Now showing items 1-20 of 28214

    • Living with relapsed myeloma: Symptoms and self-care strategies.

      Cormican, Orlaith; Dowling, Maura (2018-04-01)
      Aims and Objectives To explore which symptoms relapsed myeloma patients experience and what self‐care strategies are used. Methods This was a qualitative study utilising focus group interviews (n = 4) with relapsed myeloma patients (n = 15) and carers (n = 9). The focus groups were analysed and guided by thematic analysis. Results Three major themes with subthemes were identified following analysis of the interview data: “difficult symptoms; “self‐care” and “feeling vulnerable.” These findings indicate the challenges relapsed myeloma patients experience with ongoing symptoms and highlight the importance of continuity of care. Conclusions Symptom management for myeloma patients remains complex due to the array of treatments given. These patients require holistic care and thorough regular assessments to help them cope with the adverse effects on their physical and psychological health. For patients with a long‐term diagnosis of myeloma, self‐management workshops and regular education sessions may be of benefit.
    • Adolescent Addiction Service Report 2019

      Health Service Executive (HSE); Murray, Denis (Health Service Executive (HSE), 2019-08)
    • Primary Care Reimbursement Service: Statistical Analysis of Claims and Payments 2018

      Health Service Executive (HSE) (Health Service Executive (HSE), 2019-07)
    • The co-design, implementation and evaluation of a serious board game 'PlayDecide patient safety' to educate junior doctors about patient safety and the importance of reporting safety concerns.

      Ward, Marie; Ní Shé, Éidín; De Brún, Aoife; Korpos, Christian; Hamza, Moayed; Burke, Elaine; Duffy, Ann; Egan, Karen; Geary, Una; Holland, Catherine; et al. (2019-06-25)
      A serious game based on the PlayDecide framework was co-designed and implemented in two large urban acute teaching hospitals. To evaluate the educational value of the game voting on the position statements was recorded at the end of each game by a facilitator who also took notes after the game of key themes that emerged from the discussion. A sample of players were invited on a voluntary basis to take part in semi-structured interviews after playing the game using Flanagan's Critical Incident Technique. A paper-based questionnaire on 'Safety Concerns' was developed and administered to assess pre-and post-playing the game reporting behaviour. Dissemination workshops were held with senior clinicians to promote more inclusive leadership behaviours and responsiveness to junior doctors raising of safety concerns from senior clinicians.
    • Independent Rapid Review of Specific Issues in the CervicalCheck Screening Programme

      Health Service Executive (HSE); MacCraith, Brian (Health Service Executive (HSE), 2019-08-02)
    • Clinical Psychology Today Vol 2 Issue 2 (Winter 2018)

      Moloney, Olive; Melia, Ruth; Collins, Padraig; Clinical Psychology Today Editors (School of Psychology - National University Ireland Galway, 2018-12-01)
    • Straitéis na Gaeilge 2019-2023

      Health Service Executive (HSE) (Health Service Executive (HSE), 2019-02)
    • Smile agus Sláinte: National Oral Health Policy

      Department of Health (DoH) (Department of Health (DoH), 2019-04)
    • Sláintecare Action Plan 2019

      Department of Health (DoH) (Department of Health (DoH), 2019-03-13)
    • Skin Cancer Prevention Plan 2019-2022

      Department of Health (DoH) (Department of Health (DoH), 2019-05-27)
    • International Variation in Criteria for Internal Mammary Chain Radiotherapy.

      Duane, F K; McGale, P; Teoh, S; Mortimer, C; Broggio, J; Darby, S C; Dodwell, D; Lavery, B; Oliveros, S; Vallis, K A; et al. (2019-07-01)
      Aims; Evidence has emerged that internal mammary chain (IMC) radiotherapy reduces breast cancer mortality, leading to changes in treatment guidelines. This study investigated current IMC radiotherapy criteria and the percentages of patients irradiated for breast cancer in England who fulfilled them. Materials and methods; A systematic search was undertaken for national guidelines published in English during 2013–2018 presenting criteria for ‘consideration of’ or ‘recommendation for’ IMC radiotherapy. Patient and tumour variables were collected for patients who received breast cancer radiotherapy in England during 2012–2016. The percentages of patients fulfilling criteria stipulated in each set of guidelines were calculated. Results: In total, 111 729 women were recorded as receiving adjuvant breast cancer radiotherapy in England during 2012–2016 and full data were available on 48 095 of them. Percentages of patients fulfilling IMC radiotherapy criteria in various national guidelines were: UK Royal College of Radiologists 13% (6035/48 095), UK National Institute for Health and Care Excellence 18% (8816/48 095), Germany 32% (15 646/48 095), Ireland 56% (26 846/48 095) and USA 59% (28 373/48 095). Differences between countries occurred because in Ireland and the USA, treatment may be considered in some node-negative patients, whereas in the UK, treatment is considered if at least four axillary nodes are involved or for high-risk patients with one to three positive nodes. In Germany, treatment may be considered for all node-positive patients. Conclusions: There is substantial variability between countries in criteria for consideration of IMC radiotherapy, despite guidelines being based on the same evidence. This will probably lead to large variations in practice and resource needs worldwide.
    • Glioblastoma Multiforme in the over 70's: "To treat or not to treat with radiotherapy?"

      O'Shea, Julianne; Dunne, Mary; Grogan, Roger; MacNally, Stephen; Fitzpatrick, David; Faul, Clare; Glynn, Am; Rangaswamy, Guhan (2019-07-04)
      BACKGROUND: The incidence of Glioblastoma Multiforme (GBM) is increasing among the older population and is associated with poor prognosis. Management guidelines are lacking in this group. The purpose of this study was to analyze survival data and determine predictors of survival in patients aged ≥70 years treated with radiotherapy (RT) and/or Temozolomide. MATERIALS AND METHODS: A retrospective analysis of all GBM patients treated at our institution between January 2011 and January 2017 was carried out. RESULTS: One-hundred and four patients were eligible. Median age was 73.8 years (70-87). Thirty-three patients received radical RT and 71 palliative RT. Overall median survival (MS) was 6 months. The MS was 10.6 months for radical patients and 4.9 months for palliative patients (P < 0.0005). The MS was 6.9 months in patients aged 70-75 years and 5.2 months in those aged 76-80 years (P = 0.004). The debulked group had a statistically significantly longer survival (8.0 months) than the biopsy only group (4.9 months). Biopsy only (hazard ratio [HR] 2.4), ECOG performance status 3 vs 0 (HR 6.4), and increasing age (HR 1.06) were associated with statistically significant shorter survival after adjustment for the effects of concurrent chemo, delay in starting RT, and RT dose. CONCLUSION: The MS for radical patients was favorable and approaching current literature for the under 70 age group. Radical treatment should be considered for good performance patients aged 70-75 years. Increasing age was associated with shorter MS in patients aged ≥76 years. Debulking and good performance status were associated with improved survival.
    • Scheduled Care Access Plan 2019

      Department of Health (DoH) (Department of Health (DoH), 2019-03)
    • Scoping Inquiry into the CervicalCheck Screening Programme

      Scally, Gabriel (Department of Health (DoH), 2019-06-11)
    • How to develop a National Clinical Guideline: A manual for guideline developers

      Department of Health (DoH); National Clinical Effectiveness Committee (NCEC) (Department of Health (DoH), 2019-04)
    • Key Performance Indicators in Paediatric Anaesthesia

      Doody, K; Barry, D; Holmes, C (Irish Medical Journal, 2019-07)
      Currently no national guidelines on performance measurement exist for paediatric anaesthesia in Ireland1. The purpose of this study was to ascertain if we are achieving Key Performance Indicators (KPIs) in areas of post-operative nausea and vomiting (PONV) and post-operative pain when compared to international standards.
    • Impact of Introduction of a Clinical Pathway for the Management of Pyelonephritis on Obstetric Patients: a Quality Improvement Project

      Clooney, L; Ronayne, A; Glennon, K; Brennan, M; Hickey, N; Magee, C; Cooley, S; Eogan, M; Drew, R.J (Irish Medical Journal, 2019-06)
      Acute pyelonephritis is one of the most common medical complications of pregnancy. It occurs in 0.5–2% of pregnant women and can result in significant maternal and fetal morbidity1,2. Additionally there is a financial burden on the hospital due to prolonged inpatient stays, increased preterm birth rate and associated neonatal care 3. Although there have been many studies evaluating the benefit of treating asymptomatic bacteriuria to prevent pyelonephritis in pregnancy, there is little recent evidence around how to treat pyelonephritis in pregnancy 4-6. In 1995 a study was published which showed the benefit of ceftriaxone in pregnancy, when compared to cefazolin but did not address issues such as prophylaxis during the remaining pregnancy and need for additional gentamicin
    • Caring for Caregivers: An Evaluation of Schwartz Rounds in a Paediatric Setting

      Silke, A; Rushe, H; Keating, K; Thurstan, R; Barrett, E (Irish Medical Journal, 2019-06)
      Schwartz rounds (SR) are a multi-disciplinary intervention that aim to support clinical and non-clinical healthcare professionals in their work. Temple Street Children’s University Hospital (TSCUH) is the first paediatric hospital to introduce SR. SR are a popular intervention, with numerous sites adopting them in the US and the UK. First introduced in Ireland in 2015, they were piloted at sites in Galway University Hospital and Blackrock Hospice. SR have since spread to 15 other sites across Ireland, including regional hospitals, children’s hospices and ambulance services. 2 Only one paper has been published on the topic of SR in paediatric hospitals. This paper hopes to highlight the potential for SR in the paediatric context by evaluating the views of staff who attended SR at TSCUH.
    • Hip Fracture and the Weekend Effect in an Irish Trauma Hospital

      Downey, C; Flannery, S; Izydorczyk, A; Quinlan, J.F. (2019-06)
      We examined the relationship between the 1-year mortality (OYM) rate and (i) those admitted at the weekend, (ii) those who underwent surgery at the weekend and (iii) those admitted during the NCHD changeover months (January & July) for the management of hip fracture in Tallaght University Hospital (TUH).