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'We hope that our research transforms children's lives for the better'

As the search for our Woman of the Year continues, Stephanie Bell talks to Dr Madeleine Rooney, internationally renowned paediatric rheumatologist and worthy recipient of 2014’s Award in Health

The hopeless plight of one little girl confined to a wheelchair by arthritis aged just 10 so affected trainee doctor Madeleine Rooney that it set the course for her life’s work.

Thirty years on and not only has Dr Rooney established the province’s first specialist treatment centre for children with rheumatic diseases in Belfast’s Musgrave Park Hospital, but she is also renowned as an international researcher in the field of childhood arthritis.

She and her team have made a number of significant breakthroughs in understanding and treating the disease in children, improving their health and giving them hope. It was these grateful children and their families who teamed up with Arthritis Care Northern Ireland and the board of governors of Belfast Hospital School to nominate Dr Rooney for the Belfast Telegraph Woman of the Year in Health 2014 award, sponsored by Linwoods.

The well deserved honour took the dedicated specialist by complete surprise and she was thrilled to take to the stage at our gala Woman of the Year Awards night, in association with The Outlet, in the Ramada Hotel, Shaw’s Bridge, to pick up her trophy.

Northern Ireland’s first and only paediatric rheumatologist and a senior lecturer at Queen’s University, Dr Rooney has devoted her life to caring for children with arthritis and making major strides forward in devising effective new treatments. She remembers well what sparked her passion more than three decades ago: “It was 1983 and I was working in Musgrave Park Hospital as a trainee doctor.

“At the time children were treated in the adult ward and there was this one little girl who was just 10 and in a wheelchair because her joints had been destroyed by arthritis.

“Her little life was wrecked and her only hope was surgery when she was an adult. I just thought there has got to be a better way.

“Paediatric rheumatology was in its infancy and there were no consultants in the field and I felt there was nothing to offer her.”

Dr Rooney, who is originally from Newcastle, Co Down, started her career as a consultant and researcher in paediatric rheumatology in Northwick Park Hospital, in London, in 1991.

After four years she moved to carry on both roles in the renowned Great Ormond Street Hospital in the city, returning to Northern Ireland in 1999 when she established the local regional service in paediatric rheumatology.

Since then, with the help of her equally dedicated multidisciplinary team, she has developed a service with exemplary standards of care for children with rheumatic diseases.

In the area of research she has had a massive impact internationally in helping create a better understanding of the disease and developing new treatments.

“I am passionate about research as I think children do very badly when it comes to accessing new treatments,” she says.

"Every child should have access to clinical trials and I believe clinical research should be embedded in the NHS, so that if a family wishes their child to enter it they can. It's the only way their health will improve and why standards of treatment for cancer are constantly improving.

"You can't take what works for adults and assume it will work for children."

This year, she is poised for the results of one of her biggest studies yet. She was chief investigator on what was the first multi-centre study of the prevention and treatment of bone thinning in children caused by steroid treatment.

The study, on behalf of the British Society for Paediatric and Adolescent Rheumatology (BSPAR), commenced in 2003 and took 10 years to complete. It involved 217 children and young people at 11 centres throughout the UK, including Northern Ireland.

It is an exciting time for the team as they await the results which, it is hoped, will have a considerable impact on improving the long-term effects of steroid treatment on children.

"It was quite a big study and the first of its kind," says Dr Rooney. "There have been plenty of studies into preventing osteoporosis in adults, but none on how to protect children.

"We had three groups, a placebo group, a group receiving Vitamin D One alpha, and the third with bisphosphonate risedronate, which is widely used to treat adults.

"All three groups also received calcium and Vitamin D supplements.

"Plenty of children need steroids for a whole range of illnesses including asthma and inflammatory bowel disease and we need to protect their bones from thinning.

"One young teenager smashed a number of vertebrae just through a little bounce on the ground after she slid off a swing. That's how devastating it can be.

"It is our hope that we will have found an intervention that will work but until the results are collated and published we will not know for sure.

"However, we are very hopeful. I would like to take this opportunity to thank the children and their families who made the study possible by participating in it.

"It is a huge commitment for them and they don't get paid for it.

"They are only doing it to help other children in the same situation."

Through her tireless efforts to deliver better treatments for children, Dr Rooney has also become a leader in paediatric musculoskeletal ultrasound.

Again developed in Belfast she is now actively promoting the service across the UK.

"It used to be that children got injections in the joints that were swollen," she says. "Through a number of studies in Belfast we have developed ultrasound to identify exactly where the inflammation is, which means we can inject the joints more effectively.

"We are now trying to promote its use throughout the UK and would like to see it used as standard in all centres."

The team has also been carrying out pioneering work in trying to track down unique historical features of juvenile arthritis and has identified a plasma and synovial fluid protein fingerprint that predicts disease spread.

Juvenile idiopathic arthritis (JIA) is an inflammatory form of arthritis affecting one in a thousand children and teenagers, between the ages of six months and 17 years.

The difficulty is that there are many subtypes of the condition. The classical features of JIA are joint swelling, with pain and stiffness, and sometimes severe anaemia and tiredness.

For some children only a few joints are affected, while for others the disease gradually spreads to affect many joints within months of starting.

In time, a number of these children will develop significant joint destruction - which is irreversible.

The challenge facing doctors is that while some drug treatments work well in most children these drugs are so powerful that doctors are understandably cautious about giving them to young children if there is a chance that they don't actually need them.

However, by waiting to put the children on these drugs it could mean those with severe disease will suffer unnecessarily.

Dr Rooney's study focused on finding a way to predict if the disease is likely to spread or become more chronic in a child to enable doctors to decide on the best treatment for the individual.

She has also just applied for funding for a new study through the department of pharmacy to develop a new method of delivering pain relief to children.

Currently some of the oral medication induces severe nausea in many children and the Belfast team has been working on a new patch delivery system which will prevent this.

"We are really excited about this piece of research which could transform the lives of children not just with arthritis but in other areas too," says Dr Rooney.

"Currently about 50% of children get very sick taking their medication and this has a huge impact on the quality of their lives.

"We have designed a procedure for developing a patch to deliver the medication which would prevent them from being sick. We are currently awaiting funding and as ever we are hopefully that it will improve the lives of patients."

Dr Rooney credits her colleagues with making it possible for so many advances to be made in the treatment of childhood arthritis.

"I have a fantastic team of nurses, specialist physiotherapists, occupational therapists, pharmacists and nurses on the wards who I would like to say a very big thank you to," she says. "You can't do these things without a really good team who support you in your clinical work and research."

With the results of a major study due out and another ready to get under way, 2015 is shaping up to be an exciting year for the team. A highlight of the year for Dr Rooney will be hosting the first ever annual meeting of BSPAR in Northern Ireland.

"It's very exciting and I am looking forward to showcasing Belfast," she says. "We will have people from all over the UK in the city for three days and it will be quite a big event."

Even a year from being nominated for the Belfast Telegraph Woman of the Year in Health, her delight at receiving the award is still obvious.

"I was gobsmacked, to put it mildly," she says. "I found it very emotional, and I am not a deeply emotional person.

"It was such a nice thing to happen. You are plugging away at research and sometimes things don't go the way you want, but when it does come together it's really exciting.

"For our new research on prevention of osteoporosis in children taking steroid treatment there are literally millions of pieces of data to be analysed and it takes a lot of time and work, so to be recognised for it was wonderful.

"I found the whole night very uplifting. It was just extraordinary. It showcased a lot of things which people do, not just in health but things that go on every day that we don't get to hear about."

Half-a-century of healthy living

The Belfast Telegraph is delighted to welcome back Linwoods as sponsors for the 2015 Woman of the Year in Health Award.

Sales and marketing manager for the company Joanne Hayden said: “For half a century Linwoods has been a household name for quality dairy and baked goods, and more recently a variety of healthy super foods.

“Our reputation has been built on quality, consistent and innovative healthy foods, all 100% natural, but milled and blended for convenience and ease of use, so it seems only natural that we should be linked to the Belfast Telegraph Woman Of The Year In Health Award, celebrating outstanding achievement and performance and reinforcing the fantastic part played by so many women in our vibrant and demanding health sector.

“Today we are all increasingly conscious of the need to look after our own health and that of our families by making good dietary choices.

“At Linwoods we are proud to be at the forefront of that movement, making it easier than ever before to enjoy balanced and nutritious diets.

“This year we will be celebrating our 50th anniversary and we are delighted to report that our Linwoods Health Food range, coupled with our baked and dairy business, has given our business healthy growth, and this trend is set to go on as we continue to develop our domestic and international business.

“We look forward to celebrating with all of those who are shortlisted for the Belfast Telegraph Woman of the Year in Health Award and, on behalf of the whole community, I thank them for their commitment to the health and wellbeing of others.”

Rewarding the unsung heroines...

  • The Belfast Telegraph Woman of the Year Awards, in association with The OUTLET, Banbridge, is now recognised as the biggest celebration of women in Northern Ireland. Once again our annual awards extravaganza will culminate with a gala dinner at the Ramada Plaza Hotel in Shaw’s Bridge, Belfast, which will be staged on Thursday, March 19
  • For each category, the nominee should have been in her line of work for at least 12 months and have shown particular success, a demonstrable measure of achievement, how she inspired others around her, and how she has demonstrated passion, drive and energy in what she does
  • The closing date for nominations is noon on Thursday, February 19. If you know someone who deserves recognition, then get nominating now in one of the categories below:

1. Belfast Telegraph Woman of the Year in Education

2. Belfast Telegraph Woman of the Year in the Voluntary Sector

3. Belfast Telegraph Sportswoman of the Year

4. Belfast Telegraph Woman of the Year in Health, sponsored by Linwoods

5. Belfast Telegraph Mum of the Year, sponsored by Irwin’s

6. Belfast Telegraph Inspirational Woman of the Year

7. Belfast Telegraph Businesswoman of the Year

8. Belfast Telegraph Woman of the Year in Hair, Beauty and Fashion

9. Belfast Telegraph Woman of the Year in the Arts

10. Overall Woman of the Year, sponsored by The OUTLET

  • To nominate someone you know, tell us in 500 words or less why you think they deserve to win an award. State what award you are entering them for and include a daytime telephone for yourself. Entries can be submitted online at www.belfasttelegraph.co.uk/woty, by email to womanoftheyear@belfasttelegraph.co.uk or by post to Woman of the Year, Features Department, Belfast Telegraph, 124-144 Royal Avenue, Belfast, BT1 1EB

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