12560 research outputs found
Sort by
The impact of an electronic learning intervention to support appropriate antibiotic prescribing behaviour by non-medical prescribers for upper respiratory tract infections in the primary care setting: a feasibility study
Get PDFBackground: Interventions are available for general practitioners to support appropriate antibiotic prescribing behaviour for common, acute, uncomplicated, self-limiting upper respiratory tract infections (URTIs). Non-medical prescribers frequently manage these conditions, but no such interventions exist for these groups. This study aimed to assess the feasibility and perceived impact of a theory-based electronic learning intervention designed to support appropriate antibiotic prescribing by non-medical prescribers for URTIs in primary care settings. Methods: A repeated measures, electronic survey design was used, with data collection occurring pre-intervention (stage 1), post-intervention (stage 3), and at a 3-month follow-up (stage 4). The intervention’s usefulness was assessed by analysing prescribers’ self-reported confidence and knowledge in treating patients with URTIs, as well as their views on the relevance of the intervention to their work. The influence of the intervention on prescribing behaviour was evaluated by examining prescribers’ perceived capabilities, opportunities, and motivations (COM) in the pre-intervention questionnaire and at follow-up. Feasibility outcome measures included recruitment, retention, and engagement with the intervention. Results: Twenty-one participants (n = 18 nurses, n = 1 pharmacist, and n = 2 paramedics) responded to the recruitment materials, followed the weblink to the survey, and completed the intervention over the 2-month recruitment period. Outcome data for 21 participants were available for pre- and post intervention (stage 1 & 3) and 11 (52%) participants completed follow-up (stage 4). Behavioural practice (information and support for self-management of URTIs) and perceived COM in relation to prescribing for patients with URTIs all increased at follow-up. Mean confidence scores were high at pre- and post-intervention stages but showed a slight decrease at follow-up. The intervention was reported to be useful and applicable to participants’ practice. Conclusion: It was feasible to recruit the target sample, and participants engaged well with the intervention. However, further consideration is needed for recruiting pharmacists and paramedics and developing a retention strategy for the follow-up survey. Behaviour and COM influences on behaviour changed positively from before to after the intervention. Future work should consider using the intervention in nursing and pharmacy undergraduate programmes, with students on prescribing programmes, and with other non-medical prescribers such as paramedic and physiotherapist prescribers.</p
A complex systems view on physical activity with actionable insights for behaviour change
Get PDFPhysical inactivity and its associated health and economic burdens continue to rise despite decades of interdisciplinary research aimed at promoting physical activity. This Perspective takes a complex systems view on physical activity, proposing that at least two layers of complexity should be considered: (1) interactions between various physiological, psychological, social and environmental systems; and (2) their dynamic interactions across time. To address this complexity, all stages of the research process—from theory and measurement to study design, analysis and interventions—must be aligned with a complex systems perspective. This alignment requires intensive interdisciplinary collaboration and an integration of basic and applied research beyond current research practices to create transdisciplinary solutions. We offer actionable insights that bridge the gap between abstract theoretical approaches (for example, complex systems and attractor landscape frameworks of behaviour change) and practical research on physical activity, thereby laying a foundation for more effective behaviour change interventions
Bridging inequities in palliative and end-of-life care:the role and experiences of community connectors
Get PDFBackground: The Community Connectors programme is a UK pilot initiative designed to bridge gaps between cancer, palliative, and end-of-life care services and diverse ethnic and faith communities. Community Connectors are local individuals with strong cultural insight who enhance two-way communication, increase awareness of care services, and address the unique needs of seldom-heard groups, including South Asian, Black African-Caribbean, and Eastern European communities. By engaging trusted community members, the programme aims to foster relationships, empower communities, and improve understanding of cancer and palliative care pathways among underserved populations. Objective: To explore the experiences and perspectives of Community Connectors implementing this model, with a focus on feasibility, acceptability, and perceived impact within target communities. Methods: A qualitative longitudinal design was employed using linked interviews and reflective diaries. A qualitative descriptive approach was used to explore evolving perceptions of the role, community engagement, and barriers to care access. Semi-structured interviews (N = 3) were conducted between July 2023 and April 2024, focusing on emerging themes and changes in perceptions. In addition, Community Connectors (N = 4) kept diaries and activity logs to document their community interactions, challenges, and key observations throughout their involvement in the project. Results: Community Connectors reported success in building trust and relationships within the community, emphasising that trust, integrity, and passion for the role were more important than financial reward. Initially, there was confusion about the role, with expectations of marketing work evolving into a focus on research and engagement. They faced several challenges, including time constraints linked to the part-time nature of the role, as well as cultural sensitivities, language barriers, and stigma around cancer. Despite difficulties in measuring impact, Connectors reported personal growth, strong community relationships, and a sense of reward from their involvement. Conclusion: The Community Connector model is a feasible and culturally responsive approach to improving access to cancer and palliative care in underserved communities. Future programmes should provide clearer role definitions, sustained funding, and training in emotional resilience and cultural competence. Further research is needed to assess the long-term impact of this model on health outcomes and its integration into mainstream health services
Harmful words: a qualitative survey of pain clinicians' perspectives on unhelpful messages in chronic pain
Get PDFIndividuals living with chronic pain report experiences of stigma and invalidation, including from health professionals. Anecdotally, specialist pain clinicians must work hard to engage and treat patients who have past experiences of professionals discounting their pain, or of confusing or unsettling messaging about the cause of their symptoms. However, no study has yet explored pain clinicians’ perspectives on unhelpful clinical messaging in this area. We conducted an online qualitative survey of 165 international pain clinicians, asking about the unhelpful messages heard, and repeated, by their patients. Participants reported unhelpful messaging as prevalent and clinically impactful. Qualitative survey data was analysed using inductive reflexive thematic analysis. Five themes were generated: (1) all in your head, (2) you’re physically vulnerable, (3) an elusive fix, (4) the end of the line, (5) inadequate pain explanations. The results underscore the importance of taking a validating stance towards patients’ pain report and avoiding messages that discourage movement and exercise. Pain clinicians were reluctant to endorse multiple investigations to find an imagined ‘cause’ for pain but also disliked clinical messages that implied hopelessness about the chronic pain situation. These results can guide clinical conversations in many settings where people with chronic pain receive care. Perspective: Messages provided by clinicians to individuals living with chronic pain can be deleterious and unhelpful. Such clinical messages may invalidate pain, discourage movement, increase diagnostic uncertainty and/ or provide a fatalistic long term outlook. Improvements in pain education for clinicians are required
Explainable GMDH-type neural networks for decision making: case of medical diagnostics
Get PDFIn medical diagnostics, the use of interpretable artificial neural networks (ANN) is crucial to enabling healthcare professionals to make informed decisions that consider risks, especially when faced with uncertainties in patient data and expert opinions. Despite advances, conventional ANNs often produce complex, not transparent models that limit interpretability, particularly in medical contexts where transparency is essential. Existing methods, such as decision trees and random forests, provide some interpretability but struggle with inconsistent medical data and fail to adequately quantify decision uncertainty. This paper introduces a novel Group Method of Data Handling (GMDH)-type neural network approach that addresses these gaps by generating concise, interpretable decision models based on the self-organizing concept. The proposed method builds multilayer networks using two-argument logical functions, ensuring explainability and minimizing the negative impact of human intervention. The method employs a selection criterion to incrementally grow networks, optimizing complexity while reducing validation errors. The algorithm’s convergence is proven through a bounded, monotonically decreasing error sequence, ensuring reliable solutions. Having been tested in complex diagnostic cases, including infectious endocarditis, systemic red lupus, and postoperative outcomes in acute appendicitis, the method achieved high expert agreement scores (Fleiss’s kappa of 0.98 (95% CI 0.97-0.99) and 0.86 (95% CI 0.83-0.89), respectively) compared to random forests (0.84 and 0.71). These results demonstrate statistically significant improvements
The feasibility and acceptability of remote positive movement: a remotely delivered adapted mind-body physical activity intervention for older people
No full textIncreasing phytochemical-rich foods and Lactobacillus probiotics in men with low-risk prostate cancer: a randomised, double-blind, placebo-controlled trial
Get PDFMen on active surveillance (AS), with prostate cancer, are very interested in dietary strategies that could improve their symptoms and help prevent progression of their disease. In this real-world trial involving 208 men, intake of phytochemical-rich food capsules helped slow prostate-specific antigen (PSA) progression significantly, and improved urinary symptoms and erectile function. What was novel about this study was that men randomised to take an additional blend of five Lactobacillus probiotics had a further three-fold slowing of PSA progression as well as reduction of inflammation. Currently, nearly 50% of men opt out of AS within 5 yr. If confirmed with further follow-up, these dietary interventions, alongside other lifestyle manoeuvres, could reassure men to remain on AS, and hence avoid the risks of radiotherapy, hormones, or surgery
Perspectives on prenatal care among mothers in an ethnically diverse neighbourhood
Get PDFBackground: Timely initiation of prenatal care is critical to maximising positive maternal and infant health outcomes. Women from ethnic minority backgrounds in high income countries are likely to initiate prenatal care later than the recommended 10 weeks. We explored experiences and perspectives of prenatal care among mothers in an ethnically diverse area in the United Kingdom. Methods: We conducted in-depth qualitative semi-structured interviews with 20 expectant and recent mothers who started prenatal care after 10 weeks in an ethnically diverse area. Mothers were recruited using purposive and snowball sampling, through local networks and online advertisements. Interviews were conducted in-person, over the phone or online based on participants’ preferences. Data were analysed using a thematic framework guided by Levesque Conceptual Framework. Results: Three key themes emerged: 1.experiences of and perceptions about prenatal care appointments; 2.factors hindering timely initiation of prenatal care; and 3.strategies to enhance prenatal care uptake. Women felt dissatisfied with limited engagement during appointments and suggested that seeing the same professional could improve trust and confidence. Delays were linked to low awareness and insufficient information on scheduling, as well as employment and childcare constraints. Participants recommended simplified health information about care pathways, appointment reminders, and multilingual resources to improve access. Conclusions: Key barriers in prenatal care highlight the need for targeted co-produced interventions, including provision of simplified health information and culturally inclusive resources to enhance timely uptake among women in ethnically diverse areas in high income countries. Key messages: • Women in ethnically diverse area perceived several barriers for timely prenatal care initiation. • Key barriers in prenatal care highlight the need for targeted coproduced interventions, to support mothers in ethnically diverse areas to start prenatal care on time
Reassessing the military spending–economic growth nexus in the ‘shadows’: selected Balkan countries, 1990–2022
No full textInformality plays a pivotal role in developing and transition economies, where it can hinder growth, policy effectiveness, and competition, while also reducing regulatory burdens and enhancing competitiveness. Military expenditures (milex) support national security, attract capital, and promote social order but may divert resources from more productive sectors. This study builds on existing literature to re-examine the milex–economic growth nexus in the context of informality across selected Balkan countries (1990-2022). Using panel autoregressive distributed lag (P-ARDL) and cross-sectional augmented (CS) P-ARDL models, it explores both short – and long – run relationships. By incorporating widely accepted informality indicators, the study ensures consistency and comparability with prior research. Findings reveal that milex negatively impacts economic growth, even when informality is accounted for. While informality boosts growth in the short – run, it undermines it in the long – run. These results, confirmed through robustness checks, offer critical insights for policymakers aiming to promote sustainable development, social stability, and national security
The potential of virtual reality-based multisensory interventions in enhancing cognitive function in mild cognitive impairment: a systematic review
Get PDFBackground: This systematic review investigates the role of virtual reality (VR)-based multisensory cognitive training in cognitive function, executive function and wayfinding ability among people diagnosed with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Methods: The review was carried out using PRISMA guidelines. PubMed, Scopus, Embase, and Google Scholar were searched up from inception to February 2025 using terms related to MCI, AD, VR, and cognitive functions. Studies were included if they involved participants with MCI or early AD, used VR-based training, collected baseline data, and reported cognitive outcomes. Results: Nine studies with MCI were included, but no eligible studies focused on AD. Seven out of nine eligible studies in MCI reported significant improvements in global cognitive function (MoCA, CERAD-K, MMSE). Some studies showed improvements in executive function (EXIT-25, TMT-A/B, and SCWT), while others found no significant differences. One study reported improved depression/mental status (GDS, MOSES, QoL-AD). Just one study reported improvement in functional ability (IADL). One study reported enhanced cognition and reduced discomfort (SSQ). VR programs were generally well-tolerated, with no significant adverse events reported. Conclusions: VR shows promise for improving cognitive function in MCI. VR also showed potential benefits in executive function and psychological outcomes like depression and quality of life, though consistency varied.</p
Data sources:
Access Repository Dashboard
Do you manage University of Bedfordshire Repository? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!