The impact of changes in service delivery in patients with colorectal cancer during the first peak of the COVID-19 pandemic.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 28-28
Author(s):  
Konstantinos Kamposioras ◽  
Kok Haw Jonathan Lim ◽  
Mark P. Saunders ◽  
Kalena Marti ◽  
Daniel Anderson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Service Delivery ◽  
Cancer Care ◽  
Well Being ◽  
Telephone Consultation ◽  
Care Services ◽  
The United Kingdom ◽  
Primary Care Services ◽  
The Uk ◽  
The Impact

28 Background: Increased levels of anxiety and distress in both patients and physicians have been reported in response to the significant impact COVID-19 has on cancer service delivery globally. We aimed to investigate how these changes have been perceived by patients diagnosed with colorectal cancer and identify determinants of increased anxiety. Methods: Survey (32-item) of consecutive patients diagnosed with colorectal cancer attending a large tertiary comprehensive cancer centre in the United Kingdom (18 May to 1 July 2020). Self-reported GAD-7 (both paper/electronic forms) was used as a screening tool for anxiety. Statistical analyses of associations:Chi-square, Fisher’s exact, and uni- and multi-variable analyses were performed using SPSS v19 and R. Results: A total of 143 patients (response rate 67%), 82% male, and median age of 61-70 years were included. Majority of patients had telephone consultation (78%), including 40% who had scan results discussed over the phone; with favourable feedback received with both respectively. Twenty-three patients (18%) were considered to have anxiety, with 7 (6%) scoring for moderate or severe anxiety. Three items asked patients if they had concerns about getting COVID-19, were worried that COVID-19 would have effect on mental health, and affect their experience of cancer care. Patients answering positively to any of these items were most likely to have anxiety; multivariate analysis – OR 2.361 (95% CI 1.187-4.694, p=0.014), 3.219 (95% CI 1.401-7.395, p=0.006) and 3.206 (95% CI 1.036-9.920, p=0.043), respectively. Majority of the patients did not feel that they needed support during the pandemic period and hence the available well-being services were not used. Patients felt that friends and family had been very supportive but less so the primary care services (p<0.05). However, they felt they were supported by the clinical team. Conclusions: At our centre, during the first-peak of COVID-19 pandemic in the UK, patients with colorectal cancer did not display increased rates of significant anxiety. The findings of this survey suggests that some service changes implemented, including increased telephone follow-up, may have already improved the overall experience of cancer care. Importantly, patients were much more concerned about their cancer treatment than COVID-19, emphasising the need to continue to provide comprehensive cancer care even if we get a “2nd wave” of COVID-19.

scholarly journals What Is the Health and Well-Being Burden for Parents Living With a Child With ADHD in the United Kingdom?

2020 ◽  
pp. 108705472092589 ◽  
Author(s):  
Tessa Peasgood ◽  
Anupam Bhardwaj ◽  
John E. Brazier ◽  
Katie Biggs ◽  
David Coghill ◽  
...  
Keyword(s):  
United Kingdom ◽  
Well Being ◽  
Control Groups ◽  
Childhood Adhd ◽  
The United Kingdom ◽  
The Uk ◽  
The Impact ◽  
Mental Well Being ◽  
Health And Well Being

Objective: To explore the burden associated with childhood ADHD in a large observational study. Methods: We recruited familes with at least one child (6-18 years) with ADHD via 15 NHS trusts in the UK, and collected data from all family members. We made careful adjustments to ensure a like-for-like comparison with two different control groups, and explored the impact of controlling for a positive parental/carer ADHD screen, employment, and relationship status. Results: We found significant negative impacts of childhood ADHD on parents’/carers’ hours and quality of sleep, satisfaction with leisure time, and health-related quality of life (measured by the EuroQol-5D [EQ-5D]). We found a decrement in life satisfaction, mental well-being (as measured by the Short–Warwick Edinburgh Mental Well-Being Scale [S-WEMWBS]), and satisfaction with intimate relationships, but this was not always robust across the different control groups. We did not find any decrement in satisfaction with health, self-reported health status, or satisfaction with income. Conclusion: The study quantifies the impact on the health and well-being of parents living with a child with ADHD using a survey of families attending ADHD clinics in the United Kingdom.

Health and social care in an age of austerity

2017 ◽  
Author(s):  
Charles West
Keyword(s):  
Social Support ◽  
Health Care ◽  
Social Care ◽  
Market Competition ◽  
Well Being ◽  
Care Services ◽  
The Social ◽  
Health And Social Care ◽  
The Uk ◽  
The Impact

This chapter examines the impact of austerity policies on health, well-being and social care in the UK. In particular, it considers the health care provided by the National Health Service (NHS) and other health services, as well as the social care that is normally paid for, rather than the wider social support provided by family, friends, neighbours or colleagues. The discussion begins with an overview of the economic case for spending on health and social care, and more specifically the logic in pursuing spending policies that carry a high economic multiplier. The chapter then emphasises the duty of governments and those working in health care to achieve good value for the money spent, citing the case of the UK NHS. It also describes five principles underlying market competition in the context of health care before concluding with an analysis of social care services in the UK.

scholarly journals Niejednoznaczny wpływ Brexitu na życie młodych Polaków w Wielkiej Brytanii

2020 ◽  
Vol 46 (4 (178)) ◽  
pp. 49-70
Author(s):  
Agnieszka Trąbka ◽  
Iga Wermińska-Wiśnicka
Keyword(s):  
United Kingdom ◽  
Qualitative Data ◽  
Longitudinal Research ◽  
Well Being ◽  
The United Kingdom ◽  
The Social ◽  
The Uk ◽  
The Comparative Study ◽  
The Impact ◽  
Different Sources

Ambiguous impact of Brexit on young Poles living in the United Kingdom The paper aims to analyse the impact of Brexit on the social anchoring of young Poles in the United Kingdom in four spheres of their lives: decision and return plans; application for British citizenship; buying properties; well-being and life satisfaction. The article is based on research conducted within the project „CEEYouth: The comparative study of young migrants from Poland and Lithuania in the context of Brexit”. We also handle statistics data from the Office for National Statistics as well as qualitative data from three waves of Qualitative Longitudinal Research of 41 young (aged 19–34) Polish post-accession migrants in the UK. We find that it is hard to unambiguously assess the impact of Brexit on the mentioned spheres of young Poles’ lives. Firstly, it is caused by the fact that different sources of data show results which are contrasting and secondly, the reactions of people are dynamically changing within the lapse of time. Therefore, it could be surely said that Brexit has impacted the lives of young Polish migrants, but it has caused neither mass return, nor the general willingness to naturalise. Although the results of the Brexit referendum have caused disturbance amid many Poles, it has not impacted their life decisions or, according to statistics, their well-being.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

scholarly journals Three models for the regulation of polygenic scores in reproduction

2021 ◽  
pp. medethics-2020-106588
Author(s):  
Sarah Munday ◽  
Julian Savulescu
Keyword(s):  
Human Genetics ◽  
Ethical Issues ◽  
Well Being ◽  
Embryo Selection ◽  
Risk Scores ◽  
Regulatory Regime ◽  
Polygenic Scores ◽  
The Usa ◽  
The Uk ◽  
The Impact

The past few years have brought significant breakthroughs in understanding human genetics. This knowledge has been used to develop ‘polygenic scores’ (or ‘polygenic risk scores’) which provide probabilistic information about the development of polygenic conditions such as diabetes or schizophrenia. They are already being used in reproduction to select for embryos at lower risk of developing disease. Currently, the use of polygenic scores for embryo selection is subject to existing regulations concerning embryo testing and selection. Existing regulatory approaches include ‘disease-based' models which limit embryo selection to avoiding disease characteristics (employed in various formats in Australia, the UK, Italy, Switzerland and France, among others), and 'laissez-faire' or 'libertarian' models, under which embryo testing and selection remain unregulated (as in the USA). We introduce a novel 'Welfarist Model' which limits embryo selection according to the impact of the predicted trait on well-being. We compare the strengths and weaknesses of each model as a way of regulating polygenic scores. Polygenic scores create the potential for existing embryo selection technologies to be used to select for a wider range of predicted genetically influenced characteristics including continuous traits. Indeed, polygenic scores exist to predict future intelligence, and there have been suggestions that they will be used to make predictions within the normal range in the USA in embryo selection. We examine how these three models would apply to the prediction of non-disease traits such as intelligence. The genetics of intelligence remains controversial both scientifically and ethically. This paper does not attempt to resolve these issues. However, as with many biomedical advances, an effective regulatory regime must be in place as soon as the technology is available. If there is no regulation in place, then the market effectively decides ethical issues.

The Covid-19 lockdown in the United Kingdom and subjective well-being: Have the self-employed suffered more due to hours and income reductions?

2021 ◽  
pp. 026624262098676 ◽  
Author(s):  
Wei Yue ◽  
Marc Cowling
Keyword(s):  
United Kingdom ◽  
Rare Events ◽  
Well Being ◽  
The Self ◽  
Subjective Well Being ◽  
Data Set ◽  
The United Kingdom ◽  
Hours Of Work ◽  
Period Data ◽  
The Uk

It is well documented that the self-employed experience higher levels of happiness than waged employees even when their incomes are lower. Given the UK government’s asymmetric treatment of waged workers and the self-employed, we use a unique Covid-19 period data set which covers the months leading up to the March lockdown and the months just after to assess three aspects of the Covid-19 crisis on the self-employed: hours of work reductions, the associated income reductions and the effects of both on subjective well-being. Our findings show the large and disproportionate reductions in hours and income for the self-employed directly contributed to a deterioration in their levels of subjective well-being compared to waged workers. It appears that their resilience was broken when faced with the reality of dealing with rare events, particularly when the UK welfare support response was asymmetric and favouring waged employees.

scholarly journals ‘Should I Stay, or Should I Go?’ Psychological Distress Predicts Career Change Ideation among Intensive Care Staff in Lithuania and the UK Amid COVID-19 Pandemic

2021 ◽  
Vol 18 (5) ◽  
pp. 2660
Author(s):  
Ieva Norkiene ◽  
Lina Jovarauskaite ◽  
Monika Kvedaraite ◽  
Encarl Uppal ◽  
Mandeep Kaur Phull ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Healthcare Professionals ◽  
Psychosocial Support ◽  
Career Change ◽  
Well Being ◽  
Self Report ◽  
Care Staff ◽  
Psychological Well Being ◽  
The United Kingdom ◽  
The Uk

The COVID-19 pandemic had a significant effect on healthcare globally. Additional pressure created by coronavirus adversely affected the mental health and psychological well-being of healthcare workers, leading many to question their desire and willingness to continue working in healthcare. This study aimed to identify predictors for career change ideation among healthcare professionals in two countries; Lithuania and the United Kingdom amid the coronavirus pandemic. In total, 610 healthcare professionals from Lithuania and the UK (285 and 325, respectively) participated in a survey from May to August 2020. Psychological distress and psychological well-being were measured using the self-report scales “DASS-21” and “WHO-5”. Almost half of the sample (49.2%), 59.6% and 40.0% in Lithuanian and the UK, respectively, exhibited career change ideation, the country effect was significant (AOR = 2.21, p < 0.001). Stronger ideation to leave healthcare was predicted by higher levels of depression (AOR = 1.10, p = 0.005), stress (AOR = 1.10, p = 0.007), anxiety surrounding inadequate personal protective equipment (AOR = 2.27, p = 0.009), and lower psychological well-being scores (AOR = 1.10, p = 0.007). We conclude that psychosocial support must be provided for healthcare professionals to prevent burnout and loss of staff amid the pandemic.

scholarly journals Migration infrastructures and the production of migrants’ irregularity in Japan and the United Kingdom

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Nando Sigona ◽  
Jotaro Kato ◽  
Irina Kuznetsova
Keyword(s):  
Legal Status ◽  
Qualitative Interviews ◽  
Legal Violence ◽  
The United Kingdom ◽  
The Social ◽  
Access And Quality ◽  
The Uk ◽  
The Impact

AbstractThe article examines the migration infrastructures and pathways through which migrants move into, through and out of irregular status in Japan and the UK and how these infrastructures uniquely shape their migrant experiences of irregularity at key stages of their migration projects.Our analysis brings together two bodies of migration scholarship, namely critical work on the social and legal production of illegality and the impact of legal violence on the lives of immigrants with precarious legal status, and on the role of migration infrastructures in shaping mobility pathways.Drawing upon in-depth qualitative interviews with irregular and precarious migrants in Japan and the UK collected over a ten-year period, this article develops a three-pronged analysis of the infrastructures of irregularity, focusing on infrastructures of entry, settlement and exit, casting a comparative light on the mechanisms that produce precarious and expendable migrant lives in relation to access to labour and labour conditions, access and quality of housing and law enforcement, and how migrants adapt, cope, resist or eventually are overpowered by them.

Leveraging Twitter Using Artificial Intelligence to Explore Mental Health Insights in the UK During the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Christopher Marshall ◽  
Kate Lanyi ◽  
Rhiannon Green ◽  
Georgie Wilkins ◽  
Fiona Pearson ◽  
...  
Keyword(s):  
Mental Health ◽  
Artificial Intelligence ◽  
Language Processing ◽  
Mental Health Problems ◽  
Well Being ◽  
Research Activity ◽  
Health Crisis ◽  
Key Topics ◽  
The Uk ◽  
The Impact

BACKGROUND There is increasing need to explore the value of soft-intelligence, leveraged using the latest artificial intelligence (AI) and natural language processing (NLP) techniques, as a source of analysed evidence to support public health research activity and decision-making. OBJECTIVE The aim of this study was to further explore the value of soft-intelligence analysed using AI through a case study, which examined a large collection of UK tweets relating to mental health during the COVID-19 pandemic. METHODS A search strategy comprising a list of terms related to mental health, COVID-19, and lockdown restrictions was developed to prospectively collate relevant tweets via Twitter’s advanced search application programming interface over a 24-week period. We deployed a specialist NLP platform to explore tweet frequency and sentiment across the UK and identify key topics of discussion. A series of keyword filters were used to clean the initial data retrieved and also set up to track specific mental health problems. Qualitative document analysis was carried out to further explore and expand upon the results generated by the NLP platform. All collated tweets were anonymised RESULTS We identified and analysed 286,902 tweets posted from UK user accounts from 23 July 2020 to 6 January 2021. The average sentiment score was 50%, suggesting overall neutral sentiment across all tweets over the study period. Major fluctuations in volume and sentiment appeared to coincide with key changes to any local and/or national social-distancing measures. Tweets around mental health were polarising, discussed with both positive and negative sentiment. Key topics of consistent discussion over the study period included the impact of the pandemic on people’s mental health (both positively and negatively), fear and anxiety over lockdowns, and anger and mistrust toward the government. CONCLUSIONS Through the primary use of an AI-based NLP platform, we were able to rapidly mine and analyse emerging health-related insights from UK tweets into how the pandemic may be impacting people’s mental health and well-being. This type of real-time analysed evidence could act as a useful intelligence source that agencies, local leaders, and health care decision makers can potentially draw from, particularly during a health crisis.

Effect of a Reduced Postpartum Length of Stay Program on Primary Care Services Use by Mothers and Infants

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 937-941
Author(s):  
Kenneth D. Mandl ◽  
Charles J. Homer ◽  
Oren Harary ◽  
Jonathan A. Finkelstein
Keyword(s):  
Primary Care ◽  
Length Of Stay ◽  
Early Discharge ◽  
Urgent Care ◽  
Care Utilization ◽  
Care Services ◽  
Primary Care Services ◽  
Ambulatory Services ◽  
The Impact ◽  
Services Use

Objective. To determine the impact of reduced postpartum length of stay (LOS) on primary care services use. Methods. Design: Retrospective quasiexperimental study, comparing 3 periods before and 1 period after introducing an intervention and adjusting for time trends.Setting: A managed care plan.Intervention: A reduced obstetrical LOS program (ROLOS), offering enhanced education and services.Participants: mother-infant dyads, delivered during 4 time periods: February through May 1992, 1993, and 1994, before ROLOS, and 1995, while ROLOS was in effect.Independent Measures: Pre-ROLOS or the post-ROLOS year.Outcome Measures: Telephone calls, visits, and urgent care events during the first 3 weeks postpartum summed as total utilization events. Results. Before ROLOS, LOS decreased gradually (from 51.6 to 44.3 hours) and after, sharply to 36.5 hours. Although primary care use did not increase before ROLOS, utilization for dyads increased during ROLOS. Before ROLOS, there were between 2.37 and 2.72 utilization events per dyad; after, there were 4.60. Well-child visits increased slightly to .98 visits per dyad, but urgent visits did not. Conclusion. This program resulted in shortened stays and more primary care use. There was no increase in infant urgent primary care utilization. Early discharge programs that incorporate and reimburse for enhanced ambulatory services may be safe for infants; these findings should not be extrapolated to mandatory reduced LOS initiatives without enhancement of care.

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