Hydration and Nutrition Standards Review - HIQA

A new review suggests nutrition and hydration is not viewed as a priority for some hospitals.
The review, published by the Health Information and Quality Authority, says 21% of acute public hospitals do not have a system in place to screen for malnutrition risks.
This is despite the fact that malnutrition affects more than a quarter of hospitals.

               

A 2012 study said the annual healthcare costs associated with disease-related malnutrition was around €1.5 billion.
The review also found that in some cases the hydration needs of patients were not met.
This mainly applied to patients in emergency departments who were deemed to be admitted, but who remained there for lengthy periods while waiting for a bed in the main hospital.
While all 42 hospitals inspected had stated that patients had access to fresh drinking water, HIQA inspectors found drinking water was only topped up by staff during the day in most inspected hospitals if a jug was seen to be empty or at a patient's request.
In a number of emergency departments, patients who were not mobile and could not access a water cooler were not routinely being offered drinks.
Less than one in three hospitals inspected had a system to replenish water jugs with fresh water during the afternoon so as to ensure that patients always had access to fresh water.
In addition, there was a lack of consistency in the meals offered to patients in emergency departments.
As part of the review, HIQA analysed information from 42 hospitals, carried out unannounced inspections in 13 hospitals, as well as speaking with patients and staff and reviewing patient records.
Susan Cliffe, HIQA's Head of Healthcare, said "food should be seen as an integral part of a patient's treatment, rather than a 'hotel service' provided by the hospital."
She added that "many patients experience unintentional weight loss of over 10% of their body weight prior to admission and their nutritional status often deteriorates while in hospital.
Nutrition and hydration is fundamental to their treatment and recovery plan of care."

Alarm Raised at Resistant Infection!

US health officials have reported the first case in the country of a patient with an infection resistant to all known antibiotics, and expressed grave concern that the superbug could pose serious danger for routine infections, if it spreads.
"We risk being in a post-antibiotic world," said Thomas Frieden, director of the US Centers for Disease Control and Prevention, referring to the urinary tract infection of a 49-year-old Pennsylvania woman who had not travelled within the prior five months.

The superbug reportedly contains a gene called mcr-1 that confers resistance to colistin

Mr. Frieden, speaking at a National Press Club lunch in Washington, DC, said the infection was not controlled even by colistin, an antibiotic that is reserved for use against "nightmare bacteria."
The infection was reported yesterday in a study appearing in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology.
It said the superbug itself had first been infected with a tiny piece of DNA called a plasmid, which passed along a gene called mcr-1 that confers resistance to colistin.
"(This) heralds the emergence of truly pan-drug resistant bacteria," said the study, which was conducted by the Walter Reed National Military Medical Center. "To the best of our knowledge, this is the first report of mcr-1 in the USA."
The patient visited a clinic on 26 April 2016 with symptoms of a urinary tract infection, according to the study, which did not describe her current condition.
Authors of the study could not immediately be reached for comment.
The study said continued surveillance to determine the true frequency of the gene in the United States is critical.
"It is dangerous and we would assume it can be spread quickly, even in a hospital environment if it is not well contained," said Dr. Gail Cassell, a microbiologist and senior lecturer at Harvard Medical School.
But she said the potential speed of its spread will not be known until more is learned about how the Pennsylvania patient was infected, and how present the colistin-resistant superbug is in the United States and globally.
In the United States, antibiotic resistance has been blamed for at least 2 million illnesses and 23,000 deaths annually.
The mcr-1 gene was found last year in people and pigs in China, raising alarm.
The potential for the superbug to spread from animals to people is a major concern, Dr. Cassell said.
For now, Dr. Cassell said people can best protect themselves from it and from other bacteria resistant to antibiotics by thoroughly washing their hands, washing fruits and vegetables thoroughly and preparing foods appropriately.
Experts have warned since the 1990s that especially bad superbugs could be on the horizon, but few drug makers have attempted to develop drugs against them.

Zika Virus, No. (3) - WHO

The spread of Zika is the price being paid for a massive policy failure on mosquito control, says World Health Organization leader, Margaret Chan.
Speaking at the agency's annual World Health Assembly, Dr. Chan said experts had "dropped the ball" in the 1970s with regards to getting a handle on disease-carrying insects.
More than 60 countries and territories now have continuing Zika transmission.
Most recently, the infection, spread by mosquito bites, reached Africa.

Experts predict the same strain could reach Europe in the summer.

The virus is thought to cause serious birth defects during pregnancy and has been declared a global public health emergency.

According to Dr. Chan, outbreaks that become emergencies always reveal specific weaknesses in affected countries and illuminate the fault lines in our collective preparedness.


Image: European PA                            

"Zika reveals an extreme consequence of the failure to provide universal access to sexual and family planning services," she said.
Dr. Chan added that Latin America and the Caribbean, which have been hit hardest by Zika, have the highest proportion of unintended pregnancies in the world.

Tanning Injections - Health Warning!

The Health Products Regulatory Authority (HPRA) has issued a warning over tanning injections which are being bought illegally over the internet.
The warning follows a sharp increase in the number of products seized in Ireland last year.
In 2015, 305 seizures were made, compared to just four in 2014 and five in 2013.

The HPRA says last year's figure related to one major seizure and an investigation is on-going.
The products come in powder form and in some cases with a solution. They are mixed and injected into the stomach with an insulin needle.
The hormone in the injections, which can be bought online for as little as €40, encourages the production of melanin, making the skin turn brown.
However, the side effects can be serious, including nausea, depression and cardiovascular problems.
The injections have also been linked to skin cancer and stroke.

The Irish Cancer Society has described the practice of tanning injections as "sheer madness".

The HPRA has urged people not to use the injections, and has advised anyone who has been using the product to stop immediately and contact their doctor.

Data Analysis - New Edition of SPSS

The new edition of Pallant's SPSS Survival Manual has arrived at The James Hardiman Library.

The 6th Edition, 2016 of Pallant's research work is located at 005.55 SPSS.P rather than the regular number for Statistics titles (519.5)

The SPSS Survival Manual throws a lifeline to students and researchers grappling with this powerful data analysis software.

In her bestselling guide, Julie Pallant guides you through the entire research process, helping you choose the right data analysis technique for your project. From the formulation of research questions, to the design of the study and analysis of data, to reporting the results, Julie discusses basic and advanced statistical techniques. She outlines each technique clearly, with step-by-step procedures for performing the analysis, a detailed guide to interpreting data output and an example of how to present the results in a report. For both beginners and experienced users in psychology, sociology, health sciences, medicine, education, business and related disciplines, the SPSS Survival Manual is an essential text.

Illustrated with screen grabs, examples of output and tips, it is supported by a website with sample data and guidelines on report writing. This sixth edition (2016) is fully revised and updated to accommodate changes to IBM SPSS procedures, screens and output. It covers new SPSS tools for generating graphs and non-parametric statistics, importing data, and calculating dates. 'An excellent introduction to using SPSS for data analysis. It provides a self-contained resource itself, with more than simply (detailed and clear) step-by-step descriptions of statistical procedures in SPSS.

There is also a wealth of tips and advice, and for each statistical technique a brief, but consistently reliable, explanation is provided.' - Associate Professor George Dunbar, University of Warwick..'This book is recommended as ESSENTIAL to all students completing research projects - minor and major.' - Dr John Roodenburg, Monash University.

 

 

UK Diabetes Treatment Trial:

Type 2 Diabetes Treatment Hailed as Major Breakthrough:

A trial run of a Type 2 diabetes treatment by a West Midlands hospital trust has been hailed as a major breakthrough.

The two-year programme involved putting a latex tube, known as an Endo-barrier device, into the patient's small intestine to reduce the rate at which food is absorbed.
About one hundred people took part in the project at City and Sandwell hospitals, losing on average two stone in weight and drastically reducing their blood sugar levels.
Nick Pharhani, 52, who lost four-and-a-half stone (28 kg), said: "I do feel a lot more positive about myself."

Ireland's commitment to eHealth : The Future Health Summit

More than 1,500 delegates will gather in Dublin's Citywest Convention Centre on May 26th and 27th next to discuss some of the main health issues facing society to-day.

The Future Health Summit is actually a series of 15 separate summits covering areas as diverse as mental health, medtech, oncology, wellbeing at work, clinical leadership, diabetes, eHealth and homecare.

The theme for the 2016 summit is 'Empowering the Patient; information, choice and accountability'.

The summit is now the must-be-at European event for present and future healthcare leaders.

International interest has been growing every year with a huge range of innovators and global leaders attending from over 30 countries this year.

One of the summits within the conference which is attracting most attention is the Festival of ehealth. This event is aimed at demonstrating Ireland's commitment to ehealth and how technology is delivered to health in Ireland.

Chaired by HSE chief information officer, Richard Corbridge, the event will feature a number of leading international speakers who will be addressing topics like security, how to deploy technology successfully, the latest clinical equipment and so on.

One of the key areas for discussion will be the electronic patient record system which Corbridge and his team hope to introduce to Ireland in the coming years.

Feeling Arty in the world of Medicine

The dotMed conference aims to reconnect with the art and humanity of medicine

What do a novelist and playwright, a comic artist and writer, a photographer, a medical ethicist and a social media expert have in common? They are all medical doctors and all appeared at the dotMED conference which was held in the Smock Alley Theatre in Dublin last month.

The conference was founded by Dr Ronan Kavanagh, consultant rheumatologist  and  Dr Muiris Houston. Kavanagh says the event was born out of a sense of boredom and unfulfillment with traditional medical conferences, which are largely science- and data-based.“We also felt there was a need within ourselves and amongst our colleagues to try and reconnect with everything that is great in medicine. So dotMED is a meeting designed to inspire and re-enthuse doctors about their medical calling. We do that by exploring the spaces within medicine and between medicine and other disciplines,” he says.

Deborah Bowman, professor of bioethics, clinical ethics and medical law and dean of students at St George’s University of London, gave a thought-provoking presentation entitled Staging Medicine: Theatrical Perspectives on Health.

In her talk, she drew parallels between the art of medicine and theatre and underlined the importance of patients and doctors making a real connection in consultation.

Bowman described the patient-doctor consultation as a “mysterious, unique and special interaction” that could create hope in situations that appeared hopeless and could offer solace where there had not been any. That, she said, had “unique transformative power”“Ultimately, a human being sitting with you in a dark moment or listening to you without judgment when you have been frightened is as therapeutic as any amount of prescribing. We don’t talk about it and we don’t value it as much as we could.”

As well as the art of medicine, other art disciplines were also celebrated at dotMED, which featured a photographic exhibition as well as a live music performance by Irish musician Colm Mac Con Iomaire.

The photographic exhibition Limits was shown as part of the conference. In it, Dr Leticia Ruiz Rivera, a palliative care physician from Spain, portrayed the deeply human effects of on-call hours on junior doctors.Ruiz Rivera photographed junior doctors before and after a long and arduous on-call shift. While the before photographs show smiling young professionals, the effects of fatigue and stress can be clearly seen etched in the same faces in the photographs taken immediately after a shift.

Other artists featured included Ian Williams, a GP and comic artist from the UK, whose critically acclaimed graphic novel The Bad Doctor was published in 2015. He also pens a regular comic strip Sick Notes for the Guardian.

At a time when doctors and healthcare workers are under increasing pressure and the health service is often the subject of bad news, the focus of dotMED is a reminder of the value of humanity in human medicine and the need to treasure it indefinitely.

Nutrition at a Glance!

The James Hardiman Library has recently acquired the second edition of a popular title from the 'At a Glance Series' which is published by Wiley Blackwell :
                                      
  Located at 612.3 NUT

Nutrition at a Glance (2016) - this publication, edited by Sangita Sharma covers such topics as the relationship between diet, health and disease; as well as assessing  the consequences of food choices. It also glances at the public health features of sports nutrition, as well as the impact of genetically modified foods and aspects of food safety.

Endurance at High Altitudes!

Dr. Gerard Flaherty, Senior Lecturer in Clinical Medicine and Medical Education at NUI Galway, was elected President of the Travel Medicine Society of Ireland (TMSI) during the fourth Northern European Conference on Travel Medicine (NECTM) held in Dublin, during 2012

Altitude training for elite endurance athletes: A review for the travel medicine practitioner
by Flaherty, OConnor and Johnston, from Travel Medicine and Infectious Disease
Vol. 20 pages 1-12, 2016 and is available from the ScienceDirect database through access to
The James Hardiman Library



Summary -
Altitude Training for Elite Endurance Athletes: A Review for the Travel Medicine Practitioner

High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised.

Mindfulness for Nurses - Book Launch 12th May

The Nurse's Guide to Cultivating Mindfulness and Compassion

World's smallest pacemaker! - Dublin

An 82-year-old Dublin man has become the first patient in Ireland to have the world's smallest pacemaker fitted. Peter Cassells, from Blackrock, Dublin city underwent the procedure at the Blackrock Clinic just over a week ago.
Today, he told RTÉ News that he feels very well after the operation, which was carried out using minimally invasive surgery.
The Medtronic Micra pacemaker is smaller than an AAA battery, and 93% smaller than conventional pacemakers.The average battery life for the pacemaker is about twelve years.


There is no box required with the device, removing the risk of erosion and infection and the need to remove the device. No leads are needed, eliminating the risk of blocked veins.
The device, which costs around €7,500, was fitted by Dr. Jonathan Lyne, consultant cardiologist and electro-physiologist at the Blackrock Clinic.
It is inserted into the right heart chamber by a catheter, via a femoral vein in the thigh.

Patients can be discharged within 24 hours of the procedure, if there are no other complications.

New Books in Nursing & Midwifery Library

Located at 610.73072 BET

Located at 616.0019 BAR

Located at 616.89 SPI

Located at 616.33 EMM

Located at 618.97 NEW

Adventures with Attenborough, TV Series:1956 - 2016

Sir David Attenborough, well known educationalist, through many decades and former director of BBC Two celebrated six decades of TV productions in 2016.
His TV series of various titles, have both engaged and enthralled millions of interested participants and some of us wish that David could have been our science-teacher.

Since David began his TV programmes, many variables have impacted on the health of the planet and the Australian continent in particular has been at the centre of a number of adaptations to climate variations. One Australian example in particular that of Lake Wendouree, adjacent to the city of Ballarat, Victoria.

While David was at the beginning of his presentations to the various opportunities provided by his TV productions in 1956, the Olympic rowing competitions were taking place at Lake Wendouree.
Due to a drought from 2006 to 2011 - Lake Wendouree became a dry-lake.
The two contrasting images below, indicate the dramatic change to Lake Wendouree

                                              

(1) Boats on the lake - 1905 (2) December drought - 2006 

                                                                                                                         

US student wins writing-contest

Handless, seven-year-old girl wins US hand-writing contest:
A seven-year-old student, born without hands has won a US national hand-writing contest.

Anaya Ellick from Chesapeake, Virginia, USA does not use prosthetics.
To write, she stands to get the proper angle, holding a pencil between her arms.
Her principal, Tracy Cox from Greenbrier Christian Academy, describes her as an "inspiration".
"She does not let anything get in the way of doing what she has set out to do," says Miss Cox.
"She is a hard worker and has some of the best handwriting in her class."

 

Anya beat 50 other competitors to get the special-needs category prize at the National Handwriting Contest.

This category rewards students with an intellectual, physical, or developmental disability.
Competition director Kathleen Wright told ABC News that her "writing sample was comparable to someone who had hands".

Exercise Influencing Health - Sports Statistics

Exercise has taken a central position regarding health, especially within the western-world in recent decades with multiple studies, illustrating the links between exercise and health.

A contribution to this research is contained within a publication which has an NUI Galway lecturer as a primary author - John Newell:

Statistics for Sports and Exercise Science, A Practical Approach
is located at 613.71 NEW

This publication points the reader towards:
- Asking appropriate questions
- Designing a suitable study to answer those questions
- Choosing an adequate number of subjects for the study
- Producing appropriate graphs to describe the study area
- Carrying out a comprehensive analysis of these data
- Presenting clear and justifiable conclusions based on the data

  613.71 NEW                    Image not available Photos not available for this variation

 

British National Formulary - BNF

The BNF - British National Formulary, is published in updated book form twice a year, each March and September. It details all medicines that are generally prescribed in the UK, with information about:

• indications and dosages
• contra-indications
• cautions
• side effects
• medicinal products
• and more

It is compiled for Health Professionals involved with prescribing, monitoring, supplying, and administering medicines.

The current edition of this publication is BNF No. 71 located at 615.1341 BRI
BNF is also available, through Online Access

Clinical Examination - Shorter Version!

Copies of the much used text, Clinical Examination (7th Ed.) by Talley and OConnor are located at
616.0754 TAL

Recently copies of the smaller version, Clinical Examination Essentials (4th Ed. 2016) became available, and these copies are also located at 616.0754 TAL


Key Features:

• Hint Boxes present handy information which assists students and junior doctors in correctly diagnosing patients, e.g. A cough of recent origin, particularly if associated with fever and other symptoms of respiratory tract infection, may be due to acute bronchitis or pneumonia
• Question Boxes provide a checklist of questions which students as examiners should pose to patients to enable them to correctly identify the presenting symptoms required for an accurate diagnosis, e.g. Are you breathless at rest? On lying down? (Orthopnoea)
• The EOSCE hints panel at the end of each chapter provides practice OSCE-style scenarios and answers to test all skills required for the OSCEs

4th Edition - Clinical Photographs:

• A combination of clinical photographs and anatomical line drawings is a distinct improvement in this new edition. The clinical photographs represent real-life clinical signs, which students have to recognize when examining a patient.

International Travel Hazards

Travel Hazards - Travellers' Diarrhoea


The BMJ journal has published a Clinical Review on the hazards of international travel:
             
Travellers' Diarrhoea  -   http://www.bmj.com/content/353/bmj.i1937

Jessica Barrett and Mike Brown review the current epidemiology of travellers’ diarrhoea, evidence for different management strategies, and the investigation and treatment of persistent diarrhoea, following travel.

Related article

• Clinical Review
  

  Irritable bowel syndrome: new and emerging treatments

  Published: 18 June 2015; BMJ 350 doi:10.1136/bmj.h1622 http://www.bmj.com/content/350/bmj.h1622  

EU Health Directive - Tobacco Advertising!

Europe's highest court has upheld a tough EU law on standardising cigarette packaging and banning advertising of e-cigarettes, paving the way for its adoption this month.

The EU Court of Justice rejected a legal challenge brought by Philip Morris International and British American Tobacco.
The ruling could weigh on profits for the tobacco industry and sets a precedent for other governments to crack down on a habit that causes nearly six million deaths a year, world-wide.

"The court finds that, in providing that each unit packet and the outside packaging must carry health warnings ... the EU legislature did not go beyond the limits of what is appropriate and necessary," the court said in its decision.
The legal challenge, which was also supported by Japan Tobacco International and Imperial Brands, can now be taken no further.
The Tobacco Products Directive will take effect on 20 May, though there is a one-year sell-through period to allow wholesalers and retailers to sell existing stocks.
The Irish Cancer Society has welcomed the judgment, saying it is a defeat for the tobacco industry, which knows plain packaging works.
Its Head of Services and Advocacy, Donal Buggy, said: "Plain packaging of tobacco will save lives."
He said the ruling "represents the overcoming of another legal hurdle to the introduction of plain packaging in Ireland.
"What remains to be done now is the passing of minor technical amendments to legislation here, so that plain packaging can be introduced, in the very near future."

The EU court rejected Philip Morris International and British American Tobacco's challenge

Popular Surgery Title Available Online!

One of the Medical Library's much-in-demand titles is also available, through the Online option:

Clinical Cases and OSCEs in Surgery - Ramachandran (2nd Edition, 2011) and may be accessed through the James Hardiman Library homepage, using your

Username and Password:

Recent Additions to Nursing & Midwifery Library

Located at 613 NAI

Located at 618.20233 MUS

Located at 005.55 SPSS.P

Cancer research 'milestone' at Cambridge

Scientists say they now have a near-perfect picture of the genetic events which cause breast cancer.

The study, published in Nature, has been described as a "milestone" moment that could help unlock new ways of treating and preventing the disease.
The largest study of its kind unpicked practically all the errors that cause healthy breast tissue to go rogue.
Cancer Research UK said the findings were an important stepping-stone to new drugs for treating cancer.To understand the causes of the disease, scientists have to understand what goes wrong in our DNA that makes healthy tissue turn cancerous.

 The international team looked at all 3 billion letters of people's genetic code - their entire blueprint of life - in 560 breast cancers.

They uncovered 93 sets of instructions, or genes, that if mutated, can cause tumours. Some have been discovered before, but scientists expect this to be the definitive list, barring a few rare mutations.

'Important information'

Professor Sir Mike Stratton, the director of the Sanger Institute in Cambridge which led the study, said it was a "milestone" in cancer research.
He told the BBC: "There are about 20,000 genes in the human genome. It turns out, now we have this complete view of breast cancer - there are 93 of those [genes] that if mutated will convert a normal breast cell into a breast cancer cell. That is an important piece of information.
"We hand that list over to the universities, the pharmaceuticals, the biotech companies to start developing new drugs because those mutated genes and their proteins are targets for new therapeutics."
"There are now many drugs that have been developed over the last 15 years against such targets which we know work."

 ACK: Science Photo Library
                              

Mutations in our DNA can cause cancer

Mutations leave unique scars - known as mutational signatures - on our DNA and that allowed the team to identify 12 types of damage, which cause mutations in the breast.
Some are related to family risk, but most are still unexplained.

One class of mutation seems to stem from the body attacking viruses by mutating their genetic code, but also suffering collateral damage in the process.
Whether any of these processes can be altered is still unknown in this nascent field, but researchers hope the findings could eventually lead to ways of reducing the risk of cancers.
Dr. Serena Nik-Zainal, another researcher at the Sanger Institute, added: "In the future, we'd like to be able to profile individual cancer genomes so that we can identify the treatment most likely to be successful for a woman or man diagnosed with breast cancer.
"It is a step closer to personalised health care for cancer."

Dr. Emma Smith, from Cancer Research UK, said: "This study brings us closer to getting a complete picture of the genetic changes at the heart of breast cancer and throws up intriguing clues about the key biological processes that go wrong in cells and drive the disease.
"Understanding these underlying processes has already led to more effective treatments for patients, so genetic studies on this scale could be an important stepping stone towards developing new drugs and boosting the number of people who survive cancer."