SPHeREConference2015_AbstractBook

SPHenRetwEork 1st  Annual  Conference Health  Research,  Policy  and  Practice- Creating  Links  for  Effective  Collaboration PROGRAMME  &  ABSTRACT  BOOKFriday,  Jan  9th,  2015Royal  College  of  Surgeons  in  Ireland123  St  Stephens  GreenDublin  2

Conference  details INDEXConference  Venue Conference  Details  The  1st  Annual  Conference  of  the  SPHeRE  Network  will  be  held  at  the  Royal  Col-­‐ Venue  Maplege  of  Surgeons  in  Ireland. Welcome    by  Programme  Director Session  GuidelinesRegistra on  Desk SPHeRE  TeamThe  registra on  desk  will  be  located  in  the  concourse  area  of  the  Royal  College   Keynote  Speakersof  Surgeons,  near  the  York  St.  entrance.  It  will  be  open  from  8:30am-5:30pm. Keynote  Speaker  Abstracts Conference  ProgrammeCoffee  Breaks Poster  Presenta onsDuring  the  breaks  in  the  morning  and  a ernoon,  there  will  be  coffee,  tea  and   Speaker  Abstractswater  provided  in  the  Board  Room. Poster  Abstracts List  of  DelegatesLunchTea,  coffee  &  sandwiches  will  be  available  in  the  Board  Room.WiFi  InternetFree  Internet  AccessNetwork:  RCSI-GuestUsername:  rcsiPassword:  getconnected Venue  Map  Parallel  Sessions   Stairs  up  to   TR1,  TR2-3 College  Hall  &   Board  Room Cheyne TR4 Albert   St.  Stephen’s  Green Theatre  Front   Hall AtriumConcourse Important  Contacts York  St.   SPHeRE  Conference  Office Entrance Tel:  01  402  2735 Main  Recep on Email:  [email protected] www.sphereprogramme.com @sphereprogramme        #sphere15

Welcome CONFERENCE  TEAMDear  Delegate,   SCIENTIFIC  COMMITTEEWe   warmly   welcome   you   to   the   first   conference   of   the   SPHeRE   Programme.   Prof.  Anne  Hickey  -  This  conference  will  be  an  annual  event  for  the  community  in  Ireland  involved   SPHeRE  Director  (RCSI)in  popula on  health  and  health  services,  whether  as  service  providers,  health   Prof.  Steve  Thomas  -  service  managers,  policy  makers  or  researchers.  The  annual  SPHeRE  conference   SPHeRE  Co-director  (TCD)will  provide  an  important  pla orm  for  the  development  of  a  network  in  Ireland   Prof.  John  Browne  -  in  popula on  health  and  health  services  research  (PHHSR).  It  will  enable  policy   SPHeRE  Co-director  (UCC)and  prac ce  to  inform  research  development,  and  research  findings  to  inform   Dr  Deirdre  Hurley-Osing—UCDpolicy   and   prac ce   in   an   itera ve   and   evidence-based   manner.   The   network   Prof.  Anne  Ma hews  -    DCUwill  strive  to  ensure  the  building  of  a  relevant  and  coherent  evidence-base  for   Dr.  Sinead  McGilloway  -  UMop mal   popula on   health   and   health   services   policy   and   prac ce   in   Ireland.  The  network  will  enable  rapid  dissemina on  of  evidence  to  relevant  stakehold-­‐ SPHERE  TEAMers.   Stakeholders   and   researchers,   working   together   with   the   evidence,   will  develop  tangible  outputs  from  research  findings  that  facilitate  implementa on   Dr.  Margaret  Cur n  -  in  the  Irish  healthcare  context.   Assistant  Director  Networks   Dr.  Amanda  Slevin  -  We   hope   that   the   SPHeRE   conference   will   become   an   important   annual   event   Assistant  Director  Academic  Affairsfor  people  working  in  the  areas  of  popula on  health  and  health  services  in  Ire-­‐ Dr.  Sarah  Barry  -  land,   as   well   as   a rac ng   input   from   other   countries.   Our   aim   is   to   promote   SPHeRE  Assistant  Director  Teaching  and   provide   a   forum   to   discuss   research   and   share   findings   from   high   quality   &  Learningresearch   within   the   area   of   PHHSR.   This   annual   conference,   in   tandem   with   Ms.  Elaine  Healy  -  other  SPHeRE  network  ac vi es,  will  provide  opportuni es  to  meet  colleagues   SPHeRE  Programme  Co-ordinator  working   across   the   popula on   health   and   health   services   spectrum,   crea ng   Ms.  Rebecca  Kirrane  -  and  strengthening  professional  networks.   SPHeRE  Learning  Technologist Mr.  Ciarán  McCarthy  -  We  hope  that  today  proves  to  be  a  s mula ng  and  enjoyable  conference  and   SPHeRE  Data  Managerlook  forward  to  mee ng  you  again  at  our  future  events. Mr.  Carlos  Bruen  -   SPHeRE  Programme  Admin  (RCSI)Prof.  Anne  Hickey,  SPHeRE  Director Ms.  Michelle  Syron  -  Prof.  Steve  Thomas,  SPHeRE  Co-Director SPHeRE  Programme  Admin  (UCC)Prof.  John  Browne,  SPHeRE  Co-Director Ms.  Sheena  Cleary  - Programme  Admin  (TCD) Session  Guidelines Ms.  Mary  Morrissey  -   SPHeRE  Scholar  Representa vePlease   check   the   detailed   Programme   for   the   loca on   and   me   of   different  sessions.The  Presenters  and  Chairs  are  kindly  asked  to  be  in  the  room  allocated  to  their  session  5-  10  mins  or  earlier  before  the  session  will  start,  to  check  their  equip-­‐ment  is  working  correctly  and  the  presenta ons  are  correctly  loaded,  or  to  up-­‐load   their   presenta ons.   It   is   recommended   that   the   presenters   keep   close  track   on   me   and   (op onally)   provide   a   number   of   copies   of   their   presenta-­‐ ons  (i.e  handouts)  to  distribute  to  the  interested  par cipants.  Papers   (individual   oral   presenta ons)   will   be   presented   in   chaired   thema c  paper   sessions   and   divided     by   strand   (i.e.   best   prac ce   or   scien fic   strand).  Each   presenta on   lasts   15   mins  with  5   mins  of   scheduled   me   for   discussion  and  ques ons.  Posters   (individual   posters   in   IOS   A0   format)   will   be   presented   in   College   Hall.  Informal  sessions  will  be  organised  for  conference  par cipants  to  interact  with  authors,  from  10:45-11:15am  and  from  3:55-4:15pm.  The  presenters  are  kindly  asked  that  they  stand  next  to  their  poster(s)  during  both  sessions  for  discussion  and  ques ons.

Keynote  Speakers Prof.  Naomi  Fulop   University  College  London  and  Chair  of  UK  Health  Service  Research  Network  Naomi  Fulop  is  Professor  of  Health  Care   Organisa on  &  Management  in  the  Department   for  Applied  Health  Research,  University  College  London  and  Visi ng  Professor  at  King’s  College  London.  Prior  to  her  move  to  UCL  in  April  2012,  Naomi  was  Professor  of  Health  Policy  at  King’s  College  London.    Naomi  led  the  recently  completed  major  research  programme  on  quality  and  safety  in  European  Union  hospitals,  and  currently  leads  the  NIHR  funded  study  of  major  system  reconfigu-­‐ra ons  of  stroke  services  implemented  in  London  and  Greater  Manchester,  and  planned  in  the  Midlands  and  East  of  Eng-­‐land.  She   is  a  co-inves gator  on  the   newly  established  NIHR   CLAHRC  North  Thames.  Naomi  is  the   elected  Chair  of  the  Health  Services  Research  Network,  a  UK-wide  network  bringing  together  those  who  produce  and  use  health  services  re-­‐search  to  improve  policy  and  prac ce. Prof.  Bernade e  Hannigan,   Director  of  Research  &  Development,  Public  Health  EnglandBernie  took  up  her  current  role  in  August  2014;  Public  Health  England  itself  was  established  in  2013  with  responsibility  for  protec ng  the  health  of  the  popula on  and  promo ng  health  and  wellbeing.    From  2008  un l  2014  Bernie  was  Director  of  R&D  for  Health  and  Social  Care  in  Northern  Ireland  and  Chief  Scien fic  Advisor  to  the  Department  of  Health,  Social  Ser-­‐vices   &   Public   Safety.     Previously   she   was   at   the   University   of   Ulster   in   a   range   of   posts   including   Pro-Vice   Chancellor  (Research  &  Innova on)  and  she  is  now  an  Honorary  Professor.   Prof.  Steve  Thomas,   Trinity  College,  DublinSteve  is  an  Associate  Professor  in  Health  Policy  and  Management  and  a  co-Director  of  the  HRB-funded  na onal  SPHERE  Programme  in  Popula on  and  Health  and  Health  Services  Research.  Currently,  he  is  leading  research  into:  (1)  The  viability  of  Universal  Health  Insurance  in  the  Irish  context;  (2)  The  resilience  of  the  Irish  health  system  in  the  current  economic  cri-­‐sis  and  compared  to  other  countries  in  crisis  (Portugal,  Greece  and  Spain);  (3)  Human  resources  mo va on  and  interna-­‐ onal  migra on  (4)  Workforce  planning  for  the  universalisa on  of  care.  

Keynote  Speaker  AbstractsProf.  Naomi  Fulop  University  College  London  and  Chair  of  UK  Health  Service  Research  Network  Doing  Health  Services  Research  that  Ma ers  In  this  talk,  I  will  discuss  the  importance  of  doing  health  services  research  in  the  current  context  of  the  challenges  facing  health  care  and  the  drive  to  develop  and  implement  innova ve  solu ons  to  these  challenges.  By  drawing  on  two  very  different  examples  from  her  current  research,  I  hope  to  provide  illustra ons  of  ‘health  services  research  that  ma ers’:  first,  an  evalua on  of  large-scale  system  change  in  the  form  of  centralisa on  of  acute  stroke  services  across  London  and  Man-­‐chester,  and  secondly  a  study  developing  and  evalua ng  an  interven on  to  support  Trust  boards  to  develop  organisa on-wide  quality  improvement  strategies.  Finally,  I’ll  discuss  some  of  the  issues  and  challenges  rela ng  to  carrying  out  ‘health  services  research  that  ma ers’  including  methodological  issues,  the  co-produc on  of  knowledge,  capacity  and  capability  development,  and  the  poli cs  of  doing  this  kind  of  research.Prof.  Bernade e  Hannigan,  Director  of  Research  &  Development,  Public  Health  EnglandGood  prac ce  in  Involving  and  Engaging  Pa ents  in  ResearchHealth  research  frequently  involves  pa ents  and  other  lay  people  but  o en  solely  as  ‘subjects’  or  ‘par cipants’  on  whom  research  is  undertaken.    Recent  studies  have  concluded  that  when  people  and  pa ents  are  more  ac vely  engaged  as  true  partners   in   all   stages   of  the   research   process   –   from   agreement  on   research   priori es   and   development  of   ideas,   to   as-­‐sis ng   with   the   design   and   performance   of   projects   /   programmes  of   research   and   dissemina ng  findings   -   the   achieve-­‐ment  of  robust  research  findings  is  benefi ed.    The  uptake  of  those  findings  into  healthcare  prac ce  or  policy  is  also  likely  to   be   advantaged.   To   spread   understanding   of   the   purpose   of   engagement   and   involvement,   and   to   enable   all   health   re-­‐searchers  and  interested  people  to  acquire  the  necessary  skills  and  behaviours,  a  range  of  organisa ons  have  developed  or  are  developing  helpful  educa onal  resources  and  guidelines.  Guidance  may  also  be  gleaned  from  understanding  the  factors  that  cons tute  success  in  health  research  and  the  role  of  research  funding  bodies  in  encouraging  and  enabling  the  evolu-­‐ on  of  research  prac ce  is  important.  Aspects  relevant  to  a  spectrum  of  different  health  and  social  care  research  contexts  will  be  explored  in  this  presenta on.Prof.  Steve  Thomas,  Trinity  College,  DublinThe  Legacy  of  Austerity  on  the  Irish  Health  SystemSteve  will  explore  the  nature  of  austerity  and  its  impact  on  the  Irish  economy  and  on  current  health  system  performance  drawing  on  the  results  of  the  Resilience  Project.  He  will  also  inves gate  the  legacy  of  austerity  on  future  direc ons  for  health  care  and  reform.  This  will  involve  exploring  the  economic  vulnerability  of  households,  governments  and  health  care  provid-­‐ers,  recognising  that  austerity  changed  the  ways  things  were  done.  He  will  also  explore  the  poten al  for  and  desirability  of  reversing  the  cuts  and  changes  made  and  explore  the  likely  challenges  from  stakeholders.

Full Conference Programme09:00 Registra on  &  Coffee   Concourse09:3010:00 Welcome  Address    &  Introduc on  to  the  SPHeRE  Network  - Cheyne  Theatre10:4511:15 Prof.  Hannah  McGee,  RCSI  &  Prof.  Anne  Hickey,  Director  of  SPHeRE11:20 Keynote  Address  :  Doing  Health  Service  Research  That  Ma ers Cheyne  Theatre11:40 Prof.  Naomi  Fulop,  University  of  London  and  Chair  of  the  UK  Health  Services  Research  Network.  Chaired  by  Prof.  John  Browne,  UCC12:00 Coffee  &  Poster  Presenta on Board  Room  &  College  Hall12:20 Parallel  Sessions  1    12:40 Responding  to  the  Needs  of  Vulnerable  and   Health  Services:  Problems  and  Opportuni es Health  Interven ons:  Learning  from  Research  and   Older  Groups Prac ce13:0013:45 Chaired  by  Prof.  Anne  Hickey                                                        TR1 Chaired  by  Prof.  Steve  Thomas                                                TR2-3 Chaired  by  Prof.  John  Browne                                                          TR414:30 Ms.  Mary  Walsh,  RCSI    Self-Reported  Experiences   Dr.  Niamh  Humphries  &  Dr.  Sara  McAleese,  RCSI    ‘I   Dr.  Brian  McGuire,  NUIG    Clinical  effec veness  of  14:35 and  Long-Term  Need  in  Community-Dwelling   would  love  to  come  home,  but  could  never  work   the  Progressive  Goal  A ainment  Program  (PGAP)   Stroke  Survivors  in  Ireland:  A  Na onal  Survey like  that  again’.  A  mixed  method  study  on  health   for  people  who  are  work  disabled  due  to  back   professional  emigra on pain:  a  mul centre  RCT Dr.  Anne  O’Farrell,  HSE    Factors  associated  with   Ms.  Catherine  Fitzgerald,  UCD    Knowledge  and   Dr.  Deirdre  Connolly,  TCD    Op MaL:  A  Primary   hospitalisa ons  among  the  elderly  with  a  decubi-­‐ a tudes  of  antenatal  women  about  newborn   Care-based  Interven on  for  people  with  Mul mor-­‐ tus  ulcer  (pressure  ulcer)  in  acute  Irish  hospitals   bloodspot  screening. bidity 2008-2012. Ms.  Nora  Ann  Donnelly,  RCSI    Systema c  Review   Mr.  Conor  Keegan,  TCD    Compe ve  incen ves  in   Dr.  Caragh  Behan,  DETECT/St.  John  of  God/HRB       and  Meta-Analysis  of  the  Impact  of  Carer  Stress   Ireland’s  health  insurance  market  –  improving  the   Cost-effec veness  of  early  interven on  in  psycho-­‐ on  Subsequent  Ins tu onalisa on  of  Community   design  of  the  current  risk-equalisa on  scheme. sis  in  an  Irish  Context Dwelling  Older  People Dr.  Emma  Wallace,  RCSI  Risk  predic on  models  to   Mr.  Patrick  Moran,  TCD    The  impact  of  screening   Miss  Catherine  Quinn,  UL/HSE    The  Effec veness   of  a  Mul disciplinary  Pulmonary  Rehabilita on   predict  emergency  hospital  admission  in  commu-­‐ on  breast  cancer  mortality  and  overdiagnosis  in   Programme  on  Physical  Fitness,  Psychological  Well -being  and  self-management  of  respiratory  symp-­‐ nity-dwelling  adults:  a  systema c  review. Ireland toms  in  pa ents  with  COPD Mr.  Frank  Moriarty,  RCSI    Determining  the  Rela-­‐ Dr.  Fiona  Keogh  ,  Genio  Can  Health  Services  Re-­‐ Dr.  Susan  Coote,  UL    Web-based  Physical  Ac vity   onship  between  Poten ally  Inappropriate  Medi-­‐ search  help  bridge  the  implementa on  gap? Resources:  Listening  to  the  Voice  of  People  with   Mul ple  Sclerosis ca ons  and  Quality  of  Life  in  a  Cohort  of  Older   People Lunch Board  Room   Keynote  Address:  Good  prac ce  in    Involving  and  Engaging  Pa ents  in  Research Cheyne  Theatre Prof.  Bernie  Hannigan,  Director    of  Research  and  Development,  Public  Health  England.  Chaired  by  Prof.  Charles  Normand,  TCD Parallel  Sessions  2   Responding  to  Chronic  Illness:  The  Case  of         From  Childhood  to  College:  Child  and  Youth   Diverse  Popula ons:  PHHSR  in  Prac ce Diabetes Health  Behaviours Chaired  by  Dr.  Sarah  Barry                                                                    TR1 Chaired  by  Dr.  Amanda  Slevin                                                  TR2-3 Chaired  by  Dr.  Margaret  Cur n                                                    TR4 Ms.  Lisa  Hynes,  NUIG    It  makes  a  difference,  com-­‐ Ms.  Eimear  Keane,  UCC    Accelerometer  based   Mr.  Mar n  P.  Davoren,  UCC    Bias  in  the  assess-­‐ ing  here’:  A  qualita ve  explora on  of  clinic   moderate  to  vigorous  physical  ac vity  (MVPA)  and   ment  of  health  behaviour  risk  profiles  in  web- a endance  among  young  adults  with  type  1  dia-­‐ the  risk  of  childhood  obesity:  findings  from  the   based  versus  self-administered  surveys  of  universi-­‐ betes Cork  Children’s  lifestyle  Study ty  students14:55 Mr.  Ronan  Grimes,  TCD      Choice  of  ini al  oral   Dr.  Siobhan  O’Higgins,  NUIG    Prevalence,  impact   Dr.  Catriona  Murphy,  TCD    Sta n  use  compared  to   hypoglycaemic  agent  affects  future  insulin  use  in   subjects  with  early  onset  type  2  diabetes and  economic  cost  of  non-cancer  pain  among  5-12   evidence  based  guidelines  in  those  at  high  risk  of   year  olds  living  in  Ireland:  The  PRIME  –C  Study cardiovascular  disease  mortality:  evidence  from   the  Irish  Longitudinal  Study  on  Ageing15:15 Ms.  Pauline  Wilson,  St.  James’  Hospital    An  Analy-­‐ Miss  Catherine  Perry,  UCC    Applying  the  Dietary   Ms.  Sharon  Cadogan,  UCC    :  Baseline  analysis  of   sis  of  Diabetes-Related  Lower-Limb  Amputa ons   Approach  to  Stop  Hypertension  (DASH)  score  to   primary  care  reques ng  pa erns  for  immunoglob-­‐ in  a  large  urban  teaching  hospital children:  Is  adherence  to  kidDASH  associated  with   ulins  (Ig)  in  the  Cork-Kerry  region:  a  cross  sec onal   child  body  mass  index  (BMI)? study  15:35 Dr.  Geraldine  Doyle,  UCD    Pa ent  Level  Cos ng:  A   Ms.  Sarah  Browne,  DCU    \"We  know  what  we   Mr.  Patrick  Moore,  TCD    Coun ng  the  Time  Lived   or  the  Time  Le ?  Age,  Proximity  to  Death  and   Time-Driven  Ac vity  Based  Method  for  Cos ng   should  eat  but  we  don’t”:    The  voice  of  adoles-­‐ Prescribing  Expenditures Type  2  Diabetes  in  Europe,  Israel  and  Taiwan cents  in  diet  &  health  research15:55 Coffee    &  Poster  Presenta on       Board  Room  &  College  Hall16:15 Keynote  Address:  The  Legacy  of  Austerity  on  the  Irish  Health  System Cheyne  Theatre Prof.  Steve  Thomas,  Trinity  College  Dublin.  Chaired  by  Prof.  Ivan  Perry,  UCC17:00 Conference  Closing  -    Dr.  Graham  Love,  HRB Cheyne  Theatre

POSTER  PRESENTATIONSA1 O Caffrey TCD MEETING  THE  NEEDS  OF  OLDER  ADULTSA2 B Johnston TCD Preliminary  Results  from  TILDA:  What  are  the  factors  influencing  service  coordina on  among  an  A3 M Morrissey   HSE older  Irish  mul morbidity  popula on?A4 D O  Riordan UCC Accessing  specialist  pallia ve  care:  The  older  pa ent’s  perspec ve Implementa on  science  in  ac on  –  the  AFFINITY  Falls  Preven on  and  Bone  Health  project   Prevalence  Of  Poten ally  Inappropriate  Prescribing  (PIP)  And  Poten ally  Prescribing  Omissions   (PPO)  In  Older  Irish  Adults:  Findings  From  The  TRUST  TrialA5 A O'Donovan TCD Managing  the  Elderly  in  Radiotherapy  using  Geriatric  assessmEnt  (MERGE)A6 M.A O'Donovan RCSI Moving  in  Later  Life:  What  is  the  Impact  on  Older  People  with  an  Intellectual  Disability?  A7 L Roe   TCD The  Impact  Of  Three  Measures  Of  Frailty  On  Capturing  Health  Service  Use  In  Ireland  A8 E Sexton RCSI Beyond  Main  Effects:  Exploring  how  Personal  and  Contextual  Factors  Interact  with  Health  to  A9 B THOMAS Shape  Quality  of  Life  in  an  Older  Irish  Cohort St.  Mary's  Hos-­‐ Implemen ng  and  Suppor ng  Holis c  Con nence  Awareness  (ISHCA):  crea ng  a  new  culture  of   pital con nence  care MENTAL  WELL-BEINGB1 M Clince TCD Increase  in  the  number  of  students  with  ADHD:  An  emerging  role  for  college  health  and  disability   services.B2 R Doyle DETECT   First-Episode  Psychosis  and  Disengagement  from  Treatment:  A  Systema c  Review Hassab  Er-­‐ DETECT   Youth  Workers'  views  on  a  training  course  on  early  interven on  in  psychosis  and  their  poten al  B3 A rasoul role  in  case  iden fica on  and  managementB4 D Swan Coombe  Family   Towards  op mum  mental  disorders  treatment  (OPTIMIST  Study):  Development  and  implementa-­‐B5 N Turner Prac ce on  of  a  mental  health  finder  tool  within  GP  Prac ce  Informa on  System  C1 J CaseyC2 N Ceatha St  John  of  Gods  C3 R Dennehy Community   Improving  employment  outcomes  of  people  with  schizophreniaC4 A Ennis Services  LtdC5 A FlemingC6 C Merri QUALITATIVE  STUDIES Temple  Street   Children's  Uni-­‐ Innova on  and  educa on;  the  key  pillars  of  transla on versity  Hospital “On  my  terms”:  A  Qualita ve  Explora on  of  LGBT  People’s  Understanding  of  Well-being  through   TCD Interest  Sharing Women’s  Experience  Regarding  the  Decision  to  Deliver  by  Caesarean  Sec on:  A  Qualita ve   UCC Study Bloomfield  Hos-­‐ Service  User  Sa sfac on  Survey pital   UCC A  qualita ve  study  of  an bio c  prescribing  in  Long  Term  Care  Facili es  using  the  Theore cal   Domains  Framework. UCC A  selec on  of  urban  General  Prac oner’s  perspec ves  and  experiences  with  pa ents  related  to   driving.C7 F O  Connor HSE/TCD Increasing  the  releavance  of  pa ent  registries  to  the  publicC8 N O'Rourke RCSI GPs  endorse  Quality  of  Breast  Cancer  Care  C9 A Prendergast IT  Blanchard-­‐ Reflec ng  on  Resilience  as  a  Allied  Health  and  Social  Care  Professional  –  The  Student  Experience stown

POSTER  PRESENTATIONSD1 S Cadogan UCC RESEARCH  IN  CLINICAL  PRACTICED2 A Fleming UCC Tes ng   mes  ahead:  a  systema c  review  of  interven ons  for  improving  primary  care  laboratory   use  of  haematological  tests. An microbial  stewardship  ac vi es  in  hospitals  in  Ireland  and  the  United  Kingdom  hospitals:  a   comparison  study  of  two  na onal  cross-sec onal  surveys.D3 N O'Rourke RCSI Na onal  Clinical  Guidelines  for  Cancer  –  applying  evidence  to  prac ceD4 A StainesD5 P Wilson DCU Adjus ng  for  comorbidity  when  analysing  adverse  outcomes  in  hospital  discharge  dataD6 J Madden St  James'  Hos-­‐ An  Inves ga on  into  the  readability  of  Pa ent  informa on  leaflets  rou nely  distributed  across  9  E1 G Becker pital clinical  speciali es  in  a  large  urban  teaching  hospital Short-term  Blood  Pressure  Variability  over  24  hours  and  Target  Organ  Damage  in  Middle-Aged   UCC Men  and  Women RESEARCH  IN  PUBLIC  HEALTH BEST  Services Breas eeding  research  in  Ireland  –  wrong  ques ons  or  invisible  findings?E2 M.  P Davoren UCC Types  of  alcohol  consump on  among  young  adults  –  a  Narra ve  SynthesisE3 C Flannery   NUIG/UCC Factors  associated  with  deliberate  sun  tanning  behaviours  amongst  Irish  University  students:  A  E4 G Hickey MU quan ta ve  analysis Some  ‘lessons’  in  developing  and  implemen ng  applied  community-based  research  in  child  and   family  services    E5 L Mellon RCSI The  delivery  of  smoking  cessa on  advice  to  hospitalised  smokers:  A  two-hospital  surveyE6 P Moran TCD Cost-effec veness  analysis  of  a  na onal  public  access  defibrilla on  programmeE7 A Craig TCD Health  Literacy  and  Cancer:?Designing  a  Study  to  Assess  Health  Literacy  Levels  In  a  Prostate   Cancer  Popula on”   RESPONDING  TO  CHRONIC  ILLNESSF1 A Brennan Resource  u lisa on  and  cost  of  ambulatory  HIV  care  in  a  regional  HIV  centre  in  Ireland:  a  micro- UCC cos ng  study.F3 E Gray Irish  Na onal   s  C  prospec ve  treatment  registryF4 S Hayes Hepa s  C  F5 M McGovern Outcomes  and   Outcomes  from  the  Irish  na onal  hepaF6 R O'Connor Research  Net-­‐F7 C Quinn work Enhancing  Physical  Ac vity  Behaviour  in  People  with  Mul ple  Sclerosis  –  the  “Step  it  Up”  RCT   UL protocol. UCD A  realist  evalua on  of  the  evidence  on  how  to  implement  horizontal  integra on  in  primary  care   teams. Na onal  Reha-­‐ bilita on  Hos-­‐ Music  Therapy  with  Disorders  of  Consciousness:  Research  innova ons  to  guide  best  prac ce pital,  Dublin HSE  -  UL  Hospi-­‐ The  Effec veness  of  a  Physiotherapy  led  Bone  Health  Class  on  muscular  strength,  balance  and   tals  -  Ennis exercise  behaviour  in  pa ents  with  osteoporosis  and  osteopeniaF8 M Tracey UCC Evalua on  of  the  Implementa on  of  the  Na onal  Clinical  Programme  in  Diabetes

SPEAKER  ABSTRACTSBehan,  CCost-effectiveness  of  early  intervention  in  psychosis  in  an  Irish  ContextKennelly  B    Clarke  M            Early  interven on  in  psychosis  (EIP)  is  an  accepted  policy  interna onally.  Research  has  shown  that  EIP  is  cost-effec ve  primarily  from  reduc ons  in  in-pa ent  days.    However,  it  is  important  to  evaluate  whether  policies  are  applicable  within  a  local  context.  The  aim  of  this  study  is  to  per-­‐form  an  economic  evalua on  of  an  EIP  service  in  comparison  to  treatment  as  usual  (TAU).  We  examined  two  cohorts  presen ng  with  first-episode  psychosis  (FEP),  one  to  an  EIP  service,  the  other  community  mental  health  service  delivered  by  best  prac ce  community  mental  health  teams.  The  economic  evalua on  was  from  the  societal  perspec ve  and  concentrated  on  direct  medical  costs,  including  in-pa ent,  community  mental  health  costs,  other  medical  costs,  medica on  and  criminal  jus ce  costs.  The  primary  outcome  measure  was  relapse  requiring  admission  or  homecare  by  one  year.  The  average  cost  was  €21,456  in  the  EI  cohort  and  €20,986  in  the  TAU  cohort.  The  propor on  who  relapsed  was  28.3%  in  the  TAU  cohort  and  15.8%  in  the  EI  cohort.  It  costs  €470  for  a  12.5%  reduc on  in  relapse  requiring  admission/homecare.  Sensi vity  analysis  will  be  performed  to  test  the  assump ons  in  this  evalua on.  EIP  is  cost-effec ve  in  comparison  to  TAU.    All  interven ons  require  evalu-­‐a on  within  their  context.Browne,  S“We  know  what  we  should  eat  but  we  don’t”:    The  voice  of  adolescents  in  diet  &  health  researchBarron  C    Lambert  V          The  views  of  Irish  adolescents  have  not  been  adequately  included  in  obesity  preven on  and  interven on  strategies.    This  qualita ve  study  en-­‐gaged  with  adolescents  as  peer  researchers  on  the  topic  of  food  choices.    A  researcher  trained  15-17  year  old  male  and  female  adolescents  to  be  focus  group  facilitators.    Sixteen  volunteers  in  6  schools  conducted  focus  groups  with  their  peers.    No  adult  was  present  during  the  discus-­‐sions,  which  were  audio-recorded.    Discussions  were    analysed  using  induc ve  content  analysis.    Par cipants  were  consulted  about  the  accura-­‐cy  of  results.    Eight  focus  group  sessions  with  6-8  par cipants  per  group  were  successfully  conducted.    Par cipants  displayed  good  knowledge  when  iden fying  healthy  and  unhealthy  foods.    “We  know  what  we  should  eat  but  we  don’t”,  a  quote  from  one  group,  was  a  theme  for  all  groups.    Taste,  smell,  and  tempta on  of  “bad  foods”  are  very  appealing  to  adolescents.    Young  people  perceive  the  ea ng  habits  of  peers  to  be  unhealthy  and  this  influences  their  food  choices.    Food  marke ng,  convenience,  environmental  availability  and  price  also  influence  par cipants.    Adolescents  were  capable  researchers  in  this  study.    They  would  be  valuable  par cipants  in  developing  healthy  ea ng  interven ons.    Pro-­‐grammes  that  address  food  environments  and  peer  food  norms  are  par cularly  important  for  this  age  group.    Cadogan,  SBaseline  analysis  of  primary  care  requesting  patterns  for  immunoglobulins  (Ig)  in  the  Cork-Kerry  region:  a  cross  sectional  studyCahill  M.R    Browne  J.P          General  prac oners  (GPs)  are  responsible  for  up  to  50%  of  laboratory  requests,  yet  no  studies  to  date  have  examined  their  reques ng  pa erns.  The  aim  of  this  descrip ve  research  is  to  iden fy  the  ini al  rate  of  laboratory  Ig  requests  analysed  at  Cork  University  Hospital  in  2013,  analysing  the  rate  of  abnormal  test  results.  Data  were  extracted  for  2013  using  the  hospital’s  Cognos  impromptu  system  to  interrogate  APEX  laboratory  system.  Sta s cal  analysis  was  performed  using  Stata  v12.    In  2013,  the  CUH  analysed  almost  18,000  GP-requested  Ig  tests  (IgA,  IgG  and  IgM)  for  approximately  6,000  primary  care  pa ents.  Of  the  IgA  tests,  84%  were  normal,  4%  low  abnormal  and  12%  high  abnormal.  Of  the  IgG  tests,  92%  were  normal,  2%  low  abnormal  and  6%  high  abnormal.  Of  the  IgM  tests,  80%  were  normal,  12%  low  abnormal  and  8%  high  ab-­‐normal.  The  highest  reques ng  prac ce  accounted  for  over  25%  of  requests  (1,968  tests  between  11  GPs  in  one  prac ce),  with  one  GP  re-­‐ques ng  over  75%  (1,510)  of  these  tests.    Results  show  a  variable  reques ng  pa ern  unlikely  to  be  related  to  level  of  probable  underlying  pa-­‐thology.  This  presents  an  opportunity  explore  an  interven on  in  the  baseline  reques ng  pa erns.Connolly,  DOptiMaL:  A  Primary  Care-based  Intervention  for  people  with  MultimorbidityGarvey  J    Boland  F      Smith  S    Interven ons  are  needed  to  improve  health  outcomes  for  individuals  with  mul morbidity.  A  six-week  self-management  programme  (Op MaL)  was  designed  based  on  the  Stanford  model  (Lorig,  et  al.,  1999).  A  randomised  controlled  trial  inves gated  the  effec veness  of  Op MaL  in  a  primary  care  se ng.Fi y  par cipants  were  randomised  to  an  interven on  (n=26)  or  wai ng-list  control  group  (n=24).  The  primary  outcome  was  frequency  of  ac vity  par cipa on.  Secondary  outcomes  included  sa sfac on  with  ac vity  performance,  self-efficacy,  quality  of  life,  anxiety  and  depression,  impact  of  health  educa on  on  self-management  and  health  care  u lisa on.    A  mul ple  linear  regression  model  showed  significant  improvements  in  frequency  of  ac vity  par cipa on  for  the  interven on  group  (p=0.003).  There  was  also  a  significant  difference  between  the  groups  for  ability  to  perform  ac vi es.

SPEAKER  ABSTRACTSCoote,  SWeb-based  Physical  Activity  Resources:  Listening  to  the  Voice  of  People  with  Multiple  SclerosisCasey  B    Hayes  S    Coote  S    The  posi ve  effects  of  exercise  for  people  with  MS  (PwMS)  has  been  recently  established.  Despite  this,  PwMS  are  largely  inac ve  and  at  risk  due  to  sedentary  lifestyles.  PwMS  have  indicated  a  need  for  more  informa on  to  enable  them  to  become  more  ac ve  and  the  web  is  the  pre-­‐ferred  medium.  The  aim  of  this  paper  is  to  listen  to  the  voice  of  PwMS  to  inform  the  development  of  a  web-resource  to  encourage  exercise  and  ac vity.  Three  focus  groups  (n=  22)  and  11  semi-structured  interviews  were  conducted  Interviews  were  audio-recorded,  transcribed  verba m  and  content  thema c  analysis  was  performed.  Theme  1)  Content:    The  benefits  of  being  ac ve  and  the  variety  of  ac vi es  are  contained  in  the  resource.  Theme  2)  Format:  Videos  of  PwMS  exercising  and  informa on  is  stra fied  by  disability  and  ac vity  level.  Theme  3)  Interac vity-Building  a  Sense  of  Community:  Element  of  social  support  via  blogs,  forums  and  success  stories.  Theme  4:  Reaching  the  Audience:  Social  media  and  MS  Ireland  structures  are  used  to  market  the  resource.  The  ‘Ac vity  Ma ers’  project  will  develop  a  web  resource  that  aims  to  enable  PwMS  to  become  more  ac ve  using  this  data  and  input  from  a  range  of  stakeholders.Davoren,  M  Bias  in  the  assessment  of  health  behaviour  risk  profiles  in  web-based  versus  self-administered  surveys  of  university  students  Shiely  F    Perry  I          Self-administered  in  classroom  based  sampling  is  recognised  as  the  op mum  method  for  collec ng  student  health  behaviour  surveys.  However,  many  universi es  u lise  web-based  surveys.  The  aim  of  this  study  was  to  inves gate  the  strength  and  direc on  of  bias  in  assessing  student  health  behaviour  risk  profiles  in  web-based  versus  self-administered  surveys.  A  total  of  2,275  self-completed  ques onnaires  were  obtained  by  distribu on  at  lecture  theatres  yielding  a  response  rate  of  51%.  333  undergraduate  students  completed  the  web-based  ques onnaire  yielding  a  response  rate  of  2.4%.  Chi-square  tests,  independent  samples  t-tests  and  mul variate  logis c  regression  were  u lised  to  inves gate  bias  across  mode  of  collec on.  The  sample  was  predominantly  female,  in  first  year,  living  in  their  parents’  or  rented  house.  Independent  samples  t-tests  showed  that  alcohol  consump on  scores  and  well-being  scores  were  lower  among  the  classroom  sample.  Those  in  the  web-based  survey  were  less  likely  to  report  physical  ac vity  but  more  likely  to  have  taken  recrea onal  drugs.The  web-based  approach  provided  a  low  response  rate,  compa ble  with  previous  research.  Significant  differences  between  web  and  classroom  based  responses  were  observed  in  key  lifestyle  and  health  related  variables  even  with  adjustment  for  sociodemographic  factors.  Thus,  web-based  surveys  are  unreliable  for  either  research  or  sur-­‐veillance  in  this  popula on.Doyle,  GPatient  Level  Costing:  A  Time-Driven  Activity  Based  Method  for  Costing  Type  2  Diabetes  in  Europe  Israel  and  Taiwan.  Gibney  S    O'Donnell  S          There  remains  a  dis nct  lack  of  available  pa ent-level  cost  informa on  in  rela on  to  Type  2  Diabetes  care  in  outpa ent  and  shared-care  se ngs  which  is  central  to  value-based  healthcare  delivery.  The  objec ve  of  this  study  is  to  design  and  implement  a  methodology  to  measure  and  compare  the  micro-costs  of  care  for  5  exemplar  profiles  of  adults  with  Type  2  Diabetes  in  Ireland,  Germany,  Israel  and  Taiwan.Five  clinical  vigne es  capturing  key  types  and  levels  of  diabe c  complica on  were  developed  in  consulta on  with  local  endocrinologists  familiar  with  each  pa ent  popula on.  Vigne es  included  stable  glycaemic  control,  pregnancy,  ac ve  foot  disease,  kidney  complica ons  and  background  re nopa-­‐thy.    A  12  month  care  cycle  was  constructed  for  each  vigne e.  Care  ac vi es  were  mapped  for  each  process  step  in  the  care  cycle  spanning  specialist  (outpa ent)  and  shared-care  se ngs.  Time-Driven  Ac vity-Based  Cos ng  will  be  completed  to  determine  the  cost  of  care  ac vi es  and  resource  consump on  within  each  process  step.  A  monetary  cost  will  be  a ributed  to  the   me  spent  and  resources  consumed  in  each  pathway.  Results  will  permit  the  comparable  es ma on  of  costs  of  care  involving  outpa ent  and  shared-care  se ngs,  between  different  healthcare  services  in  each  country.  A  cost  per  pa ent  outcome  will  also  be  es mated.Fitzgerald,  CKnowledge  and  attitudes  of  antenatal  women  about  newborn  bloodspot  screening.Heery  E    Fitzpatrick  P          The  UK  Newborn  Screening  Programme  Centre  and  the  Na onal  Newborn  Bloodspot  Screening  (NBS)  Programme  in  Ireland  recommends  that  parents  should  be  provided  with  informa on  about  NBS  in  the  antenatal  period.  Research  suggests  parental  informa on  regarding  NBS  is  un-­‐planned  and  informal  with  most  women  receiving  informa on  in  the  postnatal  period  or  at   me  of  heelprick  test.  However  no  study  has  exam-­‐ined  antenatal  knowledge  and  a tudes  about  NBS.  The  aim  was  to  evaluate  antenatal  women’s  knowledge  and  a tudes  about  NBS  in  the  Republic  of  Ireland.  A  presen ng  sample  of  693  (≥36  weeks  gesta on)  antenatal  women  a ending  antenatal  clinics  at  three  large  maternity  hospitals  were  asked  to  complete  a  ques onnaire.  Logis c  regression  was  used  to  iden fy  factors  that  influence  maternal  knowledge  about  NBS.662  women  (96%)  self-completed  the  ques onnaire.  33%  agreed  that  they  understood  everything  about  NBS.  Over  87%  of  women  would  like  more  informa on  about  NBS.  13.9%  had  received  the  NBS  booklet.  Almost  60%  of  women  would  share  bloodspots  with  researchers.  Mul -­‐parity,  na ve  English  speaker  and  private  insurance  were  independent  predictors  of  knowledge.  From  this  study  across  three  major  maternity  hospitals  it  would  appear  that  low  numbers  of  women  receive  adequate  informa on  about  NBS  in  the  antenatal  period.

SPEAKER  ABSTRACTSGrimes,  R  Choice  of  initial  oral  hypoglycaemic  agent  affects  future  insulin  use  in  subjects  with  early  onset  type  2  diabetes.Benne  K    Henman  M            Ini al  sulphonylurea  use  in  the  elderly  leads  to  greater  insulin  requirement  compared  to  me ormin.  However,  li le  is  known  about  the  effects  in  those  with  early  onset  diabetes  (<  40  years).  We  aimed  to  examine  factors  associated  with  progression  to  insulin  in  subjects  with  early  onset  type  2  diabetes.  A  popula on-based  retrospec ve  cohort  study  was  conducted  using  the  na onal  pharmacy  claims  database  in  Ireland.  Newly  treated  subjects  with  early  onset  type  2  diabetes  were  iden fied.  Treatment  progression  to  insulin  use  as  either  addi on  or  switching  therapy  was  considered.  Cox  propor onal-hazards  regression  examined  the  associa on  of   me  to  progression  to  insulin  with  socio-demographic  and  treatment  factors.  Hazard  ra os  (HR)  and  95%  CIs  are  presented.  ==A  total  of  5284  subjects  were  iden fied  over  a  4  year  period  with  13%  re-­‐ceiving  some  form  of  treatment  progression.  Insulin  use  accounted  for  26%  of  treatment  progression  and  was  significantly  higher  in  the  young-­‐est  age  groups  (20-24)  compared  to  35-39  years  (HR  2.29,  95%  CI  1.37-3.82),  and  those  ini ated  on  sulphonylureas  (HR  1.53,  CI1.07-2.20).  Ini al  sulphonylurea  use  and  age  are  associated  with  progression  to  insulin  in  early  onset  type  2  diabetes.  Prescribers  should  ini ate  all  pa ents  on  guideline  recommended  me ormin  unless  otherwise  contraindicated.Humphries,  N‘I  would  love  to  come  home,  but  could  never  work  like  that  again’.  A  mixed  method  study  on  health  professional  emigrationMcAleese  S    Ma hews  A    Burgha  R.A    A  sustainable  health  workforce  must  train  and  retain  sufficient  staff  to  deliver  health  services.  The  Irish  health  workforce  is  characterised  by  high  emigra on  of  Irish-trained  staff  and  a  heavy  reliance  on  interna onally-trained  staff.  An  exploratory  online  survey  of  388  emigrant  health  professionals  was  undertaken  in  2014.  This  mixed  methods  paper  presents  quan ta ve  and  qualita ve  survey  findings.  Respondents  emigrated  because  of  poor  working  condi ons  in  the  Irish  health  system  (long  working  hours,  poor  career  progression),  which  compared  poorly  with  con-­‐di ons  abroad.  1  in  3  doctors  (33%,  n=91)  of  doctor  and  1  in  5  nursing/midwifery  respondents  (22%,  n=17)  did  not  intend  to  return  to  Ireland  in  the  future.  For  those  interested  in  return,  it  was  con ngent  upon  significant  health  system  reform.‘It’s  not  about  the  money,  it’s  about  respect  .  .  .    we  love  working  in  medicine,  but  we  love  our  families  and  health  more’  (R283).  Poor  working  condi ons  and  uncertain  career  pathways  appear  to  be  significant  drivers  of  health  professional  emigra on.  Solu ons  must  focus  on  reducing  emigra on  (via  reten on  strategies)  and  promo ng  return.    Funded  by  an  RCSI  Seed  funding  award  2014.  Hynes,  L‘It  makes  a  difference,  coming  here’:  A  qualitative  exploration  of  clinic  attendance  among  young  adults  with  type  1  diabetes.Byrne  M      Dinneen  S          Poor  outpa ent  clinic  a endance  is  common  among  young  adults  with  type  1  diabetes.  The  aim  of  this  qualita ve  study  was  to  develop  a  theo-­‐ry  of  a endance  at  a  hospital-based  diabetes  clinic.Using  a  grounded  theory  methodology,  semi-structured  qualita ve  interviews  were  con-­‐ducted  to  collect  the  data.  Twenty  nine  people  (21  young  adults  and  8  service  providers)  were  interviewed.  Data  were  collected  and  analysed  concurrently.  Many  young  adults  were  mo vated  to  a end  the  diabetes  clinic  to  gain  reassurance  through  contact  with  familiar,  suppor ve  service  providers,  and  screening  tests.  Barriers  to  a endance  included  fear  of  deteriora on  of  health,  work  demands,  and  a  lack  of  value  associ-­‐ated  with  a ending.  Barriers  prevented  the  development  of  rela onships  between  young  adults  and  service  providers,  the  core  category  in  this  theory.  A  collabora ve  rela onship  between  young  adults  and  service  providers  was  developed  through  experience  of  a endance  and  major  events  (structured  educa on  programme  or  crisis  of  diabetes)  and  facilitated  engagement  and  further  a endance.  Collabora ve  rela onships  between  young  adults  and  service  providers  in  the  diabetes  clinic  enhanced  care  in  this  study.  According  to  the  results  of  this  study,  clinic  a endance  may  be  increased  among  young  adults  by  encouraging  engagement  with  the  service.  Keane,  E  Accelerometer  based  moderate  to  vigorous  physical  activity  (MVPA)  and  the  risk  of  childhood  obesity:  findings  from  the  Cork  Children’s  lifestyle  StudyPerry  I    Harrington  J          As  public  health  policies  are  increasingly  targe ng  modifiable  lifestyle  behaviours,  it  is  essen al  to  determine  the  contribu on  of  MVPA  to  the  risk  of  childhood  overweight/obesity.          A  cross  sec onal  survey  of  1,075  children  aged  8-11  years.  Objec ve  height  and  weight  measurements  were  used  to  calculate  body  mass  index  and  children  were  categorised  as  (1)  normal  weight  or  (2)  overweight/obese.  Children  wore  wrist-worn  Geneac v  accelerometers  for  7-days  and  thresholds  applied  to  categorize  minutes  of  MVPA.  Children  who  achieved  ≥60  minutes  of  MVPA  each  day  met  MVPA  guidelines.  Poisson  regression  examined  the  associa on  of  MVPA  on  the  risk  of  overweight/obesity,  independent  of  sedentary   me.  Overall,  22.1%  (95%  CI,  19.2-24.9%)  of  children  achieved  MVPA  recommenda ons  with  a  higher  propor on  of  normal  weight  children  mee ng  recommenda ons  than  overweight  or  obese  children    (26.0%  v  9.7%,  p<0.001).  Normal  weight  children  engaged  in  approximately  20  minutes  extra  of  MVPA  per  day  than  overweight/obese  children.  Time  spent  at  MVPA  was  inversely  associated  with  the  risk  of  childhood  obesi-­‐ty  independent  of  sedentary   me.  School  children  are  not  achieving  adequate  levels  of  physical  ac vity  and  are  spending  a  large  propor on  of  the  day  sedentary.  Sustainable  popula on  level  policies  are  needed  to  increase  physical  ac vity  levels  among  children.  

SPEAKER  ABSTRACTSKeegan,  CCompetitive  incentives  in  Ireland’s  health  insurance  market  –  improving  the  design  of  the  current  risk-equalisation  scheme.Risk-equalisa on  involves  alloca ng  risk-adjusted  premium  subsidies  to  insurers  to  limit  incen ves  to  risk-select  healthier  consumers.  Risk-selec on  has  a  number  of  nega ve  implica ons  for  equity  and  efficiency.  This  analysis  tests  whether  improvements  can  be  made  to  Ireland’s  recently  introduced  risk-equalisa on  scheme,  which  bases  prospec ve  risk-adjusted  payments  to  insurers  on  age,  gender,  level  of  cover  and  number  of  overnight  hospital  stays.  This  study  u lises  individual-level  claims  expenditure  data  on  1,235,922  insured  Vhi  healthcare  members,  between  2011  and  2012.    The  current  risk-equalisa on  model,  along  with  five  alterna ve  specifica ons  is  compared.  Efficacy  is  measured  by  means  of  predic ve  metrics  (adjusted-R2,  MAE,  CPM,  predic ve  ra os).  Models  are  run  both  concurrently  and  prospec vely.  Concurrent  mod-­‐els  outperformed  prospec ve  models.  Prospec vely,  Ireland’s  current  risk-equalisa on  model  performed  poorly.  Risk-equalisa on  predicated  on  diagnos c  payments  performed  best  overall  (adjusted-R2  =0.17;  CPM  =0.29;  MAE  =  €954.3)  and  for  specific  risk-groups.  As  Ireland’s  risk-equalisa on  payments  are  prospec vely  determined,  replacing  u lisa on-based  payments  with  diagnos c-based  payments  may  reduce  incen-­‐ ves  for  risk  selec on  in  the  health  insurance  market.  This  has  important  implica ons  for  improving  compe on  both  in  terms  of  efficiency  and  equity.  This  is  par cularly  relevant  given  current  reforms  to  expand  compe ve  health  insurance  financing  in  Ireland.Keogh,  F  Can  Health  Services  Research  help  bridge  the  implementation  gap?The  Cochrane  Collabora on  came  about  in  response  to  the  lack  of  implementa on  of  strong  evidence  of  effec ve  interven ons.  We  now  have  ever  more  evidence,  that  is  increasingly  accessible,  and  arguably  the  same  lack  of  implementa on  or  transla on  of  evidence  into  health  ser-­‐vices.  What  is  the  role  of  Health  Services  Research  (HSR)  in  this  context?  This  paper  argues  that  HSR  is  uniquely  placed  to  address  the  imple-­‐menta on  gap  as,  by  defini on,  it  is  research  aimed  at  improving  the  efficiency  and  effec veness  of  the  health  care  system  through  changes  to  prac ce  and  policy,  i.e.  through  the  implementa on  of  applied  research  findings.  However,  to  really  achieve  the  end  goal  of  implementa on,  it  is  argued  that  HSR  needs  to  pay  greater  a en on  to  external  validity  and  ‘build  in’  implementa on  throughout  the  research  process;  from  the  formula on  of  research  ques ons;  the  use  of  relevant  methodologies;  to  the  produc on  of,  not  just  conclusions  based  on  the  evidence  but  that  final  step  of  HOW  these  conclusions  might  be  implemented.  Health  service  researchers  also  need  to  consider  the  nature  of  their  interac ons  with  the  end  users  of  their  research  findings  from  the  beginning  of  the  research  to  beyond  comple on  of  the  formal  research  process.McGuire,  BClinical-effectiveness  of  the  Progressive  Goal  Attainment  Program  (PGAP)  for  people  who  are  work-disabled  due  to  back  pain:  a  multicentre  RC.Ra ery  M      Hayes  S          This  study  evaluated  the  effec veness  of  a  CBT-based  ac ve  rehabilita on  programme  -  Progressive  Goal  A ainment  Program  (PGAP)  in  a  ran-­‐domised  controlled  trial  with  people  who  were  work-disabled  due  to  back  pain.People  (N=110)  aged  18+  with  non-malignant  back  pain,  work-disabled  and  with  at  least  one  elevated  psychosocial  risk  factor  (pain  disability,  fear-based  ac vity  avoidance,  fa gue,  depression  or  pain  catas-­‐trophising)  were  randomised  to  interven on  or  usual  care.  Clinical  psychologists  delivered  10  weekly  individual  sessions  of  PGAP  and  focused  on  graded  ac vity,  goal  se ng,  pacing  ac vity  and  cogni ve  behavioural  techniques  to  address  possible  barriers  to  rehabilita on.  Those  in  the  interven on  group  had  significant  reduc ons  in  fa gue,  fear  avoidant  beliefs,  and  catastrophising  post-interven on  compared  to  controls;  high-­‐er  rates  of  return  to  full- me  work  and  improvement  in  overall  work  status  were  also  reported.    These  results  were  maintained  at  12  month  follow-up.  Par cipants  stated  the  therapeu c  rela onship  and  enhanced  sense  of  control  as  par cularly  important  agents  of  change.  This  CBT-based  physical  ac va on  programme  is  beneficial  in  improving  func oning  in  pa ents  with  chronic  back  pain.Moore,  PCounting  the  Time  Lived  or  the  Time  Left?  Age,  Proximity  to  Death  and  Prescribing  ExpendituresBenne  K    Normand  C          To  inves gate  the  importance  of  age  and  proximity  to  death  (PTD)  when  considering  medica on  expenditures.A  case/control  methodology  is  used  on  a  community  based  popula on  cohort  aged  70  or  more  in  2006,  followed  for  three  years.    (N  =  231,859,  female  =136,213  (58.8%),  me-­‐dian  age  =77)  to  compare  monthly  medica on  expenditure  for  all  decedents  matched  to  a  control  group.  A  two  part  model  is  used  to  analysis  the  individual  effects  of  age  and  proximity  to  death  (PTD)  using  micro  data  from  administra ve  pharmacy  records  for  2006-2009  covering  the  popula on  of  community  medica on  users.  Decedents  typically  cost  up  to  twice  as  much  as  their  surviving  counterparts  in  terms  of  medica on  expenditure.  The  data  show  a  neutral  effect  for  age  once  PTD  is  included  which  has  a  posi ve  and  sta s cally  significant  impact  on  prescribing  expenditures.  Medium  term  expenditure  projec ons  are  overes mated  when  PTD  is  not  taken  into  account.Age  is  not  the  main  driver  of  medi-­‐ca on  expenditure,  instead  it  acts  as  a  proxy  for  proximity  to  death.  Policies  aimed  at  cost  effec ve  prescribing,  especially  at  the  end  of  life  will  be  more  effec ve  than  age  related  policies  at  reducing  expenditures.

SPEAKER  ABSTRACTSMoran,  PThe  impact  of  screening  on  breast  cancer  mortality  and  overdiagnosis  in  IrelandSmith  S      Benne  K            There  is  con nued  uncertainty  regarding  the  impact  of  contemporary  popula on  breast  screening  programmes.  In  Ireland,  the  phased  geo-­‐graphical  rollout  of  screening  created  a  natural  experiment  where  screening  was  offered  to  approximately  half  the  total  target  popula on  in  Ireland  for  eight  years  while  no  screening  was  offered  in  other  parts  of  the  country.  Using  data  from  this  programme  we  es mate  the  balance  of  benefits  and  harms  of  breast  screening  in  Ireland.  Controlled  before-a er  (CBA)  and  interrupted   me  series  (ITS)  study  designs  were  used  to  compare  breast  cancer  incidence  and  mortality  rates  in  each  group  before  and  a er  screening.  Results  showed  that  screening  was  associated  with  an  11%  decrease  in  breast  cancer  mortality  (RR  0.89  [95%CI  0.81,  0.98]).  Combining  data  on  the  incidence  of  all  breast  cancers  (TNM  0/I/II/III/IV),  we  es mate  a  lead   me  adjusted  overdiagnosis  rate  of  19%  (RR  1.19,  95%CI  1.14  to  1.25).  Contemporary  popula on-based  mammogra-­‐phy  screening  in  women  aged  50-64  reduces  breast  cancer  mortality  by  approximately  11%  and  is  associated  with  an  overdiagnosis  rate  of  19%  during  screening.  Based  on  current  breast  cancer  mortality  rates  in  Ireland,  this  equates  to  approximately  seven  overdiagnosed  cancers  for  every  breast  cancer  death  avoided  as  a  result  of  screening.Moriarty,  F  Determining  the  Relationship  between  Potentially  Inappropriate  Medications  and  Quality  of  Life  in  a  Cohort  of  Older  PeopleBenne  K    Cahir  C    Kenny  R.A  FaheyT  In  older  people  exposure  to  poten ally  inappropriate  medicines  (PIMs)  is  associated  with  adverse  events;  it  is  unclear  if  there  is  a  rela onship  with  quality  of  life  (QoL).  This  study  aims  to  determine  the  associa on  between  PIMs  and  QoL  in  an  older  Irish  cohort.  This  is  a  retrospec ve  cohort  study  of  1,393  community-dwelling  par cipants  in  The  Irish  Longitudinal  Study  on  Ageing  (TILDA)  aged  ≥65  years  with  linked  medica on  data.  PIM  exposure  in  the  year  preceding  TILDA  interview  was  determined  with  validated  screening  tools:  STOPP,  Beers  criteria  and  ACOVE  indicators.  QoL  was  assessed  using  the  CASP-R12.  Linear  regression  models  assessed  the  associa on  between  PIMs  and  QoL,  adjus ng  for  de-­‐mographics,  number  of  medica ons,  chronic  condi ons,  social  par cipa on  and  depressive  symptoms.  PIM  prevalence  was  19.0-52.1%  de-­‐pending  on  the  screening  tool  and  mean(SD)  CASP-R12  scores  was  27(5).  Mul variable  linear  regression  showed  that  number  of  PIMs,  regard-­‐less  of  screening  tool  used,  was  significantly  associated  with  CASP-R12  a er  controlling  for  poten al  confounders.  The  adjusted  regression  co-­‐efficient  for  each  STOPP  PIM  was  -0.31  (95%CI  -0.54,-0.08).  Exposure  to  PIMs  is  associated  with  reduced  QoL,  even  a er  adjus ng  for  confound-­‐ers.  Use  of  such  tools  to  op mise  prescribing  of  medicines  in  older  people  may  help  improve  outcomes.Murphy,  CStatin  use  compared  to  evidence  based  guidelines  in  those  at  high  risk  of  cardiovascular  disease  mortality:  evidence  from  the  Irish  Longitudinal  Study  on  AgeingBenne  K    Shelley  E          The  role  of  sta ns  in  the  secondary  preven on  of  cardiovascular  disease  (CVD)  is  well  established.  Sta ns  are  also  recommended  for  the  prima-­‐ry  preven on  of  CVD  in  those  with  diabetes,  and  those  with  a  high  (≥5%)  systema c  coronary  risk  es ma on  (SCORE)  in  combina on  with  de-­‐fined  low-density  lipoprotein  cholesterol  (LDL-C)  threshold  levels.  This  study  is  cross-sec onal  in  design  using  data  from  a  representa ve  sample  of  community  living  Irish  adults  aged  50-64  years  (n=3385).  Almost  5%  of  those  aged  50-64  years  had  a  history  of  cardiovascular  disease,  68.8%  of  whom  were  on  sta ns.  Sta ns  were  used  by  57.4%  of  diabe cs  and  by  19%  of  asymptoma c  adults  with  a  high  SCORE  risk  (≥5%).  These  re-­‐sults  were  compared  to  clinical  guidelines  issued  in  2007  and  2012.  Despite  strong  evidence  and  clinical  guidelines  recommending  the  use  of  sta ns  in  those  with  cardiovascular  disease,  a  gap  exists  between  guidelines  and  clinical  prac ce  in  Ireland  in  this  cohort.  It  is  of  concern  that  such  a  low  propor on  of  asymptoma c  adults  with  a  high  SCORE  risk  were  taking  sta ns.  Barriers  to  full  implementa on  of  clinical  guidelines  need  to  be  examined  in  light  of  these  findings  and  proac ve  policies  pursued  to  support  guideline  implementa on.O'Farrell,  AFactors  associated  with  hospitalisations  among  the  elderly  with  a  decubitus  (pressure  ulcer)  in  acute  Irish  hospitals  2008-2012.Pressure  ulcers  (PUs)  are  a  par cular  problem  in  elderly  persons.  The  aim  of  this  study  was  to  es mate  the  prevalence  of  PUs  among  the  elderly  in-pa ent  hospitalized  popula on  and  iden fy  factors  associated  with  them.    All  in-pa ent  hospitaliza ons  for  those  aged  65+  years  during  2008-2012  were  extracted  from  the  Hospital  In-Pa ent  Enquiry  (HIPE)  system.  Those  discharges  with  a  PU  diagnosis  were  iden fied  using  the  ICD-10-AM  code  L89*.      Sta s cal  analyses  were  carried  out  in  Stata.  Of    823,633  emergency  in-pa ent  hospital  discharges  during  study  period  ,  4,763  (5.8%)  had  a  PU  diagnosis.  525/4763  (11%)  had  a  Stage  IV  (severe)  PU  diagnosis.  The  age  standardised  rate  increased  from  183.1  per  100,000  in  2008  to  228.4  per  100,000  in  2012,  p<0.01.    Forward  selec on  stepwise  regression  analysis  iden fied  the  following  factors  as  being  independently  and  significantly  associated  with  having  a  PU  diagnosis:  older  age  >85  years,  (Odds  Ra o  (OR)  1.9,  p<  0.001);  having    diabetes  (OR  1.84,  p<0.01);  having  incon nence  (OR  6.3,  p<0.01);  having  malnutri on    (OR  14.9,  p<0.01);   being  admi ed  from  a  nursing  home  (OR  2.9,  p<0.001.  This  study  has  found  that  PU’s  are  increasing  in  the  in-pa ent  elderly  popula on.  PU’s  can  be  prevented  and  minimised  and  a  targeted  approach  should  be  taken.

SPEAKER  ABSTRACTSO'Higgins,  SPrevalence,  impact  and  economic  cost  of  non-cancer  pain  among  5-12  year  olds  living  in  Ireland:  The  PRIME  –C  Study  Durand  H    McGuire  B            The  presence  of  childhood  chronic  pain  is  associated  with  significant  limita ons  in  social  and  physical  func oning  that  can  create  developmen-­‐tal  problems.  The  Prime-C  study  aimed  to  characterise  the  nature  and  prevalence  of  chronic  pain,  iden fy  the  extent  of  persistent  pain  prob-­‐lems  and  incidence  of  new  pain  over  12-months,  amongst  5-12  year  olds.  Ques onnaires  were  administered  at  baseline  and  a  year  later  in  pri-­‐mary  school  classes;  parental  surveys  were  completed  at  home.  The  heterogeneous  sample  reflected  the  geographical  and  socioeconomic  pro-­‐file  of  children  a ending  Irish  primary  schools.  Time  1,  n=3,116  (43.6%  =  boys;  5-8year  olds=46.5%).  Time  2,  n  =  2,034  (43.1%  =  boys;  5-8  year  olds  =  37.6%).  The  prevalence  of  child  reported  chronic  pain:  T1  =  10%,  T2  =  11.4%;  rates  increased  with  age  and  among  girls.  Of  par cipants  who  reported  pain  at  T1  (n  =  131),  44  (33.6%)  reported  persistent  pain  at  T2;  10%  reported  new  pain  (n=  220).  Chronic  pain  was  persistent  for  a  third  of  the  children.  Children  with  pain  experience  more  anxiety  than  their  peers,  some mes  leading  to  increased  pain  and  decreased  daily  func oning.  Parents  tend  to  underes mate  prevalence  and  impact  of  their  children’s  pain.  The  cost  to  parents  was  es mated  at  €400  -  €500  pa.    Perry,  CApplying  the  Dietary  Approach  to  Stop  Hypertension  (DASH)  score  to  children:  Is  adherence  to  kidDASH  associated  with  child  body  mass  index  (BMI)?Keane  E    Harrington  J          Few  studies  have  used  a  diet  quality  score  to  describe  the  complex  associa on  between  diet  and  childhood  obesity.  This  study  aims  to  apply  the  validated  adult  DASH  score  to  children,  to  inves gate  the  associa on  between  diet  quality  and  BMI.  A  cross-sec onal  survey  of  1075  children  aged  8-11  years  from  primary  schools  in  Cork.    Child  height  and  weight  were  measured  using  standard  procedures  to  calculate  BMI.  Children  completed  a  3-day  es mated  food  diary.  The  kidDASH  score  was  generated  by  assigning  a  posi ve  score  to  healthy  foods  (e.g.  fruit)  and  reverse  scoring  to  unhealthy  foods  (e.g.  processed  foods).    Energy  underrepor ng  was  iden fied  using  standard  methods.    Linear  regression  models  were  stra fied  by  children  who  were  under  or  plausible  energy  reporters.    There  was  an  inverse  associa on  between  kidDASH  and  BMI  in  under  (β=-0.08;  p=0.04)  and  plausible  energy  reporters  (β=-0.04;  p=0.02).    Children  in  higher  kidDASH  quin les  had  higher  mean  consump on  of  healthy  food  components  and  lower  consump on  of  unhealthy  food  components.Quinn,  CThe  Effectiveness  of  a  Multidisciplinary  Pulmonary  Rehabilitation  Programme  on  Physical  Fitness,  Psychological  Well -being  and  self-management  of  respiratory  symptoms  in  patients  with  COPDDervan  M      McInerney  C    O'Brien  A    It  is  predicted  that  by  2020,  COPD  will  be  the  6thleading  cause  of  disability  and  third  most  frequent  cause  of  death  worldwide.  The  Global  ini a-­‐ ve  for  COPD  highlighted  the  importance  of  pulmonary  rehabilita on  in  terms  of  reducing  symptoms,  improving  quality  of  life  and  increasing  par cipa on  in  everyday  ac vi es.  Therefore  a  programme  based  on  interna onal  guidelines  was  implemented.  Par cipants  with  a  diagnosis  of  COPD  were  eligible  to  take  part  in  a  biweekly  2-hour  class  for  8  weeks  containing  exercises  and  mul disciplinary  educa on  components.  Pa-­‐ ents  underwent  pre  and  post  assessments  including  subjec ve  measures,  shu le  walk  tests,  muscle  strength  and  spirometry.  38  par cipants  (21  Male),  mean  age  68±8  years  completed  the  programme.  Sta s cal  analysis  found  significant  improvements  in  all  aspects  of  the  Chronic  Respiratory  Disease  Ques onnaire  including  dyspnoea.Wallace,  E  Risk  prediction  models  to  predict  emergency  hospital  admission  in  community-dwelling  adults:  a  systematic  reviewStuart  E    Vaughan  N              There  is  increasing  interest  in  developing  and  u lising  risk  predic on  models  to  iden fy  community-dwelling  adults  at  increased  risk  of  emer-­‐gency  admission.  A  systema c  literature  review  and  narra ve  analysis  was  conducted.    Of  18,983  records  reviewed,  27  risk  predic on  models  met  the  inclusion  criteria.  Nine  were  derived  using  self-report  data  and  the  remainder  (n=18)  used  rou ne  administra ve  or  clinical  record  data.  Study  sample  sizes  ranged  from  96  to  4.7  million  par cipants.  Two  studies  directly  compared  different  models  in  the  same  popula on.  Predictor  variables  most  frequently  included  were;  named  medical  diagnoses  (n=23);  prior  emergency  admission  (n=22);  age  (n=23)  and  gender  (n=18).  Eleven  models  included  non-medical  factors,  such  as  func onal  status.  The  six  best  performing  models  (c-sta s c  >0.8)  were  developed  using  rou ne/clinical  record  data  and  included  similar  variables;  prior  healthcare  u lisa on,  mul morbidity  or  polypharmacy  and  named  medical  diagnoses  or  prescribed  medica ons.  In  this  systema c  review,  the  models  with  greatest  predic ve  accuracy  were  developed  using  administra-­‐ ve  or  clinical  record  data  and  included  variables  of  mul morbidity  and  polypharmacy.  We  iden fied  only  two  studies  which  directly  compared  models  in  the  same  popula on.  This  is  an  important  area  for  future  research  as  local  factors  can  impact  performance.  

SPEAKER  ABSTRACTSWalsh,  M  Self-Reported  Experiences  and  Long-Term  Need  in  Community-Dwelling  Stroke  Survivors  in  Ireland:  A  National  SurveyWalsh  M      Galvin  R    Horgan  F      Over  30,000  stroke  survivors  live  with  residual  deficits  in  Ireland.  Their  needs  are  not  well  understood.  The  aim  of  this  study  was  to  document  the  recovery  experiences  of  community-dwelling  persons  less  than  5  years  post  stroke.  Par cipants  were  recruited  though  stroke  support  groups  na onally,  relevant  websites,  and  by  community  health  professionals.  Exis ng  validated  ques onnaires  were  adapted  with  permission.  The  final  ques onnaire  assessed  respondent’s  percep ons  of  their  recovery,  community  re-integra on  and  on-going  needs.  196  stroke  survi-­‐vors,  aged  24-89  years  responded.  Family  support  was  the  most  common  facilitator  of  recovery,  described  by  40%  of  respondents.  Over  75%  of  respondents  experienced  fa gue  and  emo onal  difficul es  post  stroke  and  over  half  felt  they  did  not  receive  enough  help.  Of  those  who  had  a  partner,  42%  reported  rela onship  change.  Sixty  per  cent  of  drivers  returned  to  driving  while  only  23%  of  respondents  under  the  age  of  66  worked  in  a  full  or  part- me  capacity  a er  their  stroke.  Changes  in  leisure  ac vity  engagement  were  reported  by  60%.  Psychosocial  and  physi-­‐cal  barriers  to  par cipa on  were  described.    Stroke  had  a  personal,  social  and  economic  impact  on  respondents’  lives.  Successful  return-to-work  levels  were  low.  Sa sfac on  with  help  received  for  emo onal  distress  and  fa gue  was  poor.Wilson,  PAn  Analysis  of  Diabetes-Related  Lower-Limb  Amputations  in  a  large  urban  teaching  hospitalGillen  C    Wilson  P          To  examine  the  incidence,  1  and  5  year  mortality  rate  and  factors  associated  with  diabetes-related  lower  limb  amputa ons  in  a  major  teaching  hospital:    A  retrospec ve  examina on  of  data  associated  with  all  adults  who  underwent  a  lower  limb  amputa on  over  2  separate  years  was  conducted  using  the  hospital’s  Vascubase,  Diamond-Hicom  and  Electronic  Pa ent  Record  (EPR)  systems.  Pa ents  were  classified  as  having  or  not  having  diabetes  and  a  major  or  minor  lower  limb  amputa on  according  to  ICD-10  diagnosis  and  procedure  codes.  1  and  5  year  mortality  was  established  using  the  hospital’s  Pa ent  Administra on  System  (PAS)  supplemented  by  a  third-party  website:  www.RIP.ie  Total  diabetes-related  LLA  increased  significantly  between  the  two  years  examined:  The  increase  in  procedure  numbers  was  en rely  within  the  minor  category  with  a  small  reduc on  in  the  number  of  major  procedures.  Mortality  a er  one  year  was  calculated  at  18%  in  2007  rising  insignificantly  to  24%  in  2010.    Mortality  a er  5  years  following  major  amputa on  is  83%  based  on  2007  figures.  The  study  indicated  a  considerable  fragmenta on  of  pa ent  records  and  iden fied  an  extensive  lack  of  communica on  between  both  primary  and  secondary,  and  urban  and  rural,  care-providers  highligh ng  the  need  for  a  comprehensive,  unified  database.  

POSTER  ABSTRACTSBrennan,  AResource  utilisation  and  cost  of  ambulatory  HIV  care  in  a  regional  HIV  centre  in  Ireland:  a  micro-costing  study.Jackson  A    Horgan  M                    It  is  an cipated  that  demands  on  ambulatory  HIV  services  will  increase  in  coming  years  as  a  consequence  of  the  increased  life  expectancy  of  HIV  pa ents  on  treatment.  Accurate  cost  data  are  needed  to  enable  evidence  based  policy  decisions  be  made  about  new  models  of  service  delivery,  new  technologies  and  new  medica ons.A  micro-cos ng  study  was  carried  out  in  an  HIV  outpa ent  clinic  in  a  single  regional  centre  in  the  south  of  Ireland.  Associa ons  between  pa ent  characteris cs  and  resource  use  and  costs  were  examined  using  univariate  and  mul variate  anal-­‐yses.The  total  es mated  cost  of  the  ambulatory  HIV  service  was  €3,483,538  in  2012,  nearly  90%  of  which  were  drug  costs.  Regimen  type  varied  significantly  by  pa ent  gender  and  age-group.  The  total  cost  per  pa ent  month  was  €952.  Pa ents  had  an  average  of  4.3  outpa ent  visits  scheduled  (3.8  a ended  visits)  per  year.  The  es mated  non-drug  cost  per  scheduled  visit  was  €268.These  data  are  valuable  for  planning  ser-­‐vices  at  a  local  level,  and  the  iden fica on  of  pa ent  factors  associated  with  increased  resource  use  is  of  interest  both  na onally  and  interna-­‐ onally  for  the  long-term  planning  of  HIV  care  provision.Cadogan,  STesting  times  ahead:  a  systematic  review  of  interventions  for  improving  primary  care  laboratory  use  of  haematological  tests.Cahill  M    Browne  J                    Laboratory  tes ng  is  an  integral  part  of  day-to-day  primary  care  prac ce  underlying  approximately  70%  of  diagnoses  and  treatment  decisions.  Research  suggests  that  a  large  propor on  of  requests  are  avoidable.  The  aim  of  this  systema c  review  was  to  comprehensively  search  the  liter-­‐ature  for  studies  evalua ng  the  effec veness  of  interven ons  for  improving  general  prac oners  (GPs)  laboratory  use.A  search  of  PubMed,  Cochrane  Library,  Embase  and  SCOPUS  (from  incep on  to  09/02/14)  was  conducted.  Systema c  reviews,  randomised  controlled  trials,  con-­‐trolled  clinical  trials,  controlled  before  and  a er  studies  and  interrupted   me  series  analysis  of  interven ons  objec vely  assessing  GP  re-­‐ques ng  pa erns  were  considered  for  inclusion.  Quality  and  risk  of  bias  was  assessed  using  a  modified  version  of  EPOC  Data  Collec on  Check-­‐list  and  Quality  Criteria.In  total,  6,166   tles  and  abstracts  were  reviewed,  followed  by  87  full  texts.  Of  these,  five  papers  were  eligible  for  inclu-­‐sion  in  the  systema c  review.  Four  studies  had  low  risk  of  bias  while  one  study  had  unclear  risk.  Due  to  heterogeneity,  results  could  not  be  me-­‐ta-analysed.  Feedback  and  educa on  based  interven ons  proved  most  effec ve  for  changing  GP  reques ng  behaviour.  However,  the  complex  health  systems  of  included  studies  indicate  further  qualita ve  research  is  required  prior  to  developing  an  interven on.  Caffrey,  OPreliminary  Results  from  TILDA:  What  are  the  factors  influencing  service  coordination  among  an  older  Irish  multimorbidity  popu-­lation?Normand  C    McDaid                      In  the  literature,  there  is  a  call  to  reduce  the  burden  of  managing  mul morbidity  pa ents  (those  with  two  or  more  chronic  condi ons)  as  trea ng  these  pa ents  complex,  challenging  and  a  significant  burden  from  a  clinical  perspec ve.  However,  there  is  li le  knowledge  of  the  cur-­‐rent  service  coordina on  pa erns,  which  could  help  guide  improvements  in  mul morbidity  care.  Thus,  this  is  the  key  aim  of  this  study.  Previous  methods  used  by  Olga  McDaid    was  applied  in  this  study  and  expanded  to  TILDA’s  second  wave  to  allow  for  a  compara ve  descrip ve,  cluster  and  longitudinal  analyses  of  mul morbidity  subpopula ons  aged  fi y  and  over.  Health  u lisa on  variables  and  social  support  variables  were  used  as  proxies  for  formal    (e.g.  GP  visits)  and  informal    (family  support)  service  coordina on  pa erns.    Preliminary  results  show  prevalence  of  single  condi ons  increased  slightly  but  insignificantly.  Those  with  2+  condi ons  (3643  vs.  3252)  visited  the  GP  on  average  5   mes  and  were  67  years  of  age  while  those  with  3+  condi ons  (2100  vs.  1974)  visited  the  GP  6   mes  on  average  and  were  aged  69.  Further  detailed  results  in  due  course.  Mul morbidity  service  pa erns  seem  to  be  stable  over   me  with  slight  differences  in  the  between  mul morbidity  subpopula ons.  Casey,  JInnovation  and  education;;  the  key  pillars  of  translationLynch  S.A                          Through  our  research  on  rare  disorders,  we  have  developed  gene c  tests  for  an  at-risk  Irish  popula on  to  facilitate  early  diagnosis.  In  order  for  our  work  to  be  of  prac cal  use,  we  need  to  educate  community-based  healthcare  professionals  (HCPs).  We  translated  three  new  tests  for  Irish  disorders,  developed  a  microsite,  anima on  videos  and  a  gene cs  guidelines  handbook.  We  hosted  four  CPD-accredited  seminars  for  HCPs  in  Cork,  Sligo,  Mullingar  and  Belfast.  Topics  included  carrier  tes ng  for  rare  inherited  disorders,  cys c  fibrosis,  intellectual  disability  and  pa ent  advocacy.The  new  tests  have  significantly  reduced  cost  and   me  to  diagnosis  and  avoided  invasive  diagnos c  procedures.Our  anima on  videos  help  to  explain  inheritance  pa erns  and  cousin  marriage  and  have  over  4,000  views  on  YouTube  (12  months)  (h p://www.ucd.ie/medicine/rarediseases/understandinggene cdisorders/).  Anima on  has  proven  a  useful  educa onal  tool  where  literacy  is  poor  and  we  are  transla ng  our  videos  into  10  languages.  Engagement  with  HCPs  in  the  community  through  our  educa onal  seminars  provided  us  with  an  understanding  of  how  at-risk  popula ons  engage  with  local  health  services.We  have  witnessed  the  benefits  of  inves ng  in  transla on.  Following  the  success  of  

POSTER  ABSTRACTSCeatha,  N“On  my  terms”:  A  Qualitative  Exploration  of  LGBT  People’s  Understanding  of  Well-being  through  Interest  SharingMayock  P                          The  well-being  of  lesbian,  gay,  bisexual  and  transgender  (LGBT)  people  has  a racted  considerable  interest  and  debate  over  the  past  30  years  with  a  broad,  albeit  contested,  consensus  that  LGBT  people  are  at  greater  risk  of  suicidal  behaviour.  Li le  research  a en on  has  focused  on  LGBT  well-being  through  interest  sharing,  despite  research  with  general  popula ons  on  social  well-being  through  community  involvement.  Through  10  in-depth  qualita ve  interviews  with  11  LGBT  people  involved  in  physical,  crea ve  and  social  ac vi es,  within  and  outside  LGBT  com-­‐muni es,  this  study  explored  the  rela onship  between  LGBT  well-being  and  interest  sharing.  Three  themes  emerged  highligh ng  par cipants’  agency  in  rela on  to  their  wellbeing:  ‘connec ng’  and  the  pivotal  role  of  interest  sharing  with  like-minded  peers;  ‘mastering  wellness’  with  in-­‐terest  sharing  featuring  prominently;  and  ‘making  a  difference’  through  contribu ng  to  the  groups,  LGBT  communi es  or  wider  society.  In  con-­‐trast  to  par cipants’  presenta on  as  confident  and  comfortable  in  discussing  mental  health,  broader  influences  emerged  which  undermine  LGBT  well-being,  par cularly  homonega ve  and  heteronorma ve  constraints  on  their  agency.  The  implica ons  arising  from  this  study  under-­‐score  the  need  for  policy  and  prac ce  frameworks  premised  on  social  jus ce  to  promote  LGBT  well-being.  Davoren,  M.  PTypes  of  alcohol  consumption  among  young  adults  –  a  Narrative  SynthesisShiely  F    O'Connor  K      Perry  I    Cronin  M    Demant  J  Alcohol  consump on  among  young  adults  is  a  well  documented  phenomenon.  Previous  research  highlights  its  heterogeneous  nature,  however,  pa erns  of  drinking  have  yet  to  be  synthesised.  The  aim  of  the  current  study  was  to  synthesise  studies  that  produced  types  of  alcohol  consump-­‐ on  among  a  youth  popula on.A  narra ve  synthesis  approach  was  employed  based  on  guidance  from  the  UK  Economic  and  Social  Research  Council.  MEDLINE,  PsychInfo  and  CINAHL  were  searched  for  relevant  ar cles.  Published  literature,  in  peer  reviewed  journals,  inves ga ng  different  types  of  drinkers  among  a  young  adult  popula on  were  eligible  for  inclusion  in  this  review.  Fourteen  studies  were  eligible  for  inclu-­‐sion:  twelve  quan ta ve,  one  qualita ve  and  one  mixed  methods,  forming  six  classes  of  drinker.  Abstainers  reported  no  alcohol  consump on  while  light  drinkers  reported  small  amounts.  In  comparison,  social  and  hedonis c  drinkers  drank  mostly  in  social  situa ons.  Heavy  and  harmful  consumers  reported  increased  volume,  frequency  and  harmful  consequences.  This  is  the  first  synthesis  to  propose  ideal  types  of  consump on  among  young  adults.  As  movement  across  types  among  young  adults  is  highly  probable,  we  do  not  expect  individuals  to  fit  exclusively  into  these.  However,  we  believe  this  typology,  in  addi on  to  informing  targeted  interven ons,  will  be  a  valuable  analy c  tool  in  future  research.Dennehy,  RWomen’s  Experience  Regarding  the  Decision  to  Deliver  by  Caesarean  Section:  A  Qualitative  StudyMeaney  S    O'  Donoghue  K                      Caesarean  sec on  (CS)  rates  have  increased  significantly  in  recent  decades.  This  has  been  par ally  a ributed  to  women’s  request  for  the  proce-­‐dure.  The  aim  of  this  study  was  to  explore  women’s  experience  of  decision  making  in  rela on  to  mode  of  delivery.    An  Interpre ve  Phenomeno-­‐logical  study  design  was  used.  Semi-structured  interviews  were  conducted  with  six  women,  three  to  six  months  a er  they  had  undergone  a  CS  at  Cork  University  Maternity  Hospital.  Three  were  elec ve  CS  and  three  were  emergency  CS.  Three  superordinate  themes  emerged  from  the  analysis;  discontent  with  CS  as  mode  of  delivery,  the  baby  as  a  priority,  and  informa on  and  support.  Women’s  preference  for  vaginal  delivery  was  superseded  by  biological  and  clinical  factors  and  the  decision  to  deliver  by  CS  in  all  cases  was  taken  by  health  professionals.  Women  felt  they  were  uninformed  and  had  no  real  choice  regarding  their  delivery.  Discontent  arose  when  the  CS  impacted  nega vely  on  the  par cipants  and  conflicted  with  their  personal  expecta ons  of  birth.    The  no on  of  ‘informed  choice’  in  rela on  to  mode  of  delivery  appears  redundant.  The  provision  of  informa on  may  decrease  women’s  discontent  with  and  anxiety  around  the  Caesarean  sec on  delivery  process.  Doyle,  RFirst-Episode  Psychosis  and  Disengagement  from  Treatment:  A  Systematic  ReviewThis  review  examined  rates  and  defini ons  of  disengagement  among  services  for  first-episode  psychosis  (FEP)  and  iden fied  the  most  relevant  demographic  and  clinical  predictors  of  disengagement.A  comprehensive  search  for  and  review  of  published  studies  that  reported  rates  and  predictors  of  disengagement  within  FEP  services  were  conducted.  Ten  ar cles  were  included  in  the  review.  There  was  a  lack  of  consensus  on  a  clear  defini on  of  engagement  and  disengagement.  However,  despite  differences  in  defini ons  and  study  se ngs,  the  evidence  reviewed  indicates  that  approximately  30%  of  individuals  with  FEP  disengage  from  services.  Variables  that  were  consistently  found  to  exert  an  influence  on  disengagement  across  studies  were  dura on  of  un-­‐treated  psychosis,  symptom  severity  at  baseline,  insight,  substance  abuse  and  dependence,  and  involvement  of  a  family  member.  There  is  a  need  for  a  clearly  defined  and  agreed  measurement  of  service  engagement  and  disengagement  across  FEP  services.  In  par cular,  those  who  enter  an  FEP  program  without  family  involvement  and  support  as  well  as  those  who  maintain  persistent  substance  abuse  are  at  higher  risk  of  disengagement.  Early  iden fica on  of  such  individuals  and  the  development  of  approaches  to  reduce  risk  of  service  disengagement  are  likely  to  increase  the  effec veness  of  these  services.  

POSTER  ABSTRACTSFlannery  ,  CFactors  associated  with  deliberate  sun  tanning  behaviours  amongst  Irish  University  students:  A  quantitative  analysisBurke    L.A    Gage  H                    High  skin  cancer  rates  in  Ireland  highlights  the  need  to  understand  deliberate  tanning  prac ces  within  the  young  Irish  popula on  so  that  pre-­‐ven ve  strategies  can  be  designed  to  address  this  risk  taking  behaviour.  Factors  associated  with  deliberate  sun  tanning  behaviour  amongst  university  students  in  Cork,  Ireland  were  examined  by  means  of  a  ques onnaire.  The  theory  of  reasoned  ac on,  which  links  health  behaviour  to  behavioural  inten ons,  a tudes  and  subjec ve  norms,  provided  a  framework  for  the  study.  833  responses  were  received  (75%  female,  mean  age  22  years,  range  17-57).  Repor ng  deliberate  tanning  in  the  previous  summer  (n=389,  46.7%)  was  posi vely  correlated    (r=0.622,  p<0.001)  with  sta ng  an  inten on  to  tan  next  summer  (n=532,  63.9%).  Women,  and  respondents  with  darker  (rather  than  fairer)  skin  were  more  likely  to  engage  in  deliberate  tanning  (p<=  0.001).  Deliberate  tanning  was  associated  with  enjoying  tanning  (p<0.001),  (but  not  with  thinking  a  sun  tan  is  a rac ve  or  healthy-looking),  and  with  repor ng  peer  pressure  (p=0.023).  Public  policy  should  target  young  people  who  deliberately  tan  or  state  an  inten on  to  do  so,  especially  as  these  groups  are  less  likely  to  engage  in  sun  protec on  behaviours.  Policy  should  focus  on  changing  a tudes  as  well  as  improving  understanding  of  risks.  Fleming,  AAntimicrobial  stewardship  activities  in  hospitals  in  Ireland  and  the  United  Kingdom  hospitals:  a  comparison  study  of  two  national  cross-sectional  surveys.Byrne  S    Stewart  D                    The  aim  of  this  study  is  to  benchmark  the  profile  and  performance  of  Irish  An microbial  Management  Teams  (AMTs)  against  UK  AMTs  in  order  to  iden fy  areas  where  Irish  an microbial  stewardship  may  be  improved.  A  postal  ques onnaire  was  issued  to  the  An microbial  Pharmacist  or  Pharmacist  in  charge  at  all  Irish  Hospitals  (March-April  2012)  and  all  UK  Na onal  Health  Service  (NHS)  Hospitals  (November  2011  –  January  2012).  Ethical  approval  was  granted.The  response  rates  to  the  surveys  were  73%  (n  =  51)  in  Ireland  and  33%  in  the  UK  (n=273).  In  both  surveys  the  majority  of  respondents  reported  having  an  an microbial  prescribing  policy  (88%  in  Ireland,  98%  in  UK).  This  survey  found  significant  differ-­‐ences  between  the  Irish  and  the  UK  surveys  in  terms  of  AMT  membership  and  ac vi es.  For  example,  a  significantly  higher  propor on  of  UK  respondents  measure  the  appropriateness  of  an bio c  prescribing  (75%  versus  58%,  p  =  0.033).  This  comparison  study  has  found  important  differences  between  the  Irish  hospitals  and  UK  NHS  hospitals  AMT  profiles  and  ac vi es.  Fleming,  AA  qualitative  study  of  antibiotic  prescribing  in  Long  Term  Care  Facilities  using  the  Theoretical  Domains  Framework.Bradley  C    Cullinan  S                    The  aim  of  this  study  is  to  explore  the  opinions  and  experiences  of  health  care  professionals  in  LTCF  regarding  an bio c  prescribing.Semi-structured  interviews  were  conducted  with  9  Pharmacists,  14  Nurses,  10  general  prac oners  and  4  Consultants  who  work  in  or  with  Irish  LTCF.  The  analysis  was  conducted  using  content  analysis.  The  resul ng  themes  were  coded  into  the  Theore cal  Domains  Framework  (TDF)  in  order  to  target  areas  for  future  interven ons.  Ethical  approval  was  granted.Beliefs  about  Knowledge,  Environmental  context,  Memory,  a en on  and  decision  making  processes,  and  Social  Influences  were  the  key  areas  iden fied.  Many  strategies  for  improving  an bio c  prescribing  in  LTCF  were  suggested  such  as  the  need  for  regular  audit,  educa on  and  mul disciplinary  team  coherence  in  an microbial  stewardship.  This  study  is  the  first  to  evaluate  an bio c  prescribing  behaviour  in  LTCF  using  a  behavioural  change  theory,  the  TDF.  Areas  for  future  interven ons  include  improving  knowledge  around  diagnos c  tests  and  guidelines  for  an bio c  prescribing,  and  encouraging  an bio c  surveillance  ac vi es.Gray,  EOutcomes  from  the  Irish  national  hepatitis  C  prospective  treatment  registryO'Leary  A    Norris  S                    Observa onal  studies  use  ‘real-world’  popula ons  which  comprises  the  sickest,  most  complex  pa ents  and  it  is  common  for  efficacy  rates  to  be  lower  than  in  phase  III  trials.  Established  in  2012,  the  aim  of  the  ICORN  registry  is  to  provide  real  world  evidence  of  the  clinical  effec veness,  economic  impact  and  safety  of  triple  therapy  regimens  when  used  in  rou ne  prac ce,  with  the  aim  of  informing  clinical  prac ce  and  refining  health  policy  strategies  for  the  Irish  hepa s  C  cohort  of  pa ents.  Pa ents  with  chronic  HCV  received  first  genera on  DAA-based  therapies  as  per  local  standard  of  care.  Demographic,  adverse  event,  clinical  and  virological  data  were  collected  in  the  registry  during  treatment  and  follow-up.  A  total  of  n=291  pa ents  are  registered  (June  2012  –  August  2014).  Complete  outcome  data  for  n=136  pa ents  demonstrates  an  overall  SVR  rate  of  51%.  Discon nua on  of  therapy  due  to  treatment  fu lity  rules,  adverse  events  and  intolerance  occurred  in  46%  pa ents,  and  the  re-­‐lapse  rate  was  4.5%.    The  real  world  SVR  rate  of  51%  is  lower  than  the  efficacy  rates  obtained  in  phase  III  clinical  trials.    Effec veness  in  the  real  world  se ng  provides  valuable  informa on  for  health  policy  makers  and  decision  makers  regarding  alloca on  of  resources.

POSTER  ABSTRACTSHassab  Errasoul,  AYouth  Workers'  views  on  a  training  course  on  early  intervention  in  psychosis  and  their  potential  role  in  case  identification  and  managementSu on  M    Clarke  M                    The  aim  of  the  study  was  to  explore  the  views  of  a  group  of  youth  workers  (YW)  who  a ended  A  training  course  on  Early  Interven on  in  Psy-­‐chosis  (EIP)  on  their  roles  in  EIP  and  youth  mental  health  and  on  the  training  course  provided.  Mixed  qualita ve  and  quan ta ve  methodolo-­‐gies  were  used  .Ninety  four  YW  a ended  workshops  on  EIP.  Par cipants  were  asked  to  complete  a  feedback  ques onnaire  and  nine  youth  workers  were  interviewed  and  their  opinions  were  explored  on  a  range  of  issues  related  to  youth  mental  health  and  EIP.  Most  respondents  reported  mental  health  problems  amongst  the  problems  they  face  and  as  a  whole;  they  believed  they  have  a  responsibility  for  youth  mental  health.  This  role  includes  earlier  iden fica on  of  psychosis.  However,  most  respondent  raised  concerns  about  lack  of  training  in  youth  mental  health.  With  regard  to  the  training  provided,  the  vast  majority  found  training  adequate  and  relevant  to  their  work.  Par cipants  expressed  fa-­‐vourable  views  about  their  role  in  EIP  and  Youth  Mental  health  in  general  and  expressed  their  general  sa sfac on  with  training  provided.  Hayes,  SEnhancing  Physical  Activity  Behaviour  in  People  with  Multiple  Sclerosis  –  the  “Step  it  Up”  RCT  protocol.Motl  R    Coote  S                    Exercise  has  widely-accepted  posi ve  short-term  effects  on  health  outcomes  among  people  with  Mul ple  Sclerosis  (MS).  Behaviour  change  interven ons  aim  to  promote  long-term  posi ve  lifestyle  change.  This  study  compares  the  effect  of  an  exercise  plus  Social  Cogni ve  Theory  (SCT)-based  behaviour  change  interven on  with  an  exercise  plus  control  educa on  interven on  on  mobility  among  people  with  MS.  People  with  a  diagnosis  of  MS,  0-3  score  on  the  Pa ent  Reported  Disease  Steps  scale,  without  a  MS  relapse  or  change  in  their  MS  medica on  in  12  weeks  and  who  are  physically  inac ve  are  randomised  to  one  of  two  groups.  Both  groups  undergo  a  10-week  exercise  interven on.  The  experi-­‐mental  group  also  complete  a  SCT-based  interven on  while  the  control  group  receive  an  educa on  interven on  to  control  for  contact.  Par ci-­‐pants  are  assessed  at  pre-,  post-interven on,  3-  and  6-month  follow-up.  The  primary  outcome  is  mobility.  Secondary  outcomes  include:  exer-­‐cise  self-efficacy,  outcome  expecta ons  and  goal-se ng  for  exercise,  percep ons  of  social  support,  physical  and  psychological  impact  of  MS  and  fa gue.  A  qualita ve  evalua on  of  Step  it  Up  will  be  completed  among  par cipants  and  physiotherapists  post-interven on.  This  random-­‐ised  controlled  trial  will  inform  the  clinical  effec veness  of  the  combina on  of  exercise  and  SCT-based  behaviour  change  interven ons  among  Johnston,  BAccessing  specialist  palliative  care:  The  older  patient’s  perspectiveRyan  K    BuildCARE                      Pallia ve  care  focuses  on  improving  pa ents’  symptom  burden  and  quality  of  life.  Ageing  demographics,  changing  disease  pa erns  and  increas-­‐ingly  complex  needs  at  the  end  of  life  make  pallia ve  care  an  important  global  health  issue,  as  iden fied  by  the  WHO.  The  Interna onal  Access,  Rights  and  Empowerment  (IARE)  study  was  carried  out  in  Ireland,  the  UK  and  the  US  with  the  aim  of  improving  the  rights  of  pa ents  over  the  age  of  65  accessing  SPC  services,  and  their  families  through  be er  understanding  of  their  needs  and  the  factors  that  help  or  hinder  access  to  services.  A  mixed  methods  approach  was  adopted,  with  grounded  theory  methodology  used  to  analyse  data  from  in-depth,  semi-structured  interviews  with  10  pa ents.  The  role  of  SPC  services  is  not  fully  understood  by  the  public;  pa ents  rely  on  the  Primary  admi ng  team  to  iden -­‐fy  SPC  needs  and  ini ate  access;  and  pa ents’  concerns  about  burdening  hospital  staff  or  family  can  make  it  challenging  for  them  to  communi-­‐cate  effec vely  about  their  needs,  preferences  and  concerns.  Although  choice  and  autonomy  are  regarded  as  essen al  components  of  pa ent  care,  these  ideals  cannot  be  realised  un l  strategies  are  developed  to  overcome  barriers  to  communica on.Madden,  JShort-term  Blood  Pressure  Variability  over  24  hours  and  Target  Organ  Damage  in  Middle-Aged  Men  and  WomenFitzgerald  T    Kearney  P                    Blood  pressure  variability  (BPV)  has  been  associated  with  cardiovascular  events  but  the  prognos c  significance  of  short-term  BPV  remains  un-­‐certain.  As  uncertainty  also  remains  as  to  which  measure  of  variability  most  accurately  describes  short-term  BPV,  this  study  explores  different  indices  and  inves gates  their  rela onship  with  subclinical  target  organ  damage  (TOD).    We  used  data  from  the  Mitchelstown  Study,  a  cross-sec onal  study  of  Irish  adults  aged  47-73  years  (n=2,047,  24-hABPM(n=1,207)).  As  measures  of  short-term  BPV  we  es mated  SD,  weighted  SD  (wSD),  coefficient  of  varia on  (CV)  and  average  real  variability  (ARV).  TOD  was  documented  by  microalbuminuria  and  ECG  le  ventricular  hyper-­‐trophy  (LVH).  There  was  no  associa on  found  between  any  measure  of  BPV  and  LVH  in  both  unadjusted  and  fully  adjusted  logis c  regression  models.  Similar  analysis  found  ARV,  SD  (day  &  night)  and  wSD  were  associated  with  microalbuminuria  a er  adjustment  for  age,  gender,  smok-­‐ing,  BMI,  diabetes  and  an -hypertensive  treatment.  However,  the  associa on  did  not  persist  a er  further  adjusted  for  mean  BP.  Our  findings  illustrate  choosing  the  appropriate  summary  measure  which  accurately  captures  short-term  BPV  is  difficult.  Despite  discrepancies  in  values  between  the  different  measures  there  was  no  associa on  between  any  indexes  of  variability  with  TOD  measures  a er  adjustment  for  mean  BP.    

POSTER  ABSTRACTSMcGovern,  MA  realist  evaluation  of  the  evidence  on  how  to  implement  horizontal  integration  in  primary  care  teams.The  literature  for  integrated  care  in  primary  care  teams  focuses  on  interven ons  that  target  certain  popula ons  (e.g.  older  persons).There  is  li le  evidence  to  guide  primary  care  teams  on  how  to  implement  integrated  care  at  the  community  level.  This  paper  seeks  to  iden fy  what  are  the  components  of  an  integrated  care  strategy  and  what  are  the  mechanisms  for  implemen ng  those  components;  when  the  interven on  in-­‐volves  horizontal  integra on  at  the  primary  care  team  level  and  the  target  popula on  is  a  geographical  community.    Realis c  Evalua on  (Pawson  &  Tilley,  1997)  was  used  to  select  18  primary  research  papers  for  inclusion.  Thema c  Analysis  (Braun  &  Clarke,  2006)  was  used  to  reduce  this  evidence  to  a  set  a  core  components  and  mechanisms  for  implemen ng  horizontal  integra on  in  primary  care  teams.  Seven  interven on  components  were  iden fied,  including:  Governance;  Professional  Engagement;  Regular  Interac on;  Pa ent-Centeredness;  Integrated  Care  Pathways;  Health  Informa on  Technology;  and  Shared  Burden  of  Care.  The  purpose  and  implementa on  of  each  component  is  illustrated  by  a  Context-Mechanism-Outcome  Configura on.These  seven  interven on  components  correspond  closely  with  the  six  elements  of  Wagner’s  (1999)  Chronic  Care  Model  of  integrated  care.  Further  research  is  required  to  test  the  validity  and  reliability  of  the  CMO  Configura ons  proposed.    Mellon,  LThe  delivery  of  smoking  cessation  advice  to  hospitalised  smokers:  A  two-hospital  surveyDoyle  F    x4  A                    Smoking  is  the  single  most  preventable  cause  of  disease,  disability,  and  death.    Brief  cessa on  advice  from  healthcare  prac oners  increases  quit  rates  among  hospitalised  smokers.  However,  li le  is  known  about  the  extent  inpa ents  receive  such  advice.  This  study  aim  determined  the  prevalence  of  smoking  and  cessa on  advice  received  by  in-pa ents  in  two  teaching  hospitals  in  IrelandThis  study  surveyed  1001  in-pa ents  across  two  hospital  sites,  over  a  six  month  period.  Data  was  collected  on  record  of  smoking  status,  delivery  of  smoking  cessa on  advice,  past  quit  a empts  and  a tudes  towards  smoking  cessa on.Prevalence  of  smoking  within  the  sample  was  23.2%  (232/1001).  20.7%  (n=50)  reported  that  they  would  like  to  receive  smoking  cessa on  advice  whilst  in  hospital.  Only  31.5%  (n=76)  reported  that  smoking  cessa on  was  discussed  with  them  during  admission.  Smoking  status  of  the  pa ent  was  documented  in  58%  (n=128)  of  cases,  however  delivery  of  smoking  cessa on  advice  was  documented  in  2%  (n=5)  of  cases.  A  strong,  systema c  focus  on  smoking  cessa on  is  needed  in  hospi-­‐tal  se ngs.  Although  average  dependence  scores  suggest  that  low-intensity  interven ons  will  probably  suffice  for  most  smokers,  some  vulnera-­‐ble  pa ents  will  require  more  intensive  interven ons.Merri ,  CA  selection  of  urban  General  Practitioner’s  perspectives  and  experiences  with  patients  related  to  driving.Horgan  L                          This  decade  (2010–2020)  has  been  declared  by  the  United  Na ons  as  the  ‘Decade  of  ac on  for  road  safety’  in  recogni on  of  the  deaths  and  accidents  caused  by  driving  related  issues.  This  study  provides  insight  into  how  experiences  with  pa ents  with  driving  related  issues  can  affect  the  General  Prac oner(GP)  and  also  their  opinions/perspec ves  on  experiences  with  pa ents  with  driving  related  issues  in  the  Irish  context.  A  qualita ve  study  was  conducted  using  a  descrip ve/exploratory  approach  that  draws  from  the  principles  of  the  phenomenological  methodolo-­‐gy.  Data  was  collected  through  face  to  face,  semi-structured  interviews  with  six  GP’s.  The  interviews  were  audio-taped,  transcribed  verba m  and  analysed  through  the  use  of  thema c  analysis. Research  data  analysis  resulted  in  five  key  themes  that  captured  the  varied  areas  that  arose  in  rela on  to  pa ents  with  driving  related  issues  for  GP’s.  These  themes  are  supported  with  direct  quota ons  from  the  par cipants.  This  study  proposes  that  some  GP’s  find  driving  related  issues  to  be  challenging  in  general  prac ce.  It  found  that  this  group  of  GP’s  iden fied  their  desire  for  a  mandatory  independent/state  driving  assessment/mobility  solu ons  service.  The  study  highlights  the  poten al  in  Ireland  for  Occupa onal  therapists  to  work  with  pa ents  in  rela on  to  driving.  Moran,  PCost-effectiveness  analysis  of  a  national  public  access  defibrillation  programmeHarrington  P    Ryan  M                    Proposed  legisla on  on  the  establishment  of  a  na onal  public  access  defibrilla on  (PAD)  programme  calls  for  the  mandatory  provision  of  auto-­‐ma c  external  defibrillators  (AEDs)  in  a  range  of  loca ons  throughout  the  country,  to  improve  survival  from  out-of-hospital  cardiac  arrest  (OHCA).  We  examine  the  clinical  and  cost-effec veness  of  a  range  of  poten al  PAD  programme  configura ons.Probabilis c  decision  analysis  modelling  (using  a  hybrid  decision-tree/Markov  model)  was  used  to  compare  the  costs  and  benefits  (in  QALYs)  for  a  number  of  poten al  PAD  programmes.  Implementa on  of  a  PAD  programme  is  an cipated  to  increase  average  survival  to  discharge  a er  OHCA  by  between  two  and  ten  percent  annually.  Incremental  cost  effec veness  ra os  (ICERs)  ranged  from  €95,000/QALY  for  the  most  scaled  back  programme,  to  over  €800,000/QALY  for  the  scheme  outlined  in  the  proposed  legisla on.  Sensi vity  analysis  showed  that  increasing  the  rate  of  bystander  defibrilla-­‐ on  in  the  event  of  an  OHCA  occurring  in  the  vicinity  of  a  designated  AED  loca on  could  make  PAD  programmes  more  cost  effec ve.  Any  pro-­‐spec ve  PAD  programme  should  start  by  targe ng  the  mandatory  deployment  of  AEDs  to  loca ons  with  the  highest  incidence  of  out-of-hospital  cardiac  arrest,  and  be  introduced  in  conjunc on  with  measures  to  increase  the  u lisa on  of  publicly  accessible  AEDs.

POSTER  ABSTRACTSMorrissey  ,  MImplementation  science  in  action  –  the  AFFINITY  Falls  Prevention  and  Bone  Health  project  O'Byrne-Maguire    I      M                    The  vision  of  the  na onal  implementa on  project  AFFINITY  (2012)  (Ac va ng  Falls  and  Fracture  Preven on  in  Ireland  Together),  is  a  “life  free  from  (harmful)  falls  and  fractures  in  our  ageing  popula on”.  AFFINITY  (Ireland)  is  a  commitment  within  the  European  Innova on  Partnership  on  Ac ve  and  Healthy  Ageing.  A  change  management  approach  incorpora ng  Implementa on  Science  (IS)  is    used  to  guide  the  process  of  the  na-­‐ onal  falls  preven on  project  implementa on.  Implementa on  science  is  the  study  of  methods  to  promote  the  integra on  of  research  findings  and  evidence  into  healthcare  policy  and  prac ce.  Four  stages  of  IS  involves    i)  explora on  ii)  planning  (installa on)  iii)  pre-implementa on  &  iv)full-implementa on.  This  process  was  applied  to  the  AFFINITY  project  from  April  2013  to  date.  IS  succeeds  to  priori se  ac onable  deliverables  for  the  Affinity  project.  Effec ve  working  rela onships  have  been  established  through  mee ngs  with  the  AFFINITY  project  co-leads  &  the  Na-­‐ onal  Implementa on  Team  (NIT).  Consensus  and  clarity  on  requirements  are  progressed  and  ac ons  delivered.  Leaders  are  crucial  for  large  scale  change.  It  is  crucial  to  work  with  the  key  influencers,  posi ve  and  nega ve.  IS  is  an  effec ve  approach  to  deliver  implementa on  in  Falls  Preven on.O  Connor,  FIncreasing  the  releavance  of  patient  registries  to  the  publicThe  public,  as  consumers  of  healthcare,  are  aware  of  the  availability  of  the  mul tude  of  data  collec ons  and  are  eager  to  harness  the  infor-­‐ma on  to  provide  best  evidenced  healthcare.  The  ques on  the  research  sought  to  answer,  through  the  lens  of  the  Na onal  Cancer  Registry  of  Ireland  (NCRI),  was  how  can  the  relevance  of  pa ent  registries  be  increased  for  the  public?  An  analysis  of  registries  was  carried  out  along  with  interviews  of  key  informants  to  iden fy  the  opportuni es  for  increasing  the  relevance  of  data  collec on  to  the  public.  The  results  were  analysed  according  to  the  themes  iden fied.  The  recommenda ons  developed  by  this  researcher,  were  targeted  at  the  NCRI,  and  included  having  mem-­‐bers  of  the  public  on  the  advisory  council  of  the  NCRI,  run  an  informa on  campaign  aimed  at  the  public  to  raise  awareness  of  the  role  and  con-­‐tent  of  the  NCRI,  and    to  make  the  registry  more  health  literacy  friendly.  The  research  iden fied  a  need  for  recognising  the  requirement  for  the  evolu on  of  the  NCRI  through  a  set  of  recommenda ons  that  are  evidence  based.  It  was  concluded  that  empowerment  of  the  pa ent  and  health  literacy  are  central  to  increasing  the  relevance  of  cancer  registries  for  the  public.O  Riordan,  DPrevalence  Of  Potentially  Inappropriate  Prescribing  (PIP)  And  Potentially  Prescribing  Omissions  (PPO)  In  Older  Irish  Adults:  Findings  From  The  TRUST  TrialWalsh  Kieran      Byrne  S                    The  aim  of  the  study  was  to  es mate  the  prevalence  of  PIP  and  PPO’s  using  a  subset  of  the  Screening  Tool  of  Older  Persons  Prescrip ons/Screening  Tool  to  Alert  doctors  to  Right  Treatment,  (STOPP/START)  criteria  version  1  and  2  based  on  258  community  dwelling  Irish  adults  aged  ≥65  years  screened  for  the  TRUST  (Thyroid  hormone  Replacement  for  Untreated  older  adults  with  Subclinical  hypothyroidism;  a  randomised  placebo-controlled  Trial)  study.Forty  PIP  and  14  PPO  indicators  from  the  STOPP/START  version  1  criteria  and  51  PIP  and  22  PPO  indicators  from  version  2  were  applied  to  the  TRUST  dataset.  PIP/PPO  prevalence  according  to  both  sets  of  criteria  were  es mated.The  mean  age  (±  SD)  of  the  pa ents  was  73.2  ±  5.1  years,  133  (51.6%)  were  femaleThe  overall  prevalence  of  PIP  was  14.7%  (n=38)  considering  the  STOPP  version  1  criteria  while  the  overall  prevalence  of  PPO  was  16.7%  (n=43)  considering  the  START  version  1  criteriaThe  overall  prevalence  of  PIP  and  PPO  using  ver-­‐sion  2  was  15.9%  (n=41)  and  20.5%  (n=53)  respec vely.  These  findings  indicate  that  PIP  and  PPO’s  are  prevalent  in  older  adults  screened  for  a  randomised  control  trial  (RCT)  using  a  subset  of  the  STOPP/START  version  1  and  2  criteria.  O'Connor,  RMusic  Therapy  with  Disorders  of  Consciousness:  Research  innovations  to  guide  best  practiceGray  D                          This  presenta on  will  detail  an  innova ve  research  project  at  the  Na onal  Rehabilita on  Hospital  (NRH),  Dublin    with  Disorder  of  Consciousness  (DOC)  pa ents.The  emphasis  of  this  paper  will  be  on  the  importance  of  interdisciplinary  working  and  the  valuable  role  of  music  therapy  in  improving  and  en-­‐hancing  interdisciplinary  assessment.  Research  iden fies  the  need  for  a  variety  of  assessment  tools  to  encourage  responses  indica ve  of  aware-­‐ness  in  DOC  pa ents.  This  project  uses  the  new  Music  Therapy  Assessment  Tool  for  Awareness  in  Disorders  of  Consciousness  (MATADOC).  Alt-­‐hough  processes  for  diagnosis,  rehabilita on  and  management  of  persons  in  DOC  are  advancing,  the  rate  of  misdiagnosis  remains  high,  30-40%  (Hirschberg,  Giacino,  2011),  increasing  the  risk  of  poor  decision  making  for  disability  management  (Magee,  2007).According  to  research,  the  auditory  modality  is  the  most  sensi ve  in  iden fying  responses  indica ng  awareness  in  DOC  pa ents  (Gill-Thwaites,  Munday  2004).    To  address  the  lack  of  sensi ve  tools  that  assess  responses  to  finely  manipulated  auditory  s muli,  the  MATADOC,  a  rigorous  assessment  and  evalua on  tool,  was  developed  and  validated  over  22  years  (Magee,  2013).  Case  studies  and  video  examples  will  illustrate  the  MATADOC  in  clinical  prac-­‐

POSTER  ABSTRACTSO'Donovan,  AManaging  the  Elderly  in  Radiotherapy  using  Geriatric  assessmEnt  (MERGE)Gillham  C    Leech  M                    According  to  Na onal  Cancer  Control  Programme  (NCCP),  new  cancer  cases  in  Ireland  could  poten ally  double  by  2040.    As  the  majority  will  occur  in  older  people,  integra on  of  geriatric  medicine  principles  into  oncology  to  improve  pa ent  outcomes  is  an  important  considera on.  The  aim  of  this  study  is  to  gain  consensus  on  geriatric  assessment  (GA)  in  oncology.    Phase  1  employed  an  expert  task  force,  comprising  oncology  and  geriatric  medicine  professionals,  to  itera vely  develop  consensus  guidelines  on  GA  in  Oncology,  using  the  Delphi  method.  Sta s cal  tests  for  concordance  and  intergroup  variability  were  performed  to  assess  the  level  of  agreement  between  professional  groups.  Phase  2  will  apply  these  guidelines,  as  part  of  the  MERGE  pilot  programme.  Consensus  was  reached  on  the  op mal  assessment  method  and  interven ons  re-­‐quired  for  the  commonly  employed  domains  of  GA  for  pa ents  aged  70  years  and  older  in  Phase  1.  Despite  consensus  guidelines  from  the  Na-­‐ onal  Comprehensive  Cancer  Network,  who  have  recommended  GA  be  performed  in  all  cancer  pa ents,  it  has  yet  to  be  op mally  integrated  into  oncology  in  most  countries.    The  MERGE  study  guidelines  may  assist  clinicians  in  geriatric  oncology  implementa on.O'Donovan,  M.AMoving  in  Later  Life:  What  is  the  Impact  on  Older  People  with  an  Intellectual  Disability?  Policy  ini a ves  focus  on  moving  people  with  an  intellectual  disability  (ID)  from  congregated  to  community  se ngs.  For  many  people  with  ID  this  move  occurs  in  later  life.  The  process  and  impact  of  change  in  living  arrangements  on  the  health  and  health  services  access  for  older  people  with  ID  is  examined.  Methods:  Secondary  data  analysis  is  of  IDS-TILDA  (Intellectual  Disability  Supplement  to  the  Irish  Longitudinal  Study  on  Ageing).  Data  collec on  with  this  na onally  representa ve  sample  involved  face-to-face  interviews.  There  were  66  lateral,  15  more  restric ve  and  31  more  community  based  moves  made  with  the  decision  to  move  usually  involving  mul ple  stakeholders.  For  lateral  movers  most  prevalent  move  ra onale  was  to  accommodate  service  (34.8%);  for  more  restric ve  movers,  change  in  health  status  (53.3%);  and  for  more  community  based  movers,  service  policy  (61.3%).  Moves  were  associated  with  decreased  use  of  social  work,  dental,  psychiatry  and  day  services  and  increased  use  of  neurological,  speech  and  language,  OT  and  personal  care.  Different  types  of  moves  led  to  different  health  service  experiences.  Further  tracking  of  the  why,  how  and  where  older  people  with  an  intellec-­‐tual  disability  are  moving  and  considera on  of  the  implica ons  for  health,  community  living  and  health  service  access  is  needed.    O'Rourke,  NGPs  endorse  Quality  of  Breast  Cancer  Care  Murphy    H    Hickey    A                    Based  on  the  recommenda ons  of  the  Na onal  Cancer  Strategy,  breast  cancer  surgery  was  centralised  in  Ireland  into  8  designated  cancer  cen-­‐tres  in  2009.  Semi-structured  interviews  were  conducted  with  a  stra fied  random  sample  of    General  Prac oners  (GPs)  to  explore    GP  referral  pa erns.  Analysis  was  conducted  using  matrices  in  Nvivo,  according  to  a ributes.  In  unprompted  responses,  the  majority  of  GPs  stated  a  pref-­‐erence  to  refer  their  pa ents  with  suspected  breast  cancer  to  the  designated  cancer  centres  in  the  public  hospitals,  regardless  of  health  insur-­‐ance  status,  since  the  designa on  of  the  cancer  centres.  GPs  in  the  South  and  West  of  the  country,  those  further  than  25  miles  from  a  cancer  centre  and  those  with  more  than  10  years  experience  were  more  likely  to  cite  their  preference  for  a  designated  cancer  centre  in  a  public  hospi-­‐tal.  The  overall  preference  for  public  hospital  care  was  replicated  for  some  other  cancers  but  not  for  other  diseases.    GPs  recommended  breast  cancer  services  in  public  hospitals  as  an  example  for  other  health  services  to  adopt.  GPs  endorse  the  quality  of  breast  cancer  care  in  public  hos-­‐pitals  since  the  establishment  of  designated  cancer  centres  by  the  Na onal  Cancer  Control  Programme.    O'Rourke,  NNational  Clinical  Guidelines  for  Cancer  –  applying  evidence  to  practiceO'Toole  E    Nolan    E                    The  Na onal  Cancer  Control  Programme  (NCCP)  is  developing  na onal  evidence-based  clinical  guidelines  for  the  diagnosis,  staging  and  treat-­‐ment  of  common  cancers,  commencing  with  breast,  prostate,  lung,  gynaecological  and  gastrointes nal  cancers.  The  methodology  employed  for  the  development  of  the  clinical  guidelines  is  based  on  the  steps  of  evidence-based  prac ce  (Sacke  2000):Step  1.  Develop  Clinical  Ques ons  in  PICO  format  Step  2.  Search  for  the  evidence  Step  3.  Appraise  the  literature  for  validity  &  applicability    Step  4.  Make  recommenda ons  Step  5.  Dra  guideline  prepared  &  reviewed  Step  6.  Implementa on.  The  guideline  development  involved  a  mul disciplinary  team  including  radiologists,  pathologists,  surgeons,  medical  oncologists,  radia on  oncolo-­‐gists,  pallia ve  care  consultants,  nurses,  librarians,  researchers,  methodologist  and  project  manager.        The  implementa on  is  based  on  a  frame-­‐work  for  analysing  target  behaviours  in  context  and  selec ng  the  appropriate  interven on  func ons  and  policy  categories,  using  the  Behaviour  Change  Wheel  (Michie  et  al.    2011).  Evidence  based  clinical  guidelines  will  ensure  standardised  mul disciplinary  care  for  pa ents,  pu ng  evi-­‐dence  into  prac ce  to  improve  pa ent  outcomes.  

POSTER  ABSTRACTSPrendergast,  AReflecting  on  Resilience  as  a  Allied  Health  and  Social  Care  Professional  –  The  Student  ExperienceAllied  health  and  social  care  professional  students  will,  on  entry  to  the  workplace,  face  a  range  of  emo onally  demanding  situa ons.  In  order  to  provide  a  sensi ve  yet  boundaried  response,  those  in  professional  educa on  need  to  take  the  first  steps  towards  understanding  their  own  emo-­‐ onal  resources,  their  individual  stress  ‘warning  signs’  and  how  to  access  support.  It  will  equip  students  with  an  awareness  and  range  of  skills  that  can  grow  and  evolve  throughout  their  professional  (and  personal)  lives.  Students  entering  educa on  for  the  ‘helping  professions’  may  well  be  mo vated  by  experience,  o en  in  their  own  families,  of  illness,  trauma  or  loss.  Whilst  such  experiences  can  be  an  asset  in  facilita ng  appro-­‐priate  self-disclosure  and  ‘tuning’  in  to  the  concerns  of  service  users,  avoiding  over-iden fica on  requires  considerable  understanding,  self  awareness  and  emo onal  intelligence.  Addi onally,  being  a  student  in  a  higher  educa on  context  can  itself  be  stressful  (Burgess  et  al  2009;Barlow  &  Hall,  2007);  students  benefit  from  learning  to  understand  their  own  responses  to  change  and  how  to  access  help  and  support  if  needed.This  paper  explores  the  concept  of  resilience  and  how  it  can  be  developed  and  embedded  in  undergraduate  programmes  in  Ireland.    Quinn,  CThe  Effectiveness  of  a  Physiotherapy  led  Bone  Health  Class  on  muscular  strength,  balance  and  exercise  behaviour  in  patients  with  osteoporosis  and  osteopeniaRyan  C    O'Shea  N                    It  is  es mated  that  300,000  Irish  are  affected  by  osteoporosis  and  that  cost  of  management  will  increase  to  €2  billion  in  2030  unless  more  effec-­‐ ve  health  care  resources  are  implemented.  Therefore  a  Bone  Health  Class  based  on  na onal  guidelines  was  commenced  with  the  aim  to  in-­‐crease  or  maintain  bone  mineral  density  and  improve  educa on  on  osteoporosis  management.  Par cipants  with  a  diagnosis  of  osteoporosis  or  osteopenia  via  recent  DXA  scan  results  were  recruited.    It  consisted  of  an  8  week  programme  of  a  90  minute  class  involving  exercise  and  bone  health  educa on  sessions.  Par cipants  underwent  pre  and  post  subjec ve  and  objec ve  outcome  measures  and  were  followed-up  at  3  and  12  months  post-par cipa on.  59  par cipants  (58  Female),  mean  age  65±9  years  (range  45-80years)  took  part.  47%  (n=28)  had  osteoporosis  and  52.5%  (n=31)  had  osteopenia  based  on  T-score  results.  Significant  improvements  were  found  post  programme  par cipa on  in  1  repe on  max-­‐imum  for  5  muscle  groups  (pRoe  ,  LThe  Impact  Of  Three  Measures  Of  Frailty  On  Capturing  Health  Service  Use  In  Ireland  Normand    C    O'Halloran  A                    Frailty  is  a  useful  lens  to  examine  pa erns  in  health  services  use,  but  frailty  can  be  measured  differently.  This  study  inves gated  the  ability  of  the  most  widely  reported  measures  of  frailty  to  explain  service  use.  We  classified  the  popula on  aged  65  years+  (n=3,507)  from  the  first  wave  of  The  Irish  Longitudinal  Study  on  Ageing  (TILDA)  as  non-frail,  pre-frail  and  frail  according  to  Fried  phenotype  frailty,  the  Morley  FRAIL  scale  and  the  Rockwood  Deficit  Frailty  Index.  Descrip ve  sta s cs  and  es mated  popula on  prevalence  rates  were  reported  for  hospital,  primary  care,  allied  health  and  home  based  service  use.  The  es mated  popula on  prevalence  of  frailty  using  the  Rockwood,  Fried  and  Morley  measures  were  22%,  8%  and  5%  respec vely.  All  three  measures  of  frailty  were  significantly  associated  with  use  of  GP,  hospital  and  community  services  (pSexton,  EBeyond  Main  Effects:  Exploring  how  Personal  and  Contextual  Factors  Interact  with  Health  to  Shape  Quality  of  Life  in  an  Older  Irish  CohortKing-Kallimanis  B    Hickey  A                    Older  people  can  maintain  good  quality  of  life  (QoL)  as  physical  health  declines.  However,  varia on  in  effects  of  physical  health  on  QoL  across  the  older  popula on  is  poorly  understood.  This  paper  explored  interac on  of  personal  and  contextual  factors  with  physical  health  to  affect  two  dimensions  of  QoL:  control/autonomy  (CA)  and  self-realisa on/pleasure  (SP).    Longitudinal  cohort  study  of  community-dwelling  adults  aged  50+,  obtained  from  the  Irish  Longitudinal  Study  of  Ageing  (TILDA)  (n  =  2,700).  Effects  of  change  in  body  func on  and  ac vity  on  QoL  were  exam-­‐ined,  using  condi onal  linear  regression.  Interac on  terms  were  tested  for  social  supports,  personality  and  religiosity.  Change  in  body  func on/ac vity  significantly  affected  CA  (-0.10,  p

POSTER  ABSTRACTSStaines,  AAdjusting  for  comorbidity  when  analysing  adverse  outcomes  in  hospital  discharge  dataLehwaldt  D    Ma hews  A                    Two  scores,  the  Elixhauser  and  the  Charlson    indices,  are  widely  used  as  measures  of  co-morbidity,  when  analysing  hospital  discharge  records.  Our  objec ve  is  to  assess  the  value  of  these  two  measures  when  analysing  Irish  HPE  data,  looking  at  a  range  of  adverse  outcomes  in  a  census  of  hospital  admissions,  excluding  day  cases,  and  those  under  18,  from  the  year  2009.  These  records  were  collected,  from  30  acute  hospitals,  as  part  of  the  RN4CAST  study.  The  two  scores  are  calculated  using  standardized  algorithms  from  coded  discharge  records.  Each  consists  of  a  set  of  subscores  which  are  added  to  produce  an  overall  score.  Outcomes  examined  were  all  deaths  in  hospital,  those  before  30  days,  and  a  range  of  nurse  sensi ve  outcomes  (NSOs),  described  by  Needleman.  Covariates  were  age,  sex,  admi ng  speciality  and  procedure.  Models  were  fi ed  using  the  mgcv  package  in  R.  There  were  405,927  eligible  admissions.  Overall  2.5%  of  pa ents  died,  and  2.1%  died  within  30  days  of  admission.  The  prevalence  of    NSOs  ranged  from  0.25%  for  pressure  sores  to  2.5%  for  metabolic  or  physiological  disturbance.  Only  0.9%  of  discharges  were  classed  as  failure  to  rescue.  For  each  NSO,  apart  from  'Ulcer,  Gastri s,  Upper  GI  Bleed',  the  Elixhauser  index  fit  be er.Swan,  DTowards  optimum  mental  disorders  treatment  (OPTIMIST  Study):  Development  and  implementation  of  a  mental  health  finder  tool  within  GP  Practice  Information  System  Hannigan  A    Meagher  D    McDonnell  R              Mental  health  service  provision  is  undergoing  reconfigura on  in  Ireland,  with  a  move  towards  more  care  being  provided  in  the  community.  However,  there  is  li le  systema c  data  on  the  prevalence  and  profile  of  mental  health  problems  among  pa ents  in  general  prac ce  to  guide  service-related  changes.  This  Poster  describes  the  development  and  pilo ng  of  a  so ware  tool  within  a  widely-used  GP  prac ce  informa on  system  to  improve  data  collec on  on  mental  disorders  among  pa ents  a ending  general  prac ce  in  Ireland.In  collabora on  with  the  Irish  Pri-­‐mary  Care  Research  Network  (IPCRN),  we  developed  a  ‘Mental  Health  Finder  Tool’  within  a  GP  prac ce  informa on  system  to  enable  GPs  iden-­‐ fy  pa ents  with  a  range  of  common  mental  disorders.  The  tool  was  piloted  among  a  convenience  sample  of  six  GP  prac ces.The  finder  gener-­‐ates  a  report  lis ng  all  pa ents  with  each  condi on,  as  iden fied  by  a)  the  presence  of  a  relevant  ICPC2/ICD10  code,  b)  medica on  prescribed.  For  each  case,  the  report  contains  addi onal  data  on  age,  gender,  GMS  status.  Data  on  the  prevalence  and  profile  of  mental  health  issues  among  pilot  prac ces  will  be  presented.The  introduc on  of  a  mental  health  finder  within  a  widely-used  GP  prac ce  informa on  system  will  Thomas,  BImplementing  and  Supporting  Holistic  Continence  Awareness  (ISHCA):  creating  a  new  culture  of  continence  care.Dunne  F                          Evidence  shows  that,  the  lack  of  knowledge  and  awareness  among  healthcare  workers  regarding  incon nence,  deficits  in  proper  documenta-­‐on,  limited  informa on  rela ng  to  the  management  (Mc  Carthy  etal.(2008)  and    Saxter  et  al.(2008)  .In  acknowledgement  of  this  a  proac ve  approach  was  taken  through  the  innova ve  development  of  an  eLearning  educa on  resource  -  ISHCA    to  support  the  health  care  professionals  in  rela on  to  the  assessment  and    management  of    incon nence  in  the  older  person  to  improve  prac ce  and  enhance  the  quality  of  life.  Through  a  mul disciplinary  approach,  an  audit  of  con nence  documenta on  and  needs  analysis  was  completed  .Development  of  an  e  learning  educa onal  resource  through  an  e-authoring  tool  and  each  has  an  assessed  component  integrated  within  it.  Evalua on  is  given  by  par cipants  on  comple on.   Website  www.ishca.net  went  live  in  April  2014   To  date  the  website  has  received  over  8,000  hits  with  visitors  from  all  over  the  world   Audit  of  the  programme  is  currently  ongoing.  This  e  learning  programme  has  increased  awareness  among  staff  that  the  promo on  of  con nence  in  the  older  adult  can  have  a  huge  impact  on  their  quality  of  life.  Tracey,  MEvaluation  of  the  Implementation  of  the  National  Clinical  Programme  in  DiabetesMcHugh  S    Kearney  P                    The  Na onal  Clinical  Programme  for  Diabetes  (NCPD)  was  established  to  standardise  the  delivery  of  services,  improve  the  quality  of  care  and  health  outcomes  for  pa ents  with  diabetes.  This  will  be  achieved  through  the  implementa on  of  various  interven ons.  Our  aim  is  to  evaluate  the  ongoing  roll-out  of  the  NCPD,  using  a  realist  evalua on  approach,  to  ascertain  the  context  and  mechanisms  which  have  facilitated  or  hin-­‐dered  implementa on.  A  mul ple  case  study  design  will  be  used;  we  will  examine  the  implementa on  of  three  programme  recommenda ons:  re nopathy  screening,  the  model  of  integrated  care  and  a  na onal  standardised  model  of  foot  care.  Purposive  sampling  will  iden fy  stakehold-­‐ers  involved  in  the  implementa on  of  the  NCPD.  Data  will  be  collected  by  semi-structured  interviews.  Cross-case  comparison  will  be  used  to  examine  whether  the  same  mechanisms  and  contexts  facilitated  or  impeded  implementa on  across  each  programme  recommenda on.  Data  will  be  managed  using  NVIVO  so ware  and  a  Framework  approach  will  be  used  to  analyse  interviews.This  study  will  assess  the  extent  to  which  changes  in  diabetes  care  have  been  implemented,  adapted  and  realised  at  na onal  and  local  level.  We  will  iden fy  the  precondi ons  for  suc-­‐cessful  implementa on  and  use  these  findings  to  inform  the  ongoing  development  of  the  NCPD.

POSTER  ABSTRACTSTurner,  NImproving  employment  outcomes  of  people  with  schizophreniaFerguson  L    Clarke  M                    Employment  enhances  the  quality  of  life  and  health  of  people  with  schizophrenia.    Yet  only  a  minority  of  those  with  schizophrenia  are  em-­‐ployed.    Research  indicates  that  the  Individual  Placement  and  Support  (IPS)  model  is  superior  to  other  approaches.    We  sought  to  determine  if  IPS  was  effec ve  in  Ireland.    Ethical  approval  was  a ained.    Par cipants  were  recruited  through  an  early  interven on  for  psychosis  service.    Two  interven ons  were  offered  –  (1)  a  1:1  job  coaching  (IPS)  for  those  unemployed  and  (2)  a  workplace  skills  course  for  those  employed.    Par cipa-­‐ on  in  the  research  was  op onal.    Data  was  collected  at  baseline  and  at  one  follow-up.    Descrip ve  sta s cs  were  used  to  quan fy  engagement  in  work.  59  people  u lised  the  interven ons  of  whom  39  (66%)  consented  to  be  studied.  At  baseline  44%  of  the  sample  were  employed/studying;  36%  were  job  seeking  and  3%  regarded  themselves  as  unable  to  work.    At  follow-up  (n  =  34)  62%  were  employed/studying;  18%  were  job  seeking  and  12%  regarded  themselves  as  unable  to  work.  While  prospec ve  studies  in  schizophrenia  typically  report  declining  employment  rates  our  findings  indicate  that  Irish  people  with  schizophrenia  can  be  successfully  helped  to  regain/maintain  employment.    The  IPS  approach  merits  further  evalua on  in  the  Irish  context.  Wilson,  PAn  Investigation  into  the  readability  of  Patient  information  leaflets  routinely  distributed  across  9  clinical  specialities  in  a  large  urban  teaching  hospitalCorry  C                          Selec ng  and  providing  wri en  educa on  material  which  can  be  understood  by  pa ents  must  begin  with  an  evalua on  of  readability.  The  goal  is  to  match  the  readability  of  materials  with  the  literacy  level  of  the  target  popula on.  Consequently  many  pieces  of  available  literature  are  inapporpriate  for  the  target  popula on.To  analyse  pa ent  informa on  leaflets  rou nely  distributed  across  9  clinical  speciali es  using  the  Gun-­‐ning  fog  index  and  the  Flesch  reading  ease  score  to  assess  the  readability  of  these  leaflets  for  pa ents  who  access  them.111  leaflets  were  op-­‐portunisi cally  selected  from  across  the  9  special es.  Leaflets  were  easily  accessible  to  all  pa ents.  Analysis  was  performed  using  the  Gunning  fog  index  and  the  Flesch  reading  ease  score.Of  the  111  leaflets,  34  were  readable  by  the  Gunning  fog  index  and  2  on  the  Flesch  reading  ease  score  showing  that  between  2%  and  30%  of  leaflets  distributed  in  this  se ng  are  readable  by  those  of  reading  age  11.  Clinicians  must  become  aware  of  the  dispar y  that  exists  between  the  readability  of  currently  available  material  and  the  literacy  skill  of  the  popula on  they  serve.  Few  pa ents  can  be  expected  to  follow  instruc ons  that  are  too  complex  and/or  beyond  their  literacy  skills.Craig,  AHealth  Literacy  and  Cancer:?Designing  a  Study  to  Assess  Health  Literacy  Levels  In  a  Prostate  Cancer  Population”  Seery  A                          Prostate  cancer  is  the  second  most  common  cancer  in  men.  As  different  treatment  op ons  are  available,  pa ents  enter  into  a  shared  decision-making  process  with  their  clinician  to  arrive  at  a  decision  about  treatment.  The  purpose  of  this  study  is  to:  (1)  evaluate  the  impact  Health  Litera-­‐cy  (HL)  level  has  on  cancer  knowledge  and  (2)  ascertain  if  pa ents  involved  in  a  shared  decision-making  process  are  knowledgeable  about  their  treatment  op ons.Men  previously  treated  for  prostate  cancer  (PrCa)  were  recruited  for  phase  1.  Using  the  nominal  group  technique,  infor-­‐ma on  required  to  make  a  decision  about  treatment  was  ascertained.  PrCa  pa ents  presen ng  to  clinics  throughout  Dublin  will  be  recruited  for  the  2nd  phase  which  aims  to  measure  HL  and  cancer  knowledge.  Phase  3  (semi  –structured  interview),  aims  to  further  explore  HL  issues  and  examine  the  decision  making  process.  This  mixed  method  approach  will  provide  quan ta ve  data  from  a  large  number  of  par cipants  and  the  qualita ve  aspects  will  offer  insights  into  the  shared  decision-making  process.  Results  from  phase  1  will  be  presented.The  results  from  this  study  may  help  in  iden fying  those  with  low  levels  of  HL  and  their  ability  to  enter  into  a  shared  decision-making  process  about  their  treatment.

LIST  OF  DELEGATESMs Ailbhe Spillane UCCDr Sarah   Barry SPHeRE  ProgrammeMr Doug   Beaton HSEDr Declan   Bedford RCSIDr Caragh Behan DETECT  /  SJOG  /  HRBProf Kathleen   Benne TCDMs Lauren Boland TCDMs Aline Brennan UCCMs Sarah  B Browne DCUProf John   Browne UCCMr Carlos   Bruen SPHeRE  ProgrammeProf Ruairi Brugha RCSIDr Sinead Burke Irish  Cancer  SocietyMs Anne e Burns RCSIDr Molly Byrne NUIGMs Paula Byrne NUIGProf Stephen Byrne UCCMs Sharon Cadogan UCCMs Orla Caffrey TCDDr Simone Carton Na onal  Rehabilita on  HospitalDr Jillian Casey UCDMs Nerilee Ceatha TCDMr Mark Cecche HSEMs Sheena   Cleary SPHeRE  ProgrammeMs Pauline Clerkin ULDr Anne Cody HRBDr Claire Collins Irish  College  of  General  Prac onersDr Deirdre   Connolly TCDMs Carmel Cooney TCDDr Susan Coote ULMr   Brian Cummins HRB  StandDr Laura Currie-Murphy TCDDr Margaret   Cur n SPHeRE  ProgrammeMr Mar n Davoren UCCMs Rebecca Dennehy UCCMs Nora  -  Ann Donnelly RCSIDr John Doran DITDr Frank Doyle RCSIDr Geraldine Doyle UCDMs Roisin Doyle DETECT  Early  Interven on  in  Psychosis  ServiceMs Kay Duggan-Walls HRBMs Deirdre Faherty Na onal  Cancer  Control  ProgrammeMs Catherine   Fitzgerald UCDDr Patricia Fitzpatrick UCDMs Sarah  Jane Flaherty UCCMs Caragh Flannery NUIGMr Padraic Fleming UMProf Naomi   Fulop University  of  LondonDr   Sarah   Gibney UCDMs Agnella   Graig TCD Irish  Na onal  Hepa s  C  Research  and  Outcomes  Ms Emma Gray NetworkMs Dee   Gray Na onal  Rehabilita on  Hospital

LIST  OF  DELEGATESMr Ronan   Grimes TCDProf Bernie   Hannigan Public  Health  EnglandDr   Ahmed   Hassab  Errasoul DETECT  Early  Interven on  in  PsychosisDr Sara Hayes ULDr Catherine   Hayes TCDMs Elaine   Healy SPHeRE  ProgrammeDr Lucy Hederman TCDMs Theresa Heller HSEDr Siobhán Hendrick HRBMs Sarah Hennessy HSEMs Marian Hernon UCDProf Anne   Hickey RCSIMs Anne  Marie Hoey HSEDr Frances Horgan RCSIDr   Deirdre   Hurley-Osing UCDDr Peter Hyde HRBMs Lisa   Hynes NUIGMs Bridget Johnston TCDMr Mar n Keane HRBMr Conor Keegan TCDMs Emily Kelleher UCCMs Fionnola   Kelly TCDMs Isabel Kennedy TCDDr Fiona Keogh GenioMr Gary Killeen NCCPMs Rebecca   Kirrane SPHeRE  ProgrammeMs Aoife   Lawton Lenus-  The  Irish  Health  RepositoryMs Mandy   Lee TCDDr Graham Love HRBMs Brenda Lynch UCCMr Jamie Madden UCCMr Alan Maddock TCDMs Anne  Marie Malone TCDProf Anne   Ma hews   DCUDr Sara McAleese RCSIDr Anne McCarthy HRBMr Ciaran   McCarthy SPHeRE  ProgrammeMs Rose McCaul HSEProf Hannah   McGee RCSIDr Sinead McGilloway UMMs Aisling McGowan DITDr Barbara McGrogan Na onal  Cancer  Control  ProgrammeDr Brian   McGuire NUIGDr Ambrose   McLoughlin Healthy  IrelandDr Lisa Mellon RCSIMs Ciara Merri UCCMr Patrick   Moore TCDMr Patrick Moran TCDMr Frank Moriarty RCSIMs Mary Morrissey HSEDr Catriona Murphy The  Irish  Longitudinal  Study  on  Ageing  (TILDA)Ms Deirdre Murphy AFPA

LIST  OF  DELEGATESDr Linda Murphy HIQAMs Louise Murphy Na onal  Cancer  Control  ProgrammeMs Sarah Murphy RCSIMr Seán Murphy Le erkenny  HospitalDr Juliet Nabbanja Ministry  of  Health,  UgandaMs Eileen Nolan Na onal  Cancer  Control  Programme  Prof Charles   Normand TCDMs Siobhain O'Doherty TCDMr David O'Riordan UCCMs Maeve   O'Brien HSE  Crisis  Pregnancy  ProgrammeMrs Rebecca   O'Connor Na onal  Rehabilita on  HospitalMs Fionnola   O'Connor Office  of  Health  Promo on  &  Improvement  Dr   Shane   O'Donnell UCDMs Mary  Ann   O'Donovan RCSI  Dr Anita   O'Donovan TCDDr Mairead O'Driscoll HRBDr Anne   O'Farrell HSEDr Siobhan O'Higgins NUIGMs Niamh O'Rourke RCSIDr Miriam O'Shea TCDMs Catherine   Perry UCCProf Ivan   Perry TCDMs Laura Phelan RCSIDr Maria Pierce DCUMs Aoife Prendergast Ins tute  of  Technology,  Blanchardstown,  DublinMs Catherine Quinn HSEDr Natasha Ra er RCSI Rickard Lenus-  The  Irish  Health  Repository Bennery   Roe TCDMs Lorna Rohde RCSIMs Daniela Ryan RCSIMs Áine Ryan HIQADr Mairin Sexton RCSIMs Eithne Slevin SPHeRE  ProgrammeDr Amanda   Smith TCDMs Amelia Smith RCSIProf Susan Staines DCUProf Anthony Swan ULDr Davina Sweeney DCUDr   Mary  Rose   Syron SPHeRE  ProgrammeMs Michelle   Tedstone HRBDr Donna Teljeur HIQADr Conor Thomas TCDProf Steve   Turner St  John  of  Gods  Community  Services  LtdMr Niall Tyrell TCDMs Ella Wallace RCSUDr Emma Walsh UCCMr Kieran Walsh RCSIMs Mary  Elizabeth   Whiston TCDMs Lucy Williams HSEMr Des Wilson St  James  HospitalMs Pauline Wren ESRIDr Maev-Ann