• First report of IMI-1-producing colistin-resistant Enterobacter clinical isolate in Ireland, March 2013.

      Boo, Tw; O Connell, N; Power, L; O Connor, M; King, J; McGrath, E; Hill, R; Hopkins, Kl; Woodford, N; Department of Medical Microbiology, Galway University Hospitals, HSE West, Ireland. (Euro surveillance : bulletin Européen sur les maladies transmissibles = European communicable disease bulletin, 2013-08)
      We report the first case in Ireland of an IMI-1 carbapenemase- producing Enterobacter asburiae, which was resistant to both colistin and fosfomycin. The circumstances under which this isolate was acquired were unclear. Several reports of IMI-producing Enterobacter spp. have emerged in recent years, and colistin resistance in Enterobacteriaceae is also increasingly reported. Laboratories should be aware of the unusual antibiograms of IMI-producing isolates.
    • Fish vaccine injection injuries of the hand

      O'Neill, A.C.; Ismael, T.S.; McCann, J.; Regan, P.J. (2012-04-30)
    • Fit for purpose? Evaluation of an MSc. in Medical Physics.

      van der Putten, W J; Department of Medical Physics and Bioengineering, Galway University Hospitals, and, School of Physics, National University of Ireland Galway, Galway, Ireland. Electronic address: wil.vanderputten@hse.ie. (2014-05)
      The National University of Ireland in Galway established a Master in Science (MSc.) program in medical physics in 2002. The course was designed to be 90 ECTS(1) credits and of one calendar year duration. From the outset the MSc. was designed to be part of an overall medical physics training program. MSc. programs are now widely used as part of the training and education of medical physicists. There is however paucity of data on the effectiveness of such courses and the purpose of the study reported here is to provide information on one particular MSc. course in medical physics. This is relevant to medical physicists who are involved in the development and running of medical physics training programs. The study used as methodology the Kirkpatrick levels of professional training. It was conducted through an online survey, both from students who graduated from the course and from students who were in the process of completing the course. The survey proved to be an effective way to determine attributes of modules such as learning outcomes, knowledge imparted, quality of teaching materials and others. The survey proved to be remarkably able to demonstrate interventions in the individual course modules. Although the course was shown to be effective in the imparting of the knowledge required to become a qualified medical physicist several areas for improvement were identified. These are mainly in the areas of increased practical experience and in course delivery.
    • Fitness to drive in cognitive impairment – a quantitative study of GPs’ experience

      Doherty, Una; Hawke, Ana-Louise; Kearns, Jamie; Kelly, M (Irish Medical Journal, 2015-04)
      Assessing fitness to drive is part of the role of general practitioners. Cognitive impairment may affect an individualâ s ability to drive safely. The aims of our study were to question GPs about their experience of assessing patients with cognitive impairment for driving fitness and to explore their attitudes to this role. We carried out a quantitative cross-sectional anonymous postal survey of 200 GPs in counties Galway, Mayo and Roscommon. Ethical approval was obtained from the Irish College of General Practitioners. Data was analysed using Epi Info. The response rate was 62.5% (n=125). 86 (68.8%) GPs used guidelines when assessing fitness to drive in cognitive impairment. 83 (66.4%) respondents formally assess cognitive function. 52 (41.6%) GPs would certify someone as fit to drive with verbal restrictions. 102 (81.6 %) respondents feel confident in assessing fitness to drive. 98 (78.4%) GPs have referred patients for further assessment.
    • Five years' experience of transverse groin incision for femoral artery access in arterial reconstructive surgery: parallel observational longitudinal group comparison study.

      Beirne, Christopher; Martin, Fiachra; Hynes, Niamh; Sultan, Sherif; Department of Vascular and Endovascular Surgery, Western Vascular Institute, University College Hospital Galway, Galway, Ireland. (Vascular, 2008-07)
      Vertical groin incisions (VGIs) have been used to access femoral vessels, but reports allude to wound complications. Our aim was to compare VGI with transverse groin incision (TGI) for femoral artery exposure. Over a 5-year interval, 196 patients with 284 femoral artery exposures for supra- and infrainguinal procedures were studied. Primary endpoints were surgical skin site wound infection, seroma, haematoma formation, and major lower limb amputation. Secondary endpoints were graft patency, wound paresthesias, and length of hospital stay. There were 160 TGIs and 124 VGIs. The demographics and risk factor profile were not statistically different between groups. Seroma developed in 4.4% of TGIs and 13.7% of VGIs (p= .005). The complicated skin and soft tissue infection rate was five times greater with VGI (p= .001). The VGI group had a significantly higher rate of major amputation (p= .0005). Significantly higher graft failure rates were observed in the VGI group (p= .011). No paresthesia was reported in any TGI wound. The mean hospital stay was also significantly shorter in the TGI group (p= .006). The study data support and expound on the theory that an alternative incision to VGI offers lower short- and long-term morbidity. Our findings sustain the selection of the TGI in femoral artery surgery for both supra- and infrainguinal procedures without compromise of vessel exposure.
    • Five-year Irish trial of CLI patients with TASC II type C/D lesions undergoing subintimal angioplasty or bypass surgery based on plaque echolucency.

      Sultan, Sherif; Hynes, Niamh; Western Vascular Institute, Department of Vascular & Endovascular Surgery, University College Hospital, and The Galway Clinic, Galway, Ireland. mrsherif.sultan@gmail.com (Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2009-06)
      To report a 5-year observational parallel group study comparing the effectiveness of subintimal angioplasty (SIA) to bypass grafting (BG) for treatment of TASC II type C/D lesions in the lower limb arteries of patients with critical limb ischemia (CLI).
    • Food Allergy Emergencies in Children – To what extent are Early Years Services Prepared? A cross-sectional survey

      MacGiobuin, S; Stitt, V; Philbin, D; Higgins, B; McGuire, G; Marie O’Regan, A; Kelly, M (Irish Medical Journal, 2017-08)
      Food allergies are common in preschool children. This study’s aims are to establish prevalence, to clarify management practices, levels of preparedness and the perceived role of General Practitioners amongst Early Years Services providers. This study is an anonymous, quantitative, cross sectional study. An online questionnaire was distributed to 282 Early Years Service providers. Data were analysed using SPSS. Response rate was 35% (n=98). Prevalence of food allergy was 3% (n=119). Allergic reactions to food had occurred on site in 16% (n=15). Written emergency action plans were available in 47% of facilities (n=46). Medications were not kept on site in 63% (n=62) of facilities. General practitioners were felt to have an important role in the management of food allergies by 76% of respondents (n=61). This study identifies significant areas for improvement in the management of food allergic child in Early Years Services
    • Foreign-body retrieval using a rare earth magnet

      Dolderer, Juergen H; Kelly, John L; Morrison, Wayne A; Penington, Anthony J (2004-05)
    • Formation of a type 1 diabetes young adult patient and public involvement panel to develop a health behaviour change intervention: the D1 Now study

      O’Hara, Mary Clare; Cunningham, Áine; Keighron, Cameron; Allen, Gary; Caulfield, Antony; Duffy, Ciara; Long, Michelle; Mallon, Madeleine; Mullins, Monica; Tonra, Garret; et al. (BioMed Central, 2017-10-23)
      Abstract: Background Research indicates that young adults (18–25 year olds) with type 1 diabetes (T1D) often disengage from health services and their general diabetes management. Involving young adults with T1D in co-designing research to develop a behaviour change intervention to improve engagement with health services could potentially improve overall self management and health. A local youth mental health organisation called Jigsaw, Galway developed a very successful model for involving users in service design and development. Based on this model, the aim was to form a Young Adult Panel (YAP) of 18–25 year olds with T1D and involve them in all aspects of a study to develop an intervention to improve health and wellbeing for young adults with T1D called D1 Now. Methods Recruitment of young adults was achieved through a multimedia campaign. A consultation event was organised, followed by interviews with interested young adults. A panel of 8 members was selected. Following initial training for YAP members in committee skills and an introduction to different research methods and terms, YAP members participated in different stages of the research process. They were represented on the research study steering group and attended research meetings. They developed research materials, reviewed and interpreted research findings and helped develop the online platform to enhance engagement between young adults and their diabetes healthcare providers. They contributed to an international consensus conference on health services delivery for young adults with T1D and wrote specific sections of a further grant application to test out the new intervention. Results As a direct result of the YAP, a meaningful dialogue has opened up between healthcare providers and young adults within the D1 Now research team. Their involvement has led to a better understanding of what needs to be achieved in order to improve health service delivery. They have been active members in co-designing a health behaviour change. intervention to improve engagement between young adults with T1D and healthcare providers which will be evaluated in future research. Conclusion Through the formation of the YAP, we have demonstrated that involving young adults with T1D in healthcare research is feasible and productive.
    • Fracture Patients’ Attitudes towards Online Health Information & a ‘Prescribed’ Fracture Website

      Clesham, JG; Galbraith, SR; Kearns, ME. O’ Sullivan (Irish Medical Journal, 2018-04)
      Following musculoskeletal injury patient education is essential to help patients understand their treatment. Many attend the orthopaedic fracture clinic with multiple questions related to their diagnosis and treatment.
    • Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

      Gorman, J; Vellinga, A; Gilmartin, J J; O'Keeffe, S T; Regional Health Office, Merlin Park University Hospital, HSE West, Galway, Ireland. (2010-06)
      Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).
    • Functional safety of health information technology.

      Chadwick, Liam; Fallon, Enda F; van der Putten, Wil J; Kirrane, Frank; National University of Ireland, Ireland. liam.chadwick2@gmail.com (2012-03)
      In an effort to improve patient safety and reduce adverse events, there has been a rapid growth in the utilisation of health information technology (HIT). However, little work has examined the safety of the HIT systems themselves, the methods used in their development or the potential errors they may introduce into existing systems. This article introduces the conventional safety-related systems development standard IEC 61508 to the medical domain. It is proposed that the techniques used in conventional safety-related systems development should be utilised by regulation bodies, healthcare organisations and HIT developers to provide an assurance of safety for HIT systems. In adopting the IEC 61508 methodology for HIT development and integration, inherent problems in the new systems can be identified and corrected during their development. Also, IEC 61508 should be used to develop a healthcare-specific standard to allow stakeholders to provide an assurance of a system's safety.
    • The future for health promotion: proceedings of the launch conference of the Centre for Health Promotion Studies.

      Kelleher, Cecily (ed.); Centre for Health Promotion Studies, University College Galway (Centre for Health Promotion Studies University College Galway, 1992)
      Prior to the. establishment of my Department's Health Promotion Unit, consideration had been given by the former Health Education Bureau to their supporting the establishment of a Chair in Health Promotion in University College, Galway. The Health Promotion Unit strongly supported such a chair and bas given a formal commibnent of fmancial support of £50,000 per annum over a 7-year period. Professor Cecily Kelleher took up her appoinbnent as Professor of Health Promotion in Galway University in September 1990. Centre for Health Promotion Studies. An integral part of the focus on Health Promotion in the College is the establishment of a Centre for Health Promotion Studies within the College's Social Sciences Research Centre. The aims of the Centre for Health Promotion Studies are to instigate its own studies in issues relevant to Health Promotion in an Irish context. to advise and co-operate with others on the initiation and evaluation of strategies relevant to Health Promotion. to assist in the training of personnel within and beyond the traditional health sector. to establish a national database on Health Promotion. I have already appointed Professor Kelleher as a member of: the Advisory Council on Health Promotion, the Nutritional Advisory Group on Nutrition and the Working Group developing a National Alcohol Policy.
    • Galway University Hospitals Department of Critical Care annual clinical report 2008

      Galway University Hospitals (Galway University Hospitals, 2009)
    • Gene therapy for type 1 diabetes moves a step closer to reality.

      O'Brien, Timothy; Regenerative Medicine Institute and Department of Medicine, National Centre for Biomedical Engineering Science, National University of Ireland and Galway University Hospital, Galway, Ireland. timothy.obrien@nuigalway.ie (2013-05)
    • Generation of a vascularized organoid using skeletal muscle as the inductive source.

      Messina, Aurora; Bortolotto, Susan K; Cassell, Oliver C S; Kelly, Jack; Abberton, Keren M; Morrison, Wayne A; Bernard O'Brien Institute of Microsurgery, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. messinaa@svhm.org.au (2005-09)
      The technology required for creating an in vivo microenvironment and a neovasculature that can grow with and service new tissue is lacking, precluding the possibility of engineering complex three-dimensional organs. We have shown that when an arterio-venous (AV) loop is constructed in vivo in the rat groin, and placed inside a semisealed chamber, an extensive functional vasculature is generated. To test whether this unusually angiogenic environment supports the survival and growth of implanted tissue or cells, we inserted various preparations of rat and human skeletal muscle. We show that after 6 weeks incubation of muscle tissue, the chamber filled with predominantly well-vascularized recipient-derived adipose tissue, but some new donor-derived skeletal muscle and connective tissue were also evident. When primary cultured myoblasts were inserted into the chamber with the AV loop, they converted to mature striated muscle fibers. Furthermore, we identify novel adipogenesis-inducing properties of skeletal muscle. This represents the first report of a specific three-dimensional tissue grown on its own vascular supply.
    • Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study.

      Johnson, Nichola; Dudbridge, Frank; Orr, Nick; Gibson, Lorna; Jones, Michael E; Schoemaker, Minouk J; Folkerd, Elizabeth J; Haynes, Ben P; Hopper, John L; Southey, Melissa C; et al. (BioMed Central, 2014-05-26)
      We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age ≤50 years.
    • Gestational diabetes is more prevalent in women from lower socio-economic backgrounds.

      Owens, L; Cullinane, J; Gillespie, P; Avalos, G; O'Sullivan, EP; Dennedy, C; O'Sullivan, EP; O'Reilly, M (Diabetic Pregnancy Study Group, 2011)
      The link between socio-economic disadvantage and poor health has been observed across many spectrums of medicine. There is little evidence however, suggesting that Diabetes in Pregnancy is more prevalent in women from poorer backgrounds. This study was completed by the Atlantic Diabetes in Pregnancy partnership, which offered universal screening for Gestational Diabetes at 24-28 weeks gestation. Data was collected on women who delivered in 5 antenatal centres between 2007 and 2009. The calculated socio-economic background is based on a deprivation index derived from area of residence and national census data. The Deprivation Index is scored from 1-5, from least to most deprived, using various indicators; education, employment, percentage skilled/unskilled workers, demographic information, lone parents and number of persons/room. Using a ‘bivariate probit with sample selection’ model we controlled for poor attendance amongst women from disadvanted areas. We found that incidence of gestational diabetes is significantly higher for women living in the poorest areas, compared to women living in the richest areas. This gradient disappears when diabetes risk factors are controlled for, suggesting personal, clinical and lifestyle factors correlated with socioeconomic status are significant determinants for the development of Gestational Diabetes. These risk factors include; Body Mass Index, family history, smoking, sedentary lifestyle and higher immigrant population. Gestational Diabetes is more prevalent amongst women from lower socio-economic backgrounds.