• Evaluation of intubation using the Airtraq or Macintosh laryngoscope by anaesthetists in easy and simulated difficult laryngoscopy--a manikin study.

      Maharaj, C H; Higgins, B D; Harte, B H; Laffey, J G; Department of Anaesthesia, University College Hospital Galway, Ireland. (2006-05)
      The Airtraq Laryngoscope is a novel intubation device which allows visualisation of the vocal cords without alignment of the oral, pharyngeal and tracheal axes. We compared the Airtraq with the Macintosh laryngoscope in simulated easy and difficult laryngoscopy. Twenty-five anaesthetists were allowed up to three attempts to intubate the trachea in each of three laryngoscopy scenarios using a Laerdal Intubation Trainer followed by five scenarios using a Laerdal SimMan Manikin. Each anaesthetist then performed tracheal intubation of the normal airway a second time to characterise the learning curve. In the simulated easy laryngoscopy scenarios, there was no difference between the Airtraq and the Macintosh in success of tracheal intubation. The time taken to intubate at the end of the protocol was significantly lower using the Airtraq (9.5 (6.7) vs. 14.2 (7.4) s), demonstrating a rapid acquisition of skills. In the simulated difficult laryngoscopy scenarios, the Airtraq was more successful in achieving tracheal intubation, required less time to intubate successfully, caused less dental trauma, and was considered by the anaesthetists to be easier to use.
    • Evaluation of the Airtraq and Macintosh laryngoscopes in patients at increased risk for difficult tracheal intubation.

      Maharaj, C H; Costello, J F; Harte, B H; Laffey, J G; Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland. (2008-02)
      The Airtraq, a novel single use indirect laryngoscope, has demonstrated promise in the normal and simulated difficult airway. We compared the ease of intubation using the Airtraq with the Macintosh laryngoscope, in patients at increased risk for difficult tracheal intubation, in a randomised, controlled clinical trial. Forty consenting patients presenting for surgery requiring tracheal intubation, who were deemed to possess at least three characteristics indicating an increased risk for difficulty in tracheal intubation, were randomly assigned to undergo tracheal intubation using a Macintosh (n = 20) or Airtraq (n = 20) laryngoscope. All patients were intubated by one of three anaesthetists experienced in the use of both laryngoscopes. Four patients were not successfully intubated with the Macintosh laryngoscope, but were intubated successfully with the Airtraq. The Airtraq reduced the duration of intubation attempts (mean (SD); 13.4 (6.3) vs 47.7 (8.5) s), the need for additional manoeuvres, and the intubation difficulty score (0.4 (0.8) vs 7.7 (3.0)). Tracheal intubation with the Airtraq also reduced the degree of haemodynamic stimulation and minor trauma compared to the Macintosh laryngoscope.
    • Evaluation of the self care to wellness programme (SCWP)

      Evans, David S; McSharry, Kathy; Lynott, Jackie; Department of Public Health Health Service Executive West, Health Service Executive CHO2, Centre for Independent Living Mayo (2017-03)
      The HSE is committed to supporting people to self-manage long term health conditions. The Self Care to Wellness Programme (SCWP) is a community based self-management training programme for those with long term health conditions which commenced in county Mayo in January 2015. It is a joint partnership between the HSE, Mayo Centre of Independent Living (CIL), Disability Federation of Ireland (DFI) and the Multiple Sclerosis Society (MS). The six week Programme follows the Stanford Model for Chronic Disease Self Management (Lorig et al. 1999). The aim of the study was to obtain feedback from Programme participants in terms of its impact on managing their condition. All those that attended the programme between January and December 2015 were invited to complete a questionnaire at the beginning and six months after completing the Programme. The study utilised a number of validated measures, in addition to open ended questions to allow respondents to elaborate on their responses.
    • The evolution of spinal surgery in the west of Ireland, 2005-2013.

      O’Sullivan, M D; Abdallah, D; Jadaan, M; Rahall, E; Devitt, A; McCabe, JP (Irish Medical Journal, 2016-04)
      The aim of this study was to determine the changes in both the short and long term, in the trends within the practice of spinal surgery in Galway University Hospitals (GUH) over a seven year period, January 2005 – January 2013. The absolute number of spinal surgery cases has increased from 147 in 2005, to 257 cases by 2013. Multiple level spine surgery accounts for 51% (131) of all cases by 2013, which is an increase from 31% (45) in 2005. On analysis of the trends within spinal surgery during the study period, a statistically significant (p<0.05) increase in all aspects of spinal surgery was noted, with the exception of surgeries for single level, lumbar and infection pathology respectively. The average waiting time for lumbar decompression and instrumentation climbed for an average of 1.3 months in 2008 to 12.1 months by 2012.The volume and complexity of spinal surgery has increased during the study period, in the West of Ireland.
    • Expanding access to rheumatology care: the rheumatology general practice toolbox.

      Conway, R; Kavanagh, R; Coughlan, R J; Carey, J J (Irish Medical Journal, 2015-02)
      Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant's confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p < 0.05) in 11 of the 14 aspects assessed. The Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant's self-assessed competence in diagnosis and management of common rheumatic diseases.
    • An experimental investigation of the hemodynamic variations due to aplastic vessels within three-dimensional phantom models of the Circle of Willis.

      Fahy, Paul; McCarthy, Peter; Sultan, Sherif; Hynes, Niamh; Delassus, Patrick; Morris, Liam; Galway Medical Technologies Centre (GMedTech), Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland. (Annals of biomedical engineering, 2013-09-10)
      A complete circle of Willis (CoW) is found in approximately 30-50% of the population. Anatomical variations, such as absent or surgically clamped vessels, can result in undesirable flow patterns. These can affect the brain's ability to maintain cerebral perfusion and the formation of cerebral aneurysms. An experimental test system was developed to simulate cerebral physiological conditions through three flexible 3D patient-specific models of complete and incomplete CoW geometries. Flow visualizations were performed with isobaric dyes and the mapped dye streamlines were tracked throughout the models. Three to seven flow impact locations were observed for all configurations, corresponding to known sites for aneurysmal formation. Uni and bi-directional cross-flows occurred along the communicating arteries. The greatest shunting of flow occurred for a missing pre-communicating anterior (A1) and posterior (P1) cerebral arteries. The anterior cerebral arteries had the greatest reduction (15-37%) in efferent flow rates for missing either a unilateral A1 or bilateral P1 segments. The bi-directional cross-flows, with multiple afferent flow mixing, observed along the communicating arteries may explain the propensity of aneurysm formation at these sites. Reductions in efferent flow rates due to aplastic vessel configurations may affect normal brain function.
    • 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.