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Publications

Theme:

Ageing & Dementia

 The anorexia of ageing and risk of mortality: More than a story of malnutrition?

Cox NJ,   Lim SE


Appetite loss or anorexia due to physiological, psychological and socioenvironmental effects of the aging process is termed the anorexia of aging.


The link between anorexia of aging and mortality has subsequently been established by a number of longitudinal studies across multiple settings.


Despite the association, clear interpretation of the mechanistic relationship between anorexia of aging and mortality, has been limited.


https://doi.org/10.1016/j.jnha.2024.100173

February 2024

Theme:

Workforce & Health Systems

Photovoice: An active learning tool with community nursing students

Andina-Díaz   E, Welch L, Siles-González J, Serrano-Fuentes N, Gutiérrez-García AI,   Solano-Ruiz M


Objective: To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community.


Methods: A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data.


https://doi.org/10.1111/phn.13285

February 2024

Theme:

Workforce & Health Systems

What might make nurses stay? A protocol for discrete choice experiments to understand NHS nurses' preferences at early-career and late-career stages

Ejebu OZ, Turnbull J, Atherton I, Rafferty AM, Palmer B, Philippou J, Prichard J, Jamieson M, Rolewicz L, Williams M, Ball J


Like many countries, England has a national shortage of registered nurses. Employers strive to retain existing staff, to ease supply pressures. Disproportionate numbers of nurses leave the National Health Services (NHS) both early in their careers, and later, as they near retirement age. Research is needed to understand the job preferences of early-career and late-career nurses working in the NHS, so tailored policies can be developed to better retain these two groups.


https://doi.org/10.1136/bmjopen-2023-075066

February 2024

Theme:

Long Term Conditions

Change in treatment burden among people with multimorbidity: a follow-up survey

Hounkpatin HO, Roderick P, Harris S, Morris JE, Smith D, Walsh B, Roberts HC, Dambha-Miller H, Tan QY, Watson F, Fraser SD


Background: Treatment burden is the effort required of patients to look after their health and the impact this has on their functioning and wellbeing. Little is known about change in treatment burden over time for people with multimorbidity.


Aim: To quantify change in treatment burden, determine factors associated with this change, and evaluate a revised single-item measure for high treatment burden in older adults with multimorbidity.


https://doi.org/10.3399/bjgp.2022.0103

October 2022

Theme:

Workforce & Health Systems

Position Paper on the Reporting of Norepinephrine Formulations in Critical Care from the Society of Critical Care Medicine and European Society of Intensive Care Medicine Joint Task Force

Wieruszewski PM, Leone M, Kaas-Hansen BS, Dugar S, Legrand M, McKenzie CA, Bissell Turpin BD, Messina A, Nasa P, Schorr CA, De Waele JJ, Khanna AK


Objectives: To provide guidance on the reporting of norepinephrine formulation labeling, reporting in publications, and use in clinical practice.


Design: Review and task force position statements with necessary guidance.


https://doi.org/10.1097/ccm.0000000000006176

January 2024

Theme:

Long Term Conditions

Person-centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review

Bartolomeu Pires S,  Kunke Dl, Kipps   C, Goodwin N, Portillo MC


People living with long-term neurological conditions (LTNCs) have complex needs that demand intensive care coordination between sectors. This review aimed to establish if integrated care improves outcomes for people, and what characterises successful interventions.


https://doi.org/10.1111/hex.13948

January 2024

Theme:

Workforce & Health Systems

Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using Routinely Collected Data

Dall’Ora C, Ejebu OZ, Jones J, Griffiths P


Shifts of 12 hours or longer are common in nursing services within general hospital wards. Concerns have been raised about their safety, but previous research has mostly used staff-reported measures of quality and safety and has occurred in general hospital settings only. 


This study aims to measure the association between the use of 12+ hour shifts in nursing staff (including registered nurses, healthcare support workers or nursing assistants, and nursing associates) and the rate of patient incidents in mental health and community hospitals


https://doi.org/10.1155/2023/6626585

January 2024

Theme:

Workforce & Health Systems

Evidence on the use of Birthrate Plus® to guide safe staffing in maternity services - A systematic scoping review

Griffiths P, Turner L, Lown J, Sanders J


Birthrate Plus® is a widely used tool that informs decisions about the number of midwifery staff needed to provide safe and high quality care in maternity services. Evidence about the effectiveness, validity, reliability, and feasibility of tools such as this is needed.


https://doi.org/10.1016/j.wombi.2023.11.003

January 2024

Theme:

Ageing & Dementia

Perfusion Imaging and Inflammation Biomarkers Provide Complementary Information in Alzheimer's Disease

Michopoulou S, Prosser A, Dickson J, Guy M, Teeling JL, Kipps C


Single photon emission tomography (SPECT) can detect early changes in brain perfusion to support the diagnosis of dementia. Inflammation is a driver for dementia progression and measures of inflammation may further support dementia diagnosis.


In this study, we assessed whether combining imaging with markers of inflammation improves prediction of the likelihood of Alzheimer's disease (AD).


https://doi.org/10.3233/jad-230726

January 2024

Theme:

General publications

Using collaborative autoethnography to explore the teaching of qualitative research methods in medicine

Ibrahim K, Weller S, Elvidge E, Tavener M


This article explores experiences of teaching qualitative research (QR) broadly, and qualitative methods (QM) more specifically in medicine, highlighting the challenges faced, and offering recommendations for overcoming them.


https://doi.org/10.1007/s10459-023-10224-z

May 2023

Theme:

General publications

Expanding Possibilities for Inclusive Research: Learning from People with Profound Intellectual and Multiple Disabilities and Decolonising Research

Grace J,   Nind M, de Haas C, Hope J.


This paper pursues the argument that finding a way for people with profound intellectual and multiple disabilities to belong in inclusive research requires starting from a deep knowledge of the people in question. This paper illustrates this idea in action showing what can be possible from building research around ‘being with’ people with profound intellectual disabilities, creating intersubjective knowledge together


https://doi.org/10.3390/socsci13010037

January 2024

Theme:

Long Term Conditions

Psychometric properties of the living with long term conditions scale in an English-speaking population living with long term conditions in the UK

Ambrosio   L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC


Objective: To present the psychometric properties of the living with long-term condition (LwLTCs) scale in an English-speaking population of people with different LTCs.


Design: An observational and cross-sectional study, with retest was conducted. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility and content validity were tested.


https://doi.org/10.1136/bmjopen-2023-077978

January 2024

Theme:

Long -Term Conditions

The Quality of Life of Pseudomyxoma Peritonei Patients: A Scoping Review

Taher R,   Gray D, Ramage J


Pseudomyxoma peritonei (PMP) is a form of peritoneal malignancy. It originates from a perforated appendiceal epithelial tumour. Patients with PMP experience various stressful and traumatic events including diagnosis with a rare disease, treatment with extensive and complex surgery, and long hospital stays. Currently, there is a scarcity of studies that primarily aim to assess the quality of life of patients with PMP, and there is no reviews or comprehensive understanding of the quality of life (QoL) issues faced by these patients. Even fewer studies have consulted with patients themselves. 


https://doi.org/10.1155/2024/8137209

January 2024

Theme:

Workforce & Health Systems

Ten reasons for the presence of pharmacy professionals in the intensive care unit

McKenzie   C, Spriet I, Hunfeld N


The intensive care unit (ICU) patient requires a plethora of disciplines to optimise care and clinical outcomes. Recently, the European Society of Intensive Care Medicine (ESICM) has given greater attention to ICU pharmacy professionals, i.e., the clinical pharmacist and pharmacy technician, and their integration into the ICU multidisciplinary (MDT) team. In this article, we describe ten reasons why ICU pharmacy professionals are vital for high-quality care in the ICU.


10.1007/s00134-023-07285-4

January 2024

Theme:

Workforce & Health Systems

Evaluation of the nurse-assisted eHealth intervention 'eHealth@Hospital-2-Home' on self-care by patients with heart failure and colorectal cancer post-hospital discharge: protocol for a randomised controlled trial.

Storm   M, Morken IM, Austin RC, Nordfonn O, Wathne HB, Urstad KH et al


Patients with heart failure (HF) and colorectal cancer (CRC) are prone to comorbidity, a high rate of readmission, and complex healthcare needs. Self-care for people with HF and CRC after hospitalisation can be challenging, and patients may leave the hospital unprepared to self-manage their disease at home. eHealth solutions may be a beneficial tool to engage patients in self-care.


https://doi.org/10.1186/s12913-023-10508-5

January 2024

Theme:

Long -Term Conditions

Person-centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review

Bartolomeu-Pires S, Kunkel D, Kipps C, Goodwin N, Portillo MC


People living with long-term neurological conditions (LTNCs) have complex needs that demand intensive care coordination between sectors. This review aimed to establish if integrated care improves outcomes for people, and what characterises successful interventions.


 https://doi.org/10.1111/hex.13948

January 2024

Theme:

Workforce & Health Systems

Validation of oxygen saturations measured in the community by emergency medical services as a marker of clinical deterioration in patients with confirmed COVID-19: a retrospective cohort study

Inada-Kim M, Chmiel FP, Boniface M, et al


Objectives: To evaluate oxygen saturation and vital  signs measured in the community by emergency medical  services (EMS) as clinical markers of COVID-19-positive  patient deterioration


doi: 10.1136/bmjopen-2022-067378

January 2024

Theme:

Workforce & Health Systems

The important factors nurses consider when choosing shift patterns: A cross-sectional study.

Emmanuel   T, Griffiths P, Lamas-Fernandez C, Ejebu OZ, Dall'Ora C


Aim: To gain a deeper understanding of what is important to nurses when thinking about shift patterns and the organisation of working time.


Methods: We recruited from two National Health Service Trusts and through an open call via trade union membership, online/print nursing profession magazines and social media. Worked versus preferred shift length/pattern, satisfaction and choice over shift patterns and nurses' views on aspects related to work and life (when working short, long, rotating shifts) were analysed with comparisons of proportions of agreement and crosstabulation. Qualitative responses on important factors related to shift preferences were analysed with inductive thematic analysis.


https://doi.org/10.1111/jocn.16974

December 2023

Theme:

Healthy Communities

Blood pressure measurement and adverse pregnancy outcomes: A cohort study testing blood pressure variability and alternatives to 140/90 mmHg

Wilson   MG, Bone JN, Slade LJ, Mistry HD, Singer J, Crozier SR


To examine the association with adverse pregnancy outcomes of: (1) American College of Cardiology/American Heart Association blood pressure (BP) thresholds, and (2) visit-to-visit BP variability (BPV), adjusted for BP level.


https://doi.org/10.1111/1471-0528.17724

December 2023

Theme:

COVID-19

Immunosuppressed Children and Young People, Psychosocial Wellbeing, and the COVID-19 Pandemic: a Prospective Cohort Study

Driessens   C, Mills L, Patel R, Culliford D, Gbesemete D, Lee E et al


Early on in the COVID-19 pandemic, research highlighted the impact of the pandemic on the psychosocial wellbeing of children and young people (CYP). The long-term consequences of the pandemic on clinically vulnerable CYP is  however unclear. This study aims to describe the psychosocial experiences of immunosuppressed CYP while Britain moved from the COVID-19 pandemic to epidemic.


http://dx.doi.org/10.21203/rs.3.rs-2322586/v1

December 2023

Theme:

Long -Term Conditions, Mental Health

Role of Social Prescribing Link Workers in Supporting Adults with Physical and Mental Health Long-Term Conditions: Integrative Review

Linceviciute S, Ambrosio L, Baldwin DS, Portillo MC


Social prescribing link workers interventions have been widely adopted within healthcare systems, particularly in the UK, to support a range of patients’ needs and to help improve condition management for those living with multiple long-term conditions. However, there is a lack of consistency in implementation and unclear guidance about how social prescribing link workers might address these needs, particularly in individuals living with physical and mental health long-term conditions who bear a greater burden of multifaceted everyday problems and health challenges. This review aimed to identify the existing ways in which link workers might support the needs of this group.


https://doi.org/10.1155/2023/7191247

December 2023

Theme:

Long Term Conditions

Exploring Adherence to Pelvic Floor Muscle Training in Women Using Mobile Apps: Scoping Review

Harper RC, Sheppard S, Stewart C, Clark CJ


Pelvic floor dysfunction is a public health issue, with 1 in 3 women experiencing symptoms at some point in their lifetime. The gold standard of treatment for pelvic floor dysfunction is supervised pelvic floor muscle training (PFMT); however, adherence to PFMT in women is poor. Mobile apps are increasingly being used in the National Health Service to enable equity in the distribution of health care and increase accessibility to services. However, it is unclear how PFMT mobile apps influence PFMT adherence in women.


We aimed to identify which behavior change techniques (BCTs) have been used in PFMT mobile apps, to distinguish the core "capability, opportunity, and motivation" (COM) behaviors targeted by the BCTs used in PFMT mobile apps, and to compare the levels of PFMT adherence in women between those using PFMT mobile apps and those receiving usual care.


https://doi.org/10.2196/45947

December 2023

Theme:

Healthy Communities

Causal effects of later-eating rhythm on adiposity in children through the comparison of two cohorts in the UK and China: a cross-cohort study

Zou M,   Northstone K, Leary S.


Later-eating rhythm (LER) refers to a later timing, greater energy intake, and higher meal frequency in the evening. The role of childhood LER in obesity development is emerging, but most evidence is cross-sectional. Cross-context comparison allows the improvement of causal inference in observational studies by comparing cohorts with different confounding structures. This method is applied to assess the causal effects of LER on adiposity, by exploring the likelihood of residual confounding due to socioeconomic status.


https://doi.org/10.1016/s0140-6736(23)02142-6

November 2023

Theme:

COVID-19

Impact of long COVID-19 on work: a co-produced survey

Ziauddeen   N, Pantelic M, O'Hara ME, Hastie C, Alwan NA


A proportion of people infected with SARS-CoV-2 develop post-COVID-19 condition (also known as long COVID), a predominantly multisystem condition resulting in varying degrees of functional disability limiting day-to-day activities. We aimed to describe the impact of long COVID on work.


https://doi.org/10.1016/s0140-6736(23)02157-8

November 2023

Theme:

Healthy Communities

Food insecurity and diet quality in households accessing food membership clubs in Wessex: a mixed-methods study

Taylor   E, Ziauddeen N, Alwan NA, Smith D


Food membership clubs that charge a small fee for a set number of items are in place in Wessex to address food insecurity (inadequate reliable access to sufficient affordable, nutritious food). These clubs incorporate longer-term solutions such as budgeting support, benefit maximisation, and cooking skills. The Wessex DIET project was established to measure acceptability and impact of these clubs. Given the paucity of evidence on the prevalence of food insecurity in those accessing such clubs, we aimed to quantify food insecurity and assess diet quality and wellbeing at recruitment.


https://doi.org/10.1016/s0140-6736(23)02131-1

November 2023

Theme:

Workforce & Health Systems

Reducing medication errors in adult intensive care: Current insights for nursing practice

Nixon C,   McKenzie C, Bourne RS


Intensive care unit (ICU) nurses have a pivotal role in delivering quality care for some of the sickest and most vulnerable patients in our hospitals. The direct patient care provided by ICU nurses affords a unique opportunity to influence the quality of care delivered. Delivering care that is safe is critical in the complex and dynamic environment of the ICU. Medication is the most common intervention that ICU patients receive. Medication errors (MEs) are numerous and contribute to worse ICU patient outcomes.


https://doi.org/10.1016/j.iccn.2023.103578

November 2023

Theme:

Healthy Communities

Barriers and facilitators experienced in delivering alcohol screening and brief interventions in community pharmacy: a qualitative evidence synthesis 

Smith A,   Buchanan A, Parkes J, Stone H, Tan QY, Ibrahim K


Following increases in deaths due to alcohol during the COVID-19 pandemic, there have been renewed calls to increase resources in alcohol screening and brief intervention (SBI). Research has shown that community pharmacy could be a promising setting for SBI. This review aimed to investigate the barriers and facilitators to SBI delivery in community pharmacy to inform its further development.


https://doi.org/10.1093/ijpp/riad071

November 2023

Theme:

Workforce & Health Systems

 Intravenous antimicrobial infusions: Getting it right every time, some of the time.

Kemp I,   McKenzie C


60% of the time, it works every time” stated the character Brian Fantana in the film Anchorman in (2004). In the previous issue of Intensive and Critical Care Nursing, Joan Rout and colleagues critically observed nursing practice in the preparation, double checking and administration of antimicrobials (in this case carbapenems) in the intensive care unit (ICU) and essentially asked “How well are we doing? Are we getting it right all the time, or just some of the time?” (Rout et al., 2023). The study outcomes report adherence to multiple steps that are intended to reduce the risk of errors associated with the preparation and administration of medication in the ICU. In the context of antimicrobials these processes, by design, endeavour to guarantee delivery of the correct drug at the correct dose, to the correct patient at the correct time i.e., antimicrobial stewardship.


doi:   10.1016/j.iccn.2023.103569

November 2023

Theme:

Workforce & Health Systems

Scheduled intravenous opioids.

McKenzie   C, Skrobik Y, Devlin JW


Maintaining comfort and analgesia is fundamental to providing adequate care in intensive care unit (ICU) patients. Pain assessment and its control remain the highest priorities and concerns among survivors of critical illness and their loved ones


DOI: 10.1007/s00134-023-07254-x

November 2023

Theme:

Long Term Conditions

English Validation of the Living with Long Term conditions scale

Ambrosio   L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC


Background:

The English version of the living with long term conditions (LwLTCs) scale is a comprehensive person-centred measure that evaluates the complex process of living with long term conditions.


Objectives:

To present the psychometric properties of the LwLTCs scale in an English-speaking population in people with different long term conditions.



https://doi.org/10.1093/eurpub/ckad160.811

October 2023

Theme:

Long Term Conditions

Reducing the impact of COVID-19 on physical activity and mental health 

Ambrosio   L, Faulkner J, Lambrick D, Morris J, Compton E, Portillo MC


Background:

During the COVID-19 pandemic the United Kingdom government released regular guidance on limiting the spread of COVID-19. People, including those with long term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. A consequence of these interventions was to exacerbate poor lifestyle behaviours, namely less physical activity.


Objectives:

To propose recommendations to support and sustain their physical activity of people with long term conditions during and after COVID-19 or other pandemics.


https://doi.org/10.1093/eurpub/ckad160.1570

October 2023

Theme:

Healthy Communities

The Palestinian primary ciliary dyskinesia population: first results of the diagnostic and genetic spectrum

Rumman   N, Fassad MR, Driessens C, Goggin P, Abdelrahman N, Adwan A, Albakri M,   Chopra J, Doherty R, Fashho B, Freke GM, Hasaballah A, Jackson CL, Mohamed   MA, Abu Nema R, Patel MP, Pengelly RJ, Qaaqour A, Rubbo B, Thomas NS,   Thompson J, Walker WT, Wheway G, Mitchison HM, Lucas JS.


Diagnostic testing for primary ciliary dyskinesia (PCD) started in 2013 in Palestine. We aimed to describe the diagnostic, genetic and clinical spectrum of the Palestinian PCD population.


doi:   10.1183/23120541.00714-2022.

April 2023

Theme:

Healthy Communities

 The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis

Sri   Ranjan Y, Ziauddeen N, Stuart B, Alwan NA, Cheong Y


Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis.


doi:   10.1530/RAF-22-0070

March 2023

Theme:

Healthy Communities

Ethnic differences in kidney function in childhood: the Born in Bradford Cohort Renal Study

Ziauddeen N, Jeffrey RF, Waiblinger D, Fraser SDS, Alwan NA, Yuen HM, Azad R, Mason D, Wright J, Coward RJM, Roderick PJ


Endstage kidney failure rates are higher in South Asians than in White Europeans. Low birth weight is associated with adult chronic kidney disease and is more common in South Asians. Foetal kidney size was smaller in South Asians in the Born in Bradford (BiB) birth cohort. 


As part of BiB follow up, we aimed to investigate if there were ethnic differences in kidney function and blood pressure in early childhood and whether this was different by foetal kidney size.


10.12688/wellcomeopenres.17796.1

August 2023

Theme:

Ageing & Dementia

 How can I improve cancer services for people with dementia?

Farrington   N, Richardson A, Bridges J


Tips and guidance on making cancer services


People with dementia have poorer cancer outcomes than those without, and are more likely to experience complications and poorer overall survival (McWilliams et al 2017). Few interventions are designed for older people with cancer and complex needs, such as those with dementia (Farrington et al 2022).


doi: 10.7748/cnp.21.5.22.s10

October 2023

Theme:

Healthy Communities

EXPERTS II - How are patient and caregiver participation in health and social care shaped by experienced burden of treatment and social inequalities? Protocol for a qualitative synthesis.

May CR, Chew-Graham CA, Gallacher KI, Gravenhorst KC, Mair FS, Nolte E, Richardson A


Background: The workload health and social care service users and caregivers take on, and their capacity to do this work is important. It may play a key part in shaping the implementation of innovations in health service delivery and organisation; the utilisation and satisfaction with services; and the outcomes of care. Previous research has often focused on experiences of a narrow range of long-term conditions, and on factors that shape adherence to self-care regimes.


Aims: With the aim of deriving policy and practice implications for service redesign, this evidence synthesis will extend our understanding of service user and caregiver workload and capacity by comparing how they are revealed in qualitative studies of lived experience of three kinds of illness trajectories: long-term conditions associated with significant disability (Parkinson's disease, schizophrenia); serious relapsing remitting disease (Inflammatory Bowel Disease, bipolar disorder); and rapidly progressing acute disease (brain cancer, early onset dementia).


doi: 10.7748/cnp.21.5.22.s10

October 2023

Theme:

COVID-19

COVID-19- Experiences and support needs of children and young people with Hydrocephalus and parents in the United Kingdom

Collaço N, Campion A, McNicholas R, Darlington AS


Purpose: Little is known about the impact of COVID-19 on children and young people (CYP) with hydrocephalus and their families. This study explored the experiences and support needs of CYP with hydrocephalus and parents who have a child with hydrocephalus during the COVID-19 pandemic.


Methods: CYP with hydrocephalus and parents of CYP with hydrocephalus in the United Kingdom completed an online survey with open and closed questions exploring experiences, information, support needs and decision making processes. Qualitative thematic content analysis and descriptive quantitative analyses were undertaken.


https://doi.org/10.1007/s00381-023-05980-7

May 2023

Theme:

Ageing & Dementia

Artificial intelligence for diagnostic and prognostic neuroimaging in dementia: A systematic review

Borchert RJ, Azevedo T, Badhwar A, Bernal J, Betts M, Bruffaerts R, Burkhart MC, Dewachter I, Gellersen HM, Low A, Lourida I, Machado L, Madan CR, Malpetti M, Mejia J, Michopoulou S, Muñoz-Neira C, Pepys J, Peres M, Phillips V, Ramanan S, Tamburin S, Tantiangco HM, Thakur L, Tomassini A, Vipin A, Tang E, Newby D; Deep Dementia Phenotyping (DEMON) Network; Ranson JM, Llewellyn DJ, Veldsman M, Rittman T


Introduction: Artificial intelligence (AI) and neuroimaging offer new opportunities for diagnosis and prognosis of dementia.


Methods: We systematically reviewed studies reporting AI for neuroimaging in diagnosis and/or prognosis of cognitive neurodegenerative diseases.


https://doi.org/10.1002/alz.13412

August 2023

Theme:

Ageing & Dementia

Case management for integrated care of older people with frailty in community settings

Sadler E, Khadjesari Z, Ziemann A, Sheehan KJ, Whitney J, Wilson D, Bakolis I, Sevdalis N, Sandall J, Soukup T, Corbett T, Gonçalves-Bradley DC, Walker DM


Ageing populations globally have contributed to increasing numbers of people living with frailty, which has significant implications for use of health and care services and costs. The British Geriatrics Society defines frailty as "a distinctive health state related to the ageing process in which multiple body systems gradually lose their inbuilt reserves". This leads to an increased susceptibility to adverse outcomes, such as reduced physical function, poorer quality of life, hospital admissions, and mortality. 


Case management interventions delivered in community settings are led by a health or social care professional, supported by a multidisciplinary team, and focus on the planning, provision, and co-ordination of care to meet the needs of the individual. Case management is one model of integrated care that has gained traction with policymakers to improve outcomes for populations at high risk of decline in health and well-being. These populations include older people living with frailty, who commonly have complex healthcare and social care needs but can experience poorly co-ordinated care due to fragmented care systems.


Objectives: To assess the effects of case management for integrated care of older people living with frailty compared with usual care.


https://doi.org/10.1002/14651858.cd013088.pub2

May 2023

Theme:

Ageing & Dementia

Frequency, duration, and type of physiotherapy in the week after hip fracture surgery - analysis of implications for discharge home, readmission, survival, and recovery of mobility

Almilaji O, Ayis S, Goubar A, Beaupre L, Cameron ID, Milton-Cole R, Gregson CL, Johansen A, Kristensen MT, Magaziner J, Martin FC, Sackley C, Sadler E, Smith TO, Sobolev B, Sheehan KJ


Purpose: To examine the association between physiotherapy access after hip fracture and discharge home, readmission, survival, and mobility recovery.


Methods: A 2017 Physiotherapy Hip Fracture Sprint Audit was linked to hospital records for 5383 patients. Logistic regression was used to estimate the association between physiotherapy access in the first postoperative week and discharge home, 30-day readmission post-discharge, 30-day survival and 120-days mobility recovery post-admission adjusted for age, sex, American Society of Anesthesiology grade, Hospital Frailty Risk Score and prefracture mobility/residence.


https://doi.org/10.1016/j.physio.2023.03.002

September 2023

Theme:

Ageing & Dementia

Physiotherapists' perspectives of barriers and facilitators to effective community provision after hip fracture: a qualitative study in England

Adams J,   Jones GD, Sadler E, Guerra S, Sobolev B, Sackley C, Sheehan KJ.


Purpose: to investigate physiotherapists' perspectives of effective community provision following hip fracture.


Methods: qualitative semi-structured interviews were conducted with 17 community physiotherapists across England. Thematic analysis drawing on the Theoretical Domains Framework identified barriers and facilitators to implementation of effective provision. Interviews were complemented by process mapping community provision in one London borough, to identify points of care where suggested interventions are in place and/or could be implemented.


https://doi.org/10.1093/ageing/afad130

September 2023

Theme:

Long Term Conditions

A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity

Stannard   S, Berrington A, Paranjothy S, Owen R, Fraser S, Hoyle R et al


Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity.


https://doi.org/10.1177/26335565231193951

September 2023

Theme:

Long Term Conditions

Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration

Fraser SD, Stannard S, Holland S, Boniface M, Hoyle RB, Wilkinson R et al


Most people living with multiple long-term condition multimorbidity (MLTC-M) are under 65 (defined as ‘early onset’). Earlier and greater accrual of long-term conditions (LTCs) may be influenced by the timing and nature of exposure to key risk factors, wider determinants or other LTCs at different life stages. We have established a research collaboration titled ‘MELD-B’ to understand how wider determinants, sentinel conditions (the first LTC in the lifecourse) and LTC accrual sequence affect risk of early-onset, burdensome MLTC-M, and to inform prevention interventions.


https://doi.org/10.1177/26335565231204544

September 2023

Theme:

Ageing & Dementia

What makes a multidisciplinary medication review and deprescribing intervention for older people work well in primary care?

Howard C, Sheikh C, Rutter P, Latter S, Lown M, Brad L, Fraser SDS, Bradbury K, Roberts HC, Saucedo AR, Ibrahim K


A third of older people take five or more regular medications (polypharmacy). Conducting medication reviews in primary care is key to identify and reduce/ stop inappropriate medications (deprescribing). Recent recommendations for effective deprescribing include shared-decision making and a multidisciplinary approach. Our aim was to understand when, why, and how interventions for medication review and deprescribing in primary care involving multidisciplinary teams (MDTs) work (or do not work) for older people.


https://doi.org/10.1186/s12877-023-04256-8

September 2023

Theme:

Long Term Conditions

Improving personalised care, through the development of a service evaluation tool to assess, understand and monitor delivery

Johnson L, Kirk H, Clark B, Heath S, Royse C, Adams C, Portillo MC


Systematically implementing personalised care has far reaching benefits to individuals, communities and health and social care systems. If done well, personalised care can result in better health outcomes and experiences, more efficient use of health services and reduced health inequalities. Despite these known benefits, implementation of personalised care has been slow. 


Evaluation is an important step towards achieving the ambition of universally delivered personalised care. There are currently few comprehensive assessments or tools that are designed to understand the implementation of personalised care at a service or system level, or the cultural, practical and behavioural factors influencing this. The aim of this paper is to describe the development and testing of a system-wide evaluation tool.


https://doi.org/10.1136/bmjoq-2023-002324

September 2023

Theme:

Workforce & Health Systems

Costs and cost-effectiveness of improved nurse staffing levels and skill mix in acute hospitals: A systematic review

Griffiths P, Saville C, Ball J, Dall'Ora C, Meredith P, Turner L, Jones J


Extensive research shows associations between increased nurse staffing levels, skill mix and patient outcomes. However, showing that improved staffing levels are linked to improved outcomes is not sufficient to provide a case for increasing them. This review of economic studies in acute hospitals aims to identify costs and consequences associated with different nurse staffing configurations in hospitals.


https://doi.org/10.1016/j.ijnurstu.2023.104601

September 2023

Theme:

Long Term Conditions

A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity

Stannard S, Berrington A, Paranjothy S, Owen R, Fraser S, Hoyle R, Boniface M, Wilkinson B, Akbari A, Batchelor S, Jones W, Ashworth M, Welch J, Mair FS, Alwan NA


Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity.


https://doi.org/10.1177/26335565231193951

September 2023

Theme:

Workforce & Health Systems

The Validity and Applicability of the Revised Delirium Rating Scale (DRS-R98) for Delirium Severity Assessment in a Critical Care Setting

Almuhairi ES, Badejo M, Peer A, Pitkanen M, McKenzie CA


Delirium is a neuropsychiatric syndrome common in critical illness. Worsening delirium severity is associated with poorer clinical outcomes, yet its assessment remains under-reported with most severity assessment tools not validated for critical care. The DRS-R98 is a widely applied and validated tool. The aim of this project is to report the validation and utility of the DRS-R98 in critical illness.


https://doi.org/10.1177/08850666231199986

September 2023

Theme:

Healthy Communities

Mixed methods feasibility and usability testing of a childhood obesity risk estimation tool

Grove G, Ziauddeen N, Roderick P, Vassilev I, Appleton JV, Smith D, Alwan NA


A Childhood Obesity Risk Estimation tool (SLOPE CORE) has been developed based on prediction models using routinely available maternity and early childhood data to estimate risk of childhood obesity at 4-5 years. This study aims to test the feasibility, acceptability and usability of SLOPE CORE within an enhanced health visiting (EHV) service in the UK, as one context in which this tool could be utilised.


https://doi.org/10.1186/s12889-023-16500-2

September 2023

Theme:

Healthy Communities

The interplay between social and food environments on UK adolescents' food choices: implications for policy

Shaw S, Muir S, Strömmer S, Crozier S, Cooper C, Smith D, Barker M, Vogel C


Factors from social and food environments can influence the food choices of adolescents in ways not experienced during childhood. Evidence suggests these two environments influence adolescents' food choices independently, but there is limited knowledge of how the interplay between these environments influence adolescents' diets. An enhanced understanding of this interplay surrounding adolescent food choice could aid the development of more nuanced interventions and policies. 


This qualitative study involved 13 online focus groups with adolescents (n = 45) aged 11-18 years, attending secondary school or college in England, UK. Data were analysed using thematic analysis. Social experiences which accompanied eating were perceived as more important than the food itself, and fast-food outlets were described as uniquely suited to facilitating these interactions. Young people wanted to spend their money on foods they considered worthwhile, but this did not always relate to the most affordable foods. Adolescents wanted to put little effort into making food decisions and appreciated factors that helped them make quick decisions such as prominent placement and eye-catching promotions on foods they wanted to buy. Chain food outlets were valued as they offered familiar and frequently advertised foods, which minimized the effort needed for food decisions. Adolescents' sense of autonomy underpinned all themes. 


Participants described having limited opportunities to make their own food choices and they did not want to waste these buying unappealing 'healthy' foods. Interventions and government policies should align with adolescents' experiences and values relating to food choice to ensure that they are effective with this important age group.


https://doi.org/10.1093/heapro/daad097

August 2023

Theme:

Long Term Conditions

A Parkinson care-coordinator may make a difference: A scoping review on multi-sectoral integrated care initiatives for people living with Parkinson's disease and their caregivers

Vester LB, Haahr A, Nielsen TL, Bartolomeu S, Portillo MC


Objective: To identify multi-sectoral integrated care initiatives for people with Parkinson's disease and caregivers.


Method: Following the Matrix Method we created a synthesis of literature across methodological approaches. The search was conducted in four databases until June 2022, and included studies focusing on multi-sectoral integrated care initiatives, and how they helped people with Parkinson's disease and caregivers in everyday living.


https://doi.org/10.1016/j.pec.2023.107931

August 2023

Theme:

Ageing & Dementia

Factors that influence older adults' participation in physical activity: a systematic review of qualitative studies

Meredith SJ, Cox NJ, Ibrahim K, Higson J, McNiff J, Mitchell S, Rutherford M, Wijayendran A, Shenkin SD, Kilgour AHM, Lim SER


Despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA.


https://doi.org/10.1093/ageing/afad145

August 2023

Theme:

Ageing & Dementia

Gaining access to unspoken narratives of people living with dementia on a hospital ward-A new methodology

Collins P, Bridges J, Bartlett R


This is a methodological paper that aims to advance the conceptualisation of participatory research by focusing on the value of capturing and understanding movement as a vital means of communication for older people with dementia in a general hospital ward. Qualitative research involving people with dementia tends to be word-based and reliant upon verbal fluency. This article considers a method for capturing and understanding movement as a vital means of communication.


https://doi.org/10.1002/gps.5987

August 2023

Theme:

Healthy Communities

Activity Behaviors Before and During Pregnancy Are Associated With Women's Device-Measured Physical Activity and Sedentary Time in Later Parenthood: A Longitudinal Cohort Analysis

Hesketh KR, Baird J, Crozier SR, Godfrey KM, Harvey NC, Cooper C, van Sluijs EMF


Purpose: To explore how activity behaviors before/during pregnancy relate to those in later parenthood, we assessed associations between sitting and moderate-/strenuous exercise before/during pregnancy, and sedentary time (SED) and moderate to vigorous physical activity (MVPA) 4-7 years postpartum ("later parenthood").


https://doi.org/10.1123/jpah.2022-0630

August 2023

Theme:

Long Term Conditions

Guidance and standard operating procedures for functional exercise testing in cystic fibrosis

Saynor ZL, Gruet M, McNarry MA, Button B, Morrison L, Wagner M, Sawyer A, Hebestreit H, Radtke T, Urquhart DS; European Cystic Fibrosis Society Exercise Working Group


Regular exercise testing is recommended for all people with cystic fibrosis (PwCF). A range of validated tests, which integrate both strength and aerobic function, are available and increasingly being used. Together, these tests offer the ability for comprehensive exercise evaluation. Extensive research and expert consensus over recent years has enabled the adaptation and standardisation of a range of exercise tests to aid the understanding of the pathophysiology related to exercise limitation in PwCF and has led to the development of novel exercise tests which may be applied to PwCF. 


This article provides expert, opinion-based clinical practice guidance, along with test instructions, for a selection of commonly used valid tests which have documented clinimetric properties for PwCF. Importantly, this document also highlights previously used tests that are no longer suggested for PwCF and areas where research is mandated. This collaboration, on behalf of the European Cystic Fibrosis Society Exercise Working Group, represents expert consensus by a multidisciplinary panel of physiotherapists, exercise scientists and clinicians and aims to improve global standardisation of functional exercise testing of PwCF. In short, the standardised use of a small selection of tests performed to a high standard is advocated.


https://doi.org/10.1183/16000617.0029-2023

August 2023

Theme:

Healthy Communities

Prediction of childhood overweight and obesity at age 10-11: findings from the Studying Lifecourse Obesity PrEdictors and the Born in Bradford cohorts

Ziauddeen N, Roderick PJ, Santorelli G, Alwan NA


In England, 41% of children aged 10-11 years live with overweight or obesity. Identifying children at risk of developing overweight or obesity may help target early prevention interventions. We aimed to develop and externally validate prediction models of childhood overweight and obesity at age 10-11 years using routinely collected weight and height measurements at age 4-5 years and maternal and early-life health data.


https://doi.org/10.1038/s41366-023-01356-8

August 2023

Theme:

Ageing & Dementia

Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study

Lim SER, Meredith SJ, Agnew S, Clift E, Ibrahim K, Roberts HC


Despite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs.


https://doi.org/10.1186/s12877-023-04184-7

July 2023

Theme:

COVID-19, Healthy Communities

Long Covid active case finding study protocol: A co-produced community-based pilot within the STIMULATE-ICP study (Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways)

Alwan NA, Clutterbuck D, Pantelic M, Hayer J, Fisher L, Hishmeh L, Heightman M, Allsopp G, Wootton D, Khan A, Hastie C, Jackson M, Rayner C, Brown D, Parrett E, Jones G, Smith K, Clarke R, Mcfarland S, Gabbay M, Banerjee A


Background and aim: Long Covid is a significant public health concern with potentially negative implications for health inequalities. We know that those who are already socially disadvantaged in society are more exposed to COVID-19, experience the worst health outcomes and are more likely to suffer economically. We also know that these groups are more likely to experience stigma and have negative healthcare experiences even before the pandemic. However, little is known about disadvantaged groups' experiences of Long Covid, and preliminary evidence suggests they may be under-represented in those who access formal care. We will conduct a pilot study in a defined geographical area in London, United Kingdom to test the feasibility of a community-based approach of identifying Long Covid cases that have not been clinically diagnosed and have not been referred to Long Covid specialist services. We will explore the barriers to accessing recognition, care, and support, as well as experiences of stigma and perceived discrimination.


https://doi.org/10.1371/journal.pone.0284297

July 2023

Theme:

Workforce & Health Systems

Opioid, sedative, preadmission medication and iatrogenic withdrawal risk in UK adult critically ill patients: a point prevalence study

Eadie R, McKenzie CA, Hadfield D, Kalk NJ, Bolesta S, Dempster M, McAuley DF, Blackwood B; UK ALERT-ICU study investigators


Background: Iatrogenic withdrawal syndrome, after exposure medication known to cause withdrawal is recognised, yet under described in adult intensive care.


Aim: To investigate, opioid, sedation, and preadmission medication practice in critically ill adults with focus on aspects associated with iatrogenic withdrawal syndrome.


https://doi.org/10.1007/s11096-023-01614-9

July 2023

Theme:

Long Term Conditions

First validation study of the living with long term conditions scale (LwLTCs) among English-speaking population living with Parkinson's disease

Ambrosio L, Hislop-Lennie K, Serrano-Fuentes N, Driessens C, Portillo MC


Introduction: Parkinson's disease is the second most prevalent neurodegenerative disease, affecting 10 million people worldwide. Health and social care professionals need to have personalised tools to evaluate the process of living with Parkinson's disease and consequently, plan individualised and targeted interventions. Recently, the English version of the Living with Long term conditions (LwLTCs) scale has been developed filling an important gap related to person-centred tools to evaluate the process of living with long term conditions among English-speaking population. However, no validation studies for testing its psychometric properties have been conducted.


Aim: To analyse the psychometric properties of the LwLTCs scale in a wide English-speaking population living with Parkinson's disease.


https://doi.org/10.1186/s12955-023-02154-6

July 2023

Theme:

Long Term Conditions

Physical activity and mental health experiences of people living with long term conditions during COVID-19 pandemic: A qualitative study

Ambrosio L, Morris J, Compton E, Portillo MC


Introduction: Regular physical activity is a strategy that is effective in the physical management of long term conditions. The COVID-19 pandemic, led to disruption of physical activity routines for many people with long term conditions. It is important, to understand the experiences of people with long term conditions regarding physical activity during COVID-19 to enable future identification of strategies to mitigate the impact of restrictions on health.


Objective: To explore perceptions and experiences of people with long term conditions of the impact of the UK Government physical distancing restrictions on their physical activity participation during the COVID-19 pandemic.


https://doi.org/10.1371/journal.pone.0285785

July 2023

Theme:

COVID-19

Systematic Review of the Prevalence of Long COVID

Woodrow M, Carey C, Ziauddeen N, Thomas R, Akrami A, Lutje V, Greenwood DC, Alwan NA


Long COVID occurs in those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) whose symptoms persist or develop beyond the acute phase. We conducted a systematic review to determine the prevalence of persistent symptoms, functional disability, or pathological changes in adults or children at least 12 weeks postinfection.


https://doi.org/10.1093/ofid/ofad233

July 2023

Theme:

Healthy Communities

Development of a measure of dietary quality for the UK Biobank

Montague C, D'Angelo S, Harvey N, Vogel C, Baird J


Background: Previous studies of the UK Biobank have examined intake of single food items and their association with health outcomes. Our aim was to develop a dietary quality score and examine the relationship between this score and markers of cardiometabolic health.


Methods: Principal component analysis was performed on dietary data from UK Biobank participants. Linear regression was used to analyse the relationship between diet and cardiometabolic health.


https://doi.org/10.1093/pubmed/fdad103

July 2023

Theme:

Healthy Communities

A systematic review of the effectiveness of community-based interventions aimed at improving health literacy of parents/carers of children

Belfrage SL, Husted M, Fraser S, Patel S, Faulkner JA


Aim: The aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents.

Methods: A systematic review of six databases - MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source - was conducted to identify relevant articles. Risk of bias was assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane collaboration risk of bias in non-randomised studies of interventions. The study findings were grouped and synthesised following the synthesis without meta-analysis framework.


https://doi.org/10.1177/17579139231180746

June 2023

Theme:

Long Term Conditions

A proposal to embed patient and public involvement within qualitative data collection and analysis phases of a primary care based implementation study

Moult A, McGrath C, Lippiett K, Coope C, Chilcott S, Mann C, Evans N, Turner A, Dziedzic K, Portillo MC, Johnson R


Patient and public involvement (PPI) is increasingly seen as essential to health service research. There are strong moral and ethical arguments for good quality PPI. Despite the development of guidance aimed at addressing the inconsistent reporting of PPI activities within research, little progress has been made in documenting the steps taken to undertake PPI and how it influences the direction of a study. Without this information, there are minimal opportunities to share learnings across projects and strengthen future PPI practices. The aim of this paper is to present details on the processes and activities planned to integrate PPI into the qualitative research component of a mixed-methods, multi-site study evaluating the implementation of a smart template to promote personalised primary care for patients with multiple long-term conditions.


https://doi.org/10.1186/s40900-023-00440-7

June 2023

Theme:

COVID-19

Impact of fatigue as the primary determinant of functional limitations among patients with post-COVID-19 syndrome: a cross-sectional observational study

Walker S, Goodfellow H, Pookarnjanamorakot P, Murray E, Bindman J, Blandford A, Bradbury K, Cooper B, Hamilton FL, Hurst JR, Hylton H, Linke S, Pfeffer P, Ricketts W, Robson C, Stevenson FA, Sunkersing D, Wang J, Gomes M, Henley W, Collaboration LWCR


Objectives: To describe self-reported characteristics and symptoms of treatment-seeking patients with post-COVID-19 syndrome (PCS). To assess the impact of symptoms on health-related quality of life (HRQoL) and patients' ability to work and undertake activities of daily living. 


https://doi.org/10.1136/bmjopen-2022-069217

June 2023

Theme:

Healthy Communities

Early life exposure to antibiotics and laxatives in relation to infantile atopic eczema

El-Heis S, Crozier SR, Harvey NC, Healy E, Godfrey KM


The risk of developing atopic eczema is influenced by various events pre-conception, during pregnancy, and throughout the neonatal period. Recent reports have suggested that early life exposure to microbiome altering medications, such as antibiotics and laxatives, could impact the risk of atopic eczema in infancy and childhood. For example, Lin et al., 2022, reported an increased risk of allergic disease in offspring whose mother used laxatives in pregnancy independent of laxative exposure in the offspring but no associations were found for maternal antibiotic use.


As the evidence on this topic is sparse, we aimed to examine whether maternal gestational exposure to antibiotics or laxatives were associated with the risk of atopic eczema in infancy as well as the link between offspring antibiotic exposure in the first 12 months of life and risk of infantile atopic eczema.


https://doi.org/10.1111/pai.13964

May 2023

Theme:

Workforce & Health Systems

Staffing levels and hospital mortality in England: a national panel study using routinely collected data

Rubbo B,   Saville C, Dall'Ora C, Turner L, Jones J, Ball J, Culliford D, Griffiths P


Objectives: Examine the association between multiple clinical staff levels and case-mix adjusted patient mortality in English hospitals. Most studies investigating the association between hospital staffing levels and mortality have focused on single professional groups, in particular nursing. However, single staff group studies might overestimate effects or neglect important contributions to patient safety from other staff groups.


https://doi.org/10.1136/bmjopen-2022-066702

May 2023

Theme:

Workforce & Health Systems

Antimicrobial preparation in the intensive care unit. Oh, what a waste

Pearce S, McKenzie C


In this issue of Intensive & Critical Care Nursing, David Jarrett and colleagues have published a notable study (Jarret et al., 2023). This prospective observational study elegantly describes one of the lesser appreciated challenges in administering the correct dose into our patients in the intensive care unit (ICU)


https://doi.org/10.1016/j.iccn.2023.103445

May 2023

Theme:

Long Term Conditions

 Filling the gap in service provision. Partners as family carers to people with Parkinson's disease: A Scandinavian perspective

Hjelle   EG, Rønn-Smidt H, Haahr A, Haavaag SB, Sørensen D, Navarta-Sánchez MV,   Portillo MC, Bragstad LK


Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson`s disease (PD) in Denmark and Norway.


http://10.1177/17423953231174470

May 2023

Theme:

Workforce & Health Systems

 Shift work characteristics and burnout among nurses: cross-sectional survey

Dall'Ora   C, Ejebu OZ, Ball J, Griffiths P


Background: Nurses working long shifts (≥12 h) experience higher levels of burnout. Yet other shift characteristics, including fixed versus rotating night work, weekly hours and breaks have not been considered. Choice over shift length may moderate the relationship; however, this has not been tested.

Aims: To examine the association between shift work characteristics and burnout and exhaustion, and whether choice over shift length influences burnout and exhaustion.


https://doi.org/10.1093/occmed/kqad046

May 2023

Theme:

Workforce & Health Systems

Precision-Based Approaches to Delirium in Critical Illness: A Narrative Review

Ankravs  MJ, McKenzie CA, Kenes MT


Delirium occurs in critical illness and is associated with poor clinical outcomes, having a longstanding impact on survivors. Understanding the complexity of delirium in critical illness and its deleterious outcome has expanded since early reports. Delirium is a culmination of predisposing and precipitating risk factors that result in a transition to delirium. Known risks range from advanced age, frailty, medication exposure or withdrawal, sedation depth, and sepsis. Because of its multifactorial nature, different clinical phenotypes, and potential neurobiological causes, a precise approach to reducing delirium in critical illness requires a broad understanding of its complexity. Refinement in the categorization of delirium subtypes or phenotypes (i.e., psychomotor classifications) requires attention. Recent advances in the association of clinical phenotypes with clinical outcomes expand our understanding and highlight potentially modifiable targets. Several delirium biomarkers in critical care have been examined, with disrupted functional connectivity being precise in detecting delirium. Recent advances reinforce delirium as an acute, and partially modifiable, brain dysfunction, and place emphasis on the importance of mechanistic pathways including cholinergic activity and glucose metabolism. Pharmacologic agents have been assessed in randomized controlled prevention and treatment trials, with a disappointing lack of efficacy. Antipsychotics remain widely used after "negative" trials, yet may have a role in specific subtypes. However, antipsychotics do not appear to improve clinical outcomes. Alpha-2 agonists perhaps hold greater potential for current use and future investigation. The role of thiamine appears promising, yet requires evidence. Looking forward, clinical pharmacists should prioritize the mitigation of predisposing and precipitating risk factors as able. Future research is needed within individual delirium psychomotor subtypes and clinical phenotypes to identify modifiable targets that hold the potential to improve not only delirium duration and severity, but long-term outcomes including cognitive impairment.


https://doi.org/10.1002/phar.2807

May 2023

Theme:

Healthy Communities

Influences of the community and consumer nutrition environment on the food purchases and dietary behaviors of adolescents: A systematic review

Shaw S,   Barrett M, Shand C, Cooper C, Crozier S, Smith D, Barker M, Vogel C


Adolescence is a period of increased autonomy over decision-making, including food choices, and increased exposure to influences outside the home, including the food environment. This review aims to synthesize the evidence for the influence of community nutrition environments, spatial access to food outlets, and consumer nutrition environments, environments inside food outlets, on adolescent food purchasing and dietary behaviors in high-income countries. Six databases were searched for articles published before January 2023. Results were synthesized using a vote-counting technique and effect direction plots that record the direction of the effect in relation to the anticipated relationship with health. Thirty-four observational and two intervention studies met the inclusion criteria. In the 13 studies assessing adolescent exposure to healthy community nutrition environments, results did not show clear associations with dietary and purchasing outcomes. Thirty studies assessed adolescents' exposure to unhealthy community nutrition environments with the majority (n = 17/30, 57%) reporting results showing that greater exposure to food outlets classified as unhealthy was associated with less healthy food purchases and dietary intakes. Inconsistent results were observed across the seven studies investigating associations with the consumer environment. Further research in these areas, including more high-quality intervention studies, may help to develop policy strategies to improve adolescents' dietary behaviors.


https://doi.org/10.1111/obr.13569

Theme:

Workforce & Health Systems

Micronutrient use in critical care

Cameron   LK, Lumlertgul N, Bear DE, Cooney E, McKenzie C, Ostermann M


Micronutrients, principally vitamins and minerals, play an important role both in health and in disease. Parenteral micronutrient products are commonly prescribed for critically ill patients both in line with the terms of the product's license, and for other indications where there is an underpinning physiological rationale, or precedent, for their use but little evidence. This survey sought to understand United Kingdom (UK) prescribing practice in this area.


https://doi.org/10.1016/j.clnesp.2023.03.023

Theme:

Workforce & Health Systems

The association between multi-disciplinary staffing levels and mortality in acute hospitals: a systematic review

Dall’Ora, C., Rubbo, B., Saville, C. et al. The association between multi-disciplinary staffing levels and mortality in acute hospitals: a systematic review. Hum Resour Health 21, 30 (2023). https://doi.org/10.1186/s12960-023-00817-5


Published: 20 April 2023

DOI https://doi.org/10.1186/s12960-023-00817-5


Objectives

Health systems worldwide are faced with the challenge of adequately staffing their hospital services. Much of the current research and subsequent policy has been focusing on nurse staffing and minimum ratios to ensure quality and safety of patient care. Nonetheless, nurses are not the only profession who interact with patients, and, therefore, not the only professional group who has the potential to influence the outcomes of patients while in hospital. We aimed to synthesise the evidence on the relationship between multi-disciplinary staffing levels in hospital including nursing, medical and allied health professionals and the risk of death.

Theme:

Healthy Communities

Exploring the associations between number of children, multi-partner fertility and risk of obesity at midlife: Findings from the 1970 British Cohort Study (BCS70)

Article Source: Exploring the associations between number of children, multi-partner fertility and risk of obesity at midlife: Findings from the 1970 British Cohort Study (BCS70)
Stannard S, Berrington A, Alwan NA (2023) Exploring the associations between number of children, multi-partner fertility


Background

Early parenthood, high parity, and partnership separation are associated with obesity. However, the emergence of non-marital partnerships, serial partnering and childbearing across unions, means that it is important to consider their association to obesity. This paper examined the associations between number of biological children and multi-partner fertility (MPF)—defined as having biological children with more than one partner, with obesity at midlife

Theme:

Healthy Communities

The role of social networks in the self-management support for young women recently diagnosed with breast cancer

Article Source: The role of social networks in the self-management support for young women recently diagnosed with breast cancer
Vassilev I, Lin SX, Calman L, Turner J, Frankland J, et al. (2023) The role of social networks in the self-management support for young women recently diagnosed with breast cancer. PLOS ONE 18(4): e0282183. https://doi.org/10.1371/journal.pone.0282183


It is widely acknowledged that social network support plays an important role in the quality of life and illness management of breast cancer survivors. However, the factors and processes that enable and sustain such support are less well understood. 


This paper reports baseline findings from a prospective UK national cohort of 1,202 women with breast cancer (aged <50 years at diagnosis), recruited before starting treatment, conducted in 2016–2019. Descriptive, univariate and multivariate regression analyses explored associations between the individual, and network member characteristics, and the type of support provided. 


Social network members provided a substantial level of illness-related, practical and emotional support. Highest contribution was provided by friends, followed by close family members. The social network members of women who did not have a partner provided a higher level of support than those in networks with a partner. Women without higher education were more reliant on close family members than those with higher education, and this was more so for women without a partner. 


Women with higher education without a partner were more reliant on friends and were overall best supported. Women without higher education who did not have a partner were overall least well supported. They had much smaller networks, were highly reliant on close family members, and on high level contributions from all network members. 


There is a need to develop network-based interventions to support people with a cancer diagnosis, prioritising support for the groups identified as most at risk. Interventions that support engagement with existing network members during treatment, and those that help extend such networks after treatment, are likely to be of benefit. A network perspective can help to develop tailored support and interventions by recognising the interactions between network and individual level processes

Theme:

Workforce & Health Systems

The association between multi-disciplinary staffing levels and mortality in acute hospitals: a systematic review

Dall’Ora, C., Rubbo, B., Saville, C. et al. The association between multi-disciplinary staffing levels and mortality in acute hospitals: a systematic review. Hum Resour Health21, 30 (2023). https://doi.org/10.1186/s12960-023-00817-5


Abstract

Objectives

Health systems worldwide are faced with the challenge of adequately staffing their hospital services. Much of the current research and subsequent policy has been focusing on nurse staffing and minimum ratios to ensure quality and safety of patient care. Nonetheless, nurses are not the only profession who interact with patients, and, therefore, not the only professional group who has the potential to influence the outcomes of patients while in hospital. We aimed to synthesise the evidence on the relationship between multi-disciplinary staffing levels in hospital including nursing, medical and allied health professionals and the risk of death.


Methods

Systematic review. We searched Embase, Medline, CINAHL, and the Cochrane Library for quantitative or mixed methods studies with a quantitative component exploring the association between multi-disciplinary hospital staffing levels and mortality.


Results

We included 12 studies. Hospitals with more physicians and registered nurses had lower mortality rates. Higher levels of nursing assistants were associated with higher patient mortality. Only two studies included other health professionals, providing scant evidence about their effect.


Conclusions

Pathways for allied health professionals such as physiotherapists, occupational therapists, dietitians, pharmacists, to impact safety and other patient outcomes are plausible and should be explored in future studies.


https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-023-00817-5

Theme:

Ageing & Dementia

‘A real fine balancing act’: A secondary qualitative analysis of power imbalance in comorbid cancer and dementia in an outpatient treatment setting

Farrington, N.,  Richardson, A., &  Bridges, J. (March 2023).


Aims
Studies of health services reveal a focus on provision of scheduled care at the expense of patient need, placing the health service in a position of power and the patient as passive recipient. This secondary qualitative analysis of a focused ethnography draws on the Foucauldian concept of power as pervasive and relational, to examine how an imbalance of power is manifested in situations where people with both cancer and dementia are being treated for cancer.


Design
Secondary qualitative analysis of a focused ethnographic study.


Data Sources
In the original study, qualitative data were gathered from observation and interviews with people with cancer and dementia (n = 2), caregivers (n = 7) and staff (n = 20). The study was conducted in the outpatient departments of two teaching hospitals in England between January 2019 and July 2021. Data from all sources were analysed for this secondary analysis using constant comparison.


Results
The principal theme was balance, encapsulating the competing priorities involved in delivering cancer treatment. There was tension between maintaining safety and ensuring an individual's right to treatment, and difficulty reconciling the needs of the system with the needs of individuals.


Conclusion
The pervasive nature of power can be harnessed to enhance the agency of people with cancer and dementia by incorporating principles of shared decision making.


https://doi.org/10.1111/jan.15629

Theme:

Long Term Conditions, Ageing & Dementia

The Causes and Impact of Crisis for People with Parkinson's Disease: A Patient and Carer Perspective

Fearn S, Bartolomeu Pires S, Agarwal V, Roberts HC, Spreadbury J, Kipps C.


21 June 2021


Background: The reasons for acute hospital admissions among people with Parkinson's disease are well documented. However, understanding of crises that are managed in the community is comparatively lacking. Most existing literature on the causes of crisis for people with Parkinson's disease (PwP) uses hospital data and excludes the individual's own perspective on the crisis trigger and the impact of the crisis on their care needs.


Objective: To identify the causes and impact of crises in both community and hospital settings, from a patient and carer perspective.


Methods: A total of 550 UK-based PwP and carers completed a survey on (a) their own personal experiences of crisis, and (b) their general awareness of potential crisis triggers for PwP.


Results: In addition to well-recognised causes of crisis such as falls, events less widely associated with crisis were identified, including difficulties with activities of daily living and carer absence. The less-recognised crisis triggers tended to be managed more frequently in the community. Many of these community-based crises had a greater impact on care needs than the better-known causes of crisis that more frequently required hospital care. PwP and carer responses indicated a good general knowledge of potential crisis triggers. PwP were more aware of mental health issues and carers were more aware of cognitive impairment and issues with medications.


Conclusion: These findings could improve care of Parkinson's by increasing understanding of crisis events from the patient and carer perspective, identifying under-recognised crisis triggers, and informing strategies for best recording symptoms from PwP and carers.


https://pubmed.ncbi.nlm.nih.gov/34250952/

Theme:

Long Term Conditions

What are the modifiable factors of treatment burden and capacity among people with Parkinson’s disease and their caregivers: A qualitative study

Qian Yue Tan , Helen C. Roberts, Simon D. S. Fraser, Khaled Amar, Kinda Ibrahim


March 30, 2023

Background

People with long-term conditions must complete many healthcare tasks such as take medications, attend appointments, and change their lifestyle. This treatment burden and ability to manage it (capacity) is not well-researched in Parkinson’s disease.

Objective

To explore and identify potentially modifiable factors contributing to treatment burden and capacity in people with Parkinson’s disease and caregivers.

Methods

Semi-structured interviews with nine people with Parkinson’s disease and eight caregivers recruited from Parkinson’s disease clinics in England (ages 59–84 years, duration of Parkinson’s disease diagnosis 1–17 years, Hoehn and Yahr (severity of Parkinson’s disease) stages 1–4) were conducted. Interviews were recorded and analyzed thematically.

Results

Four themes of treatment burden with modifiable factors were identified: 1) Challenges with appointments and healthcare access: organizing appointments, seeking help and advice, interactions with healthcare professionals, and caregiver role during appointments; 2) Issues obtaining satisfactory information: sourcing and understanding information, and satisfaction with information provision; 3) Managing medications: getting prescriptions right, organizing polypharmacy, and autonomy to adjust treatments; and 4) Lifestyle changes: exercise, dietary changes, and financial expenses. Aspects of capacity included access to car and technology, health literacy, financial capacity, physical and mental ability, personal attributes and life circumstances, and support from social networks.

Conclusions

There are potentially modifiable factors of treatment burden including addressing the frequency of appointments, improving healthcare interactions and continuity of care, improving health literacy and information provision, and reducing polypharmacy. Some changes could be implemented at individual and system levels to reduce treatment burden for people with Parkinson’s and their caregivers. Recognition of these by healthcare professionals and adopting a patient-centered approach may improve health outcomes in Parkinson’s disease.

Theme:

Healthy Communities

Childhood overweight and obesity at the start of primary school: External validation of pregnancy and early-life prediction models

Nida Ziauddeen,, Paul J. Roderick, Gillian Santorelli, John Wright, Nisreen A. Alwan


June 2022


Abstract

Tackling the childhood obesity epidemic can potentially be facilitated by risk-stratifying families at an early-stage to receive prevention interventions and extra support. Using data from the Born in Bradford (BiB) cohort, this analysis aimed to externally validate prediction models for childhood overweight and obesity developed as part of the Studying Lifecourse Obesity PrEdictors (SLOPE) study in Hampshire. BiB is a longitudinal multi-ethnic birth cohort study which recruited women at around 28 weeks gestation between 2007 and 2010 in Bradford. The outcome was body mass index (BMI) ≥91st centile for overweight/obesity at 4–5 years. Discrimination was assessed using the area under the receiver operating curve (AUC). Calibration was assessed for each tenth of predicted risk by calculating the ratio of predicted to observed risk and plotting observed proportions versus predicted probabilities. Data were available for 8003 children. The AUC on external validation was comparable to that on development at all stages (early pregnancy, birth, ~1 year and ~2 years). The AUC on external validation ranged between 0.64 (95% confidence interval (CI) 0.62 to 0.66) at early pregnancy and 0.82 (95% CI 0.81 to 0.84) at ~2 years compared to 0.66 (95% CI 0.65 to 0.67) and 0.83 (95% CI 0.82 to 0.84) on model development in SLOPE. Calibration was better in the later model stages (early life ~1 year and ~2 years). The SLOPE models developed for predicting childhood overweight and obesity risk performed well on external validation in a UK birth cohort with a different geographical location and ethnic composition.


https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000258

Theme:

Healthy Communities

Parent-Offspring Associations in Body Composition: Findings From the Southampton Women's Survey Prospective Cohort Study

Moon RJ, D'Angelo S, Holroyd CR, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC.


Context: Children born to parents who are overweight or obese have a high risk of adult obesity, but it is unclear if transgenerational associations relating to unfavorable body composition differ by parent.


Objective: To examine differential mother-offspring and father-offspring associations in body composition in early childhood.


Methods: A total of 240 mother-father-offspring trios from a prospective UK population-based pre-birth cohort (Southampton Women's Survey) were included for anthropometry and dual-energy x-ray absorptiometry assessment of whole-body-less-head body composition in the offspring at 3 different ages (4, 6-7, and 8-9 years) and in the mother and father at the 8- to 9-year offspring visit. Associations were assessed using linear regression adjusting for the other parent.


Results: Positive associations between mother-daughter body mass index (BMI) and fat mass were observed at ages 6 to 7 (BMI: β = .29 SD/SD, 95% CI = .10, .48; fat mass β = .27 SD/SD, 95% CI = .05, .48) and 8 to 9 years (BMI: β = .33 SD/SD, 95% CI = .13, .54; fat mass β = .31 SD/SD, 95% CI = .12, .49), with similar associations at age 4 years but bounding the 95% CI. The mother-son, father-son, and father-daughter associations for BMI and fat mass were weaker at each of the ages studied.


Conclusion: A strong association between the fat mass of mothers and their daughters but not their sons was observed. In contrast, father-offspring body composition associations were not evident. The dimorphic parent-offspring effects suggest particular attention should be given to early prevention of unfavorable body composition in girls born to mothers with excess adiposity.

Theme:

Healthy Communities, COVID-19, Mental Health

Psychological distress experienced by parents caring for an immunosuppressed child during the COVID-19 pandemic

Corine Driessens, Lynne Mills, Ravin Patel, David Culliford, Diane Gbesemete, Emma Lee, Meera Shaunak, Harry Chappell, Saul N. Faust, Hans de Graaf,


Abstract: The COVID-19 pandemic has proved unique in both its unpredictability and the extent to which it has continued to impact on daily life since March 2020. Among the immunosuppressed population the challenges of the COVID-19 pandemic are cumulative to the ever-present challenges of living with a long-term condition. This prospective longitudinal study explored patterns of concern experienced by 467 British parents caring for an immunosuppressed child during the first 2 years of the COVID-19 pandemic and related this to parental mental wellbeing. Most parents slowly adapted or were resilient to the ever-changing stressors of the COVID-19 pandemic. However, 12% experienced high levels of concern throughout the first 2 years of the pandemic. This group was also more likely to report emotional mental health problems towards the end of this period. The experience of emotional mental health problems among parents caring for an immunosuppressed child was related to low household income, single parenting, difficult access to greenspace, and higher level of exposure to COVID positive cases and COVID restrictions (North of England). Parents reported that optimism, reduction of isolation, and support promoted coping and management of the challenges of the COVID-19 pandemic. More reliable COVID information and periodic medical-condition-specific guidance would have been appreciated. These findings can increase clinical awareness of high-risk parental groups and make an important contribution to the planning of appropriate targeted psychological family interventions.

Theme:

Long Term Conditions

Accessibility and applicability of physical activity guidelines and recommendations for adults living with long term conditions during COVID-19

L Ambrosioa , D Lambrickb , J Faulknerc , and MC Portilloa

a NIHR ARC Wessex. Health and Life Sciences, University of Southampton, Southampton, UK

b School of Health Sciences, University of Southampton, Southampton, UK

c Department of Sport, Exercise and Health, University of Winchester, Winchester, UK

(April 2022)


ABSTRACT


To review the applicability and accessibility of physical activity guidelines for adults living with long-term conditions whilst shielding during the COVID-19. A narrative review with systematic methodology was conducted between 2015 and 2021, with two stages: 1) Search of electronic databases PubMed/Medline, Web of Science, PsycInfo, and Cinahl; 2) search of long-term condition organisations. Sixty-five articles were identified, where nine included specific guidelines during the COVID-19, 28 specific guidelines to individuals living with long-term conditions and 7 identified the utilization of online resources. Twenty-one long-term condition organizations websites were reviewed where all of them included a section regarding physical activity guidelines and seven referred to online and offline accessible resources during COVID-19. Accessibility and applicability were variable across academic databases and long-term conditions organisation websites. Findings could inform long-term condition policy and guidelines development to better and more relevant support people living with long-term conditions to be physically active.


External web link - https://doi.org/10.1080/09603123.2022.2066071

Theme:

Healthy Communities

Understanding the early life mediators behind the intergenerational transmission of partnership dissolution

Sebastian Stannard, Ann Berrington, Nisreen A. Alwan.

June 2022


Abstract: Whilst research has demonstrated an intergenerational transmission of partnership dissolution, there is limited evidence as to the early life course pathways through which these associations operate, and whether these differ by gender. Many studies have not considered prospective data from early childhood, thus potentially neglecting the importance of the early childhood period in explaining this intergenerational transmission. Given that serial partnering has become increasingly commonplace it is important research considers those who experience multiple partnership dissolution. This paper examines, using data from the 1970 British Birth Cohort Study, the early life mediators underpinning the association between parental separation and the number of offspring partnership dissolutions. Among both men and women there is a significant unadjusted relationship between parental separation and the experience of multiple partnership dissolutions in adulthood. These associations were reduced once parental confounders and childhood mediators are included. Formal mediation analyses demonstrated that early life mediators accounted for more of the association in men than women. Mediators included childhood living standards, and for men child cognition and child behaviour, and for women maternal mental wellbeing. Parental separation and many early life mediators were related to the likelihood of multiple partnership dissolutions through age at first partnership.


External web link - https://www.sciencedirect.com/science/article/pii/S1040260822000089?via%3Dihub#sec0045

Theme:

Healthy Communities

Inequalities in energy drink consumption among UK adolescents: a mixed-methods study

Authors: Vogel C, Shaw S, Strömmer S, Crozier S, Jenner S, Cooper C, Baird J, Inskip H, Barker M.

6 December 2022


Abstract


Objective: To examine energy drink consumption among adolescents in the United Kingdom (UK) and associations with deprivation and dietary inequalities.


Design: Quantitative dietary and demographic data from the National Diet and Nutrition Survey (NDNS) repeated cross-sectional survey were analysed using logistic regression models. Qualitative data from semi-structured interviews were analysed using inductive thematic analysis.


Setting: UK.


Participants: Quantitative data: nationally representative sample of 2587 adolescents aged 11-18 years. Qualitative data: 20 parents, 9 teachers, and 28 adolescents from Hampshire, UK.


Results: NDNS data showed adolescents' consumption of energy drinks was associated with poorer dietary quality (OR 0.46 per SD; 95% CI 0.37, 0.58; p<0.001). Adolescents from more deprived areas and lower income households were more likely to consume energy drinks than those in more affluent areas and households (OR 1.40; 95%CI 1.16, 1.69; p<0.001; OR 0.98 per £1000; 95%CI, 0.96, 0.99; p<0.001 respectively). Between 2008 and 2016, energy drink consumption among adolescents living in the most deprived areas increased, but decreased among those living in the most affluent neighbourhoods (p=0.04). Qualitative data identified three themes. First, many adolescents drink energy drinks because of their friends and because the unbranded drinks are cheap. Second, energy drink consumption clusters with other unhealthy eating behaviours and adolescents don't know why energy drinks are unhealthy. Third, adolescents believe voluntary bans in retail outlets and schools do not work.


Conclusions: This study supports the introduction of age-dependent legal restrictions on the sale of energy drinks which may help curb existing socio-economic disparities in adolescents' energy drink intake.

 

External web link - https://pubmed.ncbi.nlm.nih.gov/36472075/#affiliation-1

Theme:

Healthy Communities

UK government’s new placement legislation is a ‘good first step’: a rapid qualitative analysis of consumer, business, enforcement and health stakeholder perspectives

Sarah Muir, Preeti Dhuria, Emma Roe, Wendy Lawrence, Janis Baird & Christina Vogel


January 26.2023


Background

The current food system in England promotes a population diet that is high in fat, sugar and salt (HFSS). To address this, the UK government has implemented legislation to restrict the promotion of HFSS products in prominent locations (e.g. store entrances, checkouts) in qualifying retailers since October 2022. This study investigated the perceived impact of the legislation for affected stakeholders.


Methods

A pre-implementation rapid qualitative evaluation of stakeholder interviews. One hundred eight UK stakeholders participated in the study including 34 consumers, 24 manufacturers and retailers, 22 local authority enforcement officers and 28 academic and charitable health representatives. A participatory conference was used to enable policy recommendations to be confirmed by stakeholders.


Results

Stakeholders perceived the legislation to be a ‘good first step’ towards improving population diet but recognised this needed to be considered amongst a range of long-term obesity policies. Areas of further support were identified and these are presented as six recommendations for government to support the successful implementation of the legislation: (1) provide a free central HFSS calculator, (2) refine legislation to enhance intent and clarity, (3) conduct a robust evaluation to assess intended and unintended outcomes, (4) provide greater support for smaller businesses, (5) provide ring-fenced resources to local authorities and (6) create and communicate a long-term roadmap for food and health.


Conclusions

This legislation has the potential to reduce impulse HFSS purchases and makes a solid start towards creating healthier retail outlets for consumers. Immediate government actions to create a freely accessible HFSS calculator, support smaller businesses and provide additional resources to local authorities would support successful implementation and enforcement. Independent evaluation of the implementation of the legislation will enable monitoring of potential unintended consequences identified in this study and support refinement of the legislation. A long-term roadmap is necessary to outline strategies to support equal access to healthier and sustainable food across the whole food system within the next 20–30 years.


External web link - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02726-9


 

Theme:

Ageing & Dementia

The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies

Qian Yue Tan, Natalie J Cox, Stephen E R Lim, Laura Coutts , Simon D S Fraser, Helen C Roberts, Kinda Ibrahim

(July 2021)

Abstract

BackgroundHigh treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson's disease can offer insights into strategies to mitigate them.ObjectiveTo explore the experiences of treatment burden among people with Parkinson's disease (PwP) and their caregivers.MethodsA systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson's disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis.Results1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson's disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers.Conclusion:There are potential strategies to improve the treatment burden in Parkinson's disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson's disease.


External web link - https://pubmed.ncbi.nlm.nih.gov/34334419/

Theme:

Ageing & Dementia

Older individual's perceptions of appetite, its loss, influencing factors and adaptions to poor appetite. A qualitative study

Natalie J Cox, Leanne Morrison , Sian M Robinson , Helen C Roberts , Kinda Ibrahim

 

(December 2021)


Abstract

Appetite loss in later life is common and associated with malnutrition; however, there is limited knowledge on older individuals' perspectives of appetite. This study aimed to explore what 'appetite' means to older adults, how they experience its change and perceived influences on this experience. Semi-structured interviews were conducted with thirteen participants, aged ≥65 years, in their own home, following a recent arm fracture. Transcripts were analysed using reflexive thematic analysis with inductive coding resulting in three themes. 1. 'Appetite as an emotional experience' encompassed positive or negative thoughts and feelings driving or undermining desire to eat. Mood, the appeal of food, cooking and effects of interaction and experiences with other people were factors in this narrative. 2. 'Appetite reflects a physical need' comprised physical bodily sensations or requirements as a driver for appetite with poor appetite resulting from early or over fullness. Declines with age, illness and less activity, were factors in this narrative. 3. 'Adaption to poor appetite aligns with perception of appetite and wider physical health' accounts for how experiential strategies, or practical strategies were used to mitigate poor appetite depending on the narrative of appetite loss, alongside perceptions of physical health and unplanned weight loss. Most individuals used one narrative in their discussions and reflections but for some, perceptions of appetite and its change were more complex. Understanding relationships between these perceptions of appetite and influential factors could facilitate development of multi-component, person-centred, strategies that are optimally meaningful and relevant to address appetite loss in later life.


External web link - https://pubmed.ncbi.nlm.nih.gov/34311002/

Theme:

Ageing & Dementia

Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis

Konstantinos Prokopidis,  Panagiotis Giannos,  Jean Yves Reginster,  Olivier Bruyere, Mirko Petrovic,  Antonio Cherubini,  Konstantinos K. Triantafyllidis,  Konstantinos S. Kechagias,  Yannis Dionyssiotis,  Matteo Cesari,  Kinda Ibrahim,  David Scott,  Mario Barbagallo,  Nicola Veronese,  Special interest group in Systematic Reviews and Meta-analyses and the Task Force on Pharmaceutical Strategy of the European Geriatric Medicine Society (EuGMS) February 13 2023

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