the Pulse - Winter Edition 2023 by School of Medicine, Trinity College Dublin

Pulse the

Trinity School of Medicine Newsletter

Winter Edition 2022 Winter Edition 2023

CONTENTS Editorial ................................................................................................ 3 25 TUH Celebration .............................................................................. 4 Farewell to Our Retirees ....................................................................... 5 Professor Kevin Conlon ........................................................................ 6 Professor Paul Browne ......................................................................... 7 8 Professor Michael Rowan ..................................................................... 9 Intern case presentation....................................................................... 1 0 Professor Brendan Kelly ....................................................................... 1 1 Tuberosu Sclerosis................................................................................. 1 1 TILDA works with WHO.......................................................................... 1 1 Millin Lecture .........................................................................................1 2 Immune System Conference................................................................. 1 2 The National Centre for Pharmacoeconomics..................................... 1 3 Refugee Adolescents..............................................................................1 3 Study for Prostate Cancer...................................................................... 1 4 MIRANDA ................................................................................................1 4 European Network for ICU-Related Respiratory Infections..................1 5 Keynote Address By Prof Michelle Leech.............................................. 15 Dr Geraldine Foley................................................................................. 16 Dementia Research Network Ireland..................................................... 1 6 World Rugby Rugby Science Network (RSN) Conference..................... 17 Elgar handbook workshop..................................................................... 17 Primum Non Nocere............................................................................... Edward Kennedy Guest Lecture and Award..........................................1 7 Intern Case Presentation Final...............................................................1 7 Routledge Handbook of Mental Health Law..........................................1 8 Dataethics.............................................................................................. 1 9 AOTI Conference 2023............................................................................1 9 Global Patient Innovator Award.............................................................2 0 A Scarf for Lewy...................................................................................... 2 0 PPI Event.................................................................................................2 1 Student Services.....................................................................................2 1

EDITORIAL Welcome to the Winter 2023 mini-edition of Pulse. This issue opens with an account of the celebration of the 25th Anniversary of the relationship between Trinity College and Tallaght University Hospital. It was a really special occasion marking an ongoing successful collaboration that covers the full spectrum from basic science to population health and primary care research. We are also delighted to celebrate the extraordinary careers of three TCD Professors who have recently retired, Prof Kevin Conlon, Prof Paul Browne and Prof Michael Rowen. These pieces by colleagues who have worked with them closely over the years, are followed by celebrations of the next generation of TCD researchers and educators with articles that showcase the varied and wide activities within the school, from services offered, books recently published, presentations, representation at conferences and a really varied range of research activities. The award of the inaugural Edward Kennedy Health Policy Award to Deputy Roisin Shortall to recognise her leadership in advancing Slàintecare highlights the School of Medicine’s contribution to national health policy. I would like to thank Prof Iracema Leroi for her contributions as Editor of Pulse. I’d like to welcome Prof Sara Burke from the Centre for Health Policy and Management who is taking over the role of Pulse Editor in 2024, along with her deputy editor team of Dr Sarah Parker, Dr Liz Farsaci, Dr Rikke Siersbaek and Dr Katharine Schulmann. Finally, thanks also to the team that supports the School of Medicine’s communications and engagement – Mary O’Neill, Cait Kane, Marie Cormican, Michelle Hendrick and Jennifer Conlon. Interim Editor – Prof Susan Smith, Director of Health Policy and Engagement

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Tallaght University Hospital and Trinity College Dublin celebrates a rich 25 years relationship The Faculty of Health Sciences is delighted to mark this celebration of Tallaght University Hospital and, in particular, the relationship between Tallaght and Trinity over the past 25 years.

Prof. Brian O’Connell Dean of Faculty

We are incredibly fortunate to have such a fantastic hospital that is fully invested as a partner in teaching, research and innovation. Going back to its old roots in the Adelaide and Meath Hospitals, and the National Children’s Hospital, Tallaght has maintained a deep and ingrained tradition of patient care, but also of innovation and education. Perhaps this is why the ethos in Tallaght feels so familiar and consistent with Trinity’s mission.

In addition, with the hospital so embedded in the local community it was the natural place for the establishment of the School of Medicine’s Institute for Population Health, and the Faculty’s Academic Primary Care Collaborative. And of course, the recent establishment of Innovate Health signals Tallaght’s wish to embrace and shape the future. Trinity wants to foster this important partnership and further integrate research, technology and patient care.

25TUH - with celebratory cake cut by the Provost Linda Doyle and Lucy Nugent CEO of Tallaght

Prof. Colm O’Morain - keynote

Professor Linda Doyle, Provost

Host,Brendan Kelly, Psychiatry

panelists, l-r Fintan Sheerin Head SoN, Evelyn Deasy, Deputy Head of Pharmacy,Anne O’Connell, School of Dental Science, Seamas Donnelly, School of Medicine, Lucy Nugent CEO TUH

Fantastic to see the five Faculty Deans together at this event (l -r) Prof Shanley, Prof OMorain, Prof McCarron, Prof Sheils and current Prof O’Connell Winter Edition

The Retirement of Professor Kevin Conlon, Professor Paul Browne and Professor Michael Rowan This September saw the retirement of 3 Professors in the School of Medicine. Their contributions have been enormous and we have asked three of their colleagues to write a piece to give a reflection and overview of their careers. Prof Paul Ridgeway wrote a piece about Kevin Conlon, Professor of Surgery; Prof Elisabeth Vandenberghe has written a piece on Paul Browne, Professor of Haematology and Prof Martina Hennessy wrote about Michael Rowan, Professor of Neuropharmacology.

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Kevin Conlon

Professor of Surgery MA MCh MBA FRCSI FACS FRCSED FRCSG FTCD

Professor Kevin Conlon retired on the 31st of August 2023 after long distinguished service to the discipline of Surgery at Trinity College Dublin. Returning from Memorial Sloan Kettering, New York, just after the Millennium, he was appointed to the inaugural Chair of Surgery at Trinity College Dublin. The Adelaide and Meath Hospital (as Tallaght University Hospital (TUH) was known at the time) was recently opened, and he quickly moved to establish robust links between all the subdisciplines in surgery- those already known and those to be established. He pioneered many healthcare developments before their time, such as tablet beside digital healthcare support (5 years before the iPad) and fledgling discharge EPRs in surgery. His primary focus was serving his patients, but also the students, the future Doctors in his care. This care extended to TUH management in 2010 when he stepped into the breach to guide the Hospital through some clinical practice soon thereafter, his academic troubled waters as CEO designate in 2010. Returning to roles expanded to serve as President of the Pancreatic Society of Great Britain & Ireland (2011) as well as subsequent roles as President of the EuropeanAfrican-Hepato-Pancreato-Biliary-Association and Secretary General of the International Hepato-Pancreato-BiliaryAssociation.

Prof Conlon’s primary love will always be the diseases of the Pancreas for which he enjoys an unparalleled international reputation. He established a successful research programme in Pancreas disorders and when Pancreas Cancer Surgery was centralized in 2013, he moved that part of his practice to St Vincent’s University Hospital. Although this represented a challenge to deliver multisite clinical care, he managed in his inimitable singular attentiveness to excellent care. In later years, he served as the School of Medicine’s Director of Undergraduate Teaching and learning, and added membership of the Council of the Royal College of Surgeons in Ireland and of the Association of Surgeons of Great Britain and Ireland to his busy clinical and academic practice. He was the Editor-in-Chief of Digestive Surgery journal and authorised hundreds of articles. Professor Conlon leaves behind a legacy that extends far beyond the operating room. His contributions to the field of Pancreas surgery and his compassion for his patients will be remembered in generations to come. He will continue as an inspiration to all those who aspire to make a difference in the world of surgical oncology.

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Paul Browne Professor of Haematology

It is a challenge and pleasure to write about my colleague Paul Browne and attempt to encapsulate his many achievements both as an academic doctor, colleague and above all a person of vision, great integrity, and kindness. Paul Browne embarked on his medical career at Trinity College Dublin in 1979: fortunately for haematology in Ireland he chose Medicine despite achieving the best Maths results nationally in the Leaving Certificate. He also arrived with ‘cello in hand, fresh from the Irish Youth Orchestra string sections (with his friend, and later colleague, Ann-Marie O’Dwyer (violin)) and pursued this interest singing with the Trinity Choral Society in the choral repertoire ‘greats’. Undergraduate medicine is busy, intense, sometimes fraught but memorable at least partly for the close friendships which last a lifetime and so it was for Paul and company; Ann-Marie O’Dwyer, David Orr, Vincent Young and Hugh O’Connor. Having topped the class of ’86, all became consultants at St James Hospital and national leaders in their chosen specialties. In parallel with music and friendship, academia was not forgotten with consistent honours all the way through (from an era when Honours degrees were bestowed on the top centile of the class only) and following the award of Louis Claude Purser Entrance Exhibitioner. Paul embarked on his early medical career on the hallowed ‘Feds’ rotation with four other Trinity graduates, which at the time was the only two-year Senior House Officer scheme in Ireland, working under Professor Donald Weir at Sir Patrick Dunn’s and finally St James Hospital. SJH was a rather different campus then; many old and beautiful buildings, but no modern facilities even for the first designated haematology-oncology unit in Ireland incorporating the national BMT unit known as ‘Hospital 1, top floor’. Despite the less than perfect environment, Paul acquired the ‘haematology bug’ at least in part from the then national leaders in haematology, Professors Ian Temperly and Shaun McCann. He completed early registrar training in SJH during the early days of the AIDS/Hepatits C epidemic which was so devastating for haemophilia patients contrasting with the exciting developments of the national BMT program under Shaun McCann The laboratory-clinical interface (translational medicine in modern parlance) is one of haematology’s main attractions and so after a busy three Winter Edition

years, Paul moved to the University of Minnesota working with Robert Hebbel on the red cell endothelial biology of sickle cell thalassemia. So yes, those early papers (including that NEJM one) on endothelial biology were indeed from Paul who then transferred the insights gained to the study of graft versus host disease. The rapid developments in BMT retained its attractions, and Paul became a fellow and then faculty member mentored by Phil McGlave and Dan Weisdorf in Minnesota. These two ‘BMT’ pioneers pioneered unrelated BMT, through science-led optimization of BMT protocols, graft-versus-host disease and other revolutionary advances which underpin current practise. In 1997, Paul returned to Ireland, joining Shaun McCann in the Haematology and BMT unit and rose to the many challenges a small, developing but endlessly exciting speciality threw up. Just a flavour of these include the development of a bespoke leukaemia and transplant unit, (which then had to be completely remodelled because of a ‘VRE’ outbreak leading to an outsourced transplant practice in London (with ward rounds requiring aeroplane commutes), getting support for an Irish haematology specialist registrar scheme (a requirement for completing the FRCPath needed by all haematologists) and fulfilling the role of first national speciality director from 1997-2002, lobbying for a cytogenetics and national molecular diagnostic service (opened in 2001) and finally the expansion of a department which now includes four national services and a further two de facto ones. He was always a leader; Director of the National Adult Stem Cell Transplant Programme (2007-2019) at St. James’s Hospital, now President of the Haematology Association of Ireland (an educational and academic allIreland group), founder member of the Irish Haematology Society, Chair of Cancer Trials Ireland (then known as ICORG) from 2008 to 2012, leading the successful international peerreviewed HRB multi-million euro grant renewal to support clinical translational research in cancer and a principal investigator of the Blood Cancer Network Ireland. Transplant (EBMT) working groups such as Professors Nicholas Kroger, Jane Apperley and Alan Burnett and more latterly the international ‘myeloma club’ of Gareth Morgan, Graham Jackson, Gordon Cook where his knowledge on Scientific Advisory committees (eg Meyloma UK and 7

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European Myeloma Advisory panel) and monitoring committees (eg UK MRC Myeloma XI trials (2015-2021) which is the largest global phase 3 myeloma trial completed). Medicine has always been partly an ‘apprentice‘ training and teaching/learning is part of what all doctors strive to do daily. Paul is a gifted teacher, highly regarded by medical students and junior doctors for his ability to make complex principles accessible. The apprenticeship teaching has demonstrated to many, his ability to empathise and communicate with patients (and staff) from all walks of life. He also had that uncanny ability to recognise groundbreaking clinical developments and access them for Irish patients leading to his co-authorship in the NEJM paper on the life changing introduction of eculuzimab in Paroxysmal Nocturnal Haemoglobinuria and membership of the International PNH Consortium. Multiple myeloma, however, became and remains his main clinical interest; a disease which at the start of his career had a median survival of 3 years and was often associated with a painful, debilitating clinical course. The first major improvement in myeloma treatment was autologous stem cell transplantation and Paul started a myeloma transplant program on his return from Minnesota, working with colleagues nationally to ensure all patients had access to this novel treatment though the SJH unit. There were two autologous transplants for myeloma in 1997 in his first year back and 74 in 2022. Ongoing improvements in treatments including Paul’s recent involvement in the opening of a CAR-T clinical trial (Cartitude 4) in myeloma now mean that patients with myeloma enjoy long survival and a muchimproved quality of life. The 5-year survival of patients transplanted since 2017 is 78%. Clinical and research interests have resulted in up to 100 publications, and Paul is the successful recipient of more than €2.5 million research grants from the Health Research Board, Irish Cancer Society, Science Foundation Ireland in stem cell biology and Multiple Myeloma. Paul has always looked outwards, never limited by personal or even institutional gains, rather looking at the big world picture: what is good for health care, teaching and society. 8

He worked across borders, with many well-known names in transplantation through the European Blood and Marrow Clinical duties have just been one facet of Paul’s career; he has shown great skill in achieving consensus and thereby implementing strategies that have benefitted haematology, medicine but ultimately improved patient care. He was appointed to the Chair of Haematology in 2010, following Professor Shaun Mc Cann’s retirement and began a new phase of his career including a period as Head of the School of Medicine from 2012-2017. This was and is a daunting challenge, balancing the books during a period of financial hardship in Ireland with the need to maintain high teaching and research standards (and ensure Trinity was in the coveted QS 100 in 2018). The concept of a Cancer Institute combining the basic research strengths of Trinity in Immunology and Genetics, with translational groups in the Trinity Translational Medicine Institute and the complex integrated Cancer Services at SJH was first mooted in 2012. Paul and many colleagues in both Trinity main campus and SJH worked tirelessly on this project and Paul’s input was recognised when he became the institute’s first clinical director, with formal OECI accreditation of the Trinity St James Cancer Institute in 2020 and plans for an Institute building on the SJH campus currently underway. During this time, he continued to work clinically, mentor junior doctors, advise all of us when asked and continue to teach with skill and kindness. Paul, your colleagues in St James Hospital and the School of Medicine want to say thank-you for your many contributions. We want to tell you how proud we are of your achievements. We hold your work and you in the highest regard. We would like to take this opportunity to thank you and we are all delighted that this is not really a departure, accepting that a less visible (but still present) Paul will be the future.

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Michael Rowan Professor of Neuropharmacology

I am delighted to provide this article as a small token of gratitude to Professor Michael Rowan in celebration of his outstanding service to the School of Medicine and the College. I first met Michael when I was a second-year medical student at a dreaded Viva Voce. He asked me what three drugs I would take to a desert island? It was an astute question, almost 30 years later I am still considering and revising that list! Just a week ago I had the pleasure of awarding Michael the second John Feely memorial Medal as a token of esteem from the Irish Association of Pharmacologists. At the meeting in UCC he was greeted enthusiastically by colleagues from across the Irish clinical and academic community. Together we celebrated an outstanding body of academic work that has critically informed development of new drugs used in the treatment of amyloidassociated neurodegenerative disease. During the keynote Michael reflected on his 50 year career in Pharmacology. He began his scientific career with a BSc in Pharmacology in UCD, graduating in 1973. There he described learning the fundamentals of good experimental design, fed by a spirit of camaraderie and hard graft among young colleagues in UCD. He went on to do his PhD with Professor Philip Chambers, the well-known TCD Pharmacologist and College cellarer, on the topic of cockroaches! As well as pharmacology Philip no doubt gave him an excellent training in choosing a good wine (!) and the art of producing incredible work from a tiny office in Zoology. In 1979, Michael was appointed as Professor of Winter Edition

Neuropharmacology, Pharmacology & Therapeutics in Trinity and 5 years later in 1984 was joined by Professor John Feely as the clinical professor. They became firm friends and colleagues and together powered the engine of pharmacology in Ireland over successive decades. They were founding members of the Irish Association of Pharmacologists, and in Michael’s case also of TCIN (2003), which is celebrating its 20th anniversary this year. Michael remains a major contributor to TCIN’s international reputation for excellence. The following years brought a plethora of new technologies to his lab for measurement of memory as well as genomics along with the development of strong collaborations with partners in the U.S., Europe, and China. Michael’s career went from strength to strength, marked by high impact publications, each a breakthrough in our understanding of the role of amyloid versus fibrillary tangles in the development of Alzheimer’s disease. Michael has authored over 250 publications. His work is internationally renowned for its scientific rigor and as a result he has been cited >25,000 times, received multiple research leader awards (2022, 2023) and received funding from SFI, HRB and many European Programmes. He has taught thousands of undergraduate students and mentored many PhDs and post doc researchers. He has developed a wide range of national and international multidisciplinary networks from China to the U.S. including biomarker consortia, Neurotree and INBIND, to mention a few. His work focuses on neuroscience, long-term potentiation, synaptic plasticity, hippocampal function and dysfunction and excitatory postsynaptic potentials. The concepts of his longterm potentiation study are interwoven with 9

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issues concerning the NMDA receptor, metabotropic influences of the glutamate receptor and touch on both endocrinology and pharmacology. His neuroscience research incorporates and has had an impact on understanding themes from the glutamate receptor through an understanding of memory, Alzheimer’s disease and long-term depression. His group explores the cellular mechanisms mediating the disruptive effects of amyloid-beta oligomers on synaptic plasticity and memory mechanisms in vivo, the aim being to identify new targets to prevent memory disruption in early Alzheimer’s disease. This has informed development of new drugs such as lecanemab that selectively target B-amyloid protein in the brain. Undoubtedly, Michael’s published works are authoritative on the MOA of such drugs but will also be the critical texts referred to when sounding a note of caution regarding their limitations. On a personal note, being from Clontarf, Michael is part of the Trinity academic North-side gang (you know who you are!) and is proud of it. He has two sons, Kieron and Enda, a daughter Aileen who works in UCL and has recently become a proud grandfather. He credits the support of his lovely wife Gabrielle as critical to making his achievements possible. Apparently, his grandmother had a pub in Rochfortbridge and is reported to have been particular about sending the

married men home by 9 pm to stop them going too wild! That same quiet way of supporting the needs of others through good actions has been passed down to Michael. As a colleague he is gifted and delightful to collaborate with. As a person he is a restrained, kind and unflappable gentleman who wears his honours lightly. He avoids the limelight, the TV, the podcast and all forms of social media! Chasing him down just to get a photo or tweet is hilarious. He prefers to let his work speak for him (which it does in spades). That said, when you get him chatting, he is highly amusing company. He has a wry sense of humour, time for everyone and is generous to a fault. Michael, your colleagues at the School of Medicine want to say thank-you for your many contributions. We want to tell you how proud we are of your achievements. We hold your work and your person in the highest regard. We would like to take this opportunity to wish you every happiness and good luck on a new adventure that thankfully will see you still with us, but hopefully working a little less hard. Best Wishes from all, Martina Hennessy

Congratulations to Dr Shadan Kahatab on winning the intern’s Case Presentation All St James’s interns take part in a case presentation throughout the year during their lunchtime teaching. The top 5 presentations are then chosen to present to a panel of judges to compete for a prize. This year’s winner was Dr Shadan Kahatab who presented an excellent Medicine for the Elderly case. The runners up were Dr Alannah Lavelle, Dr Rakesh Ahmed, Dr Aisling Stafford & Dr Katherine Griffin, all of whom presented to an extremely high standard. We wish our interns all the best in their next endeavours!

Picture caption: (L-R) Dr Laura Gleeson Respiratory Consultant/Judge, Katherine Griffin Intern, Rakesh Ahmed Intern, Alannah Lavelle Intern, Shadan Kahatab Intern, Aisling Stafford Intern, Ms Claire Donohoe Upper GI Consultant/Judge, Dr Elaine Burke DSE Intern Team/Judge, Dr Joe Browne AMAU Consultant/Judge 10

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Congratualations to Prof Brendan Kelly on his new book “Asylum: Inside Grangegorman” In 1814, the Richmond Lunatic Asylum at Grangegorman in Dublin started an extraordinary programme of asylum building across Ireland, aimed at alleviating the suffering of people with mental illness who were homeless, in prison, or confined in appalling circumstances. By the midtwentieth century, Ireland had proportionately more people in ‘mental hospitals’ than any other country in the world. On a given night, the number of people in Ireland’s psychiatric hospitals was more than double those in all our other institutions put together: prisons, laundries, mother and baby homes, industrial schools, orphanages. What was the life of a patient in an asylum really like? Through letters, medical records and doctors’ notes, Brendan Kelly gives us a glimpse inside Grangegorman and the lives of those who lived and worked there. Prof Kelly’s book was published by the Royal Irish Academy, and available in bookshops and here.

Raising awareness of Tuberosu Sclerosis Mary Vasseghi standing at a Poster on Tuberosu Sclerosis Complex (TSC) to raise awareness of this serious disease which affects 1:6,000 in the International TSC Research Conference Washington D.C September 2023.

TILDA works with WHO to address knowledge gaps on measurements of ageing Regius Professor Rose Anne Kenny, Principal Investigator of TILDA was one of four speakers at an event to launch the Special Issue on October 30th. TILDA, the Irish Longitudinal Study on Ageing in Ireland is working with the World Health Organisation (WHO) to address the lack of consistency across data in measuring healthy ageing globally. To read more about the event click here. Winter Edition

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Prestigious Millin Lecture given by Mr. Michael E. Kelly, Consultant Colorectal Surgeon - Trinity St James Cancer Institute on 10th November in RCSI The Millin Lecture is named in honour of the remarkable Irish surgeon Terence Millin, who is regarded as Ireland’s greatest urologist. Millin developed a radical operation for prostate cancer and trained surgeons worldwide to perform it, and he also played international rugby for Ireland in 1925. Millin was also a two-term President of the RCSI. Recipients of the lecture honouring Millin are nominated by Fellows and selected by a panel of Council Members of the RCSI. Those who receive the honour are drawn from all surgical specialities and will be either advanced in surgical training or in their first five years in consultant practice. Click here for details.

Sex Differences In the Immune System Conference Trinity College Dublin in conjunction with the Whitehead Institute, MIT are delighted to be hosting the 3rd Biennial meeting of “Sex Differences in the Immune System.” This event will be held on campus on 12th-14th June 2024. Further information can be found on Sex Differences in the Immune System (sexdifferences-immunology.com). Author: Lynne Kelly PhD, Dept of Paediatrics. @sexdiffimmuno 12

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The National Centre for Pharmacoeconomics (NCPE) undertake health technology assessments (HTAs) of drugs. The NCPE is affiliated to the Disp. of Pharmacology & Therapeutics. The annual NCPE National Symposium took place in the Hibernia Conference Centre, Dublin Castle on 17 October 2023. The Symposium was opened by Dr Colm Henry and speakers comprised senior members of the NCPE and external speakers (including Prof John Kennedy, Prof Cathal Walsh and key figures from Patient Organisations and the Irish Pharmaceutical Healthcare Association (IPHA). Over 180 delegates (working in academia, pharmaceutical companies, in patient organisations and in the healthcare settings) heard a wide range of presentations and discussions including those on national initiatives to create financial space for funding new drugs, the role of the NCPE in European HTA and international research, the need for robust clinical evidence to inform decision making and how the NCPE support patient organisations to engage with drugfunding decision-making processes in Ireland. The inaugural NCPE Technical Workshop on Cost-effectiveness Modelling Approaches for HTA was held in the TBSI on 24 October. Over 50 participants gained valuable practical cost-effectiveness analyses modelling skills and learnt about the optimal approaches to present and interpret cost-effectiveness analyses outcomes. The NCPE led the 10-week, blended HTA Module of the National Patient Education Programme (in collaboration with IPPOSI (the Irish Platform for Patient Organisations, Science & Industry)) in Autumn 2023. This is the sixth year that the NCPE have led this module. The module is designed to educate, support and empower patients and patient organisations to engage with the drug-funding decisionmaking processes both in Ireland and at an EU level.

Refugee adolescents require multidisciplinary, holistic psychosocial approaches to support their mental health and development. A candidate approach is creative art therapy (CAT). We performed a rigorous search in black and grey literature for studies that used CAT as a mental health intervention for refugee adolescents aged 10–24. Five studies met our inclusion criteria and used CAT to diagnose and treat psychological problems and promote positive mental health. The intervention design was commonly participatory group sessions, allowing flexibility in choosing art mediums, contents, other non-art activities, and options for individual sessions. The interventions embraced past, future, home culture, and imagination and were tailored to the participant’s gender, age subgroup, and culture. Commonly identified elements of practice focused on communication, social interaction, and eliciting relationships. Language and cultural barriers and social norms represented the main implementation challenges. The absence of qualitative studies entails more research to generate an understanding of the components and adjustments necessary in creative art therapy practice when working with refugee adolescents.

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Discipline of Occupational Therapy running a study for Social Prescribing for men with Prostate Cancer Professor Deirdre Connolly and Ms. Hayley Connolly from the Discipline of Occupational Therapy are running a study looking at the suitability of Social Prescribing for men with Prostate Cancer. The study is looking for men with Prostate Cancer to complete anonymous questionnaires. To take part click here.

MIRANDA Health Research Board Collaborative Doctoral Award Programme Multidisciplinary Innovation and Research Advancing Neurological care in a Digital Age (MIRANDA), is a Collaborative Doctoral Award (CDA) in patient-focused research funded by the Health Research Board. What are the core aspects of this grant? The MIRANDA PhD programme commenced in the Academic Unit of Neurology in 2022. This comprehensive research programme was co-created with international experts in clinical practice and research. The principal investigator of the MIRANDA programme is Dr Miriam Galvin. Five PhD research scholars, with backgrounds in healthcare provision/health research, are undertaking research to improve care and outcomes for people living with motor neurone disease (MND): Project 1 Construction of an evidence-based digital platform to deliver rehabilitation to people living with MND that can be utilized by occupational therapists and physiotherapists. PhD scholar: Avril Mc Tague Project 2 Examination of information use and knowledge transfer in multidisciplinary MND clinics to support better patient care. PhD scholar: Ruairí Weiner

Project 3 Exploration of experiences and challenges for healthcare professionals working with MND to support them to deliver optimal care to people with MND. PhD scholar: Megan Walls Project 4 Development of digital technologies to accurately track speech and swallow function for home monitoring and as precise outcome measures in clinical trials. PhD scholar: Lesley Doyle Project 5 Optimisation of the ‘TiM (Telemedicine in MND) on MyPathway’ app, to remotely collect accurate, meaningful patient and caregiver measurements to facilitate improved communication with healthcare professionals and MND service planning. PhD Scholar: David Murphy Impact on clinical care: Research undertaken as part of the MIRANDA programme will directly benefit people living with MND and their families, translating research findings to a clinical setting providing improved patient care. Future translational research in other settings, particularly neurological and long-term conditions, can build upon the methodologies developed within MIRANDA.

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European Network for ICU-Related Respiratory Infections (ENIRRIs) European Network for ICU-Related Respiratory Infections (ENIRRIs): a multinational, prospective, cohort study of nosocomial LRTI Patients who develop pneumonia in the ward and need a ventilator presented the highest mortality among those admitted to the ICU and even more than those already in ICU that were under mechanical ventilation. Multidrug-resistant pathogens frequently cause nosocomial infections in this multinational cohort study.

Dr Geraldine Foley publishes novel work in palliative care Novel work on patient and caregiver relations and decision-making in palliative care by Dr Geraldine Foley (Discipline of Occupational Therapy) and team has been published in prestigious journals in the field, including ‘Palliative Medicine’ and ‘Journal of Pain & Symptom Management’.

Keynote Address by Prof Michelle Leech Prof. Michelle Leech was recently a keynote speaker on Radiomics at the VCCC Alliance Cancer Conference in Melbourne Australia as part of her Irish Cancer Society-funded research networking grant to Peter MacCallum Cancer Centre. Here she is pictured with A/Prof. David Kok, Consultant Radiation Oncologist at Peter Mac and the VCCC Alliance. Winter Edition

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Dementia Research Network Ireland (DRNI) Early Career Research Day 2023 DRNI hosted the 2023 Early Career Research Day on October 10th in St James’s Hospital Dublin. With over 90 attendees from across the island of Ireland, the event featured presentations from early career professionals, patient advocacy, and a panel discussion on the future funding landscape for Alzheimer’s and dementia research. Link to more information: https://dementianetwork.ie/news-item/drni-early-career-researcher-day-0

TCD Researchers involved in 2023 World Rugby Rugby Science Network (RSN) Conference, Bordeaux, France. On October 9th 2023, Professor Fiona Wilson chaired a female athlete symposium at the World Rugby RSN conference, featuring international speakers. Kathryn Dane, PhD candidate and Irish international player, presented on the landscape of tackle research in women’s rugby, presenting her own first-author publications. The RSN conference assembles academics, clinicians, coaches, and players to optimise best practice and safety in Rugby. 16

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Centre for Health Policy and Management hosts international health systems experts as part of Elgar handbook workshop The Centre for Health Policy and Management hosted 30 international health systems experts at Trinity College on 9-10 October. Participants presented on health system resilience and experiences of Covid-19 from around the world, which will be included in the Elgar Handbook on Health System Resilience, edited by Edward Kennedy Professor Steve Thomas, and due to be published in 2024.

Primum Non Nocere: An Impossible Task in Medicine? The ethical pillar of non-maleficence is central to modern medicine, but is it possible that we may be doing more harm than good through overscanning and overprescribing? Despite our best intentions, the overdiagnosis epidemic poses a lethal threat. Read more here.

Centre for Health Policy and Management hosts inaugural Edward Kennedy Guest Lecture and Award The Centre for Health Policy and Management hosted the inaugural Edward Kennedy Annual Guest Lecture on 7 September at Trinity. Prof Greg Marchildon, University of Toronto, was the event’s speaker. Deputy Róisín Shortall, TD, was presented with the inaugural Edward Kennedy Health Policy Award to acknowledge her courage in advancing the cause of Sláintecare. Click here to learn more.

Prof Steve Thomas, Deputy Róisín Shortall and Dr Sara Burke

Congratulations to Dr. Siobhan Burke who came first in the annual Intern Case Presentation Final Congratulations to Dr. Siobhan Burke who came first in the annual Intern Case Presentation Final that took place 4th July. Each intern presents a case at a teaching session throughout the year, following this the three interns with the best scores present their case at a final in front of a panel of judges.

Caption: Pictured from left to right following the presentations were Professor Paul Ridgway, Consultant Surgeon / Judge; Emmanuel Eguare; Lucy MacCaulay, Siobhan Burke; Dr. Victoria Meighan, ED Consultant/ Judge and Dr. Aoife Garrahy, Endocrine Consultant / Judge Winter Edition Winter Edition

Dr. Burke presented an excellent and interesting case of presenting symptoms, differential diagnosis and management of haemolytic anaemia. While the runners up Lucy and Emmanuel also presented to a very high standard. Caption: Pictured from left to right following the presentations were Professor Paul Ridgway, Consultant Surgeon / Judge; Emmanuel Eguare; Lucy MacCaulay, Siobhan Burke; Dr. Victoria Meighan, ED Consultant/ Judge and Dr. Aoife Garrahy, Endocrine Consultant / Judge 17

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“Routledge Handbook of Mental Health Law” co-edited and two chapters contributed by Prof Brendan Kelly was published in October 2023 Mental health law is a rapidly evolving area of practice and research, with growing global dimensions. This work reflects the increasing importance of this field, critically discussing key issues of controversy and debate, and providing up-to-date analysis of cuttingedge developments in Africa, Asia, Europe, the Americas, and Australia. This is a timely moment for this book to appear. The United Nations’ Convention on the Rights of Persons with Disabilities (2006) sought to transform the landscape in which mental health law is developed and implemented. This Convention, along with other developments, has, to varying degrees, informed sweeping legislative reforms in many countries around the world. These and other developments are discussed here. Contributors come from a wide range of countries and a variety of academic backgrounds including ethics, law, philosophy, psychiatry, and psychology. Some contributions are also informed by lived experience, whether in person or as family members. The result is a rich, polyphonic, and sometimes discordant account of what mental health law is and what it might be. The Handbook is aimed at mental health scholars and practitioners as well as students of law, human rights, disability studies, and psychiatry, and campaigners and law- and policy-makers.” The book is available here https://www.routledge.com/Routledge-Handbook-of-Mental-Health-Law/ Kelly-Donnelly/p/book/9781032128375

Dataethics - Changing Landscapes in the Health and Life Sciences: Ethical Challenges of Big Data

The Dataethics Erasmus Plus programme involving the TCD School of Medicine and our Eurolife partners has completed with the production of several fully accredited online courses. These, as the name implies, are focussed on the ethical and legal issues relating to Big Biological Data (BBD) which is becoming ever more central to health care and life sciences research. Not only do we have data accumulating at phenomenal rates, other developments such as the use of artificial intelligence and machine learning greatly increase the complexity of generating, using, sharing and storing this data. However, awareness of how to evaluate and deal with the ethical aspects of this are developing more slowly. Thus, Eurolife launched DATAETHICS, a transnational project 18

aimed at evaluating best practices in Life Sciences and related fields and transferring this into online learning material for all. Dataethics has brought together leading experts in the field over Winter Edition

et eum quiaSummer et the Nam course of six and Winter schools during the last three years, attended by students and staff from TCD, other Eurolife partners and beyond. These involved lectures, seminars and interactive sessions, and a training method called VaKE – Values and Knowledge Education – where participants are presented with real life dilemmas and evaluate different potential solutions, often with ethical impacts.

· DATAETHICS 4 “Ethical and Regulatory Challenges in the Era of Open Science Data Sharing in Life Sciences & Health”

· DATAETHICS 3 “Big Data, Big Implications: Data Protection in Biomedicine”

For more information on Dataethics see https://www.dataethics-eurolife.eu/

TCD Occupational Therapy Research presented at AOTI Conference 2023

the global forced migration crisis. Four research projects are dedicated to this aim. The first one is a comprehensive review of 20,000 documents on parenting in protracted refugee situations, which reveals the current state of knowledge and suggests new directions for research. The second one is a video analysis of the largest observational data of its kind, which examines how trauma affects parent-child interactions among displaced Syrian families in Jordan. The third one is the first study to explore coparenting in displacement, which uses a qualitative approach to identify four main strategies that refugee parents use to co-parent in different contexts: negotiation, mirroring, anchoring, and transformation. The fourth and final one is a study that addresses the challenge of synthesising research in this growing field of parents and children in displacement. In this study, we have used large language models to automate systematic reviews and we will discuss the potential benefits and risks of using AI for this purpose with researchers and NGOs who conduct reviews.

The courses are stand alone and fully accredited – you will be awarded ‘open badges’ which describes the learning outcomes and documents your achievements in completing each course. Open badges are a portable, secure, and verifiable credentialing methodology fully compatible with All of this has been distilled into four online electronic media and can be attached to online courses with taught material, assessments and CV’s and LinkedIn pages. dilemmas making for a challenging and hopefully stimulating and illuminating journey through If you are working with big data, check it out – its ethical issues surrounding BBD use. The courses free and you can complete at your own pace. The are entitled: courses are hosted by the Karolinska Institute · DATAETHICS 1 “Ethical Considerations in https://ki.eu-west.catalog.canvaslms.com/ Interpretation and Handling of Biomedical Big browse/data-ethics Data” For more information on Eurolife including short · DATAETHICS 2 “The Ethics of Artificial Intelligence stay grant opportunities go to in Biomedicine” https://eurolifeuniversities.org/

On 5th and 6th October there was a strong representation from the Discipline of Occupational Therapy TCD at the Association of Occupational Therapists of Ireland (AOTI) Conference in Cavan. Eight oral presentations were delivered by staff and postgraduate students in the discipline showcasing the diverse range of research activity within the Discipline spanning cancer, stroke, inflammatory arthritis, refugees/asylum seekers, and sleep hygiene. The world is facing the biggest forced migration crisis on record, with 117 million people displaced from their country or former habitual residence, nearly half of whom are children. This is more than 1% of people worldwide. Most of these people are stuck in a state of uncertainty, with no hope of returning to their homes or integrating into new ones. Our work focuses on finding solutions for the children stuck in limbo who suffer the most from Winter Edition

Nam et eum quia et

NeuroInsight Fellow Nominated for Global Patient Innovator Award We are happy to announce that Dr. Guido Giunti, NeuroInsight Fellow and Digital Therapeutic Lead at Trinity College Dublin, has been nominated for the Global Patient Innovator Award, part of the HIMSS Changemaker in Health Awards program. The Healthcare Information and Management Systems Society (HIMSS) is a global non-profit organization dedicated to advancing healthcare through the use of technology. The HIMSS Changemaker in Health Awards celebrate individuals and organizations that challenge the status quo and lead the way in transforming healthcare. Guido’s work combines medicine, participatory design, and technology to raise the voices of people with chronic conditions and make them active participants in the design and development of digital health solutions. He frequently works with patient associations such as MS Ireland and others around the world to co-create solutions that matter. Dr. Giunti’s innovative work at TCD is part of the Marie Sklodowska Curie NeuroInsight Fellowships, under the supervision of Prof. Colin Doherty from TCD’s School of Medicine and Prof. Tomas Ward from the Insight Centre. NeuroInsight is a research training program designed to equip the next generation of leaders with competencies in cutting-edge fields such as data science, precision medicine and artificial intelligence with a focus on neurological conditions.

A Scarf for Lewy Eager to raise awareness of the little-known Lewy body dementia, members of Trinity’s Dementia Research Group recently hopped on the 7.35 am train to Belfast for an event organised by the Lewy Body Society. Lewy body dementia (LBD) is the second most common type of dementia in Ireland after Alzheimer’s disease and yet very few people have heard of it. People living with LBD have problems with movement and visual perception as well as cognitive and memory difficulties. The ‘scarf wrapping’ event on the 17th of October saw the Dementia Research Group join more than 150 volunteers from across Ireland to wrap a giant 244m scarf around Belfast’s Waterfront Hall building. Volunteers were also invited to knit their own scarves to bring to the event – needless to say the DRG didn’t come empty handed! The event was enjoyed by all and was a great opportunity to bring this very challenging condition into the public arena.

Winter Edition

The Pulse

PPI Event

On November 2nd at TCD’s Global Brain Health Institute (GBHI), the HRB funded Clinical Trial Network, Dementia Trials Ireland (DTI), and GBHI welcomed dementia trial participants and Patient and Public Involvement (PPI) panel members to a special PPI engagement event. The occasion served as a heartfelt thank you for their invaluable contribution to the advancement of dementia research over the past two years. The evening’s varied programme opened with an overview of the latest innovations in disease modifying therapies for dementia led by Prof. Iracema Leroi, Trinity College Dublin. A highlight was a ‘Fireside Chat’ with a PPI panel member and trial participant who

Dr. Irina Kinchin discussing critical research needs for Lewy Body Dementia in Ireland.

talked about their motivations for getting involved in and advocating for dementia clinical trials. Afterwards, Dr. Irina Kinchin, Centre for Health Policy and Management, TCD and Rachel Fitzpatrick, TCD Research Doctoral Awardee discussed the outcomes of a recent research priority setting exercise for Lewy Body Dementia (LBD). LBD, despite being the second most common type of dementia in Ireland after Alzheimer’s disease is generally underdiagnosed and under detected in Ireland. After an engaging session, guests were invited to a reception where they mingled with DTI’s Research Fellows and chatted about their latest research. The evening was a resounding success and sure to be repeated!

Members of Dementia Trials Ireland Patient and Public Involvement Panel with DTI Lead, Prof. Iracema Leroi (third from left).

students to find a map to their journey through Trinity. I want to help them understand that they are worthy of the care that they want to offer patients. As students learn about their “I will attend to my own health, well-being, and own needs I will help them find the supports abilities in order to provide care of the highest to address those needs. Whether it’s linking in standard” - Physician’s Pledge with the Disability Services for an assessment, or using the self-guided online Silver Cloud Students in the School of Medicine want to help Simone Cameron Coen others. They respond to people’s discomfort Student Welfare & Support Officer and pain and they want to ease it. To do this, they make a commitment to life-long learning, beginning when they enter Trinity College Programme in the Student Counselling Service, Dublin. College years are exciting. They are there is a network of people who will respond filled with academic exploration, scientific to our students and a variety of tools to help experimentation, and ...life. Life can be students develop skills in self-care. In addition unpredictable, particularly as you find your to responding to a student in crisis, I want to way in your early twenties. Students come to work with them to create a sense of belonging Trinity from all over the country, from all over by co-creating events that will bring connection the world. Getting used to a new city, new flat between them. Lunchtime gatherings or mates, new ways of learning, is challenging. society taster events in TBSI, SJH, and TUH will There will be messes, there will be successes. create stronger student connections. To get in What I am here to do as the School of Medicine touch with me, please email simone.cameronStudent Welfare & Support Officer is to enable coen@tcd.ie.

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Meet the Team

Prof. Smith

Dr. Conlan

Cait Kane

Marie Cormican

mednews@tcd.ie

Mary O’Neill

Michelle Hendrick