Professor Desmond O'Neill

Title

Supporting equity of older people by redefining and refining assessment of dementia inclusive design of hospital spaces

Summary

Direct and indirect discrimination is a common experience for older Irish people on the basis of cognitive impairment. A major component lies with the design and policies of healthcare facilities, as outlined in the Irish National Audit of Dementia Care (de Suin et al., 2014). With the emerging knowledge base arising from the HRB-funded Dementia-Friendly Hospital Project (completed guideline due February 2018), we have a deeper and richer understanding of the elements which contribute to dementia-inclusive design of Irish healthcare facilities. The aim of this project is to undertake a review and redesign of the audit tool used in the 2013 audit in the light of the new Irish guidelines and undertake a repeat of the environmental audit. The objectives are to 1) develop an audit tool that reflects the contemporary, collaborative and UD based nature of the new guidelines, 2) review the barriers/facilitators to key stakeholder engagement in the design process to inform the development of the new tool, 3) use assess dementia-inclusive design changes in Irish hospitals since 2013 through a 2018 audit, 4) simultaneously test new tool to refine and calibrate, 5) use findings to recommend improvements in equity of care for older Irish person with dementia and delirium.

Funding Agency

HSE

Date From

1 March 2018

Date To

31 August 2019

Title

Healthy Ageing Research Project

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

Date From

2002

Date To

2006

Title

Dementia Friendly Irish Hospitals: Opportunities, Barriers, Costs and Solutions

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

Date From

Nov 2015

Date To

Oct 2017

Title

Robotics in Stroke

Summary

€250,000

Funding Agency

Health Services Executive

Date From

2008

Date To

2009

Title

Framing Ageing: A Clinical, Cultural and Social Dialogue

Summary

Healthcare, sociology, psychology and the growing field of 'cultural gerontology' have begun to interrogate the complexity of ageing. Despite this welcome development, there is little methodological dialogue between the humanities and gerontology. This project therefore aims to explore methodological cross-pollination through two collaborative UCD/TCD-led workshops. Entitled "Framing Ageing: A Clinical, Cultural and Social Dialogue", our project recognises that society is a web of signs subject to shifting meanings and contested interpretations. This insight has far-reaching epistemological and methodological consequences: it de-essentialises the notions of biological matter, of the body and bodily change, of mind and matter, and of the 'natural' chronology from birth to death. Drawing on research expertise in the two institutions and beyond, the workshops bring together gerontologists, who deal with ageing from clinical, psychological and social perspectives, social scientists who work with quantitative data, and humanities researchers, who investigate ageing in cultural and historical perspectives, as well as art practitioners and NGOs. A key aim is to create a transdisciplinary network that liberates the field from the constraints of pathological models of ageing by exploring an entanglement between the biopsychosocial and the interpretive, the empirical and the aesthetic, the historical and the contemporary, and research and practice.

Funding Agency

Wellcome Trust

Date From

02/01/2020

Date To

31/12/2020

Title

Development of a National Dementia Registry

Summary

Funding Agency

Dormant Accounts via the Department of Health and the National Dementia Office (HSE)

Date From

2018

Date To

2019

Title

SEAN-Key: Supported Episodic Autobiographical SEAN-Key: Noesis for health older and memory impaired adults

Summary

Funding Agency

Irish Research Council

Date From

2017

Title

Music and Dance for Health: The Multidimensional Benefits of an Arts-Based Health Intervention for Older Adults

Summary

Funding Agency

HRB

Date From

2021

Date To

2023

Title

Rethinking Ageing and Memory through Interdisciplinary Research

Summary

Ageing and memory represent two extraordinarily important themes in contemporary society. A defining characteristic of ageing is complexity and increased inter-individual variability. This provides a rich field for study and reflection, and by its very complexity lends itself to interdisciplinary study and research. Responding to the challenge of interdisciplinary working has been the emergence of an innovative, exciting and purposefully interdisciplinary movement in gerontology and the arts, humanities and social sciences (AHSS). This IRC-funded workshop is being curated by TCD, the National Centre for Arts and Health, NUIG, Maynooth University and DIT GRADCAM. The choice of locations for the workshop is emblematic of our desire to uproot and challenge existing orthodoxies of thought and theory. The first day (9 May 2016) will be held in the Trinity Long Room Hub Arts and Humanities Research Institute which hosts the Medical and Health Humanities Initiative and the second day (10 May 2016) in the National Centre for Arts and Health, Tallaght Hospital which has a vibrant arts and humanities programme The workshop will a) give an overview of current theory and practice in interdisciplinary research; b) provide examples from existing funded interdisciplinary research among the workshop organizers; c) provide a platform for researchers to present current or proposed research for which they are seeking potential partners; d) focus on perceived barriers and facilitators to interdisciplinary research across AHSS/STEM/Health Sciences; and e) develop a summary report and action plan. Participants are strongly urged to read Callard and Fitzgerald's 2015 monograph on interdisciplinary research, an Open Access book The target participants are: Scholars in AHSS, Science, Engineering, Design, Health currently engaged with, or planning interdisciplinary research Research support/development officers in academic institutions Staff in funding bodies (invitations issued to IRC, HRB, SFI, Arts Council, Wellcome, charitable foundations)

Funding Agency

Irish Research Council

Date From

February 2016

Date To

June 2016

Title

Enhancing Stroke Rehabilitation with Brain Computer Interface

Summary

Collaborator with PI Dr Tomás Ward (NUIM). Funding €118,000. Stroke is a leading cause of disability world-wide. Effective rehabilitation is essential in minimising its socio-economic impact. We contend that a brain computer interface (BCI) may be used to increase rehabilitation efficacy and outcome. Specifically a motor-relearning paradigm will be augmented for those stroke survivors with no movement through provisioning of a motor cortex-driven BCI. Using real-time measures of cortical effort in the vicinity of the affected area feedback can be administered through virtual representations and/or mechanical assistance. Efficacy will be assessed in a randomised controlled trial in collaboration with a stroke rehabilitation hospital. Stroke is a leading cause of death and disability world-wide. Effective stroke rehabilitation is essential both in maximising quality of life and minimising the burden on the health care system. Efficacy of rehabilitation is assessed using outcome measures or scales. We contend that through the addition of a suitable brain computer interface (BCI) effective stroke rehabilitation therapy can be administered to stroke recovery patients thereby increasing rehabilitation outcome. An adaptation of our existing motor cortex activity driven BCI will be used in a randomised controlled trial in collaboration with a stroke rehabilitation hospital clinic.`

Funding Agency

Science Foundation Ireland

Date From

2009

Date To

2113

Title

Implementing Dementia Friendly Irish Hospital Design

Summary

PI: Hospitals can be very complex and confusing environments for people with dementia, and may add to their distress, disorientation and suffering. 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 focussing in the first year on Tallaght Hospital and subsequently to Peamount and Naas Hospitals. 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) a preliminary Ireland specific dementia friendly hospital audit tool: these will assist in making hospital environments more dementia-friendly. The research grouping of design, arts and health is unique in Ireland, and could provide international as well as national impact on dementia-friendly design.

Funding Agency

Meath Foundation

Date From

Oct 2015

Date To

Oct 2016

Title

Residential long-term care and COVID-19: the role of the built environment in balancing infection control and quality of life

Summary

Summary: COVID-19 has brought many healthcare issues into sharp focus. Key among them is the need to balance infection control with quality of life in residential long-term care settings such as nursing homes. Science Foundation Ireland is funding a new project at Trinity College Dublin to look at the impact of space, buildings, and technology on infection control and on resident and staff wellbeing in long-term care settings. By finding that evidence, the project will highlight how we can design new long-term care buildings or retrofit existing ones to improve pandemic resilience. What is the issue? Infection control is very important in residential long-term care settings, but it needs to take the staff and residents' quality of life into account. COVID-19 has highlighted how the built environment and infection control can exacerbate social isolation, loneliness and anxiety among residents and staff. What will the research project do? The research, led by Trinity College Dublin, will identify the features of the built environment that improve infection control and those that support quality of life, and where these converge or diverge. What will the impact be? By identifying the features that enable maximal infection control while retaining good quality of life for residents, the project will inform future builds and retrofits of residential long-term care buildings and will improve pandemic resilience. Professor Desmond O'Neill, PI, says: "The pandemic has pinpointed the importance of space and spatial practices such as social distancing and isolation, all of which have huge importance for the built environment in terms of planning, design and architecture: this is of particular importance for the nursing home environment, home of those at most risk for the twin COVID-19 perils of mortality and harmful social isolation."

Funding Agency

Science Foundation Ireland

Date From

14/12/2020

Date To

31/12/2020

Title

Knowledge Synthesis Grant: Medical Illness and Driving: A knowledge synthesis of the risks of harm.

Summary

Funding Agency

Ministry of Transportation of Ontario Road Safety Research Partnership Program

Date From

2016 Sept

Date To

2017 Aug

Title

Music Therapy in Stroke

Summary

A randomized controlled trial of music therapy in stroke: grant of €40,000

Funding Agency

Meath Foundation

Date From

2006

Date To

2007

Title

Cost of Stroke

Summary

A joint project involving the Irish National Audit of Stroke Care team (TCD, RCSI, ESRI, HSE) to give an estimate of the costs of stroke in Ireland: funding €100,000.

Funding Agency

Irish Heart Foundation

Date From

2009

Date To

2010

Title

A Collaborative International Knowledge Synthesis to Update Guidelines for Determining Medical Fitness to Operate Motor Vehicles

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

Date From

2015

Date To

2016

Title

Validation of the Profile for Communication Abilities in Dementia (P-CAD)

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

Date From

Nov 2015

Date To

Oct 2017

Title

Irish National Audit of Dementia Care (INAD)

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

Date From

2013

Date To

2014

Title

Artists in Hospitals

Summary

Project to develop a training course for artists working in hospitals. Grand of €25,000

Funding Agency

Arts Council

Date From

2006

Date To

2007

Title

Road safety in ageing societies - CONcerns and SOLutions (CONSOL)

Summary

Funding Agency

European Commission - Directorate for Mobility and Transport

Date From

2011

Date To

2013

Title

Elder Abuse

Summary

Overview of elder abuse in Ireland in international context. Project undertaken with Visiting Professor James G O'Brien, University of Louisville, Kentucky, USA

Funding Agency

Atlantic Philanthropies

Date From

2009

Date To

2010

Title

Irish National Stroke Audit

Summary

A €600,000 project, PI's Prof Hannah McGee (RCSI) and Desmond O'Neill (TCD), the work involves a national stroke audit of hospital and community stroke services for the Republic of Ireland. The objective of the audit of hospital based stroke services is to establish the current level and functioning of services available for the care of stroke patients in acute hospitals in the Republic of Ireland. The audit of hospital-based services will have two components: i) an Audit of the Organisational Aspects of Stroke Care in acute hospitals with regard to their resources for organised stroke care: and ii) a Clinical Audit of Stroke Care involving review of clinical case notes for a selected sample of patients with stroke.

Funding Agency

Irish Heart Foundation/Department of Health and Children

Date From

2005