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Landmark New Study on Maternal Health Launched. MAMMI study to make mothers’ invisible health problems visible.

A first of its kind study to research and track the health and health problems of first time mothers in Ireland has been launched today by researchers from the School of Nursing and Midwifery in Trinity College Dublin.

The MAMMI study (Maternal health And Maternal Morbidity in Ireland) is a longitudinal study funded by the Health Research Board (HRB) which will follow more than 2600 women through their pregnancy and for one year after the birth of their first baby, gathering information and experiences on a range of important health issues including urinary incontinence; mental health issues such as anxiety, stress and depression; pelvic girdle pain; sexual health; domestic violence; c-sections; and diet and activity during pregnancy. The study group represents almost 10% of all first-time mothers giving birth in Ireland in a given year.

The researchers say that the study is being done because a lack of information on the health of women after a baby’s birth prevents healthcare professionals from understanding what causes common problems for women in Ireland such as pain, urinary and bowel problems, changes affecting sexual health and emotional health and difficulties in intimate partner relationships. 

Speaking about the importance of this study, MAMMI’s Principal Investigator and Chair of Nursing and Midwifery in Trinity, Professor Cecily Begley said: “Many women experience motherhood in excellent physical health, while others experience health problems, which may occur during pregnancy or result from an event that happens during or after the baby’s birth. The MAMMI study will look at a wide range of problems that can have a huge impact on a mother’s quality of life. Because of a lack of information on the prevalence, causes and interconnections between these issues for women in Ireland, women’s health problems remain invisible, not talked about and very often untreated. This is despite interventions being available, which could prevent some of the problems occurring in the first place.”

Speaking about the information gaps that currently exist in this area Professor Begley continued: “Maternity care and information gathering is focused on the pregnancy and birth period. Women have a final check-up 6 weeks after the birth, usually with their GP, when it is ‘assumed’ that her body has returned to ‘normal’.  This is the case for a lot of women who stay healthy and well but is not the case for a considerable proportion of women. This information was, and is not collected in our maternity services.”  

“There is also no connection between the woman’s record held in the maternity hospital and any records kept on her if she has to attend a general hospital with a health problem resulting from pregnancy or childbirth. This means that clinicians in the maternity services never receive feedback on how women who have been in their care for pregnancy and childbirth return to normal health and well-being. We hope that this study will bridge that gap and not only make these issues visible, but also, and crucially, provide the information that will help guide, inform and improve practice and care for mothers in the future.”

According to Dr Graham Love, Chief Executive at the Health Research Board: “The MAMMI study shows how health research is providing practical solutions to real patient issues at the time when it matters most. It is important that these findings are widely disseminated so that as many women as possible can benefit from this research.”

Urinary Incontinence or ‘Leaking Urine’

The MAMMI study has today released the first set of early findings on urinary incontinence (leaking urine) in women, before, during and after the birth of their first child. This early research looked at the prevalence and mitigating factors in urinary incontinence (UI) in 860 women, before, during and after pregnancy.  

Key findings:

Prevalence:

  • 1 in 3 women leak urine occasionally before becoming pregnant and 1 in 12 leak urine once a month or more frequently.
  • In early pregnancy, more than 1 in 3 women leak urine during pregnancy and almost one in 5 leak urine once a month or more frequently.
  • Three months after the birth, 1 in 2 women leaked some amount of urine and even 6 months after the birth, 1 in 5 women still leak urine once a month or more frequently.

Risk Factors:

Pre-pregnancy

  • Women with raised odds of leaking urine were those with a high BMI and those who experienced bed wetting as a child. Women who were obese or very obese had 4 times the chance of leaking urine before pregnancy compared with women whose BMI was in the normal range.

During Pregnancy

  • Women aged 35 years and more before pregnancy had 3 times the odds of experiencing new onset urinary leakage in pregnancy when compared with women aged 25-29 years of age.
  • Women who were overweight before pregnancy had twice the odds of experiencing new onset urinary leakage in pregnancy.
  • Women who leaked urine occasionally, less than once a month, before pregnancy had more than twice the odds of leaking urine during pregnancy.

Postnatally

  • Women who experienced urinary leakage in pregnancy had 3 times the odds of having it at 3 and 6 months after the birth when compared with women with no leakage or leakage less than once a month during pregnancy.

Speaking about the feedback from women in the study who have experienced urinary leaking, Assistant Professor in Midwifery in the School of Nursing and Midwifery, Trinity, Dr Deirdre Daly said: “The key message for women is that leaking urine is common, but it is not normal and can be treated. Far too many women put up with urinary leakage during and after pregnancy because they think it is ‘normal’ or ‘to be expected’. Because of this the majority of the women in the MAMMI study had not really talked to anyone about leaking urine.”

“The reality is that leaking urine can make some women miserable; while it affects them physically, it can also affect them emotionally and socially and affect the way women interact with their partner. Leaking urine can even make some women stop exercising or be cautious about socialising because they are afraid of leaking and of it being noticed by others. Unfortunately, and partly because we have no information on leaking urine in pregnant women or new mothers in Ireland, many women who leak urine think they are alone; this can make women feel isolated, embarrassed and reluctant to talk about it or to seek help.”

Dr Daly continued: “The reality is that routine antenatal care offers opportunities for promoting continence in all women but particularly in those with identifiable risk factors. If enquiry about UI and advice on effective preventative and curative treatments became routine some of these women could become or stay continent which would have huge benefits for their quality of life.”

Urinary incontinence means leaking urine, regardless of the amount, when you don’t mean to. It can be classified in certain ways relating to when it happens. For example, leaking urine when you cough, laugh, sneeze or take exercise, is called ‘stress urinary incontinence’, and leaking urine when you have to rush to or wait for the toilet is called ‘urge’ incontinence, because you have an urge to go when it happens. Leaking urine when you exercise, and with a sense of urgency, is called ‘mixed’ incontinence.

Some women leak urine when they exercise, and this can be embarrassing and be enough to stop women from exercising. Not taking exercise is likely to contribute to gaining weight, which in turn can raise the odds of leaking urine.

As part of the UI strand of the MAMMI study, a number of videos were produced on pelvic floor exercises and urinary incontinence and are available here: http://www.mammi.ie/videos.php

The MAMMI study is funded by the Health Research Board. Certain strands also received funding from Friends of the Coombe and Friends of the Rotunda.

If any women are concerned about UI or any of the issues being covered by the MAMMI study they should contact their healthcare provider for advice and support.

More information on the MAMMI study is available from http://www.mammi.ie

Media Coverage:


Minister for Health delivers public lecture as part of School’s Civic Engagement Strategy

On Thursday 26 February 2015 the Minister for Health, Leo Varadkar TD participated in the School’s ‘Tell Me About’ public lecture series. He spoke about both his role as Minister and his vision for the future of health services in Ireland. After the lecture, the Minister took a number of questions from the floor. A podcast of the lecture will be available shortly on the School’s YouTube page.

The 'Tell Me About' public lecture series 2014-15 comprises of seven lectures and is presented as part of the School's Civic Engagement Strategy.
nursing-midwifery.tcd.ie/events-conferences/

Ms Jeni Ryan (Civic Engagement Committee); Dr Patrick Prendergast (Provost); Minister for Health; Prof Catherine Comiskey (Head of School); Ms Carole King (Civic Engagement Committee)


International Winter School award ceremony for US nursing students at Trinity College’s School of Nursing and Midwifery

Award ceremony held on Friday 16th January 2015 to celebrate completion of a two-week intensive International Winter School in the School of Nursing and Midwifery for nursing students from California State University, Channel Islands and University of Scranton, Pennsylvania USA.
The School of Nursing and Midwifery held its International Winter School  5th -16th January 2015. Nursing students along with Faculty members travelled to Trinity College from the University of Scranton and California State University, Channel Islands to learn about nursing, midwifery and global healthcare issues. The Vice-President for Global Relations, Professor Juliette Hussey presented the certificates and closed the International Winter School by highlighting the importance of building global relationships and having a forum for the international exchange for the future of nursing and midwifery.
The International Winter Schoolprogramme  provides participants with opportunities to explore the world of Irish nursing/ midwifery and compare nursing/midwifery in the US with Ireland ; learn about different  healthcare structures and contemporary health problems in Ireland; meet Trinity College nursing students in a round table exchange of student experiences; meet leading researchers and discover what innovative practices are being developed; experience how culture, lifestyle and quality of life effect health in Ireland; as well as cultural visits to the historic Book of Kells, and contemporary exhibition on ‘Blood’ in the Science Gallery, Trinity College. The winter school includes visits to a variety of clinical areas in the Coombe, St James’s and St Patrick’s hospitals where our global participants can compare nursing and midwifery practice in Ireland with their home country. The programme is designed to offer international nursing students a great opportunity to combine learning about nursing in Ireland with an active educational programme which provides experience of clinical practice, lifestyle and culture in Dublin.

Among the comments, one student wrote: “Wonderful program, recommend to all international students. This two weeks changed my life forever in the sense of becoming more broad minded to other culture’s nursing practice. Amazing!”

Other student comments:
“Having opportunity to study the Irish health care system in Ireland has been a huge blessing. I believe I have grown as a nursing student and witnessed many characteristics that I would like to emulate in my career, namely humility and compassion. This experience has been invaluable and I honestly believe it will make me a better, more rounded nurse.”
“This program was wonderful. I feel that I have learned so much about Ireland’s health care system along with how Ireland trains their nurses. The debate was a powerful learning tool with enabled us students to use our minds to understand not only Ireland’s health care but the US’s health care as well. The staff are very welcoming and I really enjoyed my time here as well as gaining a ton of knowledge. Thank you!”
“The overall program was absolutely fantastic. It was my first time out of the country and experiencing a new healthcare system. I feel I have learned astronomical amounts that I can take home and apply to my own nursing practice.”

The International Winter School is led by Professor Naomi Elliott, Freda Neill, Emma Duffy and along with the School of Nursing and Midwifery welcomes visiting students undertaking the programme as part of building global relationships in the areas of research and education.


New report launched - RDWIFI Research Study

A team from the School of Nursing and Midwifery have just completed the first part of a project focussed on families of children with rare diseases funded by the Saoirse Foundation.

The initial part of the project which was aimed at examining the information needs of parents of children with rare diseases in Ireland was completed in December 2014. This ground breaking study examined the needs of parents of children with rare diseases and their use of web information. The study was designed to underpin the development of a specific website for families of children with rare diseases which is an important innovation. This study is fundamentally aligned with the recently published National Rare Disease Plan for Ireland 2014-2018 recommendations.

Dr Honor Nicholl (PI on the project) is seen in the photograph with the research team members Dr Catherine Tracey, Dr Aileen Lynch, Ms Thelma Begley and Ms Carole King handing a copy of the project report to Mr Tony Heffernan, CEO of the Saoirse Foundation.

Please click here for full report


Erasmus Student

The school welcomed our Erasmus Student Anna Maniscalco who will spend time in our partner clinical areas, St. Patrick's University hospital and St. James hospital.


Graduation of 10 psychiatric nurses from St Patrick's Mental Health Services

Wednesday November 12th 2014 marked the graduation of 10 psychiatric nurses from St Patrick's Mental Health Services. Speaking at the ceremony Ms Evelyn McCarthy, Director of Nursing acknowledged the long established partnership St Patricks have with Trinity College Dublin and the ever-evolving role Mental Health Nurses play in meeting the changing ways mental healthcare is delivered.  The CEO of St Patricks Mental Health Services, Mr Paul Gilligan, complimented the graduates on achieving their qualifications and at the ceremony graduates were presented with a badge that represents St Patrick's Mental Health Services philosophy: Innovative, Open, Energetic, Involving, Confident, Challenging and Expert. It was a wonderful ceremony for the graduates and their families.


The Grand Opening of Hospital 5 Unit 2's (St. James's Hospital, Dublin)

The Grand Opening of Hospital 5 Unit 2's (St. James's Hospital, Dublin) "Patient and Family Room" took place on Thursday 11th September 2014 at the Hospital. This room, which serves to provide rest and recreational space to both patients of the unit and their visitors is a welcome addition to the unit which had been previously under-resourced in this particular domain. This initiative arose as a result of a joint project between the School of Nursing and Midwifery, Trinity College Dublin (TCD), and Staff at St. James's Hospital Dublin.

The joint TCD/St. James's Hospital initiative, which was the brainchild of Ms. Lorraine Dolan, Clinical Nurse Manager (CNM) 2 at the hospital, and supported and developed by her colleague Maria (Lawlor) Kane (CNM 3) was later fostered  by Prof. Fiona Timmins, Associate Professor and Dr. Orla Dempse, Quantitative Healthcare Lead at TCD and under the Auspices of the Centre for Practice & Healthcare Innovation, TCD, the overarching project entitled "An evaluation of recreational ward facilities for long stay respiratory patients" secured funding from the Royal City Of Dublin Hospital Trust to realise the project.


Prof. Fiona Timmins appointed as one of three new Editors for the Journal of Nursing Management

Prof. Fiona Timmins, Associate Professor, School of Nursing and Midwifery has been appointed as one of three new Editors for the Journal of Nursing Management.The Journal of Nursing Management is an international peer reviewed journal which aims to advance the discipline of nursing management and leadership. The Journal encourages scholarly debate and critical analysis resulting in a rich source of evidence which underpins and illuminates the practice of management, innovation and leadership in nursing and health care. It publishes current issues and developments in practice in the form of research papers, in-depth commentaries and analyses. It's impact factor is 1.14. The Editor in Chief is Professor John Daly, Dean, Faculty of Health Head, WHO Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology, Sydney, Australia.


Provost Teaching Award

Congratulations to Dr Louise Gallagher who has been awarded the Provosts Teaching award for excellence in teaching.  This is just excellent news and wonderful for the school and the midwifery team.

 


School of Nursing & Midwifery Students Visit Malawi

Two intellectual disability nursing students, Suzanna Weedle and Eloise Sheerin along with Lecturer in Intellectual Disability, Dr. Fintan Sheerin, visited the Chilanga region of Malawi for 4 weeks during June 2014. They were part of the Canadian-led participatory action research project, Praxis Malawi (www.praxismalawi.com) of which Dr. Sheerin is Health Coordinator. The students worked closely with local people to encourage developments in supports for people with an intellectual disability there. As part of this endeavour, they initiated collaboration between teachers in a school for children with visual impairment a special education teachers in a resource room for children with learning difficulties. They also met with local people with disabilities and their parents to explore their experiences. Many of these parents are struggling to meet the needs of their families and are unable to address the specific needs of family members with a disability. They are also challenged by the stigma that often is experienced in such situations. Eloise and Suzanna’s work has set in place a structure which we hope will be the basis for a local support group.


Enable Ireland Community Design Challenge

Along with Prof. Fiona Timmins, Junior Sophister Students were invited to take part in the 2014 Enable Ireland Community Design Challenge http://www.atandme.com/?p=420 .

This is a user centred design based competition, hosted jointly by Dublin Institute of Technology (DIT) and Enable Ireland. It invites design engineering students from DIT, users and for the first time, nursing students, to meet together and come up with design ideas for improving quality of life and well being of the users.

Three students attended the competition which was held over 2 days, with consultation work in between. The nursing students were a great asset to the competition and one of them (Ms. Eimear O' Brien) was on the winning team.

This was truly inquiry based learning as expert users presented their 'frustrations' ( with say reading medicine bottles if they are diabetic or visually impaired) and along with the team they came up with a prototype solution. Details about the winning design are here: http://userdrivendesign.org/?p=416


New book on Mental Health in Ireland launched

A new book on Mental Health in Ireland was recently launched at the School of Nursing and Midwifery, Trinity College Dublin. The event was attended by mental health service users, practitioners, academics, researchers, friends and Minister of State for Disability, Equality and Mental Health, Kathleen Lynch T.D. The book was launched by Eddie Molloy, Chairman of Mental Health Reform, and by contributor and expert by experience Paddy McGowan.

Mental Health in Ireland: Policy, Practice & Law is the first extensive overview of emerging issues in the field of mental and emotional distress in Ireland covering the period from the 1940s to the present day. With contributions from experts in the area, there is an emphasis on current trends in mental health law and policy, which have implications for mental health service delivery in Ireland in the future.

The book has been edited by Agnes Higgins, Professor in Mental Health and Head of the School of Nursing and Midwifery, Trinity and Dr Shari McDaid, Director of Mental Health Reform. Professor Higgins has worked in mental health practice and education for over 30 years and Dr McDaid and has worked in social policy in Ireland for over 10 years, specialising in mental health.

To learn more about the launch , please visit

Minister Kathleen Lynch, Dr Shari McDaid, Prof Agnes Higgins


Researchers are contacting LGBTI people across the Republic of Ireland to complete a survey

LGBTIreland is a research project about the mental health and wellbeing of Lesbian, Gay, Bisexual, Transgender, and Intersex (LGBTI) people in Ireland. The study is being conducted by a research team led by Professor Agnes Higgins from Trinity College Dublin School of Nursing & Midwifery. It is commissioned by the Gay and Lesbian Equality Network (GLEN) and BeLonG To and funded by the National Office for Suicide Prevention (NOSP).

As part of the study, the researchers are contacting LGBTI people across the Republic of Ireland to complete a survey. It is hoped to gather as much information as possible as what is learned from the survey should inform the development of Irish policy and, hopefully, impact positively on the lives of LGBTI people in Ireland. To complete the survey, a person must be over 14 years of age, living in the Republic of Ireland, and identify as LGBTI.

To learn more about the study, please visit www.lgbtireland.net


'SteppingUp.ie' Support for Young People with Long-term Conditions

We’re delighted to let you know that our project 'SteppingUp.ie' Support for Young People with Long-term Conditions' has won the Category B in the 2014 Crystal Clear MSD Health Literacy Awards. The research team were: Prof. Imelda Coyne, Peter Thompson, Geraldine Prizeman, Dr Aisling Sheehan, Aileen Cassells. Peter Thompson from Stone Maidan Productions was the web designer.

This year's awards received over 131 entries and the judges were very impressed with both the volume and the exceptionally high standard of entries. A list of the shortlisted entries is posted on www.healthliteracy.ieWe attended the Crystal Clear Awards presentation lunch on Thursday, 15th May in the Hilton Hotel, Charlemont Place, Dublin 2. At this event the winner from each of the five categories was announced, and presented with a specially commissioned trophy.

In addition, all shortlisted entries will be awarded an official Certificate of Excellence. The award winners and finalists were announced to the national media following the awards ceremony and there is a feature in the health supplement of the Irish Times tomorrow (Tuesday).

http://www.hrb.ie/about/in-the-news/?no_cache=1&tx_ttnews%5Btt_news%5D=529&tx_ttnews%5BbackPid%5D=19&cHash=3ea022b97ca8b09cc5c9af5fbbfed176

Prof Imelda Coyne and Ms Geraldine Prizeman


The Actors from 'Scenes from our Lives' and the IDS-TILDA team visit the President at Aras an Uachtarain.

Prof Mary McCarron & President Michael Higgins

Following the launch in July of the accessible website (www.idstilda@tcd.ie) and DVD 'Scenes from Our Lives' members of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) team and the actors who participated in this innovative project were invited to celebrate their success with the President, President Michael D. Higgins on Wednesday last, November 14th 2012. Professor McCarron (PI) had the honour to present the President with the accessible material produced to make this study on ageing accessible to all people most especially those with an intellectual disability.

The President congratulated everyone for their achievement and noted his delight at the synergistic use of various media to convey an otherwise challenging academic message to all citizens. He especially liked the use of the arts and drama, commenting on how acting and advocacy resonates for him and noting how this project was the essence of how he as a President seeks an inclusive citizenship where everyone is treated with respect. As he had promised in his inaugural speech he was delighted to support initiatives for inclusion giving projects like this recognition on a national stage. Ms. Margaret Gahan, one of the patrons of IDS-TILDA, was delighted to present the President with a handcrafted pottery piece from Stewarts Care Centre.

It was a very exciting day for all the actors and they will talk about it for along time to come. They later enjoyed tea with the President and his staff as well as a splendid tour of the house. Professor McCarron noted that it was indeed an honour for all the actors to be sharing an afternoon with the President and have the IDS-TILDA dissemination project recognisied in such a manner.

Please see photographs from IDS_TILDA's visit to Aras an Uachtarain on the School's Flickr site


'Life as a Child and Young person in Ireland: Report of a National Consultation'

Professor Imelda Coyne, Dr Orla Dempsey and Professor Catherine Comiskey were commissioned to conduct a national consultation with children and young people in Ireland for the Department of Children & Youth Affairs (DCYA). The consultation was conducted in April 2011 and was completed by 66,705 children and young people across Ireland.

The report of the consultation 'Life as a Child and Young person in Ireland: Report of a National Consultation' was launched by Minister Frances Fitzgerald (Minister for Children & Youth Affairs) on Wednesday 7th November in Scoil Chaitriona, Lower Baggott Street, Dublin 2.



 

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Last updated 4 March 2015 nursing.midwifery@tcd.ie (Email).