7786 research outputs found
Sort by
Co-design to improve digital inclusion for social connectedness for people with memory problems and dementia
No full textA paper presented at the 'Better health outcomes from digital health?’ National Healthcare Outcomes Conference, RCSI University of Medicine and Health Sciences, 8 April 2025.</p
A multifactorial intervention to improve cardiovascular outcomes in adults with type 2 diabetes and current or previous diabetic foot ulcer disease: protocol for a multi-centre randomised control trial (MiFoot study)
No full textBackground: In the United Kingdom, the prevalence of diabetes-related foot ulcer disease (DFUD) is 6.3%, and cardiovascular disease (CVD) is the leading cause of mortality in people with DFUD. This study aims to evaluate the effectiveness of a multifactorial intervention to reduce CVD events and mortality in adults with type 2 diabetes (T2D) and DFUD.Methods: The MiFoot study is a multi-centre, pragmatic randomised controlled trial to test intervention effectiveness and cost-effectiveness compared to usual care that will include an internal feasibility study and a process evaluation. English-speaking adults (≥18 years; n = 392) with T2D and current/previous (within 5 years) DFUD will be recruited from multiple sites across the United Kingdom and randomised 1:1 to intervention (MiFoot multifactorial intervention plus usual care) or control (usual care), with data collected at baseline, 12- and 24-month follow-up. The MiFoot intervention comprises an individualised assessment with a healthcare practitioner to optimise treatment and assess the suitability of physical activity participation; group-based disease self management education and physical activity sessions; and a digital-based programme, consisting of cohort-relevant topics, physical activity guidance and peer support functionality. The primary outcome will be extended major adverse cardiovascular events (MACE, i.e. myocardial infarction, stroke, cardiovascular death, peripheral arterial bypass, coronary artery bypass, coronary angioplasty or peripheral artery angioplasty) at 24 months.Discussion: This study will provide evidence on the feasibility and clinical effectiveness, and cost-effectiveness of a multifactorial intervention to prevent or slow the progression of CVD-related complications in the extremely high-risk population with T2D and DFUD.</p
Impact of smoking on cardiovascular health: mechanisms, epidemiology and specific concerns regarding congenital heart disease
No full textSmoking remains one of the public health-preventable threats. The negative long-term effect of smoking on cardiovascular disease (CVD) is well-demonstrated [1,2], in particular a meta-analysis shows that smoking increases the risks of coronary heart disease by 30 % and increases incidence of stroke by 20–30 % [3].Smoking further contributes with the other atherosclerotic cardiovascular disease (ASCVD) risk factors to the chance of several adverse outcomes such as arrhythmias, heart failure, mortality, and impaired quality of life [4].Importantly, randomized control trials proved the advantage of smoking cessation, underlining the importance of taking an action on public health at any stage and time of a person's life [5].This review elaborates on the adverse effects of smoking on cardiovascular system and approaches to this problem in Adults with Congenital Heart Disease (ACHD).</p
Synthesising the evidence for patient and public involvement in pressure ulcer research: a scoping review protocol
No full textIntroduction: There is a growing shift toward greater inclusion of patients and the public in the design, conduct, and implementation of research to ensure it is more meaningful, relevant and impactful. This involvement creates a partnership in which patients and the public contribute to decisions throughout the research lifecycle. While the impact and importance of patient and public involvement (PPI) in research is becoming increasingly recognised, the extent of PPI in pressure ulcer (PU) research has yet to be fully established. This scoping review aims to provide insights into how PPI has been included and reported in PU research, ultimately placing a spotlight on the impact and importance of reporting PPI to guide future PU research.Methods and analysis: Through synthesising literature from a diverse global landscape, this scoping review aims to achieve the following objectives (1) To explore and map the stage(s) of the PU research cycle where PPI has been incorporated (2) To identify and describe the range of participatory methods, including frameworks, guidelines, or tools, that have been used to facilitate the involvement of patients and the public in PU research. (3) To identify and synthesise reporting impacts of including PPI in PU research, and (4) To map and analyse the terminology commonly used to describe PPI in PU research. The Joanna Briggs Institute scoping review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews framework will guide the conduct and reporting of this review. Nine databases will be included in the search strategy and all articles will be independently screened for eligibility by two authors. Data from eligible articles will be extracted using a pre-defined data extraction table, and the results will be analysed and synthesised using the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework.Ethics and dissemination: Ethics approval will not be required considering the nature of this scoping review. PPI advisory partners will be consulted for disseminating the results in a format that is accessible and understood by a layperson, in order to communicate the findings to a wide audience and diverse communities. This scoping review will be published in a peer reviewed journal and results will be disseminated at local national and international conferences.Registration: This scoping review is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/JHT34). As is typical with scoping reviews, this protocol may evolve over time. Any updates will be documented on the Open Science Framework platform, along with a clear rationale for the changes.</p
COVID-19 and neuropathy in type 2 diabetes
No full textThis study investigated the risk factors for COVID-19 and its impact on diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes (T2D). Patients with T2D underwent assessments with the NICE post-COVID questionnaire, DN4 questionnaire, vibration perception threshold (VPT), and corneal confocal microscopy (CCM) before and 11.0 ± 8.9 months after developing COVID-19. Of 76 participants with T2D, 35 (46.1%) developed COVID-19, of whom 8 (22.9%) developed severe COVID-19 and 9 (25.7%) developed long-COVID. The development of COVID-19 was associated with lower systolic blood pressure (P P = 0.42–0.94). Women were eight times more likely to develop long-COVID (P P P P P = 0.08–0.99). There was a significant reduction in corneal nerve measures (P < 0.05-0.0001) in patients with and without COVID-19. A low systolic blood pressure, altered lipids, body weight, higher VPT, and gender may determine the impact of COVID-19 in patients with T2D, but there was no evidence of an impact of COVID-19 on the development or progression of DPN.</p
Reflection, mindfulness, and shame processing in social work practice
No full textSocial workers internationally suffer from high rates of stress and burnout. One of the main drivers of these phenomena, is that social work is a rewarding but challenging profession that can heavily deplete practitioners’ emotional resources, particularly if they haven’t been trained on how to reflect on, label, and process challenging emotions, which are commonly experienced in practice. This paper will outline how enhanced capacities for reflection, engendered through mindfulness-based practice can support practitioners to engage with their emotional experiences as part of their routine practice. Using practice case studies, this theory paper will illustrate how challenging emotions, using shame as an example, which social workers often avoid, can be safely reflected on, labelled, and processed. The personal and practice benefits of the deeper engagement with, and processing of challenging emotions will be outlined. This paper also highlights the corrosive effect that unprocessed shame can have on the professional and personal life of a social worker. It also provides a theoretical framework and suggestions on how social workers and social work organisations could be supported to enable effective emotion regulation in social work practice.</p
Transnational medical education programmes and preparation for different country medical practice: a systematic review
No full textBackground: Medical education is becoming more internationalised. Increasing numbers of students engage in Transnational Medical Education Programmes, pursuing their Primary Medical Qualification outside of their home country; with plans to transition back to their home country - or a third country - after graduation. Medical education is however, inextricably embedded within medical contexts, and a potential mismatch exists between graduates' place of training and place of practice in terms of the knowledge, skills and values required to practice safely in a different context.Aim: What types of Transnational Medical Education programmes can be identified from the international literature? What are the strengths and weaknesses of these programmes and do they prepare students for international practice?Methods: This review was based on the PRISMA-Guidelines for systematic reviews. We searched five electronic databases: MEDLINE, EMBASE, CINAHL, WEB of Science and ERIC. No date or language restrictions were placed on the inclusion criteria. Data extraction was completed by two independent reviewers. Quality appraisal was carried out using the Mixed Methods Appraisal Tool (MMAT), and a narrative synthesis of the included papers was conducted.Results: Our literature search identified 12 studies. From the included studies we were able to identify three types of Transnational Medical Education Programme, and a number of strengths and weaknesses of these programmes. Strengths were: increasing medical workforce capacity, enhancing the quality of education locally, promoting intercultural competence and increasing exposure to new ways of working (enhanced communication skills, shared decision-making, experience of multidisciplinary teamwork and patient-centeredness). Weaknesses were: potential curriculum misalignment within the context of clinical practice, language barriers and encountering differences in hierarchical systems, shared decision making and patient-centredness all of which impact preparation for practice.Conclusion: Transnational medical education programmes address shortages within the medical workforce by creating additional training opportunities. They can also drive up the quality of medical education locally. There is, however, a potential mismatch between the curriculum and the place of practice which can impact upon graduates' preparation for professional practice.</p
Impact of nutritional interventions on quality of life in schizophrenia spectrum disorders: a scoping review
No full textObjectives: Schizophrenia is a chronic condition that requires long-term management. Quality of life is an important outcome measure for individuals diagnosed with schizophrenia; it can be tracked over time allowing evaluation of whether interventions lead to sustainable improvements. Nutrition and dietary interventions are an underutilized treatment for tackling the metabolic consequences of mental illness, which is now recognized as having increased importance in the management of schizophrenia. This study examines the impact of nutrition and dietary interventions on quality of life outcomes for those with schizophrenia.Methods: A systematic review of the literature was conducted, assessing the impact of nutritional interventions on quality of life outcomes in individuals with a diagnosis of schizophrenia.Results: A total of 982 articles were screened, of which nine articles met the inclusion criteria. Quality of life measures varied across studies, which made comparison across studies challenging. Previous studies had relatively small sample sizes and did not have long follow-up durations. Some of the studies found that dietary interventions such as counselling, weight management programs, food diaries and nutritional education improved quality of life, whereas others did not detect any effect.Conclusions: The review provides preliminary evidence that nutrition and dietary interventions may benefit quality of life among individuals with schizophrenia. There were however substantial limitations in studies highlighting the need for further research. The paper also highlights the need to standardize assessment tools for future quality-of-life research.</p
A Delphi-based needs assessment to identify and prioritise procedural skills through consensus for simulation-based learning in neurosurgery
No full textBackground: Training of the neurosurgeon today differs greatly from that of the past, with several well-documented challenges contributing to reduced operative time for current cohorts. The Joint Committee on Surgical Training (JCST) in the UK and Ireland have stated that simulation-based education (SBE) is part of the solution to tackle this training crisis. Our objective was to develop a prioritised list of technical skills through consensus with key opinion leaders (KOLs). This approach aimed to enhance understanding of the essential procedures that should shape a technical skills framework for neurosurgical simulation-based learning curricula.Methods: We utilised a modified Delphi process and Copenhagen Academy for Medical Education and Simulation (CAMES) Needs Assessment Formula (NAF) to reach consensus. A total of 71 procedures were included for initial analysis, which were extracted from all phases of the JCST curriculum and subsequent brainstorming with KOLs. A five person steering group oversaw the process, to ensure a robust methodological approach was followed at all stages.Results: For each of the three Delphi rounds, there were 32, 30, and 31 KOL responses, respectively. A prioritised list of 47 procedural skills was generated through consensus. The top three ranking procedures were patient positioning, pinning positions and flap design, intracranial pressure (ICP) probe insertion and external ventricular drain (EVD) insertion. Emphasis was placed on acute cranial trauma, degenerative spine, neuro-oncology and CSF diversion procedures as the categorical themes of highest priority.Conclusions: We describe a multi-jurisdiction general needs assessment for technical skills in neurosurgical simulation training. This study will inform the design of future simulation-based learning curriculum in this sphere of training.</p
Biomimetic scaffolds enhance iPSC astrocyte progenitor angiogenic, immunomodulatory, and neurotrophic capacity in a stiffness and matrix-dependent manner for spinal cord repair applications
No full textSpinal cord injury repair poses a significant challenge due to the hostile microenvironment of the injury site and the poor survival and function of clinically relevant transplanted cells. Here it is aimed to investigate whether tuning the physicochemical properties of implantable biomimetic biomaterial scaffolds can enhance the localized delivery and reparative potential of patient-derived induced pluripotent stem cells (iPSC) astrocyte progenitors. It is demonstrated that soft, collagen-IV/fibronectin-functionalized hyaluronic acid scaffolds, mimicking the physicochemical properties of healthy spinal cord tissue, optimally support the formation of iPSC-derived multicellular spheroids, promoting neural cell survival and function. These soft, collagen-IV/fibronectin scaffolds enhance angiogenic cytokine release, facilitate vascular network formation, modulate inflammatory responses, and promote neurite outgrowth from growing, mature and injured neurons, while supporting cell infiltration from spinal cord explants. These findings demonstrate that optimized biomimetic scaffold properties provide a supportive environment for iPSC astrocyte progenitors but can also modulate their reparative capacity. These findings highlight the critical role of matrix composition and scaffold stiffness in advancing scaffold-mediated patient-derived stem cell-delivery strategies for spinal cord repair applications.</p