Integrating iron research in clinical practice: a service design project for investigating disruptive sleep & wake-behaviours

2019 ◽  
Vol 64 ◽  
pp. S36-S37
Author(s):  
N. Beyzaei ◽  
J. Cho ◽  
K. Xiao ◽  
R. Friedlander ◽  
K. McFee ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Service Design ◽  
Design Project

scholarly journals Schizophrenia and bipolar disorder: No recovery without suicide prevention

2015 ◽  
Vol 207 (5) ◽  
pp. 371-372 ◽  
Author(s):  
Tom Foster
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Personal Responsibility ◽  
Service Design ◽  
Mental Capacity ◽  
Evidence Based

SummarySuicide prevention for people with schizophrenia or bipolar disorder warrants an evidence-based approach to service design as well as clinical practice. The issue of personal responsibility (diminished when mental capacity is impaired) contributing to reduction of suicide risk has, arguably, been neglected.

scholarly journals Patient and Public Involvement project to identify and prioritize key components of a new exercise rehabilitation service for people with multi-morbidity

2021 ◽  
Author(s):  
Natasha Jones ◽  
Kate Jackson ◽  
Charlie Foster ◽  
Hamish Reid ◽  
Katherine Edwards ◽  
...  
Keyword(s):  
Public Involvement ◽  
Service Design ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Published Data ◽  
Ageing Population ◽  
Service Users ◽  
Exercise Rehabilitation ◽  
Design Project

Background: In an ageing population with high levels of multi-morbidity, the preventative effects of exercise rehabilitation(ER) are significant. The NHS currently delivers ER mainly in disease-specific areas. There is a lack of published data to support the long term effectiveness of this model. In the light of emerging evidence supporting the effectiveness of physical activity for multi-morbidity, it is timely to consider different models of ER service delivery. Engagement with and adherence to ER is an important factor in its long term effectiveness. Active involvement and engagement with users is therefore essential at the service design level. The objective of this project, therefore, is to involve users in the preliminary stages of service re-design by seeking to identify and prioritise service needs from a users perspective. These priorities will be used to form the aims of a co-design project with ongoing involvement of service users, aims which can be investigated as individual research questions.Methods: Forty people with multi-morbidity participated in discussion forums. Themes from the forums were summarised and presented in a format to inform the aims of future service co-design. Results: People with multi-morbidity were interested in involvement in the re-design of NHS rehabilitation services. People felt the NHS could and should do much more to support people to exercise because the barriers and motivators for exercise are inextricably linked to the symptoms of illness. Traditional NHS models of rehabilitation were challenged and participants suggested novel and exciting ideas about potential service design. Conclusions and discussion: Participants understand the potential value of exercise and are motivated to exercise. Motivation is thwarted by perceived barriers to competence, autonomy and cultural and social relatedness. Service users have novel and exciting ideas about how the NHS could improve exercise rehabilitation services in order to improve acceptability and accessibility to all. Together with ongoing service user involvement, these ideas can form the aims of a co-design project and ultimately will be developed into research questions in an evaluation of a new complex exercise rehabilitation intervention.

The miR-21 potential of serving as a biomarker for liver diseases in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Liver Diseases ◽  
Hepatic Disease ◽  
Noninvasive Detection ◽  
Diagnosis And Prognosis ◽  
Expected Performance ◽  
Potential Biomarker ◽  
Disease Condition ◽  
Complex Regulatory Network

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

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