scholarly journals Modifying a Paediatric Rational Prescribing Tool (POPI) for Use in the UK

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 33 ◽  
Author(s):  
Fenella Corrick ◽  
Imti Choonara ◽  
Sharon Conroy ◽  
Helen Sammons
Keyword(s):  
Scottish Intercollegiate Guideline Network ◽  
The United Kingdom ◽  
Rational Prescribing ◽  
Quality Of Prescribing ◽  
Paediatric Practice ◽  
The Uk ◽  
Outpatient Settings ◽  
Clinical Category ◽  
Inappropriate Prescriptions

Rational prescribing tools can be used by individual prescribers, organisations, and researchers to evaluate the quality of prescribing for research and quality improvement purposes. A literature search showed that there is only one tool for evaluating rational prescribing for paediatric patients in hospital and outpatient settings. The Pediatrics: Omission of Prescriptions and Inappropriate Prescriptions (POPI) tool was developed in France and comprises 105 criteria. The aim of this study was to modify this tool to facilitate its use in paediatric practice in the United Kingdom (UK). POPI criteria were compared to relevant UK clinical guidelines from the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guideline Network and the British National Formulary for Children. Where guidelines differed, criteria were modified to reflect UK guidance. If there were no relevant guidelines or directly contradictory guidelines, criteria were removed. Overall, no change was made to 49 criteria. There were 29 modified to concord with UK guidelines. Four criteria were reduced to two criteria due to being linked in single guidelines. Twenty-three criteria were omitted, due to the absence of relevant UK guidance or directly conflicting UK practice, including one entire clinical category (mosquitos). One category title was amended to parallel UK terminology. The modified POPI (UK) tool comprises of eighty criteria and is the first rational prescribing tool for the evaluation of prescribing for children in hospital and outpatient settings in the UK.

scholarly journals The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emilia Majsiak ◽  
Magdalena Choina ◽  
Dominik Golicki ◽  
Alastair M. Gray ◽  
Bożena Cukrowska
Keyword(s):  
Quality Of Life ◽  
United Kingdom ◽  
Coeliac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
The United Kingdom ◽  
Before And After ◽  
The Mean ◽  
The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

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.

scholarly journals An Evaluation of the Efficacy of LED Light Curing Units in Primary and Secondary Dental Settings in the United Kingdom

2021 ◽  
Author(s):  
A Altaie ◽  
MA Hadis ◽  
V Wilson ◽  
MJ German ◽  
BR Nattress ◽  
...  
Keyword(s):  
Light Output ◽  
Led Light ◽  
The United Kingdom ◽  
Dental Practices ◽  
Light Curing ◽  
Blue Phase ◽  
And Performance ◽  
The Uk ◽  
Post Hoc

SUMMARY Objective: This study aimed to evaluate the irradiance and the quality of LED light curing units (LCUs) in primary and secondary clinics in the UK and to assess the effect of damage, contamination, use of protective sleeves, and distance of light tips to target on the irradiance and performance of LCUs. Methods: The irradiance levels (mW/cm2) of 26 LED LCUs from general dental practices and 207 LED LCUs from two dental hospitals were measured using a digital radiometer (Blue Phase II, Ivoclar, Vivadent, Amherst, NY). Ten LED light guide tips (Satelec Mini, Acteon, Merignac, France) were selected to evaluate the effect of chipping, contamination (tip debris), and use of protective sleeves and tips to sensor distance on irradiance (mW/cm2) using a MARC Resin Calibrator (Blue Light Analytics, Halifax, Canada). Homogeneity of the light output was evaluated using a laser beam profiler (SP620; Ophir-Spiricon, North Longan, UT, USA). Statistical analysis was conducted using a one-way analysis of variance (ANOVA) with post hoc Tukey test (α=0.05) and linear regression with stepwise correlation tests. Results: Thirty-three percent of the LCUs delivered irradiance output less than 500 mW/cm2. The condition of the light curing tips was poor, with 16% contaminated with resin debris, 26% damaged, and 10% both contaminated and damaged. The irradiance output was significantly reduced in contaminated (62%) and chipped (50%) light curing tips and when using protective sleeves (24%) (p&lt;0.05). Irradiance was also reduced when increasing the distance with 25% and 34% reduction at 7 mm and 10 mm, respectively (p&lt;0.05). Conclusion: There remains a lack of awareness of the need for regular monitoring and maintenance of dental LCUs. Damaged and contaminated light curing tips, use of protective sleeves, and increasing the distance from the restoration significantly reduced the irradiance output and the performance of the LCUs.

The changing landscape of local authority commissioning

2020 ◽  
pp. 177-196
Author(s):  
Dave Ayre
Keyword(s):  
Academic Research ◽  
The European Union ◽  
Public And Private ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
The Uk ◽  
Relationship Of ◽  
The Relationship

This chapter assesses the history of the relationship between public and private sectors and the extent to which the political and regulatory environment of governments and institutions such as the European Union (EU) can help or hinder the efforts of public bodies in seeking to deliver services that determine the health and quality of life for communities. The relationship of public and private sectors in the United Kingdom (UK) and the commissioning, procurement, and development of public–private partnerships is driven by the prevailing political and economic environment. However, rigorous academic research on the benefits of partnering to organisations, societies and between countries is limited. Evidence is needed to fill the policy vacuum. A bolder approach is necessary to work with public and private sectors to develop and implement successful partnering alternatives to the outsourcing of public services. The growing catalogue of outsourcing failures in construction, probation, rail franchising, health, and social care is creating an appetite for change, and the exit of the UK from the EU provides the opportunity.

Introduction: the landscapes of poverty and education across the UK

2020 ◽  
pp. 1-10
Author(s):  
Ian Thompson ◽  
Gabrielle Ivinson
Keyword(s):  
Young People ◽  
Educational Inequality ◽  
Well Being ◽  
Children And Young People ◽  
The United Kingdom ◽  
Context Specific ◽  
Social And Cultural Factors ◽  
The Uk ◽  
Different Parts

Poverty blights the lives of children and young people. Research has consistently shown that the most economically disadvantaged pupils across the United Kingdom (UK) have the poorest educational outcomes and that poverty has a pernicious effect on children’s well-being. However, far less is known about the ways that poverty is differentially experienced for children and young people in schools within the four jurisdictions of the UK. Are there historical, social and cultural factors that make poverty a postcode lottery in terms of quality of schooling in the different parts of the UK? Are successful local interventions context specific as the research evidence seems to suggest or can we learn from particular regions or cities? This introduction points out that anxieties about growing educational inequality in the UK have to be contextualised historically, geographically and in terms of the distinct political and socio-economic landscapes in England, Scotland, Wales and Northern Ireland.

The United Kingdom

2015 ◽  
Author(s):  
Margaret O’Brien ◽  
Sara Connolly ◽  
Svetlana Speight ◽  
Matthew Aldrich ◽  
Eloise Poole
Keyword(s):  
United Kingdom ◽  
Work Family Conflict ◽  
Work Time ◽  
Activity Data ◽  
The United Kingdom ◽  
Cultural Mandate ◽  
Work Family ◽  
The Uk ◽  
State Context

This chapter examines contemporary fathering practices in the UK liberal welfare state context, where recent legislation has expanded fathers’ access to work-family reconciliation rights, albeit rather minimally. Data are provided to explore whether the new cultural mandate for active fathers holds for the quantity and the quality of time fathers spend with young children. Time use and employment activity data does show an increase in British fathers’ care time and a reduction in paid work time over the decade. Since 2003 British fathers can take two weeks paid leave after the birth of a child, and by the end of the decade over 90% of fathers took significant post-birth leave. However, British fathers, continue to have one of the longest working weeks and highest level of work–family conflict amongst European fathers. In the absence of stronger work–family reconciliation measures, underlying maternalist and modified breadwinner cultures remain resilient.

Continuing care of Old People—A Medical Viewpoint

1988 ◽  
Vol 8 (2) ◽  
pp. 189-209 ◽  
Author(s):  
Richard Lewis ◽  
John Wattis
Keyword(s):  
Social Services ◽  
Continuing Care ◽  
Present System ◽  
Old People ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
Informal Carers ◽  
The Uk

ABSTRACTProvision for old people who are in need of continuing care requires close co-operation between informal carers and different agencies and disciplines providing health and social care. In the United Kingdom, the present system of care has evolved from earlier patterns of care centred on the asylums and the poor law with its workhouse institutions. It lacks cohesion. Despite the designation of old people as a priority group, resources are still inadequate to provide a good quality of care. Organisational differences between health and social services can lead to inefficient use of existing resources. More specialised medical, psychiatric and social services for old people enhance the possibilities for co-operation even though they may appear to lead to greater fragmentation. The history of the development of these services in the UK, including the recent expansion of private sector care, is reviewed, with special attention from the medical perspective to the phenomenon of ‘bed blocking’. The recently published Griffiths Report on community care is briefly considered, and some principles for future developments are laid down.

scholarly journals Access to and Use of Clinical Services and Disease-Modifying Therapies by People with Progressive Multiple Sclerosis in the United Kingdom

2017 ◽  
Vol 19 (6) ◽  
pp. 275-282 ◽  
Author(s):  
Evan Campbell ◽  
Elaine H. Coulter ◽  
Paul Mattison ◽  
Angus McFadyen ◽  
Linda Miller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Clinical Services ◽  
The United Kingdom ◽  
Disease Modifying Therapies ◽  
Disease Modifying ◽  
The Uk ◽  
Regular Review

Background: According to current UK guidelines, everyone with progressive multiple sclerosis (MS) should have access to an MS specialist, but levels of access and use of clinical services is unknown. We sought to investigate access to MS specialists and use of clinical services and disease-modifying therapies (DMTs) by people with progressive MS in the United Kingdom. Methods: A UK-wide online survey was conducted via the UK MS Register. The inclusion criteria were age 18 years or older, primary or secondary progressive MS, and a member of the UK MS Register. Participants were asked about access to MS specialists, recent clinical service use, receipt of regular review, and current and previous DMT use. Participant demographic data, quality of life, and disease impact measures were from the UK MS Register. Results: In total, 1298 individuals responded: 7% were currently taking a DMT, 23% had previously taken a DMT, and 95% reported access to an MS specialist. The most used practitioners were MS doctors/nurses (50%), general practitioners (45%), and physiotherapists (40%). Seventy-four percent of participants received a regular review, although 37% received theirs less often than annually. Current DMT use was associated with better quality of life, but past DMT use was associated with poorer quality of life and higher impact of disease. Conclusions: Access to and use of MS specialists was high. However, a gap in service provision was highlighted in both receipt and frequency of regular reviews.

Scotland

2019 ◽  
pp. 245-250
Author(s):  
Seamus V McNulty ◽  
Graham A Jackson
Keyword(s):  
Quality Of Care ◽  
Hospital Care ◽  
Dementia Care ◽  
General Hospitals ◽  
The Third ◽  
The United Kingdom ◽  
Novel Approaches ◽  
The Uk

Scotland is a small nation which has a devolved legislature, while still remaining part of the United Kingdom (UK). As the health service has become increasingly divergent from that of the remainder of the UK, more innovative approaches to dementia care have been allowed to develop. The Scottish Dementia Strategy, now in its third iteration, is unique in that it adopts a human rights-based method of dementia care, an approach that has subsequently been followed by other European countries. The Strategy is in continual evolution, with the third Strategy focusing more on care at the end stages of dementia, especially for those in nursing homes or long-term hospital care. Other novel approaches, such as the Dementia Champions programme, have shown benefits in the quality of care for patients with dementia in acute general hospitals, although less so for those in social care settings. Scotland was also a pioneer in enacting incapacity legislation, although this is now under review as shortcomings in the current procedures are becoming unmasked.

scholarly journals Reference Values of the QOLIBRI from General Population Samples in the United Kingdom and The Netherlands

2020 ◽  
Vol 9 (7) ◽  
pp. 2100
Author(s):  
Anastasia Gorbunova ◽  
Marina Zeldovich ◽  
Daphne Voormolen ◽  
Ugne Krenz ◽  
Suzanne Polinder ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
General Population ◽  
Reference Values ◽  
The United Kingdom ◽  
General Populations ◽  
The Uk ◽  
Disease Specific

The Quality of Life after Traumatic Brain Injury (QOLIBRI) instrument is an internationally validated patient-reported outcome measure for assessing disease-specific health-related quality of life (HRQoL) in individuals after traumatic brain injury (TBI). However, no reference values for general populations are available yet for use in clinical practice and research in the field of TBI. The aim of the present study was, therefore, to establish these reference values for the United Kingdom (UK) and the Netherlands (NL). For this purpose, an online survey with a reworded version of the QOLIBRI for general populations was used to collect data on 4403 individuals in the UK and 3399 in the NL. This QOLIBRI version was validated by inspecting descriptive statistics, psychometric criteria, and comparability of the translations to the original version. In particular, measurement invariance (MI) was tested to examine whether the items of the instrument were understood in the same way by different individuals in the general population samples and in the TBI sample across the two countries, which is necessary in order to establish reference values. In the general population samples, the reworded QOLIBRI displayed good psychometric properties, including MI across countries and in the non-TBI and TBI samples. Therefore, differences in the QOLIBRI scores can be attributed to real differences in HRQoL. Individuals with and without a chronic health condition did differ significantly, with the latter reporting lower HRQoL. In conclusion, we provided reference values for healthy individuals and individuals with at least one chronic condition from general population samples in the UK and the NL. These can be used in the interpretation of disease-specific HRQoL assessments after TBI applying the QOLIBRI on the individual level in clinical as well as research contexts.

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