1,454 Works

Platelet-bacterial interactions in the pathogenesis of infective endocarditis. Part I: The Streptococcus

Dorothea Tilley & Steven W. Kerrigan
Infective endocarditis (IE) is a life threatening disease caused by a bacterial infection of the endocardial surfaces of the heart. It is typified by the formation of septic thrombi or vegetative growth on the heart valve. Typically, both platelets and fibrin are deposited on exposed extracellular matrix proteins as part of the normal response to damage of the endocardium [1]. However, this sterile platelet-fibrin nidus facilitates colonisation of the endocardium by bacteria in the bloodstream...

The Cystic Fibrosis ‘Gender Gap’: Past Observations Present Understanding and Future Directions

Sanjay H. Chotirmall, Catherine M. Greene, Brian J. Harvey & Noel G. McElvaney
Cystic Fibrosis (CF) is a systemic disease impacting upon several organ systems. These include gastrointestinal, reproductive, endocrine and pulmonary manifestations of which the latter contributes the heaviest burden of disease morbidity, mortality and impact on quality of life. The defective protein in the disease state is the Cystic Fibrosis Transmembrane Regulator (CFTR) that normally functions as an ion channel permitting intracellular chloride escape. Regulated by cyclic adenosine monophosphate (cAMP) and localized to the apical membrane...

Tissue Engineered Solutions for Intracardiac Septal Defects: A Large Step Forward in an Unmet Clinical Need.

Aamir Hameed, Garry P. Duffy, Babar Hasan &
Congenital heart disease (CHD) is the occurrence of an anomaly in the heart structure during fetal development. The incidence of CHD is estimated to be 8 per 1000 live births in the United States, 6.9 per 1000 live births in Europe and 9.3 per 1000 live births in Asia.1 CHD varies in severity and timing of emergence of symptoms, hence they differ in ways of management.

Examining the relationships between attendance, online engagement and summative examinations performance

Jane C. Holland, Eric Clarke, Morag Monro, Evelyn Kelleher & Mark Glynn
Background: Non-attendance correlates with poor performance, but manual recording of attendance is problematic. Online activity reports may be a more efficient method of identifying at-risk students. Summary of work: This research is part of a prospective study examining physical attendance, online activity reports (Moodle), continuous assessments and summative examination performance. Ethical approval was granted by RCSI Ethics Committee. Two modules within the first year of the undergraduate medical program were identified for inclusion. Results: Data...

The current state of surgical training in East, Central and Southern Africa

Stephen WO Ogendo &
The current state of surgical training in East, Central and Southern Africa

Training non-physician clinicians to deliver surgical care in Africa

Ruairi Brugha &
Training non-physician clinicians to deliver surgical care in Africa

UROLINK British Association of Urological Surgeons

Christine Evans &
UROLINK British Association of Urological Surgeons

Mechanical Insufflation Exsufflation and Lung Volume Recruitment in Amyotrophic Lateral Sclerosis: a Prospective Study of the Prescription Process, the Outcomes and the Experience

Rachel McConnell
Introduction: Mechanical Insufflation Exsufflation (M-IE) and Lung Volume Recruitment (LVR) increase cough strength in Amyotrophic Lateral Sclerosis (ALS). Changes in respiratory measures, morbidity, physical function and outcomes; participant’s characteristics prescribed a M-IE and LVR device and their experience with devices are unknown. Finally, LVR adherence is difficult to measure. Aims/Objectives: The primary aim was to measure, respiratory measures, morbidity, physical function and outcome in an Irish ALS cohort. Secondary aims were to examine the characteristics...

Musculoskeletal Clinical Vignettes: a case based text

John M. O'Byrne, Richie Downey, Iain Feeley, Martin Kelly, Lauren Tiedt, Mark E. Murphy, Ellen Stuart &
Musculoskeletal conditions are an extremely common presentation to general practitioners, emergency departments and hospitals. Although the clinical examination for each joint involves a similar approach (the ‘Look, Feel, Move’ format), be it the shoulder, hip or knee, many students can find the subtle differences between each examination difficult. They may also struggle to generate an appropriate differential diagnosis, based upon the history and examination. Commonly presenting musculoskeletal conditions in general practice and orthopaedics are presented...

Musculoskeletal Clinical Vignettes: a case based text

John M. O'Byrne, Richie Downey, Iain Feeley, Martin Kelly, Lauren Tiedt, Mark E. Murphy, Ellen Stuart &
Musculoskeletal conditions are an extremely common presentation to general practitioners, emergency departments and hospitals. Although the clinical examination for each joint involves a similar approach (the ‘Look, Feel, Move’ format), be it the shoulder, hip or knee, many students can find the subtle differences between each examination difficult. They may also struggle to generate an appropriate differential diagnosis, based upon the history and examination. Commonly presenting musculoskeletal conditions in general practice and orthopaedics are presented...

The Relationship Between Performance On Cognitive Screening Tests And Everyday Functioning In Older Adults With Mild Cognitive Impairment

Elaine Scally
Introduction: Occupational therapists (OTs) play an important role in evaluating the cognitive and functional abilities of older adults with mild cognitive impairment (MCI) in the acute hospital setting. Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) and the Addenbrooke’s Cognitive Examination (ACE-III) are regularly administered by acute hospital OTs to assist in predicting the functional capacities of individuals with MCI. However findings from clinical practice show that performance on cognitive screening tools is...

Implementation of a Visual assessment Tool to Ensure that central Venous Access Devices Care is Delivered and Documented

Diana Paul
Aim: The core aim of this project is to implement a visual assessment tool to ensure that all the CVADs on the patients are checked on every shift, adequate care is provided and proper documentation is done post care delivery. Rationale: All CVADs‟ are a potential source of infections. The microbes that colonize catheter hubs and the skin surrounding the insertion site are the source of most catheter-related bloodstream infections which could result in further...

An Evaluation of the Impact of the \"Talk downs\" Model on ~Self-perceived Confidence of Nurses for Descalating Potential Aggressive Episodes.

Francis Mc Carron
This change initiative sought to ensure the development of confident and competent nursing staff capable of effectively deescalating potentially aggressive episodes. The initiative was developed in response to feedback given by nursing staff working in an acute mental health setting regarding their concern in relation to their confidence in deescalating potentially aggressive episodes. The author identified utilising educational groups on de-escalation as a method of improving nursing staff confidence. This change initiative will focus on...

An Evaluation of the Impact of the \"Talk downs\" Model on ~Self-perceived Confidence of Nurses for Descalating Potential Aggressive Episodes.

Francis Mc Carron
This change initiative sought to ensure the development of confident and competent nursing staff capable of effectively deescalating potentially aggressive episodes. The initiative was developed in response to feedback given by nursing staff working in an acute mental health setting regarding their concern in relation to their confidence in deescalating potentially aggressive episodes. The author identified utilising educational groups on de-escalation as a method of improving nursing staff confidence. This change initiative will focus on...

Utilising Available Technology to Reduce Waste and Decrease Patient Experience Times

Keith Barter
This Organisational Development Project focused on how admissions through a hospital’s Emergency Department are organized. The primary aim was to streamline the process of organising these admissions by reducing waste and utilising available technology to improve patient flow. Following the introduction of Governmental targets in Healthcare, individual healthcare institutions are seeking ways to achieve these targets. The current process in place has many steps with duplicate paper records of ward allocation for patients who require...

Utilising Available Technology to Reduce Waste and Decrease Patient Experience Times

Keith Barter
This Organisational Development Project focused on how admissions through a hospital’s Emergency Department are organized. The primary aim was to streamline the process of organising these admissions by reducing waste and utilising available technology to improve patient flow. Following the introduction of Governmental targets in Healthcare, individual healthcare institutions are seeking ways to achieve these targets. The current process in place has many steps with duplicate paper records of ward allocation for patients who require...

Quality improvement plan to reduce patient waiting times in a private emergency department

Ciara Melia
Emergency department overcrowding is a public health problem and results in long waiting times and delays in critical treatment for patients. Moreover it has been associated with a number of negative clinical outcomes such as increased complication rates and mortality. Using the DMAIC (define, measure, analyse, improve and control) model for quality improvement (QI), this dissertation investigated the long patient waiting times experienced in a private emergency department in Dublin West. Applying a variety of...

Quality improvement plan to reduce patient waiting times in a private emergency department

Ciara Melia
Emergency department overcrowding is a public health problem and results in long waiting times and delays in critical treatment for patients. Moreover it has been associated with a number of negative clinical outcomes such as increased complication rates and mortality. Using the DMAIC (define, measure, analyse, improve and control) model for quality improvement (QI), this dissertation investigated the long patient waiting times experienced in a private emergency department in Dublin West. Applying a variety of...

An Analysis of the Challenges Encountered by Anaesthetists when Obtaining Consent for Obstetric Epidurals

Rebecca Conlon
Background Obtaining informed consent for obstetric epidurals is a complex area of anaesthesia. Practice among obstetric anaesthetists in this jurisdiction is widely varied. This paper provides an analysis of the ethical and legal challenges encountered by anaesthetists when endeavouring to obtain informed consent to administer the obstetric epidural and makes recommendations as to how these challenges might be lessened. Methods A systematic review of research papers sourced from relevant data bases and websites was conducted....

Reducing the Waiting List for New Referrals to the ENT Outpatient Department

Jana Crowley
Lengthy outpatient waiting lists are a global healthcare concern affecting most hospital specialities, including in Ireland. The result is a delay in treatment and suboptimal outcomes for newly referred patients. Simultaneously, patients requiring long-term follow-up care exist amid this overburdened system. Data collection showed that in December 2017, 3,944 patients were waiting for a first time appointment within the ENT service of a large urban teaching hospital in Dublin. Of these, 766 were waiting to...

Introducing a Fast Track for Patients Undergoing Arthroscopic Subacromial Decompression and/or Rotator Cuff Repair

Javier Rojas
The prolonged length of stay (LOS) after Arthroscopic Subacromial Decompression (ASD) and Rotator Cuff Repair (RCR) is having an adverse effect on the efficiency of the healthcare system. Improving the time patients remain in hospital after surgery will have a positive impact on the patient and on the healthcare providers. The aim of this Quality Improvement Plan (QIP) is to reduce the LOS after ASD or/and RCR designing a Fast Track to allow patients to...

Increasing Compliance with the National Sepsis Management Guideline through Sepsis Screening Form Utilisation

Orla Brett
Sepsis continues to be a major burden on the healthcare service at both a national and international level, affecting millions of people annually. Sepsis is a medical emergency and if not recognised and treated promptly, can be fatal. In an aim to tackle this burden, the National Sepsis Management Committee introduced the sepsis screening form to Irish hospitals in 2016. Using the DMAIC (define, measure, analyse, improve, control) framework for quality improvement (QI), this QI...

Reducing the Waiting Times in a Vascular Outpatient Clinic

Helen Farrell
Improvement of waiting times and a reduction in numbers on waiting lists for outpatient care is a constant battle in healthcare in Ireland. Over the course of the year in 2016 there were some 8,000 patients waiting to be seen by the vascular team in an outpatient clinic. The waiting time of these appointments ranged from 0-18 months. Some of these are new patients, referred from GP or other sources, but a large percentage of...

Developing Service User Involvement in the Mental Health Department of a Paediatric Hospital

Julie Howley
This dissertation traces the development and implementation of a Quality Improvement Plan (QIP) in the area of Service User Involvement within the mental health department of a paediatric hospital. The change management project described focused specifically on the setting up and initial meetings of two Service User panels – one for parents/carers and their representatives and one for young people and their representatives. The dissertation sets out the rationale for this change project drawing on...

Developing Service User Involvement in the Mental Health Department of a Paediatric Hospital

Julie Howley
This dissertation traces the development and implementation of a Quality Improvement Plan (QIP) in the area of Service User Involvement within the mental health department of a paediatric hospital. The change management project described focused specifically on the setting up and initial meetings of two Service User panels – one for parents/carers and their representatives and one for young people and their representatives. The dissertation sets out the rationale for this change project drawing on...

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