scholarly journals Design of a treatment pathway for insomnia in prison settings in England: a modified Delphi study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022406 ◽  
Author(s):  
Lindsay H Dewa ◽  
Lamiece Hassan ◽  
Jenny Shaw ◽  
Jane Senior
Keyword(s):  
Lived Experience ◽  
Delphi Study ◽  
Positive Impact ◽  
Well Being ◽  
Stepped Care ◽  
Management Options ◽  
Treatment Pathway ◽  
Sleep Complaints ◽  
Modified Delphi ◽  
Final Treatment

ObjectiveInsomnia is highly prevalent in prisoners and is a risk factor for poor mental well-being, depression, suicidality and aggression, all common concerns in this vulnerable population. Improving sleep management options in prison offers the potential to impact positively on a number of these common risk factors. The study aim was to design a treatment pathway for insomnia in prisons informed by stakeholders with professional or lived experience of insomnia and prison-based interventions.DesignA modified Delphi technique, adapted to the stakeholder (either receiving controlled feedback online or face to face on a series of statements), was used over three rounds to gain consensus on a final treatment pathway design.ParticipantsAcademic sleep researchers, prison staff and prisoners were invited to develop the treatment pathway.ResultsFifteen stakeholders took part in round 1 and thirteen in round 2. There were six statements of contention that comprised concerns over the inclusion of sleep observations, sleep restriction therapy and promethazine. Consensus was high (>80%). Thirteen stakeholders agreed the final pathway in round 3. The final treatment pathway comprised a standardised stepped-care approach for insomnia in prison populations. The pathway resulted in five main stages: (1) transition from community; (2) detection and assessment; (3) treatment for short-term insomnia; (4) treatment for long-term insomnia and (5) transition from prison to community or another establishment.ConclusionsThe treatment pathway is designed to promote early detection of insomnia, potentially reducing unnecessary prescriptions and medication trading, misuse and diversion in the prison setting. It should make a substantial difference in reducing the large number of sleep complaints and positively impact on prisoners, staff and the prison environment. Specifically, improving sleep should have a positive impact on prisoners’ mental and physical well-being and aid smooth running of the prison.

Evaluation of Mental Health First Aid training program in Bangladesh: A modified Delphi study

2021 ◽  
Author(s):  
Akib Ul Huque ◽  
Umme Kawser ◽  
Monira Rahman ◽  
Shamini Gnani ◽  
Mala Rao ◽  
...  
Keyword(s):  
Mental Health ◽  
Training Program ◽  
Delphi Study ◽  
Mental Health Treatment ◽  
Social Impact ◽  
Well Being ◽  
First Aid ◽  
Mental Health First Aid ◽  
Modified Delphi ◽  
First Aid Training

Abstract BackgroundBangladesh, like other low-resource countries, faces a shortage of a trained mental health workforce to meet its population's mental health needs adequately. The ongoing COVID-19 pandemic has further aggravated this. Mental health first aid (MHFA) is an internationally recognized training program that has been operating in Bangladesh since 2015. It offers a potential way to reduce the mental health treatment gap and skills shortage by training laypeople to help support individuals with mental health issues. The present study evaluated the effectiveness of MHFA training in Bangladesh. MethodsAn online modified Delphi study was conducted consisting of two rounds of a self-administered survey and a consensus workshop. A five-step logic framework was used to develop questionnaire statements (n=111) that consisted of 'general,' 'I,' and 'social impact' statements around the seven MHFA aims. The statements were constructed in English and adapted in Bangla. The expert panel consisted of 20 participants trained in the MHFA program. Participants anonymously stated their opinion on 111 round-1 statements and then on 27 low agreement statements in round-2. The consensus workshop facilitated a group discussion where participants explained their views on the low consensus items. ResultsThe consensus ranged from 61.5% (Aim 3: Promote recovery of good mental health) to 100% (Aim 7: To improve own health and well-being) with an overall consensus of 83.8%. 'Social impact' items produced the most (50%) disagreements. Participants' comments reflected 12 themes of MHFA's effectiveness in fostering and promoting mental health individually and socially. There were nine themes of disagreement reflecting individual, sociocultural, and political barriers to the implementation of MHFA in Bangladesh. Participants made recommendations for the MHFA and mental health initiatives in Bangladesh to increase mental health awareness, acceptance, and support in society.ConclusionMHFA training offers Bangladesh and other low-and-middle-income countries a potential solution to tackle mental health burden at individual and societal levels and the additional challenges that the COVID-19 pandemic poses to mental health.

scholarly journals Resisting recommended treatment for prostate cancer: a qualitative analysis of the lived experience of possible overdiagnosis

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026960 ◽  
Author(s):  
Kirsten McCaffery ◽  
Brooke Nickel ◽  
Kristen Pickles ◽  
Ray Moynihan ◽  
Barnett Kramer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Lived Experience ◽  
Treatment Decision ◽  
Well Being ◽  
Management Options ◽  
Treatment Decision Making ◽  
Recommended Treatment ◽  
Qualitative Interview Study ◽  
The Impact

ObjectiveTo describe the lived experience of a possible prostate cancer overdiagnosis in men who resisted recommended treatment.DesignQualitative interview studySettingAustraliaParticipants11 men (aged 59–78 years) who resisted recommended prostate cancer treatment because of concerns about overdiagnosis and overtreatment.OutcomesReported experience of screening, diagnosis and treatment decision making, and its impact on psychosocial well-being, life and personal circumstances.ResultsMen’s accounts revealed profound consequences of both prostate cancer diagnosis and resisting medical advice for treatment, with effects on their psychological well-being, family, employment circumstances, identity and life choices. Some of these men were tested for prostate-specific antigen without their knowledge or informed consent. The men felt uninformed about their management options and unsupported through treatment decision making. This often led them to develop a sense of disillusionment and distrust towards the medical profession and conventional medicine. The findings show how some men who were told they would soon die without treatment (a prognosis which ultimately did not eventuate) reconciled issues of overdiagnosis and potential overtreatment with their own diagnosis and situation over the ensuing 1 to 20+ years.ConclusionsMen who choose not to have recommended treatment for prostate cancer may avoid treatment-associated harms like incontinence and impotence, however our findings showed that the impact of the diagnosis itself is immense and far-reaching. A high priority for improving clinical practice is to ensure men are adequately informed of these potential consequences before screening is considered.

scholarly journals Experience of Wellness Recovery Action Planning in Self-Help and Mutual Support Groups for People with Lived Experience of Mental Health Difficulties

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Rebekah Pratt ◽  
Andy MacGregor ◽  
Susan Reid ◽  
Lisa Given
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Support Groups ◽  
Positive Impact ◽  
Action Planning ◽  
Well Being ◽  
Self Management ◽  
Mutual Support ◽  
Mutual Support Groups ◽  
The Impact

The main aim of this research was to assess the relevance and impact of wellness recovery action planning (WRAP) as a tool for self-management and wellness planning by individuals with mental health problems from pre-existing and newly formed groups, where the possibilities for continued mutual support in the development of WRAPs could be explored. Interviews and focus groups were conducted and pre-post recovery outcome measures completed (Recovery Assessment Scale and Warwick Edinburgh Mental Well Being Scale). 21 WRAP group participants took part in the research. The WRAP approach, used in groups and delivered by trained facilitators who could also share their lived experience, was very relevant and appeared to have a positive impact on many of the participants. The impact on participants varied from learning more about recovery and developing improved self-awareness to integrating a WRAP approach into daily life. The apparent positive impact of WRAP delivered in the context of mutual support groups indicates that it should be given serious consideration as a unique and worthwhile option for improving mental health. WRAP groups could make a significant contribution to the range of self-management options that are available for improving mental health and well-being.

scholarly journals The Exercise Oncology Knowledge Mobilization Initiative: An International Modified Delphi Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Scott C. Adams ◽  
Jenna Smith-Turchyn ◽  
Daniel Santa Mina ◽  
Sarah Neil-Sztramko ◽  
Prue Cormie ◽  
...  
Keyword(s):  
Delphi Study ◽  
Cancer Care ◽  
Online Survey ◽  
Well Being ◽  
Knowledge Mobilization ◽  
Policy Makers ◽  
Stakeholder Groups ◽  
Modified Delphi ◽  
Oncology Research ◽  
Exercise Oncology

IntroductionExercise is vital to health and well-being after a cancer diagnosis yet is poorly integrated in cancer care. Knowledge mobilization (KM) is essential to enhance exercise opportunities. We aimed to (1) develop and refine a list of highly important exercise oncology research and KM themes and (2) establish the relative importance of the themes for supporting the implementation of exercise as a standard of care for people living with and beyond cancer.MethodsInformed by the Co-Produced Pathway to Impact KM framework, a modified Delphi study approach was used to develop, rate, and rank exercise oncology research and KM themes through an international stakeholder workshop and a three-round iterative online survey. Open-ended stakeholder feedback from cancer survivors, healthcare practitioners (HCPs), qualified exercise professionals (QEPs), policy makers, and researchers was used to update themes between survey rounds. Themes were ranked from highest to lowest importance and agreement was examined across all stakeholders and within stakeholder groups.ResultsA total of 269 exercise oncology stakeholders from 13 countries participated in the study. Twelve final exercise oncology research and KM themes were produced. The final top ranked research themes were related to: (1) QEP integration into primary cancer care teams, (2) Exercise oncology education for HCPs, and (3) Accessibility of cancer exercise programs & support services. There was statistically significant agreement between stakeholders (p<0.001) and within stakeholder groups (p’s≤0.02) on the general rankings of themes (i.e., some themes generally ranked higher and lower compared to others). Low Kendall’s W statistics indicated variability related to the specific ranked order of the themes between stakeholders and within stakeholder groups. Moreover, there were key differences in the rankings for specific themes between policy makers and other stakeholder groups that highlight potentially important discordance in the research and KM priorities for policy makers that warrants further study.ConclusionThese findings can be used to guide initiatives and align stakeholders on priorities to support exercise implementation as a standard of cancer care. Additional research is needed to better understand the differences in the proposed research and KM priorities across stakeholders.

Human potential in the system of social and economic development: problems and prospects of Vinnytsia region

2020 ◽  
pp. 71-80
Author(s):  
Olesya Tomchuk
Keyword(s):  
Economic Development ◽  
Human Development ◽  
Rural Areas ◽  
Structural Changes ◽  
Agricultural Sector ◽  
Positive Impact ◽  
Well Being ◽  
Human Potential ◽  
High Tech ◽  
Social And Economic Development

The article highlights the problems and prospects of human development, which is the basis for the long-term strategies of social and economic growth of different countries and regions at the present stage. Submitting strategies of this type provides an opportunity to focus on individual empowerment and to build a favorable environment for effective management decisions in the field of forming, maintaining, and restoring human potential. The analysis of the Vinnytsia region human potential dynamics in the regional system of social and economic development factors was carried out. Application of generalized assessment of the regional human development index components allowed the identification of the main trends that characterize the formation of human potential of the territory, including the reproduction of the population, social environment, comfort and quality of life, well-being, decent work, and education. The article emphasizes that despite some positive changes in the social and economic situation of the region and in assessing the parameters of its human development level relative to other regions of Ukraine, Vinnytsia region is now losing its human potential due to negative demographic situation and migration to other regions and countries. The main reason for such dynamics is proven to be related to the outdated structure of the region's economy, the predominance of the agricultural sector, the lack of progressive transformations in the development of high-tech fields of the economy. An important factor is the low level of urbanization of the region, which leads to the spread of less attractive working conditions and less comfortable living conditions. The key factors that cause the growth of urbanization in the region have been identified, including the significant positive impact of the transport and social infrastructure expansion, the lack of which in rural areas leads to a decrease in the level and comfort of life. Without progressive structural changes in the economy and the resettlement system, the loss of human potential will continue.

Yoga as an Innovative Solution for Financial Growth of Companies

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Ipseeta Satpathy ◽  
B. Chandra Mohan Patnaik ◽  
Chandrabhanu Das
Keyword(s):  
Inventory Management ◽  
Internal Control ◽  
Positive Impact ◽  
Cost Savings ◽  
Well Being ◽  
Primary Data ◽  
Financial Health ◽  
Antibiotic Drugs ◽  
Lifestyle Diseases ◽  
The Impact

The existence of Yoga dates back to more than ten thousand years around India and all nations. The Hindu Mythology considers the genesis of Yoga by incorporating Lord Shiva as Guru and Goddess Parvati as Shishya. Gradually with the development of civilization mankind assessed the benefits of this spiritual discipline and different leaders propagated the Yoga in different ways.In this era of 21st century Baba Ramdev propagated the yoga sutras with simple and effective techniques. The Pranayam and Suryanamaskar are the popular routines practiced by many followers of Baba Ramdev. Today Yoga is practiced as a way of Living to prevent Lifestyle diseases, combat stress and rejuvenate self. Yoga has gained immense popularity over the years with July 21st being celebrated as International Yoga Day. Corporate are also now introducing Yoga for employees as a means to relieve their stress and improve productivity. Long Hours of sitting, standing and excessive use of electronic gadgets puts pressure on bones, joints and responsible for Lifestyle diseases. Yoga is now increasingly used as a wellness solution replacing high cost antibiotic drugs. Employee well-being leads to Cost Savings in terms of personnel by reduced payment of Insurance and Medical Bills. The paper studies the Impact of Yoga to Financial benefits in MSME Organizations in Odisha in light of three different perspectives of Internal Control, Inventory management and Cash Flow. The primary data was collected from a sample of 155 high profile finance executives working in the MSME sector. Ranking Table and Regression Analysis Methodology was used to derive meaningful conclusions. The research takes initiative to transform the effectiveness of Yoga into improved financial health for the Organization. The observation from the study interprets a positive impact of Yoga on good financial health of Organization.

People and Climate Change

2019 ◽  
Keyword(s):  
Climate Change ◽  
Lived Experience ◽  
Social Institutions ◽  
Well Being ◽  
The United States ◽  
Negative Consequences ◽  
Social Dimensions ◽  
Community Inclusion ◽  
Global Issue ◽  
Political Challenge

Climate change is a profoundly social and political challenge with many social justice concerns around every corner. A global issue, climate change threatens the well-being, livelihood, and survival of people in communities worldwide. Often, those who have contributed least to climate change are the most likely to suffer from its negative consequences and are often excluded from the policy discussions and decisions that affect their lives. This book pays particular attention to the social dimensions of climate change. It examines closely people’s lived experience, climate-related injustice and inequity, why some groups are more vulnerable than others, and what can be done about it—especially through greater community inclusion in policy change. A highlight of the book is its diversity of rich, community-based examples from throughout the Global South and North. Sacrificial flood zones in urban Argentina, forced relocation of United Houma tribal members in the United States, and gendered water insecurities in Bangladesh and Australia are just some of the in-depth cases included in the book. Throughout, the book asks social and political questions about climate change. Of key importance, it asks what can be done about the unequal consequences of climate change by questioning and transforming social institutions and arrangements—guided by values that prioritize the experience of affected groups and the inclusion of diverse voices and communities in the policy process.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

scholarly journals Social Evaluation of Public Open Space Services and Their Impact on Well-Being: A Micro-Scale Assessment from a Coastal University

2021 ◽  
Vol 13 (8) ◽  
pp. 4372
Author(s):  
Abdullah Addas ◽  
Ahmad Maghrabi
Keyword(s):  
Open Space ◽  
Environmental Changes ◽  
Positive Impact ◽  
Well Being ◽  
Social Evaluation ◽  
Open Spaces ◽  
Rapid Urbanization ◽  
Public Open Space ◽  
The Impact ◽  
Public Open Spaces

Public open spaces services have been shown to be profoundly affected by rapid urbanization and environmental changes, and in turn, they have influenced socio-cultural relationships and human well-being. However, the impact of these changes on public open space services (POSS) remains unexplored, particularly in the Saudi Arabian context. This study examines the socio-cultural influence of POSS on the King Abdulaziz University campus, Jeddah, Saudi Arabia and the impact of these services on well-being. A field survey and questionnaire were used to collect data. Non-parametric tests (Kruskal–Wallis and Mann–Whitney tests) were used to find significant differences in the importance of POSS as perceived by stakeholders based on socio-demographic attributes. Factor analysis was performed for 14 POSS to identify those that are most important. The study showed that (i) university stakeholders are closely linked to services provided by public open spaces (POS) and dependent on POSS, (ii) there were significant differences in the perceived importance of POSS according to gender, age, and social groups, and (iii) 70 to 90% of stakeholders reported POSS as having a positive impact on well-being. Thus, the findings will help design and plan POSS to meet the needs of society and promote well-being.

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