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New Study On Antibiotic Prescribing and Consumption for Urinary Tract Infections

NUI Galway researchers study the culture of antibiotic prescribing and consumption for Urinary Tract Infections and find the need for more dialogue among GPs and Patients

Researchers from NUI Galway’s School of Medicine have carried out a study to explore the culture of antibiotic prescribing and consumption in the community for Urinary Tract Infections (UTIs), from the perspective of the General Practitioners (GPs) and community members. Their results were published in the medical journal BMJ Open.

This research provides insight into the decision-making processes contributing to the continued prescription and consumption of antibiotics for Urinary Tract Infections. An antibiotic is not a satisfactory outcome from every UTI GP consultation.

As a result of this qualitative research, behavioural interventions should focus on:

• Improving the quality of antibiotic prescribing for UTI by encouraging GPs to reflect on their current antibiotic-prescribing practices, including when they prescribe and what antibiotics they choose.
• Supporting a dialogue between the GP and the patient within the consultation about the positive and negative aspects of antibiotic treatment for UTI particularly when symptoms are non-specific.
• Building changes into routine care without elongating the consultation.

As part of the study the NUI Galway researchers carried out in depth interviews with 15 GPs practicing in rural and urban locations in Ireland, and six focus groups were held with community members who had direct or indirect experiences with urinary tract infection.

The study found that decisions made to prescribe or consume an antibiotic for a UTI is a set of complex processes. It includes recognising that you are unwell (need recognition), seeking advice from various sources like the web and family members prior to visiting the GP (information search), and deciding whether to go to the GP (evaluation process). All of these processes are governed by the relationship and interactions between the GP and the patient.

To view the full BMJ Open paper visit:http://bmjopen.bmj.com/content/6/1/e008894.full.pdf+html 

NUI Study to inform future Mental Health Practice

Study seeks participants aged 18-25 years old to examine common experiences of feeling disconnected or detached from one's sense of self or their surroundings.

The School of Psychology at NUI Galway is conducting a research study on people who experience feelings of being disconnected or detached from themselves and their surroundings.  Adults aged 18-25 years old are invited to participate in the study, with findings hoping to better inform professionals working within the mental health service.

Recent research in mental health has identified that it can be common for people to experience unwanted thoughts and feelings of being more or less whole, or that the world is less real to them than at other times. This has been found to be a common phenomenon among the general population, but for some people it may cause them some distress.

These experiences can be influenced by stress and fatigue, with most people not admitting to experiencing feelings of disconnect and detachment, for fear of being perceived as different or strange. International studies have found that people are more willing to report these experiences in surveys rather than disclose it to a doctor.

The study is being carried out by Aoife Ó Laoide, a Psychologist in Clinical Training at the School of Psychology in NUI Galway, under the academic supervision of Dr Jonathan Egan, Deputy Director of the University’s Doctorate Programme in Psychological Science. Ms Ó Laoide is interested in examining this phenomenon and understanding how psychological factors, such as childhood experiences, current stress, anxiety, and mood might interact with these common experiences of feeling disconnected from yourself or your surroundings.

Miss Ó Laoide said: “We are seeking people for the study who have ever felt ‘unreal’ or in a ‘dream-like’ state. People who experience a feeling of detachment or disconnection from themselves and their surroundings.  We want to investigate this relatively common phenomenon that no one wants to admit to, in order to explore how it may impact on an individual and their overall psychological well-being, with the hope of informing future clinical practice.”

For those aged 18-25 years old who wish to participate in the study please visit the online survey link at: https://www.surveymonkey.com/r/feelingunreal 

For further information contact Aoife Ó Laoide at a.olaoide1@nuigalway.

Chronic pain sufferers invited to join free online treatment programme

A recent online treatment programme, set up by expert psychologists and physiotherapists, aimed at helping those who suffer from chronic pain, has been extended due to the number of inquiries received in recent weeks.

The Centre for Pain Research at NUI Galway, with the support of the Health Research Board, is currently recruiting people with chronic pain (pain which has lasted for three months or more). The Acceptance and Commitment Therapy (ACT) trial will provide eight online sessions to people in the comfort of their own home. At the moment, such supports are mainly available through specialised hospital-based pain management teams.

Chronic pain affects up to 35% of the Irish population and is increasingly recognised as a disease in its own right. Chronic pain is sometimes associated with psychological effects, which may include anxiety and changes in mood, as well as forgetfulness, and difficulties in focusing attention, planning tasks and making decisions. The ACT trial is based on emerging clinical science that demonstrates the usefulness of managing chronic pain through mindfulness and psychological wellbeing.

The study is open to people all over Ireland and will take place over the coming months. GPs and physiotherapists around the country are being encouraged to refer suitable people with pain to the study.

To find out if you are eligible, visit http://centreforpainresearch.com/actstudy.html and complete the online survey.

For further information contact Dr Christopher Dwyer at the Centre for Pain Research, NUI Galway or emailpainresearch@nuigalway.ie, or see the website http://www.nuigalway.ie/centre-for-pain-research/. Alternatively, phone 091 495391. GP’s or physiotherapists who are interested in referring suitable patients to the trial can also use these contact details.

View more here

Artificial Pancreas During Pregnancy - Breakthrough

A diabetic woman has become the first in the world to give birth naturally after using an artificial pancreas while pregnant, experts have said.

The new mother-of-two has Type 1 diabetes and wore the piece of kit throughout her pregnancy to produce insulin and prevent symptoms of the disease.

Three other mothers have previously given birth in Cambridge after using the device but by caesarean section.

An artificial pancreas device system (APDS) is a small portable piece of equipment designed to carry out the function of a healthy pancreas.

It helps to control blood glucose levels using digital communication technology to automate insulin delivery.

An APDS is worn on the body during pregnancy and has a continuous glucose monitor (CGM), a digital controller and an insulin pump.

Dr Helen Murphy, principal investigator of the study Ms Finlayson-Wilkins took part in, said Euan's arrival was an exciting step in the treatment of diabetes in pregnancy.

"Women who have diabetes in pregnancy face higher rates of birth defects, over-sized babies, pre-term delivery and stillbirth than other pregnant women," she said.

"Treating diabetes in pregnancy can be particularly challenging because hormone levels are constantly changing and blood sugars can be difficult to predict."

The results of the ongoing National Institute for Health Research's Closed Loop in Pregnancy study are due to be published later this year.

Its findings could mean the technology benefits more pregnant women with diabetes.

View full article on BBC/Health

International imaging effort unlocks brain secrets

Cortex and subcortical regions: The study looked at the size of sub-cortical brain regions that are involved in some basic functions such as memory, movement, learning and motivation.

 New insights may help scientists better understand disorders such as schizophrenia, Alzheimer’s disease and epilepsy

An international study, which included researchers from NUI Galway, has identified significant genetic factors that influence the size of structures within the brain. It is hoped these new insights may help scientists better understand disorders such as schizophrenia, Alzheimer’s disease and epilepsy. The research was published today in Nature magazine.

NUI Galway professor of psychology, Professor Gary Donohoe, led the Irish contribution to the study, which involved a consortium of almost 300 scientists from 193 institutes - including NUI Galway. The consortium, known as the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis), shared results from analyses of genetic data and MRI scans from more than 30,000 individuals worldwide.

The study looked at the size of sub-cortical brain regions that are involved in some basic functions such as memory, movement, learning and motivation. Abnormalities in these brain regions are associated with neurological and mental health disorders.

Read more here

The article published in Nature today is ‘Common genetic variants influence human subcortical brain structures’.

This research at NUI Galway was undertaken by the Cognitive Genetics and Therapy Group (Principal Investigators: Prof Gary Donohoe and Dr Derek Morris;http://www.nuigalway.ie/psychology/coggene_group.html) and the Clinical Neuroimaging Laboratory (Principal Investigators: Prof Colm McDonald and Dr Dara Cannon;http://clinicalneuroimaginglaboratory.com/).

More information about the ENIGMA project is available at http://enigma.ini.usc.edu/

€13.5 million Funding for Health Research

(L to R) Graham Love, Chief executive HRB, Leo Varadkar, TD, Minister for Health, Prof Neil Rowan, Athlone Institute for Technology

Cancer, asthma, kidney injuries and antibiotics are just some of the areas likely to benefit from €13.5 million in funding for new health research projects announced recently by Minister for Health, Leo Varadkar.

A total of 36 projects are being supported by the Health Research Board (HRB) over the next three – five years. 

Announcing the investment, Minister Varadkar said:  "These 36 projects cover a huge range of areas, including research into stem cell research to fight pneumonia, developing diet and exercise plans following cancer surgery and combating osteoporosis in older HIV patients. Others will look at how to help asthma sufferers who cannot control their condition, new treatments for resistant types of breast cancer, and the impact of salt on kidney function. Many of these projects receiving funding today will go on to make a real difference to people’s lives, not just in Ireland but around the world."

The research teams are spread across Ireland, with researchers linked to TCD, UCD, NUI Galway, UCC, RCSI, Athlone Institute of Technology, Maynooth University and University of Limerick. The HRB will monitor progress in each project and will receive annual and end-of-grant reports. The outcomes from the projects will be assessed, using an international framework, in terms of short and medium terms outcomes like new knowledge, research capacity building, and informing policy. The HRB will also look at the longer term impact of each project such as new innovations including devices, new diagnostics, approaches to care; changes in policy or practice; or economic and commercial activity such as patents and spin-offs.

View full list of Projects here

View Press Release on HRB 

Long-term shift work linked to loss of brain function

A study has found that working anti-social hours can prematurely age the brain and dull intellectual ability.

The research, by an international team at the University of Toulouse in France, found that this type of work led to an impaired ability to think and remember.

A decade or more working rotating shifts was associated with a loss of brain function equivalent to 6.5 years of age-related cognitive decline, the research showed.

Stopping shift work led to gradual recovery - but one that took at least five years, said scientists.

Disruption of the body clock, which is based on natural day and night cycles, may cause stresses that may affect brain functioning, the researchers believe.

Writing in the journal Occupational and Environmental Medicine, the international team led by Dr Jean-Claude Marquie, concluded: "Shift work chronically impairs cognition, with potentially important safety consequences not only for the individuals concerned, but also for society."

The scientists assessed more than 3,000 workers from southern France who had their mental abilities tested on three occasions over a ten-year period.

Participants were aged 32, 42, 52 and 62 at the time of the first test in 1996.

Around a fifth had worked a shift pattern that switched between mornings, afternoons and nights.

Shift workers had lower average scores for memory, processing speed and overall brain function than those working normal office hours.

Compared with people who had never worked rotating shifts, participants employed this way for ten or more years had lower overall thinking and memory scores.

The scientists, who included researchers from the University of Swansea, said the problems increased with the length of time people worked shifts.

After ten years of rotating shift work the association became "highly significant".

However, there was evidence that the deficits were reversible.

People who stopped working shifts recovered their lost mental function after at least five years.

The researchers wrote: "Measures should be considered that mitigate the impact that prolonged exposure to shift work has on cognitive abilities, including switching to normal day work."

View Research article here: Chronic effects of shift work on cognition:findings from the VISAT longitudinal study

View Press report here

Older people in deprived areas in Ireland face problems of poor brain health

People who live in disadvantaged areas have a greater risk of developing cognitive dysfunction than people in better off areas, a study by Professor Helene McNulty and colleagues at the University of Ulster has found.

The findings of this study, funded by the Centre for Ageing Research and Development in Ireland, are based on novel analysis of existing data collected for the TUDA Ageing north-south cohort study of over 5,000 older people in Ireland. The latest results show that – over and above factors like lower levels of education – living in a disadvantaged area significantly predicts cognitive dysfunction in ageing. This means that older people living in deprived areas of Ireland, North and South, are more likely to suffer mental illnesses ranging from mild cognitive impairment to dementia.

Although cognitive dysfunction generally increased with age, older people living in the most deprived areas were more at risk of poor cognitive health compared with a person of the same age living in a less deprived area.

Compared with people in the least deprived areas, people living in the most deprived areas had:

• 3 years less education
• A greater likelihood of anxiety and depression
• Higher body mass index
• Lower rates of physical activity
• Higher rates of smoking

The full report is entitled 'Socio-economicdeprivation and risk of age-related cognitive dysfunction: results from theTUDA Ageing Cohort Study'.

The latest findings from the TUDA study were presented recently at the annual Scientific Meeting of the Irish Gerontological Society in Galway. 

View more information here

BMJ Study: High milk diet 'may not cut risk of bone fractures'

Drinking lots of milk may not lower the risk of fracturing bones, a study in the British Medical Journal suggests.

The research, conducted in Sweden, showed women who drank more than three glasses a day were actually more likely to break bones than those who had less.

View Reserach article here: Milk intake and risk of mortality and fractures in women and men: cohort studies

The researchers cautioned that their work only suggested a trend and should not be interpreted as proof that high milk consumption caused fractures.  Factors such as alcohol and weight were likely to play a role, they said.

A team of scientists in Sweden examined the dietary habits of 61,400 women in 1987-1990 and 45,300 men in 1997 and then monitored their health for years afterwards.  Participants were asked to complete questionnaires on how frequently they consumed common foods such as milk, yoghurt and cheese over a one-year period.

Researchers then tracked how many developed fractures and how many participants died in the years afterwards.

In the 20-year follow-up period in which the women were monitored, those who drank more than three glasses, or 680ml, of milk a day were more likely to develop fractures than those who had consumed less.  The high-intake group had a higher risk of death too.

Prof Karl Michaelsson, lead researcher at Uppsala University, said: "Women who drank three or more glasses a day had twice the chance of dying at the end of the study than those who drank less than one glass a day. And those who had a high milk intake also had a 50% higher risk of hip fracture."

Men were monitored for an average of 11 years after the initial survey and the results showed a similar but less pronounced trend

.

When fermented milk products such as yoghurt were considered, the opposite pattern was observed - people who consumed more had a lower risk of fractures.

Prof Michaelsson says the findings could be due to sugars in milk, which have been shown to accelerate ageing in some early animal studies

"The results should, however, be interpreted cautiously given the observational design of our study."

Dietary advice should not be changed until more research had been conducted, he said.  British experts said the research should be treated with caution because the milk in Sweden is fortified with vitamin A which could have an impact on the findings.

View more here

Study finds areas of concern for health research in Ireland

A new study has found that important areas of health research are not being prioritised in Ireland.

The Medical Research Charities Group (MRCG) recently launched the findings from the first major study into the health research environment in Ireland as perceived by health researchers. The study, ‘The Health Research Landscape in Ireland: What Researchers Say’ was commissioned by the MRCG to understand Ireland’s current health research landscape from the perspective of researchers. Despite Ireland having sustained its strong support for health research throughout the economic crisis a number of issues still remain which have been identified in the report.

Issues include "There are gaps in enabling infrastructure for health research, and financial sustainability is a concern. Particular important areas of research are not prioritised. Support is focused on the earliest stages of research training and on well-established researchers."

“Health research in Ireland needs a renewed vision and commitment that will create a world class health research landscape, providing translatable benefits to patients,” said Philip Watt, MRCG Chairman.