11913 research outputs found
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EP5.6 Assessing the Impact of Socioeconomic Factors on Data Completeness in Hip Arthroscopy Outcomes: Insights from the UK Non-Arthroplasty Hip Registry
Full text linkIntroduction: Inequities in health outcomes based on socioeconomic status (SES) are well documented, yet their impact on the completeness of clinical data remains underexplored. This study evaluates how SES influences the completeness of follow-up data in the UK Non-Arthroplasty Hip Registry and assesses the efficacy of data imputation methods in enhancing the prognostic models. Method: We examined the records of 16,039 patients from November 2013 to March 2024, correlating UK national indices of multiple deprivation (IMD) with the missingness of various variables using chi-squared analysis. Sequential, multiple imputation by chained equations was used to estimate missing iHOT-12 scores preoperatively, and at 6 months, 1 year, and 2 years postoperatively. Results: Significant associations were found between IMD and the likelihood of missing follow-up data across several variables, including funding type, treatment approach, and surgical experience. The IMD’s correlation with missing data indicated that patients from lower SES backgrounds were less likely to have complete follow-up records. Imputation results showed no significant differences in imputed iHOT-12 scores across deprivation deciles at follow-up periods (p<0.05), suggesting that data imputation effectively balanced the dataset for analysis. Conclusion: The presence of SES-related disparities in data completeness can significantly skew outcome assessments in clinical research. By employing advanced imputation techniques, this study not only adjusted for missing data but also enhanced the reliability and validity of the prognostic models in predicting outcomes from arthroscopy. The findings underscore the importance of integrating robust methods to address potential biases in healthcare related AI research, ensuring that findings are reflective of all patient groups regardless of socioeconomic status. This approach is vital for developing equitable AI modelling in healthcare
Structured Cardiac Assessment and Treatment Following Exacerbations of COPD (SCATECOPD): A Pilot Randomised Controlled Trial
Full text linkBackground/Objectives: Heart disease is common in COPD, yet it is underdiagnosed and undertreated. Heart failure (HF) is undiagnosed in up to 20% of hospital inpatients. Hospitalised exacerbations of COPD (ECOPD) confer high mortality and readmission rates, with an elevated temporal cardiac risk. We performed a pilot randomised controlled trial examining the feasibility and effect of inpatient structured cardiac assessment (SCA) to diagnose and prompt guideline-recommended treatment of heart disease. Methods: A total of 115 inpatients with ECOPD were randomised 1:1 to receive usual care (UC) or SCA, comprising transthoracic echocardiography, CT coronary artery calcium scoring, 24 h ECG, blood pressure, and diabetes assessment. Follow-up was for 12 months. The prevalence of underdiagnosis and undertreatment of heart disease were captured, and potential outcome measures for future trials assessed. Results: Among patients undergoing SCA, 42/57 (73.7%) received a new cardiac diagnosis and 32/57 (56.1%) received new cardiac treatment, compared with 11/58 (19.0%; p < 0.001) and 5/58 (8.6%; p < 0.001) in the UC group. More patients in the SCA group were newly diagnosed with HF (36.8% vs. 12.1%; p = 0.002). When heart disease was diagnosed, the proportion receiving optimal treatment at discharge was substantially higher in SCA (35/47 (74%) vs. 4/11 (34%); p = 0.029). The occurrence of a major adverse cardiovascular event (MACE) showed promise as an appropriate clinical outcome for a future definitive trial. MACEs occurred in 17.2% in usual care vs. 10.5% in SCA in one year, with a continued separation of survival curves during follow up, although statistical significance was not shown. Conclusions: A structured cardiac assessment during ECOPD substantially improved diagnosis and treatment of heart disease. HF and coronary artery disease were the most common new diagnoses. Future interventional trials in this population should consider MACEs as the primary outcome
Identification of four novel Streptomyces isolated from machair grassland soil using a culture-based bioprospecting strategy: Streptomyces caledonius sp. nov., Streptomyces machairae sp. nov., Streptomyces pratisoli sp. nov. and Streptomyces achmelvichensis sp. nov.
Full text linkA culture-dependent bioprospecting strategy, based on the use of several selective isolation media, revealed the presence of relatively high numbers of streptomycete-like colonies from machair grassland soil, in which carbonate minerals dominate. Representatives were shown to be bioactive in primary and secondary antimicrobial screens conducted through standard plug assays. The comparison of the whole-genome sequences showed that four of the isolates were novel species in the genus Streptomyces, for which the names Streptomyces caledonius sp. nov. (=DSM 118365; =NCIMB 15554), Streptomyces machairae sp. nov. (=DSM 118363; =NCIMB 15553), Streptomyces pratisoli sp. nov. (=DSM 118364; =NCIMB 15555) and Streptomyces achmelvichensis sp. nov. (=NCIMB 15556; =DSM 118366) are proposed. Genomes of the novel strains were found to be rich in biosynthetic gene clusters predicted to encode for diverse, specialized metabolites, notably antibiotics. They also contained stress-related genes that provided an insight into how streptomycetes cope with the prevailing conditions in machair grassland soils. It can be concluded that selective isolation and dereplication of streptomycetes from the unique machair habitat provides a practical way of isolating novel Streptomyces strains for ecological and biotechnological studies
The effects of a 6-week Sand- vs. Land-based jump training programme on frontal plane knee angle and jump performance in adolescent female football players.
Full text linkOur study investigated the effects of a six-week jump-training intervention (sand- vs land- based incorporated in a warmup), on frontal plane knee angle and jump performance of adolescent female football players. Fifty-six females were randomly allocated to either the SAND or LAND group. Thirty-nine females completed the program twice weekly and were eligible for analysis. Two-dimensional frontal plane projection angle (FPPA), countermovement jump (CMJ) and reactive strength index (RSI) (10-5 repeated jump test) were measured 1-week pre- and post-intervention. Analysis of covariance was used to model post-intervention group differences. Compatibility curves were used to visualise parameter estimates alongside P- values, and surprisal (S) value transforms. Mean difference (X ̅) and compatibility intervals (CI) (95|75%) for FPPA for SAND vs. LAND were X ̅= 1.29° (-0.11 to 2.69°|0.49 to 2.10°) for the dominant limb, and X ̅= 1.80° (0.56 to 3.04°|1.09 to 2.51°)| for the non-dominant limb. Interval estimates for jump performance were imprecise and unclear. The data indicates that including a sand surface within a jump training intervention could be beneficial when aiming to improve knee control in asymptomatic adolescent female football players, with no apparent detriment to jumping performance
Introduction to Professional Policing: Examining the Evidence Base. Second Edition
No full textPolicing is a dynamic profession with increasing demands and complexities placed upon police officers, staff and volunteers who provide a 24-hour service across a diverse range of communities. Written by experts in policing higher education from across both academic and professional practice, this book equips aspiring or newly appointed police officers, staff and volunteers with the knowledge and understanding to deal with the significant and often complex challenges they face daily.
This second edition of Introduction to Professional Policing explores a number of the core underpinning knowledge requirements identified as themes within the ever-evolving National Policing Curriculum (NPC) and Police Constable Entry Routes (PCER), while also informing those embarking on leadership development. These include:
Community and neighbourhood policing
Counter-terrorism
Digital policing
Ethics, equality, diversity and inclusion
Evidence-based policing
Maintaining professional standards
Police leadership
Problem solving and problem-oriented policing
Victims and protecting the vulnerable
Volunteers in policing
This edition has been reviewed and significantly updated in line with the dynamic and ongoing demands faced by operational policing and therefore the associated knowledge requirements for policing education and training. The book is refocused on the learning requirements contained within the range of entry routes now available in to policing, as well as the professional development of those serving as police staff and volunteers. This includes new chapters providing insights into community and neighbourhood policing, problem solving and volunteers in policing.
At the end of each chapter the student finds a case study, reflective questions and an extensive reference list, all of which reinforces students’ knowledge and furthers their professional development. Written in a clear and direct style, this book supports aspiring police officers, newly appointed police officers, direct entry detectives, community support officers, special constables and police staff. It will also be of interest to those embarking on a leadership journey within policing and anyone wanting to learn more about the profession of policing. It is essential reading for students taking a professional policing degree or commencing any of the police constable entry routes
Healthcare professionals’ perspectives on the implementation and purposefulness of a new alcohol recovery Navigator role in the North East of England – preliminary qualitative findings
Full text linkObjectives
This study aimed to explore clinicians’ perspectives in a single acute hospital regarding the introduction and perceived impact of an Alcohol Recovery Navigator role. The role was implemented within a hospital setting in North-East England to improve uptake of treatment in the community post-discharge and thereby help to reduce alcohol-related repeat admissions.
Study design
A qualitative study was conducted.
Methods
Semi-structured interviews were conducted with hospital clinicians (n = 8) recruited via purposive and snowball sampling. Interviews were transcribed verbatim, analysed using thematic analysis, with themes subsequently mapped onto Normalisation Process Theory constructs: coherence, cognitive participation, collective action, and reflexive monitoring.
Results
Participants reported high levels of knowledge and understanding (coherence) of the Alcohol Recovery Navigator role and valued having this service as part of patients’ recovery pathway. Staff appeared committed to engaging with the role (cognitive participation), which was perceived to have aided implementation and embedding of the role into patient care pathways. Participants were able to make the role work (collective action) by building relationships with hospital staff and patients to improve continuity of care. Staff appraisal (reflexive monitoring) observed increased engagement from patients with Navigators and perceived that the role contributed to patients making changes towards better health.
Conclusion
Participants’ perspectives support the continued provision of the Alcohol Recovery Navigator role. Implementation was viewed to have been successful, with Navigators imperative in bridging the gap between hospital and community care. Future research is required to assess the effectiveness of the wider programme
Health literacy: Reducing inequalities in healthcare access through improving the readability of healthcare material in the Northeast of England-a qualitative evaluation
No full textObjectives
Lower health literacy increases the risk of chronic illness, premature mortality, and health-harming behaviours. Leading to higher healthcare utilisation and lower preventive care participation. Many adults in England read at a 9–11-year level making most healthcare materials inaccessible. This study aimed to assess an intervention modifying healthcare materials’ readability in a hospital trust in North-East England by evaluating patient and staff perspectives.
Study design
Guided by the Theoretical Framework of Acceptability, a qualitative design evaluated modified patient leaflets for routine outpatient clinics, adjusted to a reading age of 9–11 years to align with the national average. Stakeholder perspectives on modified and unmodified materials were explored.
Methods
Twenty-five participants (six males, 19 females; aged 18–60, including 12 healthcare providers and 13 service users) with varying health literacy were recruited from four medical specialties in a single hospital trust in the northeast of England. Semi-structured interviews were conducted and analysed using Framework method.
Results
Participants preferred the modified materials for their clarity. Simpler language was perceived as reducing stigma and increasing confidence to engage with healthcare professionals. Service users felt empowered to manage their health, as revised materials were easier to understand. Healthcare providers valued improved readability, anticipating enhanced patient engagement and reduced misunderstandings. Participants emphasised the ethical imperative for accessible healthcare information to reduce inequalities.
Conclusions
Improving readability is welcomed and necessary to reduce structural inequalities. As disparities persist, ensuring accessible healthcare information could be a cost-effective scalable strategy. Further research should assess effectiveness on health outcomes
A cluster randomised feasibility trial assessing an interactive film intervention to improve wellbeing of young people in school settings in the North of England
Full text linkBackground
Adolescence is a critical period for the onset of mental illness. A partnership of a health and care network and filmmakers developed an interactive film for youth wellbeing. While such films have potential as a cost-effective preventative tool, their effectiveness remains unproven. This study aimed to assess the feasibility and acceptability of a randomised controlled trial of the interactive film intervention to improve wellbeing in school-aged youth.
Methods
In a mixed-methods cluster randomised feasibility trial in North East England (2021-2022), students in Years 10 (14-15 years) and 12 (16-17 years) from three schools were recruited and randomised to the following conditions: 1) watching the film in class, 2) watching the film in class with support from youth workers or 3) regular class activities. Feasibility outcomes included willingness of schools to participate, participant recruitment, and retention, which was accessed quantitatively and qualitatively. Data were analysed descriptively and with the use of thematic analysis.
Results
School recruitment targets were met, although this was challenging due to resource constraints and the COVID-19 pandemic. Questionnaires were completed before watching the film by 172 students (48% of the recruitment target). Follow-up targets for retention were met at 3-months (n=138) and 6-months (n=136). Retention of Year 10 students was high (96%), but Year 12 students had lower retention (60%). Qualitative findings showed students and teachers supported the intervention and trial and measurements however, consent-taking required more time. Communication and resource issues within schools were challenging and need addressing before moving to a larger trial.
Conclusion
Although some trial aspects were feasible and acceptable, particularly the intervention, others, such as recruitment, retention and school communication, posed challenges. We recommend future feasibility studies should address barriers such as randomisation, communication with schools, recruitment of older students (16-18 years), consent and measurement alignment before moving to a larger-scale trial
(Re)shaping the Future of Research In Further Education: Opportunities, Barriers and Beyond
No full textThe Role of Gerotranscendence Theory and Physical, Psychological, and Social Determinants in Predicting Life Satisfaction: A Structural Equation Modeling Analysis
Full text linkBackground: (1) Objective: This study aimed to develop and evaluate a structural model of life satisfaction in older adults, integrating the World Health Organization’s biopsychosocial determinants and the theory of gerotranscendence to provide a more holistic understanding of the aging experience. (2) Methods: A cross-sectional study was conducted with 600 older adults (≥60 years) residing in Tehran, selected through proportional random sampling. Data was collected via validated instruments assessing demographic factors, physical and mental health, social support, environmental condition quality, and gerotranscendence. Structural Equation Modeling (SEM) using AMOS 24 and hierarchical regression were employed for data analysis. (3) Results: The findings revealed that physical health, mental health, social support, environmental conditions, and gerotranscendence were all significantly associated with life satisfaction (p < 0.01). Hierarchical regression analysis showed that gerotranscendence remained an independent and significant predictor of life satisfaction, even after accounting for other variables. The final model explained approximately 39% of the variance in life satisfaction and demonstrated good fit indices (RMSEA = 0.051, CMIN/DF = 2.545, PCLOSE = 0.272, GFI = 0.815). (4) Conclusion: The proposed model offers a comprehensive framework for understanding life satisfaction in older adults, highlighting the unique contribution of gerotranscendence. These findings highlight the importance of integrated interventions that enhance physical and mental health, promote social and environmental well-being, and foster spiritual growth. Future research should consider longitudinal and mixed-method designs to further explore causal relationships and cultural contexts.
Keywords: gerotranscendence theory; life satisfaction; social determinant; psychological determinant; physical determinan