Mercy University Hospital

The Sociodemographic Index (SDI) captures a country's or region's relative socioeconomic development and has been linked to age-related disease burden and life expectancy. Frailty is a multidimensional geriatric syndrome associated with adverse health outcomes and mortality. This study examined the relationship between country-level SDI, frailty prevalence, and mortality across Europe. We conducted a secondary analysis of community-dwelling adults aged 50 years and older from 12 countries participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). Frailty status and SDI were assessed at Wave 2 (2007), with mortality follow-up at Wave 4 (2011). Countries were categorised into lower- and higher-SDI groups using the median as a cut-off. Frailty was measured using a 70-item frailty index (FI ≥ 0.25) and a modified Fried frailty phenotype (FP ≥ 3 criteria). Frailty prevalence varied substantially by country and assessment method, ranging from 7 to 40% using the FI and 4-21% using the FP. Prevalence was lowest in Switzerland and highest in Poland and was strongly correlated with national SDI scores (r ≥ 0.8). After adjustment for age and sex, lower SDI was independently associated with higher odds of frailty using both frailty measures. Although mortality was lower in higher-SDI countries, this association was not statistically significant after adjusting for age, sex, and frailty. Lower social development was strongly associated with frailty prevalence but did not independently predict mortality, highlighting frailty as a potential pathway linking social context to later-life health outcomes in Europe.

BackgroundHead-Mounted-Displays which have mixed reality capabilities have a range of functions which may improve medical training and address certain challenges facing universities worldwide. Devices such as the Microsoft HoloLens 2 device can facilitate provision of procedural tutorials from remote locations, provide tutors with a first-person perspective of a student’s field of view, and allow the insertion of holographic artefacts which can replicate in-person tutorials and facilitate vertical integration of curriculum elements. This study aimed to evaluate the feasibility, efficacy and usability of the Microsoft HoloLens 2 device in providing tutorials to medical students on peripheral intravenous cannulation from a remote location.MethodsMedical student volunteers were randomly allocated to an In-Person (IP) group and HoloLens (HL) group. Students in the IP group received a tutorial on intravenous cannulation in-person, the HL group received the tutorial remotely via the HoloLens. Both groups completed an initial metric- based competency assessment, received a period of metrics-based feedback which informed a period of deliberate practice, followed by a second competency assessment. Students in the HL group received a familiarisation session with the device, completed a Mental Rotations Test, provided feedback, completed a System Usability Scale (SUS) questionnaire and three students completed interviews. One additional student completed a Think Aloud session. ResultsSeventeen student volunteers were recruited. Sixteen students underwent block randomisation. One additional student completed the Think Aloud session. Baseline characteristics of the two groups were similar. Mean initial competency scores were similar for the HL and IP groups, both groups showed significant improvements in performance, and there was no significant difference between the groups’ post-feedback scores, (p= 0.11). Students SUS scores were mean 79.4 (Standard Deviation 13.1). Quantitative and qualitative feedback was relatively positive, but identified several usability and technological limitations, including the development of headaches and visual fatigue.ConclusionsThis study demonstrates that tutorials on intravenous cannulation which are delivered remotely using the HoloLens 2 device are feasible, show a similar improvement in student performance to in-person tutorials, and are relatively well received by students and tutors. The ability to deliver procedural tutorials to a remote location has the potential to be a significant asset to medical educators. However, it also highlights several usability issues, including the development of “cybersickness” symptoms which may be limiting factors in its widespread adoption by educational institutions, and warrants further investigation.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-026-08648-3.

Abstract Background The higher education sector plays an integral role in ensuring that healthcare professionals possess the knowledge, skills, and competencies needed to deliver high-quality, evidence-based care. However, there is a lack of academically accredited higher-education programmes specifically designed to educate healthcare professionals in the principles of inflammatory bowel disease (IBD) care. The aim of this initiative was to design, deliver, and evaluate an accredited educational programme in IBD. Methods The programme was developed in collaboration with IBD subject-matter experts through stakeholder consultations to obtain strategic input on structure and content. A Certificate in Inflammatory Bowel Disease Care was validated by Munster Technological University in 2021, and the first cohort commenced in January 2022. This fully online, 10-credit (ECTS - European Credit Transfer and Accumulation System) postgraduate programme runs over 12 weeks each academic year. Student profiles are collected at programme commencement, and a final evaluation is completed in week 12. Results To date, 79 healthcare professionals have graduated from the programme. Content analysis of evaluation data indicates that graduates found the programme practice-focused and reported improved understanding of evidence-based IBD care. Modifications are made for each cohort based on student feedback and consultation with subject-matter experts to ensure the programme remains current and relevant. Conclusion Given the global need for more healthcare professionals with specialised training in IBD, this initiative offers valuable insights into the co-design, delivery, and evaluation of academically accredited educational programmes in this field. Conflict of interest: Farrell, Dawn: No conflict of interest Sugrue, Kathleen: No conflict of interest Keogh, Aine M.: No conflict of interest

Abstract Background The assessment of episodic memory is a key component of cognitive screening and is usually assessed using a verbal delayed recall task. The number of words and trials often varies. This study will compare the diagnostic properties of recall tests using data from the Mexican Cognitive Aging Ancillary Study (Mex-Cog). Methods Data were obtained from of the Mex-Cog wave 2 (2021), a sub-analysis of the Mexican Health and Ageing Study focusing on cognition including a representative sample of community dwelling adults aged ≥ 58 years. Objective measures included: 3-word recall (scored 0–3), 10-word recall (scored 0–10), short story recall (scored 0–12) and long story recall (scored 0–50). Diagnostic accuracy for cognitive impairment was measured using Area Under the Curve (AUC) from Receiver Operating Characteristic curves. Results In all, 3,208 participants with a mean age of 72 years (range 58-99) were included of which 58% were female. The average number of words recalled was 2, standard deviation (SD) ± 1 for 3-word recall and 3 SD (± 2) for 10-word recall. For 3-word recall, 66% recalled ≤ 2 words while 42% recalled ≤ 2 words on the 10-word recall test. The 3-word and 10-word recall tests had poor agreement (Cohen’s Kappa < 0.2). The 10-word recall test had better diagnostic accuracy than 3-word recall for the lowest quartile of long story recall logical memory (AUC: 0.75 vs. 0.61, p < 0.001). Conclusion There was poor agreement between scores for 3-word and 10-word recall tests; and 10-word recall displayed better diagnostic accuracy for logical memory. The 3-item and 10-item word recall were not interchangeable subtests. Longer word lists to assess episodic memory (delayed recall) are preferable when conducting cognitive testing, acknowledging the well-established time-accuracy trade off when using cognitive screening instruments.

<h3>Introduction</h3> Aortic dissection (AD) represents a cardiovascular emergency with significant morbidity and mortality. While recent literature reports varying incidence rates of 4–7 among 100,000 people annually, the demographic patterns, diagnostic yield, and clinical outcomes in emergency department (ED) settings require further investigation. This study aims to provide comprehensive epidemiological data on patients undergoing CT angiography (CTA) for suspected aortic dissection in SVUH, a tertiary ED in Dublin. <h3>Methods</h3> Retrospectively, 922 aortic CTA studies from 2020–2024 were reviewed. Demographics, gender- and age-specific positive rates, annual trends, and incidental findings were analysed using descriptive statistics. Medians and interquartile ranges (IQR) are reported for continuous variables. A two-sample z-test compared gender positive rates. <h3>Results</h3> Out of 922 studies, 528 (57.3%) were male and 394 (42.7%) female. Median age was 66 years (IQR 54–77); males 64.5 (53–76), females 68 (56.25–78). Age distribution: &lt;50 years 17.1%, 50–59 years 18.1%, 60–69 years 23.8%, 70–79 years 21.4%, and ≥80 years 19.6%. Overall, 63 positive cases were identified (6.8%). Rates did not differ by gender (males 6.63% vs females 7.11%, p=0.76) and varied minimally across age groups over 50: 50–59 years 7.8%, 60–69 years 5.9%, 70–79 years 7.1%, ≥80 years 7.7%. Median age for positive cases was 68 years. Incidental findings occurred in 54.2% of CTAs, most commonly aneurysms (n=103). Annual positivity declined from 10.2% in 2020 to 5.3% in 2022 before stabilising at 6.0–6.1% in 2023–2024. <h3>Conclusion</h3> A 6.8% positive yield aligns with literature (2%-8%). Male predominance in scan numbers did not translate to higher AD rates. High incidence of incidental findings highlights CTAs broader diagnostic value. Declining positivity likely reflects greater clinical vigilance but also highlights the need for standardised imaging protocols and care pathways. Future studies should evaluate how implemented pathways affect rates of missed or delayed AD diagnoses for further optimized ED diagnostic yield. <i>*presenting author</i>

To evaluate the progression rate of Barrett esophagus (BE) to esophageal adenocarcinoma (EAC) using a prospectively maintained national registry, quality-assured endoscopy, and expert pathology. BE is the sole pathologic precursor of EAC. Targeting prevention and early diagnosis through quality-assured BE programs has a compelling rationale. A Barrett's Registry and Bioresource was founded in 2011, and data to November 2024 were prospectively documented in a web-based system (Dendrite, UK). Endoscopy and pathology (of specialized intestinal metaplasia) were strictly quality assured per current guidelines. Expert gastrointestinal pathologists classified non-dysplastic BE (NDBE), indefinite for dysplasia (IND), low-grade dysplasia (LGD), and high-grade dysplasia (HGD). Endoscopic eradication therapies were monitored. Multivariable regression models evaluated risk factors for progression, and Kaplan-Meier curves were constructed for overall progression, and progression excluding the first year after the index biopsy. Nine thousand four hundred thirty-six patients were registered, with a median follow-up of 4.4 years, and 5331 had at least one follow-up endoscopy. Overall, 252 cases (4.7%, 95% CI: 1.70-2.18) of HGD and 255 cases (4.7%, 95% CI: 1.72-2.20) of EAC were diagnosed. Among these, 150 cases (2.8%. 95% CI: 1.05-1.44) of HGD and 148 (2.7%, 95% CI: 1.05-1.44) of EAC were diagnosed more than 1 year after the index endoscopy. The overall incidence of HGD/EAC combined was 2.42% (95% CI: 2.14-2.73), 6.59% (95% CI: 5.14-8.46), and 13.79% (95% CI: 11.94-15.93) per year in NDBE, IND, and LGD, respectively. Independent risk factors include male sex [hazard ratio (HR): 0.655, 95% CI: 0.56-0.896, P <0.004], age (HR: 1.027, 95% CI: 1.02-1.04, P <0.001) and Barrett's length (HR: 1.635, 95% CI: 1.33-2.01, P <0.001). 604 (6.4%) patients underwent RFA, with a complete eradication of SIM in 80.5% and 10 (1%) patients required resectional surgery. Cancer-specific survival in the total cohort was 100%. A structured high-volume Barrett's program, underpinned by quality assurance, provides data that highlights a strategy that provides proof of concept in targeting prevention and early detection, and is anticipated to reduce mortality.