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Conlin M, McLaren D, Spelten E, MacDermott S. Cultivating participatory approaches in health promotion planning, delivery, and evaluation: A case study of an academic-health service partnership in rural Victoria. Health Promot J Austr 2023. [PMID: 37816340 DOI: 10.1002/hpja.818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/12/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
ISSUE ADDRESSED Community participation in planning, delivery, and evaluation of health promotion (HP) programs is a poorly explored topic. However, this approach has the potential to improve health outcomes and reduce health inequities, particularly for residents of rural and remote areas. METHODS This case study describes the outputs of an academic-health service partnership in rural Victoria. The collaboration has led to the implementation and ongoing evaluation of a microgrant program for HP which integrates community participation principles in the foundations of the program and its evaluation. RESULTS To date, 10 funded projects have been brought to completion, with COVID-19 having disturbed both grant distribution and funded activity implementation. Semi-structured interviews with health service officers served to clarify conceptualisation and operationalization of HP principles. Focus groups with health service management and officers contributed to building an overarching evaluation framework for the HP team's activities. Finally, the specific methodological evaluation framework for the microgrant program was developed through a collaborative workshop with the HP team and grantees. CONCLUSIONS Fostering community participation in HP planning, delivery, and evaluation, especially in rural areas, is feasible as evidenced by the experience described in this case study. The forthcoming evaluation results will help clarify the impact of community participation on health-related outcomes. SO WHAT?: Documentation and dissemination of processes used to increase community participation in HP programs is essential to grow the knowledge base around what works and what doesn't, and for whom.
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Affiliation(s)
- Michèle Conlin
- La Trobe Rural Health School, La Trobe University, Mildura, Victoria, Australia
| | | | - Evelien Spelten
- La Trobe Rural Health School, La Trobe University, Mildura, Victoria, Australia
| | - Sean MacDermott
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Mildura, Victoria, Australia
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MacDermott S, Sutton K, Motorniak D, Bredhauer J, Wright F, Whyte M, van Vuuren J, Spelten E. Suicide-related crisis presentations to a rural emergency department: A retrospective cohort study. Australas Psychiatry 2023; 31:13-18. [PMID: 35138960 DOI: 10.1177/10398562211067195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The study sought to investigate the profile and characteristics of suicide-related crisis presentations and factors associated with repeat presentations to a rural hospital Emergency Department (ED). METHOD This retrospective cohort study examined suicide-related crisis presentation data from a rural ED for the years 2008-2018 inclusive. Descriptive statistical analyses included demographic characteristics and trends over time. Factors associated with increased likelihood to re-present to the ED for suicide-related crisis were identified using Odds Ratio analyses. RESULTS First Nations People, adolescents and young adults were at increased risk of presentation. Suicidal crisis presentations had increased well beyond that which might be accorded to the catchment's population increase and almost a third of presentations involved individuals re-presenting in suicide-related crisis. Repeat presentation was positively associated with younger age, less acute triage category, discharge to the community and leaving the ED before/during treatment. CONCLUSIONS This study illustrates the importance of flagging, follow-up and support of rural repeat presenters to reduce further suicidal behaviours and presentation. Findings support the need for culturally safe and appropriate interventions and follow-up services. It is recommended to extend approach this to non-ED settings.
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Affiliation(s)
- Sean MacDermott
- La Trobe Rural Health School, 2080La Trobe University, Melbourne, VIC, Australia
| | - Keith Sutton
- School of Rural Health, 22457Monash University, Moe, VIC, Australia
| | - David Motorniak
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, 22457Monash University, Clayton, VIC, Australia
| | - Jacqueline Bredhauer
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, 22457Monash University, Clayton, VIC, Australia
| | - Fiona Wright
- Faculty of Medicine, Nursing and Health Sciences, School of Rural Health, 22457Monash University, Clayton, VIC, Australia
| | | | - Julia van Vuuren
- La Trobe Rural Health School, 2080La Trobe University, Melbourne, VIC, Australia
| | - Evelien Spelten
- La Trobe Rural Health School, 2080La Trobe University, Melbourne, VIC, Australia
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Spelten ER, MacDermott S, Morgan S, Mitchell L, van Vuuren J. Palliative Care in Rural Aboriginal Communities: Conversations Around Experiences and Needs. J Hosp Palliat Nurs 2021; 23:579-583. [PMID: 34508018 DOI: 10.1097/njh.0000000000000801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the experiences and needs of Aboriginal community members with regard to rural community-based palliative care. Conversations with Aboriginal Elders were conducted. (In this Aboriginal community, Elders was not confined to older age. It referred to community leaders and includes [younger] emerging leaders.) The results were analyzed using descriptive analysis. Our study showed that there was a general lack of understanding of palliative care as distinct from curative care and limited awareness of services available. There was a strong need for clear information and on-call and practical support. Some concerns were expressed regarding limited awareness among health care providers of specific cultural needs. However, the home-based nature of palliative care was not, in itself, perceived as a barrier, provided that appropriate respect was displayed. We concluded that the current lack of understanding and awareness of services still impedes access to, and utilization of, care. More attention is needed for specific cultural needs. Adoption of a cultural humility approach for the promotion and delivery of palliative care seems to best fit the expressed needs and experiences of the participants.
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O'Neill S, Van Vuuren J, Begg S, MacDermott S, MacDonald J, Spelten E. Audiologists' perspective on the treatment of ear-related ear, nose, and throat conditions in rural Victoria. Aust J Rural Health 2021; 29:972-980. [PMID: 34757662 DOI: 10.1111/ajr.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 09/04/2021] [Accepted: 09/13/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To understand the experience of audiologists in managing and treating ear-related ear, nose and throat conditions in rural areas, and to identify the compounding factors that influence patient outcomes and potential targets for intervention. DESIGN A focus group was conducted using a qualitative descriptive approach. Responses were audio-recorded, transcribed and thematically analysed. SETTING The focus group was conducted in the rural town of Mildura in the state of Victoria, Australia. PARTICIPANTS A sample of 19 audiologists from Victoria participated, of which 14 were rurally based and 5 were metropolitan-based. The length of participants' professional experience ranged from 1 to 43 years. RESULTS Long wait lists, and a lack of locally based ear, nose and throat surgeons were identified as barriers to the treatment of ear-related ear, nose and throat conditions. Open communication between health services and efficient care for time-sensitive conditions were seen as outcomes of good practice. Hand hygiene, nose-blowing, reducing tobacco smoke exposure and promoting the use of noise protective equipment were the 4 community health campaigns mentioned to support ear care for those residing in rural areas. Additional themes of ear conditions, treatment, management and primary health care were identified. CONCLUSION Improving referral pathways for the treatment of ear-related ear, nose and throat conditions, and providing education about ear, nose and throat assessment and treatment in primary health care settings could increase appropriate referrals, improve patient outcomes and reduce wait periods for treatment.
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Affiliation(s)
- Susan O'Neill
- LaTrobe Rural Health School, LaTrobe Univeristy, Mildura, VIC, Australia
| | - Julia Van Vuuren
- LaTrobe Rural Health School, LaTrobe Univeristy, Mildura, VIC, Australia
| | - Stephen Begg
- LaTrobe Rural Health School, LaTrobe Univeristy, Mildura, VIC, Australia
| | - Sean MacDermott
- LaTrobe Rural Health School, LaTrobe Univeristy, Mildura, VIC, Australia
| | | | - Evelien Spelten
- LaTrobe Rural Health School, LaTrobe Univeristy, Mildura, VIC, Australia
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Kelly WB, MacDermott S, Spelten E. A seat at the table: Regional, rural and remote health research and impact. Aust J Rural Health 2021; 29:1002-1007. [PMID: 34658082 DOI: 10.1111/ajr.12802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS Across higher education, systems and policies explicitly address the impact of research. This paper contributes to the impact and engagement discussion from a regional, rural and remote perspective. We focus on how impact and engagement fit with regional, rural and remote research and explore strategies that can be employed to enhance impact and engagement in a rural health research context. CONTEXT The impact agenda in Australia is a response to a worldwide call for demonstrable change or potential for change resulting from university research. As funding models evolve to integrate impact, there are increased pressures for universities and academics to plan for, evidence and report on it. The current lack of focus on impact in regional, rural and remote research may further disadvantage regional, rural and remote researchers' prospects for career progression and funding opportunities. APPROACH Ignoring or avoiding impact will marginalise rural researchers and research. We discuss the definitions of impact and engagement as they apply to rural research and argue that engagement and impact must be commensurate with employment conditions. To platform regional, rural and remote impact, we provide strategies to assist researchers and administrators in building impact and engagement into their research and academic culture. CONCLUSION The message to researchers is that impact is here to stay. The high levels of rural engagement can lead to impact, but we need to be clever at providing clear evidence to make that visible.
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Affiliation(s)
| | - Sean MacDermott
- La Trobe University Rural Health School, Mildura, VIC, Australia
| | - Evelien Spelten
- La Trobe University Rural Health School, Mildura, VIC, Australia
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van Vuuren J, Thomas B, Agarwal G, MacDermott S, Kinsman L, O'Meara P, Spelten E. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv Res 2021; 21:29. [PMID: 33407406 PMCID: PMC7789625 DOI: 10.1186/s12913-020-06037-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Background Healthcare systems are overloaded and changing. In response to growing demands on the healthcare systems, new models of healthcare delivery are emerging. Community paramedicine is a novel approach in which paramedics use their knowledge and skills beyond emergency health response to contribute to preventative and rehabilitative health. In our systematic review, we aimed to identify evidence of the community paramedicine role in care delivery for elderly patients, with an additional focus on palliative care, and the possible impact of this role on the wider healthcare system. Methods A systematic review of peer-reviewed literature from MEDLINE, Embase, CINAHL, and Web of Sciences was undertaken to identify relevant full-text articles in English published until October 3, 2019. Additional inclusion criteria were studies focussing on extended care paramedics or community paramedics caring for elderly patients. Case studies were excluded. All papers were screened by at least two authors and underwent a quality assessment, using the Joanna Briggs Institute appraisal checklists for cross sectional, qualitative, cohort, and randomised controlled trial studies to assess the methodological quality of the articles. A process of narrative synthesis was used to summarise the data. Results Ten studies, across 13 articles, provided clear evidence that Community Paramedic programs had a positive impact on the health of patients and on the wider healthcare system. The role of a Community Paramedic was often a combination of four aspects: assessment, referral, education and communication. Limited evidence was available on the involvement of Community Paramedics in palliative and end-of-life care and in care delivery in residential aged care facilities. Observed challenges were a lack of additional training, and the need for proper integration and understanding of their role in the healthcare system. Conclusions The use of community paramedics in care delivery could be beneficial to both patients’ health and the wider healthcare system. They already play a promising role in improving the care of our elderly population. With consistent adherence to the training curriculum and effective integration within the wider healthcare system, community paramedics have the potential to take on specialised roles in residential aged care facilities and palliative and end-of-life care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-06037-0.
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Affiliation(s)
- Julia van Vuuren
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia.
| | - Brodie Thomas
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sean MacDermott
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Leigh Kinsman
- University of Newcastle and Mid-North Coast Local Health District, Port Macquarie Base Hospital, Port Macquarie, Australia
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Peninsula Campus, Melbourne, Australia
| | - Evelien Spelten
- Department of Community Health, Rural Health School, La Trobe University, Melbourne, Australia
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Maher N, O'Riordan T, Gerlitz H, MacDermott S, Loughrey S. Are nursing home residents on enteral feeding in north dublin receiving adequate vitamin d during the covid-19 pandemic? Clin Nutr ESPEN 2020. [PMCID: PMC7831976 DOI: 10.1016/j.clnesp.2020.09.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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O’Riordan T, Maher N, Gerlitz H, MacDermott S, Hayden L, Loughrey S. Exploring the advanced practice role of the Home Enteral Feeding Dietitian. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spelten ER, Geerse O, Vuuren J, Timmis J, Blanch B, Duijts S, MacDermott S. Factors influencing the engagement of cancer patients with advance care planning: A scoping review. Eur J Cancer Care (Engl) 2019; 28:e13091. [DOI: 10.1111/ecc.13091] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/11/2019] [Accepted: 04/17/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Evelien R. Spelten
- Department of Psychology and Public Health Rural Health School, La Trobe University Melbourne Victoria Australia
| | - Olaf Geerse
- Department of General Practice and Elderly Care Medicine University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Pulmonary Diseases University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Julia Vuuren
- Department of Psychology and Public Health Rural Health School, La Trobe University Melbourne Victoria Australia
| | - Jennifer Timmis
- School of Rural Health Monash University Mildura Victoria Australia
| | - Bev Blanch
- Department of Rural Nursing and Midwifery Rural Health School, La Trobe University Melbourne Victoria Australia
| | - Saskia Duijts
- Department of General Practice and Elderly Care Medicine University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Sean MacDermott
- Rural Department of Community Health Rural Health School, La Trobe University Melbourne Victoria Australia
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Yates M, Watts JJ, Bail K, Mohebbi M, MacDermott S, Jebramek JC, Brodaty H. Evaluating the Impact of the Dementia Care in Hospitals Program (DCHP) on Hospital-Acquired Complications: Study Protocol. Int J Environ Res Public Health 2018; 15:E1878. [PMID: 30720792 PMCID: PMC6165270 DOI: 10.3390/ijerph15091878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 12/03/2022]
Abstract
Despite the increasing number of older people, many with cognitive impairment (CI), in hospitals, there is yet to be an evaluation of hospital-wide interventions improving the management of those with CI. In hospitalized patients with CI, there are likely to be associations between increased complications that impact on outcomes, length of stay, and costs. This prospective study will evaluate the effectiveness of an established hospital CI support program on patient outcomes, patient quality of life, staff awareness of CI, and carer satisfaction. Using a stepped-wedge, continuous-recruitment method, the pre-intervention patient data will provide the control data for usual hospital care. The intervention, the Dementia Care in Hospitals Program, provides hospital-wide CI awareness and support education, and screening for all patients aged 65+, along with a bedside alert, the Cognitive Impairment Identifier. The primary outcome is a reduction in hospital-acquired complications: urinary tract infections, pressure injuries, pneumonia and delirium. Secondary outcome measures include cost effectiveness, patient quality of life, carer satisfaction, staff awareness of CI, and staff perceived impact of care. This large-sample study across four sites offers an opportunity for research evaluation of health service functioning at a whole-of-hospital level, which is important for sustainable change in hospital practice.
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Affiliation(s)
- Mark Yates
- Ballarat Health Services, Deakin University, Faculty of Health, School of Medicine, Ballarat, VIC 3350, Australia.
- School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Jennifer J Watts
- Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia.
| | - Kasia Bail
- Health Research Institute and Synergy Nursing and Midwifery Research Centre, University of Canberra, Canberra, ACT 2617, Australia.
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia.
| | - Sean MacDermott
- La Trobe University, School of Rural Health, Mildura, VIC 3520, Australia.
| | | | - Henry Brodaty
- Centre for Healthy Brain Ageing, Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
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Garner S, van Dreven A, MacDermott S, Yates M. Assessment and recency drive skill acquisition. Clin Teach 2018; 16:232-235. [PMID: 30125464 DOI: 10.1111/tct.12916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The assessment of medical students' clinical skill acquisition is variable and is driven by differences in curricula and health services requirements. This project aimed to ascertain whether different assessment models impact on students' performance of as intravenous (i.v.) cannulation. Recency of practice was also explored as a factor influencing performance. METHODS A total of 137 students in the first clinical year (years 2 or 3 of a 4-year course) of their medical degree, from four regional clinical schools, participated in a multiple-station mock objective structured clinical examination (MOSCE). Intravenous cannulation was one of the stations examined. Fifty-nine students came from a model that required the assessment of i.v. proficiency during their clinical year (model 1). Seventy-eight students came from a model that required no assessment of i.v. proficiency (model 2). Students reported their most recent clinical i.v. cannulation experience relative to the MOSCE. RESULTS The MOSCE pass rate of 73% for students in model 1 was significantly higher than the corresponding MOSCE pass rate of 45% for students in model 2. There was a highly significant association between assessment model and MOSCE pass/fail rate. The assessment model was also highly associated with recency of practice. The assessment of medical students' clinical skill acquisition is variable CONCLUSIONS: The results support an assessment model that promotes the continuing clinical practice of i.v. cannulation. Integration of this model will require innovative approaches by staff and collaboration with affiliated organisations.
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Affiliation(s)
- Sue Garner
- Ballarat Clinical School, School of Medicine, Deakin University, Ballarat, Victoria, Australia
| | - Amber van Dreven
- Ballarat Clinical School, School of Medicine, Deakin University, Ballarat, Victoria, Australia
| | - Sean MacDermott
- Ballarat Clinical School, School of Medicine, Deakin University, Ballarat, Victoria, Australia
| | - Mark Yates
- Ballarat Clinical School, School of Medicine, Deakin University, Ballarat, Victoria, Australia
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Affiliation(s)
- A Chakravarti
- Departments of Urology and Histopathology, Torbay Hospital, Torquay, UK
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Abstract
OBJECTIVE To assess the safety of transurethral prostatectomy (TURP) in patients on long-term full anticoagulation. PATIENTS AND METHODS Twelve TURPs were performed on 11 patients with urinary retention or severe symptoms from prostatic obstruction who also required anticoagulation for a history of life-threatening thromboembolic disease (seven) or prosthetic heart valves (four). Patients stopped taking warfarin 3 days before surgery; on admission a day later, full intravenous heparinization was commenced. Heparin was stopped 4 h before TURP and re-commenced with an initial bolus in the recovery room, and warfarin re-started that evening. RESULTS The mean weight of prostate resected was 23 g and the mean peri-operative decrease in haemoglobin was 1.6 g/dL. Only one patient required a transfusion of 3 units, but the activated partial thromboplastin time (APTT) had risen to >4. The mean pre- and post-operative APTT were 1.7 and 2.64, respectively, and the mean total length of hospital stay 6.7 days. Three patients were re-admitted for secondary haemorrhage at 8, 9 and 28 days after TURP, but all resolved with catheterization for 24 h only. There were no other major complications or thrombo-embolic phenomena. CONCLUSION TURP can be conducted safely in this high-risk group of patients with a regimen that allows a brief but controlled interruption to their full anticoagulation. This protects from the risks of thromboembolic incidents with no major increase in haemorrhage or hospital stay.
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Bradbrook RA, Kirollos MM, MacDermott S. Irrigating fluids in endoscopic surgery: why glycine! Br J Urol 1998; 81:654-5. [PMID: 9598660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Regan P, MacDermott S, Flynn J, Given HF. Septic complications following cholecystectomies. Ir Med J 1985; 78:13-4. [PMID: 3972543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Discriminant function analysis was used to determine the optimum combination of haematological and biochemical tests which gave the best discrimination between hospital patients with high and low alcohol intakes. We studied 265 patients with alcohol-related disease, 133 gastroenterology outpatients drinking less than 20 g of alcohol per day, and 104 patients with a variety of non-alcoholic liver disease. Values of mean cell volume (MCV), serum bilirubin, aspartate transaminase, serum alkaline phosphatase (AP) and gamma glutamyl transferase (gamma GT), serum albumin, serum globulin, and uric acid were determined in each patient. The best discrimination between the three groups of patients was provided by a combination of mean corpuscular volume, log10 gamma GT, and log10 serum alkaline phosphatase. In women, 92% of the high alcohol group, 100% of the low alcohol group, and 87% of the non-alcoholic liver disease were correctly allocated by the discriminant analysis. The corresponding figures for the men were 80%, 100%, and 71%. Thus, over 80% of patients with excessive alcohol intake were correctly allocated by the use of three simple laboratory tests.
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