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AIIHPC Structured Research Network APA Cycle 2 2019 Applied Partnership Awards Applying Research into Policy & Practice Postdoctoral Fellowships ARPP 2020 Cancer Prevention Fellowship Programme Cancer Prevention Fellowship Programme Reintegration Grant Capacity Building for Evidence Synthesis Clinical Research Facilities/Centres 2021 Cochrane Training Fellowships Collaborative Doctoral Awards Conference and Event Sponsorship Scheme COVID-19 2020 CSF 2020 DIFA - 2018 DIFA 2017 DIFA 2018 DIFA 2020 DIFA-2018 Doctoral Training Programme in Precision Medicine in Cancer Emerging Clinician Scientist Awards 2020 Emerging Investigator Awards Emerging Investigator Awards 2022 ERA-NET Cofund for Neuroscience Research (NEURON) ERA-NET Cofund for Personalised Medicine Framework for Safe Nurse Staffing and Skill Mix Fulbright-HRB Health Impact Awards Health Research Awards HRB Clinical Research Facilities HRB Collaboration in Ireland for Clinical Effectiveness Reviews HRB Postdoctoral Fellowships: ARPP 2023 HRB Postdoctoral Fellowships: CSF 2023 HRB Trials Methodology Research Network HRCI 2020 HRCI-HRB Joint Funding Scheme ICORG Statistics and Data Management Interdisciplinary Capacity Enhancement Awards Investigator Led Projects IPPOSI 2020 Irish Clinical Oncology Research Group Irish Platform for Patients Organisations Science and Industry Support Award Joint Programming Initiative Healthy Diet for a Healthy Life Joint Programming Initiative in Neurodegenerative Diseases Joint Programming Initiative on Antimicrobial Resistance Knowledge Exchange and Dissemination Scheme Knowledge Translation Awards Medical Research Charities Group Support Award MRCG-HRB Joint Funding Scheme National Children's Hospital Foundation Scheme National Clinical Trials Coordination Programme National integrated PhD programme for Medical Practitioners National Intellectual Disability Supplement to TILDA Patrick Quinn Awards for Parkinson's Research PPI Ignite Awards Project Development Grants Rare Diseases Research and Innovation Catalyst Awards (RDCat) 2023 RCQPS COVID-19 Research Collaborative for Quality and Patient Safety Research Collaborative in Quality and Patient Safety Research Training Fellowships for Healthcare Professionals RL FA 2020 RL PA 2020 Secondary Data Analysis Projects SFI-HRB-Wellcome Research Partnership Structured PhD Programme in Population Health and Health Services Research The Irish Longitudinal Study on Ageing Ulysses Research Visits US-Ireland R&D Partnership Awards WHO-SOLI-2020
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Host Institution
Atlantic Technological University DCU Department of Agriculture, Food and Marine Dublin City University Dublin Dental University Hospital Dublin Institute of Technology Economic and Social Research Institute Family Carers Ireland Fondazione Telethon Fraunhofer ITMP Health Information and Quality Authority Health Research Charities Ireland HSE - St. Luke's Hospital (Rathgar) Institute of Technology Sligo IPPOSI Irish Blood Transfusion Service, National Blood Centre Irish Clinical Oncology Research Group Ltd Irish Platform for Patients Organisations Science and Industry Irish Platform for Patients' Organisations, Science and Industry Ltd Irish Platform for Patients’ Organisations, Science and Industry Katholieke Universiteit Leuven Limerick Institute of Technology Maynooth University Medical Research Charities Group Ltd National University of Ireland Galway National University of Ireland, Galway Our Lady's Hospice Queen’s University Belfast RCSI Royal College of Physicians of Ireland Royal College of Surgeons in Ireland TCD Teagasc Technological University Dublin The Alzheimer Society of Ireland The Children's Hospital of Philadelphia Trinity College Dublin UCD University College Cork University College Dublin University Hospitals Leuven & KU Leuven University of Auckland University of California San Francisco University of Cambridge University of Galway University of Limerick University of Oxford UPMC Whitfield
Funding Awarded
65 awards
Pathways to Improving Transition to Adult Services & Enhancing Self-Management in Adolescents with Cystic Fibrosis: A New Era of Treatments
The teenage years are a time of change. Being an adolescent with Cystic Fibrosis (CF) can bring additional challenges due to complex and demanding treatments. A key task for teenagers with CF is to learn the skills to manage their health, as they prepare to transition into adult-based care. In Ireland, many adolescents transition to...
The Next Generation' Diabetes Self-Management Alliance Conference
The Diabetes-Self-Management Alliance (DSMA) conference aims to share the most up-to date research evidence on how best to support people with diabetes to manage their condition on a day to day basis and to explore ways to improve diabetes self-management education and support in the future in partnership with people living with...
Irish Clinical Academic Training: An All-Ireland Integrated Training Programme for Clinical Academics
The Irish Clinical Academic Training Programme (ICAT-1) was established with the vision of changing the training landscape for clinician scientists on the island of Ireland. The proposed ICAT-2 will advance the achievements of ICAT-1 and is the next step in developing clinical academics of the future across the spectrums of...
HRB Trials Methodology Research Network (HRB-TMRN) 2021 - 2026
No summary available
HRB Clinical Research Facility Galway
No summary available
Emerge-2: placebo-controlled RCT of the Effectiveness of MEtformin in addition to usual care in the Reduction of Gestational diabetes mellitus Effects
Diabetes (high blood sugars) developing during pregnancy is called Gestational Diabetes Mellitus (GDM). GDM is increasing, affecting one-in-eight pregnant women in Ireland. Women with GDM have an increased risk of complications including delivery by Caesarean section and more blood pressure problems. Women with GDM have a 7-fold...
Maximising medication adherence and minimising physician interia: Lowering to target the blood pressure of older patients with hypertension-A cluster randomised feasibility study in general practice
High blood pressure can lead to strokes and heart disease. Despite treatment, many patients continue to have uncontrolled blood pressure. In Ireland, we do very badly in this area - the worst of sixteen high income countries worldwide. For example, the proportion of Irish male patients with controlled blood pressure is 17% - in Canada,...
Blood-based biomarkers for early detection of preclinical neurocognitive disorders
With more people now living longer lives, dementia is becoming an increasingly important problem in society. One of the biggest challenges in designing studies of potential new treatments for dementia, is accurately predicting which people are most likely to develop dementia in the future, prior to them showing signs of the disease....
Using knowledge translation to enhance the use of evidence in public health decision-making by policymakers and healthcare managers in Ireland
Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. Using high-quality evidence to inform how health policies are made is crucial to ensure safe and effective healthcare and to optimise patient and public health outcomes. Despite this, international research...
Development of a rapid, highly sensitive, handheld Raman-based device for detection of SARS-CoV-2 and serological responses against SARS-CoV-2
Serological assays to detect antibody responses to SARS-CoV-2 are critical to study immune responses to the virus, determine precise rates of infection, track progression of infections, and identify immune individuals in order to limit exposure of susceptible groups or as potential sources of convalescent serum therapeutics. The...
Treating Primary aldosteronism-induced hypertension via microwave thermal therapy
In this tripartite US-Ireland R&D partnership program R01 research plan, we propose the development, optimization, and evaluation of a minimally-invasive microwave thermal therapy (MWT) system for definitive treatment of primary aldosteronism. Primary aldosteronism (PA) accounts for 5 - 12% of all hypertension and confers a higher...
Improving psychosocial supports for youth mental health
This research program will focus on improving the mental health of young people with serious mental health disorders. Serious mental health disorders (including schizophrenia and other psychotic disorders) are ranked among the top causes of years lived with disability.
My research will build on what is currently known about...
Collaboration to reduce antimicrobial use and resistance and identify opportunities for improvement and awareness
Infections are often treated with antibiotics, even though antibiotics are not always the best option. Only infections that are caused by bacteria can be treated with antibiotics, infections caused by viruses do not respond to antibiotic treatment. An additional problem is that bacteria are becoming more and more resistant to...
Collaborative Doctoral Programme in Chronic Disease Prevention (CDP-CDP)
According to the WHO, chronic disease prevention is one of the major health challenges of the 21st century. Prevention programmes are urgently needed to reduce burden on patients and health services.
In Ireland, there is a national deficit in skills, leadership and capacity in the development, implementation and evaluation of...
Diabetic Foot Disease: from PRevention to treatment to IMproved patient Outcomes (DFD PRIMO)
Diabetic foot disease (DFD), is associated with devastating outcomes including foot ulceration, sepsis, amputation and premature death. The risk of premature death in people with DFD is reportedly nine fold the risk of amputation. Early interventions to prevent the first ulcer are a key priority of national and international clinical...
Implementation of Making Every Contact Count (MECC): developing a collaborative strategy to optimise and scale-up MECC.
Importance of the study:
Many chronic illnesses can be prevented if people adopt healthier behaviours. The Making Every Contact Count (MECC) programme, developed by the Irish Health Service Executive (HSE), aims to train all healthcare professionals to support patients to make healthier lifestyle choices during...Using guanine to re-sensitise MRSA to methicillin: Is purine nucleotide homeostasis the Achilles' heel of MRSA antibiotic resistance?
The threat of antibiotic-resistant bacterial infections to hospital patients and the wider society continues to escalate. The discovery of antibiotics in the 1940's and 1950's represented one of the most important scientific breakthroughs in history. However since then the spread of antibiotic-resistant pathogens has gradually erooded...
Defining the consequences of innate immune training on protective versus pathogenic T cell responses in patients with tuberculosis.
Tuberculosis (TB) ranks alongside HIV as the world's most deadly infectious disease, killing 1.5 million people every year. It is caused by the bacteria Mycobacterium tuberculosis (Mtb), which primarily infects people's lungs. Treating this disease is becoming more difficult due to antibiotic-resistant Mtb, therefore, scientists are...
Evidence synthesis and translation of findings for national clinical guideline development: addressing the needs and preferences of guideline development groups
National clinical guidelines aim to help healthcare providers and patients' make decisions about appropriate healthcare. These guidelines use the best available evidence, gathered from national and international research, to develop recommendations on a wide range of topics. These include preventing and managing specific conditions to...
The impact of mutations in PI3K/AKT pathway gene loci on response to PI3K inhibitors
Despite advances in the treatment of breast cancer, the National Cancer Registry of Ireland reported in 2014 that it accounted for 30% of all diagnosed female cancers and 16% of all female cancer deaths. The application of modern technologies to the study of breast cancer has demonstrated that a group of cancer pathways acquire changes...
PRoviding Improved care for Self-harM: a mixed-methods study of intervention, economic and implementation outcomes from a national clinical programme
Suicide is a societal concern in Ireland and is associated with both personal and economic costs. People who self-harm are at particular risk of suicide, and so developing services and interventions for this population can help prevent deaths. Under Ireland's national strategy to reduce suicide, a programme to help people who present...
Engineering RNA-based therapeutics for treatment of sepsis and sepsis induced multiple organ dysfunction syndrome
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Worldwide it affects over 30 million people of all ages and results in 5.3 million deaths annually. In Ireland sepsis contributes to 25% of in-hospital deaths and one in five patients diagnosed with sepsis will die from this disease. To...
Comparison of staphylococcal species from the oro-nasal cavity, periodontal pockets and foot ulcers of patients with type II diabetes: a potential microbial reservoir for diabetic foot ulcer infection
The Research Collaborative in Quality and Patient Safety (RCQPS) is a collaborative initiative between the Health Research Board, the Health Service Executive, National Quality Improvement Team and the Royal College of Physicians of Ireland. It was established in 2013 to advance nationally relevant research in the area of quality and...
Investigating breast cancer risk factors to understand breast cancer epidemiological outcomes
This proposal aims to expand cancer prevention research in Ireland through the assessment of breast cancer risk factors and their influence on clinically relevant characteristics of aggressive breast cancers.Prior research has identified factors associated with increased risk of breast cancer development. One such known factor includes...
Harnessing the power of the Gut-Lung Axis: How Dietary Short-Chain Fatty Acids Balance Inflammatory Outcomes in Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is an incurable lung condition triggered by smoking, or other air pollutants, that leads to long-term lung damage and serious trouble breathing. While COPD is an illness of the lungs, maintaining a healthy gut and a balanced diet can prevent COPD and reduce COPD attacks or flare-ups. But how...
SCaRLeT: Sex differences in Cardiovascular Risk across Life course Transitions
Heart disease is still the leading cause of death around the world. Preventing heart disease, by focusing on risk factors like smoking is essential for improving population health. Females and males do not experience heart disease equally. In adults, research suggests risk factors that can be changed like smoking do not have the same...
Developing a new approach to stroke rehabilitation for the upper limb based on TMS neurofeedback
Today in Ireland, most people who experience a stroke survive, but more than half are left with long-term disabilities due to paralysis of one arm. In the proposed research, we aim to push the boundaries of standard stroke rehabilitation, by introducing a technique that promises to boost the brain's recovery mechanisms, stimulating...
IMPlementation of osteoArthritis Clinical guidelines Together
Osteoarthritis is a disease of the joints, affecting 1 in 8 Irish people as they get older. Due to the growth of our ageing population amongst other reasons, this figure is expected to double within one generation. Most people with the disease in their hips or knees are likely to experience some level of pain as well as difficulty...
Membrane Seeping for induction of labour: The Milo Study
Post-term pregnancy refers to a pregnancy that continues past 42 weeks’ gestation. It occurs in approximately 10% of pregnancies and is the most common reason for induction of labour. Post-term pregnancy is associated with higher risk of trauma to mother and baby.
Membrane sweeping is a simple procedure potentially promoting the...
A Cognitive Occupation-Based programme for people with Multiple Sclerosis- a cluster randomised pilot trial to improve cognition and daily functioning for people with multiple sclerosis
The aim of this research is to test the feasibility of running a large-scale trial of an occupational therapy intervention called a Cognitive Occupation-Based programme for people with Multiple Sclerosis. The study will focus on how acceptable the intervention is and how well the trial runs. Sixteen occupational therapists will run the...
Feasibility and preliminary efficacy study of an online pain management programme for children undergoing major orthopedic surgery: iCanCope Post-Op Surgery
After major surgery, one in four children experience chronic post-surgical pain (i.e., pain that lasts longer than 3 months). Children and adolescents report that chronic pain makes them feel insecure, affects school attendance and affacts their relationships with friends and family. It is important that children and adolescents...
Citizen Science: The People's Trial
Randomised trials are instrumental in providing reliable and robust evidence on the benefits, harms and costs of health care, so that people can make informed choices. However, the general public?s understanding of randomised trials can be limited and ensuring public support for and participation in trials remains challenging. The...
Piloting the Community Engaged Scholars Program in Ireland
Public and patient involvement in health research is not embedded in Irish Universities. As part of the PPI Ignite Awards scheme the HRB have funded 5 Irish Universities to demonstrate the value of PPI and champion this approach in Ireland. PPI involves public/patients working in partnership with researchers in setting research...
Disseminating, Engaging, and Sharing Knowledge (DESK):patient informed resource for understanding our research
Based on the findings of the research conducted during our HRB Research Leader's Award, the aim of the proposed KEDS project is to effectively disseminate the finding of our research to chronic pain patients and the general public. Sharing research findings with the general public is very important but can be difficult to get right; we...
The patient is part of the answer - don't leave us out in the cold!
This application aims to produce a documentary that explains public and patient involvement in health research to the general public and encourages more people to become involved with researchers. Known as PPI, public and patient involvement means that people who are likely to be affected by research results are directly involved in...
"Let's Talk About" Series
Researchers in dementia at NUI Galway are producing important research insights into many aspects of dementia care in Ireland, specifically: resource allocation decision-making; support structures for family carers; and how people with dementia are treated within the care system. The focus is now turning to sharing the results...
Using visual media to communicate complex information
Services in Ireland for people with dementia are poorly developed. The main partnership award aims to (i) describe current dementia services across all sectors and (ii) ask people with dementia, carers, health workers and managers about the ideal level and type of service provision for people with dementia who have different needs and...
Evidence Synthesis Ireland
Health care decisions should be based on the combination of the full amount of information that is available rather than relying on the convenient selection of one or more individual pieces of information, or studies. Evidence synthesis methods seek to establish the overall balance of information on a given topic, and are based on...
Unlocking the potential of healthcare complaints to improve hospital care (UP-CIC)
Most assessments of quality of care in Irish healthcare services are focused on healthcare workers’ opinions, statistics (e.g., how many patients got infections), or investigating large errors. However, these assessments fail to consider patients’ unique insights into quality of care and support improvement in services. For example,...
Doctoral program in youth mental health leadership (The YouLead Program)
This doctoral training program focuses on youth mental health research. Mental health difficulties (including depression, bipolar disorder, and schizophrenia) account for approximately half of all causes of disability in individuals under the age of 35. Despite the fact that access to treatment is strongly associated with reduced risk...
Interact for Health: Increasing integrated knowledge translation capacity for impact
Although the Health Behaviour Change Research Group (HBCRG) has engaged with the HSE Health and Wellbeing (H&W) Division as health partners on a number of activities to date, we believe there is significant potential for enhanced knowledge exchange between these two groups. Additionally, integrated Knowledge Translation (iKT)...
The biology of mood: What brain imaging and genetic studies tell us about Bipolar Disorder
This project aims to translate the known biology of bipolar disorder, enhance the accessibility of the latest discoveries and interpret the meaning and relevance to individuals with bipolar disorder, their families, carers and health professionals that are not research active. To complement the current emphasis on clinical aspects of...
Learning about trials - for children, by children
This project will consist of the development of new resources for teaching primary school children (aged 10-12) about why we need trials and how trials work, with a view to being more widely used throughout the trial community. These resources will align with the START (Schools Teaching Awareness of Randomised Trials) Competition,...
Development of an online cancer genetics educational resource for undergraduate and postgraduate healthcare learners
Genetic testing is becoming cheaper and easier to perform. As such, it is being performed more and more frequently; to help explain why people have developed cancer, or to try to identify genetic changes in their tumours to which novel drugs can be targeted. Genetic testing may also help identify individuals at risk of cancer,...
Let's talk - and act - about adherence in multimorbidity - a teaching and learning resource for general practice
More than half of those over the age of 65 live with more than one chronic condition. This is known as multimorbidity (MM). The prevalence of MM increases with age and is more common in less well off patients. Using muliple medications i.e. polypharmacy, is the norm in MM and many do not take their medications as prescribed i.e....
Development and validation of diagnostic biomarkers for neurodegenerative conditions based on MRI measures of pathognomonic brain regions
Amyotrophic Lateral Sclerosis (ALS) is a devastating, relentlessly progressive neurodegenerative condition with no effective disease-modifying therapies and no validated biomarkers. Three main themes exist in ALS biomarker research; (1) development of diagnostic indicators, (2) identification of accurate prognostic markers and (3)...
Biomarker discovery and validation in autism spectrum disorder: A study of neonatal cord blood in international birth cohorts
What is Autism? Autism spectrum disorder (ASD) is a complex disorder of brain development. ASD is characterized by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviours. ASD begins in infancy and persists into adolescence and adulthood. ASD imposes significant emotional and economic burdens on...
Using Bayesian network models to predict the impact of public health interventions on disease-prevalence in population health research
Population Health Research studies determinants of health and disease with the goal of identifying interventions that promote health and reduce the burden of disease. Deciding on an appropriate intervention mandates a prior forecast of the intervention's effect on disease. For example, for an intervention targeting smoking, we might...
The Hospital Doctor Retention and Motivation (HDRM) project
Ireland is losing almost as many doctors to emigration as it trains each year. This rate of doctor emigration is a threat to the future of the health system, which may run short of doctors to staff its hospitals. So far, Ireland's solution has been to recruit doctors from other countries. One in three doctors in Ireland is from...
Targeting metabolism for individualised rectal cancer treatment: Development of an omics-led predictive signature of chemoradiation therapy response and novel neoadjuvant therapeutic strategy
Cancer of the rectum is one of the most common cancers in Ireland and worldwide. Patients with rectal cancer are commonly treated with chemoradiation therapy (CRT), which is a combination of chemotherapy and radiation therapy, to shrink the tumour before undergoing surgery to remove the tumour. CRT has been shown to improve survival...
Investigating mitochondrial dysfunction and meta-inflammation as a shared pathogenic network in pre-eclampsia and gestational diabetes mellitus
Pre-eclampsia (PE) and gestational diabetes (GDM) are two common complications of pregnancy. PE is characterised by high blood pressure and increased protein in the urine. GDM develops because the mother's body is not able to produce the extra insulin needed for pregnancy. Together, these pregnancy complications affect 15% of first...
An allostatic load framework for understanding social differences in health and mortality
A consistent finding in the epidemiological literature is that health is socially patterned. On average, individuals from more disadvantaged social backgrounds will develop diseases earlier and will die earlier compared with their more advantaged peers. So ubiquitous is the association between health and wealth that it has been...
Enhancing the evidence base for cost-effectiveness analysis in Ireland: Building improvements from the intervention-specific to system-wide levels
The objective of this research is to increase the relevance and reliability of health economic evidence in Ireland. The aim is to improve the methods for prioritising scarce health funding to the most beneficial uses. This research will translate valuable lessons learnt from cervical cancer prevention to screening for other cancers,...
The liver neighbourhood watch: regulatory tissue-resident natural killer (NK) cells protect against liver decompensation in patients with chronic liver disease
Liver cirrhosis occurs when normal liver tissue is replaced by scar tissue, leading to the eventual failure of normal liver functions. Cirrhosis develops as a result of chronic liver disease, and it accounts for 170,000 deaths annually in Europe and more than 3,000 deaths annually in Ireland. Presently the only treatment is liver...
Targeting adipose tissue inflammation by intermittent hypoxia: towards personalised medicine in obstructive sleep apnoea
Obstructive sleep apnoea (OSA) is a very frequent condition, which is strongly linked with obesity and associated with the development of various heart conditions, such as high blood pressure, heart attack or stroke. It also leads to diseases which are associated with abnormalities in blood glucose levels, such as type 2 diabetes...
HRB Trials Methodology Research Network (HRB-TMRN) 2017 -2021
No summary available
HRB Trials Methodology Research Network (HRB-TMRN) 2017 - 2021 - Pilot: Education and training for recruiters to randomised trials
No summary available
HRB Clinical Research Facility Galway 2018-2021
No summary available
Development of a nebulised cell based therapy for acute respiratory distress syndrome
Acute lung injury and acute respiratory distress syndrome (ARDS) constitute a spectrum of severe acute respiratory failure. Mortality rates over 60% have been reported and ARDS is the leading cause of death in the critically ill. ARDS develops most commonly in the context of severe sepsis, particularly infection with gram-negative...
PPI Ignite Award - National University of Ireland Galway
The Public and Patient Involvement (PPI) Ignite Awards aim to promote PPI in health research in Ireland. Our NUI Galway Primary Care PPI group of patients and members of the public were asked to describe what a successful PPI Ignite project would look like (Figure 3). They responded by saying that success would be creating an...
Lending an ear: "iPeer2Peer" plus "Teens Taking Charge" online self-management to empower children with arthritis
Childhood arthritis is common and makes everyday activities diffciult for young people. It is a chronic illness that can cause children to experience pain, fatigue and emotional upset. This makes it more difficult for children to see friends and do enjoyable activities.
When children become teenagers they start making more...Improving outcomes for young adults with type 1 diabetes in Ireland: the D1 now feasibility and cluster randomised pilot study
Many young adults with type 1 diabetes find it hard to control their blood glucose levels. With many changes going on in their lives their diabetes is often not a priority. They also find it hard to engage with hospital diabetes services because of an inflexible clinic appointment system and seeing a different member of staff at each...
Out of hospital cardiac arrest and community first response: International best practice, national consultation and prospective evaluation
Cardiac arrest occurs when the heart suddenly ceases to pump blood around the body. The term 'Out-of-Hospital Cardiac Arrest' (OHCA) is used to describe incidents where cardiac arrest occurs unexpectedly and is responded to by statutory emergency medical services (EMS). OHCA causes approximately 1,900 unexpected deaths in Ireland every...
Community Risk-based monitoring for Atrial Fibrillation Trial (CRAFT)
Atrial fibrillation, an irregular heart-beat, is common, affecting ~7% of people over 65 years of age. It is a major cause of stroke, increasing the risk of stroke 5-fold, and about one-third of patients with acute stroke have atrial fibrillation. Once detected, there are very effective treatments to prevent stroke - oral anticoagulant...
Resource allocation, priority-setting and consensus in dementia care in Ireland
A key action under the National Dementia Strategy (2014) is the delivery of appropriate supports and services for people with dementia that can be accessed in people's own homes and local communities. There is also an emphasis in the Strategy to address the individual needs of people with dementia and their carers in a manner that is...