NIHR open researchPub Date : 2024-02-15eCollection Date: 2024-01-01DOI: 10.3310/nihropenres.13530.1
Maria Krutikov, Zoe Fry, Borscha Azmi, Charlotte Lezard, Katie Thorn, Gareth Patefield, Graeme Childe, John Hudson, Oliver Stirrup, Arnoupe Jhass, Nicola Turner, Jackie Cassell, Paul Flowers, Andrew Hayward, Andrew Copas, Martin Green, Laura Shallcross
{"title":"Protocol for VIVALDI social care: Pilot study to reduce infections, outbreaks and antimicrobial resistance in care homes for older adults.","authors":"Maria Krutikov, Zoe Fry, Borscha Azmi, Charlotte Lezard, Katie Thorn, Gareth Patefield, Graeme Childe, John Hudson, Oliver Stirrup, Arnoupe Jhass, Nicola Turner, Jackie Cassell, Paul Flowers, Andrew Hayward, Andrew Copas, Martin Green, Laura Shallcross","doi":"10.3310/nihropenres.13530.1","DOIUrl":"10.3310/nihropenres.13530.1","url":null,"abstract":"<p><p>Care home residents are vulnerable to severe outcomes from infections such as COVID-19 and influenza. However, measures to control outbreaks, such as care home closures to visitors and new admissions, have a detrimental impact on their quality of life. Many infections and outbreaks could be prevented but the first step is to measure them reliably. This is challenging in care homes due to the lack of data and research infrastructure. During the pandemic, the VIVALDI study measured COVID-19 infections in residents and staff by partnering with care providers and using routinely collected data. This study aims to establish sentinel surveillance and a research database to enable observational and future interventional studies in care homes. The project has been co-produced with care providers, staff, residents, relatives, and researchers. The study (October 2023 to March 2025) will explore the feasibility of establishing a network of 500-1500 care homes for older adults in England that is underpinned by a linked data platform. No data will be collected from staff. The cohort will be created by regularly extracting resident identifiers from Digital Social Care Records (DSCR), followed by pseudonymisation and linkage to routinely collected datasets. Following extensive consultation, we decided not to seek informed consent from residents for data collection, but they can 'opt out' of the study. Our goal is to be inclusive, and it is challenging to give every resident the opportunity to 'opt in' due to cognitive impairment and the requirement for consultees. The project, and all requests to use the data will be overseen by relatives, residents, staff, and care providers. The study has been approved by the Health Research Authority Confidentiality Advisory Group (23/CAG/0134&0135) and the South-West Frenchay Research Ethics Committee (23/SW/0105). It is funded by the UK Health Security Agency.</p>","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"4 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, B. Hayee, Zoe Elliott, Bethinn Evans, N. Rowbotham, S. Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth
{"title":"A grumbling concern: A survey of gastrointestinal symptoms in cystic fibrosis in the modulator era","authors":"Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, B. Hayee, Zoe Elliott, Bethinn Evans, N. Rowbotham, S. Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth","doi":"10.3310/nihropenres.13384.2","DOIUrl":"https://doi.org/10.3310/nihropenres.13384.2","url":null,"abstract":"Background Gastrointestinal symptoms in cystic fibrosis (CF) are common and intrusive to daily life. Relieving gastrointestinal symptoms was identified as an important research priority and previously explored in an international survey in 2018. However, following the widespread introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators in 2019, the landscape of CF treatment has changed. We repeated an online survey to further describe gastrointestinal symptoms and their effect on quality of life (QoL) in the CFTR modulator era. Methods An electronic survey consisting of closed questions and free text responses was distributed via social media and professional networks for a period of one month between March - April 2022. People with CF (pwCF), their family and friends, and healthcare professionals (HCPs) were invited to take part. Results There were 164 respondents: 88 pwCF (54%), 22 (13%) family, and 54 (33%) healthcare professionals (HCPs). A total of 89/110 (81%) pwCF or family members reported CFTR modulator treatment. The most commonly reported symptoms were wind / gas and rumbling stomach noises (borborygmi) in both the modulator and non-modulator groups in addition to loose motions (modulator group) and bloating (no modulator group). Abdominal pain and bloating had the greatest impact on QoL. For those on a CFTR modulator, the proportion of pwCF reporting “no change” or “worse” for all of the symptoms surveyed was greater than the proportion reporting an improvement. For some symptoms such as stomach pains and reduced appetite, improvements were perceived more commonly in HCPs than what was reported by pwCF. Following modulator introduction, dietary changes to manage GI symptoms were recommended by 28/35 (80%) of HCPs and reported by 38/76 (50%) lay respondents. Changes in medication were recommended by 19/35 (54%) HCPs and reported by 44/76 (58%) of patients and family members. Conclusion This survey has shown that gastrointestinal symptoms remain prevalent in pwCF in the CFTR modulator era, though the nature of these symptoms may have changed. A better understanding of the underlying pathophysiology of these symptoms is essential. Future clinical studies should focus on improving symptoms and QoL.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139804569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NIHR open researchPub Date : 2024-02-05eCollection Date: 2023-01-01DOI: 10.3310/nihropenres.13384.1
Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, Bu Hayee, Zoe Elliott, Bethinn Evans, Nicola J Rowbotham, Siobhán B Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth
{"title":"A grumbling concern: A survey of gastrointestinal symptoms in cystic fibrosis in the modulator era.","authors":"Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, Bu Hayee, Zoe Elliott, Bethinn Evans, Nicola J Rowbotham, Siobhán B Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth","doi":"10.3310/nihropenres.13384.1","DOIUrl":"10.3310/nihropenres.13384.1","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal symptoms in cystic fibrosis (CF) are common and intrusive to daily life. Relieving gastrointestinal symptoms was identified as an important research priority and previously explored in an international survey in 2018. However, following the widespread introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators in 2019, the landscape of CF treatment has changed. We repeated an online survey to further describe gastrointestinal symptoms and their effect on quality of life (QoL) in the CFTR modulator era.</p><p><strong>Methods: </strong>An electronic survey consisting of closed questions and free text responses was distributed via social media and professional networks for a period of one month between March - April 2022. People with CF (pwCF), their family and friends, and healthcare professionals (HCPs) were invited to take part.</p><p><strong>Results: </strong>There were 164 respondents: 88 pwCF (54%), 22 (13%) family, and 54 (33%) healthcare professionals (HCPs). A total of 89/110 (81%) pwCF or family members reported CFTR modulator treatment. The most commonly reported symptoms were wind / gas and rumbling stomach noises (borborygmi) in both the modulator and non-modulator groups in addition to loose motions (modulator group) and bloating (no modulator group). Abdominal pain and bloating had the greatest impact on QoL.For those on a CFTR modulator, the proportion of pwCF reporting \"no change\" or \"worse\" for all of the symptoms surveyed was greater than the proportion reporting an improvement. For some symptoms such as stomach pains and reduced appetite, improvements were perceived more commonly in HCPs than what was reported by pwCF. Following modulator introduction, dietary changes to manage GI symptoms were recommended by 28/35 (80%) of HCPs and reported by 38/76 (50%) lay respondents. Changes in medication were recommended by 19/35 (54%) HCPs and reported by 44/76 (58%) of patients and family members.</p><p><strong>Conclusion: </strong>This survey has shown that gastrointestinal symptoms remain prevalent in pwCF in the CFTR modulator era, though the nature of these symptoms may have changed. A better understanding of the underlying pathophysiology of these symptoms is essential. Future clinical studies should focus on improving symptoms and QoL.</p>","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":" ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48866085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, B. Hayee, Zoe Elliott, Bethinn Evans, N. Rowbotham, S. Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth
{"title":"A grumbling concern: A survey of gastrointestinal symptoms in cystic fibrosis in the modulator era","authors":"Rebecca J Calthorpe, Natalie Goodchild, Vigilius Gleetus, Vinishaa Premakumar, B. Hayee, Zoe Elliott, Bethinn Evans, N. Rowbotham, S. Carr, Helen Barr, Alexander Horsley, Daniel Peckham, Alan R Smyth","doi":"10.3310/nihropenres.13384.2","DOIUrl":"https://doi.org/10.3310/nihropenres.13384.2","url":null,"abstract":"Background Gastrointestinal symptoms in cystic fibrosis (CF) are common and intrusive to daily life. Relieving gastrointestinal symptoms was identified as an important research priority and previously explored in an international survey in 2018. However, following the widespread introduction of cystic fibrosis transmembrane conductance regulator (CFTR) modulators in 2019, the landscape of CF treatment has changed. We repeated an online survey to further describe gastrointestinal symptoms and their effect on quality of life (QoL) in the CFTR modulator era. Methods An electronic survey consisting of closed questions and free text responses was distributed via social media and professional networks for a period of one month between March - April 2022. People with CF (pwCF), their family and friends, and healthcare professionals (HCPs) were invited to take part. Results There were 164 respondents: 88 pwCF (54%), 22 (13%) family, and 54 (33%) healthcare professionals (HCPs). A total of 89/110 (81%) pwCF or family members reported CFTR modulator treatment. The most commonly reported symptoms were wind / gas and rumbling stomach noises (borborygmi) in both the modulator and non-modulator groups in addition to loose motions (modulator group) and bloating (no modulator group). Abdominal pain and bloating had the greatest impact on QoL. For those on a CFTR modulator, the proportion of pwCF reporting “no change” or “worse” for all of the symptoms surveyed was greater than the proportion reporting an improvement. For some symptoms such as stomach pains and reduced appetite, improvements were perceived more commonly in HCPs than what was reported by pwCF. Following modulator introduction, dietary changes to manage GI symptoms were recommended by 28/35 (80%) of HCPs and reported by 38/76 (50%) lay respondents. Changes in medication were recommended by 19/35 (54%) HCPs and reported by 44/76 (58%) of patients and family members. Conclusion This survey has shown that gastrointestinal symptoms remain prevalent in pwCF in the CFTR modulator era, though the nature of these symptoms may have changed. A better understanding of the underlying pathophysiology of these symptoms is essential. Future clinical studies should focus on improving symptoms and QoL.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139864430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen A. Spencer, Alice Rutta, Gimbo Hyuha, G. T. Banda, Augustine Choko, Paul Dark, Julian T. Hertz, Blandina Mbaga, J. Mfinanga, Rhona Mijumbi, Adamson Muula, M. Nyirenda, Laura Rosu, Matthew Rubach, Sangwani Salimu, Francis M Sakita, Charity Salima, H. Sawe, Ibrahim Simiyu, Miriam Taegtmeyer, Sarah Urasa, Sarah White, Nateiya M. Yongolo, Jamie Rylance, Ben Morton, Eve Worrall, Felix Limbani
{"title":"Multimorbidity-associated emergency hospital admissions: a “screen and link” strategy to improve outcomes for high-risk patients in sub-Saharan Africa: a prospective multicentre cohort study protocol","authors":"Stephen A. Spencer, Alice Rutta, Gimbo Hyuha, G. T. Banda, Augustine Choko, Paul Dark, Julian T. Hertz, Blandina Mbaga, J. Mfinanga, Rhona Mijumbi, Adamson Muula, M. Nyirenda, Laura Rosu, Matthew Rubach, Sangwani Salimu, Francis M Sakita, Charity Salima, H. Sawe, Ibrahim Simiyu, Miriam Taegtmeyer, Sarah Urasa, Sarah White, Nateiya M. Yongolo, Jamie Rylance, Ben Morton, Eve Worrall, Felix Limbani","doi":"10.3310/nihropenres.13512.1","DOIUrl":"https://doi.org/10.3310/nihropenres.13512.1","url":null,"abstract":"Background The prevalence of multimorbidity (the presence of two or more chronic health conditions) is rapidly increasing in sub–Saharan Africa. Hospital care pathways that focus on single presenting complaints do not address this pressing problem. This has the potential to precipitate frequent hospital readmissions, increase health system and out-of-pocket expenses, and may lead to premature disability and death. We aim to present a description of inpatient multimorbidity in a multicentre prospective cohort study in Malawi and Tanzania. Primary objectives Clinical: Determine prevalence of multimorbid disease among adult medical admissions and measure patient outcomes. Health Economic: Measure economic costs incurred and changes in health-related quality of life (HRQoL) at 90 days post-admission. Situation analysis: Qualitatively describe pathways of patients with multimorbidity through the health system. Secondary objectives Clinical: Determine hospital readmission free survival and markers of disease control 90 days after admission. Health Economic: Present economic costs from patient and health system perspective, sub-analyse costs and HRQoL according to presence of different diseases. Situation analysis: Understand health literacy related to their own diseases and experience of care for patients with multimorbidity and their caregivers. Methods This is a prospective longitudinal cohort study of adult (≥18 years) acute medical hospital admissions with nested health economic and situation analysis in four hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Malawi; 3) Hai District Hospital, Boma Ng’ombe, Tanzania; 4) Muhimbili National Hospital, Dar-es-Salaam, Tanzania. Follow-up duration will be 90 days from hospital admission. We will use consecutive recruitment within 24 hours of emergency presentation and stratified recruitment across four sites. We will use point-of-care tests to refine estimates of disease pathology. We will conduct qualitative interviews with patients, caregivers, healthcare providers and policymakers; focus group discussions with patients and caregivers, and observations of hospital care pathways.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"80 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren Murrell, Helen Clough, Roger Gibb, Xingna Zhang, Mark Green, Marie Chattaway, I. Buchan, Benjamin Barr, D. Hungerford
{"title":"Understanding the impact funding cuts on Environmental and regulatory services and gastrointestinal infections: a longitudinal ecological study","authors":"Lauren Murrell, Helen Clough, Roger Gibb, Xingna Zhang, Mark Green, Marie Chattaway, I. Buchan, Benjamin Barr, D. Hungerford","doi":"10.3310/nihropenres.13426.2","DOIUrl":"https://doi.org/10.3310/nihropenres.13426.2","url":null,"abstract":"Background Gastrointestinal (GI) infections result in 17 million cases annually, with foodborne illness costing the National Health Service (NHS) £60m per year. The burden of GI infection is unequally distributed, with greater impact in more socioeconomically disadvantaged groups and areas. Local authorities (LA) provide vital services that protect public health and wellbeing. The impact of funding cuts to local services and their effect on public health is an area of concern. Environmental and regulatory (ER) services are responsible for roles such as food safety and infectious disease control. This study aims to understand the impact of local funding cuts on ER and GI infection outcomes. Methods We will conduct an ecological longitudinal study in England from 2010-2019 at the LA level to examine how changes in ER expenditure overtime have impacted ER and GI infection outcomes. Data will be gathered on food hygiene enforcement, food hygiene compliance levels, GI infection hospitalisation, NHS 111 calls relating to GI infection symptoms, GI infection pathogen data, deprivation, and population density. Measures will be aggregated to LA level and statistical analysis will be carried out. Ethics and dissemination University of Liverpool Ethics committee have confirmed ethical approval will not be required. All data will be aggregated and anonymised, therefore only data sharing agreements will be required. Findings will be disseminated to the stakeholder group in addition to outputs through conferences and publications. These findings will help understand impact of key services on public health and should inform government and public health policy and strategy.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"110 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NIHR open researchPub Date : 2024-01-03eCollection Date: 2023-01-01DOI: 10.3310/nihropenres.13382.2
Sheila Donovan, Trudie Chalder, Dipesh Gopal, Imran Khan, Ania Korszun, Elisavet Moschopoulou, Damien Ridge, Clare Robinson, Stephanie Taylor
{"title":"Qualitative study of experience of acceptance and commitment therapy (ACT+) amongst Survivors' Rehabilitation Evaluation after Cancer (SURECAN) trial participants and therapists: A protocol.","authors":"Sheila Donovan, Trudie Chalder, Dipesh Gopal, Imran Khan, Ania Korszun, Elisavet Moschopoulou, Damien Ridge, Clare Robinson, Stephanie Taylor","doi":"10.3310/nihropenres.13382.2","DOIUrl":"10.3310/nihropenres.13382.2","url":null,"abstract":"<p><strong>Background: </strong>This interview study forms part of a mixed methods process evaluation of the Survivors' Rehabilitation Evaluation after Cancer (SURECAN) trial to understand the experiences of participants (who are living with and beyond cancer) in receiving a form of acceptance and commitment therapy, and therapists providing the intervention. SURECAN is a multi-centre, pragmatic, individual participant randomised controlled trial of an intervention based on acceptance and commitment therapy supplemented by support for return to meaningful work and/or physical activity (ACT+). This qualitative study addresses the ways in which participants believe they benefit from ACT+ (or not), and how the ACT+ intervention might best be implemented into routine National Health Service (NHS) care.</p><p><strong>Methods: </strong>The study investigates experiences of ACT+ by different participants to understand how we can optimise the ACT+ intervention and its delivery (assuming the intervention is successful). We will conduct individual interviews with participants who have taken part in the active arm of the SURECAN trial to understand their experiences of engaging with and receiving ACT+, their perceptions of the impact of the therapy, and relevant contextual factors influencing these experiences. In particular, we will focus on comparing our interview findings between those trial participants who improved and those who failed to improve (or worsened), in terms of quality of life following ACT+. Additionally, we will conduct individual interviews with therapists who have delivered ACT+ as part of the SURECAN trial, to understand their experiences of delivering ACT+.</p><p><strong>Conclusions: </strong>Consistent with other qualitative protocols, this protocol is not registered. Instead, it is shared as a means of documenting ahead of time, how we are endeavouring to understand the ways in which a newly trialled talking therapy is received by patients and therapists, and how (if successful) it might be incorporated into the NHS.</p>","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"3 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NIHR open researchPub Date : 2023-12-29eCollection Date: 2023-01-01DOI: 10.3310/nihropenres.13437.2
Athanasia Kouroupa, Leila Hamza, Aisha Rafiq, Angela Hassiotis, Penny Rapaport, Andrew Jahoda, Laurence Taggart, Liz Steed, Sally-Ann Cooper, Craig Melville, Louise Marston, Rachel Royston, Afia Ali
{"title":"Stakeholder views on the barriers and facilitators of psychosocial interventions to address reduction in aggressive challenging behaviour in adults with intellectual disabilities.","authors":"Athanasia Kouroupa, Leila Hamza, Aisha Rafiq, Angela Hassiotis, Penny Rapaport, Andrew Jahoda, Laurence Taggart, Liz Steed, Sally-Ann Cooper, Craig Melville, Louise Marston, Rachel Royston, Afia Ali","doi":"10.3310/nihropenres.13437.2","DOIUrl":"10.3310/nihropenres.13437.2","url":null,"abstract":"<p><p>Success of psychosocial interventions in reducing aggressive challenging behaviour is likely to be related not only to mechanistic aspects but also to therapeutic and system factors. The study aims to examine the facilitators and barriers that influence whether psychosocial interventions for aggressive challenging behaviour in adults with intellectual disabilities lead to positive change. We conducted 42 semi-structured interviews with adults with intellectual disabilities who display aggressive challenging behaviour, family/paid carers, and professionals engaged in or delivering a psychosocial intervention across the UK. Data were analysed thematically using a framework approach. Stakeholders considered therapeutic and supportive relationships and personalised care as facilitating factors in addressing aggressive challenging behaviour. The operational structure of community intellectual disability services and conflicting expectations of professionals and carers were the main contextual barriers that impeded the implementation of psychosocial interventions in adults with intellectual disabilities. Findings highlight the valued components that maximise positive change in adults with intellectual disabilities who display aggressive challenging behaviour. Several operational adjustments including referral criteria, roles of professionals and workforce issues need to be addressed in services to maximise the implementation of psychosocial interventions leading to reduction in aggressive challenging behaviour in this population.</p>","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":" ","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593323/pdf/nihropenres-3-14575.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47880979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander D Perkins, Juliet O. Awori, Modu Jobe, Ruth K Lucinde, Meike Siemonsma, R. Oyando, David A Leon, Emily Herrett, Andrew M Prentice, Anoop SV Shah, Pablo Perel, Anthony O. Etyang
{"title":"Determining the optimal diagnostic and risk stratification approaches for people with hypertension in two rural populations in Kenya and The Gambia: a study protocol for IHCoR-Africa Work Package 2","authors":"Alexander D Perkins, Juliet O. Awori, Modu Jobe, Ruth K Lucinde, Meike Siemonsma, R. Oyando, David A Leon, Emily Herrett, Andrew M Prentice, Anoop SV Shah, Pablo Perel, Anthony O. Etyang","doi":"10.3310/nihropenres.13509.1","DOIUrl":"https://doi.org/10.3310/nihropenres.13509.1","url":null,"abstract":"Background Sub-Saharan Africa (SSA) has one of the highest prevalences of hypertension worldwide. The impact of hypertension is of particular concern in rural SSA, where access to clinics and hospitals is limited. Improvements in the management of people with hypertension in rural SSA could be achieved by shifting diagnosis and care from the clinic to the community. To develop such a community-centred programme we need optimal approaches to identify and risk stratify patients with elevated blood pressure. The aim of the study is to improve the evidence base for diagnosis and risk estimation for a community-centred hypertension programme in two rural settings in SSA. Methods We will conduct a cross-sectional study of 1250 adult participants in Kilifi, Kenya and Kiang West, The Gambia. The study has five objectives which will determine the: (1) accuracy of three blood pressure (BP) measurement methods performed by community health workers in identifying people with hypertension in rural SSA, compared to the reference standard method; (2) relationship between systolic BP and cardiovascular risk factors; (3) prevalence of hypertension-mediated organ damage (HMOD); (4) accuracy of innovative point-of-care (POC) technologies to identify patients with HMOD; and (5) cost-effectiveness of different combinations of BP and HMOD measurements for directing hypertension treatment initiation. Expected findings This study will determine the accuracy of three methods for community BP measurement and POC technologies for HMOD assessment. Using the optimal methods in this setting it will estimate the prevalence of hypertension and provide the best estimate to date of HMOD prevalence in SSA populations. The cost-effectiveness of decision-making approaches for initiating treatment of hypertension will be modelled. These results will inform the development of a community-centred programme to improve care for hypertensive patients living in rural SSA. Existing community engagement networks will be used to disseminated within the research setting.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"83 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138951278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Imane Guellil, Jinge Wu, Aryo Pradipta Gema, Farah Francis, Yousra Berrachedi, Nidhaleddine Chenni, Richard Tobin, Clare Llewellyn, Stella Arakelyan, Honghan Wu, Bruce Guthrie, Beatrice Alex
{"title":"Natural language processing for detecting adverse drug events: A systematic review protocol","authors":"Imane Guellil, Jinge Wu, Aryo Pradipta Gema, Farah Francis, Yousra Berrachedi, Nidhaleddine Chenni, Richard Tobin, Clare Llewellyn, Stella Arakelyan, Honghan Wu, Bruce Guthrie, Beatrice Alex","doi":"10.3310/nihropenres.13504.1","DOIUrl":"https://doi.org/10.3310/nihropenres.13504.1","url":null,"abstract":"Background Detecting Adverse Drug Events (ADEs) is an emerging research area, attracting great interest in the research community. Better anticipatory management of predisposing factors has considerable potential to improve outcomes. Automatic extraction of ADEs using Natural Language Processing (NLP) has a great potential to significantly facilitate efficient and effective distillation of such knowledge, to better understand and predict risk of adverse events. Methods This systematic review follows the six-stage including the literature from 6 databases (Embase, Medline, Web Of Science, ACM Guide to Computing Literature, IEEE Digital Library and Scopus). Following the title, abstract and full-text screenings, characteristics and main findings of the included studies and resources will be tabulated and summarized. The risk of bias and reporting quality was assessed using the PROBAST tool 1 . Results We developed our search strategy and collected all relevant publications. As of October 2023, we have completed the first two stages of the systematic review. We identified 178 studies for inclusion through the academic literature search (where data was extracted from 118 papers). Further refinement of the eligibility criteria and data extraction has been ongoing since August 2022. Conclusion In this systematic review, we will identify and consolidate information and evidence related to the use and effectiveness of existing NLP approaches and tools for automatically detecting ADEs from free text (discharge summaries, General Practitioner notes, social media, etc.). Our findings will improve the understanding of the current landscape of the use of NLP for extracting ADEs. It will lead to better anticipatory management of predisposing factors with the potential to improve outcomes considerably. Our results will also be valuable both to NLP researchers developing methods to extract ADEs and to translational/clinical researchers who use NLP for this purpose and in healthcare in general.","PeriodicalId":74312,"journal":{"name":"NIHR open research","volume":"122 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138959071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}