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https://www.readbyqxmd.com/read/28537170/alcohol-use-disorders
#1
Lynne Pearce
Essential facts [Figure: see text] According to recent statistics from NHS Digital, there were an estimated 1.1 million hospital admissions where alcohol was the primary or secondary issue in 2015-16. In the UK, it is estimated that 24% of adults drink in a hazardous or harmful way, while around 9% of men and 4% of women show signs of alcohol dependence.
May 24, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28532629/shared-decision-making-in-the-uk-moving-towards-wider-uptake
#2
Angela Coulter, Adrian Edwards, Vikki Entwistle, Graham Kramer, Alan Nye, Richard Thomson, Emma Walker
Shared decision making (SDM) is firmly on the policy agenda in the UK and a recent legal ruling has confirmed its importance. Policymakers, ethicists, professional regulators and societies, patient organisations and now the courts are committed to ensuring that SDM becomes the norm throughout the NHS, but an unfavourable economic climate makes this especially challenging. Considerable progress has been made over the last few years, with new learning from demonstration sites, various initiatives in capacity building and training, wider availability of patient decision aids, and important leadership initiatives...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#3
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28520199/economic-evaluation-of-strategies-for-restarting-anticoagulation-therapy-after-a-first-event-of-unprovoked-venous-thromboembolism
#4
M Monahan, J Ensor, D Moore, D Fitzmaurice, S Jowett
BACKGROUND: Following at least three months of anticoagulation therapy after a first unprovoked Venous Thromboembolism (VTE), there is uncertainty about the duration of therapy. Further anticoagulation therapy reduces the risk of having a potentially fatal recurrent VTE but at the expense of a higher risk of bleeding which can also be fatal. OBJECTIVE: An economic evaluation sought to estimate the long-term cost-effectiveness of using a decision rule for restarting anticoagulation therapy versus no extension of therapy in patients based on their risk of a further unprovoked VTE...
May 18, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28515957/a-psychologically-informed-audiologist-delivered-manualised-intervention-for-tinnitus-protocol-for-a-randomised-controlled-feasibility-trial-tin-man-study
#5
John A Taylor, Deborah A Hall, Dawn-Marie Walker, Mary McMurran, Amanda Casey, David Stockdale, Debbie Featherstone, Dean M Thompson, Carol MacDonald, Derek J Hoare
BACKGROUND: Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28515180/distribution-and-extent-of-electronic-medical-record-utilisation-in-eye-units-across-the-united-kingdom-a-cross-sectional-study-of-the-current-landscape
#6
Shin Bin Lim, Humma Shahid
OBJECTIVES: Ophthalmology units across the UK vary widely in their adoption of electronic medical records (EMR). There is a lack of evidence to show the extent and progress of EMR adoption. The aim of this study was to capture a snapshot of the current landscape of EMR use, as a baseline for comparison in future studies. SETTING: An electronic survey questionnaire was sent to all NHS ophthalmology Units in the UK. PARTICIPANTS: A total of 104 National Health Service (NHS) ophthalmology units participated in the survey, which was carried out over 6 months from December 2013 to June 2014...
May 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28514913/action-learning-ripples-within-and-beyond-the-set
#7
Robert James Warwick, Adam Palmer, Janet McCray
Purpose This paper aims to explore the impact of action learning (AL) on an individual and an organisation, particularly the process by which each affected the other. The organisation is a UK National Health Service (NHS) Trust that includes two hospitals. Design/methodology/approach This is a single person case study involving a clinician, but the voice of an author can also be heard. It involves the experience of the individual as they experience AL as part of a leadership development programme leading to a postgraduate certificate...
May 2, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28513354/nurses-goodwill-keeping-nhs-afloat-rcn-warns
#8
Stephanie Jones-Berry
Four in five NHS nursing directors in the UK are worried that their hospitals rely on the goodwill of staff to keep services running, according to research from the RCN.
May 17, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28508731/submitting-medico-legal-intra-partum-ctg-i-p-ctg-monitoring-to-the-bolam-and-bolitho-principles
#9
George G Buttigieg
The article analyses some of the seeming weaknesses of the Bolam and Bolitho tests as applied to electronic foetal monitoring in labour, in the form of intra-partum CTG monitoring. Homing on to such aspects as confirmation of foetal hypoxia/acidosis, it evaluates the Bolam and Bolitho tests in the context of evidence-based medicine versus traditionally held views, which still hold their own in medical jurisprudence. Case law examples are quoted to illustrate various points. The discussion is of practical relevance both to the individual obstetrician as well as to national budgetary implications, bearing in mind, that, for example, in 2011, 'birth asphyxia' comprised 50% of the UK NHS litigation costs, and in the 2000-2010 decade, the same NHS forked out £3...
June 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28505278/cost-effectiveness-of-outpatient-parenteral-antibiotic-therapy-a-simulation-modelling-approach
#10
A Vargas-Palacios, D M Meads, M Twiddy, C Czoski Murray, C Hulme, E D Mitchell, A Gregson, P Stanley, J Minton
Objectives: In the UK, patients who require intravenous antimicrobial (IVA) treatment may receive this in the community through outpatient parenteral antimicrobial therapy (OPAT) services. Services include: IVA administration at a hospital outpatient clinic (HO); IVA administration at home by a general nurse (GN) or a specialist nurse (SN); or patient self-administered (SA) IVA administration following training. There is uncertainty regarding which OPAT services represent value for money; this study aimed to estimate their cost-effectiveness...
May 15, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28504070/adverse-effects-on-health-and-wellbeing-of-working-as-a-doctor-views-of-the-uk-medical-graduates-of-1974-and-1977-surveyed-in-2014
#11
Fay Smith, Michael J Goldacre, Trevor W Lambert
Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'...
May 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28499393/reversing-the-pipeline-implementing-public-health-evidence-based-guidance-in-english-local-government
#12
Lou Atkins, Michael P Kelly, Clare Littleford, Gillian Leng, Susan Michie
BACKGROUND: In the UK, responsibility for many public health functions was transferred in 2013 from the National Health Service (NHS) to local government; a very different political context and one without the NHS history of policy and practice being informed by evidence-based guidelines. A problem this move presented was whether evidence-based guidelines would be seen as relevant, useful and implementable within local government. This study investigates three aspects of implementing national evidence-based recommendations for public health within a local government context: influences on implementation, how useful guidelines are perceived to be and whether the linear evidence-guidelines-practice model is considered relevant...
May 12, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey%C3%A2
#13
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28498785/laparoscopic-adrenalectomy-for-conn-s-syndrome-is-beneficial-to-patients-and-is-cost-effective-in-england
#14
Ioannis Christakis, John A Livesey, Gregory P Sadler, Radu Mihai
PURPOSE: Adrenalectomy has the potential to cure or improve the control of hypertension in patients with primary hyperaldosteronism due to unilateral adrenal adenoma (Conn's syndrome). This study assesses the patients' perception of, and costs associated with, laparoscopic adrenalectomy for Conn's syndrome. MATERIALS AND METHODS: Clinical, radiological, operative, and pathological data were collected on patients undergoing adrenalectomy for Conn's syndrome over 8-years period in a UK tertiary referral center...
May 12, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28498615/understanding-the-impact-of-haemodialysis-on-uk-nhs-patients-wellbeing-a-qualitative-investigation
#15
Daniel J W Jones, Kate Harvey, John P Harris, Laurie T Butler, Emma C Vaux
AIMS AND OBJECTIVES: While haemodialysis (HD) is an effective treatment for end-stage renal disease (ESRD), the requirements and restrictions it imposes on patients can be onerous. The aim of the current study was to obtain UK National Health Service (NHS) patients' perspectives on the challenges arising from HD with the intention of identifying potential improvements. BACKGROUND: Depression rates are particularly high in those with ESRD, however, there is limited insight into the range of stressors associated with HD treatment within the NHS contributing to such high rates, particularly those of a cognitive or psychological nature...
May 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28495906/emergency-corneal-grafting-in-the-uk-a-6-year-analysis-of-the-uk-transplant-registry
#16
Parwez Hossain, Abdo Karim Tourkmani, Dimitri Kazakos, Mark Jones, David Anderson
BACKGROUND: Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG) is limited. METHODS: Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005. RESULTS: A total of 12 976 CGs were performed...
May 11, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28490259/recent-amendments-to-nice-s-value-based-assessment-of-health-technologies-implicitly-inequitable
#17
Mike Paulden
Over recent years, the UK's National Institute for Health and Care Excellence (NICE) has implemented or proposed several amendments to its methods and processes for the economic evaluation of health technologies within the National Health Service (NHS) [1-5]. These amendments have modified the 'value' that NICE assigns to health gains attributable to specific technologies when provided to patients with distinct characteristics. This raises fundamental equity issues that should be of concern to all NHS patients and other stakeholders...
May 10, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28489467/use-of-opioid-substitution-therapies-in-the-treatment-of-opioid-use-disorder-results-of-a-uk-cost-effectiveness-modelling-study
#18
James Kenworthy, Yunni Yi, Antony Wright, Jim Brown, Ana Maria Madrigal, William C N Dunlop
AIMS: We investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) versus no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over one year. METHODS: Cost-effectiveness of OST versus no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model...
May 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28488890/exploring-experiences-of-and-attitudes-towards-mental-illness-and-disclosure-amongst-health-care-professionals-a-qualitative-study
#19
William Waugh, Claudia Lethem, Simon Sherring, Claire Henderson
BACKGROUND: The literature suggests that many health professionals hold stigmatising attitudes towards those with mental illness and that this impacts on patient care. Little attention has been given to how these attitudes affect colleagues with a mental illness. Current research demonstrates that stigma and discrimination are common in the UK workplace and impact on one's decision to disclose mental illness. AIMS: This study aims to explore health professionals' experiences of and attitudes towards mental illness and disclosure in the workplace...
May 10, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#20
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
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