Now showing items 1-20 of 1614

    • International Perspective on the Pursuit of Quality in Cancer Care: Global Application of QOPI and QOPI Certification.

      Blayney, Douglas W; Albdelhafeez, Nafisa; Jazieh, Abdul Rahman; Pinto, Carlos Frederico; Udrea, Adrian; Roach, Alex; Das, Devika; Grubbs, Stephen; Hamm, John; Jahanzeb, Mohammad; et al.
    • Histologic Case Definition of an Atypical Glomerular Immune-Complex Deposition Following Kidney Transplantation.

      Chin, Kuo-Kai; Charu, Vivek; O'Shaughnessy, Michelle M; Troxell, Megan L; Cheng, Xingxing S (2020-02-05)
      Introduction: Immune-complex deposition in the transplanted kidney can present as well-phenotyped recurrent or de novo glomerular disease. However, a subset, herein termed immune-complex glomerulopathy not otherwise specified (ICG-NOS), defies classification. We quantified, categorized, and characterized cases of transplant ICG-NOS occurring at a single US academic medical center. Methods: We retrospectively reviewed our single-institution pathology database (July 2007-July 2018) to identify and categorize all cases of immune-complex deposition in kidney allografts (based on immunofluorescence microscopy). We extracted clinicopathologic and outcome data for ICG-NOS (i.e., immune complex deposition not conforming to any well-characterized glomerular disease entity). Results: Of 104 patients with significant immune deposits, 28 (27%) were classified as ICG-NOS. We created 5 mutually exclusive ICG-NOS categories: Full-house, Quasi-full-house, IgA-rich, C1q-rich, and C1q-poor. Overall, 16 (57%) patients met criteria for definite or possible allograft rejection, including 9 (32%) with antibody-mediated rejection (ABMR), 3 (11%) suspicious for ABMR, 1 (4%) with T-cell-mediated rejection (TCMR), and 9 (32%) with borderline TCMR. After a median follow-up of 2.3 (range, 0.1-14.0) years after biopsy, 7 (25%) allografts had failed and an additional 8 (29%) had persistent renal dysfunction (hematuria, 14%; proteinuria, 21%; and estimated glomerular filtration rate <60 ml/min per 1.73 m2, 11%). Conclusion: In contrast to prior studies, our findings suggest that ICG-NOS is not necessarily a benign glomerular process and that there may be an association between ICG-NOS and alloimmunity. Our immunofluorescence-based classification provides a framework for future studies aiming to further elucidate ICG-NOS pathogenesis and prognosis.
    • Treatment Outcomes in Trigeminal Neuralgia-A Systematic Review of Domains, Dimensions and Measures.

      Nova, Carolina Venda; Zakrzewska, Joanna M; Baker, Sarah R; Riordain, Richeal Ni (2020-01-27)
      Background: Trigeminal neuralgia (TN) is a painful disorder characterized by sudden electric shock-like pain. It is a rare condition for which multiple treatments are available, including medical and surgical. The best treatment option is yet to be defined, and this is related to the lack of definition in the treatment outcomes and outcome measures. The aim of this systematic review was to summarize all the outcomes and outcomes measures that have been published to date and highlight variability in their use. Methods: We have conducted a literature search using a wide range of databases (1946-2019 for medical and 2008-2019 for surgical treatment), for all intervention studies in TN. Four hundred and sixty-seven studies were selected for data extraction on TN classification, data collection method, intervention, and treatment outcomes mapped to the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT guidelines). Results: Most studies collected data on pain (n = 459) and side effects (n = 386) domains; however, very few collected data on the impact of treatment on physical (n = 46) and emotional functioning (n = 17) and on patient satisfaction (n = 35). There was high variability on outcome measures used for pain relief (n = 10), pain intensity (n = 9), and frequency of pain episodes (n = 3). Conclusions: A clear definition of what are the important outcomes for patients with TN is essential. The choice of standardized outcome measures allowing for consistent reporting in TN treatment will allow for comparison of studies and facilitate treatment choice for patients and clinicians thus, improving health outcomes and reducing health care cost. Keywords: BNI, The Barrow Neurology Institute Pain Intensity Scale; BPI, Brief Pain Inventory; COS, Core Outcome Set; MVD, Microvascular decompression; Outcome measures; QOL, Quality of life; Systematic review; TN, Trigeminal neuralgia; Treatment outcomes; Trigeminal neuralgia; VAS, Visual analogue scale.
    • Ageing well at home: advice to help you age well in your community

      Moloney, Elizabeth; Gillman, Ciara; O’Brien, Gillian; Mercy University Hospital, Grenville Place, Cork (Mercy University Hospital, Cork Kerry Community Healthcare, 2021-06)
      The aim of this booklet is to help you age well and avoid becoming frail through general health and wellbeing advice. COVID-19 has made it more difficult to engage in normal social and physical group activities. We have had to adapt our lifestyles and regular social connections. This booklet reflects the hope we all feel as normal routines return. Included is information about a range of activities, services and agencies available in your community to help you age well. As healthcare workers, we want to support you to live well at home. By remaining active and engaged in your local community, you can delay the onset of frailty. This booklet encourages you to look after your health and wellbeing and to feel positive about the future. Now is the time to invest in your physical and mental health so you can reap the benefits in years to come.
    • Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity.

      Ghosh, Sandip; Manley, Susan E; Nightingale, Peter G; Williams, John A; Susarla, Radhika; Alonso-Perez, Irene; Stratton, Irene M; Gkoutos, Georgios V; Webber, Jonathan; Luzio, Stephen D; et al. (2020-05-15)
      Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P < .001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were 'at risk' (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P < .001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours.
    • Systematic review and network meta-analysis with individual participant data on cord management at preterm birth (iCOMP): study protocol.

      Seidler, Anna Lene; Duley, Lelia; Katheria, Anup C; De Paco Matallana, Catalina; Dempsey, Eugene; Rabe, Heike; Kattwinkel, John; Mercer, Judith; Josephsen, Justin; Fairchild, Karen; et al. (2020-03-29)
      ntroduction: Timing of cord clamping and other cord management strategies may improve outcomes at preterm birth. However, it is unclear whether benefits apply to all preterm subgroups. Previous and current trials compare various policies, including time-based or physiology-based deferred cord clamping, and cord milking. Individual participant data (IPD) enable exploration of different strategies within subgroups. Network meta-analysis (NMA) enables comparison and ranking of all available interventions using a combination of direct and indirect comparisons. Objectives: (1) To evaluate the effectiveness of cord management strategies for preterm infants on neonatal mortality and morbidity overall and for different participant characteristics using IPD meta-analysis. (2) To evaluate and rank the effect of different cord management strategies for preterm births on mortality and other key outcomes using NMA. Methods and analysis: Systematic searches of Medline, Embase, clinical trial registries, and other sources for all ongoing and completed randomised controlled trials comparing cord management strategies at preterm birth (before 37 weeks' gestation) have been completed up to 13 February 2019, but will be updated regularly to include additional trials. IPD will be sought for all trials; aggregate summary data will be included where IPD are unavailable. First, deferred clamping and cord milking will be compared with immediate clamping in pairwise IPD meta-analyses. The primary outcome will be death prior to hospital discharge. Effect differences will be explored for prespecified participant subgroups. Second, all identified cord management strategies will be compared and ranked in an IPD NMA for the primary outcome and the key secondary outcomes. Treatment effect differences by participant characteristics will be identified. Inconsistency and heterogeneity will be explored.
    • 'I've always done what I was told by the medical people': a qualitative study of the reasons why older adults attend multifactorial falls risk assessments mapped to the Theoretical Domains Framework.

      Racine, Emmy; Soye, Anna; Barry, Patrick; Cronin, Finola; Hosford, Orla; Moriarty, Eileen; O'Connor, Kieran A; Turvey, Spencer; Timmons, Suzanne; Kearney, Patricia M; et al. (2020-02-18)
      Sixteen interviews were conducted. Three main themes explained participants' reasons for attending the multifactorial risk assessment; being that 'type of person', being 'linked in' with health and community services and having 'strong social support'. Six other themes were identified, but these themes were not as prominent during interviews. These were knowing what to expect, being physically able, having confidence in and being positive towards health services, imagining the benefits given previous positive experiences, determination to maintain or regain independence, and being 'crippled' by the fear of falling. These themes mapped on to nine TDF domains: 'knowledge', 'skills', 'social role and identity', 'optimism', 'beliefs about consequences', 'goals', 'environmental context and resources', 'social influences' and 'emotion'. There were five TDF domains that were not relevant to the reasons for attending.
    • Evaluation of wavelength ranges and tissue depth probed by diffuse reflectance spectroscopy for colorectal cancer detection.

      Nogueira, Marcelo Saito; Maryam, Siddra; Amissah, Michael; Lu, Huihui; Lynch, Noel; Killeen, Shane; O'Riordain, Micheal; Andersson-Engels, Stefan; Mercy University Hospital, Grenville Place, Cork, Ireland (Nature Research, 2021-01-12)
      Colorectal cancer (CRC) is the third most common type of cancer worldwide and the second most deadly. Recent research efforts have focused on developing non-invasive techniques for CRC detection. In this study, we evaluated the diagnostic capabilities of diffuse reflectance spectroscopy (DRS) for CRC detection by building 6 classification models based on support vector machines (SVMs). Our dataset consists of 2889 diffuse reflectance spectra collected from freshly excised ex vivo tissues of 47 patients over wavelengths ranging from 350 and 1919 nm with source-detector distances of 630-µm and 2500-µm to probe different depths. Quadratic SVMs were used and performance was evaluated using twofold cross-validation on 10 iterations of randomized training and test sets. We achieved (93.5 ± 2.4)% sensitivity, (94.0 ± 1.7)% specificity AUC by probing the superficial colorectal tissue and (96.1 ± 1.8)% sensitivity, (95.7 ± 0.6)% specificity AUC by sampling deeper tissue layers. To the best of our knowledge, this is the first DRS study to investigate the potential of probing deeper tissue layers using larger SDD probes for CRC detection in the luminal wall. The data analysis showed that using a broader spectrum and longer near-infrared wavelengths can improve the diagnostic accuracy of CRC as well as probing deeper tissue layers. © 2021, The Author(s).
    • Managing clinical trials during COVID-19: experience from a clinical research facility

      Shiely, Frances; Foley, Jean; Stone, Amy; Cobbe, Emma; Browne, Shaunagh; Murphy, Ellen; Kelsey, Maeve; Walsh-Crowley, Joanne; Eustace, Joseph A.; Mercy University Hospital, Grenville Place, Cork, Ireland (BioMed Central Ltd, 2021-01-18)
      There is a dearth of literature on best practices for managing clinical trials, and little is understood on the role of the clinical trial manager. The COVID-19 pandemic has brought this into focus, and the continuance of clinical trials worldwide has been catapulted into a state of uncertainty as countries enter lockdown to manage the spread of the virus. Participant retention is an ongoing issue in clinical trials, and the concern is that in the current pandemic environment, attrition will be an issue which could potentially jeopardise trial completion. The current situation has necessitated timely problem solving by the trial manager to ensure trials remain open, and most importantly, that participant safety, paramount in clinical trials, is monitored. The purpose of our study is to highlight key issues arising in the management of clinical trials during a pandemic from first-hand experience in a clinical research facility managing both academic and commercial clinical trials. We offer some practical guidance on solution implementation.
    • A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study

      Kelly, Marie; Higgins, Anna; Murphy, Adrian; McCreesh, Karen; Mercy University Hospital, Grenville Place, Cork, Ireland (Springer Nature, 2021-02-08)
      Background: In response to issues with timely access and high non-attendance rates for Emergency Department (ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvement project. This telehealth option requires minimal resources, with the added benefit of allowing the healthcare professional streamline care. A primary aim was to investigate whether this service model can reduce wait times and non-attendance rates, compared to usual care. A secondary aim was to evaluate service user acceptability. Methods: This was a single-site quality improvement cohort study that compares data on wait time to first physiotherapy contact, non-attendance rates and participant satisfaction between patients that opted for a service based on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients were referred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, XMercy University Hospital, Cork, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with 40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on wait time and non-attendance rates was gathered using the hospital data reporting system. Satisfaction data was collected on discharge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data, Chi-Square tests were performed. A level of significance of p ≤ 0.05 was set for this study. Results: Those that contacted the telephone assessment and advice service had a significantly reduced wait time (median 6 days; 3–8 days) compared to those that opted for usual care (median 35 days; 19–39 days) (p ≤ 0.05). There was no significant between-group differences for non-attendance rates or satisfaction. Conclusion: A telephone assessment and advice service may be useful in minimising delays for advice for those referred to ED Physiotherapy for musculoskeleltal problems. This telehealth option appears to be broadly acceptable and since it can be introduced rapidly, it may be helpful in triaging referrals and minimising face-to-face consultations, in line with COVID-19 recommendations. However, a large scale randomised controlled trial is warranted to confirm these findings.
    • Prevalence and predictors of continence containment products and catheter use in an acute hospital: A cross-sectional study

      Condon, Marie; Mannion, Edel; Collins, Gillian; Ghafar, Mohd Zaquan Arif Abd; Ali, Bushra; Small, Majella; Murphy, Robert P; McCarthy, Christine E; Sharkey, Anthony; MacGearailt, Conall; et al. (Elsevier, 2021-03-05)
      Although incontinence is common in hospital, the prevalence and predictors of continence aid use (continence wear and catheters) are poorly described. A one-day cross-sectional study was conducted in a large university hospital assessing consecutive inpatients (≥55) for their pre-admission and current use of continence aids. Barthel Index, Clinical Frailty Scale and Charlson Co-morbidity scores were recorded. Appropriateness was defined by local guidelines. 355 inpatients, median age 75±17 years, were included; 53% were male. Continence aid use was high; prevalence was 46% increasing to 58% for those ≥75. All-in-one pads were the most common, an overall prevalence of 31%. Older age, lower Barthel and higher frailty scores were associated with continence aid use in multivariate analysis. Inappropriate use of aids was high at 45% with older age being the only independent predictor. Continence aids are often used inappropriately during hospitalisation by older patients. Concerted efforts are required to address this issue.
    • The importance of taking a patient-centered, community-based approach to preventing and managing frailty: A public health perspective

      Adja, Kadjo Yves Cedric; Lenzi, Jacopo; Sezgin, Duygu; O'Caoimh, Rónán; Morini, Mara; Damiani, Gianfranco; Buja, Alessandra; Fantini, Maria Pia; Mercy University Hospital, Grenville Place, Cork, Ireland (Frontiers Media S.A., 2020-11-12)
      Across the world, life expectancy is increasing. However, the years of life gained do not always correspond to healthy life years, potentially leading to an increase in frailty. Given the extent of population aging, the association between frailty and age and the impact of frailty on adverse outcomes for older people, frailty is increasingly being recognized to be a significant public health concern. Early identification of the condition is important to help older adults regain function and to prevent the negative outcomes associated with the syndrome. Despite the importance of diagnosing frailty, there is no definitive evidence or consensus of whether screening should be routinely implemented. A broad range of screening and assessment instruments have been developed taking a biopsychosocial approach, characterizing frailty as a dynamic state resulting from deficits in any of the physical, psychological and social domains, which contribute to health. All these aspects of frailty should be identified and addressed using an integrated and holistic approach to care. To achieve this goal, public health and primary health care (PHC) need to become the fulcrum through which care is offered, not only to older people and those that are frail, but to all individuals, favoring a life-course and patient-centered approach centered around integrated, community-based care. Public health personnel should be trained to address frailty not merely from a clinical perspective, but also in a societal context. Interventions should be delivered in the individuals' environment and within their social networks. Furthermore, public health professionals should contribute to education and training on frailty at a community level, fostering community-based interventions to support older adults and their caregivers to prevent and manage frailty. The purpose of this paper is to offer an overview of the concept of frailty for a public health audience in order to raise awareness of the multidimensional aspects of frailty and on how these should be addressed using an integrated and holistic approach to care. © Copyright © 2020 Adja, Lenzi, Sezgin, O'Caoimh, Morini, Damiani, Buja and Fantini.
    • Evaluation of an emergency department falls pathway for older people: A patient chart review

      O'Keeffe, Anne; O'Grady, Sile; Cronin, Finola; Dolan, Clodagh; O'Hea, Ann; O'Shea, Katie Louise; Naughton, Corina; Mercy University Hospital (Elsevier BV, 2020-07)
      The number of older adults presenting to EDs following a fall continues to rise, yet falls management often ignores opportunities for secondary falls risk reduction. Advanced Nurse Practitioners (ANPs) in EDs have an important clinical leadership role in improving outcomes for this group of patients. Aim: This study describes the development of an ANP led falls pathway in an ED to improve safe discharge. It evaluates compliance with the pathway and referrals to community falls prevention services. It also draws comparison with baseline practice as recorded in 2014. Methods: The Falls Pathway involves four steps: 1) screening at triage (3 questions), 2) risk stratification (low, medium, high), 3) risk assessment (lying and standing blood pressure (B/P), timed-up and go (TUG), 4-AT for delirium screening, polypharmacy), and 4) referral to community falls services. We undertook a 12-month chart review of all patients aged 65 years or older presenting following a fall to the ANP service in 2018. We compared data to a baseline audit in 2014; descriptive and Chi squared statistics were used to examine the data. Results: The 2018 audit involved 77 patients representing 27% of ANP caseload. A repeat fall occurred in 42% (32/77) of cases and 35% (22/77) reported a fear of falling. The Falls Pathway was initiated in nearly 80% (62/77) of patients and compliance with falls risk assessment ranged from 42% for lying and standing B/P to 75% for TUG. In 2014, a review of 59 patient charts showed 27% (16/59) experienced a repeat fall, but other risk factors such as fear of falling were not recorded. In 2018, the majority of patients (88%) discharged home were referred to community falls prevention services compared to 22% in 2014. Conclusion: The Falls Pathway improved falls risk assessment in the ED, identified opportunities for risk reduction and optimised referral to community falls services. The pathway continues to be a valuable tool but requires resources for ongoing implementation among the wider ED team.
    • Irritant contact dermatitis in healthcare workers as a result of the COVID-19 pandemic: a cross-sectional study.

      Kiely, L F; Moloney, E; O'Sullivan, G; Eustace, J A; Gallagher, J; Bourke, J F (2020-09-05)
      COVID-19 healthcare workers (HCWs) require frequent handwashing and use of personal protective equipment (PPE) to prevent infection. However, evidence is emerging that these practices are causing adverse effects on their skin integrity. A single-centre, cross-sectional study of HCWs from an Irish hospital was undertaken to evaluate the degree of COVID-19-related irritant contact dermatitis (ICD) between April and May 2020. Of 270 participants surveyed, 223 (82.6%) reported symptoms of ICD. The hands were the most commonly affected site (76.47%) and the most frequently reported symptom was dry skin (75.37%). Nearly all (268; 99.26%) HCWs had increased hand-washing frequency, but 122 (45.35%) did not use emollients. In the ICD group, 24.7% cited a history of dermatitis compared with 4.3% of unaffected staff (P < 0.001). The ICD group recorded PPE usage for an average of 3.15 h compared with the non-ICD group at 1.97 h (P = 0.21). Promoting awareness of COVID-19-related ICD is vital to highlight prevention and treatment for frontline staff.
    • Dual tasking interferes with dynamic balance in young and old healthy adults

      Sulaiman, Amal Al-Shaikh; Kelly, Marie; O'Connor, Mairead; Eva-Bamiou, Doris; Pavlou, Marousa (IOS Press, 2021-01-11)
      BACKGROUND:Functional mobility requires an ability to adapt to environmental factors together with an ability to execute a secondary task simultaneously while walking. A complex dual-tasking gait test may provide an indication of functional ability and falls risk among community-dwelling older adults. PURPOSE:The aim of this cross-sectional study is to investigate age-related differences in dual-tasking ability and to evaluate whether dual-tasking ability is related to executive function. METHODS:Forty-one community-dwelling healthy older and forty-one younger adults completed a dual-tasking assessment in which concurrent tasks were incorporated into the Functional Gait Assessment (FGA). The manual dual-task involved carrying a glass of water (FGA-M) while the cognitive dual-tasks involved numeracy (FGA-N) and literacy (FGA-L) related tasks. FGA scores under single (FGA-S) and dual-task conditions together with associated dual-task costs and response accuracy were determined. Executive function was assessed using The Behavioural Assessment of the Dysexecutive Syndrome (BADS). RESULTS:FGA-N and FGA-L scores were adversely affected in both groups compared to FGA-S (p≤0.001). However, score reductions and dual-task costs were significantly greater for older adults compared to younger adults on FGA-N (p≤0.05) and FGA-L (p≤0.001), with older adult performance on FGA-N associated with falls risk (p≤0.05). Executive function did not appear to be related to dual-tasking ability. CONCLUSION:Findings suggest that cognitively demanding tasks while walking, have a deleterious effect on dynamic balance and could place older adults at a greater risk of falls.
    • Covid-19: safe PPE - hand hygiene first in all cases.

      University of Limerick Hospitals (University pf Limerick Hospitals, 2020-04-03)
      Care of patients with respiratory symptoms/ suspected/confirmed COVID-19.
    • Perinatal factors affect the gut microbiota up to four years after birth.

      Fouhy, Fiona; Watkins, Claire; Hill, Cian J; O'Shea, Carol-Anne; Nagle, Brid; Dempsey, Eugene M; O'Toole, Paul W; Ross, R Paul; Ryan, C Anthony; Stanton, Catherine (2019-04-03)
      Perinatal factors impact gut microbiota development in early life, however, little is known on the effects of these factors on microbes in later life. Here we sequence DNA from faecal samples of children over the first four years and reveal a perpetual evolution of the gut microbiota during this period. The significant impact of gestational age at birth and delivery mode on gut microbiota progression is evident in the first four years of life, while no measurable effects of antibiotics are found in the first year. Microbiota profiles are also characteristic in children dependant on gestational age and maturity. Full term delivery is characterised by Bacteroides (year one), Parabacteroides (year two) and Christensenellaceae (year four). Preterm delivery is characterised by Lactobacillus (year one), Streptococcus (year two) and Carnobacterium (year four). This study reveals that the gut retains distinct microbial profiles of perinatal factors up to four years of age.
    • Standards for the management of cancer-related pain across Europe-A position paper from the EFIC Task Force on Cancer Pain.

      Bennett, Michael I; Eisenberg, Elon; Ahmedzai, Sam H; Bhaskar, Arun; O'Brien, Tony; Mercadante, Sebastiano; Krčevski Škvarč, Nevenka; Vissers, Kris; Wirz, Stefan; Wells, Chris; et al. (2019-01-06)
    • A Technological Review of Wearable Cueing Devices Addressing Freezing of Gait in Parkinson's Disease.

      Sweeney, Dean; Quinlan, Leo R; Browne, Patrick; Richardson, Margaret; Meskell, Pauline; ÓLaighin, Gearóid (2019-03-13)
      Freezing of gait is one of the most debilitating symptoms of Parkinson's disease and is an important contributor to falls, leading to it being a major cause of hospitalization and nursing home admissions. When the management of freezing episodes cannot be achieved through medication or surgery, non-pharmacological methods such as cueing have received attention in recent years. Novel cueing systems were developed over the last decade and have been evaluated predominantly in laboratory settings. However, to provide benefit to people with Parkinson's and improve their quality of life, these systems must have the potential to be used at home as a self-administer intervention. This paper aims to provide a technological review of the literature related to wearable cueing systems and it focuses on current auditory, visual and somatosensory cueing systems, which may provide a suitable intervention for use in home-based environments. The paper describes the technical operation and effectiveness of the different cueing systems in overcoming freezing of gait. The "What Works Clearinghouse (WWC)" tool was used to assess the quality of each study described. The paper findings should prove instructive for further researchers looking to enhance the effectiveness of future cueing systems.