To describe the utility of three of the main cognitive neuroscientific techniques currently in use within the neuroscience community, and how they can be applied to the emerging field of neuromarket research. Approach: A brief development of Functional Magnetic Resonance Imaging (fMRI), Magnetoencephalography (MEG) and Transcranial magnetic stimulation (TMS) are described, as are the core principles behind their respective use. Examples of actual data from each of the brain imaging techniques are provided to assist the neuromarketer with subsequent data for interpretation. Finally, to ensure the neuromarketer has an understanding of the experience of neuroimaging, qualitative data from a questionnaire exploring attitudes about neuroimaging techniques are included which summarize participants' experiences of having a brain scan. Findings: Cognitive neuroscientific techniques have great utility in market research and can provide more ´honest´ indicators of consumer preference where traditional methods such as focus groups can be unreliable. These techniques come with complementary strengths which allow the market researcher to converge onto a specific research question. In general participants considered brain imaging techniques to be relatively safe. However care is urged to ensure that participants are positioned correctly in the scanner as incorrect positioning is a stressful factor during an imaging procedure that can impact data quality.

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BackgroundIncreasing numbers of older patients are presenting to emergency departments(ED) following trauma. These patients require multidisciplinary care that the traditional trauma model fails to provide. A Silver Trauma Review Clinic(STRC) was developed in conjunction with the geriatric, ED and multidisciplinary services to improve the post-discharge care of patients with non-operative traumatic injuries.We aimed to assess the STRC by reviewing the journey and outcomes of patients who attended the clinic and examining new diagnoses and interventions.MethodsA retrospective review of electronic chart data was performed on all patients who attended the clinic over the initial 1 year period.Results137 patient were reviewed with a median age of 80(IQR 12.5), 69% female. The median clinical frailty scale was 3 with a median time from the patient’s initial ED presentation to clinic of 15 days(IQR 11.25) and median time from initial review to discharge 20 days(IQR 34). 71% of presentations were as a result of falls under 2 metres. Primary injuries were 34% vertebral fractures, 45% limb fracture, 18% thoracic trauma, 11% pelvic trauma with 15% of patients suffering from multiple injuries. Patients attending the STRC had a comprehensive geriatric assessment with abnormal Mini-Cog assessments found in 29%, a new diagnosis of osteoporosis in 43% and orthostatic hypotension diagnosed in 13% of patients. 61% were discharged to primary care, 19% linked into a specialist geriatric clinic.ConclusionThe STRC is a novel approach allowing timely, patient focused, comprehensive and collaborative trauma care of older patients following non-operative injuries.

Background The most common cause of admission to the orthopaedic ward are low trauma falls resulting in a hip fracture. These fragility fractures occur in older, frail, multi-morbid patients and they are associated with a high mortality rate and significant loss of independence. The Irish Hip Fracture Database is a national clinical audit that aims to improve hip fracture care and patient outcomes. Using the Irish Hip Fracture Standards, we aimed to audit the care of hip fracture patients in an Irish Model 3 Hospital pre- and post- implementation of an orthogeriatrics service. Methods Local Irish Hip Fracture Database was reviewed to assess the six Irish Hip Fracture Standards prior and 4 months following the introduction of a consultant-led dedicated orthogeriatrics service. Results There were 63 hip fracture patients (mean age 81) in the pre-service group and 69 (mean age 81) in the post-service group. Standard 1: 3.2% of hip fractures were admitted to the orthopaedic ward within 4 hours in the pre-service group versus 18.8% post-service introduction (national average 11%, 2017). Standard 2: 67.9% underwent surgery within 48 hours and during working hours versus 67.8% (national average 69%, 2017). Standard 3: 3.5% developed a pressure ulcer during their stay pre-service versus 1.6% post-service (national average 3%, 2017). Standard 4: 4.8% were assessed by a Geriatrician pre-service versus 84% post-service (national average 50%, 2017). Standard 5: 24.6% received a bone health assessment versus 87.5% post-service (national average 73%, 2017). Standard 6: 1.8% received a falls assessment prior to discharge versus 82.8% post-service (national average 47%, 2017). Conclusion The introduction of a dedicated orthogeriatrics service has led to a more collaborative multi-disciplinary approach to patient care with evidence of improvements in all Irish Hip Fracture Standards. Commitment to a resourced orthogeriatric service providing rapid comprehensive geriatric assessments is essential to advance improvements in older patients’ care.

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