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Amanda Bye, Jill Shawe, Judith Stephenson, Debra Bick, Nataliya Brima, Nadia Micali
OBJECTIVE: Being underweight at pregnancy commencement is associated with a range of adverse maternal and infant outcomes, as is being overweight or obese, yet it is an aspect of maternal health which has been relatively neglected by healthcare professionals and researchers. We aimed to investigate differences in pre-pregnancy and pregnancy healthy lifestyle advice routinely offered by relevant healthcare professionals, including midwives and GPs, to women across three different BMI categories - underweight, normal, and overweight or obese...
September 23, 2016: Midwifery
Gwyn Bevan
Marchildon highlights the lack of evidence on policies of regionalization in Canada: with regionalization being in favour in the 2000s followed by disillusion and the abolition of regions by some provincial governments. This paper looks at evidence from the UK's single-payer system of the impacts of regions on the performance of the delivery of healthcare. In England, regions were an important part of the hierarchical structure of the National Health Service (NHS) from its beginning, in 1948, to the introduction of provider competition, in the 1990s...
2016: HealthcarePapers
Elinor Clarke
Female genital mutilation (FGM) is a collective term for the deliberate alteration, removal and cutting of the female genitalia. It has no known health benefits and can have negative physical and psychological consequences. The number of women and girls in the UK that are affected by FGM is unknown. Recent NHS data suggested that FGM has been evident (declared or observed) in women who have accessed health care; however, there are gaps in knowledge and a limited evidence base on the health consequences of FGM...
October 13, 2016: British Journal of Nursing: BJN
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
Nigel Crisp, David Stuckler, Richard Horton, Victor Adebowale, Sue Bailey, Maureen Baker, John Bell, John Bird, Carol Black, Jane Campbell, Janet Davies, Heather Henry, Robert Lechler, Andrew Mawson, Patrick H Maxwell, Martin McKee, Cathy Warwick
Brexit and the troubled state of the NHS call for re-thinking the UK's approach to health. The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future. At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector. However, new scientific developments and digital technology offer societies everywhere massive and unprecedented opportunities for improving health...
October 6, 2016: Lancet
Ieuan Edward Shepherd Evans, Pallavi Bedi, Tom M Quinn, Adam T Hill
BACKGROUND: There is increased interest in the association of vascular disease with COPD and pneumonia, but there is a lack of research in this area with patients with bronchiectasis. METHODS: A retrospective study of 400 patients attending a specialist bronchiectasis clinic in NHS Lothian, Edinburgh, UK between May 2013 and September 2014 was conducted. The study assessed the prevalence of vascular disease (ischemic heart disease, cerebrovascular disease, peripheral vascular disease and atrial fibrillation)...
October 6, 2016: Chest
Kate Button, Fiona Morgan, Helen Hodgson, Alison L Weightman, Steve Jones
BACKGROUND: Musculoskeletal (MSK) conditions are the most frequently reported chronic conditions and one of the biggest causes of disability in the UK. Given the ageing population and the impact of these problems, the demand for MSK treatment will rise. Despite reduced waiting times, MSK pathways have remained variable and inconsistent and need to be improved to meet patient needs. The aim of this systematic review is to understand the evidence for the effectiveness of current models of service delivery and care pathways for adult hip/knee pain patients accessing secondary care for specialist opinions...
August 1, 2016: Systematic Reviews
Radek Wojcik, Julia Lowin, David Vilardell, Silvia Maeso, Leonardo Ruiz, John Lear, Colin Morton
OBJECTIVE: The objective of this analysis was to estimate the relative cost-effectiveness of Actikerall * (5-FU-SA) versus cryotherapy in a secondary care setting in the UK, for lesion-directed treatment in patients with actinic keratoses (AK) of the face and scalp. METHODS: The model was a simple decision tree, with a 6-month time horizon. The perspective was that of the UK National Health Service (NHS). Modelled treatment effects included reported per-patient histological clearance and recurrence rates...
October 7, 2016: Journal of Medical Economics
Jilly Martin, Paschal Sheeran, Pauline Slade
Although teenage conceptions rates in the United Kingdom (UK) have seen a downward trend recently, it remains imperative that contraceptive services for young people continue to improve. To ensure that evidence-based interventions are sustained in clinical practice, it is useful to assess the experiences of those delivering them. This study explores the experiences of sexual health clinicians who were trained to deliver a one-to-one behaviour change intervention aiming to improve contraceptive use in young women...
October 7, 2016: Psychology, Health & Medicine
Giordano Perin, Rosanna C Ching, Mohammad U Anwar
The aim of this study was to evaluate the impact of outpatient care on activities at the Adults' Regional Burns Centre and the Children's Regional Burns Unit, Mid Yorkshire Hospitals NHS Trust UK, where outpatient and inpatient responsibilities are shared between the nursing staff. Data for all inpatient and outpatient interactions (all care related activities with the presence of a Registered Nurse (RN)) was collected prospectively by the attending RN for two consecutive months (October and November 2014)...
October 1, 2016: Burns: Journal of the International Society for Burn Injuries
Lotte Elton
Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership...
October 3, 2016: Leadership in Health Services
Clare Dolman, Ian R Jones, Louise M Howard
BACKGROUND: Women with bipolar disorder are at increased risk of having a severe episode of illness associated with childbirth. AIMS: To explore the factors that influence the decision-making of women with bipolar disorder regarding pregnancy and childbirth. METHOD: Qualitative study with a purposive sample of women with bipolar disorder considering pregnancy, or currently or previously pregnant, supplemented by data from an online forum. Data were analysed using thematic analysis...
September 2016: BJPsych Open
Charlotte L Hall, John A Taylor, Karen Newell, Laurence Baldwin, Kapil Sayal, Chris Hollis
BACKGROUND: The landmark US Multimodal Treatment of ADHD (MTA) study established the benefits of individualised medication titration and optimisation strategies to improve short- to medium-term outcomes in attention-deficit hyperactivity disorder (ADHD). This individualised medication management approach was subsequently incorporated into the National Institute for Health and Care Excellence (NICE) ADHD Clinical Guidelines (NICE CG78). However, little is known about clinicians' attitudes towards implementing these medication management strategies for ADHD in routine care...
January 2016: BJPsych Open
Sophia Taylor, Weyinmi Demeyin, Ann Muls, Catherine Ferguson, Damian J J Farnell, David Cohen, Jervoise Andreyev, John Green, Lesley Smith, Sam Ahmedzai, Sara Pickett, Annmarie Nelson, John Staffurth
INTRODUCTION: Radiotherapy treatment for prostate cancer can cause bowel problems, which may lead to severe difficulties for cancer survivors including limiting travel, work or socialising. These symptoms can appear at any time following radiotherapy. This study focuses on the early identification and protocol-based management of effects known to cause long-term, or even permanent, changes to the well-being of prostate cancer survivors. The rationale of this study is to improve the care offered to men and their families following pelvic radiotherapy for prostate cancer...
October 3, 2016: BMJ Open
L M Almond, V Charalampakis, P Mistry, J Hodson, J Matthews, R Singhal, P Super
INTRODUCTION: Laparoscopic anti-reflux surgery is conventionally performed using two 10/12 mm ports. While laparoscopic procedures reduce post-operative pain, the use of larger ports invariably increases discomfort and affects cosmesis. We describe a new all 5 mm ports technique for laparoscopic anti-reflux surgery and present a review of our initial experience with this approach. METHODS: All patients undergoing laparoscopic fundoplication over a 35 month period from February 2013 under the care of a single surgeon were included...
September 30, 2016: International Journal of Surgery
Andrew J E Harding, Colin Pritchard
It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding...
July 10, 2016: International Journal of Health Policy and Management
Andrew M McIntosh, Robert Stewart, Ann John, Daniel J Smith, Katrina Davis, Cathie Sudlow, Aiden Corvin, Kristin K Nicodemus, David Kingdon, Lamiece Hassan, Matthew Hotopf, Stephen M Lawrie, Tom C Russ, John R Geddes, Miranda Wolpert, Eva Wölbert, David J Porteous
Data science uses computer science and statistics to extract new knowledge from high-dimensional datasets (ie, those with many different variables and data types). Mental health research, diagnosis, and treatment could benefit from data science that uses cohort studies, genomics, and routine health-care and administrative data. The UK is well placed to trial these approaches through robust NHS-linked data science projects, such as the UK Biobank, Generation Scotland, and the Clinical Record Interactive Search (CRIS) programme...
October 2016: Lancet Psychiatry
Alayne Stockham
The National Health Service (NHS) in the UK is evolving to meet the needs of society, but success depends on effective leadership. The World Health Organization identified intersectoral and multidisciplinary working as key to improving the quality and sustainability of the service, highlighting the need for a new leadership style. This article describes how collaborative leadership was used to successfully implement a virtual ward in the primary care setting in south-east Powys, Wales. The author describes the leadership style and addresses strategies used to manage the change process...
September 30, 2016: Nursing Management (Harrow)
Cath Jackson, Lisa Dyson, Helen Bedford, Francine M Cheater, Louise Condon, Annie Crocker, Carol Emslie, Lana Ireland, Philippa Kemsley, Susan Kerr, Helen J Lewis, Julie Mytton, Karen Overend, Sarah Redsell, Zoe Richardson, Christine Shepherd, Lesley Smith
BACKGROUND: Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. AIMS: (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study...
September 2016: Health Technology Assessment: HTA
Martin Tickle, Ciaran O'Neill, Michael Donaldson, Stephen Birch, Solveig Noble, Seamus Killough, Lynn Murphy, Margaret Greer, Julie Brodison, Rejina Verghis, Helen V Worthington
BACKGROUND: Dental caries is the most common disease of childhood. The NHS guidelines promote preventative care in dental practices, particularly for young children. However, the cost-effectiveness of this policy has not been established. OBJECTIVE: To measure the effects and costs of a composite fluoride intervention designed to prevent caries in young children attending dental services. DESIGN: The study was a two-arm, parallel-group, randomised controlled trial, with an allocation ratio of 1 : 1...
September 2016: Health Technology Assessment: HTA
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