A Preferred Approach to Outcomes Assessment

      Sugrue, Michael; Johnston, Alison; Degnim, Amy; Rubio, Isabel T.; Van den Tol, M. Petrouska; Djohan, Risal; Valentine, Mark; Mac Gregor, Geraldine; 1. Breast Centre North West, Letterkenny University Hospital, Donegal, Ireland 2. Donegal Clinical Research Academy, Donegal, Ireland. 3. Mayo Clinic, Rochester, NY, USA. 4. Vall d’Hebron Hospital Universitario, Barcelona, Spain. 5&6 University Medical Centre, Amsterdam, Netherlands (Advances in Breast Cancer Research, 2018-12)
      Introduction: Reducing positive margins and need for re-excision yet maintaining cosmesis is key in breast cancer surgery. This study describes the evaluation of early outcomes of a combined cosmetic assessment programme following breast conservation surgery (BCS). Methods: An ethically approved prospective study was conducted at Letterkenny University Hospital and a 15-month timeframe was chosen. All consecutive patients undergoing conservative breast surgery with complete local excision, from July 2015 to October 2016, were entered into the study. Patients undergoing mastectomy and reconstruction with either implant or autologous tissue were not included. 41 patients undergoing BCS were analysed. Objective and subjective cosmetic evaluations were carried out. Assessments used were the Breast Cancer Conservative Treatment—cosmetic results [BCCT.core 2.0] Software, a panel of 4 experts in breast surgery and the Breast Cancer Treatment Outcome Scale (BCTOS). Demographic and pathological data, breast excision weight, % breast volume excised (BVE), margin positivity, complications and re-excision were documented. Data was expressed as mean and standard deviation for normally distributed data and medians and inter quartile range for non-normal data. Scores were also dichotomised to excellent/good and fair/poor and results were analysed. Results: 41 patients’ mean age is 55 ± 13 years. Mean breast volume was 768.3 cm3 ± 440; BVE weighed 78.6g ± 42.6 (18.9 - 214.4) and %BVE 11.3% ± 5.2% (5.1 - 23.3). Re-excision rate was 2/41 (4.9%) all for positive margins. 0/41 infections or haematomas occurred.
    • "Do as we say, not as we do?" the lifestyle behaviours of hospital doctors working in Ireland: a national cross-sectional study.

      O' Keeffe, Anthony; Hayes, Blánaid; Prihodova, Lucia (BMC Public Health, 2019-02-11)
      This study was conducted to assess the lifestyle behaviours of a national sample of hospital doctors working in Ireland. We also sought to compare the prevalence of these behaviours in doctors to the general Irish population. This was a national cross-sectional study of a randomised sample of hospital doctors working in Irish publicly funded hospitals and residential institutions. The final cohort consisted of 1749 doctors (response rate of 55%). All hospital specialties were represented except radiology. The following data were collected: sociodemographic data (age, sex), work grade (consultant, trainee) average hours worked over a two-week period, specialty and lifestyle behaviours (smoking, alcohol, physical activity). Lifestyle data for the general population was provided by the Healthy Ireland 2015 study. Half of participants were men (50.5%). Just over half of the sample were consultants (54.3%), with 45.7% being trainees. 9.3% of doctors surveyed were smokers, 88.4% consumed alcohol and 24.5% were physically inactive. Trainees were more likely to smoke and be physically inactive when compared to consultants. Smoking rates amongst doctors were lower than the general population (9.3% -v- 23%). Doctors were more likely to consume alcohol than the general population (88.4% -v- 71.7%) but less likely to engage in binge drinking on a typical drinking occasion (12.8% -v- 39.5%). Doctors were more compliant than the general population with minimum exercise targets (75.5% -v- 70.5%), but less likely to engage in health enhancing physical activity (19.1% -v- 33%). While the prevalence of health behaviours amongst hospital doctors in Ireland compares favourably to the general population, their alcohol consumption and engagement in health enhancing physical activity suggest room for improvement. Continued health promotion and education on the importance of personal health behaviours is essential.
    • Clinical Psychology Today Summer 2018

      Foy, Sean; Galavan, Eoin; Collins, Padraig; School of Psychology, National University of Ireland Galway (School of Psychology, National University of Ireland Galway, 2018-07-01)
    • Over prescribing of antibiotics for acute respiratory tract infections; a qualitative study to explore Irish general practitioners' perspectives.

      O'Doherty, Jane; Leader, Leonard F W; O'Regan, Andrew; Dunne, Colum; Puthoopparambil, Soorej Jose; O'Connor, Raymond (BMC Family Practice, 2019-02-14)
      Anti-microbial resistance (AMR) is a global threat to public health and antibiotics are often unnecessarily prescribed for acute respiratory tract infections (ARTIs) in general practice. We aimed to investigate why general practitioners (GPs) continue to prescribe antibiotics for ARTIs despite increasing knowledge of their poor efficacy and worsening antimicrobial resistance. We used an explorative qualitative study design. Thirteen GPs were recruited through purposive sampling to represent urban and rural settings and years of experience. They were based in general practices within the Mid-West of Ireland. GPs took part in semi-structured interviews that were digitally audio recorded and transcribed. Three main themes and three subthemes were identified. Themes include (1) non-comprehensive guidelines; how guideline adherence can be difficult, (2) GPs under pressure; pressures to prescribe from patients and perceived patient expectations and (3) Unnecessary prescribing; how to address it and the potential of public interventions to reduce it. GPs acknowledge their failure to implement guidelines because they feel they are less usable in clinical situations. GPs felt pressurised to prescribe, especially for fee-paying patients and in out of hours settings (OOH), suggesting the need for interventions that target the public's perceptions of antibiotics. GPs behaviours surrounding prescribing antibiotics need to change in order to reduce AMR and change patients' expectations.
    • Food Safety Authority of Ireland (FSAI) strategy 2019-2023

      Unknown author (Food Safety Authority of Ireland (FSAI), 2019)
    • To explore Nurses’ Knowledge of Patient’s Stroke Risk in relation to Atrial Fibrillation and Anticoagulation use in Preventing Stroke.

      Galvin, Trish (School of Nursing and Midwifery, National University of Ireland, Galway, 2018-08)
    • Acute Psychiatric Unit, Ennis Hospital Approved Centre Inspection Report 29 August – 1 September 2017

      Mental Health Commission (MHC); Mental Health Commission (Mental Health Commission (MHC), 2018-03-22)
    • Economic impact of potentially inappropriate prescribing and related adverse events in older people: a cost-utility analysis using Markov models.

      Moriarty, Frank; Cahir, Caitriona; Bennett, Kathleen; Fahey, Tom (BMJ Open, 2019-01-30)
      To determine the economic impact of three drugs commonly involved in potentially inappropriate prescribing (PIP) in adults aged ≥65 years, including their adverse effects (AEs): long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), benzodiazepines and proton pump inhibitors (PPIs) at maximal dose; to assess cost-effectiveness of potential interventions to reduce PIP of each drug. Cost-utility analysis. We developed Markov models incorporating the AEs of each PIP, populated with published estimates of probabilities, health system costs (in 2014 euro) and utilities. A hypothetical cohort of 65 year olds analysed over 35 1-year cycles with discounting at 5% per year. Incremental cost, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios with 95% credible intervals (CIs, generated in probabilistic sensitivity analysis) between each PIP and an appropriate alternative strategy. Models were then used to evaluate the cost-effectiveness of potential interventions to reduce PIP for each of the three drug classes.
    • Clarifying the mechanisms and resources that enable the reciprocal involvement of seldom heard groups in health and social care research: A collaborative rapid realist review process

      Ní Shé, Éidín; Morton, Sarah; Lambert, Veronica; Ní Cheallaigh, Cliona; Lacey,  Vanessa; Dunn, Eleanor; Loughnane, Cliona; O'Connor, Joan; McCann, Amanda; Adshead, Maura; Kroll, Thilo (Health Expectations, 2019-01)
    • The Department of Public Health Mid-West Newsletter, Edition (2), Feb 2019

      Health Service Executive (HSE) Mid West (Clare, Limerick, North Tipperary), Department of Public Health (Health Service Executive (HSE) Mid West (Clare, Limerick, North Tipperary), Department of Public Health, 2019-02)
    • Irish National ICU Audit Annual Report 2017.

      National Office of Clinical Audit (NOCA) (National Office of Clinical Audit (NOCA), 2019-02-06)
    • Major Trauma Audit National Report 2017

      National Office of Clinical Audit (NOCA) (National Office of Clinical Audit (NOCA), 2019-02-06)
    • Erectile Dysfunction and Ischaemic Heart Disease.

      Ibrahim, Abdalla; Ali, Mohamed; Kiernan, Thomas J; Stack, Austin G (European Cardiology Review, 2018-12-01)
      Erectile dysfunction (ED) is a common disorder that affects the quality of life of many patients. It is prevalent in more than half of males aged over 60 years. Increasing evidence suggests that ED is predominantly a vascular disorder. Endothelial dysfunction seems to be the common pathological process causing ED. Many common risk factors for atherosclerosis such as diabetes, hypertension, smoking, obesity and hyperlipidaemia are prevalent in patients with ED and so management of these common cardiovascular risk factors can potentially prevent ED. Phosphodiesterase type 5 inhibitors provide short-term change of haemodynamic factors to help initiate and maintain penile erection. They have been shown to be an effective and safe treatment strategy for ED in patients with heart disease, including those with ischaemic heart disease and hypertension.
    • Communicable Disease Update; Vol. 18(1), February 2019

      Health Service Executive (HSE) South (South East), Deaprtment of Public Health (Health Service Executive (HSE) South (South East), Deaprtment of Public Health, 2019-02)
    • Review of current practice in the use of wardship for adults in Ireland

      The National Safeguarding Committee (The National Safeguarding Committee, 2017-12)
    • HSE Community Healthcare Dublin South, Kildare & West Wicklow Healthy Ireland Implementation Plan 2018-2022

      Health Service Executive; Healthy Ireland (Health Service Executive (HSE), 2018)
    • Diagnostic Yield of Routine EEG in Adults with Active Epilepsy

      McGinty, R.N.; Costello, D.J.; Kinirons, P; McNamara, B (Irish Medical Journal, 2019-01)
      Routine electroencephalogram (rEEG) is an important investigation in suspected seizures but can be normal in people with epilepsy. The diagnostic yield of rEEG varies considerably according to the patient group studied. We aimed to estimate the diagnostic yield of rEEG in a real-world cohort of adults with active epilepsy—a population not previously reported. This single centre study evaluated neurophysiology findings for adults with prolonged inpatient video EEG (vEEG)-confirmed active epilepsy, who had at least one prior rEEG. Sixty-eight patients had a total of 171 rEEGs, of which 93 (54.4%) were normal, 42 (24.6%) found non-specific abnormalities and 36 (21.1%) captured interictal epileptiform abnormalities (IIEAs). Serial rEEGs revealed a 22.1% yield of IIEAs on the first test, with the cumulative yield peaking at 33.8% on the fourth rEEG. This study adds to existing evidence regarding the limited diagnostic usefulness of serial rEEG in patients with active epilepsy.
    • Obstetric Anal Sphincter Injuries: A Survey of Clinical Practice and Education among Obstetricians and Gynaecologists in Ireland

      Abdelrahman, M; Geary, M; Eogan, M (Irish Medical Journal, 2019-01)
      This paper summarises results of a survey of obstetricians in Ireland regarding their technique, management, and education on episiotomy and Obstetric Anal Sphincter Injury (OASIS). An anonymous survey was emailed to all obstetricians and gynaecologists in Ireland, including trainees between January and September 2017. The response rate was 45% (155/343) with 111 out of 144 (77%) reported clinical experience as part of their training and 92 (64%) attended an OASIS workshop or classroom teaching. The majority prescribe antibiotics and laxatives post-op, request physiotherapy review and follow-up patients in outpatient settings. We identified that most specialists and trainees practice within guidelines, but some recognise a need for further teaching and exposure to these types of injuries. These results will direct future curriculum and optimise ongoing training for trainees, unify service provision and contribute to patient safety.