• Online research in health

      Anthony, Denis; University of Derby (Sage, 2019-04-30)
      This chapter shows some of the ways to use online resources in health research. It looks not only at internet-based data sources but also more widely at some of the clinical databases to illustrate the advantages and limitations of using these for research. In general, using internet-based resources can be make health research quicker and less labour intensive with rapid access to data and references. It can also provide tools to carry out data collection and analysis. However, researchers may have to learn how to use the tools available and not all health data are available. Some clinical databases are closed systems for reasons of patient confidentiality. These systems may be web-based but are on intranets rather than on the public internet with wider access – such as those that are part of hospital information and support systems (HISS).
    • Oral nutritional supplements in care homes and the community: Nutrition review and staff education.

      Giles, David; Lewis, Rachel; Ward, Derek; University of Derby (University of Derby, 2018-03-29)
      The University of Derby’s Health and Social Care Research Centre has been commissioned to support the delivery of Southern Derbyshire CCG’s review of oral nutritional supplements (ONS) and education of care home staff. Southern Derbyshire currently spends £1,409,099 on ONS prescribing (SH3-OT26 PID, 2016). While the efficacy of the use of ONS in malnourished patients is well understood (Agarwal, Miller, Yaxley, & Isenring, 2013), their use may not always be appropriate and other methods such as food fortification may result in either equal or better outcomes for considerably lower cost (Baldwin & Weekes, 2012). A successful pilot in five care homes by Southern Derbyshire CCG achieved cost savings of £183,203.33, along with the associated benefits of increased dietetic support to those residents who required input. On this basis, building on the pilot work, the present programme of work was conceived. Broadly, the project aimed to: (a) improve the nutritional state of residents in 112 care homes and at home; and (b) reduce spend on ONS prescribing. This was divided into two work streams: (1) evaluating the efficacy of a training programme on the identification, prevention and treatment of malnutrition, through a “Food First” approach including MUST training; and (2) the assessment, review and support of GP practices with patients prescribed ONS within their own home. This report provides an overview of the work done by the dietetics team up until the end of February 2018. The analysis of the dataset provides context for the recommendations presented.
    • Parental and health professional evaluations of a support service for parents of excessively crying infants

      Bamber, Deborah; Powell, Charlotte; Long, Jaqui; Garratt, Rosie; Brown, Jayne; Rudge, Sally; Morris, Tom; Bhupendra Jaicim, Nishal; Plachcinski, Rachel; Dyson, Sue E.; et al. (Springer Nature/ BMC, 2019-08-22)
      The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. Methods: Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured. Results: Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. Discussion and conclusions: The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research.
    • Parents’ experiences of having an excessively crying baby and implications for support services

      Garratt, Rosemary; Bamber, Deborah; Powell, Charlotte; Long, Jaqui; Brown, Jayne; Turney, Nicy; Chessman, Jo; Dyson, Sue E.; St James-Roberts, Ian; De Montfort University; et al. (Mark Allen Group (MAGonline), 2019-03-20)
      Evidence suggests that around 20% of healthy babies cry for long periods without apparent reason, causing significant distress to parents and a range of adverse outcomes. This study explored parents’ experiences of having an excessively crying baby and their suggestions for improved NHS support. Focus groups and interviews with 20 parents identified three key themes: disrupted expectations and experiences of parenthood; stigma and social isolation; seeking support and validation of experience. Parents experienced shock, anxiety and a sense of failure, leading to self-imposed isolation and a reluctance to seek help. Other people’s reactions sometimes reinforced their feelings. Parents need more support, including from health professionals, to cope with excessive crying, and recommendations for this support are given.
    • Patient-reported outcome measures: Clinical applications in the field of chronic pain self-management

      Elander, James; Elisabeth, Spitz; University of Derby; University of Lorraine, Metz, France (Routledge, Taylor and Francis Group, 2017-05-16)
      Chronic pain is a major influence on patient-reported quality of life. This chapter examines ways that information from patient-reported outcome measures (PROMs) can be translated into clinical practice to improve the management and self-management of chronic pain among people with rheumatic disorders and haemophilia. This includes: 1) evidence about how PROMs can be used to improve routine clinical practice and self-management programmes in rheumatic disorders and haemophilia; 2) evidence about a DVD intervention with patient perspectives about living and coping with chronic joint pain, which improved patient-reported readiness to self-manage pain; 3) evidence about pain acceptance and pain coping as influences on patient-reported quality of life among people with haemophilia; and 4) recommendations for clinical and treatment interventions to improve patient-reported outcomes for people with haemophilia-related joint pain.
    • Personal resilience for diagnostic radiographer healthcare education: Lost in translation?

      de Witt, Julie T.; University of Derby (Coventry University, 2017-12-11)
      A research study was undertaken to gain a better understanding of the concept of resilience from the perspective of the undergraduate students on a BSc (Hons) Diagnostic Radiography programme; and the impact of resilience ‘training’ interventions (based on some resilience coaching principles) prior to their first clinical placement. This article sets out the findings from a qualitative research study, analysed using thematic analysis, where students were asked about their definition of personal resilience. Few students used an approximation of the ‘traditional’ definition of resilience; indeed, some seemed to view resilience as a weakness or something to be guarded against. In terms of what students thought affected their resilience, there was no clear pattern; thus seeming to confirm that resilience is personal, and therefore questioning a one-size approach in relation to resilience ‘training’. There could be some merit in encouraging discussion around resilience in the academic setting, but there are some considerable caveats. At the outset fostering an understanding of resilience as a positive trait seems important, otherwise discussion about resilience in a class or tutorial setting may not be received by the learner in the way we may hope or expect.
    • Photography

      Hogan, Susan; University of Derby (Routledge, 2020-02-24)
    • Physical activity and sport evaluation toolkit.

      Giles, David; University of Derby (County Sports Partnerships Network, 2018-05)
      The physical activity and sport evaluation toolkit has been produced through collaboration between the East Midlands County Sports Partnership and the University of Derby. The purpose of the toolkit is to support the identification tools and methods to monitor and evaluate the effectiveness of physical activity interventions. The monitoring and evaluation of physical activity programmes should be considered from their conception. This toolkit was created for this purpose. To aid with the design and implementation of evaluation and monitoring Sport England has recently (June 2017) released an online evaluation toolkit. While the Sport England toolkit was conceived for the evaluation of their commissioned programmes and for their staff, the process may be applied to any programme. The sport and physical activity toolkit developed as a product of this evaluation consultancy fits within stage 4 of Sport England's framework “select data collection methods and tools”.
    • Physical activity: understanding and addressing inequalities

      Jackson, Jessica; Roscoe, Clare M. P.; Mourton, Niamh; University of Derby (Public Health England, 2021-02-22)
      This guidance can be used by local level practitioners and commissioners to begin tackling inequalities in physical activity across and within protected characteristic groups. It presents the findings of a review, analysis and research aimed at understanding the enablers, barriers and opportunities for increasing physical activity across inequality groups. Three major themes are identified as considerations for action by practitioners and commissioners: enablers, barriers, and identifying opportunity community consultation, engagement, and partnership adopting a holistic approach for protected characteristics and intersectionality The document concludes with a full set of recommendations for commissioners and practitioners to consider when designing services and interventions locally.
    • Prevalence of heat and perspiration discomfort inside prostheses: literature review.

      Ghoseiri, K; Safari, Reza; University of Social Welfare and Rehabilitation Sciences (U.S. Department of Veterans, 2014-01-01)
      People with limb amputation deal with thermal stresses in their daily activities. Unfortunately, in the majority of this population, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the prosthetic socket barrier, decreased body surface area, and/or vascular disease. The thermal environment inside prosthetic sockets, in addition to decreased quality of life and prosthesis use, comfort, and satisfaction, could endanger people with amputation with a high risk of skin irritations. The current review explores the importance of thermal and perspiration discomfort inside prosthetic sockets by providing an insight into the prevalence of the problem. The literature search was performed in two databases, PubMed and Web of Knowledge, to find relevant articles. After considering the review criteria and hand-searching the reference sections of the selected studies, 38 studies were listed for review and data extraction. This review revealed that more than 53% of people with amputation in the selected studies experienced heat and/or perspiration discomfort inside their prostheses. In spite of great technological advances, current prostheses are unable to resolve this problem. Therefore, more attention must be paid by researchers, clinicians, and manufacturers of prosthetic components to thermal-related biomechanics of soft tissues, proper fabrication technique, material selection, and introduction of efficient thermoregulatory systems.
    • Prevalence of pressure ulcers in Africa: A systematic review and meta-analysis

      Anthony, Denis; Alosaimi, Dalyal; Korsah, Kwadwo; Safari, Reza; Shiferaw, Wondimeneh Shibabaw; University of Derby; College of Nursing, King Saud University, Saudi Arabia; Institute of Medicine and College of Health Sciences, Debre Berhan University, Ethiopia; School of Nursing and Midwifery, University of Ghana, Ghana (Elsevier, 2021-10-27)
      A recent global review of pressure ulcers contained no studies from Africa. To identify the prevalence and incidence of pressure ulcers in Africa. Bibliographic databases, African specific databases, grey literature. Studies with prevalence or incidence data of pressure ulcers from Africa since the year 2000. Any age, including children, in any setting, specifically including hospital patients from any clinical area but not restricted to hospital settings. Holy score for bias, Joanna Briggs Institute Critical Appraisal Instrument. We followed the PRISMA guideline for systematic reviews. We searched Embase, Medline, Scopus, CINHAL, Google Scholar, specialist African databases and grey literature for studies reporting incidence or prevalence data. Nineteen studies met the inclusion criteria and were included in the study. Point prevalence rates varied from 3.4% to 18.6% for medical/surgical and other general hospital units with a pooled prevalence of 11%, for grades II-IV 5%. For spinal injury units the pooled prevalence was 44%. Restricted to English, French and Arabic. Prevalence of pressure ulcers in Africa reported here is similar to figures from a recent review of prevalence in Europe and two recent global reviews of hospitalised patients. Prevalence of pressure ulcers in spinal cord injury patients is similar to figures from a review of developing countries. The reporting of prevalence is lacking in detail in some studies. Studies using an observational design employing physical examination of patients showed higher prevalence than those relying on other methods such as medical notes or databases. Further prevalence and incidence studies are needed in Africa. Reporting of such studies should ensure items in the “Checklist for Prevalence Studies” from Joanna Briggs Institute (or similar well regarded resources) are addressed and the PICOS model and PRISMA guidelines are employed. Systematic review registration number. Prospero registration number CRD42020180093
    • Prevalence of pressure ulcers in long term care: A global review.

      Anthony, Denis; Alosoumi, Dalyal; Safari, Reza; University of Derby (Mark Allen Healthcare, 2019)
      To identify the prevalence and incidence of pressure ulcers in people with long term conditions resident in care homes or nursing homes . We followed the PRISMA guideline for systematic reviews however due to funding constraints we do not claim this review to be systematic but it is a narrative review informed by PRISMA. We searched Embase, Medline and CINHAL for observational studies reporting incidence or prevalence data. Data reported relevant head to toe examination of the pressure ulcer in residence of care or nursing homes. Internat and external validity of the included studies were assessed using the checklist devised by Hoy et al (2012). Seventeen studies met the inclusion criteria an included in the study. Some studies gave a full breakdown by grade, some only gave overall figures and some excluded grade I pressure ulcers. However within those constraints certain patterns are clear. Prevalence rates varied from 3.4% to 32.4% and large differences in prevalence in different countries was not explained by methodological differences. While some countries such as Germany, the Netherlands and the USA had robust data some countries such as the UK had none. Pressure ulcers are a common problem in long term care. However there are substantial differences between countries and many countries have no published data.
    • The prototype of a thermoregulatory system for measurement and control of temperature inside prosthetic socket

      Ghoseiri, Kamiar; Ghoseiri, K; Zheng, Y.P; Hing, L.T; Safari, Reza; Leung, A.K.L; University of Social Welfare and Rehabilitation Sciences; Hong Kong Polytechnic University (SAGE, 2015-06-11)
      Thermal related problems with prostheses are common complaints of amputee people. This article aims to introduce a thermoregulatory technique as a potential solution for those problems in prostheses wearers. A smart thermoregulatory system was designed, manufactured, and installed on a phantom model of a prosthetic socket. It captured temperature data from 16 sensors positioned at the interface between the phantom model and a silicone liner and used their average for comparison with a defined set temperature to select required heating or cooling functions for thermal equilibrium. A thin layer of Aluminum was used to transfer temperature between thermal pump and different sites around the phantom model. The feasibility of this thermoregulatory technique was confirmed by its ability to provide thermal equilibrium. Further investigations to improve the design of thermoregulatory system are necessary including temperature transfer element and power consumption based on thermal capacity and thermal inertia of the residual limb. The smart thermoregulatory system by providing thermal equilibrium between two sides of a prosthetic silicone liner can control residual limb skin temperature and sweating. Consequently, it can improve quality of life in amputee people.
    • Reducing avoidable pressure ulcers.

      Anthony, Denis; HODGSON, Heather; HORNER, Joanna; University of Leeds (Wounds UK., 2017-04-24)
      Risk assessment scales for pressure ulcers have been in use for over 50 years but there is no evidence that such scales reduce pressure ulcer incidence. Pressure ulcer interventions have been shown to be effective, sometimes alongside risk assessment scales. Care bundles are an example of multifaceted approaches that have been successfully used in a variety of clinical areas including for pressure ulcers. Pressure ulcers were monitored before and after implementation of a new scheme based on an existing care bundle. Avoidable pressure ulcers were significantly reduced following implementation of the scheme.
    • Reducing health risk factors in workplaces of low and middle-income countries.

      Anthony, Denis; Dyson, Pamela A.; Lv, Jun; Thankappan, Kavumpurathu R.; Matthews, David R.; University of Leeds; Healthcare; University of Leeds; Leeds UK; Oxford Centre for Diabetes, Endocrinology & Metabolism; University of Oxford; Oxford UK; School of Public Health; Peking University Health Science Center; Beijing China; Achutha Menon Centre for Health Science Studies; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Trivandrum India; et al. (Wiley., 2015-03-19)
      Objective: To reduce risk factors in workplace settings in low- and middle-income countries. Design and Sample: Workplace interventions were utilized as part of the Community Interventions for Health program, a nonrandomized, controlled study undertaken in three communities in China, India, and Mexico. Exactly, 45 industrial, 82 health and 101 school workplace settings with a target population of 15,726. Two independent cross-sectional surveys of workers were conducted at baseline and follow-up, after 18–24 months of intervention activities. Measures: Culturally appropriate interventions to reduce tobacco use, increase physical activity, and improve dietary intake were delivered in the intervention areas. Results: Exactly, 12,136 adults completed surveys at baseline, and 9,786 at follow-up. In the intervention group, the prevalence of tobacco use reduced significantly in men (-6.0%, p < .001) and the proportion eating five portions of fruit and vegetables daily increased (+6.9%, p < .001) compared with the control group. There were no significant differences between the groups for changes in physical activity or prevalence of overweight. Conclusions: Workplace interventions improved risk factors in China, India, and Mexico.
    • Reported school experiences of young people living with sickle cell disorder in England.

      Dyson, Simon M.; Abuateya, Hala; Atkin, Karl; Culley, Lorraine; Dyson, Sue E.; Rowley, Dave (Wiley, 2010)
      A survey of 569 young people with sickle cell disorder (SCD) in England has found such pupils miss considerable periods of time from school, typically in short periods of two or three days. One in eight has school absences equating to government-defined ‘persistent absence’. Students with SCD report that they are not helped to catch up after these school absences. Half the children reported not being allowed to use the toilet when needed and not being allowed water in class; a third reported being made to take unsuitable exercise and being called lazy when tired. Children perceived both physical environment (temperature, school furniture) and social environment (being upset by teachers or other pupils) as triggers to episodes of their illness. Policy initiatives on school absences; preventive measures to ensure maintenance of good health; and measures to prevent perceived social attitudes precipitating ill health would also support children with other chronic illnesses at school.
    • Respect, trust, and the management of sickle cell disease pain in hospital: comparative analysis of concern-raising behaviors, preliminary model, and agenda for international collaborative research to inform practice

      Elander, James; Beach, Mary Catherine; Haywood, Carlton; University of Derby; John Hopkins University, Baltimore, MD, USA (Taylor and Francis, 2011-07-28)
      Qualitative interview studies suggest that adult patients’ experiences of hospital treatment for sickle cell disease (SCD) pain reflect an absence of respect by providers for patients, and an absence or breakdown of trust. Systematic comparisons between treatment settings could help identify contextual influences on respect and trust. Quantitative comparison of concern-raising behaviors (pain treatment outcomes indicating breakdowns of trust) among adult SCD patients in Baltimore, Maryland, U.S.A., and London, U.K., followed by analysis of potential explanations for differences, including socio-cultural and behavioral factors, with a preliminary model of the processes leading to concern-raising behaviors. Rates of concern-raising behaviors were significantly higher in Baltimore than London. The model identifies respect and trust as key factors which could be targeted in efforts to improve the quality of SCD pain management in hospital. An agenda for international, interdisciplinary research to improve the treatment of SCD pain in hospital should include: comparative analyses between countries and treatment settings of factors that could influence respect and trust; research to test hypotheses derived from models about the roles of respect and trust in the treatment of pain; studies of the impact of healthcare structures and policy on patients’ experiences of care; research focusing on developmental and interpersonal processes related to respect and trust; applications of attribution and other social psychology theories; and development and evaluation of interventions to improve the hospital treatment of SCD pain by increasing respect and trust.
    • Return to practice: supporting diagnostic radiographers back into the workforce.

      Hyde, Emma; Errett, Sue; University of Derby (2017-06-12)
      The ‘Return to Practice in Diagnostic Radiography’ programme at one UK university provides a structured way for returnees to meet the Health and Care Professions Council (HCPC) return to practice requirements. The programme is designed to support returnees to re-establish clinical competency in a range of radiographic techniques and diagnostic imaging procedures within their scope of practice. The programme includes scheduled learning and teaching activities, simulation in the clinical skills suite and problem based scenarios. Guided independent study is utilised to support individual learning needs identified in a ‘gaps analysis’ exercise. Placement learning provides the opportunity for returnees to apply underpinning theory into current clinical practice, and demonstrate professional and radiographic skills. This poster shared the experience of successfully supporting the two cohorts of return to practice learners through the programme.
    • The role and value of medicines management work packages 1 & 2

      Giles, David; Lewis, Rachel; Ward, Derek; University of Derby (Southern Derbyshire County Council, 2017-07-28)
      Work Package 1 presents the findings and recommendations from the analysis of Southern Derbyshire’s Medicine Management “Work Log” SharePoint data set. The report provides an overview of the work done by the Medicine Management team. The current form and function of the SharePoint data set are also discussed. The analysis of the dataset (Annex Document) provide context for the recommendations presented, which are based on six case studies selected by Southern Derbyshire Medicines Management team. Work package 2 presents the findings and recommendations from our evaluation of the project to embed Clinical Pharmacists in Patient Facing roles within the ‘Belper Five’ group of practices. This element of the report continues to explore the value of medicines management from the viewpoint of the expanded role of the patient facing Clinical Pharmacists within a general practice setting.