scholarly journals How to increase chlamydia testing in primary care: a qualitative exploration with young people and application of a meta-theoretical model

2020 ◽  
Vol 96 (8) ◽  
pp. 571-581
Author(s):  
Lorraine K McDonagh ◽  
Hannah Harwood ◽  
John M Saunders ◽  
Jackie A Cassell ◽  
Greta Rait
Keyword(s):  
Primary Care ◽  
Young People ◽  
Sampling Methods ◽  
Healthcare Providers ◽  
Implementation Strategies ◽  
Potential Intervention ◽  
Individual Interviews ◽  
Chlamydia Testing ◽  
Wide Range ◽  
The Uk

ObjectiveThe objective of this study was to explore young people’s perspectives barriers to chlamydia testing in general practice and potential intervention functions and implementation strategies to overcome identified barriers, using a meta-theoretical framework (the Behaviour Change Wheel (BCW)).MethodsTwenty-eight semistructured individual interviews were conducted with 16–24 year olds from across the UK. Purposive and convenience sampling methods were used (eg, youth organisations, charities, online platforms and chain-referrals). An inductive thematic analysis was first conducted, followed by thematic categorisation using the BCW.ResultsParticipants identified several barriers to testing: conducting self-sampling inaccurately (physical capability); lack of information and awareness (psychological capability); testing not seen as a priority and perceived low risk (reflective motivation); embarrassment, fear and guilt (automatic motivation); the UK primary care context and location of toilets (physical opportunity) and stigma (social opportunity). Potential intervention functions raised by participants included education (eg, increase awareness of chlamydia); persuasion (eg, use of imagery/data to alter beliefs); environmental restructuring (eg, alternative sampling methods) and modelling (eg, credible sources such as celebrities). Potential implementation strategies and policy categories discussed were communication and marketing (eg, social media); service provision (eg, introduction of a young person’s health-check) and guidelines (eg, standard questions for healthcare providers).ConclusionsThe BCW provided a useful framework for conceptually exploring the wide range of barriers to testing identified and possible intervention functions and policy categories to overcome said barriers. While greater education and awareness and expanded opportunities for testing were considered important, this alone will not bring about dramatic increases in testing. A societal and structural shift towards the normalisation of chlamydia testing is needed, alongside approaches which recognise the heterogeneity of this population. To ensure optimal and inclusive healthcare, researchers, clinicians and policy makers alike must consider patient diversity and the wider health issues affecting all young people.

scholarly journals ‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson
Keyword(s):  
Young People ◽  
Skin Disease ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Emotional Impact ◽  
Skin Conditions ◽  
The Uk ◽  
Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

scholarly journals Primary palliative care research: opportunities and challenges

2019 ◽  
pp. bmjspcare-2018-001653 ◽  
Author(s):  
Stephen Barclay ◽  
Emily Moran ◽  
Sue Boase ◽  
Margaret Johnson ◽  
Roberta Lovick ◽  
...  
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
End Of Life ◽  
Data Set ◽  
District Nurse ◽  
Mixed Methods Approach ◽  
Care Research ◽  
Individual Interviews ◽  
Primary Care Teams ◽  
The Uk

IntroductionPrimary care has a central role in palliative and end of life care: 45.6% of deaths in England and Wales occur under the care of primary care teams at home or in care homes. The Community Care Pathways at the End of Life (CAPE) study investigated primary care provided for patients in the final 6 months of life. This paper highlights the opportunities and challenges associated with primary palliative care research in the UK, describing the methodological, ethical, logistical and gatekeeping challenges encountered in the CAPE study and how these were addressed.The study methodsUsing a mixed-methods approach, quantitative data were extracted from the general practitioner (GP) and district nurse (DN) records of 400 recently deceased patients in 20 GP practices in the East of England. Focus groups were conducted with some GPs and DNs, and individual interviews held with bereaved carers and other GPs and DNs.The challenges addressedConsiderable difficulties were encountered with ethical permissions, with GP, DN and bereaved carer recruitment and both quantitative and qualitative data collection. These were overcome with flexibility of approach, perseverance of the research team and strong user group support. This enabled completion of the study which generated a unique primary palliative care data set.

Exploring youth citizenship during COVID-19 lockdowns in New Zealand

2021 ◽  
Vol 16 (2) ◽  
pp. 251-261 ◽  
Author(s):  
Carol Mutch ◽  
Marta Estellés
Keyword(s):  
New Zealand ◽  
Young People ◽  
Focus Group Interviews ◽  
Citizenship Rights ◽  
Theoretical Concepts ◽  
Individual Interviews ◽  
Wide Range ◽  
Youth Citizenship ◽  
Group Interviews ◽  
The City

The research presented in this article explores how young people in New Zealand exercised their citizenship during the COVID-19 lockdowns. Building upon the theoretical concepts of ‘actions’ and ‘acts of citizenship’, this qualitative study draws on data from the experiences of 30 young people aged over 16 in the city of Auckland. Data included classroom observations, focus group interviews, individual interviews and the sharing of student artefacts (e.g. posters and videos). The experiences of the participants covered a wide range of engagement in citizenship rights, sites, scales and acts. Our findings offered an alternative to prevailing portrayals of young people as either passive victims or self-centred troublemakers during the COVID-19 pandemic. Lessons for citizenship education are discussed at the end of the article.

scholarly journals Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder: from little to very little

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Samuele Cortese
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Professionals ◽  
Attention Deficit ◽  
Hyperactivity Disorder ◽  
The Uk

Summary Drawing on data from the Clinical Practice Research Datalink, Price et al reported UK regional variations in primary care prescribing and referral rates to adult mental health services for young people with attention-deficit hyperactivity disorder (ADHD) in transition from child and adolescent mental health services. Overall, considering that around 65% of young adults with childhood ADHD present with impairing ADHD symptoms and up to 90% of individuals with ADHD may benefit from ADHD medications, the study by Price et al shows that the rate of appropriate treatment for youngsters in the transition period varies from low to very low across the UK. As such, there is a continuous need for education and training for patients, their families, mental health professionals and commissioners, to eradicate the misconception that, in the majority of the cases, ADHD remits during adolescence and to support the devolvement of appropriate services for the evidence-based management of adult ADHD across the UK.

scholarly journals Young people with attention deficit hyperactivity disorder in transition from child to adult services: a qualitative study of the experiences of general practitioners in the UK

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Tamsin Newlove-Delgado ◽  
Sharon Blake ◽  
Tamsin Ford ◽  
Astrid Janssens
Keyword(s):  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Young People ◽  
Attention Deficit ◽  
Adult Life ◽  
Hyperactivity Disorder ◽  
Adult Services ◽  
Specialist Services ◽  
Qualitative Interview Study ◽  
The Uk

Abstract Background Many young people with Attention Deficit Hyperactivity Disorder (ADHD) have impairing symptoms that persist into adulthood, yet only a minority experience continuity of care into adult life. Despite growing emphasis on the primary care role in ADHD management in NICE ADHD and transition guidance, little is known about GPs’ perspectives, which could hamper efforts to improve outcomes for young people leaving children’s services. This study aimed to understand GPs’ experiences of involvement with this group and explore their views on the roles and responsibilities of primary and secondary care in transition, to inform recommendations for policy and practice. Method Qualitative interview study with GPs across the UK. Semi-structured telephone interviews were carried out with 14 GPs recruited through a linked mapping study, social media, and snowballing; data were analysed using thematic analysis. Results In the absence of a smooth transition from child to adult services, many GPs became involved ‘by default’. GPs reacted by trying to identify suitable specialist services, and were faced with the decision of whether to continue ADHD prescribing. Such decisions were strongly influenced by perceptions that prescribing carried risks, and concerns over responsibility, particularly where specialist services were lacking. Participants described variation in service availability, and some highlighted tensions around how shared care works in practice. Conclusion Implementation of NICE guidance is highly variable, with implications for GPs and patients. Risk and responsibility for primary care ADHD prescribing are central concerns that need to be addressed, as is the inclusion of GPs in a planned transition process.

scholarly journals Mathematics delivering the advantage: the role of mathematicians in manufacturing and beyond

2017 ◽  
Vol 473 (2201) ◽  
pp. 20170094 ◽  
Author(s):  
Vicki Saward
Keyword(s):  
Young People ◽  
Manufacturing Sector ◽  
Industrial Base ◽  
Wide Range ◽  
Manufacturing Sectors ◽  
The Uk

Much has been written about the benefits that mathematics can bring to the UK economy and the manufacturing sector in particular, but less on the value of mathematicians and a mathematical training. This article, written from an industry perspective, considers the value of mathematicians to the UK's industrial base and the importance to the UK economy of encouraging young people in the UK to choose to study mathematics at school as a gateway to a wide range of careers. The points are illustrated using examples from the author's 20 years' experience in the security and intelligence and manufacturing sectors.

Burden of child and adolescent obesity on health services in England

2017 ◽  
Vol 103 (3) ◽  
pp. 247-254 ◽  
Author(s):  
Russell M Viner ◽  
Sanjay Kinra ◽  
Dasha Nicholls ◽  
Tim Cole ◽  
Anthony Kessel ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Young People ◽  
Secondary Care ◽  
Service Use ◽  
Lifestyle Modification ◽  
Glycated Haemoglobin ◽  
Obesity Management ◽  
Care Assessment ◽  
The Uk

ObjectiveTo assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England.DesignPathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data.SettingData on CYP aged 2–18 years from the Health Survey for England 2006 to 2013.Main outcome measuresClinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function).Results11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13–18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management.ConclusionsThere is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden.

scholarly journals Introduction of a Day-Case Laparoscopic Cholecystectomy Service in the UK: A Critical Analysis of Factors Influencing Same-Day Discharge and Contact with Primary Care Providers

2009 ◽  
Vol 91 (7) ◽  
pp. 583-590 ◽  
Author(s):  
CD Briggs ◽  
GB Irving ◽  
CD Mann ◽  
A Cresswell ◽  
L Englert ◽  
...  
Keyword(s):  
Primary Care ◽  
Laparoscopic Cholecystectomy ◽  
Healthcare Providers ◽  
Operation Time ◽  
Primary Care Providers ◽  
Care Providers ◽  
Day Case ◽  
Factors Influencing ◽  
Same Day Discharge ◽  
The Uk

INTRODUCTION The objective of this study was to determine the safety and acceptability of the implementation of a day-case laparoscopic cholecystectomy (LC) service in a large UK teaching hospital, and analyse factors influencing contact with primary care providers. Wide-spread introduction of day-case LC in the UK is a major target of healthcare providers. However, few centres have reported their experience. In the US, out-patient surgery for LC has been reported, though many groups have utilised 24-h observation units to facilitate discharge. Concerns remain amongst surgeons regarding the feasibility and acceptability of the introduction of day-case LC in the UK. PATIENTS AND METHODS Comprehensive care and operative data were prospectively collected on the first 106 consecutive day-case procedures in our hospital. Postoperative recovery was monitored by telephone questionnaire on days 2, 5 and 14, including complications, satisfaction and general practitioner consultation. RESULTS A total of 106 patients were admitted for day-case LC, of whom 84% were discharged on the day of surgery. Patient satisfaction rate was 94% in both the successful day-case and the admitted patients. Mean operation time was 62 min, with an average total stay on the day-care unit of 426 min. Training-grade surgeons performed 31% of operations. Both the re-admission rate after surgery and rate of conversion to open surgery were 2%. Advice from primary healthcare providers was sought by 33% of patients within the first 14 postoperative days. CONCLUSIONS Introduction of day-case LC in the UK is feasible and acceptable to patients. The potential burden to primary care providers needs further study.

Exploring youth citizenship during COVID-19 lockdowns in New Zealand

2021 ◽  
Vol 16 (2) ◽  
pp. 251-261 ◽  
Author(s):  
Carol Mutch ◽  
Marta Estellés
Keyword(s):  
New Zealand ◽  
Young People ◽  
Focus Group Interviews ◽  
Citizenship Rights ◽  
Theoretical Concepts ◽  
Individual Interviews ◽  
Wide Range ◽  
Youth Citizenship ◽  
Group Interviews ◽  
The City

The research presented in this article explores how young people in New Zealand exercised their citizenship during the COVID-19 lockdowns. Building upon the theoretical concepts of ‘actions’ and ‘acts of citizenship’, this qualitative study draws on data from the experiences of 30 young people aged over 16 in the city of Auckland. Data included classroom observations, focus group interviews, individual interviews and the sharing of student artefacts (e.g. posters and videos). The experiences of the participants covered a wide range of engagement in citizenship rights, sites, scales and acts. Our findings offered an alternative to prevailing portrayals of young people as either passive victims or self-centred troublemakers during the COVID-19 pandemic. Lessons for citizenship education are discussed at the end of the article.

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