Recent Submissions

  • Interventions supporting engagement with sexual healthcare among people of black ethnicity: a systematic review of behaviour change techniques.

    Clarke, Rebecca; Heath, Gemma; Ross, Jonathan; Farrow, Claire; Ross, Jonathan; Sexual health; Medical and Dental (CSIRO Publishing, 2024-01-02)
    Background: Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated. Method: Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised. Results: Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s). Discussion: Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.
  • Alcohol-related harms and the certainty of deaths and taxes.

    Bhala, Neeraj B (Elsevier, 2022-03-17)
    No abstract available
  • Concordance of three point of care testing devices with clinical chemistry laboratory standard assays and patient-reported outcomes of blood sampling methods

    Yonel, Z; Kuningas, K; Sharma, P; Dutton, M; Jalal, Z; Cockwell, P; Webber, J; Narendran, P; Dietrich, T; Chapple, I L C; et al. (BMC, 2022-09-22)
    Background: Point of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health care professionals (AHPs) are skilled in undertaking risk assessment and delivering preventative advice, providing opportunities to access large proportions of the population who may not visit their doctor, within non-traditional community settings. There is evidence of high levels of support from public, patients and health professionals for engaging AHPs in risk-targeted early case detection of certain NCDs. Thus, POCT devices offer a potential alternative to traditional venous blood collection, as novel care pathways for increasing early case detection and access to preventative care. The objectives of this study were to: (i) determine the concordance of the specific POCT devices with laboratory-based standard assays employed within clinical biochemistry laboratories. (ii) compare the sampling experience of both methods via patient-reported experiences. Methods: A prospective, two-centre study was undertaken involving 158 participants who provided informed consent. Venous blood was collected for traditional assays of HbA1c, creatinine/ estimated Glomerular-Filtration-Rate (eGFR) and vitamin-D. Capillary blood was collected by finger prick test and also assayed for the same biochemical indices (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D)). All users were provided with device training. Participants reported any discomfort experienced by each simultaneously applied method (randomised in order) via a 100 mm Visual-Analogue-Scale. Results: Results for each POCT device and the laboratory standard were analysed by Bland-Altman plots to determine assay concordance. POCT devices demonstrated good concordance with laboratory testing, with at least 95% of all samples being within two standard deviations, for each of the devices tested. The majority of participants reported less discomfort with POCT than venepuncture, with the average reported discomfort being 17/100 mm less for POCT compared to venous blood sample collection on the visual analogue scale. Conclusions: The POCT devices demonstrated acceptable concordance with laboratory-based assays, and patients reported lower levels of discomfort compared to traditional means of blood collection. This study demonstrates the potential of using these devices as acceptable methods for opportunistic testing of "at-risk" individuals within non-traditional community care settings.
  • Comorbidity Profiling in Rural and Urban Population of West Bengal, India: Report From a Community-Based Primary Healthcare System

    Mukherjee, Deyashini; Moitra, Subhabrata; Gun, Punyabrata; Bera, Mrinmoy; Dey-Biswas, Piyali; Mukherjee, Rahul; Mukherjee, Rahul; Respiratory; Medical and Dental (Springer, 2024-01-01)
    Introduction The burden of non-communicable diseases (NCDs) is fast changing across the world, especially in the context of rapid urbanization, adoption of Western lifestyles, and an aging multi-morbid population. Over the last three decades, India has undergone a significant demographic and socioeconomic transition. For effective targeting of health system resources and services, it is essential to understand how the prevalence of NCDs varies among population groups across India. We set out to understand the distribution of NCDs and co-morbidities in urban and rural West Bengal. Methods As part of a service improvement project, data was collected from four urban and four rural community-based clinics across West Bengal, India. The reason for visiting the healthcare center was recorded as the primary diagnosis and co-morbidities were recorded per the Elixhauser comorbidity scoring criteria. Associations between all the demographic variables and NCDs were studied using the Poisson regression model and multivariate analysis. Demographic profile, co-morbidities, and Elixhauser comorbidity index were expressed as frequency (%), mean (standard deviation, SD), or median (interquartile range, IQR) as appropriate. Results We obtained data from 1244 patients of which 886 (71%) were from urban areas and 358 (29%) were from rural areas. Patients were mostly female (61%) and had a mean (SD) age of 53 (11) years. There was a positive correlation between living in an urban residence and age, body mass index (BMI), hypertension, cardiovascular disease (CVD), and respiratory disease. There was a positive correlation between CVD and age, male sex, living in an urban residence, and hypertension but did not correlate positively with diabetes. BMI positively correlated with living in an urban residence, hypertension, diabetes, and musculoskeletal disorders. We observed a significantly higher prevalence of musculoskeletal (p=0.002) and psychological diseases (p<0.001) in the rural population, while the prevalence of hypertension (p<0.001) and respiratory diseases among the participants living in urban areas was higher (p<0.001). There was no statistically significant difference in the prevalence of diabetes between urban and rural areas (p=0.38). In the multivariable analyses, we observed that increased age, being overweight, and living in urban areas were associated with hypertension (prevalence ratio (PR): 1.40, 1.30, and 1.30, respectively; all p-values <0.05). An interaction between sex and living area was associated with a lower prevalence of musculoskeletal diseases (PR: 0.34; 95%CI: 0.18-0.66), i.e., musculoskeletal diseases were less prevalent in males living in urban areas (p=0.002). Conclusion There is a rise in multimorbidity with changing demographic patterns and a narrowing of the urban-rural gap in disease distribution. More investment is required in risk factor prevention, screening, and treatment, with greater accessibility of healthcare resources for those in rural areas. Further work needs to be done to study the trends and distribution of NCDs in West Bengal to inform healthcare policy.
  • Engagement with a youth violence intervention programme is associated with lower re-attendance after violent injury: a UK major trauma network observational study

    Dickson, Edward A; Blackburn, Lauren; Duffy, Miriam; Naumann, David N; Brooks, Adam (Public Library of Science, 2023-10-18)
    The hospital based Redthread Youth Violence Intervention Programme (YVIP) utilises experienced youth workers to support 11-24 year olds following an episode of violent injury, assault or exploitation who present to the Emergency Department (ED) at the East Midlands Major Trauma Centre (MTC), Nottingham, UK. The YVIP aims to promote personal change with the aim of reducing the incidence of further similar events. We conducted a retrospective, observational, cohort study to examine the association between engagement with the YVIP and re-attendance rates to the ED following a referral to Redthread. We also examined factors associated with engagement with the full YVIP. We found that 573 eligible individuals were referred to the YVIP over two years. Assault with body parts 34.9% (n = 200) or a bladed object 29.8% (n = 171) were the commonest reason for referral. A prior event rate ratio (PERR) analysis was used to compare rates of attendance between those who did and did not engage with the full YVIP. Engagement was associated with a reduction in re-attendances of 51% compared to those who did not engage (PERR 0.49 [95% 0.28-0.64]). A previous attendance to the ED by an individual positively predicted engagement. (OR 2.82 [95% CI 1.07-7.42], P = 0.035). A weekend attendance (OR 0.26 [0.15-0.44], P<0.001) and a phone call approach (OR 0.25 [0.14-0.47], P = 0.001), rather than a face-to-face approach by a Redthread worker, negatively impacted engagement. In conclusion, assaults with or without a weapon contributed to a significant proportion of attendances among this age group. The Redthread YVIP was associated with reduced rates of re-attendance to the East Midlands MTC among young persons who engaged with the full programme.
  • Reducing readmission rates through a discharge follow-up service

    Vernon, Duncan; Brown, James E.; Griffiths, Eliza; Nevill, Alan M.; Pinkney, Martha; Griffiths, Eliza; Frailty; Medical and Dental; Solihull Metropolitan Borough Council; Aston University, Birmingham; South Warwickshire University NHS Foundation Trust; University of Wolverhampton; Solihull Hospital (Royal College of Physicians, 2019-06)
    Approximately 15% of elderly patients are readmitted within 28 days of discharge. This costs the NHS and patients. Previous studies show telephone contact with patients -post-discharge can reduce readmission rates. This service -evaluation used a cohort design and compared 30-day emergency readmission rate in patients identified to receive a community nurse follow-up with patients where no attempt was made. 756 patients across seven hospital wards were -identified; 303 were identified for the intervention and 453 in a -comparison group. Hospital admission and readmission data was extracted over 6 months. Where an attempt to contact a patient was made post-discharge, the readmission rate was 9.24% compared to 15.67% where no attempt to -contact was made (p=0.011). After adjustment for -confounding using logistic regression, there was evidence of reduced readmissions in the 'attempt to contact' group odds ratio = 1.93 (95% c-onfidence interval = 1.06-3.52, p=0.033). Of the patients who community nurses attempted to contact, 288 were contacted, and 202 received a home visit with general practitioner -referral and medications advice being the most common -interventions initiated. This service evaluation shows that a simple intervention where community nurses attempt to contact and visit geriatric patients after discharge causes a significant reduction in 30-day hospital readmissions. Keywords: Discharge; geriatrics; readmission; telephone contract.