scholarly journals Lessons from a publicly funded tier 2 healthy weight programme in Cornwall, UK

2019 ◽  
Author(s):  
A J Williams ◽  
T Barter ◽  
R A Sharpe
Keyword(s):  
Statistical Tests ◽  
Evidence Base ◽  
Lessons Learned ◽  
Healthy Weight ◽  
Anthropometric Measures ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Weight Management Programme ◽  
The Uk ◽  
The Impact

Abstract Background The UK has one of the highest prevalence rates of obesity worldwide. Public health departments have a duty to provide some obesity treatment and prevention services. With evidence of effective programmes lacking, we investigate lessons learned from a healthy weight programme in Cornwall, UK. Methods Data from the 12-week multi-component adult healthy weight management programme were obtained for 2012–2016. Descriptive statistics and statistical tests were used to describe participants’ demographics, health status and anthropometric measures to explore the enrolment and retention of the programme as well as the impact. Results A total of 1872 adults were referred into the programme. Overall, 646 completed the programme and, 48.8% achieved the programme’s aim of a >3% reduction in weight. Those who completed and met the programme aim tended to have had healthier outcomes at baseline. Conclusions For those who engage with the programme the impact can be meaningful. However, <1% of the population of Cornwall with overweight or obesity enroled in the programme, and those who benefitted most might have been in least need. Providing services that meet the needs of the population is challenging when a variety of services is needed, and the evidence base is poor.

scholarly journals Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN

ESMO Open ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. e000258 ◽  
Author(s):  
Elena Pallari ◽  
Anthony W Fox ◽  
Grant Lewison
Keyword(s):  
Practice Guidelines ◽  
Western Europe ◽  
Statistical Tests ◽  
Geographic Location ◽  
Basic Research ◽  
Research Impact ◽  
Evidence Base ◽  
Effective Decision Making ◽  
The Uk ◽  
The Impact

BackgroundThis is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).MethodsA total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.ResultsESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.ConclusionsWe showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

scholarly journals Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016948 ◽  
Author(s):  
Jo Brett ◽  
Sophie Staniszewska ◽  
Iveta Simera ◽  
Kate Seers ◽  
Carole Mockford ◽  
...  
Keyword(s):  
Public Involvement ◽  
Evidence Base ◽  
Patient And Public Involvement ◽  
Lessons Learned ◽  
Reporting Guidelines ◽  
Consensus Development ◽  
Face To Face ◽  
Three Phase ◽  
Health And Social Care ◽  
The Impact

IntroductionPatient and public involvement (PPI) is inconsistently reported in health and social care research. Improving the quality of how PPI is reported is critical in developing a higher quality evidence base to gain a better insight into the methods and impact of PPI. This paper describes the methods used to develop and gain consensus on guidelines for reporting PPI in research studies (updated version of the Guidance for Reporting Patient and Public Involvement (GRIPP2)).MethodsThere were three key stages in the development of GRIPP2: identification of key items for the guideline from systematic review evidence of the impact of PPI on health research and health services, a three-phase online Delphi survey with a diverse sample of experts in PPI to gain consensus on included items and a face-to-face consensus meeting to finalise and reach definitive agreement on GRIPP2. Challenges and lessons learnt during the development of the reporting guidelines are reported.DiscussionThe process of reaching consensus is vital within the development of guidelines and policy directions, although debate around how best to reach consensus is still needed. This paper discusses the critical stages of consensus development as applied to the development of consensus for GRIPP2 and discusses the benefits and challenges of consensus development.

scholarly journals SWTICH DE ESQUEMAS ANTIRRETROVIRAIS DURANTE A PANDEMIA DE COVID-19 EM UM CENTRO DE REFERÊNCIA DA AMÉRICA LATINA

RAHIS ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 168-169
Author(s):  
Dirce Inês Silva ◽  
Isabela Estrela Santos ◽  
Jaqueline Xavier Oliveira
Keyword(s):  
Research Society ◽  
Hiv Treatment ◽  
Services Research ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
The Social ◽  
America Latina ◽  
Terapia Antirretroviral ◽  
The Impact ◽  
Brazilian Journal

INTRODUÇÃO : O tratamento da infecção pelo vírus da imunodeficiência humana (HIV) é realizado por meio da terapia antirretroviral (TARV) e vem apresentando avanços importantes no decorrer dos anos. Ocorreu a introdução de novas drogas e classes que ampliaram de modo significativo as opções para o tratamento da infecção pelo HIV-1. Existem razões para a troca (Swtich) da TARV, são eles : manutenção da supressão viral, resistência, probabilidade de maior adesão ao tratamento, eventos adversos, interações medicamentosas (1). Durante a pandemia de Covid-19 que vivenciamos desde março de 2020 no Brasil muitas dificuldades ocorreram nos serviços de saúde, principalmente para as pessoas que vivem com HIV como : acesso aos serviços, diagnóstico, tratamento e acompanhamento (2.3). OBJETIVO: Avaliar a prevalência de trocas de esquemas em um centro de referência da América Latina no período de Janeiro de 2020 a 31 de Julho de 2021.METODOLOGIA : Realizamos um estudo transversal no período de 2020 a 2021 , utilizando o sistema de informação : Sistema de Controle Logístico de Medicamentos (SICLOM) do Ministério da Saúde . Os dados foram analisados no Statistical Package for the Social Science(SPSS® ) 22.RESULTADOS : No período do estudo foram detectadas 473 trocas. Em 2020 ocorreram 283 trocas, 83 em mulheres e 200 em homens. E 2021 até o dia 31/07/2021 foram detectadas 190 trocas, 76 ocorreram em mulheres e 114 em homens. As trocas ocorreram devido : resistência, reações adversas, gestação , tratamento concomitante da tuberculose e simplificação do tratamento ( Figura 1 e 2)).   Figura 1 – Ocorências de Swtich de esquemas antirretroviraisFigura 2- Razões de Trocas de Esquemas Antiretrovirais CONCLUSÃO : Swtich dos esquemas antirretrovirais em utilização pode ser uma estratégia de simplificação da TARV, melhoria da adesão, e em muitos casos a redução de eventos adversos. O arsenal terapêutico no contexto brasileiro é diversificado permitindo uma troca com segurança e sem risco de perda da eficácia virológica. Sendo uma estratégia para enfrentamento da infecção pelo HIV mesmo em tempos de pandemia do COVID19. REFERÊNCIAS:1-Brites, Carlos. Terapia antirretroviral atual: tendências e desafios. Estratégias de troca (switch) naterapia antirretroviral atual. Brazilian Journal of Infectious DiseaseVol 2 . Nº 1 . Fevereiro 20162- Moura, Maria Lucia Costa de. (2020). Coronavírus e COVID-19. Revista Saúde Coletiva, 53, 10.3- Parente, J. da S.; Azevedo, S. L. de .; Moreira, L. da F. A.; Abreu, L. M. .; Souza, L. V. de. The impact of social isolation on the COVID-19 pandemic on access to HIV treatment and prevention services. Research, Society and Development, [S. l.], v. 10, n. 1, p. e28110111692, 2021.  

Creating a culture of employability in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Naomi Boycott ◽  
Justine Schneider ◽  
Michael Osborne
Keyword(s):  
Mental Health ◽  
Supported Employment ◽  
Implementation Process ◽  
Lessons Learned ◽  
Service Development ◽  
Content Type ◽  
The Individual ◽  
The Uk ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose – The purpose of this paper is to draw out the lessons learned from the implementation of the Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental health teams; one “standard” CMHT, and one early intervention in psychosis (EIP) team. Design/methodology/approach – These inferences are based on the evidence from a four-year study of IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to run a RCT looking at the impact of psychological input as an adjunct to IPS alone. Findings – In attempting to introduce IPS to mental health teams in Nottingham the authors came across numerous barriers, including service reorganisation, funding cuts and the wider context of recession. Differences were observed between mental health teams in the willingness to embrace IPS. The authors argue that this variability is due to differences in caseload size, recovery priorities and client profiles. The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS fidelity reviews can make a positive difference to the implementation process. Practical implications – The experience suggests that setting up an IPS service is possible even in the most challenging of times, and that EIP services may be a particularly fertile ground for this approach. The authors also discuss potential barriers to implementing new services in mental health teams. Originality/value – This paper will be of value to service development and the science of implementation in mental health.

Revised standards of proficiencies for midwives: an opportunity to influence childhood health?

2020 ◽  
Vol 28 (3) ◽  
pp. 150-154
Author(s):  
Samantha Meegan
Keyword(s):  
Public Health ◽  
Child Development ◽  
Evidence Base ◽  
Early Child Development ◽  
Childhood Health ◽  
Early Child ◽  
The Public ◽  
The Future ◽  
The Uk ◽  
The Impact

The first 1 000 days of life are critical during early child development, yet the significance of this time and the impact on childhood health have only recently been recognised within the UK. In early 2020, the Nursing and Midwifery Council (NMC) released revised standards of proficiency for midwives. These draw on the evidence-base generated by recent research developments within public health, providing the first update of midwifery standards for a decade. This article critically explores the main aspects within the NMC's future midwife proficiencies that relate to the public health component of the midwifery role, and will examine how these factors can equip midwives of the future to support women, their babies and families within the fundamental early days of life.

scholarly journals Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 4
Author(s):  
Carol A. Fairfield ◽  
David G. Smithard
Keyword(s):  
Acute Phase ◽  
Best Practice ◽  
Evidence Base ◽  
Post Stroke ◽  
Effortful Swallow ◽  
The Us ◽  
Screening Assessment ◽  
The Uk ◽  
Management Of Dysphagia ◽  
The Impact

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

Body mass index (BMI) and its impact on quality of life (QOL) in childhood leukemia survivors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9606-9606
Author(s):  
Anne Hudson Blaes ◽  
Kevin Scott Baker ◽  
Jill Lunsford Lee ◽  
Catherine Moen ◽  
Daniel A. Mulrooney ◽  
...  
Keyword(s):  
Physical Functioning ◽  
Weight Status ◽  
Childhood Leukemia ◽  
Short Form ◽  
Statistical Tests ◽  
Age At Diagnosis ◽  
Cell Transplant ◽  
Healthy Weight ◽  
Sf 36 ◽  
The Impact

9606 Background: Obesity after childhood cancer carries implications for survivors’ future health risks; however little is known about the impact of weight after treatment on QOL. Methods: Adult survivors of childhood leukemia in remission (51% male) completed the Health Related QOL Short Form (SF-36) between 2006-2012. Standard BMI cut points were assessed at the time of survey completion. 97% received treatment with chemotherapy, 55.6% stem cell transplant (SCT), 27.8% were in remission from a second cancer. The impact of demographic (age at diagnosis, current age, gender), treatment [radiation therapy, SCT, total body irradiation (TBI), cranial radiation, disease characteristics, history of relapse] were explored. For each subscale, linear regression models were performed. All statistical tests were two-sided, P-values < 0.05 considered statistically significant. Results: 73 survivors diagnosed at a median age of 9.0 (1.0-27.0) years and surveyed at a median of 17.4 (2.5-34.7) years later completed SF-36. 75.6% had received a median dose of 1800 (800-8750) cGy of radiation. The distribution of BMI was underweight <18.5 (9.6%), normal 18.5-24.9 (42.5%), overweight 25-29.9 (27.4%), or obese >30 (20.6%). Consistent with previous studies, those who received whole brain radiation had greater BMI at the time of survey than those who did not receive radiation and those who received TBI (F=2.52, p=0.065). In analyses adjusted for age at diagnosis and time since diagnosis, the reported vitality (fatigue) for those who were obese (mean 45.0+/-8.9) or underweight (45.8+/-9.5) was significantly lower (p=0.002) than normal (55.7+/-10.4) or overweight (50.4+/-10.0), and those who were underweight (39.0+/-13.3) also reported poor physical functioning (endurance and strength) (p=0.038) compared with the others (52.3+/-8.1 normal weight, 49.5+/-11.7 overweight, 47.1+/-9.0 obese). Conclusions: Weight management in leukemia survivors is problematic with 48% of our sample being overweight or obese. Weight status is associated with QOL, impacting survivors’ fatigue and physical functioning. Interventions to help survivors achieve a healthy weight after cancer treatment are needed, and may lead to improvements in QOL.

Learning in lockdown: exploring the impact of COVID-19 on interprofessional education

2021 ◽  
Vol 29 (11) ◽  
pp. 648-652
Author(s):  
Alison Power ◽  
Michael Palapal Sy ◽  
Maggie Hutchings ◽  
Tracy Coleman ◽  
Alla El-Awaisi ◽  
...  
Keyword(s):  
Interprofessional Education ◽  
Social Care ◽  
Lessons Learned ◽  
Global Perspective ◽  
Face To Face ◽  
Perceptions And Attitudes ◽  
Health And Social Care ◽  
Rich Data ◽  
The Uk ◽  
The Impact

The COVID-19 pandemic has had a significant impact on the learning experiences of students undertaking health and social care programmes across the globe. In the UK, the Nursing and Midwifery Council introduced emergency standards for undergraduate programmes in 2020, making significant short-term changes to programme delivery. However, the mandate for all students to undertake interprofessional education remained. Interprofessional education is key to preparing students on health and social care programmes, as it enables students to work as effective members of multi-agency/multi-professional teams on qualification. It is an important element of training, as it has a direct impact on quality of care and service user experience. This series of articles will explore the experiences of ‘lockdown learning’ from the perspective of academics, students and service users from a global perspective in relation to the delivery of interprofessional education during the pandemic, which necessitated a wholesale move from face-to-face, blended and online learning to include emergency remote teaching. The series was written by members of the Centre for the Advancement of Interprofessional Education Research Subgroup (Interprofessional Education Experiences) and aims to identify barriers and facilitators to successful shared learning and provide suggestions for how lessons learned can be taken forward to further enhance this important element of pre-registration education. The perceptions and attitudes of academics and students on such comprehensive changes are a unique and rich data source to explore and inform future provision.

The nurse's role in providing strategies and advice on weight management

2021 ◽  
Vol 30 (21) ◽  
pp. S20-S27
Author(s):  
Alison Coutts
Keyword(s):  
Weight Management ◽  
Evidence Base ◽  
Overweight And Obesity ◽  
Health Conditions ◽  
Healthy Weight ◽  
Lifestyle Modifications ◽  
The Subject ◽  
The Uk

Maintaining a healthy weight is a concern for a large proportion of adults in the UK, with obesity rates having almost doubled between 1993 and 2011. With overweight and obesity linked to several diseases and health conditions, nurses are often tasked with raising the subject with their clients/patients and advising on lifestyle modifications. This article examines ways to identify whether a person needs to lose weight and establishing targets. It then reviews the evidence base for different approaches to weight management currently available and the advice nurses can provide.

Fifty years of the UK Misuse of Drugs Act 1971: the legislative contexts

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Blaine Stothard
Keyword(s):  
Design Methodology ◽  
Evidence Base ◽  
People Who Use Drugs ◽  
Content Type ◽  
Before And After ◽  
History Of ◽  
The Government ◽  
The Uk ◽  
The Impact ◽  
Practical Implications

Purpose The purpose of this paper is to illustrate the history of relevant legislation before and after the 1971 Misuse of Drugs Act (MDA). Design/methodology/approach A chronological narrative of laws and reports with concluding discussion. Findings That UK legislators have not made use of the evidence base available to them and have favoured enforcement rather than treatment approaches. That current UK practice has exacerbated not contain the use of and harms caused by illegal drugs. Research limitations/implications The paper does not cover all relevant documents, especially those from non-governmental sources. Practical implications The practical implications centre on the failure of consecutive governments to reflect on and review the impact of current legislation, especially on people who use drugs. Social implications That the situations of people who use drugs are currently ignored by the government and those proven responses which save lives and reduce harm are rejected. Originality/value The paper attempts to show the historical contexts of control and dangerousness of which the MDA is one instrument.

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