44 results on '"Marica Cassarino"'
Search Results
2. Moving towards a multidimensional dynamic approach to nature and health: A bioavailability perspective
- Author
-
Rachel C. Sumner, Marica Cassarino, Samantha Dockray, Annalisa Setti, and Diane M. Crone
- Subjects
bioavailability model ,green space ,health ,human–nature interaction ,nature connection ,well‐being ,Human ecology. Anthropogeography ,GF1-900 ,Ecology ,QH540-549.5 - Abstract
Abstract The benefits of exposure to nature for health and well‐being have been demonstrated across multiple disciplines. Recent work has sought to establish one ‘dose’ or type of nature exposure that is universally beneficial, which has proven difficult. We use the principles of psychopharmacology to look beyond the use of dose as a concept for prescribing nature. Instead, we posit a multidimensional model of bioavailability of nature to shift the focus beyond universal effects, and instead consider the relationship between health and nature as dynamic, changeable and heavily contextual. We propose that the bioavailability of nature interactions is constructed through understanding route of administration, dose and concentration. By delineating the mechanisms of health benefit derived from the type of behavioural interaction (through being, doing and living), the route of administration of nature interactions may be highly variable not just between, but also within, individuals. We propose concentration as being a meeting between the subjective aspects of the individual and the subjective qualities of the nature at that specific time and place. We use a ‘green equation’, for mapping the processes and pathways that belie the interaction between the person and their environment. Here, the nature/health association as a dynamic interaction, and we operationalise this within a multidimensional construct of bioavailability. We provide an overview of this testable model and summarise with preliminary evidence as well as a research agenda for the future. A free Plain Language Summary can be found within the Supporting Information of this article.
- Published
- 2022
- Full Text
- View/download PDF
3. Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation.
- Author
-
Marica Cassarino, Úna Cronin, Katie Robinson, Rosie Quinn, Fiona Boland, Marie E Ward, Rosa McNamara, Margaret O'Connor, Gerard McCarthy, Damien Ryan, and Rose Galvin
- Subjects
Medicine ,Science - Abstract
BackgroundThere is encouraging evidence that interdisciplinary teams of Health and Social Care Professionals (HSCPs) can enhance patient care in the Emergency Department (ED), especially for older adults with complex needs. However, no formal process evaluations of implementations of ED-based HSCP interventions are available. The study aimed to evaluate the development and delivery of a HSCP team intervention for older adults in the ED of a large Irish teaching hospital.MethodsUsing the Medical Research Council (MRC) Framework for process evaluations, we investigated implementation and delivery, mechanisms of impact, and contextual influences on implementation by analysing the HSCP team's activity notes and participant recruitment logs, and by carrying out six interviews and four focus groups with 26 participants (HSCP team members, ED doctors and nurses, hospital staff). Qualitative insights were analysed thematically.ResultsThe implementation process had three phases (pre-implementation, piloting, and delivery), with the first two described as pivotal to optimise care procedures and build positive stakeholders' involvement. The team's motivation and proactive communication were key to promote acceptability and integration in the ED (Theme 1); also, their specialised skills and interdisciplinary approach enhanced patient and staff's ED experience (Theme 2). The investment and collaboration of multiple stakeholders were described as essential contextual enablers of implementation (Theme 4). Delivering the intervention within a randomised controlled trial fostered credibility but caused frustration among patients and staff (Theme 3).DiscussionThis process evaluation is the first to provide in-depth and practical insights on the complexities of developing and delivering an ED-based HSCP team intervention for older adults. Our findings highlight the importance of establishing a team of HSCPs with a strong interdisciplinary ethos to ensure buy-in and integration in the ED processes. Also, actively involving relevant stakeholders is key to facilitate implementation.Trial registrationClinicalTrials.gov, NCT03739515; registered on 12th November 2018.
- Published
- 2022
- Full Text
- View/download PDF
4. A randomised controlled trial exploring the impact of a dedicated health and social care professionals team in the emergency department on the quality, safety, clinical and cost-effectiveness of care for older adults: a study protocol
- Author
-
Marica Cassarino, Katie Robinson, Íde O’Shaughnessy, Eimear Smalle, Stephen White, Collette Devlin, Rosie Quinn, Dominic Trépel, Fiona Boland, Marie E. Ward, Rosa McNamara, Margaret O’Connor, Gerard McCarthy, Damien Ryan, and Rose Galvin
- Subjects
Emergency department ,Health and social care professional ,Team care ,Older patients ,Effectiveness ,Medicine (General) ,R5-920 - Abstract
Abstract Background Older people are frequent emergency department (ED) users who present with complex issues that are linked to poorer health outcomes following the index visit, often have increased ED length of stay, and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and an improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCP teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, and clinical- and cost-effectiveness of care of older adults when compared with usual care. Methods The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30 days, and 4 and 6 months of follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; cost-effectiveness in terms of costs associated with ED-based HSCP compared with usual care; and perceptions on implementation by ED staff members. Discussion This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, and clinical- and cost-effectiveness of care for older patients. The findings of this study will provide important information on the effectiveness of this model of care for future implementation. Trial registration ClinicalTrials.gov, NCT03739515. Registered on 12 November 2018.
- Published
- 2019
- Full Text
- View/download PDF
5. Impact of assessment and intervention by a health and social care professional team in the emergency department on the quality, safety, and clinical effectiveness of care for older adults: A randomised controlled trial.
- Author
-
Marica Cassarino, Katie Robinson, Dominic Trépel, Íde O'Shaughnessy, Eimear Smalle, Stephen White, Collette Devlin, Rosie Quinn, Fiona Boland, Marie E Ward, Rosa McNamara, Fiona Steed, Margaret O'Connor, Andrew O'Regan, Gerard McCarthy, Damien Ryan, and Rose Galvin
- Subjects
Medicine - Abstract
BackgroundOlder adults frequently attend the emergency department (ED) and experience high rates of adverse events following ED presentation. This randomised controlled trial evaluated the impact of early assessment and intervention by a dedicated team of health and social care professionals (HSCPs) in the ED on the quality, safety, and clinical effectiveness of care of older adults in the ED.Methods and findingsThis single-site randomised controlled trial included a sample of 353 patients aged ≥65 years (mean age = 79.6, SD = 7.01; 59.2% female) who presented with lower urgency complaints to the ED a university hospital in the Mid-West region of Ireland, during HSCP operational hours. The intervention consisted of early assessment and intervention carried out by a HSCP team comprising a senior medical social worker, senior occupational therapist, and senior physiotherapist. The primary outcome was ED length of stay. Secondary outcomes included rates of hospital admissions from the ED; hospital length of stay for admitted patients; patient satisfaction with index visit; ED revisits, mortality, nursing home admission, and unscheduled hospital admission at 30-day and 6-month follow-up; and patient functional status and quality of life (at index visit and follow-up). Demographic information included the patient's gender, age, marital status, residential status, mode of arrival to the ED, source of referral, index complaint, triage category, falls, and hospitalisation history. Participants in the intervention group (n = 176) experienced a significantly shorter ED stay than the control group (n = 177) (6.4 versus 12.1 median hours, p < 0.001). Other significant differences (intervention versus control) included lower rates of hospital admissions from the ED (19.3% versus 55.9%, p < 0.001), higher levels of satisfaction with the ED visit (p = 0.008), better function at 30-day (p = 0.01) and 6-month follow-up (p = 0.03), better mobility (p = 0.02 at 30 days), and better self-care (p = 0.03 at 30 days; p = 0.009 at 6 months). No differences at follow-up were observed in terms of ED re-presentation or hospital admission. Study limitations include the inability to blind patients or ED staff to allocation due to the nature of the intervention, and a focus on early assessment and intervention in the ED rather than care integration following discharge.ConclusionsEarly assessment and intervention by a dedicated ED-based HSCP team reduced ED length of stay and the risk of hospital admissions among older adults, as well as improving patient satisfaction. Our findings support the effectiveness of an interdisciplinary model of care for key ED outcomes.Trial registrationClinicalTrials.gov NCT03739515; registered on 12 November 2018.
- Published
- 2021
- Full Text
- View/download PDF
6. Implementing an allied health team intervention to improve the care of older adults in the emergency department: protocol for a process evaluation
- Author
-
Fiona Boland, Marica Cassarino, Rose Galvin, Úna Cronin, Katie Robinson, Rosie Quinn, Marie E Ward, Rosa MacNamara, Margaret O’Connor, Gerard McCarthy, and Damien Ryan
- Subjects
Medicine - Abstract
Introduction Health and social care professionals (HSCPs) have increasingly contributed to enhance the care of patients in emergency departments (EDs), particularly for older adults who are frequent ED attendees with significant adverse outcomes. For the first time, the effectiveness of a HSCP team intervention for older adults in the ED has been tested in a large randomised controlled trial (Clinicaltrials.gov, NCT03739515), providing an opportunity to explore the implementation process for this type of intervention. This protocol describes a process evaluation that will to investigate the implementation, delivery and impact of an HSCP team intervention in the ED.Methods and analysis Using the Medical Research Council Framework for process evaluations, we will employ a mixed-methods approach to provide a description of the process of implementation and delivery of the HSCP intervention in the ED, evaluate its fidelity, dose and reach and explore the perceptions of key staff members in relations to the mechanisms and contexts of impact at the levels of individuals, physical environment, operations, communication and the broader hospital and healthcare system.Ethics and dissemination Ethical approval for this study was received from the HSE Mid-Western Regional Hospital Research Ethics Committee (Ref: 103/18). All participants will be invited to read and sign a written consent form prior to participation. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.
- Published
- 2019
- Full Text
- View/download PDF
7. Testing Attention Restoration in a Virtual Reality Driving Simulator
- Author
-
Marica Cassarino, Marta Maisto, Ylenia Esposito, Davide Guerrero, Jason Seeho Chan, and Annalisa Setti
- Subjects
attention restoration ,driving simulator ,virtual environment ,driving behavior ,mental fatigue ,cognitive load ,Psychology ,BF1-990 - Abstract
Objectives: Attention Restoration Theory (ART) suggests that walking or being in natural settings, as opposed to urban environments, benefits cognitive skills because it is less demanding on attentional resources. However, it is unclear whether the same occurs when the person is performing a complex task such as driving, although it is proven that driving through different road environments is associated with different levels of fatigue and may engage attention differently. The present study investigated whether exposure to rural vs. urban road environments while driving would affect attentional capacity in young people after the drive, in line with the classic ART paradigms.Methods: We asked 38 young participants to complete the Sustained Attention to Response Task (SART) before and after being exposed to a rural or urban road in a virtual reality environment while driving in a full vehicle immersive driving simulator. Changes in SART performance based on environmental exposure where explored in terms of target sensitivity, accuracy, reaction times, and inverse efficiency. We analyzed potential road type effects on driving speed and accuracy. Possible effects of driving on attention were tested by comparing the sample performance to that of a control group of 15 participants who did not drive and sat on the passenger seat instead.Results: Exposure to rural or urban road environments in the driving sample was not associated with any significant changes in attentional performance. The two exposure groups did not differ significantly in terms of driving behavior. Comparisons between the driving sample and the control group controlling for age indicated that participants who drove were more accurate but slower at the SART than those who were passengers.Conclusion: The present study does not support the hypothesis that a short drive in a natural setting may promote attention restoration as compared to an urban setting. Methodological considerations as well as recommendations for future research are discussed.
- Published
- 2019
- Full Text
- View/download PDF
8. Virtual Reality Nature Exposure and Test Anxiety
- Author
-
Alison O’Meara, Marica Cassarino, Aaron Bolger, and Annalisa Setti
- Subjects
green environments ,exam anxiety ,virtual reality ,academic performance ,Technology ,Science - Abstract
The number of students affected by exam anxiety continues to rise. Therefore, it is becoming progressively relevant to explore innovative remediation strategies that will help mitigate the debilitating effects of exam anxiety. The study aimed to investigate whether green environment exposure, delivered by virtual reality (VR) technology, would serve as an effective intervention to mitigate participants’ test anxiety and therefore improve the experience of the exam, measured by positive and negative affect, and increase test scores in a pseudo exam. Twenty high and twenty low exam anxiety students completed a pseudo exam before and after being exposed to either a simulated green environment or urban environment. Only those who had high anxiety and were exposed to the nature VR intervention had significant reductions in negative affect (F(1, 31) = 5.86, p = 0.02, ηp2 = 0.15), supporting the idea that exposure to nature, even if simulated, may benefit students’ feelings about their academic performance. The findings are discussed in light of future developments in nature and educational research.
- Published
- 2020
- Full Text
- View/download PDF
9. Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review.
- Author
-
Marica Cassarino, Katie Robinson, Rosie Quinn, Breda Naddy, Andrew O'Regan, Damien Ryan, Fiona Boland, Marie E Ward, Rosa McNamara, Margaret O'Connor, Gerard McCarthy, and Rose Galvin
- Subjects
Medicine ,Science - Abstract
BackgroundDedicated Health and Social Care Professional (HSCP) teams have been proposed for emergency departments (EDs) in an effort to improve patient and process outcomes. This systematic review synthesises the totality of evidence relating to the impact of early assessment and intervention by HSCP teams on quality, safety and effectiveness of care in the ED.MethodsA systematic literature search was conducted in April 2019 to identify experimental studies examining the effectiveness of ED-based HSCP teams providing services to adults aged ≥ 18 years old and including two or more of the following disciplines: occupational therapist, physiotherapist, medical social worker, clinical pharmacist, or speech and language therapist. Data extraction and quality appraisal of each study were conducted independently by two reviewers.ResultsSix studies were included in the review (n = 273,886), all describing interdisciplinary Care Coordination Teams (CCTs) caring for adults aged ≥ 65 years old. CCT care was associated with on average 2% reduced rates of hospital admissions (three studies), improved referrals to community services for falls (one study), increased satisfaction (two studies) with the safety of discharge (patients and staff), and with the distribution of workload (staff), improved health-related quality of care (one study). No statistically significant differences between intervention and control groups emerged in terms of rates of ED re-visits, ranging between 0.2% and 3% (two studies); hospital length of stay (one hour difference noted in one study) or mortality rates (0.5% difference in one study). Increased rates of unplanned hospitalisations following the intervention (13.9% difference) were reported in one study. The methodological quality of the studies was mixed.DiscussionWe found limited and heterogeneous evidence on the impact of HSCP teams in the ED, suggesting a reduction in hospital admissions as well as improved patient and staff satisfaction. More robust investigations including cost-effectiveness evaluations are needed.
- Published
- 2019
- Full Text
- View/download PDF
10. Complexity as Key to Designing Cognitive-Friendly Environments for Older People.
- Author
-
Marica Cassarino and Annalisa Setti
- Subjects
Aging ,Cognition ,usability ,perceptual load ,environmental preference ,Environmental complexity ,Psychology ,BF1-990 - Abstract
The lived environment is the arena where our cognitive skills, preferences and attitudes come together to determine our ability to interact with the world. The mechanisms through which lived environments can benefit cognitive health in older age are yet to be fully understood. The existing literature suggests that environments which are perceived as stimulating, usable and aesthetically appealing can improve or facilitate cognitive performance both in young and older age. Importantly, optimal stimulation for cognition seems to depend on experiencing sufficiently stimulating environments while not too challenging. Environmental complexity is an important contributor to determining whether an environment provides such an optimal stimulation.The present paper reviews a selection of studies which have explored complexity in relation to perceptual load, environmental preference and perceived usability to propose a framework which explores direct and indirect environmental influences on cognition, and to understand these influences in relation to aging processes. We identify ways to define complexity at different environmental scales, going from micro low-level perceptual features of scenes, to design qualities of proximal environments (e.g.: streets, neighborhoods), to broad geographical areas (i.e.: natural vs. urban environments).We propose that studying complexity at these different scales will provide new insight into the design of cognitive-friendly environments.
- Published
- 2016
- Full Text
- View/download PDF
11. Phone-based virtual exploration of green space increases positive affect in students with test anxiety: a pre-post experimental study with qualitative insights.
- Author
-
Alison O'Meara, Tadgh Connery, Jason Chan, Cleidi Hearn, Marica Cassarino, and Annalisa Setti
- Published
- 2024
- Full Text
- View/download PDF
12. Introducing forecast-based public health warnings to promote engagement with air quality risk: a survey of citizens’ attitudes in Cork, Ireland
- Author
-
Gregory Gorman, Stig Hellebust, Dean Venables, Kevin Ryan, and Marica Cassarino
- Subjects
Strategy and Management ,General Engineering ,General Social Sciences ,Safety, Risk, Reliability and Quality - Published
- 2023
- Full Text
- View/download PDF
13. Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation
- Author
-
Marica Cassarino, Úna Cronin, Katie Robinson, Rosie Quinn, Fiona Boland, Marie E. Ward, Rosa McNamara, Margaret O’Connor, Gerard McCarthy, Damien Ryan, and Rose Galvin
- Subjects
Patient Care Team ,Personnel, Hospital ,Multidisciplinary ,42 Health sciences ,emergency department ,Process Assessment, Health Care ,Humans ,Health sciences ,Focus Groups ,FOS: Health sciences ,Emergency Service, Hospital ,allied health ,Aged - Abstract
Background There is encouraging evidence that interdisciplinary teams of Health and Social Care Professionals (HSCPs) can enhance patient care in the Emergency Department (ED), especially for older adults with complex needs. However, no formal process evaluations of implementations of ED-based HSCP interventions are available. The study aimed to evaluate the development and delivery of a HSCP team intervention for older adults in the ED of a large Irish teaching hospital. Methods Using the Medical Research Council (MRC) Framework for process evaluations, we investigated implementation and delivery, mechanisms of impact, and contextual influences on implementation by analysing the HSCP team’s activity notes and participant recruitment logs, and by carrying out six interviews and four focus groups with 26 participants (HSCP team members, ED doctors and nurses, hospital staff). Qualitative insights were analysed thematically. Results The implementation process had three phases (pre-implementation, piloting, and delivery), with the first two described as pivotal to optimise care procedures and build positive stakeholders’ involvement. The team’s motivation and proactive communication were key to promote acceptability and integration in the ED (Theme 1); also, their specialised skills and interdisciplinary approach enhanced patient and staff’s ED experience (Theme 2). The investment and collaboration of multiple stakeholders were described as essential contextual enablers of implementation (Theme 4). Delivering the intervention within a randomised controlled trial fostered credibility but caused frustration among patients and staff (Theme 3). Discussion This process evaluation is the first to provide in-depth and practical insights on the complexities of developing and delivering an ED-based HSCP team intervention for older adults. Our findings highlight the importance of establishing a team of HSCPs with a strong interdisciplinary ethos to ensure buy-in and integration in the ED processes. Also, actively involving relevant stakeholders is key to facilitate implementation. Trial registration ClinicalTrials.gov, NCT03739515; registered on 12th November 2018.
- Published
- 2023
- Full Text
- View/download PDF
14. Employees’ Experiences of Changes in their Work Commute during the COVID-19 Pandemic: A survey study in Ireland
- Author
-
Colm Scully and Marica Cassarino
- Abstract
Background: Commuting is an important part of the daily lives of most employees, with evidence that it can influence work quality, wellbeing, and health. The restrictions imposed during the COVID-19 pandemic forced many employees to work from home, with disruptions to typical commuting patterns. Aims: In this unprecedented situation, the present study aimed to explore whether changes in work commute were associated with variations in employee’s experiences in IrelandMethods: A sample of 112 Irish adults in employment completed an online cross-sectional survey. Responses were analysed using quantitative correlational analysis and content analysis. Results: We found that changing commuting patterns had no significant associations with employee’s self-rated productivity, mood, stress, ability to focus, or physical health, but individuals who were asked to alternate working from home and commuting to work were the least satisfied with their commuting circumstances. However, satisfaction did not mediate the association between changes in commute and work-related outcomes. Qualitative responses revealed that employees had developed new habits and routines in response to changes to their usual commuting pattern. Conclusions: We discuss the implications of our findings, drawing on evidence from literature and trends around commuting, telecommuting, and working during the COVID-19 pandemic.
- Published
- 2022
- Full Text
- View/download PDF
15. Factors influencing the effectiveness of nature–based Interventions (NBIs) aimed at improving mental health and wellbeing: Protocol of an umbrella review
- Author
-
Topaz Shrestha, Cheryl Voon Yi Chi, Marica Cassarino, Sarah Foley, and Zelda Di Blasi
- Abstract
Several systematic reviews support the use of nature–based interventions (NBIs) as a mechanism of enhancing mental health and wellbeing. However, the available evidence for the effectiveness of these interventions is fragmentary and mixed. The heterogeneity of existing evidence and significant fragmentation of knowledge within the field make it difficult to draw firm conclusions regarding the effectiveness of NBIs. The aim of this mixed method umbrella review is to synthesise evidence on the effectiveness of nature–based interventions through a summative review of existing published systematic reviews and meta-analyses. A systematic search in PsycINFO, PubMed, Greenfile, Web of Science, Embase, Scopus, Academic Search Complete (EBSCO), Environment Complete (EBSCO), Cochrane Library, CINAHL, Health Policy Reference Center and Google Scholar will be performed from inception to May 2022. The search strategy will aim to find published systematic reviews of nature–based interventions (NBIs) where improving health and wellbeing is an explicit goal. This is a mixed method review and systematic reviews with both quantitative and qualitative data synthesis will be considered. Two authors will independently perform the literature search, record screening, data extraction, and quality assessment of each included systematic review and meta-analysis. The individual qualitative and quantitative syntheses will be conducted in parallel and then combined in an overarching narrative synthesis. The quantitative evidence will be used to assess the strength and direction of effect of nature–based interventions on mental health and wellbeing outcomes. Evidence drawn from qualitative studies will be analysed and synthesised to understand the various pathways to engagement, process of involvement and experiential factors which may mediate experiences. The risk of bias of the systematic reviews will be assessed using a 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist. This review is registered on PROSPERO (CRD42022329179).
- Published
- 2022
- Full Text
- View/download PDF
16. Urban and rural environments differentially shape multisensory perception in ageing
- Author
-
Fiona N. Newell, Annalisa Setti, Rose Anne Kenny, Marica Cassarino, and Rebecca J. Hirst
- Subjects
Aging ,media_common.quotation_subject ,Illusion ,Experimental and Cognitive Psychology ,Cognition ,Social engagement ,Affect (psychology) ,Illusions ,Developmental psychology ,Psychiatry and Mental health ,Neuropsychology and Physiological Psychology ,Acoustic Stimulation ,Ageing ,Perception ,Urbanity ,Auditory Perception ,Visual Perception ,Humans ,Residence ,Geriatrics and Gerontology ,Psychology ,Photic Stimulation ,Aged ,media_common - Abstract
Recent studies suggest that the lived environment can affect cognition across the lifespan. We examined, in a large cohort of older adults (n = 3447), whether susceptibility to a multisensory illusion, the Sound-Induced Flash Illusion (SIFI), was influenced by the reported urbanity of current and childhood (at age 14 years) residence. If urban environments help to shape healthy perceptual function, we predicted reduced SIFI susceptibility in urban dwellers. Participants reporting urban, compared with rural, childhood residence were less susceptible to SIFI at longer Stimulus-Onset Asynchronies (SOAs). Those currently residing in urban environments were more susceptible to SIFI at longer SOAs, particularly if they scored low on general cognitive function. These findings held even when controlling for a several covariates, such as age, sex, education, social participation and cognitive ability. Exposure to urban environments in childhood may influence individual differences in perception and offer a multisensory perceptual benefit in older age.
- Published
- 2021
- Full Text
- View/download PDF
17. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis
- Author
-
Marica Cassarino, Claire Brookes, Susan D. Shenkin, Zoë Tieges, Damien Ryan, Alasdair M.J. MacLullich, Terence J. Quinn, Atul Anand, George E. Taffet, Rose Galvin, Thomas Saller, Kathryn Agarwal, Rakesh C. Arora, Yue Chang, and Margaret O'Connor
- Subjects
Aging ,medicine.medical_specialty ,MEDLINE ,PsycINFO ,CINAHL ,Sensitivity and Specificity ,AcademicSubjects/MED00280 ,03 medical and health sciences ,delirium ,0302 clinical medicine ,systematic review ,screening tool ,medicine ,Humans ,Mass Screening ,4AT ,030212 general & internal medicine ,Geriatric Assessment ,Stroke ,Aged ,Geriatrics ,business.industry ,Delirium ,General Medicine ,Emergency department ,medicine.disease ,older patients ,Meta-analysis ,Emergency medicine ,Systematic Review ,Geriatrics and Gerontology ,medicine.symptom ,Emergency Service, Hospital ,business ,030217 neurology & neurosurgery ,dementia - Abstract
Objective Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short ( Methods We searched MEDLINE, EMBASE, PsycINFO, CINAHL, clinicaltrials.gov and the Cochrane Central Register of Controlled Trials, from 2011 (year of 4AT release on the website www.the4AT.com) until 21 December 2019. Inclusion criteria were: older adults (≥65 years); diagnostic accuracy study of the 4AT index test when compared to delirium reference standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model. Results Seventeen studies (3,702 observations) were included. Settings were acute medicine, surgery, a care home and the emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2% (95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity was 0.88 (95% CI 0.82–0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77–0.92) and the pooled specificity was 0.89 (95% CI 0.83–0.93). The methodological quality of studies varied but was moderate to good overall. Conclusions The 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support its use in routine clinical practice in delirium detection. PROSPERO Registration number CRD42019133702.
- Published
- 2020
- Full Text
- View/download PDF
18. A qualitative exploration of the psychological impact of COVID-19 lockdown measures on Irish university students
- Author
-
Abigale Owens and Marica Cassarino
- Abstract
The outbreak of coronavirus disease 19 (COVID-19) has caused significant mentalhealth challenges across various populations but the psychological impact on universitystudents, who represent a population particularly vulnerable to psychological distress, are yet to be understood. Using a socio-ecological lens, this qualitative research used onlineinterviews to explore university students’ experience of COVID-19 lockdown and thepsychological impact of these measures. Coping strategies used by students to deal with these circumstances were also identified. Semi-structured interviews were conducted with 15 Irish students during the third wave of COVID-19 (January 2021) and the strictest lockdown measures. Thematic analysis identified three themes which highlighted how students were ‘negotiating change’ (theme 1), both in terms of lifestyle, academic life and social interactions. As a result of these major shifts in lifestyle, many experienced ‘feelings of loss’ (theme 2) at an intrapersonal, interpersonal and organisational level. Despite these challenging experiences of change and loss, participants also reflected on the positive aspects of lockdown, such as personal growth and improved social and family relationships (theme 3). Close relationships, goal setting, and self-care were identified as key coping strategies. These findings expands existing research on the psychological impact of the COVID-19 pandemic and highlighted the important role of third level institutions in promoting students’ self-efficacy and personal development along with academic achievement.
- Published
- 2022
- Full Text
- View/download PDF
19. Older Women’s Experiences of a Community-Led Walking Programme Using Activity Trackers
- Author
-
Amy Mason, Jessica O’Brien, Marica Cassarino, Jason S. Chan, and Annalisa Setti
- Subjects
Gerontology ,medicine.medical_specialty ,Behaviour change ,Health, Toxicology and Mutagenesis ,education ,Physical activity ,physical activity ,Fitness Trackers ,Walking ,Social dimension ,Article ,user perspectives ,Phone ,medicine ,Humans ,Exercise ,older adults ,Qualitative Research ,Aged ,Motivation ,Public health ,Activity tracker ,Public Health, Environmental and Occupational Health ,technology ,Medicine ,Female ,Thematic analysis ,Psychology ,Qualitative research - Abstract
Promoting physical activity amongst older adults represents a major public health goal and community-led exercise programmes present benefits in promoting active lifestyles. Commercial activity trackers potentially encourage positive behaviour change with respect to physical exercise. This qualitative study investigated the experiences and attitudes of older adults following a 6-week community-led walking programme utilising activity trackers. Eleven community-dwelling older women aged 60+ completed individual phone interviews following their involvement in the programme. The programme, codesigned with a group of senior citizens, equipped participants with wrist-worn activity trackers and included biweekly check-in sessions with a researcher to monitor progress and support motivation. Interviews explored participants’ experiences of the programme and of using activity trackers for the purpose of becoming more active. A thematic analysis produced three main themes: ‘programme as a source of motivation’, ‘user experiences with the technology’ and ‘views on social dimension of the programme’. Overall, participants highlighted the self-monitoring function of activity trackers as most beneficial for their exercise levels. This study provides insights into the personal and social factors perceived by older adults in relation to being part of a community-led programme using activity trackers. It highlights the role of the programme and trackers in maintaining motivation to stay active.
- Published
- 2021
20. 106 Optimising Early Assessment and Intervention by Health and Social Care Professions in the ED: Preliminary Findings from the OPTIMEND RCT
- Author
-
Stephan White, Marica Cassarino, Damien Ryan, Boland Fiona, Rosa McNamara, Íde O’Shaughnessy, Katie Robinson, Marie Ward, Gerard McCarthy, Rosie Quinn, Margaret O'Connor, Eimear Smalle, and Rose Galvin
- Subjects
Aging ,Patient care team ,Social work ,Cost effectiveness ,business.industry ,General Medicine ,Cost-effectiveness analysis ,law.invention ,Quality of life (healthcare) ,Nursing ,Randomized controlled trial ,law ,Intervention (counseling) ,Medicine ,Social care ,Geriatrics and Gerontology ,business - Abstract
Background Older adults are frequent users of emergency services and demonstrate high rates of adverse outcomes following emergency care. There is some evidence to suggest that Health and Social Care Professions (HSCP) teams working in the emergency department (ED) can enhance the care of older adults but the quality of these studies is mixed. This randomised controlled trial (Trial registration: NCT03739515) explores the impact of early assessment and intervention by an ED-based HSCP team on the quality, safety and cost-effectiveness of care of older adults. Methods Consecutive ED attendees aged ≥65 years were considered eligible for inclusion to the trial and were screened for eligibility based on pre-defined inclusion criteria. Participants were randomised to either early assessment/intervention by interdisciplinary team comprising a senior occupational therapist, senior physiotherapist and senior medical social worker or usual care. Primary outcomes included: ED length of stay and hospital admission rates. Secondary outcomes included: patient satisfaction, function, quality of life, incidence of ED re-visits, hospital admissions, nursing home admission, healthcare utilisation and mortality at 30-day and 6-month follow-up Results Considering the first 140 participants, the intervention group spent significantly shorter time in the ED than the control group (7.5 vs. 15.2 median hours, p Conclusion Preliminary findings from our trial indicates that HSCPs working in the ED can contribute to improved older patients’ care by reducing their duration of stay in the ED and increasing rates of discharge home. Participant recruitment and six month follow-up is continuing.
- Published
- 2019
- Full Text
- View/download PDF
21. 138 The Role of Health and Social Care Professional Teams in the Emergency Department: A Qualitative Study of Key Stakeholders’ Views
- Author
-
Rosa McNamara, Marie Ward, Marica Cassarino, Gerard McCarthy, Rose Galvin, Katie Robinson, Rosie Quinn, Fiona Boland, Damien Ryan, and Margaret O'Connor
- Subjects
Aging ,Nursing ,business.industry ,Key (cryptography) ,Medicine ,Social care ,Frail elderly ,General Medicine ,Emergency department ,Geriatrics and Gerontology ,Quality of care ,business ,Qualitative research - Abstract
Background Introducing Health and Social Care Professional (HSCP) teams to the emergency department (ED) has increasingly demonstrated benefits for ED patient and process outcomes. However, there is a dearth of research exploring the views of key ED stakeholders on the role of HSCP teams in care delivery the ED. This qualitative study investigated the perspectives of a wide range of ED stakeholders about HSCPs teams working in the ED. Methods A total of 65 participants including older adults who had recently attended the ED and their carers/relatives, ED doctors and nurses, HSCPs and pre-hospital staff participated in four World Café style focus groups and individual interviews across two Irish hospital sites. Written and audio-recorded data were transcribed and thematically analysed. Results Overall, participants expressed positive views on HSCPs working in teams in the ED, with benefits for patients, staff members and the hospital (Theme 1). Having an ED-based HSCP team was described as promoting effective and timely decision-making and a more integrated approach to patient care, particularly for frail older adults with complex needs (Theme 2). Barriers and enablers for effective implementation were identified at multiple levels (Theme 3) including the ED physical environment, (e.g., space and equipment), operational factors (e.g., working hours), and relations (e.g., patient-staff or staff-staff communication); factors at system level included availability of community resources and financial pressures. Conclusion Our study indicates overall acceptability of HSCPs working in teams in the ED and positive views on their contribution to enhance the quality care of older adults. However, a number of operational and relational factors need to be considered to ensure feasibility and effectiveness. This information is crucial to inform implementation.
- Published
- 2019
- Full Text
- View/download PDF
22. Understanding the Experiences of COVID-19 Spatial and Social Restrictions Among Young People with Physical Disabilities
- Author
-
Marica Cassarino and Atkins R
- Subjects
Coronavirus disease 2019 (COVID-19) ,business.industry ,Internet privacy ,business ,Psychology - Abstract
Background: The COVID-19 pandemic has caused significant social and spatial restrictions. While everyone has felt the impacts of this health crisis, limited evidence is available about the experiences of young individuals with physical disabilities; this group faces many challenges due to the pandemic restrictions, including increased vulnerability, inaccessibility of essential services and increased spatial inequalities within the environment. Aims: This study aimed to gain an insight into the experiences of spatial and social restrictions for young people with disabilities, with a look at understanding the potential impact on wellbeing.Methods and Procedures: In this qualitative study, semi-structured online interviews were completed with a convenience sample of eight people aged between 18-25, with one or more physical disabilities. The interview investigated day-to-day spatial and social activities during the lockdown. A short questionnaire collected demographic and health information. Data was analysed using thematic analysis.Results: The participants’ responses generated three core themes: 1) Adapting to a new way of life; 2) Dealing with a sense of uncertainty and isolation; 3) Widening the gap of inequality. Within these themes, participants’ narratives centred around the negative impact of restrictions on socialisation, the emotional toll of virus-related fear and stress, and the increased inequality of guidance and inaccessibility of amenities; participants also described initiating new routines as a coping strategy and the changes to work/college life. Conclusions and Implications: These findings highlight how the pandemic has exacerbated spatial and social inequalities for young people with disabilities, and has had a resulting impact on their overall well-being. Therefore, this points at the importance of promoting equal access and personhood among vulnerable groups.
- Published
- 2021
- Full Text
- View/download PDF
23. Envisioning Happy Places for All: A Systematic Review of the Impact of Transformations in the Urban Environment on the Wellbeing of Vulnerable Groups
- Author
-
Marica Cassarino, Sina Shahab, S Biscaya, De Paola, P, and Holden, M
- Subjects
Gerontology ,Geography, Planning and Development ,0211 other engineering and technologies ,Psychological intervention ,TJ807-830 ,02 engineering and technology ,Management, Monitoring, Policy and Law ,TD194-195 ,Renewable energy sources ,03 medical and health sciences ,0302 clinical medicine ,wellbeing ,vulnerable groups ,Urban planning ,Sustainable design ,GE1-350 ,030212 general & internal medicine ,Sustainable living ,equitable urban design ,Environmental effects of industries and plants ,Renewable Energy, Sustainability and the Environment ,Urban design ,021107 urban & regional planning ,transformative urban development ,Mental health ,Environmental sciences ,urban intervention ,Systematic review ,Qualitative research - Abstract
Urban planning and design can impact mental health, but it is unclear how ever-growing and changing cities can sustain the psychological wellbeing of vulnerable groups, who are among the most mentally sensitive to spatial inequalities. This systematic review synthesised quantitative and qualitative studies on urban design interventions and their impact on wellbeing in vulnerable groups. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched five online databases from inception to May 2020. A total of 10 papers were included. We found mixed evidence of benefits for wellbeing linked to urban regeneration projects or focused interventions (green spaces, transport, security). Interventions that were centred around participation, sustainable living, and quality of design (e.g., perceived sense of safety) were associated with increased residential satisfaction and wellbeing, particularly among low-income communities and women. Risk of bias was low to medium, but there was high methodological heterogeneity; studies were mainly from Western countries, and none of the included studies investigated the experiences of people with disabilities, migrants, or racial minorities. This review highlights the importance of inclusive and sustainable design interventions to create happy places for all strata of society, although further investigation is warranted.
- Published
- 2021
24. Impact of assessment and intervention by a health and social care professional team in the emergency department on the quality, safety, and clinical effectiveness of care for older adults: A randomised controlled trial
- Author
-
Andrew O’Regan, Eimear Smalle, Fiona Steed, Rose Galvin, Marica Cassarino, Dominic Trépel, Damien Ryan, Fiona Boland, Collette Devlin, Rosie Quinn, Rosa McNamara, Stephen White, Margaret O'Connor, Gerard McCarthy, Katie Robinson, Íde O’Shaughnessy, and Marie Ward
- Subjects
Male ,Critical Care and Emergency Medicine ,Health Services for the Aged ,law.invention ,0302 clinical medicine ,Patient Admission ,Elderly ,Randomized controlled trial ,Quality of life ,law ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Aged, 80 and over ,030503 health policy & services ,General Medicine ,Hospitals ,Treatment Outcome ,Patient Satisfaction ,Marital status ,Female ,0305 other medical science ,Emergency Service, Hospital ,Research Article ,medicine.medical_specialty ,Drug Research and Development ,Referral ,Patients ,Health Personnel ,Research and Analysis Methods ,03 medical and health sciences ,Patient satisfaction ,Intervention (counseling) ,Early Medical Intervention ,Humans ,Adults ,Clinical Trials ,Aged ,Patient Care Team ,Pharmacology ,business.industry ,Social Support ,Emergency department ,Length of Stay ,Triage ,Randomized Controlled Trials ,Nursing Homes ,Health Care ,Health Care Facilities ,Age Groups ,Emergency medicine ,People and Places ,Quality of Life ,Population Groupings ,Clinical Medicine ,business - Abstract
Background Older adults frequently attend the emergency department (ED) and experience high rates of adverse events following ED presentation. This randomised controlled trial evaluated the impact of early assessment and intervention by a dedicated team of health and social care professionals (HSCPs) in the ED on the quality, safety, and clinical effectiveness of care of older adults in the ED. Methods and findings This single-site randomised controlled trial included a sample of 353 patients aged ≥65 years (mean age = 79.6, SD = 7.01; 59.2% female) who presented with lower urgency complaints to the ED a university hospital in the Mid-West region of Ireland, during HSCP operational hours. The intervention consisted of early assessment and intervention carried out by a HSCP team comprising a senior medical social worker, senior occupational therapist, and senior physiotherapist. The primary outcome was ED length of stay. Secondary outcomes included rates of hospital admissions from the ED; hospital length of stay for admitted patients; patient satisfaction with index visit; ED revisits, mortality, nursing home admission, and unscheduled hospital admission at 30-day and 6-month follow-up; and patient functional status and quality of life (at index visit and follow-up). Demographic information included the patient’s gender, age, marital status, residential status, mode of arrival to the ED, source of referral, index complaint, triage category, falls, and hospitalisation history. Participants in the intervention group (n = 176) experienced a significantly shorter ED stay than the control group (n = 177) (6.4 versus 12.1 median hours, p < 0.001). Other significant differences (intervention versus control) included lower rates of hospital admissions from the ED (19.3% versus 55.9%, p < 0.001), higher levels of satisfaction with the ED visit (p = 0.008), better function at 30-day (p = 0.01) and 6-month follow-up (p = 0.03), better mobility (p = 0.02 at 30 days), and better self-care (p = 0.03 at 30 days; p = 0.009 at 6 months). No differences at follow-up were observed in terms of ED re-presentation or hospital admission. Study limitations include the inability to blind patients or ED staff to allocation due to the nature of the intervention, and a focus on early assessment and intervention in the ED rather than care integration following discharge. Conclusions Early assessment and intervention by a dedicated ED-based HSCP team reduced ED length of stay and the risk of hospital admissions among older adults, as well as improving patient satisfaction. Our findings support the effectiveness of an interdisciplinary model of care for key ED outcomes. Trial registration ClinicalTrials.gov NCT03739515; registered on 12 November 2018., Marica Cassarino and colleagues evaluate an intervention for early assessment of older patients in emergency care., Author summary Why was the study done? Some studies suggest that older patients presenting to the emergency department (ED) could benefit from receiving early assessment and intervention by a dedicated health and social care professional (HSCP) team, particularly in terms of safer discharges and increased patient and staff satisfaction. To date, no methodologically robust studies exist that have tested the effectiveness of this interdisciplinary model of ED care for older adults. In this randomised controlled trial, we evaluated the impact of an ED-based HSCP team dedicated to older patients on ED length of stay, incidence of hospital admissions, and other measures of quality and safety of care. What did the researchers do and find? Compared to those receiving usual ED care, patients who were treated by the HSCP team spent less time in the ED, had lower rates of hospital admission, and were satisfied with their care, as well as reporting better function at follow-up. We observed no differences in the numbers of patients re-presenting to the ED at 30 days or 6 months. What do these findings mean? Having a dedicated HSCP team that provide early assessment and intervention to older people with lower urgency conditions can improve quality and timeliness of ED care. Further research is needed to understand whether these benefits can extend to other patient populations, as well as clarifying implications for integration of care post-discharge from the ED.
- Published
- 2020
25. Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels
- Author
-
Marica Cassarino, Eleanor Bantry-White, and Annalisa Setti
- Subjects
urbanity ,Geography, Planning and Development ,Psychological intervention ,TJ807-830 ,Management, Monitoring, Policy and Law ,TD194-195 ,Social preferences ,Renewable energy sources ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Urbanity ,GE1-350 ,030212 general & internal medicine ,Neighbourhood (mathematics) ,neighbourhood environment ,Cognitive vulnerability ,Environmental effects of industries and plants ,Renewable Energy, Sustainability and the Environment ,Stressor ,cognitive vulnerability ,Cognition ,Environmental sciences ,Residence ,Psychology ,030217 neurology & neurosurgery ,lifespan - Abstract
Background: Understanding the impact of local communities on wellbeing is a paramount Sustainable Development Goal. In order to inform people-centred planning interventions, it is important to understand what demographic groups need supportive communities the most and where. This study explored associations between perceived neighbourhood characteristics and cognitive vulnerability, and the moderating role of age and urbanity of the place of residence. Methods: A convenience sample of 224 Irish adults completed a survey assessing cognitive vulnerability and perceptions of neighbourhood qualities, together with sociodemographic and residential information. Correlational analyses explored bivariate associations as well as moderating effects. A subsample (n = 142) provided qualitative accounts of their preferences of neighbourhood characteristics. Results: Regression analyses showed that controlling for sociodemographic factors, higher self-reported neighbourhood pleasantness was associated with lower cognitive vulnerability, particularly in older adults who lived in the most rural and urban areas (p = 0.006). Qualitative accounts suggested urban&ndash, rural variations in perceived accessibility and perceptual stressors, and age-related variations in social preferences. Conclusions: Our findings indicate a complex association between neighbourhood characteristics and cognitive wellbeing, highlighting the potential benefits of neighbourhood pleasantness for cognition particularly for older people in very rural or very urbanised places. Implications for research and environmental interventions are discussed.
- Published
- 2020
- Full Text
- View/download PDF
26. Diagnostic accuracy of the 4AT for delirium detection: systematic review and meta-analysis
- Author
-
Atul Anand, Thomas Saller, Rakesh C. Arora, Marica Cassarino, Susan D. Shenkin, Alasdair M.J. MacLullich, Damien Ryan, Zoë Tieges, Rose Galvin, Yue Chang, George E. Taffet, Margaret O'Connor, Kathryn Agarwal, Terence J. Quinn, and Claire Brookes
- Subjects
medicine.medical_specialty ,business.industry ,MEDLINE ,Emergency department ,PsycINFO ,CINAHL ,Random effects model ,medicine.disease ,Meta-analysis ,Emergency medicine ,Medicine ,Delirium ,medicine.symptom ,business ,Stroke - Abstract
ObjectiveDetection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short (MethodsWe searched MEDLINE, EMBASE, PsycINFO, CINAHL,clinicaltrials.govand the Cochrane Central Register of Controlled Trials, from 2011 (year of 4AT release on the websitewww.the4AT.com) until 21 December 2019. Inclusion criteria were: older adults (≥ 65y); diagnostic accuracy study of the 4AT index test when compared to delirium reference standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model.Results17 studies (3702 observations) were included. Settings were acute medicine, surgery, a care home, and the emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2% (95% CI 17.8-32.1%; range 10.5-61.9%). The pooled sensitivity was 0.88 (95% CI 0.80-0.93) and the pooled specificity was 0.88 (95% CI 0.82-0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77-0.92) and the pooled specificity was 0.89 (95% CI 0.83-0.93). The methodological quality of studies varied but was moderate to good overall.ConclusionsThe 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support its use in routine clinical practice in delirium detection.PROSPERO Registration number CRD42019133702.Key pointsThe 4AT is a short delirium assessment tool that is widely used internationally in clinical practice.This systematic review and meta-analysis of diagnostic accuracy studies of the 4AT included 3702 observations in 17 studies from nine countries.Studies recruited from a range of settings including the Emergency Department, and medical, stroke, and surgical wards.The 4AT had a pooled sensitivity of 0.88 and pooled specificity of 0.88.The methodological quality of studies varied but was moderate to good overall.
- Published
- 2020
- Full Text
- View/download PDF
27. Moving towards a multidimensional dynamic approach to nature and health: A bioavailability perspective. Theoretical paper with full literature review
- Author
-
Rachel Clair Sumner, Marica Cassarino, Annalisa Setti, Samantha Dockray, and Diane CRONE Prof
- Abstract
The benefits of exposure to nature for health and wellbeing have been demonstrated across multiple disciplines. Recent work has sought to establish one “dose” or type of nature exposure that is universally beneficial, which has proven difficult. We use the principles of psychopharmacology to look beyond the use of dose as a concept for prescribing nature. Instead, we posit a multidimensional model of bioavailability of nature to shift the focus beyond universal effects, and instead consider the relationship between health and nature as dynamic, changeable, and heavily contextual. We propose that the bioavailability of nature interactions is constructed through understanding route of administration, dose, and concentration. By delineating the mechanisms of health benefit derived from the type of behavioural interaction (through being, doing, living), the route of administration of nature interactions may be highly variable not just between, but also within, individuals. We propose concentration as being a meeting between the subjective aspects of the individual and the subjective qualities of the nature at that specific time and place. We use a “green equation”, for mapping the processes and pathways that belie the interaction between the person and their environment. Here, the nature/health association as a dynamic interaction, and we operationalise this within a multidimensional construct of bioavailability. We provide an overview of this testable model, and summarise with preliminary evidence as well as a research agenda for the future.
- Published
- 2020
- Full Text
- View/download PDF
28. 268A Mixed Method Investigation of Older People’s Perception of their Neighbourhood, Its User-Friendliness and its Association with Stress and Cognition
- Author
-
Marica Cassarino, Annalisa Setti, and Eleanor Bantry White
- Subjects
Aging ,business.industry ,media_common.quotation_subject ,Cognition ,General Medicine ,User friendliness ,Developmental psychology ,Perception ,Stress (linguistics) ,Medicine ,Geriatrics and Gerontology ,business ,Association (psychology) ,Older people ,Neighbourhood (mathematics) ,media_common - Published
- 2018
- Full Text
- View/download PDF
29. 66Enhancing Older Patients’ Care in the Emergency Department: A Systematic Review of Interventions by Health and Social Care Professional Teams
- Author
-
Breda Naddy, Andrew O’Regan, Fiona Boland, Marica Cassarino, Rosa McNamara, Katie Robinson, Rosie Quinn, Marie Ward, Damien Ryan, Gerard McCarthy, and Rose Galvin
- Subjects
Aging ,medicine.medical_specialty ,Older patients ,business.industry ,Family medicine ,Psychological intervention ,Medicine ,Social care ,General Medicine ,Emergency department ,Geriatrics and Gerontology ,business - Published
- 2018
- Full Text
- View/download PDF
30. 68The Geographies of Cognitive Ageing: Neighbourhood Distance from Cities and Cognitive Variations in The Irish Longitudinal Study on Ageing
- Author
-
Marica Cassarino, Rose Anne Kenny, and Annalisa Setti
- Subjects
Gerontology ,Aging ,Longitudinal study ,business.industry ,05 social sciences ,Cognition ,General Medicine ,050105 experimental psychology ,language.human_language ,03 medical and health sciences ,0302 clinical medicine ,Irish ,Ageing ,language ,Medicine ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,Cognitive ageing ,Geriatrics and Gerontology ,business ,Neighbourhood (mathematics) - Published
- 2018
- Full Text
- View/download PDF
31. Reducing young drivers’ crash risk: Are we there yet? An ecological systems-based review of the last decade of research
- Author
-
Marica Cassarino and Gillian Murphy
- Subjects
Risk ,050210 logistics & transportation ,Ecological systems ,05 social sciences ,Applied psychology ,Psychological intervention ,Transportation ,Crash ,Young driver ,Development ,Ecological systems theory ,Hazard ,Systematic review ,Empirical research ,0502 economics and business ,Automotive Engineering ,0501 psychology and cognitive sciences ,Cognitive skill ,Novice ,Psychology ,human activities ,050107 human factors ,Applied Psychology ,Civil and Structural Engineering ,Social influence - Abstract
The involvement of young novice drivers in road crashes and violations has remained a significant transport and public health issue worldwide. Despite extensive evidence that multiple individual, social, and environmental factors contribute to risk while driving, crashes among young novice drivers have decreased only marginally. There is a need to define clear indicators of risk as well as develop effective interventions. The current study reviews the literature on young novice drivers, including empirical studies, systematic reviews, and crash reports published over the past ten years to provide a synthesis of risk and protective factors across multiple domains, from individual characteristics, to social influences, to behavioural and social interventions, to the car and road environment. Adopting an ecological systems perspective, we discuss links between these domains to clarify the strongest indicators of risk for young novice drivers as compared to experienced drivers, and we collate the available evidence on social and environmental factors that can improve young drivers’ behaviour so to reduce the rate of their road crashes. Among the factors discussed, the incomplete maturation of cognitive skills crucial to safe driving (visual scanning, hazard anticipation, handling of in-vehicle distractions) and the higher susceptibility to social influences (especially peers and parents) emerged as the strongest determinants of discrepancies in performance between young novice and experienced drivers. Growing awareness of the complex array of factors intervening synergistically in young drivers’ risk, as well as technological advancements have led to the design of interventions with some level of effectiveness, however, further research and more robust programmes adopting ecological and holistic approaches are needed to fully address the young driver problem.
- Published
- 2018
- Full Text
- View/download PDF
32. 079Environmental Approaches to Cognitive Ageing: An Investigation of the Role of Population Density and Disability
- Author
-
Marica Cassarino, Rose Anne Kenny, and Annalisa Setti
- Subjects
Gerontology ,Aging ,business.industry ,05 social sciences ,General Medicine ,Population density ,050105 experimental psychology ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,0501 psychology and cognitive sciences ,Cognitive ageing ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Published
- 2017
- Full Text
- View/download PDF
33. A randomised controlled trial exploring the impact of a dedicated health and social care professionals team in the emergency department on the quality, safety, clinical and cost-effectiveness of care for older adults: a study protocol
- Author
-
Rosie Quinn, Damien Ryan, Rosa McNamara, Collette Devlin, Fiona Boland, Dominic Trépel, Íde O’Shaughnessy, Marica Cassarino, Margaret O'Connor, Stephen White, Marie Ward, Eimear Smalle, Rose Galvin, Gerard McCarthy, Katie Robinson, and HRB
- Subjects
Male ,Cost effectiveness ,Cost-Benefit Analysis ,Psychological intervention ,Medicine (miscellaneous) ,Social Workers ,Effectiveness ,law.invention ,Study Protocol ,0302 clinical medicine ,Randomized controlled trial ,law ,Patient-Centered Care ,Health care ,Pharmacology (medical) ,030212 general & internal medicine ,Cooperative Behavior ,Hospital Costs ,Randomized Controlled Trials as Topic ,lcsh:R5-920 ,030503 health policy & services ,Age Factors ,Treatment Outcome ,Female ,Patient Safety ,0305 other medical science ,lcsh:Medicine (General) ,Emergency Service, Hospital ,medicine.medical_specialty ,Team care ,effectiveness ,03 medical and health sciences ,Patient satisfaction ,Quality of life (healthcare) ,Occupational Therapists ,Patient experience ,medicine ,Older patients ,Humans ,Geriatric Assessment ,Aged ,Quality Indicators, Health Care ,Patient Care Team ,business.industry ,Emergency department ,Physical Therapists ,Family medicine ,Health and social care professional ,Interdisciplinary Communication ,business ,Ireland - Abstract
Background Older people are frequent emergency department (ED) users who present with complex issues that are linked to poorer health outcomes following the index visit, often have increased ED length of stay, and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and an improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCP teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, and clinical- and cost-effectiveness of care of older adults when compared with usual care. Methods The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30 days, and 4 and 6 months of follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; cost-effectiveness in terms of costs associated with ED-based HSCP compared with usual care; and perceptions on implementation by ED staff members. Discussion This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, and clinical- and cost-effectiveness of care for older patients. The findings of this study will provide important information on the effectiveness of this model of care for future implementation. Trial registration ClinicalTrials.gov, NCT03739515. Registered on 12 November 2018.
- Published
- 2019
34. Sometimes nature doesn't work: absence of attention restoration in older adults exposed to environmental scenes
- Author
-
Isabella C Tuohy, Marica Cassarino, and Annalisa Setti
- Subjects
Male ,Aging ,Future studies ,Restorative environments ,Older age ,Population ,Context (language use) ,Environment ,050105 experimental psychology ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,Soft fascination ,Reaction Time ,Humans ,Urban ,Attention ,0501 psychology and cognitive sciences ,education ,General Psychology ,Aged ,Work absence ,Aged, 80 and over ,education.field_of_study ,Sustained Attention to Response Task ,SART ,05 social sciences ,Cognition ,Environmental exposure ,Mental Status and Dementia Tests ,Nature ,Attention restoration theory ,Attention Restoration Theory ,Cognitive restoration ,Female ,Geriatrics and Gerontology ,Short exposure ,Psychology ,030217 neurology & neurosurgery ,ART ,Directed attention - Abstract
Background/Study Context: An accumulating body of literature indicates that contact with natural settings can benefit health and wellbeing. Numerous studies support Attention Restoration Theory (ART), which suggests that even short exposure to nature, as opposed to urban environments, can promote attention restoration by stimulating soft fascination. However, it is unclear whether the restorative effects hold in aging. This study tested nature effect on cognitive restoration in older people. Methods: Utilizing the Sustained Attention to Response Task (SART), we explored changes in attentional performance in 75 healthy older individuals before and after exposure to either natural or urban scenes. We checked for age-related differences by comparing the older sample to a group of 21 young participants. Results: We found no effects of environmental exposure for either attentional accuracy, sensitivity to visual targets or reaction times. Our older participants had worse accuracy and slower reaction times than a younger control group who used the same paradigm. Conclusion: The results of our study conducted with older adults show no attention restoration effects in this population. Potential geographical/cultural moderators as wells as methodological considerations are discussed to provide insights for future studies on cognitive restoration in older age.
- Published
- 2019
35. Cognitive and Sensory Dimensions of Older People’s Preferences of Outdoor Spaces for Walking: A Survey Study in Ireland
- Author
-
Marica Cassarino, Eleanor Bantry-White, and Annalisa Setti
- Subjects
Male ,Rural Population ,Aging ,outdoor spaces ,Urban Population ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,Vulnerability ,lcsh:Medicine ,physical activity ,Walking ,cognitive failures ,Article ,Developmental psychology ,03 medical and health sciences ,0302 clinical medicine ,Promotion (rank) ,Residence Characteristics ,Surveys and Questionnaires ,Ecological psychology ,Humans ,030212 general & internal medicine ,Outdoor spaces ,Association (psychology) ,Recreation ,Exercise ,media_common ,Aged ,Aged, 80 and over ,Physical activity ,lcsh:R ,aging ,Public Health, Environmental and Occupational Health ,Sensory sensitivity ,Cognition ,Middle Aged ,Focus group ,Preference ,Cognitive failures ,Environment Design ,Female ,Psychology ,sensory sensitivity ,human activities ,Ireland ,030217 neurology & neurosurgery - Abstract
Background: Physical exercise, particularly walking, benefits healthy ageing. Understanding the environmental circumstances in which exercise occurs is crucial to the promotion of physical activity in older age. Most studies have focused on the structural dimensions of environments that may foster walking, however, individual differences in how older people perceive and interact with outdoor spaces need further attention. This study explored the cognitive and sensory dimensions of preferences of outdoor spaces for walking. Methods: We invited 112 healthy community-dwelling people aged &ge, 60 years to complete a survey to test associations between walking preferences and cognitive/sensory vulnerability. A subsample also completed focus groups/walk along interviews to explore qualitatively the cognitive/sensory reasons for outdoor walking preferences. Results: While most participants indicated a preference for outdoor spaces that offer variety and greenery, we observed a complex association between individual cognitive/sensory needs (stimulation seeking vs. avoidance), preferences for social interactions, and the place of residence urbanity level. Furthermore, walking preferences varied based on the purpose of the walk (recreation vs. transportation). Conclusions: Our findings support an ecological approach to understanding determinants of physical activity in older age, which consider the interaction between individual cognitive processing and the environment.
- Published
- 2019
36. Natural or Urban Campus Walks and Vitality in University Students: Exploratory Qualitative Findings from a Pilot Randomised Controlled Study
- Author
-
Zelda Di Blasi, Marica Cassarino, and Topaz Shrestha
- Subjects
restoration ,Universities ,Higher education ,health promotion ,Health, Toxicology and Mutagenesis ,Energy (esotericism) ,Applied psychology ,Psychological intervention ,lcsh:Medicine ,Pilot Projects ,Anxiety ,010501 environmental sciences ,Vitality ,01 natural sciences ,Article ,vitality ,walking ,03 medical and health sciences ,wellbeing ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Students ,0105 earth and related environmental sciences ,business.industry ,lcsh:R ,college students ,Public Health, Environmental and Occupational Health ,nature ,Cognition ,Health promotion ,Thematic analysis ,medicine.symptom ,Psychology ,business ,energy - Abstract
Despite extensive evidence of the restorative effects of nature, the potential vitalizing effects of connecting with nature are yet understudied, particularly in higher education settings. University students face high levels of stress and anxiety, and may benefit from nature-based interventions that enhance positive states such as vitality. Using preliminary data from a pilot randomized controlled study with qualitative interviews, we explored the psychological experiences associated with a brief walk either in nature or an urban environment in a sample of 13 university students. The qualitative thematic analysis revealed that walking in nature was a more energizing and vitalizing experience than the urban walk. The nature walk was also found to have both affective and cognitive enhancing effects on participants. Our study highlights the usefulness of exploring subjective psychological experiences of interacting with nature, as well as supporting its restorative potential. Implications for further research and interventions are discussed.
- Published
- 2021
- Full Text
- View/download PDF
37. Dynapaenic obesity and its association with health outcomes in older adult populations: Protocol for a systematic review
- Author
-
Matthew Dl O' Connell, Marica Cassarino, Liam G. Glynn, Rose Galvin, and Siobhan Leahy
- Subjects
Gerontology ,medicine.medical_specialty ,obesity ,Aging ,Internationality ,Epidemiology ,Population ,MEDLINE ,030209 endocrinology & metabolism ,CINAHL ,03 medical and health sciences ,0302 clinical medicine ,Health care ,medicine ,Global health ,Protocol ,Humans ,dynapaenic obesity ,030212 general & internal medicine ,education ,Geriatric Assessment ,Aged ,education.field_of_study ,Muscle Weakness ,business.industry ,General Medicine ,dynapenia ,Newcastle–Ottawa scale ,disability ,risk factor ,ageing ,Research Design ,muscle strength ,Observational study ,business ,chronic disease - Abstract
IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.
- Published
- 2019
38. Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review
- Author
-
Damien Ryan, Andrew O’Regan, Marica Cassarino, Gerard McCarthy, Marie Ward, Rose Galvin, Rosie Quinn, Katie Robinson, Rosa McNamara, Fiona Boland, Margaret O'Connor, Breda Naddy, HRB, and RCQPS
- Subjects
Critical Care and Emergency Medicine ,Economics ,Health Care Providers ,Social Sciences ,Social Workers ,Database and Informatics Methods ,0302 clinical medicine ,Dedicated ,Medicine and Health Sciences ,Medicine ,030212 general & internal medicine ,Database Searching ,Nonvascular Plants ,Allied Health Care Professionals ,Multidisciplinary ,Eukaryota ,Workload ,Cost-effectiveness analysis ,Research Assessment ,Plants ,Hospitals ,Hospitalization ,Systematic review ,Research Reporting Guidelines ,Speech-Language Pathology ,Emergency Service, Hospital ,Research Article ,medicine.medical_specialty ,Systematic Reviews ,Science ,Cost-Effectiveness Analysis ,MEDLINE ,Research and Analysis Methods ,03 medical and health sciences ,Occupational Therapists ,Intervention (counseling) ,Mosses ,Humans ,early assessment ,Patient Care Team ,business.industry ,Organisms ,Biology and Life Sciences ,030208 emergency & critical care medicine ,Emergency department ,Economic Analysis ,Clinical pharmacy ,Health Care ,Health Care Facilities ,Family medicine ,HSCP teams ,business ,Delivery of Health Care - Abstract
BackgroundDedicated Health and Social Care Professional (HSCP) teams have been proposed for emergency departments (EDs) in an effort to improve patient and process outcomes. This systematic review synthesises the totality of evidence relating to the impact of early assessment and intervention by HSCP teams on quality, safety and effectiveness of care in the ED.MethodsA systematic literature search was conducted in April 2019 to identify experimental studies examining the effectiveness of ED-based HSCP teams providing services to adults aged ≥ 18 years old and including two or more of the following disciplines: occupational therapist, physiotherapist, medical social worker, clinical pharmacist, or speech and language therapist. Data extraction and quality appraisal of each study were conducted independently by two reviewers.ResultsSix studies were included in the review (n = 273,886), all describing interdisciplinary Care Coordination Teams (CCTs) caring for adults aged ≥ 65 years old. CCT care was associated with on average 2% reduced rates of hospital admissions (three studies), improved referrals to community services for falls (one study), increased satisfaction (two studies) with the safety of discharge (patients and staff), and with the distribution of workload (staff), improved health-related quality of care (one study). No statistically significant differences between intervention and control groups emerged in terms of rates of ED re-visits, ranging between 0.2% and 3% (two studies); hospital length of stay (one hour difference noted in one study) or mortality rates (0.5% difference in one study). Increased rates of unplanned hospitalisations following the intervention (13.9% difference) were reported in one study. The methodological quality of the studies was mixed.DiscussionWe found limited and heterogeneous evidence on the impact of HSCP teams in the ED, suggesting a reduction in hospital admissions as well as improved patient and staff satisfaction. More robust investigations including cost-effectiveness evaluations are needed.
- Published
- 2019
39. Implementing an allied health team intervention to improve the care of older adults in the emergency department:protocol for a process evaluation
- Author
-
Fiona Boland, Marie Ward, Úna Cronin, Katie Robinson, Marica Cassarino, Rose Galvin, Rosa MacNamara, Gerard McCarthy, Damien Ryan, Margaret O'Connor, Rosie Quinn, and HRB
- Subjects
emergency department ,Health Services for the Aged ,media_common.quotation_subject ,education ,key staff members ,Fidelity ,allied health ,law.invention ,Health team ,Nursing ,Randomized controlled trial ,law ,Intervention (counseling) ,Protocol ,Medicine ,Humans ,implementation ,media_common ,Quality of Health Care ,Protocol (science) ,Research ethics ,business.industry ,Allied Health Occupations ,Delivery of Health Care, Integrated ,interdisciplinary care ,Process Assessment, Health Care ,General Medicine ,Emergency department ,process evaluation ,health service delivery ,Health Services Research ,Process evaluation ,delivery ,business ,Emergency Service, Hospital - Abstract
IntroductionHealth and social care professionals (HSCPs) have increasingly contributed to enhance the care of patients in emergency departments (EDs), particularly for older adults who are frequent ED attendees with significant adverse outcomes. For the first time, the effectiveness of a HSCP team intervention for older adults in the ED has been tested in a large randomised controlled trial (Clinicaltrials.gov,NCT03739515), providing an opportunity to explore the implementation process for this type of intervention. This protocol describes a process evaluation that will to investigate the implementation, delivery and impact of an HSCP team intervention in the ED.Methods and analysisUsing the Medical Research Council Framework for process evaluations, we will employ a mixed-methods approach to provide a description of the process of implementation and delivery of the HSCP intervention in the ED, evaluate its fidelity, dose and reach and explore the perceptions of key staff members in relations to the mechanisms and contexts of impact at the levels of individuals, physical environment, operations, communication and the broader hospital and healthcare system.Ethics and disseminationEthical approval for this study was received from the HSE Mid-Western Regional Hospital Research Ethics Committee (Ref: 103/18). All participants will be invited to read and sign a written consent form prior to participation. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.
- Published
- 2019
40. Environment as ‘Brain Training’: A review of geographical and physical environmental influences on cognitive ageing
- Author
-
Annalisa Setti and Marica Cassarino
- Subjects
Rural Population ,Gerontology ,Aging ,Urban Population ,Psychological intervention ,Brain ,Cognition ,Environment ,Vitality ,Biochemistry ,Developmental psychology ,Socioeconomic Factors ,Neurology ,Ageing ,Walkability ,Urbanization ,Humans ,Effects of sleep deprivation on cognitive performance ,Cognition Disorders ,Psychology ,Molecular Biology ,Biotechnology ,Cognitive reserve - Abstract
Global ageing demographics coupled with increased urbanisation pose major challenges to the provision of optimal living environments for older persons, particularly in relation to cognitive health. Although animal studies emphasize the benefits of enriched environments for cognition, and brain training interventions have shown that maintaining or improving cognitive vitality in older age is possible, our knowledge of the characteristics of our physical environment which are protective for cognitive ageing is lacking. The present review analyses different environmental characteristics (e.g. urban vs. rural settings, presence of green) in relation to cognitive performance in ageing. Studies of direct and indirect associations between physical environment and cognitive performance are reviewed in order to describe the evidence that our living contexts constitute a measurable factor in determining cognitive ageing.
- Published
- 2015
- Full Text
- View/download PDF
41. EXPOSURE TO GREEN DOES NOT ALWAYS RESTORE ATTENTION IN OLDER ADULTS
- Author
-
Marica Cassarino, I. Tuohy, and Annalisa Setti
- Subjects
Gerontology ,Abstracts ,Health (social science) ,Text mining ,business.industry ,Life-span and Life-course Studies ,Psychology ,business ,Health Professions (miscellaneous) - Abstract
Objectives: Exposure to green scenes has been proven restorative for directed attention (Attention restoration theory, ART) in young adults, but very few studies have beneficial effects of green on older adults’ attention. The present study aimed to test ART on older individuals considering the potential influence of current environment of residence.
- Published
- 2017
42. Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review
- Author
-
Andrew O’Regan, Damien Ryan, Breda Naddy, Rose Galvin, Rosie Quinn, Rosa McNamara, Fiona Boland, Katie Robinson, Marie Ward, Gerard McCarthy, and Marica Cassarino
- Subjects
030506 rehabilitation ,Speech-Language Pathology ,emergency department ,assessment ,Cost-Benefit Analysis ,education ,Population ,MEDLINE ,Psychological intervention ,Social Workers ,Cochrane Library ,Pharmacists ,Workflow ,03 medical and health sciences ,0302 clinical medicine ,Occupational Therapists ,Nursing ,Early Medical Intervention ,Intervention (counseling) ,Protocol ,Humans ,Medicine ,030212 general & internal medicine ,intervention ,Patient Care Team ,Protocol (science) ,interdisciplinary team ,education.field_of_study ,business.industry ,patient care ,General Medicine ,Emergency department ,Physical Therapists ,Early Diagnosis ,Treatment Outcome ,Systematic review ,health and social care professionals ,Health Services Research ,Emergency Service, Hospital ,0305 other medical science ,business ,Delivery of Health Care - Abstract
IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.
- Published
- 2018
- Full Text
- View/download PDF
43. Environment and cognitive aging: A cross-sectional study of place of residence and cognitive performance in the Irish longitudinal study on aging
- Author
-
Marica Cassarino, Vincent O'Sullivan, Annalisa Setti, and Rose Anne Kenny
- Subjects
Male ,Rural Population ,Longitudinal study ,Urban Population ,Poison control ,Social Environment ,Developmental psychology ,03 medical and health sciences ,Executive Function ,0302 clinical medicine ,Cognition ,Humans ,030212 general & internal medicine ,Cognitive skill ,Longitudinal Studies ,Aged ,Aged, 80 and over ,Human factors and ergonomics ,Social environment ,Middle Aged ,Executive functions ,Neuropsychology and Physiological Psychology ,Cross-Sectional Studies ,Cognitive Aging ,Residence ,Female ,Independent Living ,Psychology ,Ireland ,030217 neurology & neurosurgery - Abstract
OBJECTIVE: Stimulating environments foster cognitive vitality in older age. However, it is not known whether and how geographical and physical characteristics of lived environments contribute to cognitive aging. Evidence of higher prevalence of dementia in rural rather than urban contexts suggests that urban environments may be more stimulating either cognitively, socially, or in terms of lifestyle. The present study explored urban/rural differences in cognition for healthy community-dwelling older people while controlling for a comprehensive spectrum of confounding factors. METHOD: Cognitive performance of 3,765 healthy Irish people aged 50+ years participating in Wave 1 of The Irish Longitudinal Study on Aging was analyzed in relation to current location of residence-urban, other settlements, or rural areas-and its interaction with childhood residence. Regression models controlled for sociodemographic, health, and lifestyle factors. RESULTS: Urban residents showed better performance than the other 2 residence groups for global cognition and executive functions after controlling for covariates. Childhood urban residence was associated with a cognitive advantage especially for currently rural participants. CONCLUSION: Our findings suggest higher cognitive functioning for urban residents, although childhood residence modulates this association. Suggestions for further developments of these results are discussed. (PsycINFO Database Record Language: en
- Published
- 2015
44. 205PHYSICAL ACTIVITY MODULATES GEOGRAPHICAL VARIATIONS IN COGNITIVE AGEING: RESULTS FROM THE IRISH LONGITUDINAL STUDY ON AGEING
- Author
-
Annalisa Setti and Marica Cassarino
- Subjects
Gerontology ,Aging ,Longitudinal study ,business.industry ,05 social sciences ,General Medicine ,050105 experimental psychology ,language.human_language ,Irish ,Ageing ,language ,Medicine ,0501 psychology and cognitive sciences ,Cognitive ageing ,Geriatrics and Gerontology ,business - Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.