scholarly journals Protection against discrimination in national dementia guideline recommendations: A systematic review

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003860
Author(s):  
Tiffeny James ◽  
Naaheed Mukadam ◽  
Andrew Sommerlad ◽  
Hossein Rostami Pour ◽  
Melanie Knowles ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Healthcare Workers ◽  
Minority Groups ◽  
Good Practice ◽  
National Policy ◽  
Patient Characteristics ◽  
National Guidelines ◽  
Quality Guidelines ◽  
Guideline Quality ◽  
The Uk

Background National dementia guidelines provide recommendations about the most effective approaches to diagnosis and interventions. Guidelines can improve care, but some groups such as people with minority characteristics may be disadvantaged if recommended approaches are the same for everyone. It is not known if dementia guidelines address specific needs related to patient characteristics. The objectives of this review are to identify which countries have national guidelines for dementia and synthesise recommendations relating to protected characteristics, as defined in the UK Equality Act 2010: age, disability, gender identity, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. Methods and findings We searched CINAHL, PsycINFO, and Medline databases and the Guideline International Network library from inception to March 4, 2020, for dementia guidelines in any language. We also searched, between April and September 2020, Google and the national health websites of all 196 countries in English and in each country’s official languages. To be included, guidelines had to provide recommendations about dementia, which were expected to be followed by healthcare workers and be approved at a national policy level. We rated quality according to the iCAHE guideline quality checklist. We provide a narrative synthesis of recommendations identified for each protected characteristic, prioritising those from higher-quality guidelines. Forty-six guidelines from 44 countries met our criteria, of which 18 were rated as higher quality. Most guidelines (39/46; 85%) made at least one reference to protected characteristics, and we identified recommendations relating to age, disability, race (or culture, ethnicity, or language), religion, sex, and sexual orientation. Age was the most frequently referenced characteristic (31/46; 67%) followed by race (or culture, ethnicity, or language; 25/46; 54%). Recommendations included specialist investigation and support for younger people affected by dementia and consideration of culture when assessing whether someone had dementia and providing person-centred care. Guidelines recommended considering religion when providing person-centred and end-of-life care. For disability, it was recommended that healthcare workers consider intellectual disability and sensory impairment when assessing for dementia. Most recommendations related to sex recommended not using sex hormones to treat cognitive impairment in men and women. One guideline made one recommendation related to sexual orientation. The main limitation of this study is that we only included national guidelines applicable to a whole country meaning guidelines from countries with differing healthcare systems within the country may have been excluded. Conclusions National guidelines for dementia vary in their consideration of protected characteristics. We found that around a fifth of the world’s countries have guidelines for dementia. We have identified areas of good practice that can be considered for future guidelines and suggest that all guidelines provide specific evidence-based recommendations for minority groups with examples of how to implement them. This will promote equity in the care of people affected by dementia and help to ensure that people with protected characteristics also have high-quality clinical services.

scholarly journals Open Design and 3D Printing of Face Shields: The Case Study of a UK-China Initiative

2020 ◽  
Vol 13 (3) ◽  
pp. 511-524
Author(s):  
Simeng Li ◽  
Liang Hao ◽  
Qiaoyu Chen ◽  
Lu Zhang ◽  
Ping Gong ◽  
...  
Keyword(s):  
3D Printing ◽  
Healthcare Workers ◽  
Good Practice ◽  
Analysis Method ◽  
Study Approach ◽  
Open Design ◽  
Content Analysis Method ◽  
3D Printed ◽  
The Uk

At the start of the COVID-19 outbreak, many countries lacked personal protective equipment (PPE) to protect healthcare workers. To address this problem, open design and 3D printing technologies were adopted to provide much-in-need PPEs for key workers. This paper reports an initiative by designers and engineers in the UK and China. The case study approach and content analysis method were used to study the stakeholders, the design process, and other relevant issues such as regulation. Good practice and lessons were summarised, and suggestions for using distributed 3D printing to supply PPEs were made. It concludes that 3D printing has played an important role in producing PPEs when there was a shortage of supply, and distributed manufacturing has the potential to quickly respond to local small-bench production needs. In the future, clearer specification, better match of demands and supply, and quicker evaluation against relevant regulations will provide efficiency and quality assurance for 3D printed PPE supplies.

scholarly journals “Data makes the story come to life.” Understanding the ethical and legal implications of Big Data research involving ethnic minority healthcare workers: a qualitative study

2021 ◽  
Author(s):  
Edward S. Dove ◽  
Ruby Reed-Berendt ◽  
Manish Pareek
Keyword(s):  
Public Health ◽  
Big Data ◽  
Ethnic Minority ◽  
Health Research ◽  
Healthcare Workers ◽  
Minority Groups ◽  
Significant Implication ◽  
Structured Interviews ◽  
Increased Risk ◽  
The Uk

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the UK from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from Work Package 3, the ethico-legal stream, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were manually coded using qualitative thematic analysis. Participants told us that a significant implication across all stages of Big Data research in public health are drivers of mistrust – of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach can help assure 1) that meaningful engagement is taking place and that extant challenges are addressed, and 2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied.

scholarly journals The Importance of Adopting National Policy Papers on Dual Careers in the Field of Sport

2018 ◽  
Vol 10 (1) ◽  
pp. 45 ◽  
Author(s):  
LILIANA BUDEVICI PUIU
Keyword(s):  
Social Inclusion ◽  
Good Practice ◽  
National Level ◽  
National Policy ◽  
World Health ◽  
Activity Levels ◽  
Sporting Events ◽  
National Guidelines ◽  
The Republic ◽  
Health Organization

The relevance of physical education for sport to society is promoted by many states in order to achieve its social values, especially health, social inclusion, education and volunteering. For example, Liechtenstein regards sport as a cultural component in society, being perceived as being of public interest. The Czech Republic, Estonia and Hungary emphasize through reforms implemented in the field of education and sports, encouraging young people to watch and take part in sporting events and to be informed about sports regularly. The economic aspects of sport, especially the sustainable financing of sporting activities for all and the elaboration of policies based on concrete elements, can be considered as strategic objectives of the Republic of Moldova. In this context, the adoption of normative acts that will lead to the establishment of a framework of national guidelines on double careers will have the effect of regulating those concrete measures regarding the education, work, health and financial means of athletes. At the same time, ensuring the continuation of physical activity levels and national policies in this area, as well as continuously promoting the regular exchange of information and good practice on the role of physical activities to improve the health of the population, are also objectives that can be Implemented at national level in close synergy and cooperation with the World Health Organization (WHO).

Secondary prevention: principles and good practice/screening tests

2019 ◽  
Author(s):  
David Elliman
Keyword(s):  
Cost Effectiveness ◽  
Secondary Prevention ◽  
Good Practice ◽  
National Policy ◽  
Morbidity And Mortality ◽  
Screening Tests ◽  
Important Means ◽  
The Uk ◽  
Expected Outcomes

Screening can be a very important means to reduce the morbidity and mortality of conditions that cannot currently be prevented. However, it also has the capacity to do harm by incorrectly labelling people as having a condition, when in reality they do not, thus causing anxiety and sometimes resulting in unnecessary interventions. The UK National Screening Committee recommends national policy on screening on the basis of the evidence of the overall effects of a potential programme and its cost-effectiveness. Once a programme is introduced, it should be carefully monitored to ensure that it lives up to expectations, coverage is appropriately high, the expected outcomes are delivered, and that it does not increase inequality. More detail can be found on the UK National Screening Committee website.

The British experience of dual diagnosis in the national health service

2004 ◽  
Vol 16 (1) ◽  
pp. 41-46 ◽  
Author(s):  
A. L. Lowe ◽  
M. T. Abou-Saleh
Keyword(s):  
Dual Diagnosis ◽  
Substance Misuse ◽  
Good Practice ◽  
National Policy ◽  
Psychiatric Services ◽  
Social Outcome ◽  
Severe Mental Disorders ◽  
Addiction Services ◽  
British Experience ◽  
The Uk

The co-occurrence of substance misuse and other psychiatric disorder (dual diagnosis) has been increasingly recognized in the UK. Clinical studies of patients with severe mental disorders showed high rates of substance misuse with poor clinical and social outcome. These patients often fall ‘between the cracks’ of the separate general psychiatric and addiction services. This has necessitated the development of a national policy advocating the provision of integrated care within mainstream psychiatric services. There are emergent models of good practice that require evaluation of effectiveness and cost effectiveness.

Lesbian, gay and bisexual workers: equality, diversity and inclusion in the workplace

2006 ◽  
Vol 25 (6) ◽  
pp. 465-470 ◽  
Author(s):  
Tessa Wright ◽  
Fiona Colgan ◽  
Chris Creegany ◽  
Aidan McKearney
Keyword(s):  
Sexual Orientation ◽  
Case Studies ◽  
Trade Union ◽  
Coming Out ◽  
Good Practice ◽  
Temporary Employment ◽  
Content Type ◽  
Social Fund ◽  
And Bisexual ◽  
The Uk

PurposeAims to present a report of a conference held at London Metropolitan University in June 2006 that presented and discussed the findings of a two‐year research project, funded by the Higher Education European Social Fund. The project investigated the experiences of LGB workers following the introduction of the Employment Equality (Sexual Orientation) Regulation 2003 in the United Kingdom.Design/methodology/approachThe research was a qualitative study carried out in 16 case study organisations, seen as representing “good practice” in the area of employment of LGB workers. The case studies involved: the analysis of company documentation and reports; interviews with 60 management, trade union and LGBT network group representatives, a short survey and in‐depth interviews with 154 LGB employees. The case studies were supplemented by a series of 25 national key informant interviews with individuals in UK organisations representing government, employers, employees, and LGB people charged with disseminating advice and promoting good practice.FindingsJust over half (57.8 per cent) of the LGB respondents were out to everyone at work. A third (33.8 per cent) were out to some people, while 8.4 per cent said that they were out to very few people or nobody at work. The research indicated that equal opportunities and diversity policies which include sexual orientation; the establishment and promotion of same sex benefits; positive employer and trade union signals; the existence of LGBT groups, the presence of LGB colleagues and LGB senior managers can help LGB people come out. However, LGB people may be prevented from coming out by fears about career progression; lack of visible senior LGB staff; temporary employment status; previous negative experiences of discrimination and harassment; desiring privacy; “macho” or religious attitudes/behaviours of co‐workers.Originality/valueLittle research exists in the UK on the experiences of LGB workers, and this is one of the first studies to focus on the experiences of LGB workers following the introduction of legislation to protect workers against discrimination on grounds of sexual orientation in 2003.

The political background to arts in health

2017 ◽  
Author(s):  
Daisy Fancourt
Keyword(s):  
National Policy ◽  
Health Departments ◽  
Arts Funding ◽  
Health And Wellbeing ◽  
The Arts ◽  
Policy And Strategy ◽  
The Usa ◽  
Political Background ◽  
The Uk ◽  
Arts In Health

In recent decades, there has been an increasing number of national policy and strategy papers discussing arts in health in countries around the world. Some of this activity has been driven by national arts bodies, championing the value of the arts in health and wellbeing and advocating for their inclusion within core arts funding and practice. Other activity has been led by health bodies, including health departments within governments and health services themselves. This chapter explores some of the most influential documents and considers their implication for research and practice. It draws on case studies of activity within Ireland, the UK, the USA, Australia, and Nordic countries.

The Empire of Disgust

2018 ◽  
Keyword(s):  
United States ◽  
Drinking Water ◽  
Sexual Orientation ◽  
Change Point ◽  
Minority Groups ◽  
The United States ◽  
Political Life ◽  
Swimming Pools ◽  
Economic Class ◽  
Group Resistance

All known societies exclude and stigmatize one or more minority groups. Frequently these exclusions are underwritten with a rhetoric of disgust: people of a certain group, it is alleged, are filthy, hyper-animal, or not fit to share such facilities as drinking water, food, and public swimming pools with the ‘clean’ and ‘fully human’ majority. But exclusions vary in their scope and also in the specific disgust-ideologies underlying them. In this volume, interdisciplinary scholars from the United States and India present a detailed comparative study of the varieties of prejudice and stigma that pervade contemporary social and political life: prejudice along the axes of caste, race, gender, age, sexual orientation, transgender, disability, religion, and economic class. In examining these forms of stigma and their intersections, the authors present theoretically pluralistic and empirically sensitive accounts that both explain group-based stigma and suggest ways forward. These forward-looking remedies, including group resistance to subordination as well as institutional and legal change, point the way towards a public culture that is informed by our diverse histories of discrimination and therefore equipped to eliminate stigma in all of its multifaceted forms.

scholarly journals Observations from a small country: mental health policy, services and nursing in Wales

2021 ◽  
pp. 1-12
Author(s):  
Ben Hannigan
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Policy ◽  
National Policy ◽  
Ageing Population ◽  
Small Country ◽  
Mental Health Nurses ◽  
Face To Face ◽  
Health Need ◽  
The Uk

Abstract Wales is a small country, with an ageing population, high levels of population health need and an economy with a significant reliance on public services. Its health system attracts little attention, with analyses tending to underplay the differences between the four countries of the UK. This paper helps redress this via a case study of Welsh mental health policy, services and nursing practice. Distinctively, successive devolved governments in Wales have emphasised public planning and provision. Wales also has primary legislation addressing sustainability and future generations, safe nurse staffing and rights of access to mental health services. However, in a context in which gaps always exist between national policy, local services and face-to-face care, evidence points to the existence of tension between Welsh policy aspirations and realities. Mental health nurses in Wales have produced a framework for action, which describes practice exemplars and looks forward to a secure future for the profession. With policy, however enlightened, lacking the singular potency to bring about intended change, nurses as the largest of the professional groups involved in mental health care have opportunities to make a difference in Wales through leadership, influence and collective action.

scholarly journals A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings

Mindfulness ◽  
2021 ◽  
Author(s):  
Kate Williams ◽  
Samantha Hartley ◽  
Peter Taylor
Keyword(s):  
Delphi Study ◽  
Good Practice ◽  
Evidence Base ◽  
Clinical Settings ◽  
Training Support ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Complex Decision ◽  
The Uk ◽  
Clinical Populations

Abstract Objectives Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications.

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