English rule in Ireland, c.1272-c.1315 : aspects of royal and aristocratic lordship.

Available from British Library Document Supply Centre-DSC:DXN048700 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

A pilot cross-sectional study of patients presenting with cellulitis to emergency departments.

To characterise the Emergency Department (ED) prevalence of cellulitis, factors predicting oral antibiotic therapy and the utility of the Clinical Resource Efficiency Support Team (CREST) guideline in predicting patient management in the ED setting, a prospective, cross-sectional study of consecutive adult patients presenting to 3 Irish EDs was performed. The overall prevalence of cellulitis was 12 per 1,000 ED visits. Of 59 patients enrolled, 45.8% were discharged. Predictors of treatment with oral antibiotics were: CREST, Class 1 allocation (odds ratio (OR) 6.81, 95% Cl =1.5-30.1, p=0.012), patient self-referral (OR= 6.2, 95% Cl 1.9- 20.0, p=0.03) and symptom duration longer than 48 hours (OR 1.2, 95% Cl = 1.0-1.5,p=0.049). In conflict with guideline recommendation, 43% of patients in CREST Class 1 received IV therapy. Treatment with oral antibiotics was predicted by CREST Class 1 allocation, self-referral, symptom duration of more than 48 hours and absence of pre-EO antibiotic therapy

Luteal Support with very Low Daily Dose of Human Chorionic Gonadotropin after Fresh Embryo Transfer as an Alternative to Cycle Segmentation for High Responders Patients Undergoing Gonadotropin-Releasing Hormone Agonist-Triggered IVF

The segmentation of the in vitro fertilization (IVF) cycle, consisting of the freezing of all embryos and the postponement of embryo transfer (ET), has become popular in recent years, with the main purpose of preventing ovarian hyperstimulation syndrome (OHSS) in patients with high response to controlled ovarian stimulation (COS). Indeed cycle segmentation (CS), especially when coupled to a GnRH-agonist trigger, was shown to reduce the incidence of OHSS in high-risk patients. However, CS increases the economic costs and the work amount for IVF laboratories. An alternative strategy is to perform a fresh ET in association with intensive luteal phase pharmacological support, able to overcome the negative effects of the GnRH-agonist trigger on the luteal phase and on endometrial receptivity. In order to compare these two strategies, we performed a retrospective, real-life cohort study including 240 non-polycystic ovarian syndrome (PCO) women with expected high responsiveness to COS (AMH >2.5 ng/mL), who received either fresh ET plus 100 IU daily human chorionic gonadotropin (hCG) as luteal support (FRESH group, n = 133), or cycle segmentation with freezing of all embryos and postponed ET (CS group, n = 107). The primary outcomes were: implantation rate (IR), live birth rate (LBR) after the first ET, and incidence of OHSS. Overall, significantly higher IR and LBR were observed in the CS group than in the FRESH group (42.9% vs. 27.8%, p < 0.05 and 32.7% vs. 19.5%, p < 0.05, respectively); the superiority of CS strategy was particularly evident when 16–19 oocytes were retrieved (LBR 42.2% vs. 9.5%, p = 0.01). Mild OHSS appeared with the same incidence in the two groups, whereas moderate and severe OHSS forms were observed only in the FRESH group (1.5% and 0.8%, respectively). In conclusion, in non-PCO women, high responders submitted to COS with the GnRH-antagonist protocol and GnRH-agonist trigger, CS strategy was associated with higher IR and LBR than the strategy including fresh ET followed by luteal phase support with a low daily hCG dose. CS appears to be advisable, especially when >15 oocytes are retrieved

Comital Ireland, 1333–1534

The history of late-medieval Ireland is not exactly littered with dates that command general recognition, so it is surely suggestive that two which have achieved a degree of notoriety concern the fortunes, or rather misfortunes, of Ireland’s earls and earldoms: the murder of William Burgh, the ‘brown’ earl of Ulster, in 1333; and the rebellion in 1534 of Thomas Fitzgerald (‘Silken Thomas’), soon-to-be tenth earl of Kildare. These are dates of demarcation. In the broadest terms, 1333 has been understood to mark the end of the expansion of royal power under the Plantagenets, 1534 the start of its vigorous reassertion under the Tudors. What occurred between these chronological bookends? For Goddard Orpen (d. 1932), writing in 1920 when the Anglo-Irish tradition he cherished seemed imperilled by the prospect of Irish secession from the United Kingdom, the murder of the earl of Ulster in 1333 was a moment of dark, almost metonymic, significance: ‘the door was now closed on a century and a half of remarkable progress, vigour, and comparative order, and two centuries of retrogression, stagnation, and comparative anarchy were about to be ushered in’

Annual Report, 2009-2010

Beginning in 2004/2005- issued in online format onl

“Howya gettin’ on?” Investigating Public Transport Satisfaction Levels in Galway, Ireland

Public transport transforms urban communities and the lives of citizens living in them by stimulating economic growth, promoting sustainable lifestyles and providing a greater quality of life. Globally, the healthiest cities have one thing in common, a public and active transport network that does not depend on each person owning a personal motorised vehicle. Growing dependence on the automobile has created a multitude of problems, some of which public transport can help solve. Adverse social, environmental and health effects related to automobile emissions and car-dependency suggest that using public transport will result in a decrease in an individual&rsquo s carbon footprint, will lessen overall CO2 emissions, and will help to ease urban traffic congestion as well as encourage more effective and efficient land use. With many urban areas experiencing ongoing traffic problems, it is acknowledged that any sustainable long-term solution must entail a significant public transport element. The aim of this research study, conducted in November and December 2017, was to obtain essential baseline information on service user satisfaction levels with the existing public bus services in Galway City, Ireland. By measuring levels of satisfaction, it is possible to build our overall knowledge of the public transport network and thus identify improvements in the service that would lead to an increase in bus passenger numbers and result in reductions in the amount of cars on the roads. Results suggest deficiencies in public transport infrastructure, such as Dedicated Bus Lanes, and the lack of attention to customer services are hindering improvements in the public bus service. Document type: Articl

PROJECT MANAGEMENT IN INFORMATION SYSTEMS - ART, SCIENCE, OR MAGIC: Defining criteria for testing IS Project Ideas

It seems inevitable that sometimes projects will fail. Project management and project management methodologies exist to improve the likelihood of success, but delivering change in a dynamic environment is not without risk. Research says that a significant number of projects fail, particularly in information systems. It is recognised here that poor project management and/or methodology may not be the only causes when failure occurs. Areas outside the project control and even before project initiation could also be at fault, especially if it is based on a flawed concept. Is it possible that this may be the result of poor root cause analysis and an incorrect diagnosis of what the organisation needs to change? This goes beyond the requirements analysis, to the very beginning to the idea. In addition to the art of the project manager and the science of the project management methodology then, there is a third factor that should be recognised and analysed; the “magic” of the methodology used to generate the magic of the initial idea. Project management methodologies codify what is known about how to run a project; they provide governance and procedure. Talented project managers manage delivery of the plan whilst managing the attendant risks and issues. But the process seen as project management does not extend to include validation of the methodology applied to the idea behind the project. This paper speculates that the capability of the idea, measured in the rigour applied to the root cause analysis and the derivation of appropriate fix logic (the project mandate), is what needs to be tested by the application of a pre-project methodology

The Impacts of Health Care Reconfiguration on Patient Access to Services: A Case Study of Nenagh General Hospital

Access to health care is becoming a popular area of research in health geography especially in relation to service provision and policy planning. Since 2006, many changes to health policy have been made by the Irish government which have been both supported and opposed at a local level. The principal objective of this thesis was to account for the changes which have been made to acute care services in North Tipperary and look at how these changes have impacted the community in regards to access to care. Using both qualitative and quantitative methods in the form of interviews, questionnaires and already available hospital statistics, conclusions were drawn as to how access to care has changed especially from the perspective of the community and workers within the medical community. Two questionnaires, one for the general public and one for medical professionals, focused on access to health care in North Tipperary and the attitudes of the two groups towards centralisation of care. The interviews conducted with medical professionals also focused on access to health care and the recommendations that participants had for a safer service. The hospital statistics studied were for used for the purpose of contrasting case studies into how the local hospital in Co. Tipperary has changed since centralisation began. The results of this study revealed that the current reconfiguration process is not fully supported by either the public or medical personnel in Nenagh and Limerick and that the Health Service Executive reneged on their promise to work with the public and the health care providers to develop this new service and put support services in place at a local level. This has left the public and medical professionals regarding the health service in North Tipperary as unsafe and inaccessible and has resulted in extra pressure being put on ambulance personnel to provide high quality care to the patient- care which was once available to them at the local hospital