Irish journal of medical science
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In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing. ⋯ The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.
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The management of breast cancer has evolved in the last 40 years to now encompass not only treating the cancer in the most effective way, but also to detect and treat cancers before they can pose a risk to patients. This evolution in therapy and diagnostics has moved away from treating patients with the maximum amount of therapy they can tolerate towards a new paradigm where patents receive the minimum treatment to be most efficacious.
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This study was performed to test the hypothesis that urinary levels of L-carnitine and its derivatives are enhanced in children and adolescents with hypertension and also check if analyzed parameters may serve as early markers of subclinical renal damage. ⋯ The results of this study do not explain the increased urine levels of L-carnitine. The most likely reason for excessive urinary loss was disturbed renal tubular reabsorption. It is possible to hypothesize that in hypertensive adolescents subclinical kidney dysfunction occurs. It is proposed that studies examining the concurrent plasma and urine concentration of L-carnitine and correlation with acknowledged proximal tubular markers are needed.
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As all tertiary paediatric hospitals are based in the capital of Dublin, it is therefore necessary for general surgeons in centres outside of Dublin to undertake routine elective and emergency paediatric surgery to provide children with care close to home. The aim of this study is to assess the volume and type of procedures this entails. ⋯ The range of procedures in general paediatric surgery is small with only five procedures representing the majority of all elective and emergency procedures performed. This suggests that a period of specialist paediatric surgery training would enable more general surgeons to provide this vital service.
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Increasing prevalence of overweight and obese children in developed countries poses a substantial threat to long-term health. One well-described factor is the amount of time spent watching television, with exposure to food advertising a known influence on food preferences and consumption patterns. ⋯ These results demonstrate that food and beverages depicted in advertisements during children's programming are predominantly unhealthy foods with high salt and sugar contents. The findings from this study again highlight the ongoing need for new rules regarding food advertising in children's programming.