Irish journal of medical science
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Historical Article
Establishment of a national surveillance system to monitor community HIV testing, Ireland, 2018.
HIV continues to be an important public health issue. Voluntary community-based HIV testing (VCBT) helps to reduce the undiagnosed population of HIV-positive individuals, enabling early diagnosis and treatment. Monitoring is essential to determine whether at-risk groups are being effectively reached. ⋯ Sustained national monitoring in community settings will help inform HIV testing guidelines and will enable assessment of the impact of local and regional community HIV testing strategies.
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The aim of this study was to evaluate the incidence of permanent pacemaker (PPM) implantation after cardiac surgery in our institution and investigate risk factors for PPM dependency to provide patients with accurate incidence figures at the time of consent for surgery. ⋯ As clinicians, it can be challenging to provide our patients with accurate information on the risk of PPM implantation relative to their operation. A unit-specific data may be a more accurate method of informing our patients on this risk.
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N-acetylcysteine (NAC) may be useful in the management of chemotherapy-induced liver injury. ⋯ This study shows that NAC has a therapeutic effect on hepatotoxicity in children being treated with chemotherapeutic agents due to underlying malign diseases. The early reduction in the results of liver function tests is important for the continuation of chemotherapy.
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The introduction of treat and referral by ambulance practitioners is under active consideration in Ireland. The Irish ambulance services have traditionally transported all patients following an emergency (112/999) call to an emergency department. The introduction of treat and referral will present a significant care pathway change. ⋯ GPs are in the main supportive of the introduction of treat and referral; however, they have identified several barriers that may inhibit successful introduction. Importantly, a GP appointment within 48 h does not appear to be a barrier. The adequacy of the working relationships between GPs and the ambulance service and its practitioners appears to have reduced since 2006, which is concerning.
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Clinical decision-making is a daily practice conducted by medical practitioners, yet the processes surrounding it are poorly understood. The influence of 'shortcuts' in clinical decision-making, known as heuristics, remains unknown. This paper explores heuristics and the valuable role they play in medical practice, as well as offering potential solutions to minimize the risk of incorrect decision-making. ⋯ It remains unknown if heuristics are primarily positive or negative for clinical decision-making. Future efforts should assess heuristics in real-time and controlled trials should be applied to assess the potential impact of mitigating factors in reducing the negative impact of heuristics and optimizing their efficiency for positive outcomes.