A Comparison of Total Food Intake at a Personalised Buffet in People with Obesity, before and 24 Months after Roux-en-Y-Gastric Bypass Surgery.

Long-term reductions in the quantity of food consumed, and a shift in intake away from energy dense foods have both been implicated in the potent bariatric effects of Roux-en-Y gastric bypass (RYGB) surgery. We hypothesised that relative to pre-operative assessment, a stereotypical shift to lower intake would be observed at a personalised buffet meal 24 months after RYGB, driven in part by decreased selection of high energy density items. At pre-operative baseline, participants ( = 14) rated their preference for 72 individual food items, each of these mapping to one of six categories encompassing high and low-fat choices in combination with sugar, complex carbohydrate or and protein.

Poor Sleep Associated with Clinically Severe Obesity Is Independent of OSA Status.

Purpose: Obesity has been reported to be associated with short sleep duration. It follows that patients with a BMI >35kg/m could be expected to have the poorest sleep. This poor sleep could be explained by the presence of obstructive sleep apnoea (OSA), although treatment with positive airway pressure (PAP) may modify this.

How Relevant Is Pre-operative Obstructive Sleep Apnoea in the Asymptomatic Bariatric Surgery Patient?

Introduction: The American Academy of Sleep Medicine recommends patients attending for bariatric surgery (BS) to be evaluated for obstructive sleep apnoea (OSA) as untreated OSA is associated with a greater risk of post-operative complications. Not all bariatric patients have symptoms of OSA and their phenotype may be at less risk than the typical sleep clinic phenotype. Therefore, all patients may not require pre-operative sleep studies.

How specialist palliative care nurses identify patients with existential distress and manage their needs.

Background: Existential distress is a term used when patients who are coming towards the end of their lives exhibit profound suffering, related particularly to their thoughts on life and existence. The clinical expression of this phenomenon has not been widely researched, and so specialist palliative care nurses were asked how they identify and manage this patient cohort.

Aims: To explore how palliative-care nurses identify patients with existential distress and manage their needs.

The long-term effects of bariatric surgery on female urinary incontinence.

Introduction: Obesity has been shown to negatively impact pelvic floor support and associated urinary incontinence (UI), however little is known regarding the long-term effect of bariatric surgery on urinary incontinence.

Objective: The aim of this study is to determine the impact of bariatric surgery on female UI at twelve months post-operatively.

Study Design: A prospective cohort study was performed of all patients undergoing bariatric surgery who reported UI between January 2008 to January 2017.

An evaluation of the appropriateness and effectiveness of structured reflection for midwifery students in Ireland.

Midwifery students undertaking the undergraduate midwifery education programme in Ireland participate in facilitated reflective sessions that aim to develop their skills of reflecting on and in clinical practice. This paper presents a qualitative evaluation of the appropriateness and effectiveness of the facilitated reflection sessions for pre and post-registration midwifery students in two large Dublin maternity teaching hospitals. The aim was to evaluate structured reflective practice sessions which sought to assist midwifery students to become competent reflective practitioners.

Metastatic lung cancer presenting as gastric outlet obstruction: diagnosis and management with laparoscopic gastric bypass: a novel technique.

Metastatic tumours of the duodenum are relatively rare. Here we present a case of a 64-year-old Caucasian male who presented with a 3-week history of postprandial vomiting, weight-loss and epigastric discomfort. Imaging and biopsy revealed that the patient had a primary lung tumour in his right upper lung lobe as well as a duodenal metastasis leading to gastric outlet obstruction (GOO).

Nurses' experiences of leech therapy in plastic and reconstructive surgery.

The aim of this study was to explore nurses' experience of using leech therapy. Leech therapy is useful in promoting revascularisation of skin grafts. Nurse disquiet in their role as leech therapists has been noted.

'Just waiting to be hauled over the coals': home birth midwifery in Ireland.

Objective: to describe the context of Irish home birth midwives' practise experience.

Design: ethnography derived from participant observation, unstructured interview and documentary analysis.

Setting: women and midwives' homes and meeting places in Ireland.

Educating advanced midwife practitioners: a collaborative venture.

Aim: To describe the collaborative development of an MSc course preparing Ireland's first advanced midwife practitioners.

Background: Ireland has 55 advanced nurse practitioner posts, but, as yet, no advanced midwife practitioners.

Methods: A consultative, collaborative process involving 38 midwives across Ireland generated the philosophy, aims and content of the course.

Evaluating maternity care: a core set of outcome measures.

Background: Comparing the relative effectiveness of interventions on specific outcomes across trials can be problematic due to differences in the choice and definitions of outcome measures used by researchers. We sought to identify a minimum set of outcome measures for evaluating models of maternity care from the perspective of key stakeholders.

Methods: A 3-round, electronic Delphi survey design was used.

Bacterial translocation may influence the long-term survival in colorectal cancer patients.

Purpose: The purpose of this study was to investigate the association of bacterial translocation with long-term disease-specific and disease-free survival in colorectal cancer patients.

Methods: This was a prospective cohort study in which 128 and 30 colorectal cancer patients undergoing curative and palliative resections, respectively, were recruited between 1992 and 1997. Samples of mesenteric lymph nodes were harvested for culture before administration of prophylactic antibiotics.

Splenic retrieval after laparoscopic splenectomy: a new bag.

Background: Laparoscopic splenectomy has become the gold-standard surgical approach for patients undergoing elective splenectomy. Little data exist concerning the technical difficulties of splenic retrieval. When the spleen is large, popular commercial retrieval bags are often too small to facilitate removal.

Preoperative prediction of long-term outcome following laparoscopic fundoplication.

Background: Although long-term outcomes following laparoscopic fundoplication for gastro-oesophageal disease have now been reported as very satisfactory, a small, but important, minority of patients are unhappy with the outcome, often due to recurrent reflux symptoms or new-onset dysphagia. In this study, we sought to establish whether various parameters that can be determined before surgery, can predict the long-term outcome of surgery.

Methods: Data collected prospectively were evaluated to determine factors that were associated with outcome at 5 years following laparoscopic fundoplication.

Division of short gastric vessels at laparoscopic nissen fundoplication: a prospective double-blind randomized trial with 5-year follow-up.

Objective: To determine whether division of the short gastric vessels at laparoscopic fundoplication confers long-term clinical benefit to patients.

Summary Background Data: Dividing the short gastric vessels during surgery for gastroesophageal reflux is controversial. This prospective randomized study was designed to determine whether there is a benefit in terms of patient outcome at a minimum of 5 years after primary surgery.