Irish Healthcare - Overview

Health Service Executive Director General Tony O'Brien has told the Committee on the Future of Healthcare that 80% of Ireland's health services are of a very high standard, but that this is overshadowed by the 20% of services that are not delivered as they should be.

He said despite resource restraints over the past six years of austerity, there have been numerous improvements, including stroke care, where Ireland is now placed in the top three in Europe.
However, Mr O’Brien said treating an older population is costly and getting more costly, and unless this is planned for significant difficulties will emerge in future.
He said the HSE is already seeing the effect on bed capacity.
More emergency work and less elective work is being carried out each year, and if these trends continue the HSE will be unable to accommodate elective work in the future, he said.
Mr O’Brien said the HSE was created with a big bang and was not well thought through, saying it is not possible to manage all staff from one central location.
He said seven hospital groups have been established and should now be allowed time to bed in, adding that a rethink is needed of existing policies and capital expenditure.
Healthcare planning is tied to the electoral cycle, he said, as well as a 12-month economic cycle, which hampers rather than facilitates reform.
Mr O'Brien said Ireland needs to build consensus on health spending and how much taxpayers are willing to hand over for the health service they want.

Tony O'Brien, HSE said treating an older

population is costly and getting more costly

Committee chairperson Róisín Shortall questioned whether Mr O'Brien meant that the taxpayer should spend more on healthcare, considering Ireland's spend is close to the top of the OECD at the moment.

Mr O'Brien clarified, saying Ireland is spending a very substantial sum on healthcare, and there is an opportunity to spend that funding better.

Liam Woods, Interim Acting Director of Acute Services, said the HSE reduced agency staff costs by €38 million last year, but there was still a high level of such agency staff.

New Treatment - Lung Disease

Scientists in Ireland are developing a new treatment for lung diseases, including cystic fibrosis and asthma, as part of an €8.8m international project.

The first of its kind dry powder inhaler will deliver an innovative drug into the lungs in a way that is hoped will effectively break up thick sticky mucus, that can cause lung infections.
Cystic fibrosis is caused by a genetic anomaly that leads to the production of a thick sticky mucus in the lungs, which in turn can lead to serious infections.



Ireland has the highest incidence of cystic fibrosis in the world.

While there are therapies that can break up the mucus, there are a limited number of effective ones.
In fact there have been no new versions of these mucolytic therapies in the past 20 years, and only one in the past 50.
Scientists at the University of California and University College Dublin have developed a novel compound which shows great promise as a drug for breaking up mucus.

Professors John Fahy and Stefan Oscarson from those universities have secured €8.8m from the US National Institutes of Health (NIH) for two projects associated with the development of new lung disease treatments.
As part of one of these, scientists from the Science Foundation Ireland-funded AMBER and SSPC centres, led by Prof Anne-Marie Healy, head of the school of pharmacy at TCD have been awarded €600,000 to devise a new method of delivering the drug into the lungs.
They will develop a first of its kind dry powder inhaler that will enable the treatment to reach the mucus and break it up.
Professor Anne Marie Healy, Head of the School of Pharmacy and Pharmaceutical Sciences at Trinity, Investigator in AMBER and SSPC (The Synthesis and Solid State Pharmaceutical Centre, led by the University of Limerick) said,
"I am delighted to be part of a transnational NIH project, which aims to take the research from bench to bedside," said Prof Healy.
"Ireland has the highest incidence of cystic fibrosis in the world, with approximately 1 in 19 Irish people carrying one copy of the altered gene that causes the condition.
"In addition, Ireland has the fourth highest prevalence of asthma in the world, with almost 5,000 asthma admissions to hospital on average each year.
"Our proposed new treatment has the potential to greatly improve the respiratory function of these patients with lung disease, thus improving overall quality of life and reducing hospital admissions."
It is expected that within the five year lifetime of the project the new treatment will be clinically trialled on humans.

It is hoped that as well as being used for treating cystic fibrosis and asthma, the inhaler will also be useful for tackling other lung conditions, like chronic obstructive pulmonary disease.

Life - Course Criminology

The study of Life-Course Criminology seems far removed from the study of health care and medical topics.

Recently received title -
An Introduction to Life-Course Criminology by Carlsson and Sarnecki reviews the various features/theories associated with criminology and how criminal-careers might be predicted, and interventions introduced to provide the most appropriate impacts. The authors also provide examples from their work on the Stockholm Life-Course project.

This title is located at 364.3 CAR

 

 

A related topic to Criminology, the study of Forensic Medicine.
Titles on this subject are located at 614.1 - in particular

Simpson's Forensic Medicine - 614.1 PAY

 

 

 

Teamwork - Healthcare Delivery

Within recent decades healthcare delivery has become increasingly reliant on the principles, which support teamwork.

Educational studies have also focused on promoting the inter-professional practices associated with nurturing the teamwork aspects, required to deliver modern medical care.

A recent publication on this topic is now part of the James Hardiman collection:

Healthcare Teamwork (Inter-Professional Practice and Education)  by  T J K Drinka and P G Clark (2nd edition, 2016) is located at

362.1068 DRI

                   

 

Medicinal Cannabis - Review

Simon Harris pledges to take action on Medicinal Cannabis

Minister makes promise to mother of child, with catastrophic form of epilepsy.



The Minister made the promise to Vera Twomey after she embarked on a walk from County Cork to Leinster House, in order to draw attention to this issue.
Her six year old daughter, Ava Barry, has a catastrophic form of epilepsy but is now almost seizure free after she started taking two doses of Cannabis Oil a day.
Ava suffers from Dravet Syndrome and needed around - the - clock care before she started taking Cannabidiol Oil earlier this month. Ms. Twomey is calling for a change to Irish law to allow for Cannabis to be used for medicinal purposes.

Cannabis for medicinal purposes is legal in a number of countries including The Netherlands, The Czech Republic, Canada, Australia, Malta, Croatia and some US states. It is usually made available on prescription from doctors and supplied in a standardised form through pharmacies.
Mr. Harris said that the government had ordered a review of the Republic's policy on Medicinal Cannabis.

Fingerprints reveal Lifestyle

Traces of skin, oil and grime left on your phone, can reveal a lot about your lifestyle, and may some day serve as a "fingerprint" in criminal investigations, researchers have said.

The study involved 39 volunteers who allowed scientists to swab their smart phones - and right hands - in several places.
Researchers found a bounty of chemical information left behind on the devices.
These included anti-inflammatory and anti-fungal skin creams, hair loss treatments, anti-depressants and eye drops, according to the study in the Proceedings of the National Academy of Sciences.
They also found food molecules from citrus, caffeine, herbs and spices.
Sunscreen ingredients and DEET mosquito repellent were detected months after they had last been used by the phone owners.

Researchers found lots of chemical information

left behind on mobile devices

"By analysing the molecules they've left behind on their phones, we could tell if a person is likely female, uses high-end cosmetics, dyes her hair, drinks coffee, prefers beer over wine, likes spicy food, is being treated for depression, wears sunscreen and bug spray - and therefore likely spends a lot of time outdoors - all kinds of things," said study co-author Amina Bouslimani of the University of California, San Diego.
"This is the kind of information that could help an investigator narrow down the search for an object's owner."
Other applications could include criminal profiling, airport screening, medication adherence monitoring and environmental exposure studies.
"You can imagine a scenario where a crime scene investigator comes across a personal object - like a phone, pen or key - without fingerprints or DNA, or with prints or DNA not found in the database," said senior author Pieter Dorrestein, of the San Diego School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences.
"They would have nothing to go on to determine who that belongs to. So we thought, what if we take advantage of left-behind skin chemistry to tell us what kind of lifestyle this person has?"
The study was considered a "proof of concept" exercise, and more work is needed to refine the techniques for widespread use.
For now, the approach can only provide a general profile of person's lifestyle, not a one-to-one match.

Medico-Legal Issue - Case Study

A 14-year-old girl who died of cancer has been cryogenically frozen in the hope that she can be "woken up" and cured in the future after winning a landmark court case in her final days.


Justice Peter Jackson 

The girl's divorced parents had disagreed over whether her wish to be frozen should be followed, so the girl, who cannot be named for legal reasons, asked a High Court judge to intervene.

In a letter to the court, she said: "I don't want to die but I know I am going to... I want to live longer... I want to have this chance."

The girl, known as JS, asked Mr Justice Peter Jackson to rule that her mother, who supported her desire to be cryogenically preserved, should be the only person allowed to make decisions about the disposal of her body. Shortly before her death in a London hospital on October 17, in what is believed to be a unique case, the judge granted JS her wish.

Her body was frozen and taken to a storage facility in the US. She is one of only 10 Britons to have been frozen, and the only British child.
She told a relation: "I'm dying, but I'm going to come back again in 200 years."

But after a decision that raises profound moral and ethical questions, the judge and the girl's doctors expressed serious misgivings about the process, which did not go entirely to plan.
Her mother spent the last hours of her daughter's life fretting about details of the freezing process, which was "disorganised" and caused "real concern" to hospital staff.

Mr Justice Jackson suggested that "proper regulation" of cryonic preservation should now be considered.
The case can only now be reported because the judge ruled that nothing could be published until one month after JS's death. He also ruled that her parents' names and other specific details should stay secret.

JS, who lived with her mother in London, was diagnosed with a rare form of cancer last year and by August this year she had been told it was terminal. She began researching cryonics online - a controversial and costly process that involves the freezing of a dead body in the hope that resuscitation and a cure may one day be possible - and decided she wanted to be frozen after her death.

advertisement

Unable to play media

source:

Embed code Size: 320x240 480x320 1280x720

---

Direct link

Tap to unmute

Blue Billywig Video Player

Legally, she had to have the permission of both of her parents, but her estranged father had disagreed, sparking the court battle. (© Daily Telegraph London)

Gut Bugs - Support Cancer Drugs

Bacteria living deep inside the digestive system seem to alter how cancer drugs work, a study suggests.

Immunotherapies - which harness the body's own defences to fight tumours - can clear even terminal cancer in a small proportion of patients.
However, a small study by the University of Texas found those harbouring a more diverse community of gut bugs are more likely to benefit.
Cancer Research UK said understanding gut bugs had "great potential".
The human body is home to trillions of micro-organisms - estimates suggest our own tissues are so heavily outnumbered that our bodies are just 10% human.

And a growing wealth of studies shows these microbes can influence our immune systems and have been implicated in auto-immune diseases and allergies.



Higher Levels
Immunotherapies are one of the most exciting breakthroughs in treating cancer. They work by taking the brakes off the immune system to help it to attack tumours more easily.
The research group compared the gut bacteria in 23 patients who responded to the therapy and 11 who did not.
Dr Jennifer Wargo, a melanoma surgeon and scientist, told the BBC News website: "We found a night-and-day difference in the diversity of bacteria species in the faecal samples."
The study, presented at the National Cancer Research Institute's Cancer Conference in Liverpool, found Ruminococcus bacteria in much higher levels in those that responded to treatment.
It suggests that it may be possible to boost the effectiveness of immunotherapy by altering the balance of bacteria in the gut.

'Scratch the Surface'

Procedures such as a trans-poo-sion - a transplant of faecal matter containing beneficial bacteria - are already used as a treatment for some diseases.

Dr Wargo added: "It is hugely plausible I think - we still need to dig a little deeper, but I think we're on to something.
"I think it really does shape our body's immune response as a whole and to cancer."
It is not yet clear if the differences in bacteria are the cause of the better response.
People with diets containing more fruit and vegetables tend to have a richer set of gut bugs, so it is possible that it is those with a healthier lifestyle that respond better to therapy.
"It might point to a healthy diet increasing your chances, which I think would be a great message," she added.
Sir Harpal Kumar, chief executive of Cancer Research UK, said: "Our bodies are filled with trillions of bacteria, and we are just beginning to scratch the surface of understanding their great potential.
"It's really interesting and exciting to see new evidence emerge on the close connection between the immune system and the bacteria living in our guts. As this, and several other studies, have shown, manipulating these bacteria could be exploited in future to help patients respond better to treatment."

New Treatment for Breast Cancer

Irish scientists may have found a way of treating one of the most aggressive forms of breast cancer.
Researchers hope that a drug currently used to treat ovarian cancer can also be used to prevent the growth of triple-negative breast cancer cells.



If found successful in clinical trials the drug, APT-246, has the potential to save lives.
More than 250 people are diagnosed with triple-negative breast cancer each year, accounting for around one in six breast cancer cases globally.
This form of breast cancer is typically one of the most difficult to treat and is more prevalent in younger women.
The research was carried out by Ph D student Naoise Synnott, under the supervision of Professor Joe Duffy and Professor John Crown, involving laboratory tests in combination with current chemotherapy treatments.
It was funded by Breast-Predict and the Clinical Cancer Research Trust.
Ms Synott said: "At the moment the only form of drug treatment available to patients with triple negative breast cancer is chemotherapy.
"While this will work well for some patients, others may find that their cancer cells don't respond as well as might be hoped to chemo, leading patients suffering the side effects of this treatment without any of the desired outcomes".
Ms. Synott said she hopes the research will provide better treatment and give "hope to future triple-negative breast cancer patients".

Director of Breast-Predict, Professor William Gallagher said: "Over the last two decades drugs such as Herceptin have been discovered to target or block proteins that are responsible for the growth of some breast cancers.
"Finding a similar drug therapy for triple-negative breast cancer has so far eluded scientists, making these findings all the more important".
Head of research at the Irish Cancer Society, Dr. Robert OConnor hailed the development as a significant milestone.
He said since 2010, the Irish Cancer Society has invested €20 million in vital research thanks to the Irish public who continue to fund its work.

Galway Research on MRSA

Scientists in Galway have discovered that penicillin can be used to make other antibiotics or the body more effective at fighting MRSA.

The finding may open up new avenues for combating antimicrobial resistance, which is claiming an increasing number of lives around the world.
The microbiology team at NUI Galway, working in conjunction with the University of Liverpool, found that while penicillin cannot kill MRSA, it weakens its virulence.
The research, published in the Journal of Infectious Diseases, shows that the penicillin causes the bacteria to switch off its toxin genes and thicken its cell wall.
The body's own immune system and other antibiotics can then exploit this state of change to kill off the infection.

MRSA can be extremely virulent

A recent report from the UK government found that antimicrobial resistance infections, will cause more deaths than cancer by 2050 if not addressed urgently.
Caused by a form of the staphylococcal bacteria, MRSA is resistant to most antibiotics used to treat ordinary infections, and up to a fifth of patients who contract it die from the infection.
The research was funded by the Health Research Board and Medical Research Council.
"Our findings explain the anti-virulence mechanism of penicillin-type antibiotics and support the re-introduction of these drugs as an adjunct therapeutic for MRSA infections.
"MRSA can be extremely virulent, which is part of the challenge in treating it," said Professor James O'Gara from NUI Galway.