scholarly journals Barriers and enablers of implementation of alcohol guidelines with pregnant women: a cross-sectional survey among UK midwives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lesley A. Smith ◽  
Judith Dyson ◽  
Julie Watson ◽  
Lisa Schölin
Keyword(s):  
Theoretical Domains Framework ◽  
Professional Role ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Networks ◽  
Convenience Sample ◽  
Improved Outcomes ◽  
The Uk ◽  
Alcohol Assessment

Abstract Background In 2016, the UK Chief Medical Officers revised their guidance on alcohol and advised women to abstain from alcohol if pregnant or planning pregnancy. Midwives have a key role in advising women about alcohol during pregnancy. The aim of this study was to investigate UK midwives’ practices regarding the 2016 Chief Medical Officers Alcohol Guidelines for pregnancy, and factors influencing their implementation during antenatal appointments. Methods Online cross-sectional survey of a convenience sample of UK midwives recruited through professional networks and social media. Data were gathered using an anonymous online questionnaire addressing knowledge of the 2016 Alcohol Guidelines for pregnancy; practice behaviours regarding alcohol assessment and advice; and questions based on the Theoretical Domains Framework (TDF) to evaluate implementation of advising abstinence at antenatal booking and subsequent antenatal appointments. Results Of 842 questionnaire respondents, 58% were aware of the 2016 Alcohol Guidelines of whom 91% (438) cited abstinence was recommended, although 19% (93) cited recommendations from previous guidelines. Nonetheless, 97% of 842 midwives always or usually advised women to abstain from alcohol at the booking appointment, and 38% at subsequent antenatal appointments. Mean TDF domain scores (range 1–7) for advising abstinence at subsequent appointments were highest (indicative of barriers) for social influences (3.65 sd 0.84), beliefs about consequences (3.16 sd 1.13) and beliefs about capabilities (3.03 sd 073); and lowest (indicative of facilitators) for knowledge (1.35 sd 0.73) and professional role and identity (1.46 sd 0.77). Logistic regression analysis indicated that the TDF domains: beliefs about capabilities (OR = 0.71, 95% CI: 0.57, 0.88), emotion (OR = 0.78; 95%CI: 0.67, 0.90), and professional role and identity (OR = 0.69, 95%CI 0.51, 0.95) were strong predictors of midwives advising all women to abstain from alcohol at appointments other than at booking. Conclusions Our results suggest that skill development and reinforcement of support from colleagues and the wider maternity system could support midwives’ implementation of alcohol advice at each antenatal appointment, not just at booking could lead to improved outcomes for women and infants. Implementation of alcohol care pathways in maternity settings are beneficial from a lifecourse perspective for women, children, families, and the wider community.

scholarly journals Analysis of the factors affecting the adoption and compliance of the NHS COVID-19 mobile application: a national cross-sectional survey in England

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e053395
Author(s):  
Marcus Panchal ◽  
Sukhpreet Singh ◽  
Esther Rodriguez-Villegas
Keyword(s):  
Independent Study ◽  
Contact Tracing ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Privacy And Security ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Factors Affecting ◽  
Privacy Concerns ◽  
The Uk

ObjectivesTo conduct an independent study investigating how adults perceive the usability and functionality of the ‘National Health Service (NHS) COVID-19’ application (app). This study aims to highlight strengths and provide recommendations to improve adoption of future contact tracing developments.DesignA 60-item, anonymous online questionnaire, disseminated through social media outlets and email lists by a team from Imperial College London.SettingEngland.ParticipantsConvenience sample of 1036 responses, from participants aged 18 years and above, between December 2020 and January 2021.Primary outcome measuresEvaluate the compliance and public attitude towards the ‘NHS COVID-19’ app regarding its functionality and features. This included whether participants’ expectations were met, and their thoughts on the app privacy and security. Furthermore, to distinguish how usability, perception, and adoption differed with varying demographics and user values.ResultsFair compliance with the app features was identified, meeting expectations of the 62.1% of participants who stated they downloaded it after weighted analysis. However, participants finding the interface challenging were less likely to read information in the app and had a lesser understanding of its functionality. Furthermore, little understanding regarding the app’s functionality and privacy concerns was a possible reason why users did not download it. A readability analysis of the text revealed information within the app was conveyed at a level that may be too complex for up to 43% of the UK population. The study highlighted issues related to the potential of false positives caused by the design choices in the ‘Check-In’ feature.ConclusionThis study showed that while the ‘NHS COVID-19’ app was viewed positively, there remained issues regarding participants’ perceived knowledge of app functionality, potentially affecting compliance. Therefore, we recommended improvements regarding the delivery and presentation of the app’s information, and highlighted the potential need for the ability to check out of venues to reduce the number of false positive contacts.

scholarly journals GP retention in the UK: a worsening crisis. Findings from a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e026048 ◽  
Author(s):  
Katherine Owen ◽  
Thomas Hopkins ◽  
Thomas Shortland ◽  
Jeremy Dale
Keyword(s):  
National Policy ◽  
Intention To Leave ◽  
Work Intensity ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Length Of Service ◽  
Cross Sectional ◽  
Career Intention ◽  
National Initiatives ◽  
The Uk

ObjectiveTo investigate how recent national policy-led workforce interventions are affecting intentions to remain working as a general practitioner (GP).DesignOnline questionnaire survey with qualitative and quantitative questions.Setting and participantsAll GPs (1697) in Wessex region, an area in England for which previous GP career intention data from 2014 is available.Results929 (54.7%) participated. 59.4% reported that morale had reduced over the past two years, and 48.5% said they had brought forward their plans to leave general practice. Intention to leave/retire in the next 2 years increased from 13% in the 2014 survey to 18% in October/November 2017 (p=0.02), while intention to continue working for at least the next 5 years dropped from 63.9% to 48.5% (p<0.0001). Age, length of service and lower job satisfaction were associated with intention to leave. Work intensity and amount were the most common reasons given for intention to leave sooner than previously planned; 51.0% participants reported working more hours than 2 years previously, predominantly due to increased workload.GPs suggested increased funding, more GPs, better education of the public and expanding non-clinical and support staff as interventions to improve GP retention.National initiatives that aligned with these priorities, such as funding to expand practice nursing were viewed positively, but low numbers of GPs had seen evidence of their roll-out. Conversely, national initiatives that did not align, such as video consulting, were viewed negatively.ConclusionWhile recent initiatives may be having an impact on targeted areas, most GPs are experiencing little effect. This may be contributing to further lowering of morale and bringing forward intentions to leave. More urgent action appears to be needed to stem the growing workforce crisis.

scholarly journals A pilot survey of socio-economic differences in child-feeding behaviours among parents of primary-school children

2008 ◽  
Vol 11 (10) ◽  
pp. 1030-1036 ◽  
Author(s):  
Heather R Clark ◽  
Elizabeth Goyder ◽  
Paul Bissell ◽  
Lindsay Blank ◽  
Stephen J Walters ◽  
...  
Keyword(s):  
Primary Schools ◽  
Overweight And Obesity ◽  
Primary School Children ◽  
Cross Sectional Survey ◽  
Child Feeding ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Parent Status ◽  
The Uk ◽  
Feeding Behaviours

AbstractObjectiveParents’ child-feeding behaviours have been implicated in children’s food choices and weight, but little is known about the social class distribution of parent’s child-feeding behaviours in the UK. The present study compares parents’ self-reported child-feeding behaviours in two socio-economically contrasting areas.DesignA cross-sectional survey using the Parental Feeding Style Questionnaire. Mean scores were calculated for five child-feeding behaviours: control over eating, emotional feeding, encouragement/prompting, instrumental feeding and restriction. Parents’ self-reported child-feeding behaviours were compared with their sociodemographic characteristics.SettingThree primary schools in two contrasting electoral wards of Sheffield, UK.SubjectsTwo hundred and ten parents of children aged 4 to 11 years, recruited from a convenience sample.ResultsParents in the least deprived ward reported using all five types of child-feeding behaviour more frequently than parents in the most deprived ward. After adjusting for parent sex, parent age, single parent status, employment status and level of education, emotional feeding was the only behaviour showing any evidence of a difference between wards. The most frequently used behaviours were control, encouragement and restriction – behaviours that might be used to directly influence children’s food intake and weight.ConclusionsChild-feeding behaviours differ between areas within a single city and within a largely white population, and this distribution is related to socio-economic and educational factors. Experimental and longitudinal studies are needed to further investigate the potential role of child-feeding behaviours in childhood overweight and obesity.

scholarly journals Are former heavy drinkers in the UK less likely to identify as being in recovery compared to those in the USA? A pilot test

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
John A Cunningham ◽  
Alexandra Godinho
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Dependence ◽  
Preliminary Test ◽  
Apparent Difference ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Heavy Drinkers ◽  
The Usa ◽  
The Uk

Abstract Background To provide a preliminary test of the prediction that fewer former heavy drinkers will identify themselves as being in recovery in the UK versus the USA. Methods An online cross-sectional survey was completed by a convenience sample of former heavy drinkers. This sample was identified from participants recruited to complete a questionnaire about alcohol consumption. The recruitment advertisement specified that the participants did not need to drink alcohol. The survey included items assessing self-reported current and past levels of alcohol consumption, alcohol dependence at time of heaviest alcohol consumption (ICD-10 criteria), and questions regarding identifying as currently or ever being in recovery taken from a survey by Kelly et al. (2018). Results Out of 5002 participants who completed the questionnaire, 150 were identified as former heavy drinkers from the UK or the USA. The proportion of participants reporting alcohol dependence, and the proportion of participants reporting past year abstinence, did not differ significantly between the UK and the USA (p = .841 and 0.300 respectively). Compared to participants from the UK, participants in the USA were more likely to report that they had a problem with drinking but now no longer do (24.1 % vs. 56.0 %; p < .001), and that they currently identified (4.2 % vs. 21.2 %; p = .003) or ever identified (7.4 % vs. 30.2 %; p = .001) as being in recovery. Conclusions Identifying as being in recovery appears more common in the USA than the UK among former heavy drinkers. This apparent difference in prevalence may reflect historic differences in treatment services offered in these countries, particularly with respect to the predominance of a 12-step approach in the USA. These findings should be replicated in a representative sample.

Biographic Characteristics and Factors Perceived as Affecting Female and Male Careers in Academic Surgery: The Tenured Gender Battle to Make It to the Top

2016 ◽  
Vol 57 (3-4) ◽  
pp. 139-154 ◽  
Author(s):  
Laura Schwarz ◽  
Sonia Sippel ◽  
Andrew Entwistle ◽  
Anna Kathrin Hell ◽  
Sarah Koenig
Keyword(s):  
Career Guidance ◽  
Work Satisfaction ◽  
Attrition Rate ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Career ◽  
Academic Surgery ◽  
Female Surgeons ◽  
High Degree

Purpose: Given the high attrition rate in the field of academic surgery, we aimed to characterise the professional and personal situations of female and male academic surgeons as well as to gather data on their respective perceptions of career advancement and work satisfaction. Methods: We conducted a cross-sectional survey in Germany, inviting all identifiable academically highly qualified female surgeons and their male counterparts in a 1:2 ratio to participate. An anonymous 103-item online questionnaire was designed and the data collected between July and September 2014. Results: The questionnaire was sent to 93 female and 200 male surgeons, of whom 63 women (67.7%) and 70 men (35.0%) replied. The average age was 47.5 and 47.1 years, respectively. Respondents identified ‘high degree of expertise', ‘ambition', and ‘clarity of one's professional aims' as important factors affecting professional career development. Both groups felt ‘workload', ‘working hours/shifts', and ‘gender' to be a hindrance, the latter of significantly greater importance to female surgeons. The mean work satisfaction scores were high in both female (69.5%) and male (75.7%) surgeons. The predictors ‘support from superiors' (standardised β coefficient = 0.41) and ‘manual aptitude' (β = 0.41) contributed incrementally to the variance in ‘high degree of work satisfaction' (90-100%) observed for female surgeons. However, childcare provided by ‘kindergarten/crèche/after-school care' had the greatest negative predictive value (β = -1.33). Conclusions: Although there are many parallels, female faculty members experience the culture of academic surgery to some extent differently from their male counterparts, especially when impacted by parenthood and childcare. Faculty development programmes need to develop strategies to improve perceived equality in career opportunities by respecting individuals' requirements as well as offering gender-appropriate career guidance.

scholarly journals Survey of young people in one region of the UK on accessing COVID-19 information (SOCIAL)

2021 ◽  
Vol 5 (1) ◽  
pp. e000942
Author(s):  
Oliver G P Lawton ◽  
Sarah A Lawton ◽  
Lisa Dikomitis ◽  
Joanne Protheroe ◽  
Joanne Smith ◽  
...  
Keyword(s):  
Social Media ◽  
Young People ◽  
Significant Role ◽  
Online Survey ◽  
Descriptive Statistics ◽  
Sources Of Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Education Gaps ◽  
The Uk

COVID-19 has significantly impacted young people’s lives yet little is known about the COVID-19 related sources of information they access. We performed a cross-sectional survey of pupils (11–16 years) in North Staffordshire, UK. 408 (23%) pupils responded to an online survey emailed to them by their school. Descriptive statistics were used to summarise the data. Social media, accessed by 68%, played a significant role in the provision of information, despite it not being considered trustworthy. 89% felt that COVID-19 had negatively affected their education. Gaps in the provision of information on COVID-19 have been identified.

scholarly journals COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

2021 ◽  
Vol 18 (11) ◽  
pp. 6076
Author(s):  
Hasan S. Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Health Care Workers ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Care Workers ◽  
The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

scholarly journals The Level of Lymphedema Awareness among Women with Breast Cancer in the Kingdom of Saudi Arabia

2021 ◽  
Vol 18 (2) ◽  
pp. 627
Author(s):  
Fatmah Alsharif ◽  
Wedad Almutairi ◽  
Faygah Shibily ◽  
Fatmah Alhothari ◽  
Fidaa Batwa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Saudi Arabia ◽  
Soft Tissues ◽  
Demographic Data ◽  
Medical Team ◽  
Online Questionnaire ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Status

Background: Lymphedema is a condition in which excessive fluid accumulates in soft tissues. It is a common complication of breast cancer treatments. It can lead to serious consequences and interfere with the activity of daily living. This study aimed to determine the level of awareness of breast-cancer-related lymphedema (BCRL) among women with breast cancer in the Kingdom of Saudi Arabia. This was a descriptive quantitative cross-sectional design that included a convenience sample of women diagnosed with breast cancer in the Kingdom of Saudi Arabia. Data were collected by distributing a self-administrated online questionnaire consisting of four parts, including demographic data (five items), the status of education about BCRL (three items), basic medical history of breast cancer (six items), and BCRL level of awareness of risk factors and management (nine items). Results: In total, 95 out of 135 of participants did not know about lymphedema, 119 of the participants (88.1%) did not receive any explanation about the possibility of lymphedema from their medical team before surgery, and 121 of them (89.6%) did not receive it after surgery. The most significant factor affecting participants’ level of awareness regarding BCRL was the lack of information about the possibility of BCRL occurrence, which was not provided to them by the medical team. Recommendation: Early and continuous education for future management is essential to prevent problems related to BCRL and improve quality of life.

scholarly journals Hidden bedside rationing in the Netherlands: a cross-sectional survey among physicians in internal medicine

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ursula W. de Ruijter ◽  
Hester F. Lingsma ◽  
Willem A. Bax ◽  
Johan Legemaate
Keyword(s):  
Internal Medicine ◽  
The Netherlands ◽  
Patient Choice ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Physician Characteristics ◽  
Distribution Of Resources ◽  
Healthcare Rationing ◽  
Do So

Abstract Background Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice. Methods Cross-sectional online questionnaire on knowledge of -, experience with -, and opinion on rationing among physicians in internal medicine within the Dutch healthcare system. Multivariable ordinal logistic regression was used to explore relations between hidden bedside rationing and physician characteristics. Results The survey was distributed among 1139 physicians across 11 hospitals with a response rate of 18% (n = 203). Most participants (n = 129; 64%) had experience prescribing a cheaper course of treatment while a more effective but more expensive alternative was available, suggesting bedside rationing. Subsequently, 32 (24%) participants never disclosed this decision to their patient, qualifying it as hidden. The majority of participants (n = 153; 75%) rarely discussed treatment cost. Employment at an academic hospital was independently associated with more bedside rationing (OR = 17 95%CI 6.1–48). Furthermore, residents were more likely to disclose rationing to their patients than internists (OR = 3.2, 95%CI 2.1–4.7), while salaried physicians were less likely to do so than physicians in private practice (OR = 0.5, 95%CI 0.4–0.8). Conclusion Hidden bedside rationing occurs in the Netherlands: patient choice is on occasion limited with costs as rationale and this is not always disclosed. To what extent distribution of healthcare should include bedside rationing in the Netherlands, or any other country, remains up for debate.

scholarly journals Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Elham Abbas Aljaaly
Keyword(s):  
Bariatric Surgery ◽  
Saudi Arabia ◽  
Care Process ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Nutrition Risk ◽  
Nutrition Care ◽  
Management Protocol ◽  
Perioperative Nutrition

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.

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