Now showing items 1-20 of 30242

    • Health Service Executive: System Wide Metadata 2019

      Health Service Executive (HSE) (Health Service Executive (HSE), 2019-10)
    • Diagnosis and staging of patients with ovarian cancer: National Clinical Guideline No. 20 Annex 1: Systematic review of cost effectiveness

      HRB-CICER (Collaboration in Ireland for Clinical Effectiveness Reviews); National Clinical Effectiveness Committee (NCEC) (Department of Health, 2018-08)
    • Diagnosis and staging of patients with ovarian cancer: National Clinical Guideline No. 20

      Department of Health; Department of Health (Department of Health, 2019-08)
    • Being “Mindful” of Dignity in Dying: Developing Awareness, Fostering a Psychological Understanding, and Supporting Dignified Endings-To-Life

      Hession, Natalie; Elmer, Nicola; O'Kane, Aifric; Cotter, Pádraig; Psycho-Oncology Department, St. Luke's Radiation Oncology Network (IJEPP, 2019)
      Experiencing a sense of dignity when nearing end-of-life has been shown to be very important. There are many things that hospice and palliative nurses can do to support dignified endings-to-life. This paper explores the different aspects of this process from both the perspective of the person dying and in particular the individual in the caring role. Consideration is given to the different components of experiencing dignity in dying, especially those aspects that nursing staff can influence most. The importance of a sense of dignity to people who are dying is explored using two psychological models that provide an intrapersonal and transpersonal perspective. These include the Abandonment of Self Model and the Surface-Depth Model respectively. The types of obstacles to nursing staff providing this type of care and support are reflected upon, with particular emphasis placed on the practitioner’s own personal fears and anxieties and how these may manifest within the patient-nurse relationship. The final section explores the use of mindfulness practises as a way of interacting more fully with people diagnosed with terminal illnesses to support their experience of a dignified ending-to-life. This process is termed “mindful engagement”.
    • Child and Adolescent Mental Health Services (CAMHS) – CHO 1 2017 Inspection Report

      Mental Health Commission (MHC) (Mental Health Commission (MHC), 2018-07-25)
    • Dietitians’ Attitudes and Experiences of Blended Tube Feeding in Paediatrics

      O’Sullivan, K; O’Sullivan, M; Quigley, S; Delahunt, A; Sugrue, S (Irish Medical Journal, 2019-08-01)
    • Varicella Related Hospital Admissions in Ireland

      McCarthy, K.N.; Ó Maoldomhnaigh, C.; Butler, K.M.; Gavin, P.J. (Irish Medical Journal, 2019-07)
      Aim The aim of this study was to evaluate trends in admissions for patients with primary varicella infection in Irish hospitals. Methods The Hospital Inpatient Enquiry System was evaluated from Irish hospitals from 2005-2016 for patients with primary varicella infection. Results There were 2717 admissions with primary varicella infection. The average annual number of admissions was 226 for an incidence of 4.87/100,000. Average length of stay (ALOS) was 5-days. Sixty-two (2.5%) patients required intensive-care with an ALOS of 26-days. The most common secondary diagnoses were cellulitis, volume-depletion and streptococcal infection. The number of admissions due to streptococcal infection and cellulitis significantly increased over the period. Conclusion Chickenpox places a consistent burden on Irish healthcare, accounting for in excess of 1100 acute and 160 intensive-care bed days annually. This study adds weight to the argument that universal varicella vaccine should be considered and provides baseline epidemiology to determine vaccine effectiveness in the future.
    • The Emergence of New Psychoactive Substance (NPS) Benzodiazepines. A Survey of their Prevalence in Opioid Substitution Patients using LC-MS

      Drug Treatment Centre Board; Mc Namara, S.; Stokes, S.; Nolan, J. (Irish Medical Journal, 2019-07)
    • The Role of Interventional Radiology in the Management of Obstetric and Gynaecological Haemorrhage

      O’Brien, C.; Healy, G.M.; Anglim, B.C.; O’Brien, A.; Duignan, J.; Patel, A.; Cheung, M.; Cantwell, C.P. (Irish Medical Journal, 2019-07)
      Aim We will review our experience of emergent arterial embolization used to treat haemodynamically unstable patients with obstetric and gynaecological haemorrhage. Methods This is a retrospective study of patients with haemodynamically unstable obstetric and gynaecological haemorrhage treated with emergent arterial embolization from 2010 to 2015. Results 22 patients (average age 41 (SD +/-9) years) had emergent arterial embolization. 63% had post-partum haemorrhage(PPH). 82% of cases were performed with conscious sedation and local anaesthesia. Embolization was technically successful in all cases. Embolization was clinically successful in 95% (21/22). In one case of PPH the patient represented six days later with recurrent bleeding and was treated with surgical suturing of the cervix. There were no complications or deaths. Conclusion Arterial embolization is a highly successful treatment of obstetric and gynaecological haemorrhage in unstable patients.
    • Circumcision Rates after the Release of Preputial Adhesions

      Aworanti, O.M; Rasheed, F.; Aldiab, A; Mortell, A. (Irish Medical Journal, 2019-07)
      The non-retractile foreskin in children is one of the most frequent indication for referral to a paediatric surgeon in Ireland. This is probably due to parental concerns when children complain of related symptoms coupled with a misperception among some general practitioners (GP) of the natural separation process of the inner surface of the prepuce from the glans surface1,2,3. Phimosis from the Greek word ‘Ψιμoσισ’ (muzzling) generally describes the non-retractile foreskin. Phimosis is best classified as either pathological or physiological. Pathological phimosis is either due to balanitis xerotica obliterans (BXO) or due to a constricting phimotic ring that hinders retraction, both usually in the older boy. Physiological phimosis is simply the non-retractile or incompletely retractile state of the foreskin in usually asymptomatic young boys. Foreskin retraction has been established to be complete by the age of 3 years in 90% 1 and by the age of 16 years in 99% 2 of boys. During this preputial separation process, complaints such as local discomfort, ballooning of the foreskin during micturition and smegma retention cysts are common and require simple reassurance only 3. No pathologic sequelae have been attributed to these physiologic processes on assessing urine flow rates, post-void residual bladder volumes and bladder wall thickness in young boys with physiologic phimosis 3. Furthermore, as partial separation of the foreskin ensues, young boys can suffer from episodes of balanoposthitis1,3. This inflammation of the glans and prepuce (or prepuce only - termed posthitis) generally resolves with antibiotic treatment and can be prevented with improved local hygiene. Therefore, absolute and strong indications for a medical circumcision are limited to pathological phimosis due to BXO and prevention of recurrent urinary tract infections (UTI) usually in children with vesicoureteric reflux or posterior urethral valves respectively4,5
    • Exploring the Interface of Oncology and Palliative Care in Ireland

      Coleman, K.; Brady, C.; O’Reilly, S.; O’ Brien, T. (Irish Medical Journal, 2019-07)
    • A Prospective Audit of Inappropriately Occupied Hospital Beds in Patients with Newly Acquired Traumatic Spinal Cord Injury

      Smith, E.; Synnott, K. (Irish Medical Journal, 2019-07)
      Aim To quantify the inappropriate bed occupancy amongst patients with traumatic spinal cord injury (TSCI) awaiting transfer of care from the acute to community. Methods A prospective audit was carried out, of all newly acquired cases of TSCI in 2017, who progressed through acute care and specialist rehabilitation. Results Forty-four patients who were audited spent a total of 3915 days occupying a hospital bed, inappropriate for their phase of care, 78 awaiting admission to specialist acute care, 3126 awaiting admission to rehabilitation and 711 awaiting discharge from rehabilitation. Conclusion Valuable health-care resources are being wasted because TSCI patients cannot move seamlessly from one phase of care to the next. This impacts negatively on the quality of care being delivered to this patient cohort.
    • The Administration of Naloxone: Social Care Worker Perspectives and Experiences

      Deacy, J.J.P.; Houghton, F. (Irish Medical Journal, 2019-07)
    • Incidence of Asymptomatic Chiari Malformation

      O’Reilly, E.M; Torreggiani, W (Irish Medical Journal, 2019-07)
      Aim The aim of this study is to define the incidence of asymptomatic Chiari malformation in an Irish population. Methods MRIs performed over 24 months were analysed. Exclusion criteria include: space occupying lesion, hydrocephalus, Chiari symptoms and inadequate views. Data were analysed to give incidence of asymptomatic Chiari and to analyze the relationship between symptom and position of the cerebellar tonsils (Chi square and Fishers exact test). Results Sample Characteristics: 147 patients (Male = 65: Female = 82), age range 15 to 93 years (M age = 53.35, SD= 16.67). 2%had a Chiari malformation (n=2). There was no significant association between symptom and tonsil position (Fishers exact test, ² (8) = 9.98, p = .23.) Conclusion This study shows an asymptomatic Chiari Malformation rate of 2%. This study supports the idea that in asymptomatic patients, a tonsil herniation of up to 5 millimeters may be an incidental and inconsequent finding.
    • Community first responders for out-of-hospital cardiac arrest in adults and children.

      Barry, Tomas; Doheny, Maeve C; Masterson, Siobhán; Conroy, Niall; Klimas, Jan; Segurado, Ricardo; Codd, Mary; Bury, Gerard (2019-07-19)
    • The Validity of Google Trends Search Volumes for Behavioral Forecasting of National Suicide Rates in Ireland.

      Barros, Joana M; Melia, Ruth; Francis, Kady; Bogue, John; O'Sullivan, Mary; Young, Karen; Bernert, Rebecca A; Rebholz-Schuhmann, Dietrich; Duggan, Jim (2019-09-02)
    • Key Worker-Mediated Enhancement of Physical Health in First Episode Psychosis: Protocol For a Feasibility Study in Primary Care.

      McCombe, Geoff; Harrold, Aine; Brown, Katherine; Hennessy, Liam; Clarke, Mary; Hanlon, David; O'Brien, Sinead; Lyne, John; Corcoran, Ciaran; McGorry, Patrick; et al. (2019-07-10)
    • Identifying and prioritising midwifery care process metrics and indicators: a Delphi survey and stakeholder consensus process.

      Devane, Declan; Barrett, Nora; Gallen, Anne; O'Reilly, Mary Frances; Nadin, Margaret; Conway, Gillian; Biesty, Linda; Smith, Valerie (2019-06-10)
    • Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting.

      Beamish, Laura; Sagorin, Zach; Stanley, Cole; English, Krista; Garelnabi, Rana; Cousineau, Danielle; Barrios, Rolando; Klimas, Jan (2019-09-14)