5 results on '"O'Mahony, Deirdre"'
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2. Antibiotics administered as continuous intravenous infusion over 24 hours by elastomeric devices to patients treated at home: a study of infusion efficiency.
- Author
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Docherty, Toni, David, Michael, Schneider, Jennifer, O'Kane, Gabrielle, Morris, Joni, Paavola, Catherine, Sawers, Janelle, O'Mahony, Deirdre, and Cooper, Joyce
- Abstract
Background: Elastomeric infusion devices or 'Infusors' are commonly used to administer 24‐h continuous intravenous infusions to hospital patients at home, a service which can increase hospital capacity. Aim: This study sought to determine Infusor efficiency by measuring infusion lengths administered by Infusors to patients in the community setting and reviewing any impacting factors on varying infusion rates, if observed. Method: Patients and nurses completed data collection forms daily over a 12‐month period. The following information was recorded: time Infusor attached to patient, time Infusor emptied, Infusor 'empty' or 'not empty' when removed, volume of antibiotic solution remaining, Infusor storage details, antibiotic solution and dose, indication for treatment, and date (season). Statistical analyses was conducted using Stata. Data were analysed using descriptive statistics, including median and range for continuous variables, and frequency counts and percentages for categorical variables. Ethical approval was granted by Northern Sydney Local Health District (NSLHD) Research Office (Reference no: RESP/14/184), the Human Research Ethics Committee (HREC) (Reference no: LNR/14/HAWKE/265) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained from all participants via a study information leaflet that was provided with the patient questionnaire and patients were informed that their participation in the study was optional. Patients indicated their consent by completing the data collection form for each day of treatment. Results: A significant number of Infusors (27%) emptied outside the expected infusion duration of 24 h ± 10% (21.6–26.4 h) and Infusors were removed 'not empty' when the nurse visited >24 h on 35% of occasions. Infusors were more likely to empty >24 h if they contained piperacillin‐tazobactam 13.5 g (predicted probability = 1.0), in winter (predicted probability = 0.83), and in cooler overnight storage locations (predicted probability = 0.64). Infusors were more likely to empty <24 h if they contained vancomycin (predicted probability = 0.12). Conclusion: Infusors delivering 24‐h continuous intravenous infusions in the home setting may empty at unpredictable times and may be affected by temperature or solutions with varying doses. Outpatient parenteral antimicrobial therapy clinicians should be aware of possible unfinished infusions from Infusors. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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3. ASCO Domestic Quality Programs.
- Author
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Makhoul I, Power S, Smith C, Niece T, and O'Mahony D
- Subjects
- Humans, Neoplasms therapy, Quality of Health Care standards, Medical Oncology standards, Societies, Medical standards
- Abstract
A growing sense of the need to define good-quality cancer care has emerged in the past decade of the 20th century. The goals were to assess, improve, and reward quality. Animated debates between cancer care delivery academic and community organizations, governmental agencies, and insurance companies have led to multiple initiatives and pilot projects. ASCO was on the cutting edge of quality in oncology movement. We can define three phases, overlapping rather than sequential, in ASCO's journey. The first phase was generating definitions of good-quality care characterized by the publication of ASCO guidelines. The second phase was the creation of the tools to measure the implementation of standards of care with the creation of the Quality Oncology Practice Initiative (QOPI). The third phase was the launch of a comprehensive approach to cancer care quality as illustrated by QOPI Certification, then the more complete iteration, ASCO Certified Program. The latter is the most elaborate program to define quality from the patient and health care providers' perspective on one hand and governmental agencies and insurance providers' perspective on the other. Since the publication of the Ensuring Quality Cancer Care Report in 1998 to the ASCO Certified in 2023, a quarter century has elapsed. ASCO did not operate in a vacuum. Through collaborative efforts, reacting to and interacting with various players, it has advocated for positive change. During this period, ASCO has led the movement of quality in oncology intelligently and with the upmost sense of responsibility toward the patients, health care professionals, and society at large. While many of these efforts began domestically, their reach is extending globally through research, education, and the promotion of equitable care.
- Published
- 2024
- Full Text
- View/download PDF
4. Risk Stratification Tools to Aid Decisions on Adjuvant Chemotherapy Usage in Resected Soft Tissue Sarcomas: A Ten-Year Review of an Irish Sarcoma Center Experience.
- Author
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Weadick CS, Goggin C, Keogh RJ, Murphy JF, Feeley L, Bennett MW, O'Reilly S, Redmond HP, Kelly J, O'Mahony D, Noonan S, Clover AJP, and Bambury RM
- Abstract
Background: Soft tissue sarcoma (STS) is comprised of approximately 80 subtypes, with an incidence of 4 - 5 per 100,000 annually in Europe. The National Comprehensive Cancer Network (NCCN) guidelines recommend consideration of neoadjuvant/adjuvant chemotherapy in tumors at high risk of recurrence based on the American Joint Committee on Cancer (AJCC) staging. Alternatively, the Sarculator is a risk prediction tool that has identified a threshold of risk, above which chemotherapy may provide an overall survival (OS) benefit. Using this nomogram, patients with a 10-year predicted OS < 60% are classified as high risk and should be considered for chemotherapy. The aim of this study was to assess the prognostic accuracy of these two risk prediction methods in an Irish population., Methods: All newly diagnosed patients with resected STS discussed in the STS tumor board in Cork University Hospital between January 2012 and December 2021 were identified. Clinicopathological data were collected. Risk assessment using AJCC and Sarculator nomogram was performed on all patients with an extremity/trunk sarcoma. The OS was calculated including Kaplan-Meier method for time to event analysis., Results: In total, 200 STS patients were reviewed, of whom 134 had truncal or extremity tumors. Sarculator score was calculated for 60 of these (well differentiated liposarcomas, desmoid tumors and dermatofibrosarcoma protuberans were excluded). Using the Sarculator nomogram to calculate 10-year predicted OS, 19 patients were categorized as high risk and 41 were categorized as low risk. Using AJCC staging, 25 patients were categorized as high risk and 35 as low risk. The 5-year OS rate in the Sarculator high-risk group was 60.2%, compared with 87.1% in the low-risk group (P = 0.009). The 5-year OS rate in the AJCC high-risk group was 67.6%, compared with 86.3% in the low-risk group (P = 0.083)., Conclusions: Our cohort is representative of the broad histological subtypes expected. In our population, Sarculator score results correlate with international outcomes and higher scores were associated with increased mortality. The Sarculator was more predictive of clinical outcome than AJCC staging, and its use would lower the proportion of patients being considered for adjuvant chemotherapy thereby sparing toxicity, which is important in the setting of uncertain clinical benefit., Competing Interests: The authors declare no conflict of interest., (Copyright 2024, Weadick et al.)
- Published
- 2024
- Full Text
- View/download PDF
5. Impact of Medical Oncology-Focused Quality Programs on Cancer Care Around the World.
- Author
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O'Mahony D, Pinto CF, Orem J, Mcleod M, Aggarwal A, and Gralow JR
- Subjects
- Humans, Delivery of Health Care standards, Global Health, Medical Oncology standards, Neoplasms therapy, Quality of Health Care
- Abstract
Quality cancer care is efficient, accessible, coordinated, and evidence-based. Recognizing the necessary key components, development of pathways and guidelines to incorporate these key domains, and finally respectful adaptation to cultural differences can ensure that cancer care globally is of the highest quality. This quality care should be judged not only on how it optimizes health outcomes for patients, but also its impact on the care providers and the global community.
- Published
- 2024
- Full Text
- View/download PDF
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