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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

Miriam Avery BN (Hons), PhD, Greta Westwood CBE, RN, PhD, MSc, Alison Richardson BN (Hons), MSc, PhD, PGDip, ED, RN

Published: 28 January 2021


Abstract


Aims and Objectives

This study aimed to understand the routes by which nurses, midwives and allied health professionals (NMAHPs) pursue and sustain a research career and the enablers and barriers to career progression.


Background
Robust evidence is central to practice and professional decision making of NMAHPs, with generation and translation of research arguably best led by those clinically active. Whilst countries like the UK and USA have fellowship schemes to support research career development, anecdotal reports suggest barriers exist in translating these opportunities into sustainable clinical academic careers.


External web link - https://onlinelibrary.wiley.com/doi/10.1111/jocn.15673


Theme:

General publications

Creating pre-conditions for change in clinical practice: the influence of interactions between multiple contexts and human agency

Michelle Myall, Carl May, Alison Richardson, Sarah Bogle, Natasha Campling, Sally Dace and Susi Lund – August 2020


Abstract

Purpose – The purpose of this paper is to explore what happens when changes to clinical practice are proposed and introduced in healthcare organisations. The authors use the implementation of Treatment Escalation Plans to explore the dynamics shaping the translational journey of a complex intervention from research into the everyday context of real-world healthcare settings.


External web link - https://www.emerald.com/insight/content/doi/10.1108/JHOM-06-2020-0240/full/pdf?title=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

Matt Johnson, Lucy Rigge, David Culliford, Lynn Josephs, Mike Thomas, Tom Wilkinson - december 4 2019


ABSTRACT

Most clinical contacts with chronic obstructive pulmonary disease (COPD) patients take place in primary care, presenting opportunity for proactive clinical management. Electronic health records could be used to risk stratify diagnosed patients in this setting, but may be limited by poor data quality or completeness. We developed a risk stratification database algorithm using the DOSE index (Dyspnoea, Obstruction, Smoking and Exacerbation) with routinely collected primary care data, aiming to calculate up to three repeated risk scores per patient over five years, each separated by at least one year.


External web link - https://www.nature.com/articles/s41533-019-0154-6

Theme:

General publications

Evaluating the impact of a polypharmacy Action Learning Sets tool on healthcare practitioners’ confidence, perceptions and experiences of stopping inappropriate medicines

Cindy Faith Brooks, Anastasios Argyropoulos, Catherine Brigitte Matheson‑Monnet and David Kryl

June 2022


Background

Issues of medication adherence, multimorbidity, increased hospitalisation risk and negative impact upon quality of life have led to the management of polypharmacy becoming a national priority. Clinical guidelines advise a patient-centred approach, involving shared decision-making and multidisciplinary team working. However, there have been limited educational initiatives to improve healthcare practitioners’ management of polypharmacy and stopping inappropriate medicines. This study aimed to evaluate the impact of a polypharmacy Action Learning Sets (ALS) tool across five areas: i. healthcare practitioners’ confidence and perceptions of stopping medicines; ii. knowledge and information sources around stopping medicines; iii. perception of patients and stopping medicines; iv. perception of colleagues and stopping medicines and v. perception of the role of institutional factors in stopping medicines.


External web link - https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-022-03556-8

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

Sue Latter, Natasha Campling, Jacqueline Birtwistle, Alison Richardson, Michael I. Bennett, Sean Ewings, David Meads & Miriam Santer – September 2020


Background

Patient access to medicines at home during the last year of life is critical for symptom control, but is thought to be problematic. Little is known about healthcare professionals’ practices in supporting timely medicines access and what influences their effectiveness. The purpose of the study was to evaluate health professionals’ medicines access practices, perceived effectiveness and influencing factors.


External web link - https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-020-00649-3

Theme:

Workforce & Health Systems

The influence of personal communities in understanding avoidable emergency department attendance: qualitative study

The influence of personal communities in understanding avoidable emergency department attendance: qualitative study


Gemma McKenna, Anne Rogers, Sandra Walker & Catherine Pope – September 2020

Background

Use of emergency department (ED) care globally seems to be increasing at a faster rate than population growth. In the UK there has been a reported 16% rise in emergency admissions over the past 5 years. Estimates that between 11 and 40% of ED attendances are non-urgent, with 11% of patients being discharged from the ED without treatment (NHS Digital 2017), and a further 44% require no follow-up treatment …….


External web link - https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05705-5

Theme:

Workforce & Health Systems

A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

Yuan-Sheng Ryan Poon, Yongxing Patrick Lin, Peter Griffiths, Keng Kwang Yong, Betsy Seah & Sok Ying Liaw

September 24, 2022


Background

Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.


External web link - https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00764-7

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

Mal North, Simon Bourne, Ben Green, Anoop J. Chauhan, Tom Brown, Jonathan Winter, Tom Jones, Dan Neville, Alison Blythin, Alastair Watson, Matthew Johnson, David Culliford, Jack Elkes, Victoria Cornelius & Professor Tom M. A. Wilkinson – October 2020


Abstract

Exacerbations of COPD are one of the commonest causes of admission and readmission to hospital. The role of digital interventions to support self-management in improving outcomes is uncertain. We conducted an open, randomised controlled trial of a digital health platform application (app) in 41 COPD patients recruited following hospital admission with an acute exacerbation. Subjects were randomised to either receive usual care, including a written self-management plan (n = 21), or the myCOPD app (n = 20) for 90 days.


External web link - https://www.nature.com/articles/s41746-020-00347-7

Theme:

Long Term Conditions

Planning and optimising CHAT&PLAN: A conversation-based intervention to promote person-centred care for older people living with multimorbidity

Corbett, T., Cummings, A., Lee, K., Calman, L., Fenerty, V., Farrington, N., Lewis, L., Young, A., Boddington, H., Wiseman, T., Richardson, A., Foster, C., Bridges, J. - October 16, 2020


Background

Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLANTM, a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions.


External web link - https://doi.org/10.1371/journal.pone.0240516

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

Farhad Pazan, Mirko Petrovic, Antonio Cherubini, Graziano Onder, Alfonso J. Cruz-Jentoft, Michael Denkinger, Tischa J. M. van der Cammen, Jennifer M. Stevenson, Kinda Ibrahim, Chakravarthi Rajkumar, Marit Stordal Bakken, Jean-Pierre Baeyens, Peter Crome, Thomas Frühwald, Paul Gallaghar, Adalsteinn Guðmundsson, Wilma Knol, Denis O’Mahony, Alberto Pilotto, Elina Rönnemaa, José Antonio Serra-Rexach, George Soulis, Rob J. van Marum, Gijsbertus Ziere, Alpana Mair, Heinrich Burkhardt, Agnieszka Neumann-Podczaska, Katarzyna Wieczorowska-Tobis, Marilia Andreia Fernandes, Heidi Gruner, Dhayana Dallmeier, Jean-Baptiste Beuscart, Nathalie van der Velde & Martin Wehling

(August 2021)


Background

Frailty and adverse drug effects are linked in the fact that polypharmacy is correlated with the severity of frailty; however, a causal relation has not been proven in older people with clinically manifest frailty.


External web link - https://link.springer.com/article/10.1007/s00228-020-02951-8

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:

Long Term Conditions

The influence of social relationships and activities on the health of adults with obesity: A qualitative study

Nestor Serrano-Fuentes MSc, Anne Rogers PhD, Mari Carmen Portillo PhD

24 June 2022


Background


Obesity in adults is a leading health challenge that causes millions of deaths worldwide and represents a risk factor for developing long-term conditions. Social relationships are one of the multiple drivers shaping obesity and obesity-related practices. However, there is still little evidence as to the processes by which relationships influence the adoption of positive and negative obesity health-related practices—eating, physical activity and alcohol intake. This study aims first to identify the types of relationships relevant to the adoption of practices in adults with obesity and, second, to explore the type of activities these relationships engage with or promote to produce those practices and their potential health consequences.


External web link - https://onlinelibrary.wiley.com/doi/10.1111/hex.13540

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

Sebastian Stannard, Emilia Holland, Sarah R Crozier, Rebecca Hoyle, Michael Boniface, Mazen Ahmed, James McMahon, William Ware, Zlatko Zlatev, Nisreen A Alwan, DS Fraser 

Correspondence to Dr Sebastian Stannard; S.J.Stannard@soton.ac.uk

October 10, 2022


Abstract


Objectives The prevalence of multiple long-term condition (LTC) multimorbidity is increasing with younger onset among socioeconomically deprived populations. Research on life course trajectories towards multimorbidity is limited and early-onset multimorbidity poorly characterised. Understanding sentinel conditions (the first LTC occurring in the life course), the sequence of LTC accrual and the permanency of the reporting of LTCs may help identify time points for prevention efforts. We used a longitudinal birth cohort to estimate the prevalence of a common three-condition early-onset multimorbidity (multiple long-term condition multimorbidity (MLTC-M)) group at midlife, describe the frequency of sentinel conditions, the sequence of LTC accrual and explore the permanency of one of these conditions: psychological distress.


External web link - https://bmjopen.bmj.com/content/12/10/e059587.full

Theme:

Healthy Communities

Adult diet in England: Where is more support needed to achieve dietary recommendations?

Dianna M. Smith , Christina Vogel, Monique Campbell, Nisreen Alwan, Graham Moon (June 23, 2021)


Background

Small-area estimation models are regularly commissioned by public health bodies to identify areas of greater inequality and target areas for intervention in a range of behaviours and outcomes. Such local modelling has not been completed for diet consumption in England despite diet being an important predictor of health status. The study sets out whether aspects of adult diet can be modelled from previously collected data to define and evaluate area-level interventions to address obesity and ill-health.

 

External web link - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252877

Theme:

Healthy Communities

Implementing a social network intervention: can the context for its workability be created? A quasiethnographic study

J. Ellis , I. Vassilev, E. James and A. Rogers - October 27, 2020


Background

Policy makers and researchers recognise the challenges of implementing evidence-based interventions into routine practice. The process of implementation is particularly complex in local community environments. In such settings, the dynamic nature of the wider contextual factors needs to be considered in addition to capturing interactions between the type of intervention and the site of implementation throughout the process. This study sought to examine how networks and network formation influence the implementation of a self-management support intervention in a community setting.


External web link - https://implementationsciencecomms.biomedcentral.com/articles/10.1186/s43058-020-00087-5

Theme:

Healthy Communities

Public attitudes to a human challenge study with SARS-CoV-2: a mixed-methods study

(10 February 2022)


Caroline Barker, Katharine Collet, Diane Gbesemete, Maria Piggin, Daniella Watson, Philippa Pristerà, Wendy Lawerence, Emma Smith, Michael Bahrami-Hessari, Halle Johnson, Katherine Baker, Ambar Qavi, Carmel McGrath, Christopher Chiu, Robert C. Read, Helen Ward


Background: Human challenge studies involve the deliberate exposure of healthy volunteers to an infectious micro-organism in a highly controlled and monitored way. They are used to understand infectious diseases and have contributed to the development of vaccines. In early 2020, the UK started exploring the feasibility of establishing a human challenge study with SARS-CoV-2. Given the significant public interest and the complexity of the potential risks and benefits, it is vital that public views are considered in the design and approval of any such study and that investigators and ethics boards remain accountable to the public.


External web link - https://wellcomeopenresearch.org/articles/7-49/v1

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

Household food insecurity risk indices for English neighbourhoods: Measures to support local policy decisions

Authors: Dianna M. Smith  , Lauren Rixson , Grace Grove, Nida Ziauddeen, Ivaylo Vassilev, Ravita Taheem, Paul Roderick, Nisreen A. Alwan


Published: 9 December 2022


Background

In England, the responsibility to address food insecurity lies with local government, yet the prevalence of this social inequality is unknown in small subnational areas. In 2018 an index of small-area household food insecurity risk was developed and utilised by public and third sector organisations to target interventions; this measure needed updating to better support decisions in different settings, such as urban and rural areas where pressures on food security differ.


External web link - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267260

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 composition of the gut microbiome differs among community dwelling older people with good and poor appetite.

Cox N, Bowyer R, Lochlainn M, Wells P, Roberts H, Steves C. (February 2021)


Background
Anorexia of ageing is common and important in the development of sarcopenia in older individuals. Links have been proposed between the gut microbiota and sarcopenia. Disordered gut function is also recognized in anorexia of ageing, but how this may relate to resident gut microbiota is unexplored. Understanding this relationship may provide a basis for novel interventions for anorexia of ageing and sarcopenia. This study explores compositional differences of the gut microbiota between community dwelling healthy older adults with good or poor appetite, and associated differences in sarcopenia.

External web link - https://doi.org/10.1002/jcsm.12683

Theme:

Ageing & Dementia

Recommendations for the management of COVID-19 pandemic in long-term care facilities.

Gosch M, Heppner H, Lim S. et al. (January 2021)


Abstract
Long-term care facilities (LTCF) and their vulnerable residents are particularly affected by the coronavirus disease 2019 (COVID-19) pandemic. Estimates from various countries suggest that 3–66% of all COVID-19 deaths were residents of LTCF, of which 80% died in their facilities. Despite these significant numbers, recommendations for LTCF for the prevention and medical care of residents during the COVID-19 pandemic are still lacking. These recommendations are based on the existing literature and the expertise of the authors who are specialists in geriatric medicine. The recommendations are addressed to LTCF management, their operators, physicians working in LTCFs and also politicians, to provide the necessary framework conditions. We are confident that our recommendations will offer important help and guidance for LTCFs as well as their physicians. Adherence to these recommendations is likely to improve the outcomes and care of residents in long-term facilities during the COVID-19 pandemic.


External web link - https://doi.org/10.1007/s00391-021-01847-1

Theme:

Ageing & Dementia

Planning and optimising CHAT&PLAN: a conversation-based intervention to promote person-centred care for older people living with multimorbidity.

Corbett T, Cummings A, Lee K, Calman L, Fenerty V, Farrington N, Lewis L, Young A, Boddington H, Wiseman T, Richardson A, Foster C, Bridges J. (October 2020)


Background
Older people are more likely to be living with cancer and multiple long-term conditions, but their needs, preferences for treatments, health priorities and lifestyle are often not identified or well-understood. There is a need to move towards a more comprehensive person-centred approach to care that focuses on the cumulative impact of a number of conditions on daily activities and quality of life. This paper describes the intervention planning process for CHAT& PLANTM, a structured conversation intervention to promote personalised care and support self-management in older adults with complex conditions.


External web link - https://doi.org/10.1371/journal.pone.0240516

Theme:

Ageing & Dementia

New horizons in appetite and the anorexia of ageing.

Cox NJ, Morrison L, Ibrahim K, Robinson SM, Sayer AA, & Roberts HC. (July 2020)


Abstract
Appetite drives essential oral nutritional intake. Its regulation is complex, influenced by physiology, hedonism (the reward of eating) and learning from external cues within a person’s society and culture. Appetite loss is common in the older population and not always attributable to medical conditions or treatment. Although the physiological basis of the anorexia of ageing (loss of appetite due to the ageing process) has been established, the effect of ageing on hedonism and external cues, which may be equally important, is less well understood. The anorexia of ageing is associated with reductions in dietary diversity and oral intake, and increased risk of malnutrition, sarcopenia and frailty.


External web link - https://academic.oup.com/ageing/article/49/4/526/5733078?login=true

Theme:

Ageing & Dementia

The challenge of managing undernutrition in older people with frailty.

Roberts H, Lim S, Cox N & Ibrahim K. (April 2019). 


Abstract

Many older people with frailty are at risk of malnutrition and poor health, yet there is evidence that improving nutrition and weight loss can reduce frailty. This will become more important as the number of older people with frailty increases worldwide in future. Identifying those at risk is challenging due to the difficulty of reaching and screening those older people most at risk, the large number of nutritional assessment tools used, and the lack of consensus on the criteria to make a diagnosis of malnutrition. The management of older people with or at risk of malnutrition should be multi-modal and multi-disciplinary, and all care staff have an important role in delivering appropriate nutritional advice and support. This paper will highlight a number of practical approaches that clinicians can take to manage malnutrition in older people with frailty in community and acute settings, including environmental changes to enhance mealtime experience, food fortification and supplementation


External web link - https://www.mdpi.com/2072-6643/11/4/808

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

Theme:

Ageing & Dementia

Enhancing the management of anorexia of ageing to counteract malnutrition: are physical activity guidelines optimal?

Crabtree, D.R., Cox, N.J., Lim, S.E.R. et al. Enhancing the management of anorexia of ageing to counteract malnutrition: are physical activity guidelines optimal?. Aging Clin Exp Res (2023). https://doi.org/10.1007/s40520-022-02317-3

January 20, 2023


Introduction

Poor appetite in later life—termed “anorexia of ageing”—is acknowledged as a key determinant of age-related malnutrition. While physical activity (PA) is often recommended for increasing drive to eat, these recommendations are not well-evidenced in the older population. In this opinion piece we outline limitations to physical activity recommendations in anorexic older adults. We then discuss current evidence for the relationship between physical activity and appetite amongst younger adults and postulate how this relationship may change in later life, with implications regarding future recommendations and research.

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