Background: The Assisted Decision-Making (ADM) (Capacity) Act 2015 was enacted by Dáil Éireann in December 2015. The purpose of the act, as it applies to healthcare, is to promote the autonomy of persons in relation to their treatment choices, to enable them to be treated according to their will and preferences, and to provide healthcare professionals with important information about persons and their choices in relation to treatment. In practice, those patients with cognitive impairment, particularly dementia, and those with complex needs requiring composite decisions present the greatest challenge to healthcare professionals practicing in accordance with this legislation. Patients with complex needs requiring multifaceted decisions are often over 70 years of age and present in acute hospitals experiencing some form of cognitive impairment. Objectives: The aim of this project is to develop an educational tool which will promote understanding of ADM among healthcare professionals working in acute care settings, and encourage their adoption of this understanding into their care planning with older people. Research design: The study design for this project is mapped out over four consecutive work packages combining a multimethod approach including rapid realist review, qualitative exploration, participatory learning and action sets and intervention trialling and revision. This incremental and context sensitive approach to research design is appropriate for the exploration, development and evaluation of a complex behaviour change intervention. Conclusion: The targeted beneficiaries of this project are healthcare professionals working within acute care settings as well as older people and their family carers who are interacting with the acute care system. The potential impact is improved communication between healthcare professionals and their patients in relation to assisted decision-making and care planning. This educational intervention will be embedded into the pedagogic strategies of the RCPI in their postgraduate education curricula as well as the continuous professional development scheme.
The University College Dublin (UCD) PPI Ignite Connect Background: Network will fundamentally embed public and patient involvement (PPI) in health-related research, education and training, professional practice and administration in UCD's institutional structures and procedures. A significant focus of the programme of work is on actively engaging and developing long-term reciprocal relationships with seldom heard groups, via our ten inaugural partners. This rapid realist review will explore what are the mechanisms that Methods: are important in actively engaging seldom heard groups in health and social care research. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions, and (5) disseminate findings. The reviewers will consult with expert and reference panels to focus the review, provide local contextual insights and develop a programme theory consisting of context-mechanism-outcome configurations. The expert panel will oversee the review process and agree, via consensus, the final programme theory. Review findings will follow the adopted RAMESES guideline and will be disseminated via a report, presentations and peer-reviewed publication.The review will update and consolidate evidence on the Discussion: mechanisms that enable the reciprocal engagement and participation of 'seldom heard' groups in health and social care research. Via the expert and reference process, we will draw from a sizeable body of published and unpublished research and grey literature. The local contextual insights provided will aid the development of our programme theories. This new evidence will inform the design and development of the UCD PPI Ignite program focused on ensuring sustained reciprocal partnerships.
Daly's Bridge is a historic steel suspension footbridge in Ireland, known locally as the 'Shaky Bridge' for its noticeable movement under pedestrian loading. While there is concern regarding the performance of the structure, testing or modelling have not been carried out till date and inadequate information exist in relation to carrying out such analyses. In this paper, Daly's bridge is instrumented and tested for the first time and a model of the bridge is established and improved in the process. Apart from ambient vibration, excitation from traversing pedestrians and cyclists is considered. Video analysis of dynamic deflection, a wavelet packet based technique using acceleration responses and dynamic measurements from a cheap smartphone
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