EU states 'can do more' to battle Ebola virus

Former Irish European commissioner David Byrne has called on Ireland and other EU states to do more to fight the outbreak of the deadly Ebola virus in west Africa.

Mr Byrne, who held the health portfolio in the European Commission from 1999 to 2004, is one of 44 prominent public health experts who signed a letter in The Lancet medical journal that urged Western governments to “mobilise all possible resources” to assist west Africa in controlling the epidemic. On Friday, the death toll from the disease passed the 3,000 mark, six months after the outbreak began.

The Irish Government could help by facilitating medical staff to take career breaks so they can volunteer to work fighting the disease, and by providing medical supplies to control the spread of infection, Mr Byrne told The Irish Times yesterday.

The EU Commission has donated more than €180 million to help fight the epidemic, he said. “It’s for the governments of the member states now to up their game. The EU doesn’t have the ability to send health personnel into west Africa in the numbers needed, but the health communities in each country can.”

Ireland is a long-standing supporter of the WHO and enjoys a good reputation internationally for its aid work, he pointed out. It is also a signatory of an international agreement that requires countries to be supportive when the WHO declares an outbreak a “public health emergency of international concern,” as it has done in the case of the current Ebola outbreak.“We’re now dealing with an outbreak of a serious disease in developing countries that don’t have the resources to fight it. Meanwhile, the developed world hasn’t given enough attention to the problem, probably because it doesn’t think the disease will spread further,” said Byrne.

Irish Aid has made donations totalling about €460,000 in response to the Ebola outbreak.

The Lancet letter said the Ebola epidemic has “spiralled completely out of control” after months of “inaction and neglect” from the international community.

“Today, the virus is a threat not only to the countries where the outbreak has overwhelmed the capacity of national health systems, but also to the entire world.

“The Ebola epidemic represents a public health imperative; unchecked, it might very well become a geopolitical one.”
View article in Irish Times here

Brain Research Funding Received

A professor of brain research at Dublin's Trinity College is to receive €1.2m in funding over six years to study the systems that support memory in the brain.

Professor Shane O'Mara is the first Irish-based recipient of a Senior Investigator Award.  The award is a joint scientific funding initiative between Science Foundation Ireland, the Health Research Board and the Wellcome Trust Biomedical Partnership.

The scheme aims to support exceptional, world class researchers investigating important questions in health and disease.

Professor O'Mara will work in partnership with Professor John Aggleton from Cardiff University to figure out how interactions between differing brain areas, support normal memory and what happens to memory, when brains are damaged.

View article on RTE/Health

Monitoring Physician's Wellbeing

Providing some links to articles from The Lancet which monitor the
health of physicians.

Physician wellness: a missing quality indicator

• Physician, heal thyself

• The Lancet, Volume 377, Issue 9775, 23–29 April 2011, Page 1380   PDF (69 K)

• Doctors get ill too

• The Lancet, Volume 374, Issue 9702, 14–20 November 2009, Page 1653  PDF (69 K)

Summary:

When physicians are unwell, the performance of health-care systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. We review the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to health-care systems. We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation.

Conclusion:

The first step to incorporation of physician wellness as a quality indicator is to promote dialogue among key stakeholders (physician groups, health-system decision makers, payers, and the general public) about the components needed in such a quality-indicator system to best measure physician and organisational wellness, and the interventions needed to improve physician and organisational wellness. Assessment of physician wellness as an indicator of an organisation's quality of health care is only the first step. Increased awareness of the importance of physician wellness, both individually and organisationally, is needed by physicians, their patients, and their employers. A shift in the culture of care and wellness of physicians is necessary. If these groups do not recognise the crucial importance of physician wellness, there is little reason to expect that physicians and their employers will invest in taking better care of physicians, or that the public will support and appreciate such efforts.

Ultimately, individual physicians will personally benefit from taking better care of themselves. Such efforts would probably lead to increased job satisfaction and overall wellbeing, and reduced likelihood of physicians experiencing an overwhelming sense of stress and burnout. The organisations employing physicians will benefit by having more productive and efficient health-care providers in conjunction with reduced absenteeism, job turnover, and recruitment and retention issues. And perhaps the patients themselves will benefit by receiving better quality of care.

M-Health Research Group launched at NUI, Galway

The M-Health Research Group was established in NUI Galway in 2014.

The particular focus of this area of research, M-Health, which is led by Dr. Jane Walsh, is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices (e.g. mobile phones, tablet computers and PDAs), for health services and information, but also to affect emotional states. M-health applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs and direct provision of care (via mobile telemedicine).

M-health research encompasses a variety of possibilities, including increased access to healthcare and health-related information (particularly for hard-to-reach populations); improved ability to diagnose and track diseases; timelier, more actionable public health information; and expanded access to ongoing medical education and training for health workers.

View here

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World-renowned Galway neuroscientist returns to NUI Galway with formula for happiness

There is a formula for happiness after all. 

The equation has been described by Professor Ray Dolan, Professor of Neuropsychiatry and Director of the Wellcome Trust Centre for Neuroimaging at University College London. Professor Dolan presented some of his latest research findings on Tuesday, 23 September, at NUI Galway in a lecture jointly hosted by the University’s School of Psychology, the Discipline of Psychiatry, and the Galway Neuroscience Centre.

In a talk entitled ‘Value Encoding in the Human Brain’, Professor Dolan explained how he and his team of researchers believe that happiness is governed primarily by expectation and surprise, work which they have published recently in the prestigious international journal The Proceedings of the National Academy of Sciences.

Professor Dolan and his team used a combination of behavioral neuroscience, computational modeling and neuroimaging approaches to study emotional reactivity in the form of momentary happiness in response to reward.

He also presented results from other work that may help to explain why some people have a propensity to gamble and take risks, while others avoid risk. He explained how the chemical transmitter dopamine in the brain is likely to play a key role in determining whether and how someone will gamble. Furthermore, dopamine’s actions in the brain also appear to play a critical role in learning. Professor Dolan demonstrated how a decline in dopamine levels with ageing can result in impaired learning. In turn, drugs that elevate levels of dopamine in the brain can act as cognitive enhancers.

Professor Dolan, who is a native of Monivea in Galway and a graduate of NUI Galway (known then as University College Galway), is a clinician scientist with a primary interest in the neurobiology of emotion and how emotion impacts on cognition, including decision making.  He has published over 500 peer reviewed papers in scientific journals and is consistently ranked among the top five most cited neuroscientists in the world in the field of neuroscience and behaviour.

View full Press Release here

Bates' Visual Guide - New Library Resource

Bates' Visual Guide to Physical Examination

Now in its Fifth Edition and featuring completely reshot content and new clinical skills videos, Bates' Visual Guide delivers head-to-toe and systems-based physical examination techniques for the (Advanced) Assessment or Introduction to Clinical Medicine course.  The site features more than 8 hours of video content.

Students and faculty in medical, nursing and related programs will appreciate the careful attention to clinical accuracy, as well as the range of patient types profiled in the series.  Institutions will benefit from the online delivery of content - available for the first time via IP-authenticated or referring URL access - allowing their users to view the videos from any web-based location or device.

View in Library website here

Berries in cancer therapy experiment

The berries grow in wetlands and swamps

Wild berries native to North America may have a role in boosting cancer therapy, according to a study in the Journal of Clinical Pathology.

Scientists suggest chokeberries could work in combination with conventional drugs to kill more cancer cells.

But the UK research is at an early stage, with experiments carried out only on cancer cells in laboratories.

Cancer Research UK says much more work is needed to test the effectiveness of berries, particularly in human trials.

Researchers from the University of Southampton and King's College Hospital, London, tested a berry extract on pancreatic cancer samples.

Pancreatic cancer is particularly hard to treat and has an average survival period of just six months after diagnosis.

The study found that when the berry extract was used, together with a conventional chemotherapy drug called gemcitabine, more cancer cells died than when the drug was used alone.

They believe compounds known as polyphenols in the berries may reduce the number of harmful cells.  And the team previously carried out similar early work on brain cancer cells.

Henry Scowcroft, at the charity Cancer Research UK, said: "It's far too early to say from this small laboratory study whether chemicals extracted from chokeberries have any effect on pancreatic cancer in patients.

"And the findings certainly don't suggest that the berries themselves should be taken alongside conventional chemotherapy.

"But innovative approaches are urgently needed to improve treatment for people with pancreatic cancer - a disease for which there has been precious little progress over recent decades."

Bashir Lwaleed, a senior lecturer at Southampton University, who carried out the study, said: "We need to do more research to understand how the chemotherapy and berry work together.

"At the moment we cannot suggest people go out and buy supplements - we are still at the experimental level."

View more on BBC/Health 

NUIG Cancer Researcher Awarded for Participation in Lindau Nobel Laureate Awards

The Minister for Skills, Research and Innovation, Mr Damien English T.D., (left) and Professor Orla Feely, Chairperson of the Irish Research Council, (right) recently presented NUI Galway researcher Dr Aideen Ryan with an award in recognition of her selection and participation in the Lindau Nobel Laureate Meetings

Since 1951, the Lindau Nobel Laureate Meetings have been bringing together the most esteemed scientists of their times with outstanding young scientists from all over the world. This year, 600 young researchers representing almost 80 countries took part in the Meeting. Dr Ryan was one of four young Irish researchers who were chosen in a competitive process to attend the 64th Lindau Nobel Laureate Meeting dedicated to Physiology and Medicine.

Dr Ryan works within the Immunology group of the Regenerative Medicine Institute (REMEDI) at NUI Galway, and her research looks specifically at colon cancer. 

Colon cancer is one of the most common causes of cancer-related deaths in Ireland and represents a significant health problem. Dr Ryan’s research is taking a fresh approach by focusing on the cancer cells interaction with the immune system.

Dr Ryan’s recent research work, published in the journal Oncogene, has provided new insights into how the body’s immune system affects the spread of colon cancer cells and it is hoped that this work will inform the development of new drugs that could be used to strengthen our immune system’s response to cancer.

View full Press Release here

Customised Management of IBD

Prof Walter Reinisch, an international expert in Inflammatory Bowel Disease (IBD), travelled to Ireland last week to share his expertise with the specialist gastroenterology team in University Hospital Galway and at the GUT club in Dublin.

Prof Reinisch’s presentation, titled ‘Optimising the use of current treatment options in moderate to severe ulcerative colitis (UC)’, offered a valuable opportunity to gain insights from the substantial progress that he and his colleagues have made in treating and managing this condition.

In an interview with Irish Medical Times, Prof Reinisch outlined how the development of three key optimisation procedures had been central to his success in improving UC outcomes.

These treatment techniques, in tandem with major advancements in the development of anti-inflammatory drugs, have had life-changing consequences for some UC patients.  “In terms of treatment, the major breakthrough was the development of the biologics and the availability of the monoclonal antibodies, particularly the anti-TNF-alpha agents — currently we have at least three of them on the market,” he said.

In seeking to improve patient outcomes, identifying the severity and type of treatment required in a newly diagnosed patient was equally important to early diagnosis, Prof Reinisch maintained. His most recent paper, published in May of this year entitled Factors associated with poor outcomes in adults with newly diagnosed ulcerative colitis (DOI: http://dx.doi.org/10.1016/j.cgh.2014.03.037), reviews prognostic factors for adults with newly diagnosed UC and discusses which patients might benefit from rapid and progressive therapy.

View full article on Irish Medical Times 

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Allergy service delays ‘put lives at risk’

Food Allergy and Anaphylaxis Meeting, Dublin 9-11th October

Public hospital services for treating children with allergies are completely swamped with year-long waits for first appointments, and three-year waits for a vital food allergy test at the country’s most established paediatric allergy centre.

The delays mean children are at risk of “further episodes of anaphylaxis” while waiting to be seen, according to Jonathan Hourihane, who heads the internationally recognised paediatric allergy service at Cork University Hospital.

“The HSE thinks once you are on a waiting list that you are safe, but that’s not quite the case because anaphylaxis can happen at any time,” said Professor Hourihane.

The saturated state of public paediatric allergy services is outlined in a draft document prepared by Professor Hourihane and colleagues for the HSE’s National Paediatric Clinical Advisory Group. In it, he describes each of the five services in Cork, Dublin, Drogheda, Mullingar, and Galway as “overwhelmed”.

The document, describing the current chaotic state of our allergy services, says there has been “no HSE strategy to develop allergy care in Ireland”, at a time when Census figures show that 28,600 children have all three major allergic conditions — asthma, eczema, and food allergy.

Paediatric dietician Ruth Charles, secretary of the Irish Food Allergy Network, said difficulties accessing expert opinion meant many parents were “chopping and changing children’s diets themselves, so that kids could end up with significant nutritional deficits”. She said: “For example, a parent might eliminate dairy because their child has eczema [inflammatory skin disease] and this can have a significant effect on bone development.”

The resource deficit in allergy services extends to adults — there is no public adult service — and to the number of doctors, employed in the area. Between the five paediatric services, there are just two whole time equivalent allergy consultants.  Professor  Hourihane’s document says if we were to follow UK guidelines, we should have nine, but that “a realistic goal would be the creation of two additional full-time posts within the current specialist services”.

Ms Charles said another deficit was the lack of allergy training for undergraduates. She said such training was particularly important in relation to maternity hospital staff, public health nurses, and GPs as the first points of contact with infants with allergies.

The deficits in allergy services are particularly relevant at a time when Ireland is due to host — for the first time — the international Food Allergy and Anaphylaxis Meeting 2014, which takes place in Dublin’s Convention Centre on October 9 to 11.

The conference, designed for healthcare professionals, will be attended by worldwide allergy experts.

View full Press Report here

Location Impacts on Access to Speech Therapy

Three thousand children are waiting more than a year for speech therapy, as Ireland has just half the number of language therapists it needs.  A paper due out today, finds that access to speech and language therapy is effectively a lottery - depending on where you live.

The report by Inclusion Ireland found that residents of Wexford and Donegal were found to be less likely to have quick access to services than those in parts of Cork and Wicklow.
One in four affected families said, their children had not seen a therapist in a year.

To read 'The Case of Speech and Language Therapy' please click here.

Irish Centre for Social Gerontology Seminar Series

Wednesday 24th September  13:00- 14:00

Mayo Clinic and NUI Galway Formalise Collaboration

Pictured at the signing of the MOU were Professor Lokesh Joshi, Vice-President for Research , NUI Galway; Dr Jim Browne, President, NUI Galway; Professor Tony Windebank, Deputy Director for Discovery, Centre for Regenerative Medicine at Mayo Clinic; and Professor Tim O’Brien, Director of REMEDI NUI Galway

Collaboration will focus on stem cell therapy, gene therapy, biomaterials and biomedical engineering

The National University Ireland Galway has signed an agreement to formalise collaborative ties with the Mayo Clinic Centre for Regenerative Medicine in the US. The agreement follows many years of close cooperation, and paves the way for joint collaborations in clinical trials using regenerative therapies.

Collaborative research projects will focus on a number of key strategic areas of importance for both institutes, including adult stem cell therapy, gene therapy, biomaterials and biomedical engineering. Furthermore, the agreement facilitates ongoing student and staff exchange between Galway and the US.  

The Memorandum of Understanding (MOU) puts the emphasis on regulatory science to facilitate global translation of regenerative medicine therapies to the clinic. Both the National University Ireland Galway and the Mayo Clinic Centre for Regenerative Medicine have GMP cell manufacturing facilities, licensed for use by the respective national medical authorities.

National University of Ireland Galway’s President, Dr Jim Browne, welcoming the signing of the MOU, said: “Formalising our longstanding links paves the way for advancing our common agenda which is to realize the potential of regenerative medicine. Here in Galway we have Ireland’s only facility licenced to produce stem cells for human use, while the new clinical and translational research facility for conducting clinical trials with patients will be complete in early 2015.”

NUI Galway’s Regenerative Medicine Institute (REMEDI) and the Network of Excellence for Functional Biomaterials (NFB), both of which are supported by Science Foundation Ireland, are working together specifically to develop joint clinical trial programmes in the area of regenerative medicine.

View full Press Release here

UpToDate: Continuous Publishing

Tip: Have confidence in your decisions with UpToDate's continuous publishing

Continuous Publishing Did you know that UpToDate® publishes every business day  to keep you abreast of changes in medical research and practice? UpToDate authors and editors continually monitor over 450 medical journals, specialty guidelines, clinical databases and clinical trials for important new medical findings.  In July 2014, 953 updates were published and 37 new topics were added. In the first half of 2014, 6,419 updates were published and; 109 new topics were added. 192 updates from the second quarter of 2014 are featured in “What’s New”— a small number of the most important updates chosen by our editors.  Find What’s New on the top right menu bar or enter What’s New in the search box. UpToDate received 1,537 feedback items for its editors, causing changes to over 500 topics in the first half of 2014.  UpToDate also encourages clinicians to provide topic feedback. Transparency in updates: Directly below the author’s name is the date on which the literature was last reviewed and the date on which this specific topic was last updated. You can see which literature was referenced for each topic by viewing the references listed at the bottom of the page for that topic.

Benefits of New Medical Devices

Benefits of Research into Next Generation Medical Devices to Society:
Medical devices make a critical difference to quality of life for millions of people every day. From the simple bandage, to the contact lens, to the most sophisticated life-supporting products, the medical devices sector plays a crucial role in the diagnosis, prevention, monitoring and treatment of diseases to improve the lives of people suffering from illness or disability.

Pre-clinical translation of research prototypes to practice, towards delivery of next generation of implants and devices, including bio-orthopaedics, neural engineering, drug-eluting stents, implants and biomechanics. Medical devices include instruments, implants, machines or software and are central to developments in healthcare. This is especially relevant in Ireland, which is experiencing an increased incidence of chronic diseases, an ageing population and challenges to the sustainability of its healthcare system. With its strong research and manufacturing infrastructure, Ireland is well poised to take a leading role in developing next generation medical devices to take on these challenges.

Dr. Bruce Murphy of Trinity College Dublin, is researching this key topic.

New books added to our Library

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Ebola vaccine trial begins

A trial of an experimental vaccine against the Ebola virus is to begin in Oxford.

The first of 60 healthy volunteers will be injected with the vaccine.  It contains only a small portion of genetic material from the virus, so it cannot cause the disease.

Normally it would take years of human trials before a completely new vaccine was approved for use.  But such is the urgency of the Ebola outbreak in west Africa that this experimental vaccine is being fast tracked at an astonishing rate.

If the trials are successful, it could be used to immunise health workers in affected areas by the end of the year.  By then, around 10,000 doses should be available.

The vaccine is being developed by GlaxoSmithKline and the US National Institutes of Health.

Blood tests from the volunteers will reveal the extent of their antibody response within two to four weeks.

Further volunteers will be given the vaccine in Africa next month and there are trials in the United States of a different formulation - both vaccines could be used if they prove safe and effective.

Promising results from animal studies were published earlier this month.

The United States has said it will send 3,000 troops to West Africa to build treatment clinics and to train health workers in how to halt the spread of the deadly virus.

The official death toll now stands at more than 2,400 people, although the outbreak may have killed many times that number.

View more here on BBC/Health

Free Seminar on Regulation of Medical Devices NUIG

Biomedical Science Building, NUI, Galway

On Monday, 13 October, the Network of Excellence for Functional Biomaterials (NFB) at NUI Galway will host a free seminar on the regulatory elements that need to be considered when developing medical devices involving a combination of advanced materials and biomolecules. The European Regulation of Medical Devices (EROMed) Seminar will take place in the Seminar Room of the Biosciences Building from 9.30am to 5.30pm.

This free event is organised as part of the EU-funded NeuroGraft project and will be of interest to local medical device industries and researchers. The seminar is coordinated by Obelis, a regulatory company, and the NFB, a Science Foundation Ireland (SFI) funded research group.

Injuries and degenerative diseases of the central nervous system (CNS) constitute a bottleneck in medical and surgical practice for which no therapy currently exists. The aim of the NeuroGraft project is to develop a novel multichannel conduit system to aid regeneration following spinal cord injury. The NeuroGraft consortium consists of one academic and four industrial partners across four countries.

For further details of the event contact sharon.s.kelly@nuigalway.ie. 091 494233

View full Press Release here

New Irish cancer clinical trial takes centre stage at major US conference

A new Irish clinical trial funded by the Health Research Board has revealed that you can achieve the same results with less radiation and fewer doses for patients with malignant spinal cord compression.

Malignant spinal cord compression (MSCC) is a complication of metastatic cancer that occurs when a tumour secondary deposit presses on the spinal cord and nerves. This pressure exposes patients to neurological damage that can result in pain, loss of muscle strength and function of one or more of the senses and in some cases paralysis of one limb or the whole body. Almost 400 people in Ireland suffer from MSCC each year and many are in palliative care at the time.

Lead researcher, Pierre Thirion, MD, a consultant radiation oncologist at St Luke’s in Dublin explains,

‘We found that one single dose of 10Gy of radiation therapy will deliver the same mobility and stability benefits for the patient as four doses of 5Gy (total 20Gy) of radiation therapy. Ultimately this research will reduce the burden of treatment as well as frequency of hospital visits for this patient group which is a real quality of life benefit as many are in late stages of cancer.’

The findings are being presented to more than 11,000 radiation oncologists at the American Society for Radiation Oncology’s (ASTRO) meeting in San Francisco. It the first Irish trial ever to be featured at the plenary session of a major US medical educational conference and Pierre’s plenary presentation is one of only four selected from more than 2000 submissions from all over the world.

Commenting on the achievement, Dr Graham Love, Chief Executive at the Health Research Board says,

‘Presenting at ASTRO is like being nominated for the OSCARS in the radiation oncology world. This is an incredible achievement for Pierre and the ICORG team. Their discovery will help improve the quality of life for vulnerable patients, as well as reducing the demand for radiation services and delivering savings for the health system.’

The study was designed and managed by ICORG  the All Ireland Co-operative Clinical Oncology Research Group), funded by the HRB with additional support from St Luke’s Institute of Cancer Research (SLICR)*

View more here

Hepatitis C Treatments - Early Access Required

 

The Irish Haemophilia Society has called for 350 seriously-ill people with the Hepatitis C virus to be given early access to new treatments that could save their lives.

It said this group can not medically tolerate the current Interferon treatment, due to severe liver damage that increases their risk of death.

The society said of the 12,365 patients who need Hepatitis C treatment, 350 have been identified by specialist hepatologists to be in need of urgent treatment.

An expert group, chaired by Department of Health official Dr. Deirdre Mulholland, is looking at the new treatment options.

IHS Chief Executive, Brian O' Mahony said immediate action is needed by way of an early access programme.

The drugs cost around €45,000 and are given as a once-off treatment.

Mr O'Mahony said early access could save lives and around €10.5m through avoiding decompensated liver disease and preventing the need for liver transplants.

He also said one of the drugs would be made available free, prior to licensing in October.

More than 260 people with haemophilia were infected with the virus from contaminated blood products.

View more here