Public Health Research

Five European universities to tackle thyroid problem - TRUST THYROID TRIAL

Dr Patricia Kearney, Department of Epidemiology & Public Health, UCC is one of a group of researchers from European Universities who will participate in a new research project investigating current treatment practices for people who suffer from a mildly underactive thyroid gland.

The researchers met recently with medical experts from around Europe at the University of Glasgow for the inaugural meeting for the new study titled: “Thyroid Hormone Replacement for Subclinical Hypo-Thyroidism Trial” (TRUST).  It is funded by a €6 Million grant from the EU’s FP7 programme.

TRUST researchers will follow 3,000 older subjects over a five year period in an attempt to better understand how to treat people who suffer from subclinical hypothyroidism. Half of the subjects will be treated with a hormone replacement drug, thyroxine, while the other half will be given a placebo; both groups will then be monitored to evaluate how they respond to the treatments.

The thyroid gland is located in the neck and controls how quickly the body uses energy and produces proteins; it also controls how sensitive the body is to various hormones. A mildly underactive thyroid, a condition also known as subclinical hypothyroidism (SCH) affects around one in six people over the age of 65 and has been linked to various health problems, such as heart attacks and strokes, in later life.

The project will mean academics from University College Cork will collaborate with experts in ageing, thyroid problems and vascular disease from around Europe, including researchers from the Leiden University Medical Centre and Leyden Academy on Vitality and Ageing, Netherlands; University College Cork and University of Berne, Switzerland.  Dr Patricia Kearney, Department of Epidemiology & Public Health will lead the study for Ireland.

The Early Development Instrument – a potentially powerful indicator of Early Childhood Care and Development

There is strong epidemiological evidence that early childhood development (from gestation to age six) strongly influences life-long health trajectories.  Indeed, major public health problems such as obesity, heart-disease and mental health problems have roots in early childhood.  The early years environment, stimulation and relationships all have a direct impact on brain development.  There is also evidence of a social gradient in child development.  In addressing the social determinants of health it is essential that early childhood development is considered.

The Department of Epidemiology and Public Health in UCC is currently working on a population level index of early childhood development, the Early Development Instrument (EDI). The EDI was developed at the Offord Centre for Child Studies, McMasters University, Hamilton, Ontario in the late 1990s as a population level measure of early childhood development at school entry age. The EDI measures the extent to which children have attained the physical, social, emotional, language and cognitive maturity necessary to engage in school activities. It seeks to operationalise the concept of “school readiness”. Ms. Margaret Curtin, a PhD student in the Department with previous experience of community development and early childhood interventions has collected data from virtually all primary schools Junior Infants classes in Cork city and in Mitchelstown. The preliminary findings from this work suggest that more than one quarter (27%) of all “Junior Infant” class children are “vulnerable”, i.e.  not developmentally ready to engage in, and thereby benefit fully from school. The prevalence of vulnerability is influenced by a wide range of factors operating at the level of the individual child, the family and the neighbourhood.  

In Canada and Australia the EDI has proven effective at promoting community engagement and has been a powerful lever for change.  Indeed, the Cork schools involved in the original pilot study have already used the results to highlight the need to retain resources in less advantaged areas.

The overall aim of the study is to explore the potential of the EDI as an indicator of early development in Ireland.   Related objectives are

  • to assess the feasibility of using the EDI to measure area-level variation in early childhood development in the Irish context

  • to examine correlation between EDI scores and child/family level indicators

  • to map area-level variation at electoral district in Cork City and examine correlation with census derived indicators

This work is funded by the Health Research Board in Ireland under Grant No. PHD/2007/16

Developing the Healthy Cities Programme in Cork

What is the Healthy City Project?

In October 2008, following a meeting between the Galway Healthy City Coordinator, city council and HSE officials, and UCC staff, momentum commenced and has continued regarding the development of aCorkHealthyCityproject. Since then, approval has been sought and received from the City Development Board (CDB) of Cork City Council for the establishment of a Healthy City Forum.

The CDB Strategy “Imagine our Future: 2002-2012” was reviewed in 2009. As part of this review, a description and work strategy of the Healthy City Forum has been inserted into the document, with identified aims and milestones. Earlier this year, the HSE provided funding for 12 months for a .5 FTE position to coordinate the development of a Health Profile forCorkCity. This will ensure the group has evidence to inform future work.  This will be led by the Health Promotion Department (HSE South) and Cork City Council, assisted in research capabilities by UCC (Departments of Epidemiology & Public Health and General Practice).

Who is involved in this project?

Partners include representatives from the Departments of Epidemiology & Public Health and General Practice (UCC), Health Promotion Department (HSE South), Community Work Department (HSE South), Department of Public Health (HSE South), Directorate of Community andEnterprise(Cork City Council), and NICHE (Community Health Project located in Knocknaheeny /Hollyhill area ofCork’s North side).

Why has this initiative been developed?

TheHealthyCityproject seeks to advance the principle of creating supportive and healthier environments for inhabitants, as well as and strengthening the health-proofing capacity for policies, projects and programmes, ongoing in the city. The ultimate goal is the attainment of improved health and wellbeing for the people ofCorkCity. The aim of the Healthy City Project is to support health promotion initiatives that are ongoing in health and non-health care sectors, and to facilitate the emergence and growth of further health promoting projects via collaboration between the statutory, voluntary and community sectors.

How is it being advanced?

A Working Group has been formed, drawing from the partner institutions and agencies (UCC, CCC, HSE and NICHE). This group meets regularly to discuss progress and to identify tasks for the relevant partners. The group has completed a Project Plan and a plan for the Cork City Health Profile. The health profile coordinator is working with the partners to develop the health profile for Cork city. In the spring of 2010 and 2011, a third year BSc student (Public Health & Health Promotion) from the Department of Epidemiology and Public Health has completed a 12 week work placement with the Healthy Cities project.

Where is the project headed?

The project is currently focused on the development of a health profile for Cork City and a Cork City Health Plan. With the help of Smart Research Group, we are conducting community needs assessments throughout the city. We have conducted a number of focus groups citywide. This will be supplemented by an online survey and street survey along with meetings with stakeholders. An application has been made to the W.H.O for designation of Cork as a Healthy City in June 2011 (next healthy city phase is commencing in 2014) and we are currently awaiting a response from the W.H.O. Ultimately, the Project aims to aspire to the standards as set by the WHO. Designation for this process is viewed as a major benefit but not a requirement for the continued work among the partners of the Healthy Cities Project in Cork.

The role of UCC in the Cork Healthy Cities Initiative

As an academic institution UCC is a key partner in the Healthy Cities Forum.  With the commitment and invovlement of the well respected and recognised Departments of General Practice and Dept of Epidemiology and Public Health; UCC provides the Healthy Cities Forum with guidance in terms of best practice in data collection, interpretation and reporting on health. 

Since October 2008, staff members at the departments of General Practice and Epidemiology and Public Health at UCC have worked closely with all stakeholders to develop the healthy cities initiative in Cork. More recently, we have also started to work with the the UCC Social Science Research Cluster. This cluster is supported by the ISS21 (Institute of Social Sciences for the 21st Century) and represents interests from the Departments of General Practice, Epidemiology & Public Health, Geography, Applied Social Studies, Occupational Therapy and Sociology, a research cluster has been established entitled “Health, Wellbeing and Food.” This cluster has recently made the decision to adopt theHealthyCity concept as one of its thematic areas, due to the multisectoral and inter-disciplinary nature of the concept.

Additionally students of both the BSc and Masters in Public Health and Health Promotion will play a key role in the development and reporting of the city health profile.  Co-ordination of this process is essential to ensure that data is robust and accruate for the city health profile. For more information, contact Anne Fitzpatrick at anne.fitzpatrick@ucc.ie.

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