Heart Disease - New Pathway

A new initiative to tackle heart disease and the issues that cause cardiovascular problems is being launched in Galway today.

Heart disease is still the main cause of death each year in Ireland. However, experts say 90% of cardiovascular illness could be averted with early intervention and increased awareness.

The NIPC will promote research and help develop new treatment practices, offering support and resources to hospitals and medics and will work to influence policy at a national level. The National Institute for Preventive Cardiology is a collaboration between the Croí charity and NUI Galway.

To mark the launch of the Institute, a National Conference on Cardiovascular Disease Prevention will be held at the Croi Heart and Stroke Centre in Galway on Saturday, 29th November. National and international world leaders in CVD Prevention will speak at this inaugural event which will examine global challenges and future developments in preventive healthcare.

Click here to register and to view the full agenda and meeting details.

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Scientists use stem cells to correct skin defects

New research has found evidence that stem cells could be used to correct genetic defects in skin and to treat certain rare diseases.

Three separate studies by scientists in the US, Europe and Japan have raised hopes that the methods could be used to develop treatments for a range of problems, including epidermolysis bullosa.

It is a disorder where sufferers are born with extensive blistering and patches of missing skin.

They are left with extremely fragile skin for all of their lives.

In the first study, the researchers used Induced Pluripotent Stem Cells (iPSCs) - adult cells that are reprogrammed to an embryonic stem cell-like state.

The scientists took diseased cells from three adult patients with epidermolysis bullosa.

The researchers converted the cells into iPSCs and used specialist tools to edit and fix the mutation in the genetic code responsible for defective collagen protein production, which causes the condition.

They then grew pieces of human skin that produced the correct collagen, and grafted them into mice where they lasted for three weeks.

It is hoped the risk of rejection in humans will be minimal because the skin is made from the patient's own cells.

A second study confirmed these findings in the lab, showing that it is possible to genetically correct iPSCs from mice with epidermolysis bullosa and use the repaired cells to heal blistered skin.

The third study explored the possibility that skin cells taken from epidermolysis bullosa patients, where some have spontaneously reverted back to normal, may also have therapeutic potential for creating skin grafts.

All three papers are published in the journal, Science Translational Medicine.

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Awareness of Atrial Fibrillation

Many Irish adults could regularly conduct a number of simple checks on themselves to detect a very common heart rhythm disorder, according to the Irish Heart Foundation. 

Having Atrial Fibrillation, means that you are five times more likely to be at risk of a stroke.

However, a number of simple checks can help people to detect if they are a sufferer.  More than 40,000 people over the age of 50 in Ireland suffer from Atrial Fibrillation.

The foundation points out that the vast majority of suffers are unaware that they have it and that just 26% of the population have heard of it.

Medical director of the Irish Heart Foundation and consultant cardiologist Dr. Angie Brown said the condition is not life-threatening but can lead to serious problems if undetected.
"It is a serious condition and can lead to serious complications such as stroke and other heart problems. By knowing how to take your own pulse or by having it regularly checked, you can detect the condition," she said.

As a result, the Irish Heart Foundation is making people aware of how to check their pulse and to contact their doctor if the detect and abnormalities.

"The recommended normal heart rate is between 60 and 100 heartbeats per minute but some people can have heart rates over 100," said Dr. Brown.

"You should see your doctor if you have a persistent heart rate above 120 beats per minute or below 40 beats per minute," she added.

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Educational gaming App launched for surgeons

RCSI has launched a new gaming App for iPhone and iPad aimed at testing students’ and doctors’ medical knowledge on the go.

The SurgiQuiz game, which allows surgeons to obtain Continuous Professional Development (CPD) credits, is targeted at surgeons, health sciences students and anyone that is interested in human anatomy.

Developed by the College’s Department of Surgical Affairs in conjunction with the Department of Anatomy, it consists of 3,000 tough questions that are aimed at challenging even practising surgeons.

The game also includes a global leaderboard so people can compete to get their name on the board.

The free App is available for download from the App store on iPhone and iPad. An Android version is also in development.

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Suicide risk reduced after talk therapy, study suggests

Talk therapy sessions can help reduce the risk of suicide among high-risk groups, suggests a US study.

Researchers from John Hopkins University tracked more than 5,000 Danish people who had attempted suicide and later received psychosocial counselling.

They found suicides went down by 26% after five years, compared to people who had no therapy sessions.

The findings are published in Lancet Psychiatry.

The participants in the study volunteered to have six to 10 talking therapy sessions at suicide prevention clinics in Denmark.

Their outcomes were compared with around 17,000 people who had attempted suicide but had not gone for treatment afterwards.

Participants were then followed up for up to 20 years.

The aim of this therapy is to give people time and space to talk about their troubles and explore difficult feelings with a trained professional.

During the first year, those who received therapy were 27% less likely to attempt suicide again. They were also 38% less likely to die of any cause.

After five years, this same group saw 26% fewer suicides. Ten years later, the positive effects of the therapy were still evident.

Dr Elizabeth Stuart, study co-author and associate professor in the Bloomberg School's department of mental health, said the long-term follow-up was ideal for gathering information on which suicide prevention treatments worked.

"Our findings provide a solid basis for recommending that this type of therapy be considered for populations at risk for suicide," she said.

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NUI Galway to host major international conference on brain disorders

A major conference on neurodegenerative diseases takes place in Galway this week from 27-28 November.

NUI Galway will host the 24th Annual Meeting of the Network of European Central Nervous System Transplantation & Restoration (NECTAR). The NECTAR meeting is a major international gathering for researchers working on the development of cell and gene therapies for neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease.

In one of the sessions, Professor Roger Barker of the University of Cambridge and one of his patients, Mrs. Sheila Roy, will share their experiences of a new experimental drug called ProSavin® with the audience. ProSavin® is a viral gene therapy manufactured by Oxford BioMedica that is currently undergoing clinical trial for the treatment of Parkinson's disease. It is injected directly into the brain, inducing production of the neurotransmitter dopamine which is deficient in this condition. Trials in laboratory animals and humans have been a success, with ProSavin® demonstrating significant efficacy without the side effects associated with other current treatments for Parkinson's disease.

This conference has been held annually across Europe since its inauguration in Lund, Sweden in 1984, and this is the first time in its history that this prestigious international meeting has come to Ireland. 

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Irish Medicines Board, Becomes - HPRA

Irish Medicines Board becomes The Health Products Regulatory Authority (HPRA)

 A new name for the national regulator for medicines, medical devices and other health products came into effect today. The Health Products Regulatory Authority (the HPRA) is the new name for the Irish Medicines Board (IMB), since July 2014.

According to the HPRA, the new name more clearly reflects its broader remit and wider scope of functions and responsibilities across the health products sector which have expanded significantly since the IMB was first established in 1996.

To coincide with its new brand announcement, a new user friendly website, which provides significant information on health products and will be of interest to members of the public, healthcare professionals as well as health products industry has also been launched at www.hpra.ie.

Pioneering Ebola clinical trials to start next month

Médecins Sans Frontières/Doctors Without Borders (MSF) will host the first clinical trials of Ebola treatments in three treatment centres in West Africa, the international medical humanitarian organisation has announced.

The separate trials, which are aimed at quickly finding an effective therapy for the disease that has so far resulted in 5,000 deaths in the current outbreak in the region, will be led by three different research partners.

The French National Institute of Health and Medical Research (INSERM) will lead a trial using antiviral drug favipiravir in Guéckédou, Guinea; the Antwerp Institute of Tropical Medicine (ITM) will lead a trial of convalescent whole blood and plasma therapy at the Donka Ebola centre in Conakry, Guinea; and the University of Oxford will lead, on behalf of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), a Wellcome Trust-funded trial of the antiviral drug brincidofovir at a site yet to be determined.

The World Health Organ-ization (WHO) and health authorities of the affected countries are also taking part in this collaborative effort.

The trials’ protocols are in the final stages of development and are designed with a simple target of 14-day survival and with broad inclusion criteria.

The main principles and designs have been shared with the respective countries’ ethical authorities, with the goal of starting the first trials next month.

Initial results could be available in February.

The two drugs, brincidofovir and favipiravir, were selected from WHO’s shortlist of potential Ebola treatments after review of safety and efficacy profiles, product availability, and ease of administration to patients, MSF said.

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Times Higher Education to Partner with Elsevier on THE World University Rankings

Times Higher Education (THE) and Elsevier today announced a partnership in which Scopus and SciVal will provide the data and analytics for the THE World University Rankings, beginning in 2015.

Scopus data will underpin the World University Rankings, as well as THE’s other rankings such as the 100 Under 50, Asia University, and the BRICS & Emerging Economies rankings. Under the agreement with THE, Elsevier will also run their annual global academic reputation survey though THE will have ownership of the results and data behind the ranking indicators.

Trevor Barratt, Managing Director of THE, remarks, “Research publication data for the rankings will in the future be drawn from Elsevier’s Scopus database. The new data source will allow us to analyze a deeper range of research activity from a wider range of institutions than at present, including those institutions from emerging economies that account for a growing portion of the world’s research output and which have shown a great hunger for THE’s trusted global performance metrics.”

This is a great endorsement of the work  done over the last 10 years – improving the quality of the Scopus database, the breadth of global coverage and developing the market-leading research metrics and benchmarking tool, SciVal. 

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Brain Injury Ireland - Services

Acquired Brain Injury Ireland provides a range of specialised services throughout Ireland. As the needs of the individual change over time, Acquired Brain Injury Ireland provides a flexible approach, focusing strongly on individual development and incorporating person centred planning (PCP). Person Centred Planning ensures that the person served is fully involved in all decisions that affect his or her life. A personal profile is drawn up for each person that identifies their current abilities and their support needs. In partnership with the individual a personal rehabilitation programme is drawn up which is tailored to their needs and which enables them to realise personal goals which are meaningful to their lives. This approach, which is internationally recognised best practice, ensures that the services provided are never generic or based on assumptions of what is best for the individual. Acquired Brain Injury Ireland provides the following range of services throughout Ireland 

• Assisted Living Service                                               
• Transitional Living
• Community Rehabilitation Service
• Day Resource Service
• Rehabilitation Support Team
• Case Management
• External Awareness and Education Programme
• Individual Development

       

Sports Drinks and Sugar Content -

A survey by the Irish Independent found that sports drinks on sale in Irish stores contain between 17g and 50g of sugar per bottle.

The World Health Organisation recommends people consume a maximum of 50g of added sugar a day, though it's about to issue a new recommendation that "ideally" that should be cut to 25g.
The highest level we found was in Glanbia's Nutramino Protein XL drink sold in sports shops with a 500ml bottle containing 50g sugar - or more than 12 teaspoons worth.

Most of the sports drinks sold in convenience stores and supermarkets contained around four or five teaspoons of sugar in a 500ml bottle.

Lucozade Sport's 750ml bottle contained 27g of sugar, or seven teaspoons worth.  But some nutrition experts say sports drinks should be avoided, particularly by children, with dentists also critical of their damage to teeth.

Obesity expert Dr. Donal O'Shea said that last year's major EPIC study had proven that regularly drinking sugar-sweetened drinks directly increased the risk of getting diabetes.  "If you're a gold medal Olympian who's burning 6,000 calories a day and can't eat enough to replace that, maybe a sports drink is okay, but for everyone else they have no benefit," said the consultant endocrinologist.

"These are marketed so cleverly that you have seven and eight-year-olds who think they can't play a game of football without having a sports drink at half-time. But parents need to know they are no use, they are harmful, and children should be drinking water instead," he said.
Dietitian, Gaye Godkin agreed that sports drinks have "no place" in the diet.
"The evidence suggests that chocolate milk is the best thing for recovery," she said.
Irish people spend around €27m a year on sports drinks, but a recent UK study found that 55pc of sports drinks are consumed at home.

Sports drinks are designed to help people rehydrate during or after sport by providing sugar, salt and minerals at specific quantities which the body can absorb quickly.  Glanbia performance nutritionist Dr Crionna Tobin said that Nutramino Protein XL was "not a sports drink as most consumers would understand the term", but a "recovery product for those who take part in rigorous exercise".

Carbohydrate was an important nutrient to aid recovery post-exercise and European Food Safety Agency (EFSA) guidelines indicated usage of 4g per kilo of body weight in the first four to six hours after exercise, equating to 280g for a 70kg person. The 50g of sugar in Nutramino was "comfortably inside this level", Dr Tobin said.

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Compulsive Exercise - Eating Disorders

A LEADING eating disorder specialist, has said many young people have become obsessed with exercise and are pushing themselves to "extreme degrees" in order to lose weight.

Young people, both male and female, now suffer from "compulsive exercise" which is disrupting their family, work and social life, according to Dr. Sarah Prasad, an eating disorders specialist at St, Patrick's Hospital, Dublin.

"For a lot of my patients, their motivation to exercise is all about the drive to lose weight and they certainly take that to extreme degrees," said Dr Prasad.
She has patients ranging in ages from 18 to 52 but says she is aware of 12- and 13-year-olds suffering with such issues.

"For example, they can develop very obsessional and rigid patterns around exercise which means they might need to go to the gym for an hour every morning and after that they need to go walk a certain amount or certain distance. They might do a yoga video then after that.
"It's all driven by this fear that if they don't do it, they're going to put on weight. Or if they don't stick to that very regimented exercise routine, they will then compensate in other ways," she said.

"In my day-to-day life, I would see young boys and girls and you can see that their Body Mass Index is very low," she told the Irish Independent. ".. my concern is gym instructors have them doing all sorts of vigorous physical activities when they should be saying 'we need to get your weight up first'."

She added that often young people's overtraining was a "manifestation of other things going on for individuals, like anxiety or depression".

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'Diet and Major Renal Outcomes'

NUI Galway’s Dr Andrew Smyth

A healthy diet may help protect our kidneys, according to a new study presented by NUI Galway researchers at a major conference in Philadelphia.

Dr Smyth presented the initial findings of the study at Kidney Week 2014, the annual meeting of the American Society of Nephrology, which was attended by over 13,000 people. The study, which was called ‘Diet and Major Renal Outcomes: The NIH-AARP Diet and Health Study’, used data from a large US study (National Institutes of Health Diet and Health Study). Dr Martin O'Donnell of NUI Galway was the senior author on the report.  

Over 500,000 people aged 50-71, living in the United States, provided medical information and completed a diet questionnaire, which was used to measure how healthy each person's diet was at baseline (using four different scoring systems), as well as calculating each person's intake of sodium and potassium. Using available follow-up data, the researchers explored the association between diet and kidney outcomes, including the need for dialysis or dying with chronic kidney disease. During the study period, almost 5,000 people required dialysis or died with chronic kidney disease.

Using three of the four diet scoring systems, people with the highest scores for diet quality had the lowest risk of kidney outcomes. In these three scoring systems, people scored highly for eating plenty of healthy foods (such as fruits and vegetables) and for eating low amounts of unhealthy foods (e.g. deep fried, fatty or sugary foods). The biggest effects were seen with the scoring systems that focus on the whole diet. The fourth scoring system, which focuses only on healthy foods (Recommended Food Score), was not associated with kidney outcomes. In addition, the researchers found that high sodium intake was associated with an increased risk of kidney outcomes, as was low potassium intake.

View abstract here (p.14A): (copy and paste link)  file:///C:/Users/0031535s/Downloads/KW14Abstracts.pdf

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Dementia study questions advice on taking supplements

Taking vitamin B12 and folic acid supplements does not seem to cut the risk of developing dementia in healthy people, say Dutch researchers.

In one of the largest studies to date, there was no difference in memory test scores between those who had taken the supplements for two years and those who were given a placebo.

The research was published in the journal Neurology.

B vitamins have been linked to Alzheimer's for some years, and scientists know that higher levels of a body chemical called homocysteine can raise the risk of both strokes and dementia.

Vitamin B12 and folic acid are both known to lower levels of homocysteine.

Study leader Dr Rosalie Dhonukshe-Rutten, from Wageningen University in the Netherlands, said: "Since homocysteine levels can be lowered with folic acid and vitamin B12 supplements, the hope has been that taking these vitamins could also reduce the risk of memory loss and Alzheimer's disease.

"While the homocysteine levels decreased by more in the group taking the B vitamins than in the group taking the placebo, unfortunately there was no difference between the two groups in the scores on the thinking and memory tests."

Dr Eric Karran, director of research at Alzheimer's Research UK, said: Longer follow-up periods would be needed to see if vitamin B12 or folic acid could slow the severe memory decline associated with dementia. 

 He added: "Although this study casts doubt on the use of vitamin B or folic acid supplements to aid memory, a balanced diet is a good way to keep healthy at all ages.

"Evidence suggests that we can maintain a healthy brain for longer by keeping a healthy weight, eating a balanced diet, not smoking, staying active, drinking in moderation and keeping blood pressure and cholesterol in check."

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Mediterranean diet is best way to tackle obesity, say doctors

A Mediterranean diet may be a better way of tackling obesity than calorie counting, leading doctors have said.

Writing in the Postgraduate Medical Journal (PMJ), the doctors said a Mediterranean diet quickly reduced the risk of heart attacks and strokes.  And they said it may be better than low-fat diets for sustained weight loss.

The PMJ editorial argues a focus on food intake is the best approach, but it warns crash dieting is harmful.  They criticise the weight-loss industry for focusing on calorie restriction rather than "good nutrition".

They make the case for a Mediterranean diet, including fruit and vegetables, nuts and olive oil, citing research suggesting it quickly reduces the risk of heart attacks and strokes, and may be better than low-fat diets for sustained weight loss.

The lead author, cardiologist Dr Aseem Malhotra, says the scientific evidence is overwhelming.  "What's more responsible is that we tell people to concentrate on eating nutritious foods.

Inspired by traditional cuisine of countries such as Greece, Spain and Italy, the Mediterranean diet has long been associated with good health and fit hearts.

Typically, it consists of an abundance of vegetables, fresh fruit, wholegrain cereals, olive oil and nuts, as well as poultry and fish, rather than lots of red meat and butter or animal fats.

View article in PMJ : Healthy eating: an NHS priority: A sure way to improve health outcomes for NHS staff and the public

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Patient Safety and Antibiotics - Advice

The Health Service Executive is warning that new bugs are emerging that are multi-resistant. People are being advised to avoid taking antibiotics for a flu or cold, as the HSE says they will get better.
A new website called undertheweather.ie has been set up to give advice on how to treat viral infections.

People are being advised to avoid taking antibiotics for a flu or cold

The HSE says rest, fluid and paracetamol is all people need to get over many of these illnesses.
Dr Philip Crowley, HSE National Director for Quality and Patient Safety, said: "Undertheweather.ie is part of our on-going work to tackle the global threat of overuse of antibiotics, and the fact that antibiotics are becoming less and less effective.

"The common conditions included in the site are almost always caused by a virus, so an antibiotic is useless in dealing with these illnesses, Mr. Crowley said.
"We want to support people to know what to do when they are unwell, and when to get advice from a health professional, but also that antibiotics are almost never the answer when it comes to these common complaints," he added.

www.undertheweather.ie

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New Code of Professional Conduct and Ethics for Nurses and Midwives

The new Code of Professional Conduct and Ethics has been developed by NMBI and is effective from 10 December 2014.   It replaces the Code of Professional Conduct for Each Nurse and Midwife (2000) and follows an extensive consultation process.

The purpose of the Code is to guide nurses and midwives in their day-to-day practice and help them to understand their professional responsibilities in caring for patients in a safe, ethical and effective way.

Use the links below to read each chapter in the Code.  Alternatively you can download the Code in PDF format (see below):

• Purpose, aims and structure of the Code
• Glossary: words and phrases in the Code
• Principle 1: Respect for the dignity of the person
• Principle 2: Professional responsibility and accountability
• Principle 3: Quality of practice
• Principle 4: Trust and confidentiality
• Principle 5: Collaboration with others
• Subject index and references

Download the Code of Professional Conduct and Ethics (PDF 0.3 MB)

For more information view on NMBI here

Map Brings Focus to Numbers

New Map Highlights Cancer Death Rate Inequalities:

People living in some poorer parts of the Dublin region, are twice as likely to die from cancer as people in more affluent areas, according to new analysis released by the Irish Cancer Society.
Drawing on analysis from the Centre for Health Geoinformatics at NUI Maynooth, the society says that people in poorer areas also have greater difficulty accessing healthcare.

A new map of cancer death rates compiled by Dr Jan Rigby, and funded by the Health Research Board, shows there are major health gaps within areas of Dublin.

For example, the map shows that cancer death rates varied from 381 per 100,000 in Blakestown North-West to 128 per 100,000 in Castleknock South-East.
    

Dublin city Dún Laoghaire–Rathdown South Dublin Fingal Meath Kildare Wicklow

Kathleen O'Meara, Head of Advocacy and Communications at the Irish Cancer Society said "Cancer affects all parts of Irish society but some people are more at risk than others and where you live has a huge influence on this.

“Unfortunately, the more deprived the area, the higher the risk of a person getting and dying from cancer. As well as this, often the poorest in society, have the greatest difficulties in accessing healthcare.

“In some deprived Dublin areas, there are not enough primary care resources - for instance in North Dublin there is one GP for every 2,500 people.

“Nationally this figure is 1:1600. In addition there have been increased A & E charges, long stay charges and increased prescription charges. By 2013 it has meant that every person in Ireland was on average paying about €100 in additional costs for accessing care and prescribed drugs.”

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Surgical Residents - Innovative Training

Novel 3-D simulation technology helps surgical residents train more effectively:

Vishal Patel, Rajesh Aggarwal, Daniel Cohen, Dave Taylor, Ara Darzi. Implementation of an Interactive Virtual-World Simulation for Structured Surgeon Assessment of Clinical Scenarios.

Journal of the American College of Surgeons, 2013; 217 (2): 270  10.1016/j.jamcollsurg.2013.03.023

A novel interactive 3-dimensional (3-D) simulation platform offers surgical residents a unique opportunity to hone their diagnostic and patient management skills, and then have those skills accurately evaluated according to a new study appearing in the August issue of the Journal of the American College of Surgeons. The findings may help establish a new tool for assessing and training surgical residents.

Previous research studies have shown that the management of patient complications following operations is an extremely important skill set for surgeons to master. Therefore, in addition to performing operations, surgeons must also be able to effectively manage surgical patients in the emergency room, on the hospital floor unit, or in the intensive care unit. Until now, the standard approach for this instruction has been to learn to master this skill set on patients.

"The way we learn in residency currently has been called 'training by chance,' because you don't know what is coming through the door next," said study coauthor Rajesh Aggarwal, MD, PhD, MA, FRCS, a National Institute for Health Research (NIHR) clinician scientist in surgery at Imperial College, St. Mary's Hospital in London. "What we are doing is taking the chance encounters out of the way, residents learn and forming a structured approach to training."

Using an online virtual world called Second Life™, a multidisciplinary team of researchers from Imperial College, St. Mary's Hospital developed three virtual reality environments -- a standard hospital ward, an intensive care unit, and an emergency room.

‘Ebola – The Facts’ Lecture at NUI Galway

NUI Galway’s School of Nursing and Midwifery is running a free public lecture on Ebola: how it spreads, how it affects the human body, and how the outbreak can be contained. The lecture, on Tuesday, 18 November from 7-9pm in Áras Moyola, will also focus on hand washing and its importance in preventing the spread of infections in the community.

Dr Diarmuid O’Donovan, senior lecturer in NUI Galway’s School of Medicine and the Director of Public Health for the HSE West, will be delivering the lecture alongside Evelyn Byrne, lecturer from the School of Nursing and Midwifery. Evelyn Byrne will explain why hand washing is important, including a demonstration on effective hand washing. Dr O’Donovan recently returned from working with the World Health Organisation (WHO) on the Ebola response.

‘Ebola – The Facts’ is the second event of a public lecture series, an innovative community outreach initiative started in NUI Galway’s School of Nursing & Midwifery this year. The series aims to share knowledge and expertise on health matters with local communities.

Dr Adeline Cooney, Head of NUI Galway’ School of Nursing and Midwifery, said: “This public lecture series is interactive in nature, allowing full community engagement and we look forward to active and lively discussions and debates.”

If there are any future topics you would like covered during the lecture, please contact john.quinlivan@nuigalway.ie or mary.e.gannon@nuigalway.ie.