The Pulse - Summer Issue 2021

TRINITY PULSE NEWSLETTER Volume 1, Issue 1

Newsletter Date: 27 May 2021

SCHOOL OF MEDICINE Editor’s welcome Welcome to the ‘new look’ of Trinity’s School of Medicine (SoM) e-bulletin, now renamed ‘Trinity Pulse’.

Congratulations to Michelle Leech, Associate Professor and Head of Discipline of Radiation Therapy, for proposing the winning title of our recent ‘re-name the e-bulletin’ competition!

We have decided to change our approach and update our format. The new purpose of our newsletter is to celebrate the full SoM community, ensuring that all groups, centres, disciplines, institutes, labs and courses have a voice.

We hope to highlight the great successes of our SoM

community, as well as celebrate the day-to-day work of members.

Thus, we have moved away from listing announcements of upcoming events and instead we have included the following sections: (1) The four B’s – short exposés under each of the four pillars of the SOM: The Blackboard (teaching); The Bench (translational biomedicine); The Bedside (clinical practice), and Beyond (wider engagement with policy and society); (2) a ‘Showcase of Delights’, highlighting recent successes such as publications, courses launched, grant awards, inventions, Nobel prizes, and other wonderful achievements; and, finally (3) an in-depth interview of ‘A day in the life of….’, detailing the everyday

Prof Iracema Leroi

work of SoM members. This issue spotlights the work of Siobhan Ward and Philomena McAteer who run Trinity’s award-winning body donation program through the Department of Anatomy. We sincerely hope you will enjoy this term’s read. As always, we hope to continuously improve our communications, so your feedback is welcome. Please contact us at: Mednews@tcd.ie and spread the word through; @TrinityMed1 twitter account.

Inside this issue: Guest Editor Reflection

2

The Blackboard

3—6

Teaching

The Bench

7—8

Translational Science

The Bedside

9

Patient Care

The Beyond:

10

Engagement with the wider community

Showcase of Delights

11—24

Special points of interest: •

A Day in the life of …….. 25—28

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NEWSLETTER

Guest Editor reflection:

We are currently reworking the ways that we communicate with each other within the School and also between the School and the outside world. The purpose of these changes is to make sure that we amplify the excellent work that we are doing to the public and also to each other. It’s also vital to improve our communications to increase our connectedness because we operate across many sites and that we tailor our communication toward different audiences for our mutual benefit. A key challenge for us is that often some of our best

Prof Michelle Leech

work is hidden, be that in relation to important research, innovative teaching or valuable impact on how society functions and on bettering people's lives. Universities add much value to society and Trinity is at the forefront of this. This is to be celebrated but it also needs appropriate resourcing and investment.

Telling our stories helps build up important reservoirs of good-will and consolidates Trinity's position as central to societal well-being and international innovation. To facilitate this, we as a School have been rethinking how we manage

and handle our social media presence. We have a new SOM social media policy and together are in the process of revamping our website, twitter accounts, and other important platforms including this ebulletin.

We are furthermore delighted that Prof Iracema Leroi has taken on the position of Academic Editor for the School's bulletin and are sure that her expertise and insights will help us connect better with each other and also externally with international alumni.

Prof Steve Thomas

Showase of Delights

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NEWSLETTER

Showase of Delights The School of Medicine has successfully been awarded three out of the seven Strategic Alignment of Teaching and Learning Enhancement (SATLE) Funding 2020 granted to Trinity, to support the strategic focus of the National Forum for the Enhancement of Teaching and Learning in Higher Education of “Transforming Teaching and Learning for Stu-

Enhancing blended learning in anatomy education This initiative aims to enhance the discipline of anatomy’s blended learning Dr Denis Barry

perspectives by increasing its digitised radiological and historic anatomical content as it relates to the anatomy of the head and neck, and the thorax, abdomen and pelvis.

We firstly wish to digitise historical gross anatomy teaching materials including preserved cadaveric specimen, posters, bones and models that were originally prepared and labelled by anatomists and doctors for educational purposes and which often date back to the late twentieth century. These reveal

extraordinary insights into the normal and pathological anatomy of the human body, and often are associated with detailed case histories revealing fascinating insights into health care procedures of the time and retain enormous pedagogical significance.

Digitising these specimen and aligning them with existing curricular elements will revitalise their original purpose, greatly enhancing student learning experiences.

Furthermore, a progressive area of anatomy education is the integration of radiological content By across anatomy curriculum. engaging with hospital radiologist partners, to source and interpret radiographs showing normal and otherwise content, the clinical and contemporary significance of anatomy education will be enhanced.

These historical and contemporary radiological resources will be integrated into the interactive E-learning platform, Articulate and hosted on the colleges virtual learning environment, Blackboard. Files generated may be made available through creative commons licensing. This digital content will complement existing curricular supports and enhance current and future generations of health care student’s appreciation of anatomy and its clinical significance.

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NEWSLETTER

DEPTH – Digitally Enhanced Practical Teaching in Health Teaching and learning practical skills is an area which many would not traditionally consider to be suited to online or distance learning methods. Restrictions associated with the COVID-19 pandemic required those who teach and those who learn to adapt and to demonstrate innovation

Dr Cuisle Forde

•

examine opportunities and barriers to digitally enhanced practical teaching

•

analyse student, academic, and clinical professional perspectives on digitally enhanced practical teaching

•

•



resources outlining opportunities, barriers and considerations related to the acquisition of practical skills using technology



an analysis of the attributes of practical skills and their suitability to being taught and assessed using technology

examine the feasibility and efficacy of digitally  enhanced practical teaching (in skill acquisition and assessment) in partnership with students

resource informed by results of this research to include



.

recommendations on digitally enhanced practical teaching and assessment for both those who teach and those who learn case studies on the acquisition of practical skills using technology

in methods of practical skill acquisition. This project aims to consolidate some positive disturbances that occurred in relation to practical teaching during 2020 in partnership with students. Specific aims are to;

Staff in the School of Medicine have responded to the teaching challenges related to the current COVID-19 pandemic with innovation and dedication to uphold high standards and high rates of student success. Research carried out as part of this project will contribute evidence to this experience from several stakeholders, including students, which may regarding the retention of certain practical teaching and assessment methods going forward.

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NEWSLETTER

Showcase of Delights

Supporting Student Success Through Clinical Teacher Training The standard of a placement and learning potential realized for students often pivots on the supervision the student receives from the clinical teacher. Clinical teachers are expected to teach and prepare students to competently meet the demands of clinical practice, but being a clinical teacher requires additional skill development beyond their practitioner skills. This project aims to promote student success through the development of an open access digital interdisciplinary teaching and learning module which will be available to support multidisciplinary clinical teachers who supervise students in the clinical learning environment.

The interdisciplinary project team successful in securing the National Forum for the Enhancement of Teaching and Learning in Higher Education funding will work together on this innovative initiative which specifically aims to: •

Explore multidisciplinary healthcare students and clinical teachers’ perspectives on effective teaching and learning in the clinical learning environment.

•

Identify barriers and enablers for effective teaching and learning in the clinical learning environment.

•

Develop an open access interdisciplinary teaching and learning module for clinical teachers consisting of interactive units of learning including; 

relevant educational theories related to clinical teaching and learning



strategies for effective teaching and learning in the clinical learning environment



tools to enhance student engagement and promoting a culture of belonging in the clinical learning environment



tools to enhance clinical educators' supervisory and management skills to support students through diverse and complex clinical practice

In harmony with Trinity College Dublin and TCD Students Union Student Partnership Policy, this initiative will invite healthcare students to participate in focus groups exploring their views on effective teaching and learning in the clinical learning environment and students will be asked to review the module during its development ensuring a collaborative approach to developing the course material.

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NEWSLETTER

Epi-Clinic – a support clinic for School of Medicine staff designing epidemiological studies Noel McCarthy (Professor of Population Health Medicine) and Lina Zgaga FTCD (Associate Professor of Epidemiology) at the Institute of Population Health are offering a consultation clinic on epidemiological study design for School of Medicine researchers as a trial/pilot. This aims to bring more structure to ad hoc requests for input

on study designs. The pilot will run every third Monday starting June 2021, from 9-12, with 30-minute slots bookable by email. These can be for initial consultation sketching out an epidemiological study design for planned research, or for more detailed consideration of aspects of more developed research plans. Areas of advice can include study design, data analysis plan and

Showcase of lights

De-

Prof Noel McCarthy

sample size estimates. If you would like to try this out please email ioph@tcd.ie indicating what you are seeking, where relevant and available an existing study plan or bid criteria, any deadlines that you face, and well as your availability during clinic time slots. We will come back with a time to meet and discuss.

Dr Lina Zgaga

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Data Science Research in Brain Health at the Gillan Lab The Gillan Lab (www.gillanlab.com) in the School of Psychology and Global Brain Health Institute have received over 2 million euros in funding in 2020 from the SFI Frontiers for the Future scheme and an ERC Starting Grant to advance their efforts in developing big data approaches to the study of mental health and age-related cognitive decline.

The lab has been working for several years on improving our understanding of the biological, Dr Claire Gillian psychological, cognitive, environmental and psychosocial processes that confer risk for brain health problems. Because brain health is incredibly complex and risk is multifactorial, individual risk factors often have small effect sizes, making them hard to estimate in individual studies with small samples, and difficult to action clinically. To remedy this, the lab is developing new methods that can dramatically scale up research, increasing breadth by allowing researchers to gather larger samples and depth, by facilitating methods to gather more information per person.

One of the core projects connecting these grants is a smartphone app called neureka (www.neureka.ie). Neureka unites citizen scientists around the world who want to contribute to cognitive neuroscience research in brain health. There are over 9000 registered users to date from >90 countries around the world. The app allows researchers to measure cognitive abilities repeatedly and regularly through gamification. It also supports ecological momentary assessments of mood and compulsive aspects of psychopathology, as well as rich demographic, lifestyle and physical health phenotyping.

The lab realises that there is strength in numbers and so the app is free to use, not just by the public, but other researchers. If you want to use neureka for a research study, get in touch with Dr Claire Gillan on gillancl@tcd.ie. Or if you want to contribute to our understanding of brain health in the population yourself - download neureka now!

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NEWSLETTER

Dr Niamh Lynam-Lennon.

I am based in the Dept. of Surgery, where I lead a team of 4 researchers investigating treatment resistance in gastrointestinal cancers. Oesophageal and rectal cancers are commonly treated with radiation and chemotherapy. Despite advances in treatment, resistance to these therapies is still a significant global clinical problem. My research is focused on elucidating underlying mechanisms of treatment resistance so that we can (i) identify and validate novel biomarkers predicting response to radiation and chemotherapy to enable improved patient stratification and (ii) identify novel treatment strategies to enhance the tumour response to therapy, with the ultimate goal of improving treatment and survival for patients. Our research spans several topical areas including miRNA and gene expression profiling, altered mitochondrial function and energy metabolism and altered inflammation (specifically the complement system) and the role these pathways/mechanisms play in treatment resistance. We use a number of different experimental models, including in vitro cell line models that reflect inherent and acquired radioresistant oesophageal adenocarcinoma and rectal cancer, ex vivo tumour explant models and blood and tumour tissue samples from consenting oesophageal and rectal cancer patients. These models allow us to functionally interrogate mechanisms of treatment resistance in the lab and also importantly ensure that our data translates to a patient setting and has clinical utility.

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Trinity’s Memory Clinics: Tallaght and James’s supporting people at risk of dementia With the ageing of Ireland’s population, the number of people living with dementia in Ireland is estimated to double by 2050. There are already over 55,000 people with dementia and many more who fall into the ‘at risk’ category by having symptoms consistent with mild cognitive impairment (MCI), a precursor stage to dementia. The memory clinic at St James’ Hospital (SJH), directed by David Robinson, and at Tallaght University Hospital (TUH), co-directed by Sean Kennelly and Sean O’Dowd, are both national leaders in the diagnosis, management, and support of people living with memory complaints.

Started many years ago by Professor Brian Lawlor, the SJH clinic now sees over Dr David Robinson 250 new referrals per years, including people as young 45 years old. Over recent years, the interdisciplinary clinic at TUH sees a similar number of new referrals annually, and is leading the nation’s brain health program through links with medical exercise programs and wellbeing for those at risk of dementia. The model of diagnosis and care is rooted in an inter- and multi-disciplinary approach, with teams including geriatricians, psychiatrists, neurologists, psychologists, Speech and language therapists, Occupational Therapists and social workers. Both clinics have been to the forefront nationally in integrating clinical expertise with use of cerebrospinal fluid and imaging biomarkers, ensuring more accurate diagnosis. The services are underpinned by the importance of holistic and therapeutic post-diagnostic care and support.

Together, the clinics are developing a portfolio of clinical trials in dementia, including both nonpharmacological approaches and drug-based interventions. The Cognitive Clinical Trials Unit in TUH currently has several studies ongoing including a European phase-2 IMP study. Two further global industry-sponsored phase-3 trials for Alzheimer disease are due to start in Summer 2021, involving patients form both clinics.

Tallaght University Hospital Memory Service Team: (From left) Prof Des O’Neill; Prof Sean Kennelly; Ruth Ennis (Research manager), Cathy McHale (cANP), Fiona Tobin (OT); Des O’Donnell (SpR), Caroline Kenny (Neuropsychologist); Lisa Sheridan (SLT), Cliona Small (Reg), Joshi Dookhy (ANP), Time Dukelow (SpR), Caitriona mc Guinn (OT), Mary Kelly (Admin lead) Absent: Sean O’Dowd, Emmet Byrne (CNS)

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TRINITY PULSE NEWSLETTER

Noel McCarthy is Professor of Population Health Medicine based at the Institute of Population Health, Tallaght.

What a time to return to Ireland and Trinity, and to join the Institute of Population Health at Tallaght. The extent to which countries can respond differently to similar challenges, and with very different outcomes has been demonstrated starkly in the past year. South East Asian and Antipodean countries appeared to get public health interventions right. They were open to rapid and radical change, learned quickly, and deployed very active management approaches with huge public engagement. There were errors and setbacks as countries experimented with control approaches, but this region was characterised by these issues being identified quickly and alternative approaches trialled and implemented. Europe and North America showed far Prof Noel McCarthy more inertia. Slow starts were followed by persisting with decisions rather than continuous experimentation and optimisation. Governments didn’t appear to trust their populations to engage in control in a sophisticated way. Bite size public messages mainly asked that people contribute through the medium of doing nothing. Although such passive approaches slow transmission their inferiority to more active management is evident in weaker COVID control and more severe social side effects.

These contrasting approaches and outcomes offer lessons far beyond pandemic control and will inform how the Institute of Population Health at Tallaght contributes to this community.

Critical social, health, and healthcare problems can be effectively managed and changed rather than endured. Tallaght University Hospital, local community health services, and wider community institutions already work together flexibly. Examples include local Health Service Executive investment in experimental service developments such as the “Tomorrows Care” initiative, and council, community, business, health service and university exploration of a wellness village model to support life and service provision for older people. Further experimental approaches, grounded in community needs and assets, and with robust, and iterative evaluation and optimisation are needed. Trinity research and education capacity, within and beyond the School of Medicine can contribute to this. The Institute of Population Health offers local infrastructure at this interface to facilitate and coordinate Trinity working with this community. Process measures of success for the Institute of Population Health will be the extent to which Tallaght tried both simple and radical approaches, evaluated them thoroughly, made and addressed mistakes, maintained trust across communities and institutions in the area, and engaged the range of Trinity capacity in working with the community. Outcomes will be wellbeing in the local population, and evidence to support the application of effective approaches elsewhere.

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Congratulations to our Researchers being awarded the Irish Research Council Congratulations to our researchers on being awarded an IRC New Foundations award for their research. The awardees are: Dr Damien Brennan

Prof Iracame Leroi

Dr Geraldine Foley

Dr Tamasine Grimes

Prof Eve Patten

Ms Katy Tobin

Dr Simon McCarthy Jones

Prof Amanda Phelan

Congratulations to Professor Joe Keane, being elected to membership of the Royal Irish Academy Professor Joe Keane has been elected to membership of the Royal Irish Academy this year, with the online ceremony currently ongoing. Well done Prof Keane.

Prof Joe Keane

Dr Geraldine Foley publishes with colleagues in International Journal of Qualitative Methods This grounded theory methods article contains detailed examples of interviewing in projects that cover research topics as diverse as accessing abortion care services, grandparenting, living with motor neurone disease, Dr Geraldine Foley intergenerational solidarity and friendship, and longterm care service use.

The article will help researchers understand contrasts and commonalities between interviewing techniques in qualitative methods. The article is indispensable reading for researchers setting out to conduct a Grounded Theory study that involves interviewing or focus groups.

The publication, co-authored Professor Virpi Timonen (Social Policy, TCD) Dr Catherine Conlon (Social Policy, TCD) Dr Catherine Elliott O’Dare (UCD) was published on 14th April, 2021.

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NEWSLETTER

EACR Young Investigator of the year Award Maria Davern was awarded EACR Young Investigator of the year Award in the junior category (less than 3 years post-doc experience at the EACR conference) for highest scoring abstract entitled: “Novel Insights into Immuneindependent Functions of Immune Checkpoint Inhibitors in Oesophageal Adenocarcinoma; Potential Implications for Overcoming Chemoresistance to First-line

Chemotherapy Regimens”, awarded by the IACR. This research has provided insights into novel immuneindependent functions of immune checkpoints in oesophageal cancer which confer resistance to chemotherapy and offer potential targets to combine with chemotherapy to enhance sensitivity

Maria Davern

Advanced understanding of potential differences in EQ-5D values in the palliative care context

Dr Irina Kinchin

Irina Kinchin as Principal Investigator and team of Investigators from Trinity College Dublin, University of Technology Sydney, and Curtin University. Evidence suggests that people value health differently in different social care contexts. If this is true, values obtained from the most widely used instrument for measuring health-related quality of life (EQ-5D) may be sensitive to the context in which they have been obtained. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be

underestimated, and hence interventions which may appear to be beneficial to participants are not deemed cost-effective and are not funded. Therefore, it is crucial to understand how EQ-5D values might vary, given the social context. The EuroQol Group provided funding to conduct an exploratory study to use a discrete choice experiment with over 6000 people across Ireland, UK and Australia to value EQ-5D in palliative care context as described and contextualised using vignettes.

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Inaugural Lecture from Professor Adrian Hill Professor Adrian Hill from the Jenner Institute in Oxford delivered the 146th Inaugural Lecture to the DU Biological Association. He outlined the development process for the ChAdOx1 nCoV-19 vaccine, and discussed efficacy, adverse events and global impact.

Professor Hill was a previous Committee member of the DU Biological Association, and is now leading the fight against COVID19.

The kickoff meeting of the MSCA Innovative Training Network titled 'Network of Excellence of Training on Hate' (NETHATE) The kickoff meeting of the Marie Skłodowska-Curie actions Innovative Training Network titled 'Network of Excellence of Training on Hate' (NETHATE) The members of the consortium participated, which are: Trinity College Dublin, University of Antwerp, University of Limerick, University of Turku, University of Helsinki, Erasmus University Rotterdam, University of Leiden, University of Gothenburg, University of Plymouth, Amadeu Antonio Stiftung/Institute for Democracy and Civil Society,

Friedrich-Schiller University Jena.

It was an opportunity for the PhD students to meet the different members of the consortium and learn about planned research and learning activities of the consortium.

It will deliver the doctoral training of 15 PhD students and training of Europe's next generation of researchers, teachers and practitioners in understanding the roots and impacts of hate.

It is an innovative and multi-disciplinary training programme that deals with critical issues of the dignity of all people and existence and prosperity of a democratic society.

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NEWSLETTER

Scientists find that binding iron improves the effect of the anti-TB drug Bedaquiline

Although Tuberculosis, or TB, killed nearly as many people as COVID-19 (approx. 1.8 million) in 2020, it did not receive as much media and public attention. The pandemic has proven that transmissible infection is indeed a global issue. TB remains a serious public health concern in Ireland, particularly with the presence of multi-drug resistant types and the numbers of complex cases here continuing to rise, with cases numbering over 300 annually.

Science tells us that iron is crucial for daily human function, but it is also an essential element for the survival of viruses and bacteria.

For some time, scientists have known that depriving infections of iron can limit bacterial burden and help improve patient outcomes.

Now scientists at Trinity College and St James’s Hospital have recently applied such a trick (of binding iron to support the immune system) to the treatment of TB, along with a new TB antimicrobial called Bedaquiline. The findings have been published in the prestigious journal, the International Journal of Molecular Sciences: https:// bit.ly/3bXNBcd .

The research is led by Professor Joseph Keane and Dr James Phelan.

Bedaquiline has been in use for less than 10 years for multi-drug resistant TB, yet last year Ireland saw its first case of TB that was Bedaquiline-resistant. We know that even as new antituberculosis drugs are Introduced, the TB bacteria will become increasingly resistant.

For some time, Dr Phelan has been looking at how to support the immune system to improve treatment effectiveness. He has previously demonstrated how an iron-binding drug, called Desferrioxamine, or DFX, supports lung immunity against TB infection by driving the activation of a key metabolic pathway called ‘glycolysis’. The process of glycolysis helps immune cells make energy to fight infection which in turn drives several signals that improve the patient

macrophages’ (white blood cells) ability to address TB infection.

Recent data has shown that a large fraction of people suffering from TB lack this glycolytic response. DFX could compensate for this metabolic defect.

As an extension of this work, the research team has now demonstrated that immune macrophage cells infected with TB bacteria, and treated with the drug Bedaquiline, do a better job of killing the bacteria, if they are also treated with this ironbinder DFX. In addition, this approach also drives a panel of cytokines, or immune messengers, that could also help the macrophages to eliminate the pathogen.

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NEWSLETTER

Congratulations to Aisling Page a 4th Year Medical Student being Awarded the University Pinks Sports Award for outstanding athletic performance in Karate.

Aisling Page

Aisling Page, a 4th year medical student was captain of the Trinity Karate club for two years from 2018-2020. She has been a member of the Trinity karate club for the past 4 years. Over this time she has represented Trinity at inter-colligate, inter-varsity and all Ireland level competitions.

University Pinks is awarded to a select number of student athletes who have fulfilled a strict set of criteria in their chosen sport while representing Trinity in competition.

student athletes.

It is equivalent to Oxford and Cambridge’s Blue University Sports Award.

It is the highest sport accolade that Trinity can bestow upon

Final Year Medical Student appointed to National and International Academic and Community Healthcare Leadership In February, Shubhangi commenced her role as the youngest Reviewer of the BMJ Journal of Medical Ethics, following three years of leadership in undergraduate academia in TCD. In May, Shubhangi commences a three-year role as Trustee of Choice Support UK, a nationwide charity supporting intellectually disabled and mentally ill people of all ages accessing

rights-affirming participation in employment, relationships and self-advocacy.

They have also been selected to the Washington Ireland Program 2021 in the interim between their degree and commencing Academic Internship in St. James’ Dublin, where they will be investigating the systems requirements for developing allisland public healthcare services, particularly

post-Brexit.

Their activities will train them in global standards of clinical ethics and ethics of medical leadership and management, and Dr Shubhangi guide strategic Karmakar integrated care provision for people with mental health issues across the UK and Ireland.

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Med Day 26th February 2021 Despite all of the challenges facing Med Day 2020 due to the pandemic, I am delighted to say that our wonderful committee and amazing student volunteers overcame every obstacle facing them to raise an incredible amount of money. The grand total raised

by Med Day 2020+1 is €85,886. This is far more than our annual goal and more than we ever could have imagined possible to raise, particularly in this year of all years. As a result, not only is Med Day 2020+1 able to support our 4 chosen beneficiaries but we can now support an additional 5 worthy causes at our TCD affiliated teaching hospitals.

Med Day 2020+1 funding is in support of these 9 deserving causes: Pulmonary Function Assessment Devices for COVID -19 Survivors, TUH Intra-Dialytic Exercise for Haemodialysis Patients, TUH Coombe Care providing support and assistance to vulnerable new

mothers and families, CWIUH Equipment for the Physical and Psychological Rehabilitation of Burns Patients at the National Burns Unit, SJH Development of Genetic Testing for Inherited Platelet Disorders, SJH Replacement of Syringe Pumps for Palliative Care Patients, OLH Point of Care Testing Machines for Warfarin Patients, TUH Improving the Artistic Environment of the Mental Health Admission Unit, SJH Reorientation of ICU Patients using Digital Calendar Clocks, TUH We on the Med Day Committee would like to extend a huge thank you to everyone who supported us this year, whether it be through participating in the day, donating or sponsoring us. We hope that the entire School of Medicine and student population has enjoyed what has been a very different but highly gratifying Med Day.

Winner of the 8th Medical Student Essay Competition 2021 in anaesthesiology Congratulations to Conor Farrell a 3rd Year Medical student on winning the 8th Medical Student Essay Competition with his essay titled “ Safety while we watch - What should a Patient Safety Culture in Anaesthesiology look like?”

Conor’s essay will be published and he will present the essay at the National Patient Safety in Anaesthesia Conference which will be held in Dublin on 13rd November 2021.

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Congratulations to Eimear Mylod PhD Student being awarded the Breakthrough Cancer Research Best Oral Presentation award .

PhD student Eimear Mylod, from the Cancer Immunology and Immunotherapy Group within the Dept. of Surgery was awarded the Breakthrough Cancer Research Best Oral Presentation at the Irish Association for Cancer Research annual meeting 2021

Eimear presented her work on the role of the innate lymphocyte natural killer cell and the chemokine fractalkine in oesophageal adenocarcinoma.

Oesophageal adenocarcinoma has a 5-year survival rate of just 20% and rates of this cancer are rising rapidly, meaning new therapeutic options are urgently needed.

Eimear Mylod

Congratulations to Laura Kane 2nd being awarded the Prof. Patrick G. Johnston Award for Excellence in Cancer Research Outreach at the annual Irish Association for Cancer Research (IACR) conference 2021 Laura is a 2nd year PhD student in the Maher lab group won this award at an international conference, competing against others from different universities all over the country.

Laura presented a lay summary of her PhD research on the biological activity of

pancreatic cyst fluid and its potential to harbour novel biomarkers of pancreatic cancer.

Laura was one of six finalists to present at the IACR 2021 conference and was chosen by a panel of scientists, patients and the general public.

Laura Kane

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TILDA publish CANDID Initiative Leveraging Cognitive Ageing Dementia Data from Around the World Guide to strengthen knowledge information sharing for researchers.

TILDA researchers have released a cognitive data comparability guide, strengthening access to, and usability of, the wide variety of cognitive datasets within the HRS family of ageing studies. It provides step-by-step guidance on how to access datasets, documentation and codebooks via the Gateway to Global Aging or respective studies websites.

This guide serves as an important asset for researchers to improve and strengthen ease of access to brain health data across studies across the HRS longitudinal studies on ageing. Data can be leveraged to answer important research questions on dementia prevalence, risk factors and care worldwide, and to inform policy and prevention strategies.

This guide strengthens access/knowledge to brain health and dementia-related research; gives detailed descriptions on twelve HRS cognitive datasets, and comparability guidelines for best practice use.

Maher Lab Group publish important review on the potential of multi-omic data integration for the identification of novel pancreatic cancer biomarkers Publication of our review entitled “Multi-Omic Biomarkers as Potential Tools for the Characterisation of Pancreatic Cystic Lesions and Cancer: Innovative Patient Data Integration” in Cancers 2021

Dr Stephen G Maher

Pancreatic cystic lesions are protrusions found within or on the surface of the pancreas, which in many cases have the potential to progress to pancreatic cancer. Current methods of identifying pre-malignant lesions are imperfect. We highlight the importance of biological markers

in this context, with a focus on ‘omics’-related work .

Dissemination of current research in the area of pancreatic cancer to show the potential utility of multi-omic data integration for the identification of novel biomarkers.

Members of the team included: Laura E. Kane, Gregory S. Mellotte, Kevin C Conlon, Barbara M Ryan and Stephen G Maher

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Publication of international guidance on hearing, vision and dementia care (Littlejohn et al., 2021; Gerontology)

The SENSE-Cog research program (www.sense-cog.eu) is a 6.7million EU-funded project led by Professor Iracema Leroi in TCD and SJH, and involving 8 EU countries and 32 investigators.

SENSE-Cog has been investigating the links between hearing, vision and dementia for the past five years. It has included epidemiological studies of hearing, vision and cognition using several EU longitudinal aging cohorts. It has validated cognitive rating

scales for people with hearing and vision impairment. There is an ongoing EU-wide RCT for hearing/vision rehabilitation in people with dementia. The SENSE-Cog team has developed international guidance for hearing and vision care, 'International practice recommendations for the recognition and management of hearing and vision impairment in people with dementia'. Professor Leroi was the originator of

this project and led the 29 -person task force to develop the guidance.

This is the first set of international, interdisciplinary practice recommendations that will guide the development of multidisciplinary services and policy to improve the lives of people with dementia and hearing and vision impairment.

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Surgical decision making project for End of Life adopted by European Board Exams UNION EUROPÉENNE DES MÉDECINS SPÉCIALISTES (UEMS) After successfully running a pilot project (simulated assessment) in Tallaght University Hospital that validated a new assessment tool for clinical decision making in surgeons, said assessment tool was used in a high-stake examination earlier this year as part of the formal assessment; the European Board exam UEMS. This study is about surgical decision making in End-OfLife scenarios, a decision that is reserved for the senior most member of the team.

There is little to none

literature regarding how to assess the ability of a surgeon to make an End-OfLife decision in the best interest of the patient with timely referral to palliative care This project involved surgeons in their senior training years at a nodal point of transition to pre-autonomous practice, appearing for fellowship examinations.

Differential performances observed by junior and senior surgeons shows that bespoke structured

scenarios can be used for assessment in prospective examinations and in a formative manner for training.

This is a pioneer project for understanding the factors involved in clinical decision making for End-OfLife situations in surgery by creating and validating an assessment tool leading to improvement in prospective examinations.

Members of the team were Prof. Paul Ridgway, Dr. Muhammad Umair.

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Impact of Covid-19 crisis on older people….A new TILDA Report Researchers at TILDA have released one of the most wide-ranging and detailed accounts since the COVID-19 crisis unfolded, examining the impact of the COVID-19 crisis and restrictions on the lives of older adults living in Ireland. The report is available here: https:// doi.org/10.38018/ TildaRe.2021-01.

A series of COVID-19 brief reports released by TILDA are also available to view here: https://tilda.tcd.ie/ CovidData/briefs/ This report covers a range of aspects affecting adults aged 60 years and older during the first few months of the pandemic. These include

changes to everyday

of the pandemic, finding 21% of adults aged 60 reported activities due to socialpotentially clinically distancing and restrictions on meaningful levels of social interactions, and how depressive symptoms, a these changes to peoples’ doubling of reported figures lives have impacted on physical seen before the pandemic. and mental wellbeing.

Researchers also found that almost 30% of adults aged 60 The findings give an important and over delayed or did not baseline for identifying and get medical care they needed, evaluating the long-term this may have significant knock impact of the Sars-CoV-2 virus -on effects for older adult and restrictions, on health health and services. The report outcomes for older adults. is the most wide-ranging account of the impact of the TILDA’s report gives a highly pandemic on the lives of older detailed account to show the adults, and contains important consequences of the COVID-19 Information to help crisis on the lives of older Government, policy planners, adults. Researchers show a and the health care sector see significant rise in loneliness and what support is needed in the depression in the initial stages current and future context.

Professor Joe Keane recipient of grant from Royal City of Dublin Hospital Trust.

The Royal City of Dublin Hospital trust has renewed a successful RCDHT fellowship programme award, to train up doctors to PhD at Trinity College Dublin / St. James's Hospital. Fellows will undergo an

apprenticeship in medical research and generate research findings in the area of pulmonary infection.

Dr Laura Gleeson is a graduate of the first RCDHT fellowship, and she just been awarded a competitive €500,000 HRB grant to continue research.

Such academic activity draws the best doctors to work at

St. James’s Hospital.

Fellows who benefit from the RCDHT programme also work on the front lines of COVID care. We face an uncertain future of pandemics, but the renewal of this core funding will secure an ongoing contribution to the national pandemic endeavor, at both the research and clinical service level.

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GBHI Celebrates Founding Donor Chuck Feeney’s 90th Birthday Members of the Global Brian Health Institute community came together to share birthday greetings, musical and personal messages with Chuck Feeney reflecting on his remarkable life and his impact on GBHI, Trinity, Ireland and the world. Like so much this year, including the Atlantic Fellows’ learning experience, this involved online collaboration across the globe.

community, including faculty at Trinity and UCSF and 140+ Atlantic Fellows for Equity in Brain Health from 40+ countries, continue to share our deepest gratitude to Chuck Feeney and Atlantic for Feeney dedicated his life’s providing us with the work and fortune to advance resources needed as we fairer, healthier, and more collectively strive to Inclusive societies; investing improve brain health for over $8 billion globally, over 38 populations across the years, through The Atlantic world.

Philanthropies. The GBHI GBHI was founded in 2015 by a generous gift, from Feeney’s charitable foundation, to address the global dementia challenge through research, practice, education, and advocacy.

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The School of Medicine’s Brochure on the Experiences of Medical Students During the COVID-19 Pandemic

The School of Medicine recognises that the COVID -19 pandemic has impacted on medical students and their learning experiences. A number of medical students have volunteered in ICU, some have helped out at COVID -19 vaccination clinics and others have joined their classes online from locations across the world. The School is compiling the experiences of medical students during the COVID-

19 pandemic into a brochure. Medical students from years 1 to 5 have been invited to make submit their contributions to this brochure and this will be published at the end of the academic year. This brochure will provide unique insights into the experiences of TCD medical students over the last 13 months.

Congratulations to our Fellows and Scholars

Congratulations to our Fellows being elected to Fellowship by the Provost on 26th April.

Dr Jean Fletcher Prof Catherine Hayes Dr Adriele Prino-Mello Dr Lina Zgaga Prof Steve Thomas Prof Colin Doherty

Also big congratulations to our many our students awarded Scholarship and performing so well under such difficult circumstances - we are very proud of their achievement.

These are Occupational Therapy Zofia Dabrowska Physiotherapy Aisling Keller Ella Roberts

Medicine Jing Xian (Estelle) Choo Sophie Coalter Emily Doyle Simon Hollingsworth Columb Kavanagh Aidan Kelly Eimear Kyle Mary McLoughlin James Prendergast Liz Shi Yun.

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Trinity Covid Response Fund… exploring caregivers coping in 29 CLIC-Caregiver study is a cross-sectional, online, and global survey directed at informal caregivers of people with chronic health challenges. Embedded within a larger survey for general public (‘Comparing Loneliness and Isolation in COVID-19’ (CLIC)), and validated loneliness and isolation tools, the survey is translated into ten different languages and disseminated over 100 countries.

This project received so far the support from several grants: the TCD COVID response funding; the Irish Research Council awards; the Atlantic Institute Solidarity Grant The study group recruited a new research assistant to expand the analysis.

And two posters will be presented in the Alzheimer’s Association International Conference (AAIC) annual meeting and satellite symposium.

Findings will be distributed to relevant stakeholders in the form of a project report, with region and country-specific outcomes.

This will support recommendations and actions supporting caregivers of people with brain health challenges.

Members of the team include Pr Iracema Leroi, Pr Brian Lawlor, Pr Roger O’Sullivan, 9 current and senior Atlantic fellows from 7 different countries, 2 researchers from Taiwan and 4 from northern Ireland, UK, and USA.

Congratulations to Naomi Algeo being awarded the Best Oral Presentation

Naomi Algeo

Naomi Algeo (Irish Research Council PhD Scholar) was awarded Best Oral Presentation across Social, Nursing and Allied Health at the recent Irish Association for Cancer Research Conference.

Her presentation focused on the development of the 'Work and Cancer' Programme, developed using the Medical Research Council Framework for Complex Interventions as

part of her doctoral studies.

Naomi Algeo was awarded this prize for her current research at TCD. Dr Louise Brennan (Discipline of Physiotherapy, TCD) was also awarded Best Poster across Social, Nursing and Allied Health (for previous research at another institution).

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A Long Read….

A Day in the Life of the Co-ordinators of Trinity’s Body Donor…

A conversation with Philomena McAteer and Siobhan Ward .

On April 14, 2021, during Ireland’s third pandemic lockdown, our Editor interviewed them both by Zoom.

You have both been in the job for over 40 years…why is that?

Siobhan: Our work is a bit unusual - very niche, I’d say.

Ms Siobhan Ward and Ms Philomena McAteer

Anatomy was an unusual area to be working in and not readily transferrable, jobs weren’t that easy to come by in those early days, there was high unemployment so having an interesting job with full education provided by TCD meant I was happy to stay … little did I know I would stay so long.

Also seeing and being a part of developments in Anatomy can be rewarding. We enjoy the energy of the students and meeting with so many wonderful donors and their families. Trinity is a lovely place to work, an oasis in the city centre.

What was the path that got you here?

Siobhan: I started back in 1977 in the ‘dark ages’ with two very ‘old’ gentlemen, Edward and Gerald, (they were only in their 40’s & 50’s)!

I saw a job advertised in the paper looking for a trainee technician in Anatomy and was interviewed by Prof Erskine, Dr Blanche Weekes and Brian Thornburgh.

I sensed on entering the Anatomy Building an atmosphere that was unique, in that I was met at the door and ushered to the waiting area, which was surrounded by “No Entry” warning signs; it was indeed an interesting interview. I had no idea that I would be working with the dead… that was explained to me at the interview. I thought, well, that’s different, I think I will be ok with that.

I started as a trainee technician and progressed to Chief Technical Officer having qualified from TU Dublin. At that time TCD provided day-release for technical staff training, so day and night classes were the order of the week!

My mother didn’t like me being in the job; however, I ended up being the first female technician in Anatomy… today we are a team of 4 female technical staff!!!

Philomena: Like Siobhan, I saw a job vacancy advertised in the paper and applied! I was interviewed in 1981 by Professor Erskine, Dr Weekes and Pat Daly in the Old Anatomy Library.

I was successful in the interview and so began my journey in Anatomy.

I studied science and laboratory techniques at Letterkenny IT and when I started in Trinity Siobhan and I completed our studies together, with day release and night classes. I was lucky to have Edward Kermode, Gerald O’Neill, and Siobhan Ward as mentors for me in those early difficult days. Starting in Anatomy might not be as easy as starting in other areas,

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as the main requirement was to work with donor bodies…preserving remains and preparing classes for medical and therapy students.

Day -2-Day: Siobhan and Philomena receive many enquiries (phone calls, letters, emails) each day from altruistic people who want to donate their bodies to medical science. Information packs and registration forms are sent out each week. Trinity’s human body donor program receive on average 15 - 20 donors each year. These bodies are preserved and used for teaching anatomy in daily practical classes to over 600 medical, dental and therapy students. Over the years, the program has been awarded various accolades for its contribution to medical science. Siobhan and Philomena make every effort to listen to the needs of donors, bereaved donor families and students to ensure that each donor and their family is given the highest level of respect by everyone involved in the program. Together, they have expertly and sensitively managed Trinity’s Body Donor program helping donors and their families navigate the donation process during a most difficult time in their lives. They are also responsible for providing practical classes for scores of medical & therapy students along with Surgical Training events and conferences.

How have you furthered your education?

Siobhan: in 2010, the SOM supported us both to complete MSc’s in Bereavement Studies run by the Irish Hospice Foundation and RCSI. This has informed our work and helped to develop the TCD Body Donor Program over the past years.

What aspects of body donation have you each researched?

Philomena: My MSc research focused on ‘What is the impact of whole-body donation on the bereaved donor family?’ One of the findings from this research was that bereaved families would benefit from having a place to gather, while the donor was residing with us. During the planning for the new building we requested a ‘The Remembrance Room’ and this was accommodated. This has proved very beneficial to families, staff, and students. Along with this Remembrance Room we hold an Act of Remembrance and Thanksgiving in the College Chapel every 2 years which is also a support for families, staff, and students.

Siobhan: My research focused on the student experience. I asked the question “Are students adequately prepared to encounter donor bodies” and if not, how can we help to prepare them for working with the body in practical classes. This led to the introduction of an orientation programme for 1st year students, to help prepare them better to encounter the body for the first time.

When introducing students to the donor body for the first time it is important to consider students’ past experiences, their religious and cultural backgrounds, age, and peer support.

Some students may have a family member ill at home or in hospital or may have had a recent bereavement, which might make working in anatomy more challenging for them. Many international students are far from home when they have this first experience and we are very aware of their needs.

Another important development is that we now use the donor’s first name, rather than a number, when referring to the body. Students really value this, and it brings an important element of humanity into the process.

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Tell me about Job-Sharing: Shivil: In 1996 with children starting school and trying to manage family and work life we applied to job share our position as senior technical officers on a trial basis. This created a temporary vacancy which was competently filled by Mary Lynch.

In 1999, the then Chief Technical Officer, Gerald O’Neill, retired and the post was advertised, and again we decided to apply on a job-sharing basis. At this point in time there was no job sharing Chief Technical Officers, so this was a ‘first’ and the idea was not without criticism!!!

To succeed, we needed the endorsement of Prof Moira O’Brien, who was the first female Professor of Anatomy in Trinity. Following the joint interview process we became the first job-sharing Chief Technical Officers in TCD.

Another vacancy was thus created, and Claire Murphy successfully joined the team. It’s interesting to note that this team of 4 technical staff have remained together in Anatomy since 1999 following the long tradition of our predecessors (Edward Kermode, 57 years and Gerald O’Neill, 50 years, Siobhan, 44 years, Philomena, 40 years, Mary Lynch, 28 years and Claire Murphy, 22 years!!!). Perhaps the formaldehyde has helped to preserve the A-Team!!

Looking back now we can safely say that job sharing worked well for us and for college; we have seen our private and working lives roll out in parallel – marriage, children, further education, house moves, aging parents, illness, etc.

We have been described in College in many ways; one being “the pantomime horse” coined

by Pat Daly and the other which combines Siobhan and Phil “Shivil” coined by Paul Glacken, as a convenient way of addressing both of us simultaneously!!

What changes have you seen over the years?

Shivil: One of the biggest changes for us was the move from the Old Anatomy Building on campus to the new build, TBSI in 2011. This move celebrated 300 years of medical education at TCD and provided a fitting place for donor bodies to reside. Packing up and leaving the 1890 Anatomy Building was not an easy task! However, with the move we gained a dedicated Remembrance Room, a ‘state of the art’ Anatomy Dissection Theatre with modern AV facilities, a new Mortuary and Embalming facility in a very bright and clean new build. But… we forfeited the Old Anatomy Building and 1825 Museum.

The Old Anatomy Museum now lay vacant, housing our rich anatomical past. The question was how to manage this heritage site?

The atom was split in 2016 and Siobhan took herself off to the ‘Mother Ship’ Old Anatomy and Philomena remained in the ‘Star Ship Enterprise’, TBSI. Curating the contents of the old anatomy building was an enormous task. Initially the School of Medicine provided some students to assist Siobhan in the clearing out and sorting of the contents of the building. This was the start of curating of the old anatomy collection, which is ongoing today, thankfully with the help and expertise of our new colleague and curator Evi Numen. Interesting times ahead with the continuous development and plans for this area.

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What is one of the most Challenging aspects of the job?

Shivil: One major highlight and challenge in our career was when we were asked in 2012 by Loose Horse Productions to consider taking part in an RTE documentary which would examine the workings of the TCD Body Donor Programme, called A Parting Gift. This meant we were opening our doors to the public for the first time, to provide information and insight into the day to day operations of a modern donor programme.

Traditionally Anatomy operated a ‘closed door policy,’ as a protection for the donor bodies.

Now we had to consider allowing TV cameras to enter our domain. Why would we do this?

With great consideration we thought about the benefits of providing information that was open and transparent, while still protecting the donors and their families. It was a huge challenge to get it right! So, with the backup and support of the Donor Families, Anatomy Staff, School of Medicine, College Secretary, College Communications, College Community and the Provost this documentary aired in November 2014 and was very well received. The main success of this documentary is that it gave a voice to donors and their families for the first time. Other highlights were being nominated for an IFTA award and receiving ‘The Provost’s Award for Enhancing the Trinity Experience’.

To find out more about body donation, please see the documentary, ‘A Parting Gift’ https:// www.youtube.com/watch?v=K2xsZuTGZJ4 Another significant challenge was a live broadcast on RTE, called ‘Growing Up Live’ which was hosted by Old Anatomy and was run during Science Week and aired in 2018. This was a major operational challenge for College and along with allowing access to a live audience and a huge crew it had to be managed with great care and vigilance. Thankfully, Estates and Facilities staff performed brilliantly as always! But for me, Siobhan, giving a live presentation was both exciting and daunting!

The day to day challenges in Anatomy are dealing with bereaved donor families, looking after students in the Anatomy Dissection Theatre, caring for the donor remains and attending donor funerals.

During this covid-19 pandemic we had to suspend the donor program and explain this to families. Declining donors at any time is difficult and always a challenge. Thankfully when the vaccines are fully rolled out, we will be able to receive donors again.

Another ongoing challenge in Old Anatomy is addressing ethical considerations regarding the use and display of sensitive historical human remains.

Thankfully we can contact the Inspector of Anatomy, Professor Ceri Davies, for guidance and advice on any challenges relating to the donor programme.

Please share a meaningful experience you have had recently.

Shivil: We recently had a plastic surgeon practicing skin grafts techniques using one of our donor bodies. The donor’s name was Mary Ellen. Following this the surgeon performed surgery on the living patient. The surgeon wrote a note to the family thanking them for this invaluable experience.

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SCHOOL OF MEDICINE

School of Medicine Level 1 Trinity Biomedical Sciences Institute Trinity College 152-160 Pearse Street Dublin 2

https://www.tcd.ie/ medicine/

The mission of the School of Medicine of Trinity is to deliver Medical Education to the highest international standards. We train clinicians who are equipped with the scientific and clinical knowledge and skills to fulfil their professional roles in a competent, caring, and patient centred manner, reflecting all domains of excellent practice. We strive to produce individuals who, through self-efficacy, critical thinking and outstanding clinical, professional and ethical standards, have the skills to become leaders in their chosen field of practice and fulfil health service roles with distinction, in line with the Trinity graduate attributes.

The School, as a leading research-intensive institution, will foster a commitment to life-long learning in its students in preparation for post-graduate training. It further aims to integrate its educational obligations with other missions to deliver and effect high-quality patient care, improved global health, research excellence and new knowledge generation.

The School embraces an ethos of social responsibility, accountability, public service and community involvement. It is dedicated to meeting the healthcare needs of the national and global community, by training doctors and allied practitioners to practice with integrity, and with a deeper understanding of the impact of psycho-social influences and inequity on health and disease.

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