From gut feeling to evidence base: drivers and barriers to the development of health care for older people

2015 ◽  
Author(s):  
Paul V. Knight
Keyword(s):  
Older People ◽  
Evidence Base ◽  
Evidence Based ◽  
The Past ◽  
Key Points ◽  
Provision Of Services ◽  
The Uk ◽  
Complex Scenario ◽  
Care For Older People ◽  
Do So

Key points• Major advances in medicine, policy, and services for older people have been made over the past fifty years.• The numbers of older people in the UK and elsewhere are increasing and will continue to do so.• This increase has concomitant sociological, medical, and economic challenges that need to be met because they affect the provision of services at all levels.• These challenges are occurring at a time when resources are becoming scarcer and budgets shrinking.• Governments are faced with orchestrating infrastructure and policy in this demanding and complex scenario.• Managers are attempting to do more with less.• Clinicians and other medical professionals are trying to base treatments on sound evidence-based strategies.• There is recognition of the need to include older people and the general public in these processes.• Research may provide us with information that can help resolve these problems.

Benefit segmentation

2003 ◽  
Vol 45 (3) ◽  
pp. 1-13 ◽  
Author(s):  
Rizal Ahmad
Keyword(s):  
Older People ◽  
Personal Characteristics ◽  
Chronological Age ◽  
Consumer Market ◽  
Independent Variables ◽  
Older Consumers ◽  
Benefit Segmentation ◽  
Market Opportunities ◽  
The Uk ◽  
Do So

The UK currently has about 20 million people who are 50 years old or over. This number is expected to grow to 25 million by 2021. Older people offer new market opportunities, and companies that choose to ignore them will do so at their own peril. Literature indicates that marketers’ existing understanding of older consumers revolves around their personal characteristics, in terms of socioeconomic, demographical and psychographical data. Marketers tend to use personal characteristics as independent variables for segmenting older consumers. For simplicity, marketers also tend to treat older consumers in a similar way to which they treat the rest of the consumer market and differentiate older consumers only in terms of their chronological age. In this article, the author discusses the potential application of benefit segmentation technique for segmenting and targeting older consumers in the UK.

Substance misuse and older people: a question of values

2015 ◽  
Author(s):  
Ilana Crome
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Prescription Drugs ◽  
Substance Misuse ◽  
Evidence Based ◽  
Younger Adults ◽  
Evidence Based Treatment ◽  
Treatment Regimes ◽  
Key Points ◽  
Physical Disorders

Key points• Substances are drugs that alter mental state and are potentially addictive.• Substance abuse is not confined to the younger population; it is also prevalent in older people—alcohol and prescription drugs are the most commonly misused in this population.• The possibility of substance misuse should not be dismissed because of the patient’s age.• Recommended alcohol limits are likely to be lower than for younger adults.• Risk factors differ for older people, e.g. bereavement, retirement, loneliness, boredom.• Substance misuse is often accompanied by other mental and physical disorders.• Older people can improve with treatment so should be comprehensively assessed and offered evidence-based treatment regimes that are adjusted to take their special needs into account.

scholarly journals Cognitive and environmental interventions to encourage healthy eating: evidence-based recommendations for public health policy

2019 ◽  
Vol 6 (10) ◽  
pp. 190624 ◽  
Author(s):  
Lindsay A. Walker ◽  
Christopher D. Chambers ◽  
Harm Veling ◽  
Natalia S. Lawrence
Keyword(s):  
Public Health ◽  
Behaviour Change ◽  
Cognitive Training ◽  
Evidence Based ◽  
Environmental Interventions ◽  
Average Percentage ◽  
Public Health Burden ◽  
The Public ◽  
The Uk ◽  
Do So

Policymakers are focused on reducing the public health burden of obesity. The UK average percentage of adults classified as obese is 26%, which is double that of the global average. Over a third of UK adults report using at least one weight management aid. Yet, many people still struggle to change their diet-related behaviour, despite having the awareness, intention and capability to do so. This ‘intention–behaviour gap’ may be because most existing dietary-choice interventions focus on individual decision-making, ignoring the effects of environmental cues on human behaviour. Behaviour change interventions that ‘nudge’ people into making healthier choices by modifying the food environment have been shown to be effective. However, this type of intervention is typically challenging for policymakers to implement for economic, ethical and public accessibility reasons. To overcome these concerns, policymakers should consider ‘boosting’ interventions. Boosting involves enhancing competences that help people make decisions consistent with their goals. Here, we outline cognitive training as a boosting intervention to tackle obesity. We synthesize the evidence for one type of cognitive training (go/no-go training) that may be effective at modifying food-related decisions and reducing body weight. We offer evidence-based recommendations for an obesity-focused Public Health Wales behaviour change programme.

The State of Evidence-Based Policy Evaluation and its Role in Policy Formation

2012 ◽  
Vol 219 ◽  
pp. R41-R52 ◽  
Author(s):  
Philip Davies
Keyword(s):  
Public Service ◽  
Policy Evaluation ◽  
Research Evidence ◽  
Policy Formation ◽  
Evidence Based ◽  
Policy Cycle ◽  
Policy And Practice ◽  
The Past ◽  
Evidence Based Policy ◽  
The Uk

This paper argues that evidence-based policy has clearly made a worldwide impact, at least at the rhetorical and institutional levels, and in terms of analytical activity. The paper then addresses whether or not evidence-based policy evaluation has had an impact on policy formation and public service delivery. The paper uses a model of research-use that suggests that evidence can be used in instrumental, conceptual and symbolic ways. Taking four examples of the use of evidence in the UK over the past decade, this paper argues that evidence can be used instrumentally, conceptually and symbolically in complementary ways at different stages of the policy cycle and under different policy and political circumstances. The fact that evidence is not always used instrumentally, in the sense of “acting on research results in specific, direct ways” (Lavis et al., 2003, p. 228), does not mean that it has little or no influence. The paper ends by considering some of the obstacles to getting research evidence into policy and practice, and how these obstacles might be overcome.

scholarly journals Modernising social care services for older people: scoping the United Kingdom evidence base

2009 ◽  
Vol 29 (4) ◽  
pp. 497-538 ◽  
Author(s):  
SALLY JACOBS ◽  
CHENGQIU XIE ◽  
SIOBHAN REILLY ◽  
JANE HUGHES ◽  
DAVID CHALLIS
Keyword(s):  
United Kingdom ◽  
Older People ◽  
Social Care ◽  
Developed Countries ◽  
Evidence Base ◽  
Research Literature ◽  
Care Services ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Care For Older People

ABSTRACTIn common with other developed countries at the end of the 20th century, modernising public services was a priority of the United Kingdom (UK) Labour administration after its election in 1997. The modernisation reforms in health and social care exemplified their approach to public policy. The authors were commissioned to examine the evidence base for the modernisation of social care services for older people, and for this purpose conducted a systematic review of the relevant peer-reviewed UK research literature published from 1990 to 2001. Publications that reported descriptive, analytical, evaluative, quantitative and qualitative studies were identified and critically appraised under six key themes of modernisation: integration, independence, consistency, support for carers, meeting individuals' needs, and the workforce. This paper lists the principal features of each study, provides an overview of the literature, and presents substantive findings relating to three of the modernisation themes (integration, independence and individuals' needs). The account provides a systematic portrayal both of the state of social care for older people prior to the modernisation process and of the relative strengths and weaknesses of the evidence base. It suggests that, for evidence-based practice and policy to become a reality in social care for older people, there is a general need for higher quality studies in this area.

scholarly journals Simulation past, present and future—a decade of progress in simulation-based education in the UK

2020 ◽  
pp. bmjstel-2020-000601
Author(s):  
Helen Higham
Keyword(s):  
Evidence Base ◽  
Healthcare Systems ◽  
National Society ◽  
Interprofessional Team ◽  
The Past ◽  
Cognitive Aids ◽  
Simulation Based ◽  
The Uk ◽  
Simulation Practice

This review will present developments in simulation-based education (SBE) over the past decade with a focus on activity in the UK’s National Health Service and the role of the national society (the Association for Simulation Practice in Healthcare). The article covers the evolution of strategic changes for the use of SBE in the UK and the operational challenges faced by clinicians and other faculty in SBE. The expansion of the evidence base to support SBE in healthcare both in technical skills and, more broadly, in interprofessional team training is explored. Finally, the wider role of simulation in patient safety and healthcare systems, including testing pathways and the development of cognitive aids and involvement of patients in SBE is considered.

scholarly journals What factors promote or inhibit implementation of a new procedure for screening and treatment of malnutrition in community settings? A prospective process evaluation of theImplementing Nutrition Screening in Community Care for Older People(INSCCOPe) project (UK)

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023362 ◽  
Author(s):  
Mike Bracher ◽  
Jane Murphy ◽  
Katherine Steward ◽  
Kathy Wallis ◽  
Carl R May
Keyword(s):  
Older People ◽  
Process Evaluation ◽  
Community Care ◽  
Evaluation Study ◽  
Routine Care ◽  
Ethical Review ◽  
Nutrition Screening ◽  
Ethical Approval ◽  
The Uk ◽  
Care For Older People

IntroductionMalnutrition remains underdetected, undertreated and often overlooked by those working with older people in primary care in the UK. A new procedure for screening and treatment of malnutrition is currently being implemented by a large National Health Service (NHS) trust in England, incorporating a programme of training for staff working within Integrated Community Teams and Older People’s Mental Health teams. Running in parallel, the Implementing Nutrition Screening in Community Care for Older People process evaluation study explores factors that may promote or inhibit its implementation and longer term embedding in routine care, with the aim of optimising sustainability and scalability.Methods and analysisImplementation will be assessed through observation of staff within a single area of the trust, in addition to the procedure development and delivery group (PDDG). Data collection will occur at three observation points: prior to implementation of training, baseline (T0); 2 months following training (T1); and 8 months following training (T2). Observation points will consist of a survey and follow-up semistructured telephone interview with staff. Investigation of the PDDG will involve: observations of discussions around development of the procedure; semistructured telephone interviews prior to implementation, and at 6 months following implementation. Quantitative data will be described using frequency tables reporting by team type, healthcare provider role group, and total study sample (Wilcoxon rank-sum and Wilcoxon signed-rank tests may also be conducted if appropriate. Audio and transcription data will be analysed using Nomarlization Process Theory as a framework for deductive thematic analysis (using the NVIVO CAQDAS software package).Ethics and disseminationEthical approval for the study has been granted through institutional ethical review (Bournemouth University); NHS Research Ethics committee approval was not required. Dissemination will occur through presentations to academic and practitioner audiences and publication results in peer-reviewed academic journals.

Privatization, Hybridization and Resistance in Contemporary Care Work

2020 ◽  
pp. 97-108
Author(s):  
Pat Armstrong ◽  
Donna Baines
Keyword(s):  
Nursing Home ◽  
Older People ◽  
Nursing Home Care ◽  
Non Profit ◽  
Main Form ◽  
The Uk ◽  
Market Relations ◽  
Care For Older People ◽  
Integrated Processes

This chapter identifies seven forms of overlapping and interwoven privatization. In the current era of austerity, privatization has been able to extend its reach through these integrated processes and, in some cases, operate almost by stealth as an overarching ideological force that legitimizes private-market relations in places where it once would have been thought to be contrary to a public sector ethic of entitlement and equity. This is a growing dynamic across many public and non-profit/voluntary services and organizations. The chapter discusses the seven forms of privatization in the provision of long-term residential or nursing home care for older people in Ontario, Canada and in the UK. Private ownership is commonly thought to be the only or main form of privatization, but austerity analyses can be more incisive and specific, with a greater awareness of the complexity and multiplexity of the forms of privatization operating within formerly public and non-profit spaces. The chapter then looks at resistance in the sphere of care for older people, some of which has been successful.

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