Professor Desmond O'Neill

Summary

The first data is being analyzed from the first longitudinal study on ageing in Ireland, a joint research project between TCD (leader Prof Des O'Neill (1983)), RCSI and Queen's University Belfast. Funding of €800,000 has been provided by the Health Research Board, and the acronym for the study (HARP) helps to identify the country of origin! Drawing on a second cohort of older people from the Republic of Ireland, as well as a cohort from Northern Ireland, the study has great potential to help understand the process of ageing in Ireland, and in particular some of the reasons why longevity has been lagging behind that of the EU 15 states. The survey looks at not only health, social and psychological variables, but also at usage patterns and perceptions of health and social services in both systems. A sub-study of the project is the examination of psychological models of coping after stroke, which is being carried out at the Stroke Service in Tallaght Hospital, the first acute service in the Republic of Ireland. As much neurorehabilitation serves as much to facilitate adaptation as to restore function, this is a key (and under-expolored) area of research. A first study from this arm of the project won the poster prize at the National Stroke Study Day in May 2005, and further publications are in preparation.

Funding Agency

Health Research Board, Ireland

Project Type

Clinical/epidemiological

Summary

Collaboration together with Dr Sean Kennelly (TCD) and investigators from UCC (Drs Suzanne Timmons and Paul Gallagher) and support of Health Services Executive. This is the first national audit of dementia care in acute hospitals. Organisational, Casenote review,and eviornmental audit of care standards for patients with dementia when they are attend acute hospitals. Modelled on the very successful UK audit.

Funding Agency

Meath Foundation, HRB, AP

Project Type

National Audit

Person Months

12

Summary

Background. The Canadian Medical Association's (CMA) Driver's Guide is widely used by physicians across Canada to guide decision-making about assessing the impact of medical conditions and treatments on driving abilities, advising patients of the risks and reporting to transportation authorities. The CMA Driver's Guide and other similar international guidelines are limited in their currency, applicability, rigour of development, and integration of knowledge-user perspectives. Those most affected by the guidelines, healthy drivers, patients and caregivers have not provided input. Objective. The objective is to create an up-to-date knowledge synthesis and clinical guidelines on driving risks with two topics of high priority for updating: traumatic brain injury (TBI) and dementia. The knowledge synthesis will leverage skills of Canadian and international knowledge experts, and incorporate the input of clinician and transportation knowledge-users as well as drivers, patients and caregivers. Method. Recommendations from existing international guidelines on driving with TBI and dementia will be summarized and reviewed and precise questions will be refined and prioritized to shape a revised search strategy for an updated knowledge-synthesis. Data addressing the prioritized questions from the references from existing guidelines and systematic reviews as well as the updated literature search will be extracted and the quality of evidence and risk of bias will be rated by the synthesis team. Revised guidelines based on the knowledge synthesis will be developed, and clinician- and transportation- knowledge-users will provide feedback on their clarity, currency, applicability and acceptability. The values, preferences and perspectives of healthy drivers as well as individuals and caregivers with TBI and dementia regarding the revised guidelines and interpretations of risk will be ascertained. Relevance. Motor vehicle collisions are predicted to be the 3rd leading cause of disability-adjusted life years lost by 20208. Current estimates predict that within the next 20 years there will be almost 100,000 drivers with dementia in Ontario9, and 1.1 million Canadians with dementia10, many of whom will drive for years after diagnosis11. Additionally, by 2031, it is estimated that 730,000 patients will be hospitalized annually for traumatic brain injury (TBI) in Canada12, and since most individuals with TBI are not hospitalized13, this is a vast under-estimate. Driving is a risk with both of these conditions1. No recent synthesis has been done with the aim of creating quality guidelines for clinicians. A well-executed knowledge synthesis incorporating knowledge-user input will increase confidence of clinicians using the guidelines41, inform transportation policy, and provide a model for updating syntheses and Canadian and other international guidelines for other health conditions and driving. Knowledge Translation. Knowledge-users will be involved throughout the knowledge synthesis process, knowledge syntheses will be published in open-access journals, presented at international conferences, and the corresponding chapters of the CMA Driver's Guide will be updated in electronic and print format. The process refined in the present grant will be used to advocate for further internationally-developed knowledge syntheses of medical illness and driving and high quality, knowledge-user informed clinical practice guidelines.

Funding Agency

Canadian Institutes of Health Research

Programme

Knowledge Synthesis

Project Type

Knowledge Synthesis

Summary

Co-investigator on this proposal which aligns with 'Management and Decision Making' specifically 'Timely Diagnosis and intervention' and 'Person Centred Planning and Decision making'. The argument for this theme is that (1) the availability of the P-CAD will facilitate timely and interdisciplinary management of cognitive communication difficulties associated with dementia. (2) It will provide a valid and reliable tool to enable decision making through informing person centred care pathways. These care pathways will be monitored throughout the person's journey with dementia.

Funding Agency

HRB

Programme

Applied Dementia Research

Project Type

Dementia research

Summary

PI: To date, academic and pragmatic discourse on dementia-friendly design of Irish hospitals has been lacking in expertise from the perspective of design and architecture, and in particular the paradigms of inclusive/universal design. This research will examine the key issues around the design of dementia friendly hospitals in Ireland to identify key opportunities, barriers, costs and solutions. This will be conducted using mixed methods research underpinned by a user-centred design and stakeholder engagement process using three case study Irish hospitals including Tallaght, Peamount and Naas. This process will informed by a literature review and international case studies of dementia friendly hospitals to determine best practice evidence based design as implemented globally. The physical hospital environment will be analysed using spatial and physical design framework based around: Approach and Arrival; Entering, Exiting and Circulation; Key internal and external spaces; and Elements and Systems (including materials, finishes, technology, artwork etc.) The final output will result in a Dementia Friendly Design Manual and Key Findings to Underpin any Future HSE Guidelines, containing 1) guidance around stakeholder engagement or participatory design processes 2) an Ireland specific dementia friendly hospital audit tool based on the King's Trust tool

Funding Agency

HRB

Programme

Applied Dementia Research