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Marica Cassarino
School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Castletroy, Ireland

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Research article
Published: 28 July 2021 in PLOS Medicine
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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.

ACS Style

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; Rose Galvin. 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. PLOS Medicine 2021, 18, e1003711 .

AMA Style

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, Rose Galvin. 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. PLOS Medicine. 2021; 18 (7):e1003711.

Chicago/Turabian Style

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; Rose Galvin. 2021. "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." PLOS Medicine 18, no. 7: e1003711.

Review
Published: 20 July 2021 in Sustainability
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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.

ACS Style

Marica Cassarino; Sina Shahab; Sara Biscaya. Envisioning Happy Places for All: A Systematic Review of the Impact of Transformations in the Urban Environment on the Wellbeing of Vulnerable Groups. Sustainability 2021, 13, 8086 .

AMA Style

Marica Cassarino, Sina Shahab, Sara Biscaya. Envisioning Happy Places for All: A Systematic Review of the Impact of Transformations in the Urban Environment on the Wellbeing of Vulnerable Groups. Sustainability. 2021; 13 (14):8086.

Chicago/Turabian Style

Marica Cassarino; Sina Shahab; Sara Biscaya. 2021. "Envisioning Happy Places for All: A Systematic Review of the Impact of Transformations in the Urban Environment on the Wellbeing of Vulnerable Groups." Sustainability 13, no. 14: 8086.

Preprint content
Published: 13 July 2021
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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.

ACS Style

Rachel Atkins; Marica Cassarino. Understanding the Experiences of COVID-19 Spatial and Social Restrictions Among Young People with Physical Disabilities. 2021, 1 .

AMA Style

Rachel Atkins, Marica Cassarino. Understanding the Experiences of COVID-19 Spatial and Social Restrictions Among Young People with Physical Disabilities. . 2021; ():1.

Chicago/Turabian Style

Rachel Atkins; Marica Cassarino. 2021. "Understanding the Experiences of COVID-19 Spatial and Social Restrictions Among Young People with Physical Disabilities." , no. : 1.

Journal article
Published: 19 February 2021 in International Journal of Environmental Research and Public Health
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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.

ACS Style

Topaz Shrestha; Zelda Di Blasi; Marica Cassarino. Natural or Urban Campus Walks and Vitality in University Students: Exploratory Qualitative Findings from a Pilot Randomised Controlled Study. International Journal of Environmental Research and Public Health 2021, 18, 2003 .

AMA Style

Topaz Shrestha, Zelda Di Blasi, Marica Cassarino. Natural or Urban Campus Walks and Vitality in University Students: Exploratory Qualitative Findings from a Pilot Randomised Controlled Study. International Journal of Environmental Research and Public Health. 2021; 18 (4):2003.

Chicago/Turabian Style

Topaz Shrestha; Zelda Di Blasi; Marica Cassarino. 2021. "Natural or Urban Campus Walks and Vitality in University Students: Exploratory Qualitative Findings from a Pilot Randomised Controlled Study." International Journal of Environmental Research and Public Health 18, no. 4: 2003.

Original article
Published: 11 January 2021 in Aging, Neuropsychology, and Cognition
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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.

ACS Style

Rebecca J. Hirst; Marica Cassarino; Rose Anne Kenny; Fiona N. Newell; Annalisa Setti. Urban and rural environments differentially shape multisensory perception in ageing. Aging, Neuropsychology, and Cognition 2021, 1 -16.

AMA Style

Rebecca J. Hirst, Marica Cassarino, Rose Anne Kenny, Fiona N. Newell, Annalisa Setti. Urban and rural environments differentially shape multisensory perception in ageing. Aging, Neuropsychology, and Cognition. 2021; ():1-16.

Chicago/Turabian Style

Rebecca J. Hirst; Marica Cassarino; Rose Anne Kenny; Fiona N. Newell; Annalisa Setti. 2021. "Urban and rural environments differentially shape multisensory perception in ageing." Aging, Neuropsychology, and Cognition , no. : 1-16.

Review
Published: 11 November 2020 in Age and Ageing
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Objective Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. 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.

ACS Style

Zoë Tieges; Alasdair M J Maclullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O’Connor; Damien Ryan; Thomas Saller; Rakesh C Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan D Shenkin; Rose Galvin. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age and Ageing 2020, 50, 733 -743.

AMA Style

Zoë Tieges, Alasdair M J Maclullich, Atul Anand, Claire Brookes, Marica Cassarino, Margaret O’Connor, Damien Ryan, Thomas Saller, Rakesh C Arora, Yue Chang, Kathryn Agarwal, George Taffet, Terence Quinn, Susan D Shenkin, Rose Galvin. Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis. Age and Ageing. 2020; 50 (3):733-743.

Chicago/Turabian Style

Zoë Tieges; Alasdair M J Maclullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O’Connor; Damien Ryan; Thomas Saller; Rakesh C Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan D Shenkin; Rose Galvin. 2020. "Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis." Age and Ageing 50, no. 3: 733-743.

Journal article
Published: 22 October 2020 in Multimodal Technologies and Interaction
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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.

ACS Style

Alison O’Meara; Marica Cassarino; Aaron Bolger; Annalisa Setti. Virtual Reality Nature Exposure and Test Anxiety. Multimodal Technologies and Interaction 2020, 4, 75 .

AMA Style

Alison O’Meara, Marica Cassarino, Aaron Bolger, Annalisa Setti. Virtual Reality Nature Exposure and Test Anxiety. Multimodal Technologies and Interaction. 2020; 4 (4):75.

Chicago/Turabian Style

Alison O’Meara; Marica Cassarino; Aaron Bolger; Annalisa Setti. 2020. "Virtual Reality Nature Exposure and Test Anxiety." Multimodal Technologies and Interaction 4, no. 4: 75.

Journal article
Published: 25 September 2020 in Sustainability
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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–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.

ACS Style

Marica Cassarino; Eleanor Bantry-White; Annalisa Setti. Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels. Sustainability 2020, 12, 7951 .

AMA Style

Marica Cassarino, Eleanor Bantry-White, Annalisa Setti. Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels. Sustainability. 2020; 12 (19):7951.

Chicago/Turabian Style

Marica Cassarino; Eleanor Bantry-White; Annalisa Setti. 2020. "Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels." Sustainability 12, no. 19: 7951.

Original research paper
Published: 25 August 2020 in Health Expectations
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Background There is some evidence that health and social care professional (HSCP) teams contribute to enhanced patient and process outcomes in increasingly crowded emergency departments (EDs), but the views of service users and providers on this model of care need investigation to optimize implementation. Objective This qualitative study investigated the perspectives of key ED stakeholders about HSCP teams working in the ED. Methods Using a participatory design, we conducted World Café focus groups and individual interviews in two Irish hospital sites with 65 participants (purposive sampling) including ED patients and carers/relatives, ED doctors and nurses, HSCPs and pre‐hospital staff. Data were thematically analysed using NVivo software. Results Participants reported that ED‐based HSCP teams could improve quality and integration of care and staff experience (Theme 1) and would be appropriate for older adults with complex needs and non‐urgent complaints (Theme 2). Concerns were raised about operational and relational barriers to implementation (Theme 3), and changes in processes and culture were considered necessary for HSCPs to work successfully in the ED (Theme 4). In contrast to service providers, service users’ concerns centred on the importance of positive communication and relations (Theme 5). Conclusions Our study indicates potential acceptability of HSCP teams working in the ED, especially to care for older adults; however, operational and relational aspects, particularly developing interdisciplinary and integrated care, need addressing to ensure successful implementation. Differences in priorities between service users and providers (relational vs operational) highlighted the usefulness of gathering views from multiple stakeholders to understand ED processes.

ACS Style

Marica Cassarino; Rosie Quinn; Fiona Boland; Marie E. Ward; Rosa McNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin; Katie Robinson. Stakeholders’ perspectives on models of care in the emergency department and the introduction of health and social care professional teams: A qualitative analysis using World Cafés and interviews. Health Expectations 2020, 23, 1065 -1073.

AMA Style

Marica Cassarino, Rosie Quinn, Fiona Boland, Marie E. Ward, Rosa McNamara, Margaret O’Connor, Gerard McCarthy, Damien Ryan, Rose Galvin, Katie Robinson. Stakeholders’ perspectives on models of care in the emergency department and the introduction of health and social care professional teams: A qualitative analysis using World Cafés and interviews. Health Expectations. 2020; 23 (5):1065-1073.

Chicago/Turabian Style

Marica Cassarino; Rosie Quinn; Fiona Boland; Marie E. Ward; Rosa McNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin; Katie Robinson. 2020. "Stakeholders’ perspectives on models of care in the emergency department and the introduction of health and social care professional teams: A qualitative analysis using World Cafés and interviews." Health Expectations 23, no. 5: 1065-1073.

Preprint content
Published: 21 August 2020
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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, 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.

ACS Style

Alison O'meara; Marica Cassarino; Aaron Bolger; Annalisa Setti. Virtual Reality Nature Exposure and Test Anxiety. 2020, 1 .

AMA Style

Alison O'meara, Marica Cassarino, Aaron Bolger, Annalisa Setti. Virtual Reality Nature Exposure and Test Anxiety. . 2020; ():1.

Chicago/Turabian Style

Alison O'meara; Marica Cassarino; Aaron Bolger; Annalisa Setti. 2020. "Virtual Reality Nature Exposure and Test Anxiety." , no. : 1.

Review
Published: 12 June 2020
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Objective Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. 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 (≥ 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. Results 17 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. 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. Key points The 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.

ACS Style

Zoë Tieges; Alasdair M. J. MacLullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O’Connor; Damien Ryan; Thomas Saller; Rakesh C. Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan. D. Shenkin; Rose Galvin. Diagnostic accuracy of the 4AT for delirium detection: systematic review and meta-analysis. 2020, 1 .

AMA Style

Zoë Tieges, Alasdair M. J. MacLullich, Atul Anand, Claire Brookes, Marica Cassarino, Margaret O’Connor, Damien Ryan, Thomas Saller, Rakesh C. Arora, Yue Chang, Kathryn Agarwal, George Taffet, Terence Quinn, Susan. D. Shenkin, Rose Galvin. Diagnostic accuracy of the 4AT for delirium detection: systematic review and meta-analysis. . 2020; ():1.

Chicago/Turabian Style

Zoë Tieges; Alasdair M. J. MacLullich; Atul Anand; Claire Brookes; Marica Cassarino; Margaret O’Connor; Damien Ryan; Thomas Saller; Rakesh C. Arora; Yue Chang; Kathryn Agarwal; George Taffet; Terence Quinn; Susan. D. Shenkin; Rose Galvin. 2020. "Diagnostic accuracy of the 4AT for delirium detection: systematic review and meta-analysis." , no. : 1.

Preprint content
Published: 23 April 2020
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The benefits of exposure to nature for health and wellbeing have been demonstrated across multiple disciplines. There exists a general assumption that nature will be beneficial to all in all ways at all times. However, there are fundamental issues apparent in the lack of accord across conceptual as well as definitional aspects, for example, even within the definition of what “nature” means; and there are inconsistencies in empirical findings. Moreover, 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 model that employs a multidimensional perspective using bioavailability to allow a change of focus to look 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 (being, doing, or 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 understanding concentration – examining 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.

ACS Style

Rachel Clair Sumner; Marica Cassarino; Annalisa Setti; Samantha Dockray; Diane Crone. Moving towards a multidimensional dynamic approach to nature and health: A bioavailability perspective. 2020, 1 .

AMA Style

Rachel Clair Sumner, Marica Cassarino, Annalisa Setti, Samantha Dockray, Diane Crone. Moving towards a multidimensional dynamic approach to nature and health: A bioavailability perspective. . 2020; ():1.

Chicago/Turabian Style

Rachel Clair Sumner; Marica Cassarino; Annalisa Setti; Samantha Dockray; Diane Crone. 2020. "Moving towards a multidimensional dynamic approach to nature and health: A bioavailability perspective." , no. : 1.

Study protocol
Published: 15 October 2019 in Trials
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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.

ACS Style

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; Rose Galvin. 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. Trials 2019, 20, 1 -7.

AMA Style

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, Rose Galvin. 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. Trials. 2019; 20 (1):1-7.

Chicago/Turabian Style

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; Rose Galvin. 2019. "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." Trials 20, no. 1: 1-7.

Preprint content
Published: 14 October 2019
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Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-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 improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs 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, clinical and cost-effectiveness of care of older adults when compared to 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, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to 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, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation. Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515

ACS Style

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; Rose Galvin. 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: Study Protocol. 2019, 1 .

AMA Style

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, Rose Galvin. 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: Study Protocol. . 2019; ():1.

Chicago/Turabian Style

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; Rose Galvin. 2019. "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: Study Protocol." , no. : 1.

Preprint content
Published: 17 September 2019
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Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-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 improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs 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, clinical and cost-effectiveness of care of older adults when compared to 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, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to 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, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation. Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515

ACS Style

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; Rose Galvin. 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: Study Protocol. 2019, 1 .

AMA Style

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, Rose Galvin. 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: Study Protocol. . 2019; ():1.

Chicago/Turabian Style

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; Rose Galvin. 2019. "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: Study Protocol." , no. : 1.

Preprint content
Published: 17 September 2019
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Background : Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-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 improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs 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, clinical and cost-effectiveness of care of older adults when compared to 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, four and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to 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, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation. Trial registration : ClinicalTrials.gov, NCT03739515; registered on 12 th November 2018. Protocol version 1. URL: https://clinicaltrials.gov/ct2/show/NCT03739515

ACS Style

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; Rose Galvin. 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: Study Protocol. 2019, 1 .

AMA Style

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, Rose Galvin. 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: Study Protocol. . 2019; ():1.

Chicago/Turabian Style

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; Rose Galvin. 2019. "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: Study Protocol." , no. : 1.

Preprint content
Published: 31 July 2019
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Background Older people are frequent Emergency Department (ED) users who present with complex issues that are linked to poorer health outcomes post-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 improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCPs 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, clinical and cost-effectiveness of care of older adults when compared to 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 outcomes include ED length of stay (from arrival to discharge) and incidence of inpatient admissions from the ED. Secondary outcomes include: ED re-visits, unplanned hospital admissions and healthcare utilisation at 30-days and six-month follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; costs-effectiveness in terms of costs associated with ED-based HSCP compared to 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, clinical and cost-effectiveness of care for older patients. The findings of the study will provide important information on the effectiveness of this model of care for future implementation.

ACS Style

Marica Cassarino; Katie Robinson; Íde O’Shaughnessy; Eimear Smalle; Stephan White; Collette Devlin; Rosie Quinn; Dominic Trépel; Fiona Boland; Marie E. Ward; Rosa McNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin. 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: Study Protocol. 2019, 1 .

AMA Style

Marica Cassarino, Katie Robinson, Íde O’Shaughnessy, Eimear Smalle, Stephan White, Collette Devlin, Rosie Quinn, Dominic Trépel, Fiona Boland, Marie E. Ward, Rosa McNamara, Margaret O’Connor, Gerard McCarthy, Damien Ryan, Rose Galvin. 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: Study Protocol. . 2019; ():1.

Chicago/Turabian Style

Marica Cassarino; Katie Robinson; Íde O’Shaughnessy; Eimear Smalle; Stephan White; Collette Devlin; Rosie Quinn; Dominic Trépel; Fiona Boland; Marie E. Ward; Rosa McNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin. 2019. "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: Study Protocol." , no. : 1.

Review
Published: 31 July 2019 in PLOS ONE
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Dedicated 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. A 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. Six 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. We 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.

ACS Style

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; Rose Galvin. Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review. PLOS ONE 2019, 14, e0220709 .

AMA Style

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, Rose Galvin. Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review. PLOS ONE. 2019; 14 (7):e0220709.

Chicago/Turabian Style

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; Rose Galvin. 2019. "Impact of early assessment and intervention by teams involving health and social care professionals in the emergency department: A systematic review." PLOS ONE 14, no. 7: e0220709.

Health services research
Published: 09 July 2019 in BMJ Open
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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.

ACS Style

Marica Cassarino; Úna Cronin; Katie Robinson; Rosie Quinn; Fiona Boland; Marie E Ward; Rosa MacNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin. Implementing an allied health team intervention to improve the care of older adults in the emergency department: protocol for a process evaluation. BMJ Open 2019, 9, e032645 .

AMA Style

Marica Cassarino, Úna Cronin, Katie Robinson, Rosie Quinn, Fiona Boland, Marie E Ward, Rosa MacNamara, Margaret O’Connor, Gerard McCarthy, Damien Ryan, Rose Galvin. Implementing an allied health team intervention to improve the care of older adults in the emergency department: protocol for a process evaluation. BMJ Open. 2019; 9 (7):e032645.

Chicago/Turabian Style

Marica Cassarino; Úna Cronin; Katie Robinson; Rosie Quinn; Fiona Boland; Marie E Ward; Rosa MacNamara; Margaret O’Connor; Gerard McCarthy; Damien Ryan; Rose Galvin. 2019. "Implementing an allied health team intervention to improve the care of older adults in the emergency department: protocol for a process evaluation." BMJ Open 9, no. 7: e032645.

Articles
Published: 07 June 2019 in Experimental Aging Research
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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.

ACS Style

Marica Cassarino; Isabella C. Tuohy; Annalisa Setti. Sometimes Nature Doesn’t Work: Absence of Attention Restoration in Older Adults Exposed to Environmental Scenes. Experimental Aging Research 2019, 45, 372 -385.

AMA Style

Marica Cassarino, Isabella C. Tuohy, Annalisa Setti. Sometimes Nature Doesn’t Work: Absence of Attention Restoration in Older Adults Exposed to Environmental Scenes. Experimental Aging Research. 2019; 45 (4):372-385.

Chicago/Turabian Style

Marica Cassarino; Isabella C. Tuohy; Annalisa Setti. 2019. "Sometimes Nature Doesn’t Work: Absence of Attention Restoration in Older Adults Exposed to Environmental Scenes." Experimental Aging Research 45, no. 4: 372-385.