10137 research outputs found
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Chapter 22: Applying the Model of Human Occupation to Individuals With Mental Health Conditions
No full textKirsty Forsyth - ORCID: 0000-0002-6732-1699
https://orcid.org/0000-0002-6732-1699Donald Maciver - ORCID: 0000-0002-6173-429X https://orcid.org/0000-0002-6173-429XMichele Harrison - ORCID: 0000-0001-6088-2998
https://orcid.org/0000-0001-6088-2998Item is not available in this repository.https://ot.lwwhealthlibrary.com/content.aspx?bookId=3270§ionId=256365419&resultClick=1inpressinpres
Periodontal Disease and Alzheimer’s: Insights from a Systematic Literature Network Analysis
Get PDFStefania Paladini - ORCID: 0000-0002-1526-3589
https://orcid.org/0000-0002-1526-3589Evidence This study investigated the relationship between periodontal disease (PD) and Alzheimer’s Disease (AD) through a Systematic Literature Network Analysis (SLNA), combining bibliometric analysis with a Systematic Literature Review (SLR). Analyzing 328 documents from 2000 to 2023, we utilized the Bibliometrix R-package for multiple bibliometric analysis. The SLR primarily centered on the 47 most globally cited papers, highlighting influential research. Our study reveals a positive correlation between Periodontal Disease (PD) and Alzheimer’s Disease (AD), grounded in both biological plausibility and a comprehensive review of the literature, yet the exact causal relationship remains a subject of ongoing scientific investigation. We conducted a detailed analysis of the two main pathways by which PD could contribute to brain inflammation: (a) the Inflammatory Cascade, and (b) Microbial Involvement. The results of our SLNA emphasize the importance of oral health in reducing Alzheimer’s risk, suggesting that managing periodontal health could be an integral part of Alzheimer’s prevention and treatment strategies. The insights from this SLNA pave the way for future research and clinical practices, underscoring the necessity of interdisciplinary methods in both the investigation and treatment of neurodegenerative diseases like Alzheimer’s. Furthermore, our study presents a prospective research roadmap to support ongoing advancement in this field.https://doi.org/10.14283/jpad.2024.7911pubpub
PROMOTING HEALTH SYSTEMS RESILIENCE IN THE FRAGILE CONTEXT OF NORTHERN GHANA: A STUDY OF COMMUNITY-BASED HEALTH PLANNING AND SERVICES (CHPS) EFFECTIVENESS
Get PDFIn 1999, the government of Ghana adopted the Community-based Health Planning and Services (CHPS) programme as a national policy. It then launched a scaling-up initiative in 2000 to support its Universal Health Care (UHC) agenda. Since its adoption, CHPS has significantly contributed to health service delivery in Ghana, such as improved family planning and immunization coverage. Despite these gains, however, critical implementation gaps persist. Doorstep services and volunteer support, necessary for supporting population health and family planning in marginalised communities, continue to diminish and CHPS scale-up in fragile settings such as the Northern region of Ghana, where poverty is high and health indicators relatively low, is slow.
This research investigated the factors constraining the implementation and effectiveness of CHPS in the fragile context of the Northern region of Ghana using a mixed-methods research methodology. Data collection was completed in three distinct stages, comprising 1) a review of the district health information management system (DHIMS) data; 2) key informant interviews and focus group discussions (FGDs) with CHPS stakeholders at the national, regional, district, sub-district, CHPS and community levels; and 3) participatory research using group model building (GMB) in the Kumbungu and Gushiegu districts of the former Northern region. Findings identify that the Ghanaian Government is the main contributor to CHPS infrastructure. However, nearly all participating district facilities were ill-equipped and did not have adequate equipment and medicines owing to lapses in central government funding and National Health Insurance Scheme (NHIS) reimbursement challenges. As a result, there was a general perception of neglect among community members. The participatory research findings conclude that CHPS implementation was confronted by inadequate funding to support the programme’s implementation, poor community engagement and support, and diminished health worker capacity owing to gaps in training, logistics, equipment, and infrastructure. These are further compounded by the drivers of fragility resulting from high poverty levels and a vicious cycle of debt servicing.
To mitigate the identified barriers, stakeholders during the study developed a set of interventions aimed at improving CHPS effectiveness. Feedback interviews twelve months after the GMBs showed good progress for interventions targeting health worker capacity, logistics management and community engagement. Comparatively, there was more progress for community engagement interventions than interventions relating to increasing political commitment and funding. Beyond identifying the enablers for CHPS effectiveness, this study supports the argument that the concept of fragility reaches beyond situations of conflict and disasters to include systemic challenges, such as the failure of governments to provide adequate resources to foster the smooth delivery of basic health services. This is particularly so in the context of this research where funding for health services is mainly centralised in a decentralised country. Comparatively, the community engagement interventions had more progress than the interventions for increasing political commitment and funding. In poor and marginalised settings, effective and sustained community engagement can bridge resource gaps, empower users to demand accountability from officials and contribute to resilient health systems.
Using the GMB systems thinking methodology presented a holistic approach to understanding the systemic barriers to CHPS implementation and identified enablers that can minimise their impact on the programme. This approach of bringing together community members, health workers and policymakers on a shared platform was particularly appreciated by community members who seldom share a common platform with government officials in matters of social discourse
Building an ethical research culture: Scholars of refugee background researching refugee-related issues
Get PDFHelen Baillot - ORCID: 0000-0003-2848-023X
https://orcid.org/0000-0003-2848-023XRecent scholarship on the need to decolonize refugee research, and migration research more generally, points to the urgency of challenging ongoing colonial power structures inherent in such research. Increased involvement of scholars with lived experience is one way to challenge and remake unequal and colonial power relations. Through discussions with researchers of forced migration, we aimed to explore the challenges, barriers, and supports related to involvement in such research, and to identify how research practices and structures could be improved to increase and facilitate the involvement of scholars with refugee backgrounds. In this field reflection, we highlight key points and suggestions for better research practice that emerged from these discussions. In doing so, we are endeavouring to contribute to the important ongoing conversation about ethics and decolonizing research. We build on existing ethical guidelines by opening up some of the complexities of ethical practice and offering concrete actions that can be taken to work through these.This research was funded by the Scottish Irish Migration Initiative, a collaboration between University College Dublin and the University of Edinburgh. The webinar in March 2023 was supported by the Scottish Irish Migration Initiative, Universities of Sanctuary, and the School of Social Policy, Social Work and Social Justice at University College Dublin.https://doi.org/10.1093/jrs/feae00537pubpub
Paediatric Rheumatology Fails to Meet Current Benchmarks, a Call for Health Equity for Children Living with Juvenile Idiopathic Arthritis, Using Digital Health Technologies
Get PDFDerek Santos - ORCID: 0000-0001-9936-715X
https://orcid.org/0000-0001-9936-715XPurpose of Review
This critical review begins by presenting the history of Juvenile Idiopathic Arthritis (JIA) management. To move the conversation forward in addressing the current shortcomings that exist in the clinical management of children living with JIA, we argue that to date, the advancement of successful treatments for JIA has been historically slow. Factors implicated in this situation include a lack of rigorous research, JIA being considered a rare disease, and JIA’s idiopathic and complex pathophysiology.
Recent Findings
Despite the well-intended legislative changes to increase paediatric research, and the major advancements seen in molecular medicine over the last 30 years, globally, paediatric rheumatology services are still failing to meet the current benchmarks of best practice. Provoking questions on how the longstanding health care disparities of poor access and delayed treatment for children living with JIA can be improved, to improve healthcare outcomes.
Summary
Globally, paediatric rheumatology services are failing to meet the current benchmarks of best practice. Raising awareness of the barriers hindering JIA management is the first step in reducing the current health inequalities experienced by children living with JIA. Action must be taken now, to train and well-equip the paediatric rheumatology interdisciplinary workforce. We propose, a resource-efficient way to improve the quality of care provided could be achieved by embedding digital health into clinical practice, to create an integrative care model between the children, general practice and the paediatric rheumatology team. To improve fragmented service delivery and the coordination of interdisciplinary care, across the healthcare system.Open Access funding enabled and organized by CAUL and its Member Institutionshttps://doi.org/10.1007/s11926-024-01145-w26pubpub
Healthcare experiences of people living with medically unexplained symptoms: a systematic review
Get PDFItem is restricted in this repository.A diagnosis of medically unexplained symptoms (MUS) is made when a person reports a complaint for which no organic disease can be detected. People with MUS commonly present to primary care services in the UK; however, there is no consensus regarding the evidence base for care. This literature review explores the experiences of these patients when they interact with health services. The following themes emerged: experience of diagnosis; expectations; communication; and healthful relationships. People with MUS report negative experiences of health care. Nurses in primary care have an opportunity to provide person-centred care to support these patients, and research could explore the potential contribution of nurses working in primary care in the UK to support them and enhance the evidence base for practice.https://doi.org/10.12968/bjon.2024.33.5.25633pubpub
Variation in Systemic Antibiotic Treatment for Diabetic Foot Osteomyelitis in England and Wales: A Multi-Centre Case Review
Get PDFDerek Santos - ORCID: 0000-0001-9936-715X
https://orcid.org/0000-0001-9936-715XBackground: Diabetic foot osteomyelitis (DFO) is a major complication and can lead to significant morbidity and mortality. Systemic antibiotic therapy is often initiated first line to achieve quiescence of infection. To perform a multi-centre case review of systemic antibiotic intervention to treat adults with DFO in England and Wales and compare with national guidelines ‘Diabetic foot problems: prevention and management’. Methods: Eight centres from England and Wales retrospectively collated data from a minimum of five adults (aged ≥ 18 years) from electronic case records. All patients were treated with systemic antibiotics following a new diagnosis of DFO (1 June 2021–31 December 2021). Results: 40 patients (35 males and 5 females) were included; the mean age was 62.3 years (standard deviation (SD) 13.0). Patients commenced systemic oral 14 (35%) or intravenous 26 (65%) antibiotic therapy following a new diagnosis of DFO. Twenty-seven (67.5%) patients were medically or surgically managed in the 12-week period with clinical quiescence of infection. Twenty-one patients (52.5%) had no recurrence of DFO infection within 12 weeks; seventeen (42.5%) of these patients had clinical quiescence of infection with systemic antibiotics alone without surgical intervention and nine (22.5%) of these cases had no recurrence of DFO. There were no cases of major amputation or death. All centres showed significant in-centre variability in systemic antibiotic management; variability was reported in the clinical and quantity indicators specifically to antibiotic selection, single versus dual therapy, mode of delivery and duration of treatment. Conclusions: This case review identifies there is existing variation when treating adults with systemic antibiotics for DFO. Further national guidance is required to standardise service delivery and care to improve patient outcomes.https://doi.org/10.3390/jcm1311308313pubpub1
Raising awareness isn’t enough: The role of the psychology of education in disability-related justice and inclusion in primary classrooms
Get PDFSian Jones - ORCID: 0000-0002-2399-1017
https://orcid.org/0000-0002-2399-1017What: When it comes to education, disability inequality is arguably a structural and systemic
issue. The social model of disability, enshrined in teacher education programmes in the UK
espouses the ways in which school environments rather than disabled children themselves,
need to adapt and change. However, the role of psychology in addressing disability-related
systemic injustice is less clear. The aim of this paper is to consider the potential role of the
psychology of education in working towards disability justice in schools.
Why? Many inclusive teacher-education programmes set out the ways in which environments
may be created to include disabled children. Psychologists have focused on disabled children’s
needs to access and participate in the classroom, but often do not consider their exclusion in
social model terms, from curriculum materials, classroom displays, or material culture more
generally. Favazza and colleagues (e.g. 2017) now offer a sizeable body of research showing
that disability representation in school classrooms is negligible. This lack of representation is
reflected among the staff in the teaching profession, where the 2016 census suggests that 0.5%
of English teaching staff declared a disability (DfE, 2017) and more recent census data shows
disability data were not collected (DfE, 2023a). It is this lack of representation of disabled
people, and its possible psychological underpinnings, that this paper addresses.
How? This paper uses social and affirmative model lenses to (a) explore the ways in which
disability may be seen as a structural inequality in contemporary UK education, and (b) suggest
ways in which researchers and practitioners in the Psychology of Education may work to
towards disability justice. This may be achieved by considering extant research practice, and
through research focusing on perceptions of and attitudes towards disability, alongside existing
psychological work that focuses on disabled children’s individual needs.48pubpub
A qualitative meta-synthesis of studies of patients' experience of exercise interventions in advanced cancer
Get PDFFrom Frontiers via Jisc Publications RouterHistory: collection 2023, received 2023-09-21, accepted 2023-12-11, epub 2024-01-04Peer reviewed: TruePublication status: PublishedErna Haraldsdottir - ORCID: 0000-0003-4891-0743
https://orcid.org/0000-0003-4891-0743Background: People with advanced cancer often experience reduced functional capacity and quality of life. Research evaluating the potential benefit of exercise programmes for limiting such decline is accumulating. However, an appraisal of the evidence that considers the patient experience of exercise programmes, what mattered to them and what motivated and encouraged them to engage in exercise, has not been published. The aim of this meta-synthesis was to identify, appraise and bring together evidence from qualitative research in this area. Methods: Four databases were searched from 2nd January to 8th January 2023 for relevant studies. Qualitative studies investigating the experience of exercise as an intervention for adults with advanced cancer were included. Major findings and study characteristics were extracted. Findings were summarised, compared, and synthesised using meta-synthesis. Results: Eight studies were eligible and generated seven sub themes which informed the construction of three key themes: (1) Impact of Delivery Method; (2) Emerging Motivation; and (3) Physical Impact. Conclusion: The analysis revealed that exercise has the potential to positively influence all four dimensions of well-being: physical, psychological, social, and spiritual, for people with advanced cancer. Future research is required to consider the differential impact that the type, volume, and duration of exercise may have on the exercise experience for this patient group.pubpu
Psychological and Social Suffering of Another Generation of Palestinian Children Living Under Occupation: An Urgent Call to Advocate [Viewpoint]
Get PDFAlastair Ager - ORCID: 0000-0002-9474-3563
https://orcid.org/0000-0002-9474-3563https://www.hhrjournal.org/2024/05/psychological-and-social-suffering-of-another-generation-of-palestinian-children-living-under-occupation-an-urgent-call-to-advocate/26pubpub
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