Towards understanding the nature and need of delirium guidelines across nations and cultures.

Background: Delirium is associated with a variety of adverse healthcare outcomes but is highly predictable, preventable and treatable. For this reason, numerous guidelines have been developed for delirium recognition, prevention and management across different countries and disciplines. Although research is adduced as evidence for these guidelines, a constant finding is the lack of implementation if they exist at all.

A comparison of undergraduate teaching of psychiatry across medical schools in the Republic of Ireland.

Objectives: To examine the delivery and assessment of psychiatry at undergraduate level in the six medical schools in the Republic of Ireland offering a medical degree programme.

Methods: A narrative description of the delivery and assessment of psychiatry at undergraduate level by collaborative senior faculty members from all six universities in Ireland.

Results: Psychiatry is integrated to varying degrees across all medical schools.

The relationship among frailty, delirium and attentional tests to detect delirium: a cohort study.

Background: Few studies explored if frailty predisposes to delirium in hospitalized older patients. The aims of this study were to evaluate if frailty: 1) is independently associated with delirium, and 2) affects the patient's performance in three tests of attention used to detect delirium.

Methods: Data are from a prospective cohort study of patients admitted to an Acute Geriatric Unit (AGU).

Incidence of Thyroid Cancer among Patients with Thyroid Nodules.

Aim To evaluate thyroid nodules and to determine the incidence of thyroid cancer. Methods This retrospective cohort study collected data from ten patients who presented with thyroid nodules to Barrington’s Hospital Limerick. Ultrasound/FNA results of thyroid nodules were used to measure the incidence of thyroid cancer.

Effect of exercise modality on markers of insulin sensitivity and blood glucose control in pregnancies complicated with gestational diabetes mellitus: a systematic review.

Background/aim: Exercise can be used as a strategy to attenuate hyperglycaemia experienced during gestational diabetes mellitus (GDM). To maximize its use for clinical management, the most effective modality should be identified. The purpose of this review is to elucidate the most effective modality of exercise on insulin sensitivity and blood glucose control in pregnant women with or at risk of GDM.

Motor Disturbances in Elderly Medical Inpatients and Their Relationship to Delirium.

Motor disturbances in delirious patients are common, but their relationship to cognition and severity of illness has not been studied. We examined motor subtypes in an older age inpatient population, their relationship to clinical variables including delirium, and their association with 1-year mortality in a prospective study, using the Confusion Assessment Method, Acute Physiology and Chronic Health Evaluation II, Montreal Cognitive Assessment (MoCA), Barthel Index, and Delirium Rating Scale-Revised 98 (DRS-R98). Motor subtypes were evaluated using 2 items of DRS-R98.

Persistent and recurrent hyperparathyroidism.

Despite remarkable progress in imaging modalities and surgical management, persistence or recurrence of primary hyperparathyroidism (PHPT) still occurs in 2.5-5% of cases of PHPT. The aim of this review is to expose the management of persistent and recurrent hyperparathyroidism.

The impact of the Biomolecular Era on breast cancer surgery.

Surgery has always played a central role in the management of breast cancer, with local control via complete tumour resection long established as the cornerstone of effective breast cancer therapy. While extensive surgical resection in the form of the Halstead radical mastectomy dominated treatment up until at least the 1970s, the advent of adjuvant loco-regional and systemic therapies has resulted in a decrease in the magnitude of surgical intervention in recent decades. The Biomolecular or "-omics" era initiated with the discovery of the DNA double helix in 1953 and intensified by the completion of the human genome project in 2003 has seen an unprecedented expansion in our understanding of the molecular and genetic heterogeneity of cancer.

A systematic review and meta-analysis of the association between the apolipoprotein E genotype and delirium.

The role of apolipoprotein E (APOE) in Alzheimer's disease and other dementias has been investigated intensively. However, the relationship between APOE and delirium has only recently been explored in studies that have included relatively small samples. A meta-analysis of the published pooled data is timely to explore the relationship between APOE and delirium and to inform further research in this topic.

The utility of the clock drawing test in detection of delirium in elderly hospitalised patients.

Objectives: Delirium is common neuropsychiatric condition among elderly inpatients. The clock drawing test (CDT) has been used widely as bedside screening tool in assessing cognitive impairment in elderly people. Previous studies which evaluate its usefulness in delirium reported conflicting results.

A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria.

Background: The recently published DSM-5 criteria for delirium may lead to different case identification and rates of delirium than previous classifications. The aims of this study are to determine how the new DSM-5 criteria compare with DSM-IV in identification of delirium in elderly medical inpatients and to investigate the agreement between different methods, using CAM, DRS-R98, DSM-IV, and DSM-5 criteria.

Methods: Prospective, observational study of elderly patients aged 70+ admitted under the acute medical teams in a regional general hospital.

Integrating postgraduate and undergraduate general practice education: qualitative study.

Background: Educational activity in general practice has increased considerably in the past 20 years. Vertical integration, whereby practices support students and trainees at different stages, may enhance general practices' capacity to fulfil this role.

Aims: To explore the potential for vertical integration in undergraduate and postgraduate education in general practice, by describing the experience of (and attitudes towards) 'vertical integration in general practice education' among key stakeholder groups.