News Ireland daily BLOG by Donie

Thursday 30th May 2013

HSE West claims the reorganisation of public hospitals will result in improved patient outcomes?


The HSE West stressed this week that the reorganisation of public hospitals into hospital groups will result in greater efficiency, accountability and improved outcomes for patients. The groups come as a transition to independent hospital trusts.

The Minister for Health’s decision will mean that the west/north west group will consist of University Hospital Galway and Merlin Park Hospital, Sligo Regional, Letterkenny General, Mayo General, Portiuncula and Roscommon County Hospital. NUI Galway will be the academic partner for this group.

The rationale behind the formation of the groups was the large number and range of acute hospitals operating in relative isolation, the duplication and fragmentation of resources, and the difficulty in recruiting and retaining key staff. The inequitable distribution of workloads and resources was another reason for setting them up, a meeting of the HSE West’s regional health forum was told this week.

Bill Maher, the chief executive of the Galway and Roscommon University Hospitals Group, said the new hospital groups have been described by the health minister as the “most fundamental reform of the Irish acute hospital system in decades”. It is recommended there should be six such groups in Ireland.

He outlined the group has more autonomy to manage resources, both funding and staffing, in a way that is appropriate to the needs of patients.

“We have already started developing our strategic plan, working to national standards of quality and care. This will outline how we will play to the strengths of each of the hospitals in the group so that they will develop services that meet the needs of their patients and of which their locality will be proud.

Steering group

“In addition we have plans in place for a steering group to progress integration and prepare for our transition to a trust. It is our intention to become the first hospital trust in the country.”

The HSE West has already had a head start with part of the group already up and running for more than a year now.

“We have developed effective corporate and clinical governance structures along with quality and safety systems for patient care. This will make it easier to integrate all the hospitals into a common governance arrangement and put structures in place to bring the seven hospitals to the next level of performance and accountability.”

Mr Maher outlined that the Minister had approved the appointment of five non-executive directors to the group.

‘The board has met four times this year including meetings in Roscommon and Portiuncula. Our next board meeting will take place in Galway on 18 June and will be held in public. This is the first of two public board meetings planned for this year which will provide real local accountability to the public we serve.”

However, Cllr Padraig Conneely, the chairperson of the HSE West’s regional health forum, expressed concern about the geographical spread of the new hospital group. He feared there would be a return to the “bad, old days of the HSE” with a “very huge geographical spread and fragmented accountability”. Sligo and Donegal were a long way away from a management perspective, he felt.

He said Mr Maher was doing a “good job” but wondered if he would be able to control such a large group. He feared the new group with its seven hospitals would be “awkward” and “hard to control”.

A number of other forum members from outside Galway voiced similar concerns saying the hospitals within Mr Maher’s remit had now gone from four to seven.

Mayo Fine Gael councillor Seamus Weir said Galway to Letterkenny was a long way and he feared the hospitals in between would not just be “squeezed” but “pulled apart”.

Letterkenny Fianna Fail councillor Ciaran Brogan feared Donegal would become the “poor relation”.

Bill Maher said he was confident the HSE will build on the success of the local hospital group. He said he recognised the geographical aspect of it and while it did concern him he said the HSE had a “very good way” of doing things and with support these new bodies will be successful.

Irish consumer sentiment hits a four-month high for May 2013


Irish consumer sentiment registered its strongest rise in four months in May though confidence in the country’s economic prospects remained fragile, a survey showed on Wednesday.

The KBC Bank Ireland/ESRI Consumer Sentiment Index improved to 61.2 in May from 58.9 a month earlier, to hit its highest level since January.

Only 10% of around 800 consumers surveyed expected to see an improvement in their personal financial situation in the coming year compared to 56 percent who see a further weakening.

“A broadly stable sentiment reading for May suggests Irish consumers remain cautious,

” Austin Hughes, economist at KBC Bank Ireland, said.

“While they may read or hear of an improvement in some economic indicators, this hasn’t translated into more meaningful measures such as their own financial situation,” he said.

The survey’s authors said that low inflation and a cut in European Central Bank interest rates may have helped sentiment, but this fell short of the feelgood factor evident in recent German and U.S. consumer sentiment data.

The May reading will likely add to calls for the government to ease its programme of spending cuts and tax hikes in the 2014 budget from the 3 billion euros ($3.9 billion) planned, Hughes said.

“A slightly smaller adjustment than previously envisaged might reduce downside risks to sentiment and spending later in 2013 and into next year,” he said.

The survey’s sub-index to measures consumers’ perceptions of their future financial situation rebounded to 51.3 following three monthly declines.

The index of current economic conditions increased by 0.6 to 76.0.

Irish drinkers consuming over the recommended units of alcohol a day are risking cancer


Irish people are consuming more than 700 times the recommended safe level of alcohol needed to prevent drink-related cancers, a major European conference has been told.

Overall, the risk of developing cancer is smaller if you stick within the guideline amounts, which are around:

  • One standard drink a day for women e.g. a glass (175ml) of wine or a pint of beer or cider.
  • Two standard drinks a day for men e.g. 2 glasses (175ml) of wine or 2 pints of beer or cider.

We don’t yet fully understand the link between alcohol and cancer, but research has proven two things:

  1. Alcohol damages your DNA, which is a risk in itself
  2. Alcoholic drinks have a lot of calories; being overweight also increases your risk of cancer

Alcohol is a known carcinogen (cancer-causing agent) and is responsible for one in 10 male cancers and one in 33 female cancers in Ireland. This amounts to around 900 cases of cancer every year.

Alcohol can increase the risk of a number of types of cancer, including liver, breast, colon and mouth cancer.

Speaking at the official conference of European Week Against Cancer, which is being hosted by the Irish Cancer Society (ICS), Prof Peter Anderson, of the Institute of Health and Society at Newcastle University in the UK, explained that the average Irish person who drinks alcohol and consumes around 37g per day. This is over 700 times the recommended exposure level set by the European Food Safety Authority to prevent food and drink-related cancers.

“The guidelines for alcohol consumption are not strong enough, particularly when considering it as a carcinogenic. By comparison, there are more stringent guidelines in place for restricting the use of pesticides on fruit than there are for controlling alcohol consumption in humans,” he pointed out.

He told the conference that from a public health perspective, the government should ban all alcohol advertising and sponsorship, as it has done for tobacco products.

“Alcohol advertising helps foster more favourable drinking experiences and promotes social approval for consumption. It will not be possible for Irish society to develop a healthier relationship with alcohol if alcohol continues to be marketed in such an aggressive fashion,” he insisted.

Meanwhile, according to ICS head of advocacy, Kathleen O’Meara, Ireland has one of the highest rates of cancer in the world and the role of alcohol can no longer be ignored.

“We now know that one in 10 cancers in men and one in 33 in women are caused by drinking. When people smoke as well as drink, the two work in combination to substantially increase the risk of cancer. Alcohol and tobacco are estimated to account for about three-quarters of oral cancer cases in Europe,” she explained.

She said that reducing the number of people who develop cancer ‘will require all decision-makers to make this a priority issue and work together to develop solutions’.

The conference was told that even heavy drinkers can reduce their risk of cancer. For example, research has shown that the risk of developing cancer of the mouth throat and oesophagus falls over time if a person stops drinking.

“Alcohol is one of the key determinants not only for cancer but also of other chronic diseases such as cardiovascular disease and diabetes. It is crucial that we work together to make the European public aware of the risks of drinking too much alcohol,” added Prof Maja Primiz-Zakelj, president of the Association of European Cancer Leagues.

Avatar therapy helps schizophrenia patients silence their tormenting voices

A pilot study shows this?


Psychiatrists are developing a system that can help people with schizophrenia control and sometimes silence the tormenting voices in their heads by confronting a computer avatar of them.

In a pilot study of 16 patients who underwent the British experimental treatment, known as “avatar therapy”, doctors found almost all of them reported a reduction in how often they heard voices and how severe the distress caused by them was.

The first stage in the therapy is for the patient to create a computer-based avatar by choosing a face and a voice for the entity they believe is talking to them.

The system then synchronises the avatar’s lips with its speech, enabling a therapist to speak to the patient through the avatar in real time. The therapist encourages the patient to oppose the voice and gradually teaches them to take control of their hallucinations.

“Even though patients interact with the avatar as though it was a real person, because they have created it they know that it cannot harm them, as opposed to the voices, which often threaten to kill or harm them and their family,” Professor Julian Leff, who developed the therapy, told reporters.

“The therapy helps patients gain the confidence and courage to confront the avatar, and their persecutor.”

Schizophrenia is a psychiatric disorder that affects around one in 100 people worldwide. Its most common symptoms are delusions and auditory hallucinations, or hearing voices.

Leff said patients often told him the voices were the worst feature of their condition. “They can’t think properly, they can’t concentrate, they can’t work and they can’t sustain social relationships,” the professor of mental health sciences at University College London told the briefing.

In the pilot study, three of the patients, who until the trial had been tormented by voices for between 3-1/2 and 16 years, stopped hearing them completely after working with the avatar system.

Each therapy session was also recorded and given to the patient on an MP3 player “so that the patient essentially has a therapist in their pocket which they can listen to at any time when harassed by the voices”, Leff said.

As a result of the early success, the medical charity The Wellcome Trust has given Leff’s team 1.3 million pounds ($2 million) to test the therapy in a larger group of patients.

Thomas Craig, a psychiatrist who will lead the larger trial at King’s College London’s Institute of Psychiatry, said auditory hallucinations were particularly disturbing for patients and can be extremely difficult to treat successfully.

“The beauty of the (avatar) therapy is its simplicity and brevity,” he said. “Most other psychological therapies for these conditions are costly and take many months to deliver.”

He added that if the larger trial proved successful, avatar therapy could be widely available within a few years, since the technology is relatively simple and many mental health professionals already have the skills needed to deliver it.

Scientists find the oldest feathered dinosaur yet in China


Scientists say this 160-million-year-old fossil, found in northeastern China, indicates that dinosaurs began evolving into birds earlier than previously thought

An on-line survey result below shows that Scientists outside of China should examine the fossil?

Yes      No

94%     6%

When did birds first emerge from among the dinosaurs? It’s an argument that has plagued paleontologists and cast a shadow over the reputation of Archaeopteryx, a feathered dinosaur that has long been considered the earliest known bird.

Now, scientists say they found an even older feathered dinosaur – one that reestablishes Archaeopteryx as part of the bird lineage even as it may simultaneously dethrone Archaeopteryx as the earliest known “bird.” The study, published online in the journal Nature, provides a key link in the evolutionary chain of events that led from dinosaurs to birds.

“It pushes [back] the origins of birds — or origin of animals that are very closely related to the bird,” said Luis Chiappe, a vertebrate paleontologist at the Natural History Museum of Los Angeles who was not involved in the paper. “And that’s quite exciting.”

But some say the fossil may just represent a bird-like dinosaur, not a true bird — and in any case, could have been altered before scientists had a chance to study it.

The new find, christened Aurornis xui, was discovered in northeastern China in the Liaoning Province. The 20-inch, chicken-sized fossil is estimated to be about 160 million years old, about 10 million years older than Archaeopteryx.

After a thorough examination of the fossil researchers from Europe and China constructed a computer-generated family tree that puts both Aurornis and Archaeopteryx in the Avialae family – the group of dinosaurs whose only living representatives are birds.

“Around the origin of birds 160 million or so years ago, there were many fossils that were experimenting with birdness — getting more and more bird-like,” Chiappe said. “What exactly the line is that made it to birds is not entirely clear … and this is just one candidate.”

The study authors argue that Aurornis represents the earliest known bird, but other scientists say it could be part of a group of bird-like dinosaurs that were developing feathers and bird-like features but never quite got off the ground, evolutionarily speaking.

“You’re looking at an animal that is either a very primitive bird or something very closely related to birds,” Chiappe said. “I tend to think that it’s not a bird, but that it’s one of those true very close ancestors of bird.”

In any case, it’s possible the fossil has been altered because it seemed almost too good to be true – too perfectly preserved, Chiappe said. He noted that as many as 80% of fossils in Chinese museumsare thought to be artificially “enhanced” in some way.

“I’d like to see the animal at some point,” Chiappe said, referring to the fossil.


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