Development of new drugs against Chagas disease

Dr. Tim O’Sullivan, School of Pharmacy & School of Chemistry

Impact: International

Chagas disease affects approximately 6.5 million people worldwide. The purpose of this research is to develop new drugs for treating Chagas disease, a neglected disease which affects large parts of South America in particular. In this project, we aim to design, synthesise and evaluate novel molecules which are effective against Chagas disease, but have better side-effect profiles than existing drugs. Current treatments for this disease display limited efficacy and are often associated with severe side-effects. As a result, treatment is often cut short. By developing new drugs which are more potent and exhibit fewer side-effects, the disease can be more effectively treated. This should ultimately result in faster recovery from the disease, improved quality of life for the patient and a reduced burden on healthcare systems. Working with international collaborators at the Carlos Chagas Institute in Brazil, we have identified several novel molecules which are highly effective against the T. cruzi parasite, the causative agent of Chagas disease. This work has been published in a peer-reviewed publication.

SDG 3 - Good Health and Well-being

• Target 3.3 - Fight communicable diseases

Promoting awareness and behavioural change around air quality in Cork

Dr. Marica Cassarino, School of Applied Psychology

Impact: Local, National

The Cork Air Quality Partnership is a collaboration between the School of Applied Psychology UCC, the ERI Centre for Research into Atmospheric Chemistry, Cork City Council and Cork Healthy Cities. This partnership, still in its initial phase, aims to develop strategies to enhance the public's awareness about the risk associated with air pollution and promote behavioural change for the improvement of air quality in Cork City. This research focuses on understanding public attitudes and motivations to inform effective communication/engagement strategies.

The research has already generated two policy-informing documents related to public's views of air quality in Cork City and around schools. Further research will test communication and engagement interventions at school and community level. The research developed within the partnership will help to advance and enrich the Cork Clean Air Strategy, which is the first in Ireland, with potential for implementation at regional and national level. Outputs will include policy recommendations, public engagement events, peer-reviewed publications and conference presentations. The research showcases the importance of collaboration and partnership between research and civic society stakeholders in achieving key sustainable goals in Cork, which is one of the main growing urban areas in Ireland. To this end, the partnership addresses the National Planning Framework 2040 and provides opportunities for international collaboration.

SDG 3 - Good Health and Well-being

• Target 3.9 - Reduce illnesses and death from hazardous chemicals and pollution (particularly indicator 3.9.1 which relates to the mortality rate attributed to ambient air pollution)

SDG 11 - Sustainable Cities and Communities

• Target 11.2 - Affordable and sustainable transport systems
• Target 11.6 - Reduce the environmental impact of cities (particularly indicator 11.6.2 which tracks the annual mean levels of fine particulate matter (e.g. PM2.5 and PM10) in cities (population weighted))

SDG 13 - Climate Action

• Target 13.3 - Build knowledge and capacity to meet climate change
  

SDG 17 - Partnerships for the Goals

• Target 17.17 - Encourage effective partnerships
  

Catching Stories of Infectious Disease in Ireland

Dr. Cliona O’Carroll, Department of Folklore and Ethnology, School of Irish Learning

Impact: Local, National

'Catching stories' brings oral testimony of infectious diseases together with social history and immunological commentary in a cultural heritage resource, in order to bring conversations around public health initiatives and vaccination into the public sphere in an innovative way, and to provide public health communicators and communities with a platform for exchange. Twentieth-century vaccination initiatives have been victims of their own success in Ireland and elsewhere, in part due to a loss of awareness of the human cost of such diseases. Collecting and sharing community memories of once-common diseases makes these stories available to the public again, and contributes to public discourse in the field of vaccine hesitancy.

Cultural heritage methods and platforms are used to enhance public engagement with past and present experiences of infectious disease and vaccination in Ireland, in an online resource where visitors can listen to what it was like to live in a family ravaged by TB, lose a classmate to measles, or lose two stone through the sweat of fear when queueing up for ‘the branding iron’ of 1960s childhood vaccination. By presenting this oral testimony side-by-side with relevant biomedical commentary and social history, this research offers multiple entry points to the topic, allowing the public and public health communicators to approach disease and vaccination through the interplay of human experience and scientific insight. The project trials and champions the creative use of cultural heritage platforms, materials and methods to address social challenges in a way that brings vernacular stories, voices and memories to the fore.

“This is unique - it marries public health and cultural heritage very well, a mixture of old and new stories. This adds value to typical public health reporting - by relaying the personal experiences of real people - ordinary people - anecdotal evidence to supplement the statistics we generally see - this is a great piece of work”

- Denise Cahill, Healthy Cities Co-ordinator, Cork City, on the ‘Catching Stories’ resource, May 2022

SDG 3 - Good Health and Well-being

• Target 3.3 - Fight communicable diseases

SDG 11 - Sustainable Cities and Communities

• Target 11.4 - Protect the world's cultural and natural heritage
  

Non-invasive lung oxygen monitoring of infants

Professor Stefan Andersson Engels, IPIC SFI Centre for Photonics, Tyndall National Institute & Department of Physics

Impact: International

Each year, 1.1 million infants die due to complications from Respiratory Distress Syndrome (RDS). RDS usually affects premature babies and occurs where the lungs are not fully developed, causing breathing difficulties and treatment requires very accurate monitoring of lung performance. Funded by Science Foundation Ireland, multi-disciplinary research undertaken by researchers from the Department of Physics, IPIC at Tyndall, INFANT, Cork University Hospital and Swedish industry partner, GPX Medical, has developed a new non-invasive optical device to provide real-time information on the lung function of newborn babies. The novel Gas in Scattering Media Absorption Spectroscopy (GASMAS) system uses light-emitting technology and sensors placed on a baby’s chest to detect levels of oxygen in different parts of the baby’s lungs. This powerful diagnostic technology has the potential to play a future clinical role in reducing sickness and mortality of infants by optimizing respiratory function monitoring.

A clinical study has been initiated and has the potential to significantly alter the way babies are monitored in the neonatal intensive care unit, particularly preterm infants and term babies on mechanical ventilation, reducing X-ray exposure, unnecessary blood tests, and stress-inducing treatment for both infants and their families. The team aims to explore this novel, potentially low-cost, non-invasive technique with an aim to facilitate treatment guidance of infants in all countries in the future, particularly in developing countries where infant mortality rates are higher.

SDG 3 - Good Health and Well-being

• Target 3.2 - End all preventable deaths under 5 years of age (particularly indicator 3.2.1. which aims to reduce neonatal mortality to at least as low as 12 per 1,000 live births)
• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health

SDG 17 - Partnerships for the Goals

• Target 17.16 - Enhance the Global Partnership for Sustainable Development
  

Developing biophotonics technology to improve cancer detection

Dr. Marcelo Saito Noguiera, IPIC, Tyndall National Institute

Impact: International

Colorectal cancer is the second most deadly type of cancer worldwide. The purpose of this research is to create a light-based instrument that senses and differentiates tissues more accurately and faster to improve the accuracy of detection. This method is non-invasive, cost-effective, allows for early detection, and enables data analysis algorithms to extract molecular information from medical instruments, wearables, and portable test kits. This cutting-edge cancer research has the potential to decrease mortality rates associated with colorectal cancer, helping to achieve SDG target 3.4 - to reduce by one third premature mortality from non-communicable diseases through prevention and treatment by 2030. Following initial positive results, a probe for colon cancer detection during colonoscopy is being developed. These techniques can be integrated into existing clinical tools, which enhances their potential to improve the current healthcare system and also makes them commercially attractive. With deaths from colon cancer expected to increase by over 70% by 2040, this technology has the potential to save countless lives in the long term and have international impact.

  “The tools we are developing will contribute to target 3.4, as they identify and locate disease at an earlier stage based on molecular changes. If accurately detected, the disease can be fully treated in less procedures, and the risk to the patient and number of cancer surgeries would be reduced.”

- Dr. Marcelo Saito Noguiera 

SDG 3 - Good Health and Well-being

• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health

SDG 17 - Partnerships for the Goals

• Target 17.6 - Knowledge sharing and cooperation for access to science, technology and innovation
  

Understanding and Attitude towards resources stewardship and its integrations in the medicine curriculum in UCC 

Dr. Gabriella Rizzo, Department of Medicine, School of Medicine

Impact: Local, National

The focus of this research is to explore the understanding of the “resources stewardship” programme about sustainable medicine amongst clinical and academic lecturers in UCC’s School of Medicine, whilst also exploring attitudes towards the “resource stewardship” approach to clinical practice and possible barriers to its implementation in the undergraduate curriculum. One of the significant outputs of this research is the mapping of the current undergraduate curriculum towards sustainable medicine and future integration of high-value, cost-conscious care (HVCCC) into it. This research initiative aims to foster a wider national collaboration with other Irish Medical Schools to join the challenge and create a focused movement, where HVCCC can be adopted nationwide as a core element of the education of our future doctors. This research expands knowledge in this under-investigated and under-published area.

SDG 3 - Good Health and Well-being

• Target 3.8 - Achieve universal health coverage

SDG 4 - Quality Education

• Target 4.7 - Education for sustainable development and global citizenship

The host-microbe metabolic dialogue, directing their signalling landscapes in health and disease 

Dr. Susan Joyce, School of Biochemistry and Cell Biology

Impact: International

The purpose of this research is to form a mechanistic understanding of food enrichment for specific classes of microbes and their fitness to function, to understand how microbial metabolism of diet and host-produced factors reprogramme cell and metabolic processes, the interactions between food-microbes and their hosts towards disease and in maintaining health, and defining health, in the context of microbial functions and modification of metabolites to influence cell signalling processes. This research has impact on an international level and contributes to efficient food production and safety through the Department of Agriculture, Food and Marine’s project to support alternative approaches to animal bulking. The research also supports female STEM development initiatives and the training of PhD students as part of exchequer and non-exchequer funded projects.

“We are committed to untangling the intriguing multifaceted puzzle of what defines health and pushes towards disease.”

– Dr. Susan Joyce

SDG 3 - Good Health and Well-being

SDG 2 - Zero Hunger

SDG 4 - Quality Education

SDG 5 - Gender Equality

Ensuring Adequate Funding for Ireland's Health System

Dr. Brian Turner, Department of Economics, Cork University Business School

Impact: National

This ongoing research examines the funding of the Irish health system, advocating for adequate funding to provide high quality health services to a growing and ageing population into the future.  It also examines the Irish health system reform proposals (currently Sláintecare), informing stakeholders on their progress and challenges to achievement.

The outputs from this ongoing research include peer reviewed journal articles, book chapters in edited volumes, responses to consultations, reports, presentations at national and stakeholder events, and media contributions.  These help to inform stakeholders on the issues involved in funding and reform, with evidence-based conclusions and balanced discussion.  There is also evidence of impact on policy-makers as an invitation was received to appear before the Oireachtas Committee on the Future of Healthcare and the submission was cited in multiple places in the Sláintecare report. This research is informing the research landscape in Ireland as evidenced by frequent citations of the research outputs in other research and invitations to present to, or attend meetings with, stakeholders to help inform their discussions on the future Irish health care and funding landscape.

“Ensuring that Ireland's health system is adequately funded into the future will help to ensure the availability of high quality health services to those who need them into the future, in the face of an ageing and growing population.”

– Dr. Brian Turner

SDG 3 - Good Health and Well-being

• Target 3.8 - Achieve universal health coverage

LEANBH (Learning to Evaluate Blood Pressure at Home)

Professor Fred Adam, Dr. Fergus McCarthy*, Dr. Stephen McCarthy, Dr. Paidi O’Reilly, Dr. Simon Woodworth, Department of Business Information Systems, Cork University Business School

*Department of Obstetrics and Gynaecology, INFANT Research Centre

Impact: Local, National, International

LEANBH delivers a complete, tested, easy to use connected health solution offering pregnant women with suspected hypertension in pregnancy a safe, clinically monitored, ambulatory alternative to BP monitoring in hospital, allowing them to monitor their BP from the comfort of their home. Hypertension in pregnancy, particularly the onset of pre-eclampsia, is a very serious condition which affects about 4% of pregnant women worldwide. Undiagnosed and untreated, it can lead to the death of both mother and baby, particularly in lo income settings.

LEANBH offers the following:

• Replacing direct patient clinician contact with self-guided outpatient or inpatient monitoring
• A clinically monitored interface allowing timely direction of care.
• A BP cuff validated for use in pregnancy.
• Reduced attendance at hospital reducing the need for travel.
• Reduced anxiety from not having to attend hospital or primary care while still having appropriate monitoring of BP in pregnancy.

Readings are monitored daily by consultants and patients can be contacted when a change in their care is required. LEANBH delivers a safe alternative to direct contact and provides automated self BP monitoring for women with confirmed or suspected hypertension in pregnancy. This allows early detection and care and can drastically reduce maternal and fetal morbidity. Research on connected health such as LEANBH and other projects conducted in INFANT in collaboration with CUBS researchers will change the face of our healthcare systems, not only in the developed world, but also in low resource settings where it will deliver greater scrutiny and care for patients at a viable cost.

SDG 3 - Good Health and Well-being

• Target 3.1 - Reduce maternal mortality
• Target 3.c - Increase health financing and support health workforce in developing countries

Electrochemical discrimination of the active bronchodilatory ingredient from its excipients in Ventolin formulations at Nanoporous Gold

Dr. Lorraine Nagle, Electrochemical Materials & Energy Group, Tyndall National Institute

Impact: International

The emergence of specific drug–device combination products in the inhalable pharmaceutical industry demands more sophistication of device functionality in the form of an embedded sensing platform to increase patient safety and extend patent coverage. Controlling the nebuliser function at a miniaturised, integrated electrochemical sensing platform with rapid response time and supporting novel algorithms could deliver such a technology offering. Drug regulators worldwide indicate that specific drug–device combination nebulisers are preferred over the more common open-label nebulisers for increased control over dosing reproducibility and reliability to enhance patients’ safety. Desirable features include a lock-out system control to prevent overdosing and output signal confirming dose delivery.

Current technology fails to provide this crucial monitoring and the integration of a sensor that is compatible within the controller that regulates nebuliser function is challenging.  The development of an electrochemical-based controller that accurately detects if the appropriate medication has been placed into a nebuliser’s medication reservoir is envisaged that is capable of distinguishing active pharmaceutical ingredients in drug formulations from its excipients. Nanoporous gold is an emerging electrochemical sensing platform candidate owing to its high specific surface area, superior catalytic activity, increased density of low-indexed crystalline planes, excellent conductivity and ease of fabrication. The present study emphasizes the potential of harnessing its unique nanogeometrical properties in selectively discriminating active pharmaceutical ingredients from excipients in drug formulations.

SDG 3 - Good Health and Well-being

• Target 3.8 - Achieve universal health coverage

Evaluation of national clinical programme for the management of self-harm in Irish hospitals

Dr. Brendan McElroy, Department of Economics, Cork University Business School

Impact: National

This research evaluates the cost effectiveness of the introduction of a comprehensive, standardised national programme in Irish Emergency Departments on the management of self-harm. Self-harm is a leading indicator of suicide. The variability in management policies across Irish Emergency Departments was addressed through a national clinical programme on self-harm. This study analyses the programme's effectiveness and value for money in reducing repeat self-harm. It informs the continued funding of the policy by the HSE whilst also providing evidence to the international community of health policy makers on the value of such a service.

SDG 3 - Good Health and Well-being

• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health (particularly indicator 3.4.2 which relates to suicide mortality rate)

Missing Microbes In Infants Born By C-Section

Iwona Kozak, APC Microbiome Ireland

Impact: International

Rebalancing babies’ gut bacteria, whether after antibiotic exposure or Caesarean-section birth, is the topic of a new collaborative research project. Infant gut microbiota can be severely depleted in infants born by C-section or exposed to antibiotics. The population of bacteria in the gut develops over the first four years of life and plays a key role in human health. Establishment of a healthy gut microbiome in early life is influenced by birth mode, antibiotic use and nutrition, including breast milk components. This research project aims to develop microbiome-based solutions to help establish a healthy microbiome in early life to facilitate the long-term health of individuals. This longitudinal study of infant's microbiomes will generate multitude of information about the dynamic changes in gut microbial composition.

SDG 3 - Good Health and Well-being

The relevance of the UN SDGs in Dentistry

Professor Mairead Harding, Dr. Martina Hayes, Dr. Cris daMata, Hannah Binner, First- and Second-Year Dental Student Groups, Cork University Dental School and Hospital & Oral Health Services Research Centre & Environmental Research Institute

Impact: Local

This research was completed by students in first and second year of the dental programme with the aim of introducing dental students to the 17 UN Sustainable Development Goals and encouraging them to explore through searching the literature how SDGs are important in the practice of Dentistry, the promotion of better oral health and why not addressing them impacts on the individual and society. Dental students were provided with a lecture introducing the SDGs and guidance with respect to sustainability in dentistry. Students also had the resources of the Brookfield Health Science library and tools to search for evidence informed literature. Students then worked in groups to develop presentations on the SDGs and Dentistry. These presentations were then shared with a wider audience amongst their peers. Through this research activity, students reviewed all 17 SDGs and worked in small groups to identify the relevance of the SDGs to dentistry and oral health. They also identified how dentists could attain specific SDGs through their practice. The research introduces students to the UN SDGs from the first year of dentistry, and allows students to apply prior knowledge to dentistry and establishes the SDGs as an integral part of their practice of dentistry. It supports the philosophies to 'leave no one behind' and 'think globally and act locally'.

A quote from one of the student presentations:

“We are the future! We as citizens have a duty to inform the Department of Health the Minister for Health and the Dental Council on issues affecting the progression of sustainable development with regards to dentistry.”

SDG 3 - Good Health and Well-being

SDG 2 - Zero Hunger

SDG 10 - Reduced Inequalities

SDG 17 - Partnerships for the Goals

Choosing Healthy Eating for Infant Health (CHErIsH) Study

Dr. Karen Matvienko-Sikar on behalf of the CHErIsH team, School of Public Health

Impact: Local, National, International

This study focused on reducing risk of childhood obesity and overweight by improving infant feeding practices among parents and primary caregivers.  Its aims included the development, implementation and evaluation of a complex intervention to support and promote healthy infant feeding practices among parents and primary caregivers within primary care settings. This will prevent childhood obesity, thus ensuring a healthier start in life for infants and children. This intervention has been implemented in a primary care centre in Cork as part of a feasibility study, and the findings of this study can inform future obesity prevention efforts in primary care. Study conduct and findings also resulted in an invited presentation to the Oireachtas Joint Commission on Children and Youth Affairs Joint Committee on Tackling Childhood Obesity in 2018. The systematic methodological approach to developing the CHErIsH behaviour change intervention with stakeholders, and the robust approach to evaluating intervention acceptability, feasibility, and fidelity can, and has, informed further development of behaviour change interventions in Ireland and internationally.

SDG 3 - Good Health and Well-being

Kilimanjaro ULTRA 2020: A Digital Delivery Register for Reproductive Health in Low Resource Settings

Daire Buckley¹, Dr. Simon Woodworth^1,2, Dr. Ali S Khashan^1,3

1 INFANT Research Centre 2 Cork University Business School 3 School of Public Health

Impact: International

The objective of the project is to prove that inefficient, ubiquitous paper-based maternal and neonatal health records can be replaced with an easy-to-use, cost-efficient, and sustainable electronic records. Further, ULTRA aims to demonstrate data harmonisation is possible to enable comparisons across institutions, populations and on a global scale. ULTRA is based entirely on open-source software and is designed to be portable and integrated well into other settings, with no license costs to consider. This proposal will lead to significant improvement in maternal and reproductive health and will ensure every child is registered and counted. This will be achieved primarily by improving data quality and better use of existing staff who already maintain the conventional delivery registers. It also enables evidence-informed decision-making and can dramatically shift the odds of survival of mothers and their babies. Furthermore, high-quality perinatal data will improve women’s chances to take part in their sexual and reproductive health decision-making.

The ULTRA application is a mobile electronic registry designed to cover all stages of pregnancy and childbirth from the first antenatal visit through delivery, to the final postnatal visit. It is implemented through a specific configuration of the DHIS2 software and is based directly on Tanzania’s paper-based MTUHA Health Management Information System (HMIS). ULTRA has been developed in partnership with clinicians and ICT specialists in Tanzania to address the current problems that arise from paper-based registries in capturing accurate pregnancy and birth data. ULTRA aims to address some of the underlying structural gaps that would, at a health systems level, better enable robust, comprehensive, and useable health records and data to mitigate stark incidence rates of maternal and perinatal morbidity and mortality. Thus, enabling health care systems to record and monitor obstetric data accurately in low-income countries to provide knowledge of the nature and magnitude of the need for obstetric care within this defined geographical region of sub-Saharan Africa. The project will enhance global health research collaborations between Ireland and low-income countries but more importantly, it may strengthen collaborations among researchers based in low-income countries. The project will create opportunities of implementing the system in different countries, leading to data harmonisation and more research collaborations.

SDG 3 - Good Health and Well-being

• Target 3.1 - Reduce maternal mortality
• Target 3.2 - End all preventable deaths under 5 years of age

SDG 5 - Gender Equality

• Target 5.6 - Universal access to reproductive health and rights

SDG 9 - Industry, Innovation and Infrastructure

• Target 9.5 - Enhance research and upgrade industrial technologies

SDG 17 - Partnerships for the Goals

• Target 17.16 - Enhance the Global Partnership for Sustainable Development

Four avoidable deaths every day in Ireland are alcohol-related: from evidence to public health advocacy

Dr. Zubair Kabir, School of Public Health

Impact: National, International

Alcohol consumption is a leading cause of death for people aged 15–49 years globally. Ireland has one of the highest per-capita alcohol consumption in OECD countries. This research estimates the burden of alcohol-related deaths in Ireland collaborating with Alcohol Action Ireland (AAI) towards evidence and public health advocacy. The Public Health (Alcohol) Act 2018 in Ireland is a landmark legislation. This contains a suite of modest measures to reduce per-capita alcohol consumption to the OECD average of 9.1 litres for every person aged 15 and over by 2020 and hence reduce alcohol harms. However, this got delayed in implementation. AAI’s advocacy work is instrumental in translating research findings into an impactful and a more sustainable future. Alcohol is inextricably linked to SDG 3. However, reducing alcohol harm will impact 14 of the 17 SDGs. The research finding of 4 deaths per day in Ireland attributable to alcohol has formed an important part of AAI’s advocacy work which aims to reduce alcohol harm. Research outputs have been broadcasted through several platforms, including the Oireachtas Health Committee. The research has provided significant impetus towards the full implementation of the Public Health Alcohol Act 2018, which is closely watched internationally.

“Alcohol is an obstacle to sustainable human development. Alcohol plays a complex role in the Irish society. Four people die every day in Ireland due to alcohol- which are totally preventable. Alcohol is linked to 14 of the 17 SDGs. The Public Health (Alcohol) Act 2018 can address several of these targets in Ireland. We need political commitment and action, coupled with robust scientific evidence and strong public health advocacy. UCC partnering with AAI will help achieve this goal!”

– Dr. Zubair Kabir

SDG 3 - Good Health and Well-being

• Target 3.1 - Reduce maternal mortality
• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health
• Target 3.5 - Prevent and treat substance abuse
• Target 3.6 - Reduce road injuries and deaths
• Target 3.8 - Achieve universal health coverage

SDG 10 - Reduced Inequalities

• Target 10.4 - Adopt fiscal and social policies that promote equality

Tailoring strategies to support the implementation of DAFNE (Dose Adjustment For Normal Eating), a structured patient education programme for people with Type 1 diabetes

Dr. Sheena McHugh, School of Public Health

Impact: National, International

This study aims to improve the implementation of effective evidence-based interventions in the health system, thereby improving the quality of care and health outcomes for people with diabetes. It involves working with health professionals in hospitals across Ireland to tailor implementation strategies to support their delivery of the DAFNE programme, an effective structured education programme for people with Type 1 diabetes. ‘Tailoring’ is a process of selecting strategies to suit local circumstances to increase the likelihood of successful implementation of evidence-based interventions in routine healthcare. By supporting the implementation of evidence-based interventions, this research has the potential to contribute to improved outcomes for people with type 1 diabetes in Ireland; thus, helping to achieve the SDG target of reducing premature mortality from non-communicable diseases.

Through an enhanced understanding of the tailoring process and what is acceptable and practical for health professionals and service users, the research findings will guide future tailoring efforts in the Irish health care system to help strengthen the adoption, implementation and subsequent health impact of evidence-based interventions for non-communicable diseases. Implementation science is a relatively young research field in Ireland. It refers to the scientific study of methods to promote the uptake of evidence-based practices into routine care, and, hence, to improve the quality and effectiveness of health services. This work involves building research capacity and applying implementation science approaches to address persistent challenges in the Irish health service.

“There are things out there that can help. We just need to make sure they happen.”

- Member of Public and Patient Involvement Panel 

SDG 3 - Good Health and Well-being

PRoviding Improved care for Self-harM: a mixed-methods study of intervention, economic and implementation outcomes from a national clinical programme (PRISM)

Dr. Eve Griffin, School of Public Health & National Suicide Research Foundation

Impact: International

For every 25 people who present to hospital with self-harm, one will die by suicide within 5 years. In 2014, a National Clinical Programme was introduced in Ireland to improve care for individuals who attend hospital with self-harm. This inter-disciplinary, mixed-methods research project is comprehensively evaluating this national programme, to establish if it has resulted in changes to patient outcomes, processes of care and economic savings. This research will provide a better understanding of how patients are managed in acute settings and how well services are utilised to improve patient outcomes. The findings will be used to optimise delivery of acute mental health services, with the potential to positively impact the wellbeing of this vulnerable group, and in turn lead to the reduction in mortality from non-communicable diseases. Furthermore, the investigation of suicide risk in this research will identify factors contributing to suicide deaths which may be preventable.  The evaluation will yield a model for evaluating interventions related to self-harm, which will enable a more comprehensive understanding of how health service change and public health interventions impact on this population. The framework will also be applicable to other settings, including initiatives such as acute hospital reconfiguration.

SDG 3 - Good Health and Well-being

• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health (particularly indicator 3.4.2 which relates to the suicide mortality rate)

SMARTProbe - point of care enhancement of breast disease detection during biopsy

Dr. Eric Moore, School of Chemistry & Tyndall National Institute

Impact: Local, National, International

There is a real issue with the current clinical pathway for breast cancer detection as it takes too long to receive a diagnosis (can be up to 12-14 days) and there is significant invasive and unnecessary breast tissue removal for millions of women annually. SMARTProbe will enable clinicians to test at the point-of-care, and discharge immediately up to 80% (benign) of women presenting for a biopsy, thereby reducing breast cancer diagnosis time from weeks to minutes and offers a new prioritisation for the treatment of women’s health. The potential to diagnose earlier and enable patients to avoid significant psychological distress from delays would be significant. This in particular impacts on SDG 3, ensure healthy lives and promote well-being for all at all ages. There is a credible, global opportunity to better service women's health through a technology like SMARTProbe, which can crucially improve both the patient experience through the provision of real-time information and additionally ease the clinical processing workflow which is currently burdened by significant levels of unnecessary biopsy samples.

“SMARTProbe will offer "peace of mind" for patients undergoing biopsy for suspected cancer tissue. It will provide real time diagnosis and enable clinicians to immediately reassure and discharge patients that have benign tissue and fast track suspected cancer biopsies.”

– Dr. Eric Moore

SDG 3 - Good Health and Well-being

• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health
• Target 3.8 - Achieve universal health coverage
• Target 3.d - Improve early warning systems for global health risks

SDG 9 - Industry, Innovation and Infrastructure

• Target 9.5 - Enhance research and upgrade industrial technologies
• Target 9.b - Support domestic technology development and industrial diversification 

SDG 17 - Partnerships for the Goals

• Target 17.9 - Enhance SDG capacity in developing countries

Blue ecosystem sustainable solutions for health and industrial innovation

Dr. F. Jerry Reen, School of Microbiology and SSPC Funded Investigator; Professor Anita Maguire, School of Chemistry and SSPC Principal Investigator; Professor (Emeritus) Fergal O’Gara (BIOMERIT Research Centre, School of Microbiology and SSPC Funded Investigator; Dr. Stuart Collins, School of Chemistry and SSPC Funded Investigator

Impact: International

The rich tapestry of the ocean microbiome presents an exciting canvas upon which multi-disciplinary teams can design the next generation of sustainable technologies. The purpose of this research is to harness the unique and untapped potential of marine microbes, delivering sustainable and efficient biotransformations for societal, industrial, and climate benefit. A long standing and fruitful multidisciplinary collaboration with colleagues from the Schools of Microbiology and Chemistry this research has delivered several ‘first in class’ enzymes from marine bacteria that can perform pharmaceutically important transformations.

Green Pharma relies on solutions that can shorten and optimise the drug synthesis pipeline, replacing the finite chemical catalysts used heretofore. Marine enzymes have the potential to deliver these enhancements with the added benefit of being environmentally friendly and sustainable. An additional suite of enzymes from this research is currently under development. The unique properties of the enzymes discovered in this research provide new possibilities for how the drug synthesis pipeline can be re-designed. The natural diversity that exists within the marine ecosystem can expand the capabilities of chemical transformation, offering new frameworks and platforms for drug development pipelines of the future.

“Nature already has the solutions to many of our challenges, we simply need to listen and understand that we may learn for the benefit of all.” – Dr. F. Jerry Reen

SDG 3 - Good Health and Well-being

• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health

SDG 12 - Responsible Consumption and Production

• Target 12.6 - Encourage companies to adopt sustainable practices and sustainability reporting
  

SDG 14 - Life Below Water

• Target 14.2 - Protect and restore ecosystems
  

Exploring the wider role of transcription factors in diverse E. coli

Dr. Nicky O’Boyle, School of Microbiology

Impact: International

Transcription factors regulate response to the environment by switching on/off subsets of genes. This research has identified that some transcription factors, predicted only to activate genes for metabolism of a given nutrient, actually regulate a much wider gene set. The aim of this research is to harness this information to develop targeted approaches for combatting infection. Proteins (Transcription Factors) are being investigated that regulate metabolism of amino acids in neonatal meningitis-associated E. coli (NMEC) but also regulate other unexpected, and unrelated processes such as virulence, and infection by bacterial viruses/phage. Recent work has shown how one of these transcription factors modulates susceptibility to phage by binding to a transferase encoding gene that alters the structure of NMECs slimy polysaccharide coat.

It is hoped that further understanding in this area could aid the development of improved therapeutics that clear this type of E. coli from the maternal or infant gut preventing this often-fatal infection. This relates to SDG target 3.4 in reducing incidence of non-communicable diseases, but importantly also SDG target 3.2, as this type of infection is only found in newborn infants. These alternative therapies could even take the form of simple dietary alterations that shift the metabolic profile of the gut in a targeted manner, reducing expression of fitness-promoting genes in NMEC. Such a strategy would be affordable and could be made broadly available (impacts SDG targets 3.8, 3b), even in developing countries. This work enhances basic understanding of how metabolism is interlinked with treatment efficacy in nasty bacterial pathogens like NMEC. There are concerted efforts globally to develop alternative approaches to traditional antibiotic-based therapies for bacterial infections. Enhancing phage therapy by modifying bacterial metabolism could represent a huge advance in our ability to treat life-threatening infectious disease.

SDG 3 - Good Health and Well-being

• Target 3.2 - End all preventable deaths under 5 years of age
• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health
• Target 3.8 - Achieve universal health coverage
• Target 3.b - Support research, development and universal access to affordable vaccines and medicines

SDG 2 - Zero Hunger

SDG 12 - Responsible Consumption and Production

Anti-virulence approaches to combatting infections with pathogenic E. coli

Dr. Nicky O’Boyle, School of Microbiology

Impact: Local, National, International

Certain types of E. coli can cause serious infections including meningitis in newborn babies, recurrent urinary tract infections and severe diarrhea. With many of these infections, antibiotics are ineffective or can even make disease outcomes much more severe. This research explores how some compounds can reduce expression of genes important for virulence without actually killing these E. coli, thereby reducing emergence of resistance and enhancing outcomes for patients. This research has identified a new function for an old antibiotic. Aurodox - an antibiotic used throughout the 80s as a growth promoter in poultry has a surprising ability to shut off expression of a set of genes required for attachment of enterohaemorrhagic E. coli (EHEC) to the gut lining. EHEC is a nasty bacterium capable of causing haemolytic uremic syndrome (HUS) - a condition that is exacerbated by many antibiotics and leads to kidney failure, with a requirement for lifelong dialysis. As such, this work relates directly to SDG target 3.4 in reducing incidence of non-communicable diseases. EHEC has caused several large outbreaks due to contamination of bean sprouts, beef products, unpasteurised milk, and spinach in recent years. It is hoped that it will be eliminated from the food chain by improving our basic understanding of the bacterium, enhancing food safety and addressing SDG target 2.1. Anti-virulence approaches take many forms, including inexpensive probiotics and dietary interventions.

By enhancing our understanding of the regulation of virulence in pathogenic E. coli, we can make effective therapies globally accessible (SDG targets 3.8, 3b, 3d). A foundation of basic understanding of the regulation of virulence is essential for the development of precision therapies that target processes essential for bacterial infection. This work is informing the design of such therapies, and revealing new targets for future drug design. By exploiting anti-virulence approaches, it is hoped to produce strategies with less selection for resistance. This will be of increasing importance as last line of defence antibiotics become ineffective.

SDG 3 - Good Health and Well-being

• Target 3.2 - End all preventable deaths under 5 years of age
• Target 3.4 - Reduce mortality from non-communicable diseases and promote mental health
• Target 3.8 - Achieve universal health coverage
• Target 3.b - Support research, development and universal access to affordable vaccines and medicines
• Target 3.d - Improve early warning systems for global health risks

SDG 2 - Zero Hunger

• Target 2.1 - Universal access to safe and nutritious food