To celebrate Brain Awareness Week 2020 we asked our INFANT physchologists what a typical working day looks like for them.

Meet Leanna – Clinical Neuropsychologist at INFANT

Please describe your job: What do you do?

I am a Chartered Clinical Neuropsychologist working within the wonderful setting of the INFANT Research Centre, which allows me to be a Scientist and a Practitioner all in one -every Psychologist’s goal and desire! ‘Child Neuropsychology’ is a specialist branch of psychology and neurology that seeks to understand the relationship between the brain and behaviour in children and adolescents. Simply put, it explores how the brain has a direct impact on behavioural, cognitive, and psychosocial adjustment. It attempts to explain the way in which the activity of the brain is expressed in observable and measurable behaviour. I measure this with the help of various specialist assessment tools, diagnostic tools, clinical questionnaires, screeners, parents reports, EEGs, observation and also with the use of novel assessment tools such as ‘Eye-Tracking’. Every day, I am afforded the opportunity to use my training in both Clinical Psychology and Neuropsychology and endeavour to understand why and when something alters, delays or affects brain development during pregnancy, birth and/or early childhood. Thus, I can assess how this may relate to problems exhibited with walking, talking, social and emotional interaction, learning, paying attention, and difficulties at school and/or home. Through these varying assessment techniques, I am informed as to how a child learns best, why they may have learning and behavioural difficulties and consequently put in place the most appropriate strategies and techniques to help these children reach their full potential. Also, it enables me to inform and support parents and teachers where appropriate, through detailed reports and personal feedback. Not only do I get to work with children who may have experienced challenges at birth or after, but I also get to work closely with neurotypical children. This is also important for informing research on normal development. If we do not understand normal development and children’s needs at critical periods of development, we cannot meet these requirements unless we know what to expect in terms of thinking, communication, social and emotional development and physical abilities at certain important time points. One of my main roles as lead Psychologist is to have the responsibility for the delivery and ongoing development of psychological services. Fundamentally, this involves planning, organising, motivating, and delivering a range of initiatives that encourage the application of psychological and neuropsychological principles to support children within the research area. This also enables me to identify ways to improve psychological well-being and aid in supporting parents and children involved in our research, working within the multi-professional team at INFANT.

In striving to learn more about brain and behaviour development across pregnancy and the lifespan of the child, as a Neuropsychologist I have helped to develop an ‘Early Life Lab’. This uses the expertise of new and progressive technologies such as EEG’s, examining brain activity in neurotypical and atypical development, brain function, structure and cognitive processes, and developing an ever-expanding library of neuro-developmental, neuro-cognitive assessments, rating tools, and screeners. The aim of this lab is primarily to continue to integrate neuropsychology services into the specialised multidisciplinary team in order to have neuropsychology as an integral part of several established specialty programs treating a targeted group using a battery of neuropsychological and developmental assessments from birth to early adolescents. Examples of these include high-risk children such as Hypoxic Ischemic Encephalophy (HIE) children, premature babies, seizures and autism spectrum disorders.  On a wider platform, I have also been involved and responsible for identifying the development of a ‘Neurodevelopmental follow-up’ work package that will be implemented and followed by all centers in the HRB-Primary Care Clinical Trials Network Ireland. This aims to ensure further best practice and consistency across the networks.

Tell us about a typical working day…

The great thing about my job is that every day is different, varying from day to day and week to week, which adds novelty and excitement. I am part of a multidisciplinary team ranging from research psychologists, engineers, paediatricians, neonatologists, PhD students, medics, physiotherapists, nurses and many more professionals working together on different research projects. I love working closely with other professionals and having a range of responsibilities, such as working with children and their parents and staff, teaching, training, supervision, research and specialist assessments and consultation. I usually start my day by checking emails for any updates and new appointments for assessments or important items to be followed up. Presently, I am involved in the neurodevelopmental assessment of four to five-month babies and eighteen-month toddlers, assessing their language and communication skills, how they are learning, their eye-hand coordination, personal-social-emotional skills, and their gross motor development. Even now, after many years of assessing children, I am fascinated by their ever-developing skills and abilities at this age, their intuition and innate ability to socially engage and wrap you around their little fingers. Four months is my favourite age, as they have not learned to say “No” yet! At 18 months of age, an assessment is very different, but still very similar in what we are assessing. However, at eighteen months they can say “No!”, and also move very quickly. Often, I could end up anywhere in the room, in any position assessing and observing through the use of specialist fun tools. After the assessment, I will score and analyse the results, providing feedback for parents in the form of written reports and verbal feedback. All the anonymised data is then inputted into our database and results analysed and reported on. If there are any concerns in relation to a child’s development, we have a specialist follow-up clinic and clear referral pathways to ensure the child receives the appropriate services necessary to meet these identified needs. I also spend a lot of my time in a consultative role and in the supervision and mentoring of medical students, PhD students, and research psychologists. As a Psychologist, clinical supervision is imperative to our profession: both giving and receiving it. It is a core clinical activity to ensure the delivery of effective and high-quality services. On a regular basis I also input and help to inform policies and procedures within the team, in line with psychological best practice and provision; for example, with regard to child protection, risk assessment and ‘Standard Operation Procedures’ (SOP’s) in relation to psychology input and assessments. An invigorating aspect of my job is my work as a supervisor, mentoring and advising students from UCC, Masters, and Doctorate students on the ‘Applied Psychology’ and the Doctorate in Clinical Psychology’ (D. Clin. UCC) courses. By doing this, we are forging collaborative links with clinical psychology and other branches of psychology offering great experiences to students in the area of supervised research opportunities. Also, preparing and delivering lectures occasionally helps to keep my knowledge and skills up to date.

What do you love about your job?

Every day is different, yet every day always brings a smile and a helping hand. Working in research and within the INFANT platform, nothing is a difficulty or a problem, help is always nearby if needed. The team and the collaboration within are unique, and unlike any other organisation which I have worked in before. I look forward to work every morning, knowing that I can work on my own in a trusted and respected environment, yet also working with a variety of people, and I know I can depend on the team for any knowledge that I do not have in areas that I may know very little about, such as Engineering or Physiology. It is a challenging task attempting to attach EEG leads on the head of a very alert four-month baby! But I am learning, thanks to the team. I love that I still get the opportunity to be a practitioner, and to use my clinical skills to assess the amazing babies and children that are involved in our research studies. It is an incredible opportunity, as I learn so much from these little ones, and from their parents. I experience their resilience, patience, persistence, and the most incredible, unique and informative parenting skills that cannot be learned from any parenting book! Last, and by no means least, as a Psychologist, and as a Scientist-Practitioner, my bread and butter is evidenced-based best practice, informed by research, working with some truly incredible people, and that is what I am lucky enough to do every day, in a nurturing and supportive environment.

What do you find most challenging?

Before I worked in research I worked within a clinical setting with children and adults. Being a clinical neuropsychologist in a research setting is quite different from a clinical setting, where you see patients on a daily basis. Working in a clinical setting you are assessing, formulating and testing hypotheses to diagnose, provide intervention and ongoing support on a regular basis. In research it is different in that we use experimental methods and statistics, using scientific methods to formulate and test hypotheses, develop experiments, collect and analysis data and use that information to develop conclusions and report on the findings. One of the most challenging aspects of this role change when I first began working in INFANT, was that I was assessing purely for research outcomes, not to provide intervention, therapy or ongoing support; therefore, I had a very different hat on! A further challenge for me, as in all research, I would think, is that every day brings a new research question, new ideas, and new thoughts, but unfortunately only one at a time! Research takes time and a great deal of patience.

Do you have any advice for anybody who wants to work in your field?

I am an oldie in Psychology! I am very lucky in this respect, as when I applied many moons ago for my clinical training, it was not as difficult, and certainly not as incredibly competitive as it is today. Getting on the ‘Clinical Doctorate’ is tough enough in itself, and then another long pathway lies ahead in order to become a Neuropsychologist. But the fantastic thing about becoming a clinical psychologist is that all along the way, you are gaining incredible practical experience and transferable skills that will help you in all areas of life. Also, you acquire skills that are transferable and valuable in other areas of work. Gain experience. That is the one essential component for advancing in this field of work; strengthen your desire and determination to become a Psychologist through your supervised experience in the field. The rewards of seeing a smile on someone’s face, or the thought you may have enabled someone to make a little change that will have an everlasting impact on their life or their child’s, is well worth the wait. To be able to inform clinical practice through research is an absolute privilege.

Meet Triona – Research Psychologist at INFANT

Please describe your job: What do you do?

I work as a Research Psychologist with children from birth to 3 years of age. This means that I use lots of research methods to gain a better understanding of children’s development: across their cognition, language, movement, emotions, behaviour and social skills. I use lots of different ways to see this, whether using developmental assessment kits with different games and materials (Bayley, Griffiths), using clinical questionnaires, observing children’s play and interactions, talking to parents, or trialling new innovative assessment tools.

Tell us about a typical working day…

This can vary massively, which suits me! Some days will be spent conducting assessments with children, whether 4 month old babies or 2 year old toddlers. This can be lots of fun, but also requires lots of energy! I also spend a lot of time writing reports on assessments and discussing clinical cases with my supervising Clinical Psychologist and Clinical Lead Paediatrician. Other days will be spent looking at data that has already been collected, analysing this so that we can publish results. Currently, I am spending time tailoring a novel touchscreen assessment with the aim of using this with toddlers to screen for difficulties in a much quicker and easier way.

What do you love about your job?

There are so many things. Firstly, we have the incredible babies and children who visit us! I find it fascinating to see the personalities of our smallies shine through, from such a young age ? We also have the most amazing Mums and Dads who participate in our research – I am constantly blown away by how dedicated they are to their children and to our research. I am also so lucky to work with such fantastic people in INFANT, across so many different clinical and research roles. No matter what profession we are in, we all have a shared aim of improving maternal and child health – which makes INFANT truly unique.

What do you find most challenging?

This would be the amount of research questions that can be asked, and not having enough time to answer them. This is of course part of research in itself, in that there will always be questions! Therefore we will strive to keep developing our knowledge base so that children can reap the benefits in years to come.

Do you have any advice for anybody who wants to work in your field?

Talk to people! Don’t be afraid to ask for experience. It is worth knowing that the route to getting psychology jobs can be tough. However, if you find that you are passionate about psychology and children’s development, then it is worth the journey. I could not recommend it any more highly!

The Pregnancy Loss Research Group and INFANT Research Centre at University College Cork today launched www.corkmiscarriage.com, a first-of-its–kind website in Ireland.

One in four pregnancies end in first-trimester miscarriage. For many women and their partners, miscarriage is unexpected and can be an upsetting experience. The silence and stigma associated with pregnancy loss can be compounded by the lack of reliable, accessible online information.

The new website provides medically accurate, sensitive and user-friendly information for those who experience first-trimester miscarriage. It is designed to guide users through what to expect when a miscarriage happens, what to do and how to access appropriate services while complementing the care and support women receive in maternity hospitals.

The website will also be a helpful resource for clinical staff who care for bereaved parents through the difficult journey of miscarriage.

The website has been developed by Clinical Bereavement Midwife Specialist Anna Maria Verling, Parent Advocate Rachel Rice, INFANT Public Engagement Manager Caoimhe Byrne in collaboration with Dr Sabina Tabirca and Dr Keelin O’Donoghue, Consultant Obstetrician at CUMH and Principal Investigator at INFANT.

Anna Maria Verling, said: “We identified a particular gap in the information and support available to women and their partners who experience first trimester miscarriage. Couples need to have access to reliable, medically accurate information when healthcare professionals may not be available to answer their questions and alleviate their worries. Developing an on-line resource meets this need.”

“It wasn’t until I experienced pregnancy loss, that I realised how unprepared I was for the physical and emotional reality of miscarriage. It is not always possible at the time of diagnosis to take in all the information that is provided by healthcare professionals. It would have made such a difference to have had access to understandable and reliable information that I could have referred to at any time, day or night“ commented Rachel Rice.

Dr O’Donoghue and her team at INFANT, UCC, are leading investigators in the area of pregnancy loss and perinatal death.

Dr Keelin O’ Donoghue said: “This website highlights the importance of the research group, bereaved parents, clinical staff and the INFANT team working collaboratively and applying expertise from different backgrounds and perspectives to create a resource to support the women, partners and families that we care for”

The website will provide information on Pregnancy, Pregnancy Concerns, Miscarriage Symptoms, Miscarriage Types, Management and Services, Feelings and Emotions, and Pregnancy after Miscarriage.  While the website is specific to the services operating in Cork University Maternity Hospital, the information is relevant to parents and maternity services nationally and internationally.

New research reveals that a substance, L-ergothioneine, most commonly found in mushrooms, could help alleviate some features of pre-eclampsia.

Pre-eclampsia is a complex disorder of pregnancy that can have potentially serious consequences for women and their babies.  There is currently is no cure for pre-eclampsia other than delivery, which can present a major medical problem if the condition results in an extremely premature birth.

Now researchers in the Department of Pharmacology & Therapeutics at University College Cork (UCC), the INFANT Centre at UCC and the University of Liverpool, have shown that a natural diet‐derived substance, L-ergothioneine, can alleviate some of the features of this condition.

Significant research suggests that pre-eclampsia may be caused by substances released from the placenta that disrupt normal biological processes in the mother. In particular, disruption of mitochondrial function can lead to exaggerated oxidative stress. Ergothioneine is a potent and effective mitochondrial antioxidant. Ergothioneine can be found in a wide variety of foods, but the chief source of ergothioneine in the human diet is mushrooms.

“We wanted to see if this natural antioxidant could ameliorate some of the biological features of pre-eclampsia using our model of disease” says Dr. McCarthy at UCC, leader of this research. “Our research shows that treating rats with pre-eclampsia with the natural antioxidant L-ergothioneine reduced blood pressure, prevented fetal growth restriction and dampened production of the damaging substances released from the placenta during pre-eclampsia.” Furthermore, using an exciting new approach we identified that treatment with ergothioneine diminished mitochondrial-derived oxidative stress”.

The new research opens up a new avenue for therapeutic investigation in the elusive search for a treatment for pre-eclampsia.  Ergothioneine appears to be a safe, natural diet‐derived antioxidant whose therapeutic potential looks promising but remains to be validated by the gold standard of sufficiently powered, human clinical trials.

The study is published in the leading journal Hypertension. This research was supported by a Health Research Board Health Research Award.

INFANT PhD Mark O’ Sullivan in conversation with Jane Haynes, UCC Office of Marketing and Communications.

Featured in INDEPENDENT THINKING – The University College Cork Magazine.

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A pocket-sized medical device that monitors and diagnoses brain injury in newborns could prove to be a game-changer for infant health.

Mark O’Sullivan, a UCC PhD researcher, is in the process of developing a small, portable, battery-operated device which could in the future replace the more heavy-duty EEG machines currently used in hospitals.

Mark, who studied Electronic Engineering at undergraduate level and completed an MSc in Music Technology, specialising in Audio Signal Processing, is undertaking his PhD with the INFANT Research Centre and the Embedded Systems Research Group in UCC’s School of Engineering.

The idea behind the Neurobell device evolved while Mark was researching EEG (electroencephalogram) signals (the signals produced in the brain) and how, through monitoring and processing them, he could come up with better methods of detecting brain injury.

Mark and his colleagues realised pretty quickly that there was huge potential for designing a device that could be ‘a disruptive technology in the field’.

“Currently, EEG monitors are large machines that are rolled into wards. It can take up to an hour to apply dozens of electrodes across the baby’s head and then set it up on a laptop or PC,” he explains.

“We figured out that all the electronics in that machine can be developed into a pocket-sized device.”

The ramifications, he explains, are potentially game-changing.

Firstly, by equipping doctors with a pocket-sized device, gone are the days of waiting hours for an EEG machine to be rolled into the ward.

But what’s the substitute for the neurophysiologist who, conventionally, is the one who comes in and reviews the hours and hours of recorded EEG data? This is where INFANT’s expertise plays a commanding role.

“INFANT developed the ANSeR algorithm, which can detect seizures in newborns and is now licensed out and is actually making an impact,” Mark explains.

“My goal would be that the Neurobell project I’m working on now would be the next step forward; where we have developed similar algorithms and implemented them on a portable device.”

While Mark was well-supported by the expertise of INFANT and the Embedded Systems Research Group when it came to the ethical, regulatory and technical elements of his project, with plans to develop this product – and a company around it – he needed to learn the basics of commercialising the technology.

Enter GatewayUCC, a state of the art Innovation and Incubation Centre based at UCC, and one wing of UCC Innovation.

Mark was accepted onto GatewayUCC’s SPRINT Accelerator Programme. Designed to support early-stage start-ups, entrepreneurs and UCC-based researchers, SPRINT focuses on commercialisation of UCC-generated technologies and routes to market. The programme covers all aspects of the commercialisation process; from business strategy and legal issues, to crafting an elevator pitch and building a team to scale a business.

“I knew at that stage that, while I love the engineering side, I also wanted to pursue this and get this out of the university and into clinicians’ hands – that takes commercial expertise and knowledge which, at the time, I didn’t have,” explains Mark.

Starting SPRINT in October 2018 gave Mark his first experience of commercial development, and each module helped him to build a solid foundation of the essentials he needed to progress his research into business.

Every week offered a different lesson for Mark – financial basics, how to raise funding, the all-important regulatory elements, and beyond. With frequent seminars delivered by experienced entrepreneurs and industry experts, the opportunities to build a strong network were second-to-none.

“If there’s anything that I’ve learned, it’s that in business, your network is essentially everything. So, having these extremely high-profile individuals coming in to talk to us was really valuable,” he says.

Another skill that has proven to be invaluable, is learning the ‘lingo’ of the business world.

“I’m now at the stage where I’m applying for Enterprise Ireland funding,” says Mark. “Such applications are extremely commercial-based and, without the knowledge I got in Gateway, I don’t think I’d be able to go through the application process without additional support.

“And I now feel comfortable thinking and talking in a more business-minded language, which helps when talking with investors, and industry or enterprise office reps – I think they can see value in that.”

So, what’s the next step for Mark? Well, right now he is firmly fixed on developing his research and product into a spin-out company.

“With medical devices, it takes a long time to get there; in terms of getting through the regulatory steps, clinical investigations and, eventually, getting onto the market. So, I’ll be involved with UCC for another couple of years, but the overall aim is to get this into a start-up,” he says.

What is driving Mark right now, he says – due, in part, to the guidance of his PhD supervisors: Emanuel Popovici, Andriy Temko and Geraldine Boylan – is the prospect of making a positive clinical difference and benefitting others.

“The more I dig into the clinical side, the more I realise that this is something that could really have an impact – and that helps to drive me even more.”

INFANT team announced as one of eleven competitors in the SFI Artificial Intelligence for Societal Good Challenge.

The prize offers €2 million each in funding to teams that win competitions in the categories of AI for societal good and zero emissions.

AI-4-LIFE – led by Prof Geraldine Boylan, Prof Liam Marnane and Societal Champion Dr Mairead O’Riordan – will focus on the challenge of reducing neonatal morbidity and mortality.

Lack of oxygen at birth is responsible for 23% of all deaths in full-term infants and approximately 1.15 million infants survive with significant disability. The team plan to develop a new, easy to interpret, fetal monitoring system that will use artificial intelligence (AI) assisted interpretation to monitor the vital signs of mother and baby during labour to quickly identify any issues.

The AI-4-LIFE project has the potential to impact current clinical practice and improve the lives of families, their babies and international society.

Eleven teams have received initial funding from SFI to work on their challenges. At the end of April, they will be short-listed to go through to the second seed phase following pitches at Futurescope in the Convention Centre Dublin. The final prize of €1 million will be awarded at the end of this year.

Good Clinical Practice Course

Please note, there must be a minimum of 5 participants for the course to be run.

Full GCP Course – INFANT 2020: (4-hour course)

Please note, there must be a minimum of 5 participants for the course to be run.

Taken from UCC’s Independent Thinking Magazine.

It is well recognised that hospitals that have a research centre such as INFANT, which is integrated into a clinical care setting, have better outcomes for patients and higher overall standards of care, she points out.

INFANT is also Ireland’s leading partner in conect4children, a pan-European research network which is carrying out clinical trials to develop better treatments for children.

“Our aim is to ensure that Irish children participate in the best trials available across Europe. About 60% of current drugs used for children were developed for adults. We often use a smaller dose of the drug for children – but children are not small adults; their physiology and how they handle drugs is very different to adults. The gold standard for safe drug use is to test using randomised controlled trials which need to be done for children also,” explains Geraldine.

As well as the development of drugs and devices specifically for children, INFANT is involved in research in a wide range of areas from eczema and allergies to stillbirth and pregnancy loss, and optimal nutrition for premature babies.

The centre was founded with Science Foundation Ireland (SFI) funding which ended in May of this year, so it’s now standing on its own two feet, as such: “It’s a new phase for us, a very exciting phase. We were very grateful to get SFI funding to set the centre up, and over the last six years we have built up an amazing and talented team of people here. INFANT has now moved into the toddler phase and we are growing and evolving and adding new team members all the time,” Geraldine says.

Just as INFANT is growing up, so too are the newborn babies who were the focus of much of the early research. The centre expanded to the third floor – a brand-new extension at CUH, which opened last year and was funded through the university and philanthropy.

It now has its own state-of-the art development assessment unit headed by a senior neuropsychologist, ensuring that all babies are followed up, into and throughout the childhood years.

“We are really delighted with this assessment unit. We regularly have international visitors here at INFANT and they can’t believe the purpose-built set-up we have here for doing assessments. My challenge as director is to sustain this unit and the team, to ensure we can follow up every child who participates in research into their teenage years,” says Geraldine.

The idea, she explains, is to see how the complications these children experienced as newborns or in the womb affects them as they grow, and to ensure better outcomes through assessment and early intervention. It’s very hard to get funding for this kind of research – but Geraldine says she is never going to stop trying.

One research team, for example, is investigating the right balance of nutrition for growing preterm babies. INFANT is also heading a team that is developing a new drug for children at risk of peanut allergy.

Another project is focused on identifying babies who will develop severe eczema, while the neonatal brain team have identified biomarkers in the blood for severe brain injury in babies.

NFANT researchers are also trying to understand the underlying causes of pregnancy loss and stillbirth and are looking at mothers’ experiences of maternal morbidity, to bring these issues to the forefront and begin conversations between patients, healthcare providers and the community.

A panel of parents of sick children who have been through the neonatal unit at CUH, and families who have experienced complications of pregnancy, is being set up to provide input into the design and development of parent information leaflets and future research projects at INFANT.

Geraldine expresses deep gratitude to the staff in the maternity hospital and the paediatric unit, who manage to find the time during their incredibly busy workdays to support and facilitate INFANT research. The ever-growing talented multidisciplinary team includes clinical researchers, scientists, engineers, computer scientists, physicists and nurses, and her own enthusiasm and passion is infectious, no doubt.

“You need the right team and the right people, and we have been very lucky in INFANT with our amazing team of people here, which is our major strength. It’s very rare to get a centre with all this different expertise together in one place,” she says.

“We have a talented and enthusiastic pool of PhD students and post docs – the next generation who, I hope, will continue on the work we started and build on it. We have so much more to do, so many areas we have not even scratched the surface of yet, in terms of the research we need to do.”

The birth of a baby is a wonderful occasion. Too often, babies are born too soon or very sick and mothers can suffer severe complications.

The INFANT Research Centre is committed to understanding how to reduce these risks and give all babies a healthy start to life.

By making a donation today you can shape the future of INFANT.  Enabling us to continue our valuable and ground-breaking research for women and children and funding solutions for those that need them most.

Your donation, whether large or small, will be hugely appreciated and we are very grateful for your support.

DONATE NOW!

Last week, INFANT postdoctoral researcher Dr Elaine McCarthy was presented with her British Nutrition Foundation (BNF) Drummond Early Career Scientist Runner-up Award in London.

Earlier this year, the BNF announced the recipients of the 2019 BNF Drummond Early Career Scientist Award – recognising early career excellence in nutrition science.

Elaine has been recognised for her work in the field of paediatric and neonatal nutrition, with iron nutrition in young children being the focus of much of her research.

The BNF Drummond Early Career Scientist Award is an annual scheme run by the BNF. Applicants are judged on their contributions to nutrition science to date, their potential to become future leaders in the field, and the scientific merit and clarity of communication in their work.

Elaine’s invited review entitled “the neonatal period: a missed opportunity for the prevention of iron deficiency and its associated neurological consequences?” is now published in the Nutrition Bulletin.

Well done Elaine!