71 Works

Case-based Reporting and Analysis to Enhance the Value and Use of Routine Health Facility Data for Health Policy, Programming and Research: Case Study of a New Malaria Surveillance System in The Gambia

Samuel Emetu Anya
A sustained decline in the burden of malaria from 2003 to 2007 in The Gambiahighlighted the need for real-time data to monitor the changing epidemiology ofmalaria. The aim of the studies described in this thesis was to determine thevalue and use of routine case-based health facility data for malaria policy,programming and research.To achieve this aim, individual, rather than aggregate, malaria case records atthe six sentinel sites were analysed by age, sex, month, season and location.The...

Development of a Novel Pro-angiogenic SDF-1α Gene-Activated Collagen Scaffold for Diabetic Wound Healing

Diabetes is a disease that arises due to the loss or impairment of the body’s ability to control the blood glucose level. Hyperglycemia leads to alterations in the structural functions of both macro and microvascular systems, causing vascular complications in diabetic patients such as the diabetic foot ulcer. In diabetic wounds, inadequate angiogenesis is one of the significant pathological factors hindering the progression to regular healing events. During wound healing, various cells orchestrate to promote...

A study of the androgen mediated transcriptome and AR interactome in AI resistant breast cancer

Rachel Bleach
Aromatase inhibitors (AI) are the vanguard treatment for hormone receptor positive, postmenopausal breast cancer, however, acquired resistance occurs in up to 40% of patients. AI therapies, by their mechanism of action, create a predominantly androgenic steroid environment. In this study, a multi-omic approach was undertaken to elucidate the role of the androgen receptor (AR) in AI resistant breast cancer. Evidence from this study suggests that cancer cells adapt to utilise the adrenal prohormone, androstenedione and/or...

The Association Between Medication Adherence Across Multiple Medications and Health Outcomes in Ageing Populations

Caroline Walsh
Aim: The overarching aim of this thesis is to explore the association between medication (non-) adherence and a range of health outcomes, particularly healthcare utilisation and health-related quality of life, in older adults. A specific focus of the thesis was the objective measurement of adherence across multiple medications in older adults with multimorbidity.
Methods and results: Four inter-related studies were conducted to address the thesis aims. The first study involved a systematic review of the literature...

Exploring Therapists’ Perceptions of Facilitating Family Involvement in Neurorehabilitation: A Qualitative Study

Marie Keegan
Introduction: There is a high prevalence of Acquired Brain Injury (ABI) in the Republic of Ireland and ABI can result in a range of physical, cognitive and communicative issues. Post ABI patients frequently go through the inpatient rehabilitation process to help to remediate these impairments. Current research advocates the involvement of family members in the rehabilitation process and further research is needed to expand on what this involvement entails and how to best facilitate this....

Improving Waiting Times for Outpatient Holter Monitoring

Harmonie Adams
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...

Improving Compliance with a Novel Pre-Operative Assessment Pathway for Neurosurgical Referrals.

Natasha Lynch
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...

Reducing Wait Times for Patients under Consideration for Tonsillectomy

Emma Rachel Larragy
The aim of this quality improvement project is to reduce wait times for patients under consideration for tonsillectomy. In 2017, in the Republic of Ireland, 5,267 patients presented to Otolaryngology, Head and Neck surgery services with acute and chronic tonsillitis. In the same year, 3,690 patients underwent tonsillectomy making this procedure the second most commonly performed in this surgical specialty in the country. The project focuses on the wait time between General Practitioner referral and...

Reducing Hospital Length of Stay for Low Risk Pulmonary Embolism Patients

Aaron Brady
Pulmonary embolism (PE) is a potentially fatal condition which affects millions of people globally. Traditionally, people diagnosed with a PE are treated in hospital. However, published guidelines from the European Society of Cardiology (ESC) and British Thoracic Society (BTS) suggest that the early discharge and outpatient management of low-risk PE patients is safe and non-inferior to inpatient management. Despite the evidence and the publication of these guidelines, approximately 80% of low-risk PE patients are managed...

Improving the Inpatient Management of Central Diabetes Insipidus Post- Transsphenoidal Pituitary Surgery

Pamela Moorehouse
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...

Podcasts from the journal Medical Education. Personality factors and medical training: a review of the literature

Eva Doherty & Kevin Eva
It has been acknowledged that certain personality characteristics influence both medical students’ and doctors’ performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. Eva Doherty (Director of human factors and patient safety, National Surgical Training Centre, The Royal College of Surgeons in Ireland, Dublin, Ireland) speaks to Kevin Eva, Editor in Chief of Medical Education about the importance of...

The art of auscultation – a digitally enhanced learning resource

Shona Pfeiffer & Patrick Kennelly
Interpretation of complex auscultation concepts as a student is a difficult skill, traditionally developed through repeated patient exposure, and this difficulty extends to the teaching of such concepts. This resource embeds cardiac, respiratory, and gastrointestinal auscultation sounds, visualisations, and descriptions into a clinical e-book resource, with graduated progression from simplistic to challenging auscultation sounds and variations of the same pathology in slow motion and real-time. The aim of this e-book is to promote a learner-centred...

Dublin Fire Brigade: Violence In The Workplace And Occupational Stress In The Control Room

Paul Harris, John F. Connolly & Ciaran O'Boyle
This study was designed to (i) identify the nature, incidence and prevalence of work-related violence (ii) examine sources and frequency of stress, and (iii) evaluate psychological distress in operational and control-room personnel. The measures used were the Survey of Violence Experienced by Staff, the Sources of Occupational Stress Questionnaire and the General Health Questionnaire. 96% of operational personnel had experienced some form of work-related violence in their careers. Primary sources of occupational stress in control...

Development of a Novel Pro-angiogenic SDF-1α Gene-Activated Collagen Scaffold for Diabetic Wound Healing

Diabetes is a disease that arises due to the loss or impairment of the body’s ability to control the blood glucose level. Hyperglycemia leads to alterations in the structural functions of both macro and microvascular systems, causing vascular complications in diabetic patients such as the diabetic foot ulcer. In diabetic wounds, inadequate angiogenesis is one of the significant pathological factors hindering the progression to regular healing events. During wound healing, various cells orchestrate to promote...

Reduce the Waiting Time for New Referrals in a Private Dermatology Clinic

Sandy Luc
Long waiting lists are continuing to be a global healthcare issue and Ireland is no exception. The World Health Organisation declared a global pandemic in early 2020 and as a consequence, waiting lists are lengthened even further. Data collection from this study revealed that in November 2019, a total of 181 patients attended the private dermatology clinic yet only 8% were new patients. The average time new patients waited for this appointment was 121.77 days....

Reducing Wait Times for Patients under Consideration for Tonsillectomy

Emma Rachel Larragy
The aim of this quality improvement project is to reduce wait times for patients under consideration for tonsillectomy. In 2017, in the Republic of Ireland, 5,267 patients presented to Otolaryngology, Head and Neck surgery services with acute and chronic tonsillitis. In the same year, 3,690 patients underwent tonsillectomy making this procedure the second most commonly performed in this surgical specialty in the country. The project focuses on the wait time between General Practitioner referral and...

Reducing Hospital Length of Stay for Low Risk Pulmonary Embolism Patients

Aaron Brady
Pulmonary embolism (PE) is a potentially fatal condition which affects millions of people globally. Traditionally, people diagnosed with a PE are treated in hospital. However, published guidelines from the European Society of Cardiology (ESC) and British Thoracic Society (BTS) suggest that the early discharge and outpatient management of low-risk PE patients is safe and non-inferior to inpatient management. Despite the evidence and the publication of these guidelines, approximately 80% of low-risk PE patients are managed...

Improving the Inpatient Management of Central Diabetes Insipidus Post- Transsphenoidal Pituitary Surgery

Pamela Moorehouse
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...

Frailty Awareness in the Adult Population: Knowledge of Frailty Risk Factors and Symptoms.

Michael Kelleher
Introduction: Frailty is one of the most problematic conditions affecting the ageing population (Clegg et al, 2013). The World Health Organisation (2018) has projected the number Of individuals aged 60 and older is expected to nearly double from 12% to 22% by 2050 resulting in an increased incidence of frailty. The current prevalence of frailty In Ireland is 12.7% and growing (Turner et al, 2018). There is no known research Globally that has investigated the...

Frailty Awareness in the Adult Population: Knowledge of Frailty Risk Factors and Symptoms.

Michael Kelleher
Introduction: Frailty is one of the most problematic conditions affecting the ageing population (Clegg et al, 2013). The World Health Organisation (2018) has projected the number Of individuals aged 60 and older is expected to nearly double from 12% to 22% by 2050 resulting in an increased incidence of frailty. The current prevalence of frailty In Ireland is 12.7% and growing (Turner et al, 2018). There is no known research Globally that has investigated the...

The Impact of Biofeedback on Self-efficacy in Adults with Asthma

Joanne Walsh
Objective: To examine self-efficacy among adults with asthma, following a nurse led educational intervention using biofeedback of treatment use.
Method: The research design employed was a quantitative, non-experimental, cross sectional, descriptive survey. An adapted version of a previously validated closed-ended questionnaire known as the Asthma Self-Efficacy Questionnaire was used as the data collection instrument. A total of 88 participants, completed the asthma self-efficacy questionnaire once. Data was analysed using descriptive and inferential statistics. data analysis was...

Evaluation Research in Education

Pauline Joyce
This paper gives an overview of evaluation and evaluation research, particularly how it fits with education. Reference to some evaluation debates over the years is presented as well as some seminal works in the topic area. A brief synopsis of evaluation in the education setting is then presented before outlining various approaches to evaluation.

The Irish Study of Sexual Health and Relationships Sub-Report 1: Learning About Sex and First Sexual Experiences

Kay Rundle, Richard Layte & Hannah Mc Gee
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 studyof 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 of...

SLAN 2007: Survey of Lifestyle, Attitudes and Nutrition in Ireland. Alcohol use in Ireland: A profile of drinking patterns and alcohol-related harm from SLAN 2007.

Karen Morgan, Ruairi Brugha, Hannah Mc Gee, Patrick Dicker, Mark Ward, Emer Shelley, Eric Van Lente, Janas Harrington, Margaret Barry, Ivan Perry & Dorothy Watson
The SLÁN 2007 survey contained a series of questions relating to alcohol use. These included questions about frequency (how often) an quantity (how much) of alcohol consumed, as well as questions about alcohol-related harm. Quantity of alcohol consumed was assessed by asking respondents how many standard drinks were taken, a ‘standard’ drink being defined as a half pint or a glass of beer, lager or cider; a single measure of spirits; a single glass of...

Brain Drain to Brain Gain: Ireland's Two-Way Flow of Doctors

Aisling Walsh & Ruairi Brugha
Medical workforce stressors continue to undermine Ireland’s ability to achieve medical workforce sustainability and compliance with the WHO Global Code on the International Recruitment of health personnel. These include: i) high rates of emigration among graduates of Irish medical schools, attracted by working conditions, training and career opportunities in other English speaking countries; ii) the need to be compliant with the European Working Time Directive, which restricts hospital doctors’ working week; and iii) increasing demand....

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