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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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.
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This study highlights the multiple sources of delay along a hip fracture clinical pathway. The national recommendation is that 'patients with a hip fracture should be admitted within 4 hours of arrival at the Emergency Department to which they first presented'. ⋯ We identified numerous sources of delay, occurring at every point along the pathway, emphasising the complexity of providing acute integrated care. There was no single stage that persistently contributed to the delay in the patient pathway. The focus is now to achieve marginal gains in each area. Increased staff and resources to the front line are a clear solution but this is complex to achieve.
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Biclonal lymphoid disorders, when two distinct lymphoproliferative disorders (LPD) co-exist, are rare (incidence of 1.4%) and associated with a poor prognosis. NOTCH1 mutations occur in 10% of CLL at diagnosis, associated with a short disease-free interval and increased risk of Richter's transformation. We hypothesised that the incidence of NOTCH1 mutations in CLL with a second LPD may be increased, because the mutation occurs early in leukaemogenesis, permitting clonal divergence. ⋯ In conclusion, we identified a significant (52%) incidence of NOTCH1 mutations in CLL in the context of biclonal LPD, associated with an indolent clinical course.
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Despite the important role of some haematological parameters in tendency to thrombosis is known, their relationship with long-term stent thrombosis (ST) remains unclear. ⋯ We found that higher MPV/PC ratios were associated with long-term ST and mortality. The MPV/PC ratio may constitute both a rapid and an easily obtainable parameter for identifying reliably high-risk patients who have undergone pPCI.