Publications by staff affiliated to St. Finbarr's Hospital, Cork

Recent Submissions

  • Correction to: Dialectical behaviour therapy for treating adults and adolescents with emotional and behavioural dysregulation: study protocol of a coordinated implementation in a publicly funded health service.

    Flynn, Daniel; Kells, Mary; Joyce, Mary; Suarez, Catalina; Gillespie, Conall (BMC Psychiatry, 2018-05-07)
    Upon publication of the original article (1) it was highlighted by the authors that there was just one error in the manuscript in the 'Sample size' subsection of the Methods/Design.
  • Better palliative care for people with a dementia: summary of interdisciplinary workshop highlighting current gaps and recommendations for future research.

    Fox, Siobhán; FitzGerald, Carol; Harrison Dening, Karen; Irving, Kate; Kernohan, W George; Treloar, Adrian; Oliver, David; Guerin, Suzanne; Timmons, Suzanne (BMC Palliative Care, 2017-07-14)
    The care experienced by people with dementia and their families has the potential to be improved; palliative care frameworks may have much to offer in this endeavour. However, a solid evidence base is required to translate palliative care into practice in the context of dementia. This paper presents suggested research priorities as a starting point to build this evidence base. An interdisciplinary approach to research and priority setting is essential to develop actionable knowledge in this area.
  • Risk Factors for Macro- and Microvascular Complications among Older Adults with Diagnosed Type 2 Diabetes: Findings from The Irish Longitudinal Study on Ageing.

    Tracey, Marsha L; McHugh, Sheena M; Fitzgerald, Anthony P; Buckley, Claire M; Canavan, Ronan J; Kearney, Patricia M (Journal of diabetes research, 2016)
    Objective. To explore risk factors for macro- and microvascular complications in a nationally representative sample of adults aged 50 years and over with type 2 diabetes in Ireland. Methods. Data from the first wave of The Irish Longitudinal Study on Ageing (TILDA) (2009-2011) was used in cross-sectional analysis. The presence of doctor diagnosis of diabetes, risk factors, and macro- and microvascular complications were determined by self-report. Gender-specific differences in risk factor prevalence were assessed with the chi-squared test. Binomial regression analysis was conducted to explore independent associations between established risk factors and diabetes-related complications. Results. Among 8175 respondents, 655 were classified as having type 2 diabetes. Older age, being male, a history of smoking, a lower level of physical activity, and a diagnosis of high cholesterol were independent predictors of macrovascular complications. Diabetes diagnosis of 10 or more years, a history of smoking, and a diagnosis of hypertension were associated with an increased risk of microvascular complications. Older age, third-level education, and a high level of physical activity were protective factors (p < 0.05). Conclusions. Early intervention to target modifiable risk factors is urgently needed to reduce diabetes-related morbidity in the older population in Ireland.
  • Comparison of the quick mild cognitive impairment (Qmci) screen and the SMMSE in screening for mild cognitive impairment.

    O'Caoimh, Rónán; Gao, Yang; McGlade, Ciara; Healy, Liam; Gallagher, Paul; Timmons, Suzanne; Molloy, D William (Age and ageing, 2012-09)
    the Qmci is more sensitive than the SMMSE in differentiating MCI and NC, making it a useful test, for MCI in clinical practice, especially for older adults.
  • Which part of the Quick mild cognitive impairment screen (Qmci) discriminates between normal cognition, mild cognitive impairment and dementia?

    O'Caoimh, Rónán; Gao, Yang; Gallagher, Paul Francis; Eustace, Joesph; McGlade, Ciara; Molloy, D William (Age and ageing, 2013-05)
    the Qmci incorporates several important cognitive domains making it useful across the spectrum of cognitive impairment. LM is the best performing subtest for differentiating MCI from NC.
  • Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes

    O’Sullivan, Ronan; Murphy, Aileen; O’Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D. William (BMC Research Notes, 2016-04-26)
  • Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives.

    Cornally, Nicola; McGlade, Ciara; Weathers, Elizabeth; Daly, Edel; Fitzgerald, Carol; O'Caoimh, Rónán; Coffey, Alice; Molloy, D William (BMC Palliative Care, 2015-11)
    The introduction of the LMD-ACP programme enhanced the delivery of care in the long-term care sites and led to a more open and positive care environment.
  • Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults.

    O'Caoimh, Rónán; Cornally, Nicola; Weathers, Elizabeth; O'Sullivan, Ronan; Fitzgerald, Carol; Orfila, Francesc; Clarnette, Roger; Paúl, Constança; Molloy, D William (Maturitas, 2015-09)
    Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n=18, (78%) were derived in North America from secondary analysis of survey data. The majority n=12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n=16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community.
  • Validation of the Dutch version of the quick mild cognitive impairment screen (Qmci-D).

    Bunt, Steven; O'Caoimh, Rónán; Krijnen, Wim P; Molloy, D William; Goodijk, Geert Pieter; van der Schans, Cees P; Hobbelen, Hans J S M (BMC geriatrics, 2015-10)
    The Qmci-D shows similar,(good) accuracy as the SMMSE-D in separating NC from MCI; greater,(albeit fair), accuracy differentiating MCI from dementia, and significantly greater accuracy in separating dementia from NC. Given its brevity and ease of administration, the Qmci-D seems a useful cognitive screen in a Dutch population. Further study with a suitably powered sample against more sensitive screens is now required.
  • Perceived risk of mental health problems in primary care.

    Paúl, Constança; Teixeira, Laetitia; Azevedo, Maria João; Alves, Sara; Duarte, Mafalda; O'Caoimh, Rónán; Molloy, William (Frontiers in aging neuroscience, 2015)
    In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83-2.69 for institutionalization; OR = 1.66, 95% CI 1.41-1.94 for hospitalization; OR = 1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.
  • Which part of a short, global risk assessment, the Risk Instrument for Screening in the Community, predicts adverse healthcare outcomes?

    O’Caoimh, Rónán; FitzGerald, Carol; Cronin, Una; Svendrovski, Anton; Gao, Yang; Healy, Elizabeth; O’Connell, Elizabeth; O’Keeffe, Gabrielle; O’Herlihy, Eileen; Weathers, Elizabeth; Cornally, Nicola; Leahy-Warren, Patricia; Orfila, Francesc; Paúl, Constança; Clarnette, Roger; Molloy, D. William (Journal of Aging Research, 2015)
    The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults’ one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC ( concern , its severity , and the ability of the caregiver network to manage concern) make to the accuracy of the instrument, across its three domains (mental state, activities of daily living (ADL), and medical state), by comparing their accuracy to other assessment instruments in the prospective Community Assessment of Risk and Treatment Strategies study. RISC scores were available for 782 patients. Across all three domains each subtest more accurately predicted institutionalisation compared to hospitalisation or death. The caregiver network’s ability to manage ADL more accurately predicted institutionalisation (AUC 0.68) compared to hospitalisation (AUC 0.57, P = 0.01 ) or death (AUC 0.59, P = 0.046 ), comparing favourably with the Barthel Index (AUC 0.67). The severity of ADL (AUC 0.63), medical state (AUC 0.62), Clinical Frailty Scale (AUC 0.67), and Charlson Comorbidity Index (AUC 0.66) scores had similar accuracy in predicting mortality. Risk of hospitalisation was difficult to predict. Thus, each component, and particularly the caregiver network , had reasonable accuracy in predicting institutionalisation. No subtest or assessment instrument accurately predicted risk of hospitalisation.
  • Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

    O Caoimh, Rónán; Gao, Yang; Svendrovski, Anton; Healy, Elizabeth; O Connell, Elizabeth; O Keeffe, Gabrielle; Cronin, Una; O Herlihy, Eileen; Cornally, Nicola; Molloy, William D (BMC geriatrics, 2014-09-19)
    The majority of patients in this community sample were perceived to be low risk for adverse outcomes. Frailty, cognitive impairment and functional status were markers of perceived risk. Age, gender and social isolation were not and may not be useful indicators when triaging community dwellers. The RISC now requires validation against adverse outcomes.
  • Supernumerary teeth among Irish school children attending the public orthodontic service in Cork and Kerry.

    O'Dowling, I; Orthodontic Department, St Finbarr's Hospital, Douglas Road, Cork. (Irish Dental Association, 2009-02)
  • The unerupted maxillary canine - a post-surgical review.

    O'Dowling, Ian; Orthodontic Department, St Finbarr's Hospital, Douglas, Cork. (Irish Dental Association, 2009-10)
    The orthodontic records of 685 patients referred for surgical exposure of an unerupted impacted maxillary canine tooth were examined. The condition was more common among females than males, slightly less than 2:1. The impacted teeth had a palatal-labial ratio of 3:1. All of the teeth were exposed using the open surgical technique and in 98% of cases the tooth erupted and was orthodontically aligned. In 2% of cases ankylosis occurred and the teeth were subsequently extracted. The presence of peg-shaped lateral incisors associated with the impacted maxillary canine tooth was 3.4% of the total number of impacted teeth and congenital absence was found in 1.7% of impacted teeth.