Tuesday 31 March 2015

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Fitness linked to lower cancer risk

Very fit men in their late 40s are less likely to get lung cancer and colorectal cancer than unfit men, a study in JAMA Oncology suggests.  Their high fitness levels also appear to increase their chances of surviving cancer if they are diagnosed later on.
University of Vermont researchers said even small improvements in fitness could help to reduce cancer risk.
Cancer Research UK said investigating links between men's fitness levels and cancer risk was a new approachBeing physically active and eating a healthy, balanced diet are already known to be important factors in reducing people's risk of developing cancer and other diseases.
But study author Dr Susan Lakoski said it would be more beneficial to tell people how much they needed to improve their fitness in order to reduce their risk of cancer to acceptable levels.
This could come in the form of a personalised plan, which should start with measuring their cardio-respiratory fitness.
This study of 14,000 men aged between 46 and 50, in Texas, tested their cardio-respiratory fitness levels at the outset by making them run on a treadmill to the point of exhaustion.
After that, their fitness levels were regularly tested over an average of six and a half years between 1971 and 2009.
Between 1999 and 2009, 1,310 of the men had been diagnosed with prostate cancer, 200 with lung cancer and 181 with colorectal cancer.
The study found that the men with high levels of fitness in middle-age reduced their risk of lung cancer by 55% and their risk of colorectal cancer by 44%, compared with the men with low levels of fitness - those who took more than 12 minutes to run or walk a mile.

Wednesday 25 March 2015

Study on Sleep Duration and Mortality

We all know that getting too little sleep is bad. You feel tired, you may be irritable, and it can contribute to obesity, high blood pressure, diabetes, and heart disease, doctors say. But too much sleep? You don't often hear people complaining about it.
However, research carried out over the past 10 years appears to show that adults who usually sleep for less than six hours or more than eight, are at risk of dying earlier than those who sleep for between six and eight hours.
To put it more scientifically, there is a gradual increase in mortality risk for those who fall outside the six-to-eight-hour band.
Prof Franco Cappuccio, professor of cardiovascular medicine and epidemiology at the University of Warwick, has analysed 16 studies, in which overall more than a million people were asked about their sleeping habits and then followed up over time.
His analysis showed that 12% more of the short sleepers had died when they were followed up, compared to the medium sleepers.
However, 30% more of the long sleepers had died, compared to the medium sleepers. Cappuccio was aware of the possibility that people sleeping too long might be depressed, or might be using sleeping pills. He corrected for this, though, and found the association was still there.
His own theory is that people who sleep for more than eight hours sometimes have an underlying health problem that is not yet showing in other symptoms.

So, it's not the long sleep that is causing the increased mortality risk, it's the hidden illness.

Thursday 19 March 2015

RCSI study: Do flip-flops increase the risk of tripping?

Flip-flops really do increase the risk of tripping, the results of a fresh study have confirmed.

Three researchers from the RCSI’s School of Medicine, the Gait Laboratory, Central Remedial Clinic (CRC), in Clontarf, and the School of Physiotherapy set out to answer the question ‘Do flip-flops increase the risk of tripping when walking?’
“From our research, we concluded that the required increase in knee flexion and ankle dorsiflexion, along with the sizeable difference between barefoot and flip-flops in ground clearance, may increase the risk of tripping during walking in flip-flops, compared to bare feet,” they determined.
Fifteen healthy participants between the ages of 17 and 75 years with no history of gait pathology were recruited for the research that took place in the Gait Laboratory of the CRC.
Light-emitting diode markers were placed on the hallux, base of the fifth metatarsal and heel of each foot, as well as the ankle and knee joints.
Plastic wands were then attached to the shanks, thighs and hips, to define the planes of movement along the lower limbs, with additional markers attached to corresponding locations on the slippers.
Each participant made five walks barefoot and five in flip-flops, for data collection.
The researchers said 12 key kinematic and temporal-spatial gait parameters were analysed using three-dimensional motion analysis: gait speed, single and double support duration, step length, total ankle range of motion (ROM) in the sagittal plane, total sub-talar joint ROM in the coronal plane, and peak knee flexion in swing.
Minimum toe clearance when barefoot and minimum shoe clearance in slippers in swing, knee and ankle position at initial contact and separation distance between barefoot and flip-flop markers, were also used.
They found that wearing slippers caused an increase in peak knee flexion in swing and ankle dorsiflexion.
The average separation between the heel and base of the flip-flop, in pre-swing, was 8.8cm (SD = 1.48). In mid-swing, the slipper cleared the ground by an average 1.6cm (SD = 0.56) at its lowest point, in contrast to the mean barefoot clearance of 4.2cm (SD = 0.8).

Wednesday 18 March 2015

New Books in Nursing & Midwifery library


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Monday 16 March 2015

Is Too Much Exercise Bad For Your Heart?

 
Internationally acclaimed academic Professor Keith George examines the impact of extreme exercise on the heart at a free public talk at the Croi Heart and Stroke Centre in Galway

The overwhelming majority of scientific evidence shows that exercise is perhaps the most important route to ahealthier better life. It reduces high blood pressure, lowers cholesterol levels, reduces the impact of inflammation, improves vascular function, directly improves heart function and contributes to a longer healthier life. In fact, you could say it is the cheapest cardiovascular polydrug on the market!

Even with all of this compelling evidence about the benefits of exercise some studies claiming that too much exercise can be harmful have gained widespread media attention over the past number of years. The question is why? And if exercise is a drug then does it have any side effects? Is the dose-response a linear one? These are some of the many questions that will be examined by Professor Keith George, Professor of Exercise andCardiovascular Physiology and Head of the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK. He is giving a FREE Public Talk on this topic on Friday March 20th at 7pm in the Croí Heart and Stroke Centre, Newcastle, Galway

Places at this event are limited and will be allocated on a first come first served basis.

To book online or for further information visit www.croi.ie Croí Heart and Stroke Centre on 091 544310

Friday 13 March 2015

PubMed Health - new database of Systematic Reviews added to our Collections

PubMed Health provides information for consumers and clinicians on prevention and treatment of diseases and conditions.
PubMed Health specializes in reviews of clinical effectiveness research, with easy-to-read summaries for consumers as well as full technical reports. Clinical effectiveness research finds answers to the question “What works?” in medical and health care.
PubMed Health Information:
PubMed Health is based on systematic reviews of clinical trials. These clinical effectiveness reviews can show what treatments and prevention methods have been proven to work—and what remains unknown.
PubMed Health provides summaries and full texts of selected systematic reviews in one place. The reviews were generally published or updated from 2003. There is also information for consumers and clinicians based on those reviews.
A search on PubMed Health runs simultaneously in PubMed. A filter is used to identify all the indexed scientific articles at the NLM that might be systematic reviews. This search includes articles from before 2003.
PubMed Health is a service provided by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).

Thursday 12 March 2015

Be cautious about claims that daily coffees are good for heart

At best, the study found an association between coffee-drinking and lower coronary calcium scores. This is long way from proving causation, a more difficult challenge that would require a randomised forward-looking study

A recent article in the Irish Times questions a study in Heart journal :-

“People who drink three to five coffees a day are less likely to develop clogged arteries that could lead to heart attacks” is a headline that must have sent coffee drinkers’ hearts beating faster in anticipation of future guilt-free consumption.

It follows the publication of a study in the medical journal Heart, which studied a group of more than 25,000 South Korean men and women with an average age of 41, who had no signs of heart disease.

The researchers at the Kangbuk Samsung Hospital in Seoul examined the relationship between levels of coffee consumption and the coronary artery calcium (CAC) score, which is calculated from a CT scan.

Both the press releases and reportage of the research left much to be desired. At best, the study found an association between coffee-drinking and lower coronary calcium scores. This is long way from proving causation, a more difficult challenge that would require a randomised forward-looking study.

Then there is the issue of the CAC score itself. This is a parallel marker indicating the possibility of a furred-up coronary artery. However, it is not the gold standard measurement – that is an angiograph which directly visualises each coronary artery and is the ultimate arbiter of the presence of coronary heart disease.

“Moderate coffee consumption lessens risk of clogged arteries and heart attacks.” It has all become more than a little confusing. Not long ago, coffee was a confirmed member of the “bad for you club”. Now it is claimed to be so good you should drink up to five cups a day to avoid developing heart disease.

Fat is another dietary factor that has undergone rehabilitation. For decades we were advised to avoid saturated fat to keep our cholesterol in check.

People stopped eating steak and limited their egg and milk intake. The resulting gap was filled with sugar and carbohydrate, which has contributed to a worldwide obesity epidemic.

What is the confused consumer to do? A certain scepticism of mainstream health reportage would help. If possible, try to find out more about the original research – and when it comes to coping with “yo-yo” dietary trends, the sage advice of “everything in moderation” has stood the test of time.

NUIG study finds 9 in 10 medical students may leave Ireland on qualifying

Pishoy Gouda, a final year medical student at NUI Galway, was the principal investigator of this study.

Nine out of 10 medical students plan to leave or are “contemplating” leaving Ireland when they qualify, a new study involving the State’s six training schools has found.

Read article here:  Ireland's medical brain drain: migration intentions of Irish medical students

Career opportunities, working conditions and lifestyle are cited as the top three factors for migration by some 88 per cent of over 2,000 students surveyed.

The study led by NUI Galway (NUIG) and published on Thursday has found pay was not a key issue among the respondents.

The Irish Hospital Consultants’ Association had said highly trained doctors are being “driven out”.

The study’s supervisor, NUIG senior lecturer in social and preventive medicine Dr Diarmuid O’Donovan, has called for action to retain medical graduates and attract back those who have already emigrated.

Staff at HSE West’s public health department and at the Royal College of Surgeons in Ireland, University of Limerick, University College Cork, University College Dublin and Trinity College Dublin were involved with NUIG in the study, published in the open access journal Human Resources for Health.
  
Some 1,519 of the 2,000-plus medical students surveyed were Irish, and some 85 per cent of the total identified career opportunities as a determining factor in going abroad. Some 83 per cent identified working conditions, and 80 per cent identified lifestyle as factors.
Some 34.3 per cent said they were “definitely” planning to migrate, and a further 53.3 per cent said they were contemplating it – a total of almost 88 per cent.

Final-year NUIG medical student Pishoy Gouda, the principal investigator, said previous studies on this theme had focused on graduates, whereas this analysis involved junior, intermediate and senior students in the six medical schools.

“We found the outcome alarming, as it shows that even pre-med and first-year students are thinking about leaving already,” he said. It reflected a “widespread culture of intention to migrate” in the medical schools.

Wednesday 11 March 2015

Antenna-like structures found on immune cells for first time


A team of NUI Galway scientists have found that cells of the immune system have a previously undescribed ability. In a paper just published Journal of Cell Biology, the scientists describe the presence of primary cilia on immune cells. These antenna-like structures are found on almost all cell types in the body, but since the 1960s, it has been thought that they do not arise in blood cells.

Professor Ciaran Morrison of NUI Galway’s Centre for Chromosome Biology, who co-authored the paper with Dr Suzanna Prosser, explains the significance: “The paper is of scientific interest because it provides new information about how ciliation is controlled. Also, we have shown that immune cells do at least have all the material they would need to make primary cilia. The next question is whether the cells make cilia in the body.”


The 60 scientists led by 11 Principal Investigators at the Centre for Chromosome Biology in NUIGalway are dedicated to understanding many different areas of chromosome biology, such as how cell proliferation is controlled, the structure and maintenance of the genome, precise control of genome duplication and how genes are expressed. Their work is critical to the ongoing scientific battle against cancer and other areas including human reproduction and fertility and genetic diseases such as Huntington’s Disease.

New hospital technologies could improve patient safety, says Hiqa

Assessment of how IT could improve outcomes follows chief medical officer request
The introduction of new technologies could lead to reduced mortality, increased patient safety, shorter waiting lists and reduce hospital overcrowding, the Health Information and Quality Authority (Hiqa) has said.

Dr Máirín Ryan, Hiqa’s director of health technology assessment and acting deputy chief executive, said a survey of 32 hospitals nationally to identify electronic systems currently in use in Ireland found limited use of such systems outside two hospitals where the technology was being used in very restricted settings.

She said the evidence from other countries was that such systems led to increased accuracy in the recording of vital signs which in turn led to improved mortality rates and morbidity rates for patients, the latter evidenced by reduced lengths of stay in hospital.  

“The results of one study from the UK which most closely reflected the Irish context, and which specifically looked at the switch from a paper-based to an electronic system, indicated that the reduction in length of stay could lead to a substantial increase in hospital bed capacity... and a potential reduction in waiting lists,” she added.

A recommendation for the introduction of an early warning score was recommended by the National Clinical Effectiveness Committee in 2013.

Another of the report’s key recommendations was the introduction of a national early warning score across the wider hospital system.

As part of its assessment, Hiqa carried out a systematic review of the available literature in this area, examining 10 studies on electronic early warning systems and 17 on electronic clinical handover systems internationally, including one Irish study.

Hiqa recommended that all electronic early warning and clinical handover systems be developed in line with National Clinical Effectiveness Committee quality assured National Clinical Guidelines.

Tuesday 10 March 2015

New COPD Review published in Cochrane - NUIG School of Nursing & Midwifery

The review was led by a team from NUI Galway's School of Nursing and Midwifery based in Áras Moyola.

Pulmonary Rehabilitation is a non-pharmacological intervention for patients with Chronic Obstructive Airways Disease (COPD) and its effectiveness was confirmed in a Cochrane Review which has generated major interest across the world. (Click here to view Abstract)

The review was led by a team from the School of Nursing and Midwifery at the National University of Ireland Galway. The team consisted of Bernard McCarthy, Dr Dympna Casey, Professor Declan Devane, Professor Kathy Murphy, Edel Murphy and the internationally renowned Canadian pulmonologist Dr Yves Lacasse. The two-year project brought together the findings of 65 randomised control trials involving 3822 participants for inclusion in the analysis.

COPD is a chronic lung disease that causes obstruction in breathing. This results in persistent and progressive breathlessness, productive coughing, fatigue and recurrent chest infection. Worldwide, COPD is a major cause of long term health issues. The World Health Organisation projects that by the year 2030 it will be the third most frequent cause of death globally.

Bernard McCarthy, NUI Galway, the lead author explains: “At this time, COPD is an incurable, life-limiting condition that is associated with significant economic costs due to progressive disease severity and frequent hospital admissions and readmissions. Our findings from pooling all the international research demonstrate that pulmonary rehabilitation has a significant positive effect. Pulmonary rehabilitation which includes exercise as a key component and may also include assessment, education, psychological support and dietary advice, has been shown to relieve breathing difficulty and fatigue and improves individuals’ sense of control over their condition. These all lead to a better quality of life for individuals with COPD, facilitating them to re-engage with their normal lives.”

View full text of the Cochrane Review :Pulmonary rehabilitation for chronic obstructive pulmonary disease

Monday 9 March 2015

Incidences of bowel disease are increasing

Inflammatory bowel disease (IBD) can severely affect a person’s quality of life and it is imperative that those with the condition are identified and treated, a meeting in Dublin has heard.
Consultant gastroenterologist Dr Deirdre O’Donovan works in the Blackrock Clinic and her particular areas of interest are IBD and functional bowel disease. Speaking on a number of new IBD developments at Blackrock Clinic’s recent GP educational meeting, Dr O’Donovan explained how the incidence of Crohn’s disease and ulcerative colitis (UC) was increasing. Globally, the highest incidence is in Northern Europe and North America.
The incidence of Crohn’s is about six per 100,000 while the incidence of UC is about 11 per 100,000 (Ingle SB,Gastroenterology, 2007). 
The exact etiological factors and their relative contributions to disease are still debated, yet there is a definite genetic susceptibility. There are also significant environmental triggers, in particular a disregulated immune response to intestinal microflora.
It was important to identify those patients who would do well as outpatients and those who needed referral into hospital, Dr O’Donovan explained.
View full article here on Irish Medical Times

Friday 6 March 2015

Variations in Hospital Death Reports

The figures are contained in the first annual report of the National Healthcare Quality Reporting System, which measures the performance of the health service across a number of indicators. File photograph: Reuters

 A number of hospitals have significantly higher death rates due to heart attacks and strokes than the national average, according to a new report from the Department of Health.

 The rate at which patients die in hospital from heart attacks (acute myocardial infarction) has dropped 40 per cent in a decade and the Irish mortality rate is well below the OECD average.

The Mater Hospital in Dublin, Midland Regional Hospital in Portlaoise and Kerry General Hospital recorded the lowest death rates within 30 days of admission for a heart attack.

The figures are contained in the first annual report of the National Healthcare Quality Reporting System, which measures the performance of the health service across a number of indicators.

The report says differences may arise for many reasons, and not just because of the quality of care provided. It says the indicators measured act like smoke alarms by attracting attention and enabling people to determine whether the problem is caused by smoke (lesser urgency) or fire (priority for action).

The report also says some areas of the health service are performing well.  Immunisation rates have improved, death rates from heart attacks have fallen, survival rates from cancer are improving and the incidence of hospital acquired infections has dropped sharply.

Areas where there is room for improvement are also identified. These include cervical cancer survival rates and falling uptake of breast cancer screening.


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Thursday 5 March 2015

The Brains behind the Breakthroughs

A research showcase, “The Brains behind the Breakthroughs”, will be hosted by the NUI Galway NeuroSociety at 7pm in the Westwood Hotel on Monday, 9 March. This free public seminar will showcase the depth and scale of brain research being conducted in NUI Galway.

Designed specifically for a lay audience, it promises to give an insight to the life of a neuroscientist and the approaches being taken to tackle some of the biggest questions about the brain.

Professors, senior research scientists and students will present a variety of perspectives on their current areas of research which range from increasing our understanding of pain and brain pathology to the latest in medical neuroimaging and genetic studies.

Professor David Finn will introduce proceedings as head of the Galway Neuroscience Centre which represents the multi-disciplinary research groups focused on neuroscience in NUI Galway.

An additional Brain Awareness Week event, on the 11th and 12th March, NUI Galway’s Neuroscience Centre will be holding an exhibition in the Aula Maxima aimed at teaching secondary school students about the brain and disorders of the nervous system.

This event is being hosted to celebrate, Brain Awareness Week (9-15 March), which is a global campaign to increase public awareness of the progress and benefits of brain research. It is a worldwide celebration of the brain that grows more successful every year. 

Tuesday 3 March 2015

New Books


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Nurses and midwives invited to participate in professional competence survey

Under the 2011 Act,  the Nursing and Midwifery Board of Ireland (NMBI) is required to collect evidence to demonstrate continuing professional competence on the part of registered nurses and midwives.  In the future it will be a condition of registration that  nurses and midwives meet the requirements of the professional competence scheme.
The Board is in the process of scoping out what is required.  It has commissioned a study from a group of academics led by  Professor Josephine Hegarty, Catherine McAuley School of Nursing and Midwifery at UCC.  The team includes reresentatives from UCD, NUI Galway, UL and TCD.
The survey, which will take between 10 and 15 minutes to complete, seeks feedback on a number of aspects of professional competence, including portfolio assessments, learning plans, monitoring and indicators that could be used by NMBI.
The survey will be open until 14th March 2015.  NMBI is encouraging all registered nurses and midwives to participate in this consultation process. Start the survey now.

NMBI Board approves new midwives’ standards

The Chief Medical Officer (CMO) report into the HSE Midland Regional Hospital Portlaoise perinatal deaths recommended that NMBI develop a process for continuously improving the practice standards for midwives to ensure the skill set is based on best evidence and service need (Recommendation 31).
To meet this recommendation, a working group was set up to review the practice standards for midwives and the terms of reference for the Midwives Committee were revised to provide for a process for the review of the practice standards on an annual basis.
The working group was chaired Professor Declan Devane Professor of Midwifery at the School of Nursing and Midwifery, NUI Galway. An extensive process of stakeholder consultation was conducted.
It is proposed that the Practice Standards for Midwives 2015 will be launched during Midwives Week on 5 May 2015 which is the International Day of the Midwife.

Monday 2 March 2015

1.1 billion people at risk of hearing loss - WHO

Some 1.1 billion teenagers and young adults are at risk of hearing loss due to the unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues such as nightclubs, bars and sporting events, according to WHO. Hearing loss has potentially devastating consequences for physical and mental health, education and employment.
Data from studies in middle- and high-income countries analysed by WHO indicate that among teenagers and young adults aged 12-35 years, nearly 50% are exposed to unsafe levels of sound from the use of personal audio devices and around 40% are exposed to potentially damaging levels of sound at entertainment venues. Unsafe levels of sounds can be, for example, exposure to in excess of 85 decibles (dB) for eight hours or 100dB for 15 minutes.
WHO recommends that the highest permissible level of noise exposure in the workplace is 85 dB up to a maximum of eight hours per day. Many patrons of nightclubs, bars and sporting events are often exposed to even higher levels of sound, and should therefore considerably reduce the duration of exposure. For example, exposure to noise levels of 100 dB, which is typical in such venues, is safe for no more than 15 minutes.
To mark International Ear Care Day, celebrated each year on March 3rd, WHO is launching the “Make Listening Safe” initiative to draw attention to the dangers of unsafe listening and promote safer practices. In collaboration with partners worldwide, WHO will alert young people and their families about the risks of noise-induced hearing loss and advocate towards governments for greater attention to this issue as part of their broader efforts to prevent hearing loss generally.