Irish journal of medical science
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There has been a considerable amount of research focused upon assessing doctor burnout. However, psychological resilience (PR) has been examined far less frequently. ⋯ The research reported in this paper provides insights in to how healthcare leaders could empower frontline doctors to change how they work in order to allow them to improve their psychological resilience and help them to thrive, rather than just survive.
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Cognitive impairment (CI) is common in multiple sclerosis (MS), including newly diagnosed MS, where it is particularly underrecognised. Determining the presence of CI in the outpatient clinic often relies on patient-reported complaints, with limited time and resources in this setting. Prior studies have shown that self-reported cognition relates poorly to formal neuropsychological testing in the MS population and correlates more with factors such as anxiety, depression and fatigue. ⋯ Study findings add to the literature of perceived cognition in MS, in a newly diagnosed cohort. Findings are consistent with previous research using detailed neuropsychological assessments, confirming the sensitivity of BICAMS, applicable in a routine clinical setting.
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Chyle leakage from the thoracic duct or cisterna chyli is a relatively rare complication of oesophageal cancer surgery. The majority of cases settle with conservative measures, but high volume leaks may be refractory and result in significant morbidity and require intervention with reoperation or embolization. ⋯ This article is built around two recent cases, where interventional radiology to embolize and disrupt complex fistulae was successfully performed. The lessons from this experience will change practice at this centre to initial lymphangiography with a view to embolization or disruption of thoracic duct and cisterna chyli leaks as first line therapy for type III chyle leaks, with surgery reserved for where this fails.
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Maxillofacial space infection (MSI) experience review is beneficial for its management. ⋯ Comprehensive managements are advisable for MSI patients with multiple-space infection, respiratory difficulty, systemic diseases to avoid disseminated exacerbation, and occurrence of life-threatening complications. Community outpatient treatment was beneficial to a reduced LOS. Timely access to dental outpatient management and simultaneously steady control of diabetes and hypertension was advocated. Improved coverage of insured dental outpatient treatment should be stressed.
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Observational Study
Trends in private maternity care in Ireland's capital during and after the Great Economic Recession 2009-2017.
Maternity care in hospitals in the Republic of Ireland is funded by a hybrid of public finance and private health insurance. ⋯ Ireland's recent economic recession was accompanied by an overall decrease in the number of women choosing private maternity care after 2009. Furthermore, economic recovery with increasing female employment after 2012 was not associated with a recovery in demand for private care. These findings have important implications for healthcare policies and for the future organisation and funding of our maternity services.