Scotland

2019 ◽  
pp. 245-250
Author(s):  
Seamus V McNulty ◽  
Graham A Jackson
Keyword(s):  
Quality Of Care ◽  
Hospital Care ◽  
Dementia Care ◽  
General Hospitals ◽  
The Third ◽  
The United Kingdom ◽  
Novel Approaches ◽  
The Uk

Scotland is a small nation which has a devolved legislature, while still remaining part of the United Kingdom (UK). As the health service has become increasingly divergent from that of the remainder of the UK, more innovative approaches to dementia care have been allowed to develop. The Scottish Dementia Strategy, now in its third iteration, is unique in that it adopts a human rights-based method of dementia care, an approach that has subsequently been followed by other European countries. The Strategy is in continual evolution, with the third Strategy focusing more on care at the end stages of dementia, especially for those in nursing homes or long-term hospital care. Other novel approaches, such as the Dementia Champions programme, have shown benefits in the quality of care for patients with dementia in acute general hospitals, although less so for those in social care settings. Scotland was also a pioneer in enacting incapacity legislation, although this is now under review as shortcomings in the current procedures are becoming unmasked.

scholarly journals United Kingdom Effort to Combat COVID-19: Learn-to-reflect Policy

2020 ◽  
Vol 14 (2) ◽  
pp. 349
Author(s):  
Gusti Ayu Meisa Kurnia Dewi Silakarma
Keyword(s):  
United Kingdom ◽  
Case Fatality ◽  
Implementation Process ◽  
Economic Power ◽  
Health Issues ◽  
The Third ◽  
The United Kingdom ◽  
The Uk ◽  
Similar Dynamic

 Hingga saat ini, belum ada basis indikator dan ukuran internasional yang diterapkan sebelum COVID-19—baik indikator kesehatan, ekonomi, maupun sosial-politik— yang dapat digunakan untuk memprediksi bagaimana performa tiap negara dalam merespon COVID-19. Negara dengan ekonomi yang besar belum tentu dapat merespon pandemi dengan mumpuni. Dinamika yang tidak jauh berbeda juga dialami oleh Inggris. Inggris masih menempati posisi ketiga tertinggi di wilayah Eropa dengan kasus kumulatif COVID-19 per Agustus 2020. Pun ini diperumit dengan tingkat kematian (case fatality rate/CFR) COVID-19 di Inggris sebagai persentase tertinggi di Eropa. Ini menjadikan proses implementasi kebijakan Inggris terkait COVID-19 menarik untuk dikaji. Analisis kebijakan ini didasari pada lensa syndemic yang menekankan pentingnya implikasi non-kesehatan untuk diinkorporasi dalam pembuatan kebijakan serta whole-of-society menggarisbawahi koordinasi aktor-aktor negara dan non-negara penting untuk proses implementasi. Temuan tulisan ini ialah kebijakan pemerintah Inggris berbentuk learn-to-reflect; mencoba inklusif dan holistik serta berhasil menekan pertumbuhan kasus baru, namun observasi mendatang antara koordinasi aktor dalam multisektor isu terhadap efektivitas kebijakan jangka panjang masih diperlukan. Kata-Kata Kunci: Inggris; COVID-19; Syndemic-Pandemic; Whole-Of-Society; Kolaborasi Pemerintahan; Ketimpangan  To date, no fixed international indicators set prior to the start of COVID-19—either health, economics, or socio-politics indicators—can be used to predict how states’ policies fared in responding to COVID-19. A state with an enormous economic power does not necessarily equip to respond the pandemic adequately. The United Kingdom (UK) has encountered similar dynamic. The UK remains as the third country with the most cumulative cases of COVID-19 in the Europe as per August 2020. This complicated by the UK’s COVID-19 CFR that remains as the highest in the Europe. This brought to light a puzzle in how the UK implement its COVID-19 policy. The analysis in this study utilized a syndemic lens in which emphasises the importance of non-health issues to be incorporated into the policy, as well as based the policy implementation process on the whole-of-society approach where state and non-state actors’ coordination remains significant. The findings on UK policy response mimicked a model of learn-to-reflect; attempted to be inclusive and holistic, as well as successfully reduced new daily COVID-19 cases, yet, the upcoming observation on the coordination between actors on multisectoral issues and how this affects the effectiveness of long-term policy remains as an utmost necessity. Keywords: United Kingdom; COVID-19; Syndemic-Pandemic; Whole-Of-Society; Governance Collaboration; Inequality

GA: Armani’s Giorgio Armani

2018 ◽  
Author(s):  
Paul Brooker ◽  
Margaret Hayward
Keyword(s):  
Final Section ◽  
The Body ◽  
Body Shop ◽  
The Third ◽  
Haute Couture ◽  
Fashion Designer ◽  
The Body Shop ◽  
The Uk ◽  
Career Woman

The Armani high-fashion example illustrates the importance of adaptive rational methods in his founding and developing of an iconic high-fashion firm. Armani adapted stylistically to fashion’s new times in the 1970–80s by creating a new style catering for the career woman. His stylistic adaptation is compared with that of another famous Italian fashion designer, Versace, who instead modernized haute couture fashion and created a succession of glamourous styles. Both leaders exploited the same opportunity but in different ways. The third section compares these leaders’ legacies in the 1990s–2000s and assesses from a long-term perspective how capably they had used adaptive rational methods. The final section shifts the focus from fashion to the cosmetics industry and from Italy to the UK. Anita Roddick used adaptive rational methods to establish The Body Shop corporation in the 1970s–80s. However, she then abandoned rational methods with dire results for her corporation in the 1990s.

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

scholarly journals The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emilia Majsiak ◽  
Magdalena Choina ◽  
Dominik Golicki ◽  
Alastair M. Gray ◽  
Bożena Cukrowska
Keyword(s):  
Quality Of Life ◽  
United Kingdom ◽  
Coeliac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
The United Kingdom ◽  
Before And After ◽  
The Mean ◽  
The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

scholarly journals Language Legislation and Policy in the uk and Ireland: Different Aspects of Territoriality in a ‘Celtic’ Context

2016 ◽  
Vol 23 (4) ◽  
pp. 454-484 ◽  
Author(s):  
Robert Dunbar
Keyword(s):  
United Kingdom ◽  
Language Policy ◽  
Indigenous Languages ◽  
Scottish Gaelic ◽  
The United Kingdom ◽  
Language Legislation ◽  
The Uk

In spite of the long-term dominance in Britain and Ireland of English, other indigenous languages continue to be spoken, and in relatively recent years several of those languages have benefited not only from a more coherent and supportive language policy but also from significant language legislation. One of the interesting features of these other indigenous languages is that, although strongly associated with rural ‘heartlands’ in the particular jurisdictions with which they are associated, they are also spoken in other parts of those jurisdictions, and, indeed, in other parts of the United Kingdom and Ireland. In this article, the ways in which the concept of territoriality has impacted upon legislation and on broader policy for two of these languages, Irish and Scottish Gaelic, will be considered.

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