scholarly journals VP208 Informing An Economic Model For Hyperhidrosis: A Clinical Survey

2017 ◽  
Vol 33 (S1) ◽  
pp. 246-247
Author(s):  
Julija Stoniute ◽  
Eoin Moloney ◽  
Stephen Rice ◽  
Nick Levell ◽  
Dawn Craig
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Economic Model ◽  
Online Survey ◽  
Dropout Rates ◽  
Current Clinical Practice ◽  
Excessive Sweating ◽  
Survey Tool ◽  
Wide Range ◽  
The Uk

INTRODUCTION:Hyperhidrosis is characterized by uncontrollable excessive sweating, which occurs at rest, regardless of temperature. As part of a wider study exploring the clinical and cost effectiveness of alternative treatments for primary hyperhidrosis, a survey of United Kingdom (UK) dermatologists was conducted to gain a better understanding of current clinical practice in the area and inform economic model inputs.METHODS:The survey was conducted by means of an online survey tool, “Qualtrics”. It was circulated to members of the British Association of Dermatologists. Topics covered included treatments typically administered, medication dosages prescribed, effectiveness of treatments, adverse events related to treatments and resource use associated with individual treatments.RESULTS:Forty-five respondents from forty-two different dermatology units completed the survey. The majority of clinicians (83 percent) prescribed more than one medication - most commonly oxybutynin and propantheline bromide. The next most commonly reported treatments were: iontophoresis, botulinum toxin and curettage.Respondents were asked to indicate dosage, frequency and details about follow-up visits related to medication use. Doses prescribed were largely consistent with British National Formulary (BNF) recommendations. For other treatments, dermatologists were asked to indicate duration of the procedure, job title of the treatment provider and details about monitoring visits. Results were similar to the findings from the literature and previously conducted interviews with clinicians.Respondents were asked to indicate the dropout rates for each type of treatment due to lack of effectiveness and adverse events. Dropout rates were relatively high for both reasons.CONCLUSIONS:The results highlight the wide range of treatments for hyperhidrosis currently administered by dermatologists across the UK, and the variation in current clinical practice. This variation highlights the lack of evidence-based guidance underpinning practice and the importance of clinical surveys as a complement to usual data collection methods.

scholarly journals SWOT analysis of plant health clinics as perceived by plant doctors in Nepal

2018 ◽  
pp. 137-146
Author(s):  
R. K. Adhikari ◽  
P. P. Regmi ◽  
R. B Thapa ◽  
Y. D. G.C. ◽  
E. Boa
Keyword(s):  
Online Survey ◽  
Swot Analysis ◽  
Plant Health ◽  
Survey Tool ◽  
Extension System ◽  
Health Clinics ◽  
Novel Approach ◽  
Wide Range ◽  
Plant Clinics ◽  
External Forces

 This paper identified and examined the internal and external forces that enable or inhibit the performance of plant clinics in Nepal. The study used web-based online survey tool to collect primary information. Likert scaling and indexing techniques were used on data analysis. Pretested set of questionnaires were mailed to 209 plant doctors and the response rate was 54.54%. Being ninth country to initiate plant health clinics, Nepal is successful to adapt this novel approach into the existing extension system. It has increased access to plant health services by providing wide range of services at a place. However,limited understanding and only profit motive of local private agro-vet and input dealers has created some biased-understanding and un-trust with clinic organizers. This SWOT analysis clearly spells the scope of plant clinics to fulfill the gap between farmers need and existing services provided by public extension system.Journal of the Institute of Agriculture and Animal Science.Vol. 33-34, 2015, page: 137-146

The effect of the COVID-19 pandemic on non-elective otolaryngology admissions and a positive change in clinical practice

2021 ◽  
Vol 103 (7) ◽  
pp. 496-498 ◽  
Author(s):  
B Wright ◽  
C McKenna ◽  
CEE Reddy
Keyword(s):  
Clinical Practice ◽  
Northern Ireland ◽  
Adverse Events ◽  
Respiratory Illness ◽  
Positive Change ◽  
Peritonsillar Abscess ◽  
Outpatient Basis ◽  
Large Numbers ◽  
The Uk

As the COVID-19 pandemic progressed across the UK and Northern Ireland in March 2020, our otolaryngology department began to make preparations and changes in practice to accommodate for potentially large numbers of patients with COVID-19 related respiratory illness in the hospital. We retrospectively reviewed the number of non-elective admissions to our department between the months of January and May in 2019 and 2020. A significant reduction in admissions of up to 94% during the months of the pandemic was observed. Our practice shifted to manage patients with epistaxis and peritonsillar abscess on an outpatient basis, and while prospectively collecting data on this, we did not observe any significant adverse events. We view this as a positive learning point and change in our practice as a result of the COVID-19 pandemic.

scholarly journals Diagnosis and management of bile acid diarrhoea: a survey of UK expert opinion and practice

2019 ◽  
Vol 11 (5) ◽  
pp. 358-363 ◽  
Author(s):  
Julian R F Walters ◽  
Ramesh Arasaradnam ◽  
H Jervoise N Andreyev ◽  
Keyword(s):  
Bile Acid ◽  
Expert Opinion ◽  
Best Practice ◽  
Online Survey ◽  
Design Method ◽  
Diagnosis And Management ◽  
Bile Acid Malabsorption ◽  
Presenting Symptoms ◽  
Wide Range ◽  
The Uk

ObjectiveBile acid diarrhoea (BAD), which includes bile acid malabsorption, causes a variety of digestive symptoms. Diagnostic rates and management vary considerably. We conducted a survey of current practice to review expert opinion and provide guidance on diagnosis and management.Design/methodAn online survey was conducted of clinical members of the UK Bile Acid Related Diarrhoea Network, who had all published research on BAD (n=21). Most were National Health Service consultants who had diagnosed over 50 patients with the condition.ResultsThe preferred terminology was to use BAD, with primary and secondary to classify causes. A wide range of presenting symptoms and associated conditions were recognised. SeHCAT (tauroselcholic acid) was the preferred diagnostic test, and 50% of respondents thought general practitioners should have access to this. Patients who met the Rome IV diagnostic criteria for functional diarrhoea, irritable bowel syndrome (IBS) with predominant diarrhoea or postcholecystectomy diarrhoea were usually investigated by SeHCAT, which was used sometimes in other types of IBS. Treatment with a bile acid sequestrant was offered to patients with low SeHCAT values, with expected response rates >70% in the most severe. Colestyramine was the usual sequestrant, starting between 2 g and 8 g daily; colesevelam was an alternative. In patients who had an incomplete response, increasing the dose, changing to an alternative sequestrant, use of loperamide and a low fat diet were suggested. Recommendations for follow-up and to improve the overall patient experience were made.ConclusionThis expert survey indicates current best practice in the diagnosis and management of BAD.

Third sector partnerships for older people: insights from live at home schemes in the UK

2018 ◽  
Vol 22 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Olumide Adisa
Keyword(s):  
Older People ◽  
Online Survey ◽  
Third Sector ◽  
Later Life ◽  
Evidence Base ◽  
Content Type ◽  
Health And Social Care ◽  
Wide Range ◽  
The Uk ◽  
At Home

Purpose While there is a rich literature on the role of partnerships between statutory agencies and third sector organisations for public service delivery in health and social care, the evidence base on, partnerships between community-based groups and charities for older people in the UK is lacking. Drawing on quantitative and qualitative data, the purpose of this paper is to examines partnerships within 46 live at home (LAH) schemes. These schemes were specifically designed to tackle isolation and promote independence and wellbeing by providing a wide range of activities, based on the needs of its members. Design/methodology/approach This study is based on an online survey of 46 LAH schemes and face-to-face interviews with seven scheme managers to capture data on the various partnership initiatives within the LAH schemes. Findings Third sector partnerships for older people varied by type – formal, semi-formal and informal. In addition, third sector partnership working fosters the achievement of clear outcomes for older people who LAH and could be a mechanism for building social capital in communities. The study also identified barriers to developing third sector partnerships within this context. Mapping existing partnerships in LAH schemes were considered to be useful in engaging with partners. LAH scheme managers were better able to identify partnerships that could be deepened and broadened, depending on the desired outcomes. Originality/value To the author’s knowledge, there are few studies on third sector partnership working in LAH schemes for older people. According to Age UK, there are 1.2m chronically lonely older people in the UK. Over half of all people aged 75 and over live alone (ONS, 2015). Loneliness and social isolation in later life are considered to be two of the largest health concerns we face. Scaling up these third sector partnerships may offer a credible way to shore up support for older people who live alone or want to live at home.

scholarly journals Characterising the evidence base for advanced clinical practice in the UK: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036192 ◽  
Author(s):  
Catrin Evans ◽  
Brenda Poku ◽  
Ruth Pearce ◽  
Jeanette Eldridge ◽  
Paul Hendrick ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Health Workforce ◽  
Grey Literature ◽  
Evidence Base ◽  
Current Evidence ◽  
Multiprofessional Team ◽  
Wide Range ◽  
Current Evidence Base ◽  
The Uk

IntroductionA global health workforce crisis, coupled with ageing populations, wars and the rise of non-communicable diseases is prompting all countries to consider the optimal skill mix within their health workforce. The development of advanced clinical practice (ACP) roles for existing non-medical cadres is one potential strategy that is being pursued. In the UK, National Health Service (NHS) workforce transformation programmes are actively promoting the development of ACP roles across a wide range of non-medical professions. These efforts are currently hampered by a high level of variation in ACP role development, deployment, nomenclature, definition, governance and educational preparation across the professions and across different settings. This scoping review aims to support a more consistent approach to workforce development in the UK, by identifying and mapping the current evidence base underpinning multiprofessional advanced level practice in the UK from a workforce, clinical, service and patient perspective.Methods and analysisThis scoping review is registered with the Open Science Framework (https://osf.io/tzpe5). The review will follow Joanna Briggs Institute guidance and involves a multidisciplinary and multiprofessional team, including a public representative. A wide range of electronic databases and grey literature sources will be searched from 2005 to the present. The review will include primary data from any relevant research, audit or evaluation studies. All review steps will involve two or more reviewers. Data extraction, charting and summary will be guided by a template derived from an established framework used internationally to evaluate ACP (the Participatory Evidence-Informed Patient-Centred Process-Plus framework).DisseminationThe review will produce important new information on existing activity, outcomes, implementation challenges and key areas for future research around ACP in the UK, which, in the context of global workforce transformations, will be of international, as well as local, significance. The findings will be disseminated through professional and NHS bodies, employer organisations, conferences and research papers.

An online survey of nurses’ perceptions, knowledge and expectations of the National Health Service modernization programme

2005 ◽  
Vol 11 (1_suppl) ◽  
pp. 64-66 ◽  
Author(s):  
Maria Bryson ◽  
Natalie Tidy ◽  
Michael Smith ◽  
Sharon Levy
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Online Survey ◽  
Health Records ◽  
Health Visitors ◽  
Wide Range ◽  
Nurses Perceptions ◽  
College Of Nursing ◽  
The Uk

We conducted an online survey to investigate nurses’ perceptions, knowledge and expectations of the National Health Service (NHS) modernization programme in the UK. The questionnaire was available for 28 days via the Website of the Royal College of Nursing. The questionnaire was completed by 2020 nurses, midwives and health visitors working in all sectors of the health service in a wide range of specialties and environments of care. Less than one-quarter of respondents felt that they had adequate information about NHS information technology (IT) developments. In all, 528 (26%) said this was the first they had heard of the initiatives. Only 383 respondents (19%) felt adequately informed about the development of electronic health records; 470 (23%) felt inadequately informed and 456 (23%) had only heard something about it. The findings of this survey suggest that nursing staff are not widely aware of current IT plans and programmes in the NHS. They suggest that nurses also lack confidence in using advanced IT, which is compounded by lack of training.

scholarly journals Typologies of postnatal support and breastfeeding at two months in the UK

2019 ◽  
Author(s):  
Emily H Emmott ◽  
Abigail Emma Page ◽  
Sarah Myers
Keyword(s):  
Family Support ◽  
Support Group ◽  
Emotional Support ◽  
Health Professionals ◽  
Online Survey ◽  
Latent Class ◽  
Wide Range ◽  
Breastfeeding Rates ◽  
The Uk ◽  
To Receive

Extensive evidence suggests that social support improves breastfeeding outcomes. Building on this evidence-base, public health services and interventions aiming to improve breastfeeding rates have primarily targeted informational and emotional support to mothers, reflecting an individual behaviour-change approach. However, mothers exist within a wider social network, and the characteristics of their broader support networks may be an important predictor of breastfeeding outcomes. Here we explore the typologies of postnatal support for mothers in the UK; a population with one of the lowest breastfeeding rates in Europe. Using retrospective data from an online survey (data collection period between December 2017 and February 2018), we carry out a latent class regression (n=432) to identify “clusters” of postnatal support in our data. Mothers in our sample were most likely to receive practical and emotional support from partners and maternal grandmothers, and breastfeeding information from health professionals. We identify three distinct typologies of postnatal support: 1) Extensive support, where mothers received support from a wide range of supporters including partners, maternal grandmothers, friends and health professionals, but mothers were the only ones to feed the infant; 2) Family support, where mothers received support from partners and maternal grandmothers, including with infant feeding, but less likely to receive support from health professionals; and 3) Low support, where mothers primarily received support from partners. 94% of women with extensive support were predicted to be breastfeeding at two months, followed by 48% of mothers in the low support group, and 13% in the family support group. Our findings highlight the complexities of family support and its potential impact on breastfeeding, as well as the significance of professional support. Overall, our results hint at the potential value for health professionals to engage with wider family in order to achieve extensive support for mothers.

scholarly journals COVIDTrach; the outcomes of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK: Interim Report

2020 ◽  
Author(s):  
◽  
Nick JI Hamilton
Keyword(s):  
Health Care Workers ◽  
Online Survey ◽  
Interim Report ◽  
Surgical Specialty ◽  
Collaborative Project ◽  
Survey Tool ◽  
Mechanically Ventilated ◽  
Care Workers ◽  
National Guidance ◽  
The Uk

COVIDTrach is a UK multidisciplinary collaborative project that aims to evaluate the outcomes of tracheostomy in COVID-19 patients. It also examines the implementation of national guidance in COVID-19 tracheostomies and the incidence of COVID-19 infections amongst those health care workers involved in the procedure. An invitation to participate in an online survey tool (REDCap) was disseminated to all UK NHS departments involved in tracheostomy in mechanically ventilated COVID-19 patients via the Federation of Surgical Specialty Associations, it's subsidiary organisations and the Intensive Care Society. To date 78 hospitals have submitted 564 COVID-19 tracheostomy cases. Fifty-two percent (n=219/465) of patients who had undergone tracheostomy and were still alive, had been successfully weaned from mechanical ventilation at the point of completing the survey. The all cause in-hospital mortality following tracheostomy was 12% (n=62/530), with 3% of these (n=2/62) due to tracheostomy related complications and the remaining deaths due to COVID-19 related complications. Amongst 400 cases submitting data two weeks after the tracheostomy, no instance of COVID-19 infection amongst operators was recorded. FFP3 masks or Powered Air Purifying Respirators were used by operators in 100% of tracheostomies and a face visor or hood with face shield was available in 99% of cases. This interim report highlights early outcomes following tracheostomy in mechanically ventilated COVID-19 patients. Future reporting from COVIDTrach will include more detailed analysis at later timepoints using comparator groups in order to provide a more comprehensive assessment of tracheostomy in COVID-19.

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