The Biomedical Engineering Laboratory at Mercer’s Institute for Successful Aging (MISA) provides a space for engineering concepts and skills to be applied to clinical and research problems in medicine, with a particular focus on older age.
The laboratory is hosted by Mercer’s Institute for Research on Ageing (MIRA) and the Department of Medical Physics and Bioengineering (MPBE) at St James’s Hospital. Its integration with and physical proximity to the working life of a large acute hospital allows engineering and medicine to work together, close to the point of care. In this way, medical and engineering efforts can be combined and focused on identifying and solving problems that are of real concern to patients and clinicians.
The Biomedical Engineering Laboratory hosts hospital personnel and visiting postdoctoral, postgraduate and undergraduate students working on clinical projects with a technological or engineering science component. The MISA Laboratory is equipped to support electronic prototyping, software development, data analytics, optics development, system modelling and 3D printing.
Research at the Biomedical Engineering Laboratory at MISA is focused on bringing benefits to the patient through the application of engineering science. Through engineering research, new technologies can be developed for more rapid and effective diagnosis, underlying disease processes can be better understood, existing technologies can be more effectively applied and care made more efficient.
Gait analysis is the quantitative systematic study of human walking. The continuing ability to navigate the environment successfully and without falling is an essential component of independent living. The team has established a clinical gait analysis laboratory in MISA. The use of inertial sensors allows for the assessment of gait in free walking environments and is a promising area of research as a means of monitoring gait decline in community-dwelling older adults.
Looking to inpatient care, a further sub-theme of falls research at the Biomedical Engineering Laboratory at MISA is in exploring falls prevention and detection technology for improving the management of falls in tertiary care, with a focus on usability by staff and user-centred design.
Our work on neurocardiovascular systems examines the interplay between the health of the cardiovascular system, its neural regulatory systems and the brain. Our ultimate aim is to provide insights into mechanisms which to lead to falls, faints, cognitive impairment and other age-related issues. This approach is informing the scientific development of novel diagnostic and treatment approaches that leverage cutting edge technology.
Our unique integration within MISA allows us to rapidly translate our findings into impactful and innovative clinical processes, for example, within the Falls and Syncope Unit (FASU) in MISA. As part of this work, we have recently introduced innovative measurements of cerebral perfusion and beat-to-beat blood pressure into clinical use in FASU.
Our work is carried out in collaboration with our broad network of clinical and academic colleagues in MISA, St James’s Hospital, Trinity College Dublin and our international collaborators.
The LAMP (Local Asset Mapping Project) at MISA is based on the concept of ‘social prescribing’. In social prescribing, a prescriber issues a patient with a prescription of local non-medical activities and organisations that may be of benefit to the patient’s health and wellness. Items on the prescription could range from walking clubs to support groups to social events. The prescription objectives could be, for example, to assist the patient in improving levels of physical activity, to help reduce social isolation or to improve diet.
The Biomedical Engineering Laboratory at MISA developed the web portal used for LAMP social prescribing. The core of the portal is a database of over 6,000 items in the south-central Dublin region. The portal’s user interface allows a prescriber to identify items close to a patient’s home address, and to filter items suitable for that patient for inclusion on a bespoke social prescription.
Gait and TUG assessment app based on norms from the TILDA apps or web portals can be useful in translating research data or other data into practical, useful tools for clinical applications. The Biomedical Engineering Laboratory at MISA can support this process by developing user-friendly prototypes of apps and web interfaces. The creation of even early-stage functional prototypes helps move an idea from concept to reality.
Research on the tiny eye movements known as Ocular Microtremor (or OMT) and their clinical importance was pioneered in St James’s Hospital and spans several decades. Despite being too small to feel or see, OMT is thought to hold immense potential in quantifying brain activity. Potential clinical applications of OMT range from assessing mild traumatic brain injury (mTBI) to determining brainstem death.
Much of the published research data on OMT was generated using an eye-contacting measurement probe originally developed at St James’s Hospital. Continuing this tradition of device innovation, the MISA Biomedical Engineering Laboratory is developing a contactless probe that will allow for the widespread adoption of OMT as a clinical tool. This work is supported by the Enterprise Ireland Commercialisation Funding Programme (http://www.enterprise-ireland.com).
SJH Design Week is an annual event hosted by the Biomedical Engineering Laboratory to support St James’s Hospital staff in solving problems through design. Leading up to Design Week, staff are invited to submit ideas to improve the delivery of care, with a focus on better design. Ideas submitted have included, for example, concepts for improving medical equipment, ‘gadgets’ for assisting in clinical procedures and improvements to processes and facilities.
Design and engineering students from the National College of Art and Design (NCAD) and Trinity College Dublin (TCD) are then paired with staff to work on the shortlisted ideas over Design Week. Design concepts are developed over the week and then presented to an open audience at the hospital, with an overall winner determined by a judging panel. Several concepts are taken forward after the week to develop them further towards a final product.
Continuous beat-to-beat blood pressure measurement is critical in the assessment of age-related disorders such as syncope, falls, brain ageing and is critical in the assessment of fast transient changes of blood pressure. However, current technologies are expensive and require significant expertise to operate and interpret, therefore they are only suited to specialist centres such as MISA.
Our current focus is on developing next-generation continuous blood pressure measurement technologies that are cost-effective, and user friendly and therefore suitable for broader community adoption.
One of the challenges older people face as they age is mobility decline. As we age, muscle tone tends to reduce as well as other factors that impinge on our ability to walk successfully. One out of three adults over the age of 65 experience at least one fall every year. Falls are one of the most common reasons for older people’s admission to hospital and are a common cause of death for this cohort of people.
With this issue, some patients who attend hospital (particularly Medicine for the Elderly) are at risk of falling and so the MISA Biomedical Engineering Laboraotry is developing new technologies to help assist the multifactorial effort towards falls prevention.
The Dementia Services Information and Development Centre (DSiDC) is a national organisation committed to best practice in all aspects of dementia care. The DSiDC was set up in 1998 in response to a growing demand for resources for practitioners working in the area of dementia and care of older people.
DSiDC offers three core professional services:
Our vision is of a society where the civil and legal rights of people with dementia are fully respected and can participate in the making of all decisions that affect them, without discrimination or prejudice.
Our mission is to transform people’s understanding and awareness of dementia through our educational programmes and research, informed by the voice of the person with dementia and those around them.
Our values are of dignity and respect, autonomy and choice, participation and empowerment.
The DSiDC works alongside health and social care professionals, people with dementia and their care partners, community organisations, private and public care providers and national policymakers to achieve its goals.
Modern healthcare decisions are increasingly being driven by insights gleaned from data. Ultimately this is done to improve services, outcomes and experiences for patients and carers.
The MISA Biomedical Engineering Laboratory has strong clinical data analytics expertise across the full data pipeline, from signal processing patient data obtained from advanced physiological sensors to modelling disease processes and the use of machine learning in analysing large scale physiological datasets, such as the Irish Longitudinal Study on Ageing (TILDA) database.
With our software and device design skills, we also have the proven expertise to translate these data-driven insights into user-friendly clinical decision support tools.
Fundamentally, the Biomedical Engineering Laboratory at MISA is about improving services, outcomes and experiences for patients through the application of technology.
That is why we try to encourage innovation through our activities and collaborations, whether by nurturing an early-stage idea for a new device, by promoting design thinking in healthcare, by maximising the practical impact of engineering research outputs or by supporting clinical staff on technical aspects of new approaches to healthcare.
The MISA Biomedical Engineering Laboratory is equipped with a 3D printer to facilitate in-house rapid prototyping of design concepts.3D printing has become an indispensable part of our innovation pathway, helping to communicate ideas, test concepts and manufacture prototypes.
Global Brain Health Institute
The Irish Longitudinal Study on Ageing
Trinity Research & Innovation