131 Works

An Exploration of Carers of Stroke-Survivors in Ireland Experiences of the Discharge Planning Process and Transition of Care to the Home Setting

Shelagh O'Connor
IntroductionIn Ireland, it is estimated that 10,000 people have a stroke annually. A high numberof stroke-survivors with residual deficits requiring care are discharged to their own.Informal carers are often central in homecare provision. The discharge planningprocess (DPP) is the process used to establish the requirements necessary for apatient to transition from one level of care to another, and may involve carers.
Aims and ObjectivesThe aim of this study was to explore the experiences of carers of...

The Assessment of Myocardial Performance and the Impact of Pathological Processes on Cardiac Adaptation in the Neonatal Population using Functional Echocardiography

Colm Breatnach
Introduction: Functional echocardiography is a rapidly expanding field in both research and clinical settings. Newer techniques facilitate comprehensive and objective assessments of myocardial performance not previously possible. Although work has been done to assess feasibility and obtain reference values for several new modalities in normal term and preterm infants, data is still lacking in several important disease states. Objectives: We aim to study the impact of several important conditions on neonatal myocardial function over the...

Cognitive impairment and medication adherence in stroke

Daniela Rohde
Aim The overarching aim of this thesis was to explore the bidirectional association between adherence to secondary prevention medications and cognitive impairment in stroke survivors. A secondary aim was to provide an updated account of the longer-term outcomes of cognitive impairment post-stroke. Methods and results Five interrelated studies were conducted to address these aims. Study 1 explored the association between cognitive impairment and cardiovascular medication use in an Irish sample of the general population aged...

The Prevalence of Frailty in Older Adults Referred to Primary Care Physiotherapy and the Influence of Frailty Screening on the Clinical Practice of Physiotherapists : A Mixed Methods Study

Melissa Boland
IntroductionGlobally, the proportion of the population of older adults (aged 65 and older) is growing rapidly. Frailty is a state of increased vulnerability to poor resolution of homeostasis following a stress and is the most problematic expression of population ageing. Physiotherapy is a heavily utilised social and community care service by older adults in the Republic of Ireland. An increasing number of older adults, with the potential presence of frailty, are likely to present to...

The Perceptions of Older Patients and their Family or Caregivers Towards Physical Activity and Exercise on a Specialist Geriatric Ward: A Qualitative Study

Bláthnaid Mealy
IntroductionFunctional decline or deconditioning is considered the main complication of hospitalisation for older people, often resulting in adverse outcomes. Low levels of activity and mobility accelerate this decline, yet despite this, evidence demonstrates how activity levels of hospitalised older adults remains very low. Family or caregiver involvement may have a positive impact on patient physical activity during a hospital admission. Given the aging population and the likelihood of the problem of hospital associated deconditioning escalating,...

Improving the Patient Journey for Hip Fracture Patients from Arrival in the Emergency Department to Admission to the Orthopaedic Ward

Mary Jones
This Quality Improvement (QI) Project focuses on the admission pathway of hip fracture patients in a large acute hospital in Dublin. Hip fractures are the most common fragility fracture in the over 50’s in Ireland, accounting for 36.5% of orthopaedic admissions and 46.7% of orthopaedic bed days (Kelly et al 2018). It is a common injury but its effects on patients and carers is often underestimated by clinical staff (Saletti-Cuesta et al 2018)The National Office...

Improving Nursing Handovers in a Voluntary Mental Health Facility

Around the globe, ineffective handovers have resulted in grave consequences, leading to handover improvement strategies being introduced, along with guidelines beingformulated in many countries. Despite this, however, few studies focused on improving handovers in a psychiatric setting. This current Quality Improvement Project aims tofill this gap and improve nursing handovers in a mental health facility by 50% over eight months. Using Lean Six Sigma's, Define Measure Analyse Improve Control framework and various quality improvement tools,...

A qualitative exploration of adolescents with severe haemophilia and their caretakers regarding their future transition to adult services

Objective: To qualitatively explore the views of adolescents with severe haemophilia A or haemophilia B and their caretakers such as parents and multidisciplinary staff relating to transition from child to adult services.Methods: Qualitative design using semi-structured interviews based upon the Critical Incident Technique (CIT).Results: Thematic analysis using the CIT approach identified five themes all of which pertained to either the positive or negative aspects of the transition programme for adolescents with severe haemophilia and their...

End-Stage Renal DiseaseSleep Disturbance in Patients with Advanced Chronic Kidney Disease or End-Stage Renal Disease

Claire Kennedy
Patients with advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD) have a large burden of symptoms, with sleep disturbance, restless legs syndrome and fatigue among the most prevalent (1). These sleep-related symptoms are considered an absolutepriority for both treatment and research by patients and their caregivers (2). Despite this, clinicians consistently underestimate and overlook these symptoms in clinical encounters (3). The impact of RRT modality choiceon such symptoms is not well defined and...

An investigation into the expression, content and function of exosomes in an experimental model of epilepsy

Epilepsy is a serious neurological disease characterised by recurrent unprovoked seizures affecting 65 million people worldwide. Current anti-epileptic therapies target only symptomatic seizures and are not fully effective in ameliorating disease pathophysiology. Temporal lobe epilepsy is the most common form of epilepsy in adults and a third of temporal lobe epilepsy patients are drug refractory, and the underlying pathophysiology remains to be fully elucidated. Recent work revealed microRNAs serve important functions in cells, in post-transcriptional...

Improving the utilisation and the awareness of high-sensitivity cardiac troponin test

Reginald Imasuen
Cardiac troponin is one of the biomarkers to diagnose a myocardial infarction and has been in use for many years. There has been many improvements in these biomarkers to aid in the diagnosis of a myocardial infarction. An improvement in troponin sensitivity to be specific. Each new generation of troponin has led to improved diagnostic sensitivity. The new generation of troponin are known as the high-sensitivity troponin. The advantage of the high-sensitivity troponin is the...

The role of viral regulatory protein ICP0 in herpes simplex type 1 keratitis

David Shahnazaryan
Herpes simplex keratitis (HSK) is the commonest cause of infectious blindness in the developed world. It is caused by herpes simplex virus type 1 (HSV‐1) and is characterised by recurrent episodes of infection and immune‐mediated corneal inflammation that lead to significant loss of vision. Following transmission of HSV‐1 the virus is initially suspended in the tear film, where it encounters a multi‐pronged defence comprising enzymes, complement, immunoglobulins and crucially, a range of anti‐viral and pro‐inflammatory...

Reducing Hospital Attendances for New Vascular Referrals While Improving Risk Factor Investigation

Jason Ridge
Vascular disease is strongly associated with advancing age. As Ireland’s population gets older and the prevalence of other risk factors such as diabetes increase so too does the incidence of vascular disease. In an already heavily burdened system it is important that all processes operate efficiently without sacrificing quality of care provided to the patient. A key metric of quality care provision is patient satisfaction. Something which is negatively impacted by repeated hospital attendances. This...

Profiling Frailty in a Population of Older Adults Living With Human Immunodeficiency Virus (HIV) In Ireland

Chiara Reddin
Introduction Due to advances in healthcare in recent years, people living with Human Immunodeficiency Virus (PLWH) are for the first time reaching older age since the HIV epidemic began in the 1980s. It is known that PLWH suffer from premature ageing syndromes, such as frailty, younger than the general population (Bhatia et al., 2012). This presents new challenges for healthcare professionals in facilitating older PLWH to live better for longer into older age and in...

Identifying delays occurring in out-of-hours FAST calls causing increasing door-to-treatment time

Kyra O'Dwyer
Stroke is one of the leading causes of death and disability worldwide and is a huge economic burden. The management of stroke is time dependant. Shorter times result in reduced mortality and morbidity. National Guidelines in Ireland suggest a door-to-treatment time of one hour or less from presentation to the emergency department. Despite this recommendation, delays are still occurring for patients accessing timely treatment. This quality improvement project was carried out in a busy North...

Investigating the immune response to Staphylococcus aureus bloodstream infection in haemodialysis patients

Roisin Connolly
Staphylococcus aureus bloodstream infection (SA-BSI) is a serious and potentially fatal problem in haemodialysis patients. An effective S. aureus vaccine would have significant benefits in this group. Previous antibody-inducing vaccine candidates failed to prevent or attenuate SA-BSI and it is now accepted that next-generation anti- S. aureus vaccines must also induce effective T-cell-mediated immunity. Recent advances have helped to elucidate the role of specific T-cell subsets, notably Th1 and Th17 cells, which coordinate an effective...

Investigating the correlation between job satisfaction, autonomy, and self-efficiency among school nurses in Bahrain- a mixed methods study

Faten Hasani
To understand the relationship between job satisfaction, autonomy, and self-efficacy amongst school nurses in Bahrain a total of 142 school nurses in Bahrain were surveyed. Twenty-seven school nurses were also interviewed. Data were collected using structured psychometric tools and analyzed using Burnard’s (1991) framework. Conclusion drawn remarkably shows high level of job satisfaction among school nurses in Bahrain. Herzberg’s two-factor theory was used to determine the hygiene and motivation factors. The relationship between self-efficacy correlates...

Metabolic Reprogramming of the Cystic Fibrosis Neutrophil

Oliver J. McElvaney
Cystic fibrosis (CF) is the commonest lethal genetic condition affecting Caucasians, arising from a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene on the long arm of chromosome 7. It is a chloride channelopathy, manifesting clinically as a multisystem disorder. The major cause of morbidity and mortality in CF is neutrophilic lung disease, though significant debate exists as to whether the main determinant of this is an intrinsic defect due to defective CFTR...

Elucidating the Role of Complement Activation in the Pathogenesis of Alpha-1 Antitrypsin Deficiency

Laura Fee
Alpha-1 antitrypsin deficiency (AATD) is characterised by low circulating levels of alpha-1 antitrypsin (AAT) and is associated with neutrophil-driven chronic obstructive pulmonary disease (COPD), liver disease and other autoimmune comorbidities including vasculitis and panniculitis. Complement C3 has recently been identified as a binding partner of AAT. The aim of this study was to evaluate the significance of the lack of this binding event in AATD. A significant link between AATD manifestations and those which are...

How does undergraduate teaching prepare graduates for the paediatric SHO role? A study investigating how graduates of undergraduate training in Ireland meet stakeholder minimum accepted competencies (MAC) of knowledge and expectations of good practise as new paediatric SHO recruits.

Patrick Mccrossan
BackgroundThere may be a gap between what students learn during medical school andtheir clinical responsibilities as first-year paediatric doctors. At undergraduatelevel, in the United Kingdom (& Ireland), each medical school sets its owngraduating assessment and successful completion by the candidate leads to thelicensed right to practise by the Medical Council. It is therefore important todefine the standard for successful completion of medical school.
AimsWe sought to determine how current Irish undergraduate education preparesdoctors commencing clinical practice...

How does undergraduate teaching prepare graduates for the paediatric SHO role? A study investigating how graduates of undergraduate training in Ireland meet stakeholder minimum accepted competencies (MAC) of knowledge and expectations of good practise as new paediatric SHO recruits.

Patrick Mccrossan
BackgroundThere may be a gap between what students learn during medical school andtheir clinical responsibilities as first-year paediatric doctors. At undergraduatelevel, in the United Kingdom (& Ireland), each medical school sets its owngraduating assessment and successful completion by the candidate leads to thelicensed right to practise by the Medical Council. It is therefore important todefine the standard for successful completion of medical school.
AimsWe sought to determine how current Irish undergraduate education preparesdoctors commencing clinical practice...

“More of an art than a science”: The development of an accreditation framework for continuing education activities for pharmacists

Sarah Rhiannon Drumm
Accreditation is a recognition that an educational activity meets certain standards. The processes for accreditation vary considerably depending on the type of activity, and currently there are differing accreditation systems in place for pharmacy continuing education (CE) across different countries. The aim of this thesis was to research a selection of these systems, which would provide an opportunity to develop a catalogue of accreditation approaches currently in place in a number of different countries, and...

The effect of a Pilates-based core exercise group on balance and gait in ambulant children with Cerebral Palsy: A Randomised Control Trial

Clodagh Coman
Children with Cerebral Palsy (CP) demonstrate dysfunctional core muscleactivation contributing to problems with postural control for functional activitiesand walking. Pilates-based core exercises aim to improve postural control byencouraging coordinated activation of deep core stabilising muscles duringfunctional movements.This thesis will present the findings of a blinded assessor, parallel, randomisedcontrolled trial (RCT), with 46 participants, on the effect of Pilates-based coreexercises on balance and gait in ambulant children with spastic CP, ages sevento 17 years.The primary objectives...

How to Empower Professionals and the Public to Improve Mental Health Care: Exploring Educational Initiatives

Dolores Keating
Irish mental health policy emphasises early intervention, interdisciplinary working, the recovery philosophy and, perhaps most importantly, partnership between healthcare professionals, patients, caregivers and the community. Pharmacists have frequent contact with people experiencing mental health problems but appear to lack the confidence to engage effectively in mental health care. This thesis explores how educational interventions can empower pharmacists and members of the public to better support people experiencing mental health problems. Pharmacy students were found generally...

Responsive polypeptide containing block copolymers and polymer particles

Elena Bobbi
The synthesis and characterisation of novel stimuli-responsive polymers designed for biomedical applications is described. The first system is temperature-sensitive and is foreseen as useful for the study of the influence of particle shape on cellular uptake while the second one for the redox-sensitive delivery of drugs. Chapter 1 contains a background on the field of synthetic polymers for biomedical applications and on the polymerisation techniques applied by researchers and particularly in this work, namely RAFT...

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