Impact on and adaptations by the National Addictions Management Service in response to the COVID-19 pandemic

ObjectiveIn England, the National Health Service commissioned a National Management Service for children with primary ciliary dyskinesia (PCD). The aims of this study were to describe the health of children seen in this Service and compare lung function to children with cystic fibrosis (CF).DesignMulti-centre service evaluation of the English National Management PCD Service.SettingFour nationally commissioned PCD centres in England.Patients333 children with PCD reviewed in the Service in 2015; lung function data were also compared with 2970 children with CF.ResultsMedian age at diagnosis for PCD was 2.6 years, significantly lower in children with situs inversus (1.0 vs 6.0 years, p<0.001). Compared with national data from the CF Registry, mean (SD) %predicted forced expiratory volume in one second (FEV1) was 76.8% in PCD (n=240) and 85.0% in CF, and FEV1 was lower in children with PCD up to the age of 15 years. Approximately half of children had some hearing impairment, with 26% requiring hearing aids. Children with a lower body mass index (BMI) had lower FEV1 (p<0.001). One-third of children had positive respiratory cultures at review, 54% of these grew Haemophilus influenzae.ConclusionsWe provide evidence that children with PCD in England have worse lung function than those with CF. Nutritional status should be considered in PCD management, as those with a lower BMI have significantly lower FEV1. Hearing impairment is common but seems to improve with age. Well-designed and powered randomised controlled trials on management of PCD are needed to inform best clinical practice.

Download Full-text

Evaluation of pharmacy-led weight management service to minimise the risk of cardiovascular disease

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-021-00338-3 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Aliki Peletidi ◽

Reem Kayyali

Keyword(s):

Physical Activity ◽

Weight Management ◽

Activity Levels ◽

Management Service ◽

Initial Weight ◽

Public Health Services ◽

Clinical Role ◽

Physical Activity Levels ◽

Before And After ◽

The Mean

Abstract Aims The primary aim of the programme was a minimum of a 5% weight reduction of the initial weight, while the secondary outcomes were a reduction in participants’ body mass index (BMI), waist circumference (WC), blood pressure (BP), AUDIT-C score and an increase in the Mediterranean diet (MD) score and an improvement in physical activity levels. Methods This 'before and after' study was a 10-week weight management (WM) programme and it was developed and delivered in community pharmacies in Patras chosen for convenience, thus consisting the first service of its type in Greece. The sample size was calculated (n = 96) based on the mean BMI for a Greek male and female individual, and the standard deviation (SD) of weight at baseline of 14 kg. Results Nearly every participant enrolled in the 20 participating pharmacies, 97.4% (n = 114/117), achieved the programme’s aim, losing at least 5% of their initial weight. The mean percentage of total weight loss of the 117 participants at the 10th week was 8.97% (SD 2.65), and the t-test showed statistically significant results (P-value < 0.001; 95% CI [8.48, 9.45]). A significant reduction in the waist-to-height ratio (WHtR) was observed in both male (P-value = 0.004) and female (P-value < 0.001) participants. The participants’ BP and AUDIT-C score and physical activity levels significantly improved (P-value < 0.001), as well as their MD score. Conclusion This study provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement.

Download Full-text

Applying Bowen Theory to Psychiatric Assessment and Disposition in the ED

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390320987636 ◽

2021 ◽

pp. 107839032098763

Author(s):

Kathleen B. Kerr

Keyword(s):

Psychiatric Hospitalization ◽

Theoretical Orientation ◽

Admission Rate ◽

Hospitalization Rate ◽

The Other ◽

Psychiatric Evaluation ◽

Bowen Theory ◽

Management Service ◽

Psychiatric Assessment ◽

Psychiatric Hospitalizations

BACKGROUND: A number of variables have been shown to influence whether an individual who experiences an emergency psychiatric assessment is admitted to a psychiatric hospital. This study focused on the theoretical orientation of the assessing clinician as a possibly influential variable. The theoretical orientation being studied was Bowen family systems theory or Bowen theory (Bt). Overall the Bt perspective looks at the family as the primary crucible that generates symptoms but at the same time as the natural unit and the best built-in resource to deal with those symptoms. AIMS: This study examined whether the theoretical orientation of the nurse psychiatric assessor would affect her inpatient admission rate of patients seen for psychiatric evaluation in an emergency department (ED). METHOD: A clinician/researcher with extensive experience applying Bt in clinical practice worked in a Crisis Management Service providing psychiatric evaluation and disposition in a busy community hospital ED. Given Bt’s emphasis on the system rather than individual pathology, the clinician researcher hypothesized that her psychiatric hospitalization rate would be lower than the other clinical nurse specialists. A retrospective chart review analyzed 1 year of cases from all referrals that might have resulted in psychiatric hospitalizations ( n = 1,801). RESULTS: The clinician/researcher’s psychiatric hospitalization rate was significantly lower ( p = .004) than the other clinicians. CONCLUSION: An approach to psychiatric assessment in the ED applied a Bt perspective in a way that significantly reduced psychiatric hospitalizations.

Download Full-text

Online Third Places: Supporting Well-Being Through Identifying and Managing Unintended Consequences

Journal of Service Research ◽

10.1177/10946705211018860 ◽

2021 ◽

pp. 109467052110188

Author(s):

Joy Parkinson ◽

Lisa Schuster ◽

Rory Mulcahy

Keyword(s):

Well Being ◽

Unintended Consequences ◽

Abductive Reasoning ◽

Service Research ◽

Data Sets ◽

Management Service ◽

Consumer Empowerment ◽

Online Service ◽

Third Places ◽

Third Place

Unintended consequences of service are important yet infrequently examined in transformative service research. This research examines an online service community that transformed into an online third place, with consumers socializing and forming lasting relationships. Using practice-informed theory-building and an abductive reasoning approach, findings are presented from both manual and automated coding of three qualitative data sets that form the basis of a case study examining an online weight management service forum. Extending beyond current conceptualizations of the third place, this study is the first to propose a framework delineating online third place characteristics and their impact on consumers’ eudaimonic (the capacity for self-realization) and hedonic (attainment of pleasure and avoidance of pain) well-being. Findings show that in the absence of a physical or virtual servicescape, social factors including social density, equity, and personalization are key to constructing an online third place that supports well-being through building social connections and enjoyment. The new framework provides guidance for service managers to transform their online service communities into online third places to support consumer well-being and to identify and manage potential unintended consequences, for example, by ensuring segmentation of the community based on consumer groups’ shared interests and consumer empowerment through participation.

Download Full-text