Publications
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.
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.
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.
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.
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:
General publications
Enablers and barriers to progressing a clinical academic career in nursing, midwifery and allied health professions: A cross‐sectional survey
Theme:
General publications
How everyday objects can improve quality of life for people with dementia
Theme:
General publications
Making digital health accessible to all: An interview with Dr Sarah Fearn and Dr Alexandra Young
Theme:
General publications
Ten top tips for Frailty for General Practice
Theme:
General publications
Creating pre-conditions for change in clinical practice: the influence of interactions between multiple contexts and human agency
Theme:
General publications
Primary care risk stratification in COPD using routinely collected data: a secondary data analysis
Theme:
General publications
COVID-19: experiences of lockdown and support needs in children and young adults with kidney conditions
Theme:
General publications
Evaluating the impact of a polypharmacy Action Learning Sets tool on healthcare practitioners’ confidence, perceptions and experiences of stopping inappropriate medicines
Theme:
Workforce & Health Systems
Ward staffing guided by a patient classification system: A multi-criteria analysis of “fit” in three acute hospitals
Theme:
Workforce & Health Systems
How long do nursing staff take to measure and record patients’ vital signs observations in hospital? A time-and-motion study
Theme:
Workforce & Health Systems
Guidance to support nurses’ psychological well-being during Covid-19 crisis.
Theme:
Workforce & Health Systems
Supporting patient access to medicines in community palliative care: on-line survey of health professionals’ practice, perceived effectiveness and influencing factors
Theme:
Workforce & Health Systems
The association between ward staffing levels, mortality and hospital readmission in older hospitalised adults, according to presence of cognitive impairment: a retrospective cohort study
Theme:
Workforce & Health Systems
The influence of personal communities in understanding avoidable emergency department attendance: qualitative study
Theme:
Workforce & Health Systems
Older people's experiences in acute care settings: systematic review and synthesis of qualitative studies
Theme:
Workforce & Health Systems
Patient involvement in pressure ulcer prevention and adherence to prevention strategies: An integrative review
Theme:
Workforce & Health Systems
Cognitive impairment is associated with an increased risk of adverse outcomes in hospitalised older people with an unscheduled admission, by increasing hospital mortality, extending hospital stays and increasing frequency of readmissions.
Theme:
Workforce & Health Systems
Beyond ratios - flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation and economic modelling study
Theme:
Workforce & Health Systems
Nurses’ experiences and preferences around shift patterns: A scoping review
Theme:
Workforce & Health Systems
A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions
Theme:
Workforce & Health Systems
The association between midwifery staffing levels and the experiences of mothers on postnatal wards: Cross sectional analysis of routine data
Theme:
Workforce & Health Systems
The impact of COVID-19 on nurses (ICON) survey: Nurses' accounts of what would have helped to improve their working lives
Theme:
Long Term Conditions
A novel exploration of the support needs of people initiating insulin pump therapy using a social network approach: a longitudinal mixed‐methods study
Theme:
Long Term Conditions
A randomised controlled feasibility trial of E-health application supported care vs usual care after exacerbation of COPD: the RESCUE trial
Theme:
Long Term Conditions
Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity
Theme:
Long Term Conditions
Self-management in older people living with cancer and multi-morbidity: A systematic review and synthesis of qualitative studies
Theme:
Long Term Conditions
Mediating engagement in a social network intervention for people living with a long-term condition: A qualitative study of the role of facilitation.
Theme:
Long Term Conditions
A systematic review of the evidence for deprescribing interventions among older people living with frailty
Theme:
Long Term Conditions
Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials
Theme:
Long Term Conditions
Characterising risk of non-steroidal anti-inflammatory drug-related acute kidney injury: a retrospective cohort study
Theme:
Long Term Conditions
Digital tools to support the maintenance of physical activity in people with long-term conditions: A scoping review
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
External web link - https://doi.org/10.1080/09603123.2022.2066071
Theme:
Long Term Conditions
SYMptoms in chronic heart failure imPACT on burden of treatment (SYMPACT): a cross-sectional survey
Theme:
Long Term Conditions
Change in treatment burden among people with multimorbidity: a follow-up survey
Theme:
Long Term Conditions
The influence of social relationships and activities on the health of adults with obesity: A qualitative study
Theme:
Long Term Conditions
Early-onset burdensome multimorbidity: an exploratory analysis of sentinel conditions, condition accrual sequence and duration of three long-term conditions using the 1970 British Cohort Study
Theme:
Long Term Conditions
Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study
Theme:
Healthy Communities
Adult diet in England: Where is more support needed to achieve dietary recommendations?
Theme:
Healthy Communities
Implementing a social network intervention: can the context for its workability be created? A quasiethnographic study
Theme:
Healthy Communities
Public attitudes to a human challenge study with SARS-CoV-2: a mixed-methods study
Theme:
Healthy Communities
Understanding the early life mediators behind the intergenerational transmission of partnership dissolution
Theme:
Healthy Communities
Inequalities in energy drink consumption among UK adolescents: a mixed-methods study
Theme:
Healthy Communities
Household food insecurity risk indices for English neighbourhoods: Measures to support local policy decisions
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
Theme:
Ageing & Dementia
Implementing grip strength assessment in hip fracture patients: a feasibility project.
Theme:
Ageing & Dementia
The composition of the gut microbiome differs among community dwelling older people with good and poor appetite.
Theme:
Ageing & Dementia
Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials
Theme:
Ageing & Dementia
Recommendations for the management of COVID-19 pandemic in long-term care facilities.
Theme:
Ageing & Dementia
Clinical Nurse Specialist Role in Young Onset Dementia Care.
Theme:
Ageing & Dementia
Association between Quality of Interactions Schedule ratings and care experiences of people with a dementia in general hospital settings: a validation study.
Theme:
Ageing & Dementia
Planning and optimising CHAT&PLAN: a conversation-based intervention to promote person-centred care for older people living with multimorbidity.
Theme:
Ageing & Dementia
Can probiotics, prebiotics and synbiotics improve functional outcomes for older people: a systematic review.
Theme:
Ageing & Dementia
Future Impact of dementia within an ageing population; simulation modelling of prevalence, outcomes and costs of dementia within the Wessex region.
Theme:
Ageing & Dementia
The impact of regional 99mTc-HMPAO singlephoton-emission computed tomography (SPECT) imaging on clinician diagnostic confidence in a mixed cognitive impairment sample.
Theme:
Ageing & Dementia
Quality of Life Assessments in Individuals with Young-Onset Dementia and Their Caregivers.
Theme:
Ageing & Dementia
New horizons in appetite and the anorexia of ageing.
Theme:
Ageing & Dementia
Progression modelling of cognitive decline and associated FDG-PET imaging features in Alzheimer’s disease.
Theme:
Ageing & Dementia
Poor appetite is associated with six month mortality in hospitalised older men and women.
Theme:
Ageing & Dementia
Hybrid simulation modelling for dementia care services planning
Theme:
Ageing & Dementia
Self-management in older people living with cancer and multi-morbidity: A theory-led systematic review and synthesis of qualitative studies.
Theme:
Ageing & Dementia
Volunteer-led physical activity interventions to improve health outcomes for community-dwelling older people: A systematic review.
Theme:
Ageing & Dementia
Covid-19: supporting nurses’ psychological and mental health.
Theme:
Ageing & Dementia
Older people's experiences in acute care settings: systematic review and synthesis of qualitative studies.
Theme:
Ageing & Dementia
Physical activity among hospitalised older people: the feasibility and acceptability of a volunteer-led mobility intervention in the SoMoVe study.
Theme:
Ageing & Dementia
Comprehensive geriatric assessment in primary care: a systematic review.
Theme:
Ageing & Dementia
The challenge of managing undernutrition in older people with frailty.
Theme:
Ageing & Dementia
The challenge of managing undernutrition in older people with frailty.
Theme:
Ageing & Dementia
The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies
Theme:
Ageing & Dementia
A systematic review of the evidence for deprescribing interventions among older people living with frailty
Theme:
Ageing & Dementia
Older individual's perceptions of appetite, its loss, influencing factors and adaptions to poor appetite. A qualitative study
Theme:
Ageing & Dementia
Older individual's perceptions of appetite, its loss, influencing factors and adaptions to poor appetite. A qualitative study
Theme:
Ageing & Dementia
A Comprehensive Literature Search of Digital Health Technology Use in Neurological Conditions: Review of Digital Tools to Promote Self-management and Support
Theme:
Ageing & Dementia
Exploring the prevalence and types of fall-risk-increasing drugs among older people with upper limb fractures
Theme:
Ageing & Dementia
Multidisciplinary team healthcare professionals’ perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework
Theme:
Ageing & Dementia
Mood and physical activity are associated with appetite in hospitalised older men and women
Theme:
Ageing & Dementia
Moving our care home: A qualitative study of the views and experiences of residents, relatives and staff
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
Theme:
Long Term Conditions
Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study
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
Theme:
Ageing & Dementia
Enhancing the management of anorexia of ageing to counteract malnutrition: are physical activity guidelines optimal?