• Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

      Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid (BMC public health, 2015-09)
      Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective.
    • Strength In Numbers Hackathon: Using a novel technology-focused brainstorming activity to engage stakeholders in intervention development

      Hynes, Lisa; O'Hara, Mary Clare; Jordan, Vincent; Hutchinson, O. Clyde; O'Dea, Fergus; Byrne, Molly; Dinneen, Seán F (European Health Psychologist, 2016)
      Young adulthood has been identified as a particularly challenging time to live with and manage a chronic condition, like type 1 Diabetes (McKnight, Wild, Lamb, Cooper, Jones, Davis et al., 2015; Wiebe, Helgeson, & Berg, 2016). A growing body of research shows that living with type 1 Diabetes as a young adult is associated with more Diabetesrelated problems as well as reduced wellbeing (Bryden, Dunger, Mayou, Peveler & Neil, 2003; National Health Service, 2015). Despite growing awareness of the risks faced by young adults with type 1 Diabetes, there is a lack of evidence-based guidance in the research for supporting young adults to improve selfmanagement and outcomes (O’Hara, Hynes, O’Donnell, Nery, Byrne, Heller & Dinneen, 2016).
    • Strength in Numbers: an international consensus conference to develop a novel approach to care delivery for young adults with type 1 diabetes, the D1 Now Study

      O’Hara, Mary Clare; Hynes, L.; O’Donnell, M.; Keighron, C.; Allen, G.; Caulfield, A.; Duffy, C.; Long, M.; Mallon, M.; Mullins, M.; et al. (BioMed Central, 2017-12-04)
      Abstract: Background A 3-day international consensus meeting was hosted by the D1 Now study team in Galway on June 22–24, 2016 called “Strength In Numbers: Teaming up to improve the health of young adults with type 1 diabetes”. The aim of the meeting was to bring together young adults with type 1 diabetes, healthcare providers, policy makers and researchers to reach a consensus on strategies to improve engagement, selfmanagement and ultimately outcomes for young adults living with type 1 diabetes. Methods This diverse stakeholder group participated in the meeting to reach consensus on (i) a core outcome set (COS) to be used in future intervention studies involving young adults with type 1 diabetes, (ii) new strategies for delivering health services to young adults and (iii) potential digital health solutions that could be incorporated into a future intervention. Results A COS of 8 outcomes and 3 key intervention components that aim to improve engagement between young adults with type 1 diabetes and service providers were identified. A digital health solution that could potentially compliment the intervention components was proposed. Conclusion The outputs from the 3-day consensus conference, that held patient and public involvement at its core, will help the research team further develop and test the D1 Now intervention for young adults with type 1 diabetes in a pilot and feasibility study and ultimately in a definitive trial. The conference represents a good example of knowledge exchange among different stakeholders for health research and service improvement.
    • Subacute anterior spinal cord ischemia with lower limb monoplegia: a clinical dilemma and challenging scenario.

      Waters, Peadar S; Tawfick, Wael; Hynes, Niamh; Sultan, Sherif; Department of Vascular and Endovascular Surgery, Galway University Hospital, Western Vascular Institute, Newcastle Road, Galway, Ireland. (2012-12)
      A 70-year-old woman presented with crescendo right lower limb monoplegia. Magnetic resonance imaging depicted anterior spinal artery syndrome with an 8.5 cm Crawford type II thoracoabdominal aortic aneurysm (TAAA). A staged hybrid procedure was performed, following which she had total exclusion of her TAAA and full resolution of her monoplegia. Clinical presentations of TAAAs can be diverse and require detailed clinical knowledge and lateral thinking to unearth unorthodox presentations. This erratic presentation of a TAAA with anterior spinal artery syndrome outlines particular challenges with management and portrays the need for tailored utilization of contemporary techniques to deal with the growing complexity of TAAAs.
    • Successful Pregnancy after Simultaneous Pancreas-Kidney Transplantation

      Smyth, A.; Gaffney, G.; Hickey, D.; Lappin, D.; Reddan, D.; Dunne, F. (2012-08-15)
    • Successful pregnancy after simultaneous pancreas-kidney transplantation:a case report

      Smyth, A; Gaffney, G; Hickey, D; Lappin, D; Redden, D; Dunne, F; Departments of Endocrinology, Obstetrics & Gynaecology and Nephrology, Galway University Hospitals, Galway, Ireland; Department of Urology & Transplantation, Beaumont Hospital, Dublin 9, Ireland. (Diabetic Pregnancy Study Group, 2011)
      The effect of pregnancy on simultaneous kidney pancreas transplant recipients has previously been described, but experience is limited. Compared to kidney transplant recipients, these patients experience higher rates of preterm delivery, low birth weight, hypertension, infection, pre-eclampsia, acute rejection and graft loss in later years. Risks are reduced by planning pregnancy with functional grafts and stable immunosuppression doses. We describe the case of a thirty-five year old female who six years previously underwent simultaneous kidney pancreas transplant. She had preceding type 1 diabetes mellitus for nineteen years, complicated by retinopathy and nephropathy that required haemodialysis. She also had polycystic ovarian syndrome and required hormonal support to achieve pregnancy. Immunosuppression included tacrolimus, prednisolone and mycophenolate mofetil which was changed to azathioprine prior to pregnancy. An integrated multidisciplinary team closely followed progress during pregnancy. She developed pregnancy-induced hypertension requiring labetolol. Tacrolimus doses were adjusted based on trough levels and blood glucose levels and HbA1c remained within normal limits. She did not require insulin treatment at any point and there was no deterioration in retinopathy despite progressive hypertension. She experienced deterioration in renal indices at twenty-six weeks gestation. Intramuscular betamethasone was administered. Due to further deterioration in renal indices delivery was planned and she underwent an uncomplicated, elective Caesarian section at thirty weeks gestation, performed by her obstetrician with assistance from her transplant surgeon. She delivered a male infant of 1.18kg, appropriate for gestational age, who had hypothermia and respiratory distress, which required intubation and ventilation and an eleven week stay in the special care baby unit. At eighteen month follow the infant shows normal development and there has been no deterioration in either graft’s function.
    • Supraclavicular scalenectomy for thoracic outlet syndrome--functional outcomes assessed using the DASH scoring system.

      Glynn, Ronan W; Tawfick, Wael; Elsafty, Zahrah; Hynes, Niamh; Sultan, Sherif; Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland. (2012-02)
      To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression.
    • Surgery for oesophageal cancer at Galway University Hospital 1993-2008.

      Chang, K H; McAnena, O J; Smith, M J; Salman, R R; Khan, M F; Lowe, D; Department of Surgery, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland. kahhoong_chang@yahoo.co.uk (2010-12)
      Surgical volume and outcome remain controversial in the management of oesophageal cancer.
    • Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

      Chan, Jeffrey C Y; Purcell, Elizabeth M; Kelly, John L; Department of Plastic, Reconstructive and Hand Surgery, University College Hospital Galway, Newcastle Road, Galway, Republic of Ireland. chancy@eircom.net (2007)
      The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.
    • A Survey of Colorectal Cancer Surveillance Practices In Ireland, And Implementation of A Survivorship Care Plan Pilot Programme

      Greally, M.; Keane, F; Power, D.G; Leonard, G.D (Irish Medical Journal, 2019-02)
      The number of colorectal cancer (CRC) survivors in Ireland is rising. We aimed to survey current surveillance practices and pilot the use of survivorship care plans (SCPs) in the clinic.
    • Survey of Smartphone Use among Anaesthetists In Saolta University Health Care Group

      Kinirons, Alhomary, B. (Irish Medical Journal, 2018-03)
      Recent centuries have witnessed a revolution in technology which has made significant contributions to improve the quality of many aspects of our lives, including healthcare systems. Among these rapidly advancing technologies, smartphones stand out as an example of valuable devices that have dramatically changed the healthcare domain and the clinical practice. There is substantial evidence of the role of smartphones and medical applications in the daily practice of healthcare professionals. In one market research, it was estimated that 72% of US physicians use smartphones, and this number was expected to rise to 81% by 20121. This increasing popularity of smartphones can be attributed to the numerous benefits associated with their use. For instance, they can provide immediate access to a wealth of medical and health information via internet, emails and instant messages. Furthermore, they can lead to improved communications between healthcare professionals, and hence improved patient care2. An essential feature of smartphones is the integrated software applications (apps). These apps can either be preinstalled on the device or can be web apps that are accessed and downloaded via the internet. It is estimated that over 300,000 apps were developed between 2007 and 20103, and developers categorise a subset of these applications as medical apps. The utilisation of these medical apps by health care personnel, including anaesthetists has evolved recently.
    • Survivorship care for postmenopausal breast cancer patients in Ireland: What do women want?

      Meade, Elizabeth; McIlfatrick, Sonja; Groarke, Ann Marie; Butler, Eimear; Dowling, Maura (Elsevier, 2017-06)
      The aim of this study was to identify the concerns of postmenopausal breast cancer patients in Ireland and inform the development of a survivorship care plan.
    • Sustained weight loss and improvement of quality of life after laparoscopic adjustable gastric banding for morbid obesity: a single surgeon experience in Ireland.

      Chang, K H; Condon, E T; O'Connor, E J; McAnena, O J; Department of Surgery, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland. kahhoong_chang@yahoo.co.uk (2010-03)
      Although substantial weight loss is the primary outcome following bariatric surgery, changes in obesity-related morbidity and quality of life (QoL) are equally important. This study reports on weight loss, QoL and health outcomes following laparoscopic adjustable gastric banding (LAGB).
    • Sustaining a good model of practice education in challenging times

      Reed, Jackie; Walsh, Eileen; Lyons, Rena; 1. Health and Social Care Professions, Education and Development, Galway. 2. Discipline of Speech and Language Therapy, School of Health Sciences, College of Medicine, Nursing and Health Sciences, NUI Galway, Ireland (2015)
    • A systematic review of interventions to improve outcomes for young adults with Type 1 diabetes.

      O'Hara, M C; Hynes, L; O'Donnell, M; Nery, N; Byrne, M; Heller, S R; Dinneen, S F (Wiley, 2016-10-20)
      Many young adults with Type 1 diabetes experience poor outcomes. The aim of this systematic review was to synthesize the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with Type 1 diabetes.
    • Tailoring the properties of cholecyst-derived extracellular matrix using carbodiimide cross-linking.

      Burugapalli, Krishna; Chan, Jeffrey C Y; Naik, Hemantkumar; Kelly, John L; Pandit, Abhay; National Centre for Biomedical Engineering Science, National University of Ireland, Galway, Ireland. (IngentaConnect, 2009)
      Modulation of properties of extracellular matrix (ECM) based scaffolds is key for their application in the clinical setting. In the present study, cross-linking was used as a tool for tailoring the properties of cholecyst-derived extracellular matrix (CEM). CEM was cross-linked with varying cross-linking concentrations of N,N-(3-dimethyl aminopropyl)-N'-ethyl carbodiimide (EDC) in the presence of N-hydroxysuccinimide (NHS). Shrink temperature measurements and ATR-FT-IR spectra were used to determine the degree of cross-linking. The effect of cross-linking on degradation was tested using the collagenase assay. Uniaxial tensile properties and the ability to support fibroblasts were also evaluated as a function of cross-linking. Shrink temperature increased from 59 degrees C for non-cross-linked CEM to 78 degrees C for the highest EDC cross-linking concentration, while IR peak area ratios for the free -NH(2) group at 3290 cm(-1) to that of the amide I band at 1635 cm(-1) decreased with increasing EDC cross-linking concentration. Collagenase assay demonstrated that degradation rates for CEM can be tailored. EDC concentrations 0 to 0.0033 mmol/mg CEM were the cross-linking concentration range in which CEM showed varied susceptibility to collagenase degradation. Furthermore, cross-linking concentrations up to 0.1 mmol EDC/mg CEM did not have statistically significant effect on the uniaxial tensile strength, as well as morphology, viability and proliferation of fibroblasts on CEM. In conclusion, the degradation rates of CEM can be tailored using EDC-cross-linking, while maintaining the mechanical properties and the ability of CEM to support cells.
    • Targeting the Pim kinases in multiple myeloma.

      Keane, N A; Reidy, M; Natoni, A; Raab, M S; O'Dwyer, M (Nature Publishing Group, 2015-07-17)
      Multiple myeloma (MM) is a plasma cell malignancy that remains incurable. Novel treatment strategies to improve survival are urgently required. The Pims are a small family of serine/threonine kinases with increased expression across the hematological malignancies. Pim-2 shows highest expression in MM and constitutes a promising therapeutic target. It is upregulated by the bone marrow microenvironment to mediate proliferation and promote MM survival. Pim-2 also has a key role in the bone destruction typically seen in MM. Additional putative roles of the Pim kinases in MM include trafficking of malignant cells, promoting oncogenic signaling in the hypoxic bone marrow microenvironment and mediating resistance to therapy. A number of Pim inhibitors are now under development with lead compounds entering the clinic. The ATP-competitive Pim inhibitor LGH447 has recently been reported to have single agent activity in MM. It is anticipated that Pim inhibition will be of clinical benefit in combination with standard treatments and/or with novel drugs targeting other survival pathways in MM.
    • Taught a lesson by taut skin.

      Geoghegan, Pierce; Sexton, Donal J; Giblin, Louise; O'Regan, Anthony; Galway University Hospital, County Galway, Republic of Ireland. geoghep@tcd.ie (2012-09)
    • A TCP model for external beam treatment of intermediate-risk prostate cancer.

      Walsh, Seán; van der Putten, Wil; School of Physics, National University of Ireland Galway, Connacht, Ireland. Walshsharp@gmail.com (2013-03)
      Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes.