Background: Drug resistance is the main factor limiting the efficacy of anticancer therapies. Combinative therapies are superior to monotherapies. Understanding the tumour heterogeneity and mechanisms that contribute toward resistance is a key element in personalised medicine. Herein, we aim to discover a novel combinative therapy and expand the applications of circulating tumour DNA (ctDNA) in colorectal cancer (CRC).
Methods: We explored the in vitro efficacy of two drug combinations [Palbociclib with Gedatolisib (P+G) and Palbociclib...

Stroke is the third leading cause of death and disability worldwide. It constitutes a formidable burden of disability for patients, their families, health professionals and the wider community. It combines aspects of both acute and chronic disease, and there is increasing evidence that those affected by stroke can benefit to a very significant extent from organised stroke care throughout the course of the illness. Delivering this care requires a unique combination of skills, drawing on...

The SAVI Report: Sexual Abuse and Violence in Ireland. Executive Summary

Prolonged outpatient waiting times are a global healthcare concern affecting most hospital specialties, including in Ireland. Improvement of waiting times is a constant battle and priority for Ireland’s health service, the Health Service Executive. The result of lengthy waiting for outpatient Holter monitor appointments can mean a delay in diagnosis and the potential consequences of delay in treatment. Patient satisfaction and trust in healthcare providers is negatively impacted by long waits. This quality improvement project...

The clinical presentation of neurosurgical patients tends to be sporadic in nature. These patients present to healthcare settings across the country before being referred to the National Referral Centre for Neurosurgery and Neurology in Ireland. The growing demands on the healthcare sector, such as an ageing population and finite resources, has limited the luxury of in-patient pre-operative assessment days prior to surgery. The organisation in question had established a nurse-led pre-operative assessment clinic for elective...

Central diabetes insipidus is a common complication of transsphenoidal pituitary surgery. Damage to the pituitary stalk during surgery results in the disruption of water homeostasis, resulting in increased thirst and the production of large volumes of dilute urine. While symptomatic central diabetes insipidus can be managed with the administration of desmopressin, it has the potential to progress to severe dehydration, hypernatremia and become a life-threatening medical emergency. This project utilised the DMAIC framework and associated...

Advances in therapeutics for Alzheimer’s disease (AD) has stagnated for almost 2 decades and there is an increasing interest in deviating from standard targets and strategies which have repeatedly failed in clinical trials. It is a widespread belief in the field that targeting multiple components of AD pathology and applying treatments at earlier stages of AD are key to the development of a cure. Approaches which the short non-coding molecules MicroRNAs (miRNAs) could greatly aid....

The Major Trauma Audit (MTA) was established by the National Office of Clinical Audit (NOCA) in 2013. This audit focuses on care of the more severely injured trauma patients in our healthcare system. The methodological approach for the MTA is provided by the Trauma Audit & Research Network (TARN). In 2016, the MTA became the first national clinical audit endorsed by the National Clinical Effectiveness Committee (NCEC) and mandated by the Minister for Health. Since...

Introduction: People with Parkinson’s Disease (PD) often have difficulty completing dual-tasks due to reduced automaticity of movement, which consequently increases falls risk. Further outcome measures (OMs) are required to enable assessment of dual-task mobility.
Aims and Objectives: Primary aim: To establish the concurrent validity of the L-Test-MANUAL and L-Test-COGNITIVE with the TUG-MANUAL and TUG-COGNITIVE in participants with idiopathic PD. Secondary aim: To determine the predictive ability of the L-Test, L-Test-MANUAL and L-Test-COGNITIVE in identifying fallers....

Background: It has previously been suggested that the use of illustrations in MCQs may have variable effects on individual items. This study examines the effect of illustrated questions, as opposed to pure text, to discern if any overall bias between the two formats is detectable. Summary of work: We reviewed 6 Histology MCQ papers from our Medical Junior Cycle. Classical test theory analysis was performed on all MCQs, which were then divided into two groups,...

The Guidelines of the 4th Joint Societies Task Force on Cardiovascular Disease Prevention in Clinical Practice (4th JTF)* were issued in 2007, summarising and evaluating available evidence on reducing the incidence of atherosclerotic events arising from coronary heart disease, cerebrovascular disease and peripheral arterial disease. The purpose of the guidelines is to assist physicians in selecting the best strategies for managing cardiovascular disease. They are an important agreed protocol across countries and professionals that have...

Introduction: The incidence of lower limb amputation in Ireland is rising due to increased prevalence of diabetes and an aging population. Walking is a common goal of patients who are admitted for prosthetic rehabilitation, however very little is known about whether this goal is maintained after discharge in the Irish setting.
Aim: The aim of this study was to determine if walking is maintained after discharge from prosthetic rehabilitation.Methods: Patients discharged from a national prosthetic...

The ISSHR was commissioned by the Department of Health and Children and the Crisis Pregnancy Agency in response to a recommendation by the National AIDS Strategy Committee. It is the largest nationally representative study of sexual knowledge, attitudes and behaviour ever undertaken in Ireland. International evidence indicates that aspects of sexual health, such as contraception, crisis pregnancy and sexually transmitted infections, should be examined jointly. To this end, the Crisis Pregnancy Agency and the Department...

Background: Psychotic experiences (PE) refer to the subclinical expressions of psychotic symptoms and are prevalent in the general population, particularly during childhood, adolescence and early adulthood. Young people with PE are at increased risk of comorbid mental disorders and poorer functioning. Subtle variances in neuropsychological abilities and cognitive performance are also associated with PE. The overall aim of this thesis was to study how these risk markers and correlates change across the lifespan and improve...

Introduction: The ductus arteriosus is an essential component of the fetal circulation. In over 60% of babies under 28 week’s gestation, the ductus maintains its patency. Epidemiological studies have found a patent ductus arteriosus (PDA) to be associated, among other outcomes, with chronic lung disease (CLD) and death. Objectives: I aim to identify infants at high risk of developing CLD/Death by utilising the PDA risk-based severity score (PDAsc). Those infants are then randomised to early...

Infective Endocarditis is a microbial infection characterised by the presence of septic vegetations on the surface of the endocardium (Moreillon and Que, 2004). Infection most commonly occurs on the heart valves that has been damaged by congenital defects such as previous disease or trauma (Durack, 1995). As a result these sites have the ability to generate turbulent blood flow which in turn can cause damage to inner most lining of the blood vessels, the endothelium,...

Worldwide, breast cancer remains a leading cause of death amongst women. Annually, it i sestimated that breast cancer is diagnosed in over a million women (Kasler et al., 2009) with over 450,000 deaths worldwide (Tirona et al., 2010). The incidence of the disease is highest in economically-developed countries, with lower rates in developing countries. Despite continual advances in breast cancer care which have led to reduced mortality, however, the incidence of the disease is still...

As academic staff become familiar with the qualifications framework of the UAE and work towards demonstrating alignment between learning outcomes, teaching/learning strategies and assessment, this is an opportune time to revisit traditional masters’ dissertation guidelines and methodologies to ensure students demonstrate mastery of a topic via achievement of a capstone project. Such a project is an opportunity to demonstrate both a contribution to knowledge and an improvement in practice. This discussion document takes the view...

This is the third National Audit of Hospital Mortality Annual Report. It provides mortality information across six key diagnoses: acute myocardial infarction (heart attack), heart failure, ischaemic stroke, haemorrhagic stroke, chronic obstructive pulmonary disease, and pneumonia. These diagnoses were chosen based on clinical and methodological selection criteria in order to ensure a focus on quality, safety and improvement in acute hospital care; hospitals can also view all diagnoses locally via the National Quality Assurance Improvement...

Measuring quality of care is one of the essential components to improving the quality of modern healthcare. Clinical audits are key to this process. The purpose of clinical audit is to identify learning opportunities to inform quality assurance and improvement initiatives to further enhance the structure, process and outcome of care. Through the governance structures established by the National Office of Clinical Audit (NOCA), the National Audit of Hospital Mortality (NAHM) was deployed to 44...

The National Office of Clinical Audit (NOCA) established the Major Trauma Audit (MTA) in 2013. This audit focuses on the care of the more severely injured trauma patients in our healthcare system. The Trauma Audit and Research Network (TARN) provides the methodological approach for the MTA in Ireland and all 26 eligible hospitals now submit data to the MTA.
In 2016, the MTA became the first national clinical audit endorsed by the National Clinical Effectiveness Committee...

Major Trauma Audit (MTA) was established in the National Office of Clinical Audit (NOCA) in 2013. It specifically focuses on the care provided to the more severely injured patients in our healthcare system. NOCA has engaged the internationally recognised Trauma Audit and Research Network (TARN) to provide its methodological approach for MTA in Ireland. Eligible trauma receiving hospitals were identified by NOCA with the HSE National Emergency Medicine Programme. NOCA now has 26 trauma receiving...

This report is based on data from 18 Units in 15 hospitals which undertook 70% of all critical care activity in Health Service Executive (HSE)-funded hospitals during 2018. Units varied widely in numbers of beds, numbers of admissions, and in case mix on admission to the Unit. Some Units were High Dependency Units (HDUs), some were Intensive Care Units (ICUs), some were mixed ICU/HDU, and some were specialist Units (e.g. neurosurgical, cardiothoracic). Our data provide...

This report is based on data from 18 Units in 15 hospitals which undertook 70% of all critical care activity in Health Service Executive (HSE)-funded hospitals during 2018. Units varied widely in numbers of beds, numbers of admissions, and in case mix on admission to the Unit. Some Units were High Dependency Units (HDUs), some were Intensive Care Units (ICUs), some were mixed ICU/HDU, and some were specialist Units (e.g. neurosurgical, cardiothoracic). Our data provide...

The Irish Hip Fracture Database (IHFD) is a clinically led, web-based audit that measures the best practice standards of care, known as the Irish Hip Fracture Standards (IHFS) (Table 2), and outcomes of patients with hip fractures. The IHFD started as a collaboration between the Irish Gerontological Society (IGS) and the Irish Institute for Trauma and Orthopaedic Surgery (IITOS). The National Office of Clinical Audit (NOCA) was established in 2012 and has a specific focus...