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  • Issues affecting supply of palliative medicines into community pharmacy: A qualitative study of community pharmacist and pharmaceutical wholesaler/distributor perspectives

    Campling, N.; Breen, Liz; Miller, E.; Birtwistle, J.; Richardson, A.; Bennett, M.; Latter, S. (Elsevier, 2022-06)
    ackground Patient access to medicines in the community at end-of-life (pertaining to the last year of life) is vital for symptom control. Supply of such medicines is known to be problematic, but despite this, studies have failed to examine the issues affecting community pharmacy access to palliative medicines. Objective To identify community pharmacists' and pharmaceutical wholesalers'/distributors' views on supply chain processes and challenges in providing access to medicines during the last year of life, to characterise supply in this UK context. Methods Qualitative design, with telephone interviews analysed using Framework Analysis. Coding frames were developed iteratively with data analysed separately and then triangulated to examine differences in perspectives. Findings Thirty-two interviews (24 community pharmacists and 8 wholesalers/distributors) were conducted. To ensure appropriate palliative medicines were available despite occasional shortages, community pharmacists worked tirelessly. They navigated a challenging interface with wholesalers/distributors, the Drug Tariff to ensure reimbursement, and multiple systems. IT infrastructures and logistics provided by wholesalers/distributors were often helpful to supply into community pharmacies resulting in same or next day deliveries. However, the inability of manufacturers to predict operational issues or accurately forecast demand led wholesalers/distributors to encounter shortages with manufactured stock levels, reducing timely access to medicines. Conclusions The study identifies for the first time how palliative medicines supply into community pharmacy, can be improved. A conceptual model was developed, illustrating how influencing factors affect responsiveness and speed of medicines access for patients. Work is required to strengthen this supply chain via effective relationship-building and information-sharing, to prevent patients facing disruptions in access to palliative medicines at end-of-life.
  • Barriers and facilitators of successful deprescribing as described by older patients living with frailty, their informal carers and clinicians: a qualitative interview study

    Peat, George W.; Fylan, Beth; Marques, Iuri; Rayner, D.K.; Breen, Liz; Olaniyan, Janice; Alldred, D.P. (2022-03)
    Objective To explore the barriers/facilitators to deprescribing in primary care in England from the perspectives of clinicians, patients living with frailty who reside at home, and their informal carers, drawing on the Theoretical Domains Framework to identify behavioural components associated with barriers/facilitators of the process. Design Exploratory qualitative study. Setting General practice (primary care) in England. Participants 9 patients aged 65+ living with frailty who attended a consultation to reduce or stop a medicine/s. 3 informal carers of patients living with frailty. 14 primary care clinicians including general practitioners, practice pharmacists and advanced nurse practitioners. Methods Qualitative semistructured interviews took place with patients living with frailty, their informal carers and clinicians. Patients (n=9) and informal carers (n=3) were interviewed two times: immediately after deprescribing and 5/6 weeks later. Clinicians (n=14) were interviewed once. In total, 38 interviews were undertaken. Framework analysis was applied to manage and analyse the data. Results 6 themes associated with facilitators and barriers to deprescribing were generated, respectively, with each supported by between two and three subthemes. Identified facilitators of deprescribing with patients living with frailty included shared decision-making, gradual introduction of the topic, clear communication of the topic to the patient and multidisciplinary working. Identified barriers of deprescribing included consultation constraints, patients' fear of negative consequences and inaccessible terminology and information. Conclusions This paper offers timely insight into the barriers and facilitators to deprescribing for patients living with frailty within the context of primary care in England. As deprescribing continues to grow in national and international significance, it is important that future deprescribing interventions acknowledge the current barriers and facilitators and their associated behavioural components experienced by clinicians, patients living with frailty and their informal carers to improve the safety and effectiveness of the process.
  • Method of Micro-Sampling Human Dentine Collagen for Stable Isotope Analysis

    Curtis, Mandi J.; Beaumont, Julia; Elamin, F.; Wilson, Andrew S.; Koon, Hannah E.C. (2022-07-15)
    Sampling of dentine for stable carbon (δ13 C) and nitrogen (δ15 N) isotope ratios in the direction of tooth growth allows the study of temporal changes to the diet and physiological stress of an individual during tooth formation. Current methods of sampling permanent teeth using 1mm increments provide temporal resolution of six - nine months at best depending on the tooth chosen. While this gives sufficient sample sizes for reliable analysis by mass spectrometry, sectioning the dentine across the incremental structures results in a rolling average of the isotope ratios. A novel method of incremental dentine collagen sampling has been developed to decrease the collagen increment size to 0.35mm along the incremental structures thus reducing averaging and improving the temporal resolution of short-term changes within the δ13 C and δ15 N values. This study presents data for a MicroMill-assisted sampling method that allows for sampling at 0.35mm width x 1mm depth increments following the incremental growth pattern of dentine. A NewWave MicroMill was used to sample the demineralised dentine section of modern donated human third molars from Sudan and compared to data from the same teeth using the 1mm incremental sectioning method 2 from Beaumont et al. (2013). The δ13 C and δ15 N isotopic data showed an increased temporal resolution, with each increment providing data for two-four months of dentine formation. The data show the potential of this method for studying dietary reconstruction, nutritional stress, and physiological change with greater temporal resolution potentially to seasonal level and with less attenuation of the δ13 C and δ15 N values than was previously possible from human dentine.
  • Impact of COVID-19 on carers of people with dementia in the community: Findings from the British IDEAL cohort

    Quinn, Catherine; Gamble, L.D.; Parker, S.; Martyr, A.; Collins, R.; Victor, C.; Dawson, E.; Hunt, A.; Pentecost, C.; Allan, L.; et al. (2022-05)
    Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID-19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID-19 pandemic on carers for community-dwelling people with dementia and compare responses with pre-pandemic data. Data were collected between September 2020 and April 2021 in England and Wales. Carers were identified from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort and data were collected either through the telephone, video conferencing, or an online questionnaire. Responses from 242 carers were compared against benchmark data from the IDEAL cohort collected pre-pandemic. Analyses were conducted for the full sample of carers and spousal/partner carers only. In total 48.8% of carers thought their healthcare needs were negatively affected during the pandemic. Compared with pre-pandemic data carers were more lonely and experienced less life satisfaction. There was little impact on carers' experience of caregiving, although carers felt trapped in their caregiving role. Carers were more optimistic and had higher social contact with relatives. There were changes in the methods carers used for contacting relatives and friends. Most carers coped very or fairly well during the pandemic. There was little difference in the experiences of spousal/partner carers and the full sample. After a long period of providing care under pandemic conditions carers require additional support. This support needs to be focused on alleviating feelings of loneliness and increasing life satisfaction. Services need to consider how to improve access to health care, particularly resuming face-to-face appointments.
  • Interventions for self-management of medicines for community dwelling people with dementia, mild cognitive impairment and family carers: a systematic review

    Powell, Catherine; Tomlinson, Justine; Quinn, Catherine; Fylan, Beth (2022)
    Background People with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicines self-management could be supported for this population is unclear. This review identifies interventions to improve medicines self-management for people with dementia, MCI and their family carers, and which core components of medicines self-management they address. Methods A database search was conducted for studies with all research designs and ongoing citation searches from inception to December 2021. Selection criteria included community dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. Exclusion criteria were wrong population, not focusing on medicines management, incorrect medicines self-management components, not in English and wrong study design. Results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. Results Thirteen interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person’s knowledge and understanding, supply management, monitoring effects and side-effects and communicating with healthcare professionals; and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. Conclusion Interventions, and measures to assess self-management, need to be developed which address all components of medicines self-management, to better meet the needs for people with dementia and MCI and their family carers.
  • Career intentions, their influences and motivational factors in diagnostic radiography: A survey of undergraduate students

    Hizzett, Kayleigh; Snaith, Beverly (2022-02)
    Introduction: The choice of career and speciality can be a complex process. It is unclear what influences career decisions within undergraduate radiographers and whether the curriculum provides sufficient support. Methods: An online cross-sectional survey was undertaken. All undergraduate diagnostic radiography students within one UK higher education institution were invited to participate. Questions were related to anticipated career choice, motivational factors and influences. Results: The response rate was 67.6% (90/133). The most popular specialist area for career preference was general radiography. The top three motivational factors were work life balance, career development and job satisfaction. The most influential factors on career choice were clinical placements, radiographers on placements and formal teaching. Career guidance was predominantly sourced from the personal academic tutor and was informed by role models. Conclusion: Radiography academic teams and clinical placement providers must work together to ensure that students have access to high quality placements across specialities. The experiences received during undergraduate training are important in specialty choice. Implications for practice: Career guidance is essential and should begin as early as possible. Clinical and academic radiographers need to appreciate the influence they have on students future career plans.
  • Evaluating the potential for cone beam CT to improve the suspected scaphoid fracture pathway: InSPECTED - A single-centre feasibility study

    Snaith, Beverly; Harris, M.; Hughes, J.; Spencer, N.; Shinkins, B.; Tachibana, A.; Bessant, G.; Robertshaw, S. (2022-03)
    The suspected scaphoid fracture remains a diagnostic conundrum with over-treatment a common risk-averse strategy. Cross-sectional imaging remains the gold standard with MRI recommended but CT used by some because of easier access or limited MRI availability. The aim of this feasibility study was to evaluate whether cone beam computed tomography (CBCT) could support early diagnosis, or exclusion, of scaphoid fractures. Patients with a suspected scaphoid were recruited fracture between March and July 2020. All underwent a 4-view X-ray. If this examination was normal, they were immediately referred for a CBCT scan of the wrist. Those with a normal scan were discharged to research follow-up at 2 and 6-weeks. 68 participants were recruited, 55 had a normal or equivocal X-ray and underwent CBCT. Nine additional radiocarpal fractures (16.2%) were demonstrated on CBCT, the remainder were discharged to research follow-up. Based on the 2-week and 6-week follow up three patients (4.4%) were referred for MRI to investigate persistent symptoms with no bony injuries identified. CBCT scans enabled a rapid pathway for the diagnosis or exclusion of scaphoid fractures, identifying other fractures and facilitating early treatment. The rapid pathway also enabled those with no bony injury to start rehabilitation, suggesting that patients can be safely discharged with safety-net advice following a CBCT scan.
  • Five years of #MedRadJClub: An impact evaluation of an established twitter journal club

    Bolderston, A.; Meeking, K.; Snaith, Beverly; Watson, J.; Westerink, Woznitza (2022)
    Twitter journal clubs are a relatively new adaptation of an established continuing professional development (CPD) activity within healthcare. The medical radiation science (MRS) journal club 'MedRadJClub' (MRJC) was founded in March 2015 by a group of academics, researchers and clinicians as an international forum for the discussion of peer-reviewed papers. To investigate the reach and impact of MRJC, a five-year analysis was conducted. Tweetchat data (number of participants, tweets and impressions) for the first five years of MRJC were extracted and chat topics organised into themes. Fifth anniversary MRJC chat tweets were analysed and examples of academic and professional outputs were collated. A total of 59 chats have been held over five years with a mean of 41 participants and 483,000 impressions per hour-long synchronous chat. Ten different tweetchat themes were identified, with student engagement/preceptorship the most popular. Eight posters or oral presentations at conferences, one social media workshop and four papers have been produced. Qualitative analysis revealed five core themes relating to the perceived benefits of participation in MRJC: (1) CPD and research impact, (2) professional growth and influencing practice, (3) interdisciplinary learning and inclusion, (4) networking and social support and (5) globalisation. MRJC is a unique, multi-professional, global community with consistent engagement. It is beneficial for both CPD, research engagement, dissemination and socialisation within the MRS community.
  • Comparison of scattered entrance skin dose burden in MSCT, CBCT, and X-ray for suspected scaphoid injury: Regional dose measurements in a phantom model

    Hughes, J.; Harris, M.; Snaith, Beverly; Benn, H. (2022)
    Introduction: Scaphoid radiography has poor sensitivity for acute fracture detection and often requires repeat delayed imaging. Although magnetic resonance (MR) imaging is considered the gold standard, computed tomography (CT) is often used as an alternative due to ease of access. Cone-Beam CT (CBCT) offers equivalent diagnostic efficacy to Multi Slice CT (MSCT) at reduced dose. We aimed to establish the difference in scattered dose between modalities for scaphoid imaging. Methods: Anatomical regional entrance surface dose measurements were taken at 3 regions on an anthropomorphic torso phantom positioned as a patient to a wrist phantom undergoing scaphoid imaging for three modalities (CBCT, MSCT, four-view projection radiography). Exposure factors were based on audit of clinical exposures. Each dose measurement was repeated three times per anatomical region, modality, exposure setting and projection. Results: Under unpaired T-test CBCT gave significantly lower mean dose at the neck (1.64 vs 18 mGy), chest (2.78 vs 8.01) and abdomen (1.288 vs 2.93) than MSCT (p
  • A single-centre experience of implementing a rapid CXR reporting and CT access pathway for suspected lung cancer: Initial outcomes

    Hunter, R.; Wilkinson, Elaine; Snaith, Beverly (2022-05)
    Lung cancer remains a major cause of preventable death and early diagnosis is critical to improving survival chances. The chest X-ray (CXR) remains the most common initial investigation, but clinical pathways need to support timely diagnosis through, where necessary, escalation of abnormal findings to ensure priority reporting and early CT scan. This single-centre study included a retrospective evaluation of a rapid lung cancer CXR pathway in its first year of operation (May 2018-April 2019). The pathway was initially designed for primary care referrals but could also be used for any CXR demonstrating abnormal findings. A parallel cross-sectional survey of radiographers explored their understanding, adherence and concerns regarding their role in the pathway operation. Primary care referrals on the rapid diagnostic pathway were low (n = 51/21,980; 0.2%), with 11 (21.6%) requiring a CT scan. A further 333 primary care CXR were escalated by the examining radiographer, with 100 (30.0%) undergoing a CT scan. Overall, 64 of the CT scans (57.7%) were abnormal or demonstrated suspicious findings warranting further investigation. There were 39 confirmed primary lung carcinomas, most with advanced disease. Survey responses showed that most radiographers were familiar with the pathway but some expressed concerns regarding their responsibilities and limited knowledge of CXR pathologies. This baseline evaluation of the rapid lung cancer pathway demonstrated poor referral rates from primary care and identified the need for improved engagement. Radiographer escalation of abnormal findings is an effective adjunct but underlines the need for appropriate awareness, training, and ongoing support. Engagement of the multiprofessional team is critical in new pathway implementation. Rapid diagnostic pathways can enable early diagnosis and the radiographer has a key role to play in their success.
  • Developing conflict resolution strategies and building resilient midwifery students: A mixed methods research protocol

    Simpson, N.; Steen, M.; Vernon, R.; Wepa, Dianne (2022-02-18)
    This study will undertake a preparatory phase summarising the body of literature on midwifery students’ knowledge, understanding and experiences of workplace bullying, and violence.
  • Living with knee osteoarthritis: the positive impact of reducing the knee torque induced when sleeping supine. A randomised clinical trial

    Buckley, John G.; Scally, Andy J.; Bhattacharjee, C. (MDPI, 2022-03-09)
    When lying supine, due to the reaction force from the mattress acting mostly through the heel, an external knee-extension joint-torque is induced that keeps the knee fully extended. This torque becomes zero if the feet are hung over the end of the support. This study investigated, in patients with knee-osteoarthritis (knee-OA) who routinely sleep supine, whether a change to such a sleeping position would ameliorate the knee pain and associated physical problems they suffer. Patients were recruited (General-Practitioners Centre, UK) over a 9-month period; those eligible (51/70) were randomly allocated to an intervention (65% female; age 71.5 [11.3] yrs; BMI, 29.20 [5.54] kg/m2; knee-OA severity, 20 mild–mod/3 severe) or control group (63% female; age, 68.3 [9.7] yrs; BMI, 28.69 [5.51] kg/m2; knee-OA severity, 17 mild–mod/2 severe). The primary outcome was improvements (0 [worst] to 100 [best]) in knee pain at 3 months and was rated in the Knee-Injury-and-Osteoarthritis-Outcome-Score questionnaire (KOOS). Secondary outcomes were improvements (0–100) in the other four KOOS-subscales. There were no differences between groups in KOOS outcomes at baseline, and there were no changes in KOOS outcomes in the control group at 3 months. Relative to the baseline KOOS values in Knee-Pain (50.1), Symptoms (52.5), Activities-of-Daily-Living (53.8) and Quality-of-Life (31.5), were all seen to improve at 3 months in the intervention group (by between 11.9 and 12.9); however, when comparing to controls, only the improvements in the subscale Activities-of-Daily-Living (which improved by 12.2) were statistically significant. Findings indicate that for those with knee-OA who routinely sleep supine, sleeping with the feet over the end of the mattress (to prevent the knee being pushed into/held in full extension) can help ameliorate the physical problems they suffer.
  • The blood-to-plasma ratio and predicted GABAA-binding affinity of designer benzodiazepines

    Manchester, Kieran R.; Waters, L.; Haider, S.; Maskell, P.D. (2022)
    Purpose: The number of benzodiazepines appearing as new psychoactive substances (NPS) is continually increasing. Information about the pharmacological parameters of these compounds is required to fully understand their potential effects and harms. One parameter that has yet to be described is the blood-to-plasma ratio. Knowledge of the pharmacodynamics of designer benzodiazepines is also important, and the use of quantitative structure–activity relationship (QSAR) modelling provides a fast and inexpensive method of predicting binding affinity to the GABAA receptor. Methods: In this work, the blood-to-plasma ratios for six designer benzodiazepines (deschloroetizolam, diclazepam, etizolam, meclonazepam, phenazepam, and pyrazolam) were determined. A previously developed QSAR model was used to predict the binding affinity of nine designer benzodiazepines that have recently appeared. Results: Blood-to-plasma values ranged from 0.57 for phenazepam to 1.18 to pyrazolam. Four designer benzodiazepines appearing since 2017 (fluclotizolam, difludiazepam, flualprazolam, and clobromazolam) had predicted binding affinities to the GABAA receptor that were greater than previously predicted binding affinities for other designer benzodiazepines. Conclusions: This work highlights the diverse nature of the designer benzodiazepines and adds to our understanding of their pharmacology. The greater predicted binding affinities are a potential indication of the increasing potency of designer benzodiazepines appearing on the illicit drugs market.
  • Minimal Impact of COVID-19 Pandemic on the Mental Health and Wellbeing of People Living With Dementia Analysis of Matched Longitudinal Data From the IDEAL Study

    Sabatini, S.; Bennett, H.Q.; Martyr, A.; Collins, R.; Gamble, L.D.; Matthews, F.E.; Pentecost, C.; Dawson, E.; Hunt, A.; Parker, S.; et al. (2022-03-09)
    Objective: Research suggests a decline in the mental health and wellbeing of people with dementia (PwD) during the COVID-19 pandemic; however few studies have compared data collected pre-pandemic and during the pandemic. Moreover, none have compared this change with what would be expected due to dementia progression. We explored whether PwD experienced changes in mental health and wellbeing by comparing pre-pandemic and pandemic data, and drew comparisons with another group of PwD questioned on two occasions prior to the pandemic. Methods: Community-dwelling PwD enrolled in the IDEAL programme were split into two groups matched for age group, sex, dementia diagnosis, and time since diagnosis. Although each group was assessed twice, one was assessed prior to and during the pandemic (pandemic group; n = 115) whereas the other was assessed prior to the pandemic (pre-pandemic group; n = 230). PwD completed measures of mood, sense of self, wellbeing, optimism, quality of life, and life satisfaction. Results: Compared to the pre-pandemic group, the pandemic group were less likely to report mood problems, or be pessimistic, but more likely to become dissatisfied with their lives. There were no changes in continuity in sense of self, wellbeing, and quality of life. Discussion: Results suggest the pandemic had little effect on the mental health and wellbeing of PwD, with any changes observed likely to be consistent with expected rates of decline due to dementia. Although personal accounts attest to the challenges experienced, PwD appear to have been resilient to the impact of lockdown and social restrictions during the pandemic.
  • HARP (Health for Asylum Seekers and Refugees) project final evaluation

    Haith-Cooper, Melanie; Balaam, M.C.; Mathew, D. (University of Bradford, 2021-09)
  • Methods and approaches for enhancing communication with people with moderate-to-severe dementia that can facilitate their inclusion in research and service evaluation findings from the IDEAL programme

    Collins, R.; Hunt, A.; Quinn, Catherine; Martyr, A.; Pentecost, C.; Clare, L. (2022)
    Objectives Dementia can affect language processing and production, making communication more difficult. This creates challenges for including the person’s perspective in research and service evaluation. This study aims to identify methods, tools and approaches that could facilitate meaningful communication with people with moderate-to-severe dementia and support the inclusion of their perspectives. Methods This qualitative study was conducted as part of the IDEAL programme and involved in-depth, semi-structured interviews with 17 dementia research and/or care professionals with expertise in communication. Transcripts were analysed using framework analysis. Findings Three main themes each with sub-themes were identified: (1) Awareness, knowledge and experience; (2) Communication approach and (3) Personalization. A person-centred orientation based on getting to know the participant and developing a bi-directional exchange formed the fundamental context for effective communication. Building on this foundation, an approach using pictures, photographs or objects that are meaningful to the person and appropriate for that person’s preferences and ability could help to facilitate conversations. The findings were integrated into a diagram illustrating how the topics covered by the themes interrelate to facilitate communication. Conclusions Useful skills and approaches were identified to help researchers engage and work with people with moderate-to-severe dementia and ensure their perspective is included. These covered getting to know the participant, using a variety of tangible tools and interactional techniques and considering the environment and context of the conversation.
  • Longitudinal trajectories of quality of life among people with mild-to-moderate dementia: a latent growth model approach with IDEAL cohort study data

    Clare, L.; Gamble, L.D.; Martyr, A.; Sabatini, S.; Nelis, S.M.; Quinn, Catherine; Pentecost, C.; Victor, C.; Jones, R.W.; Jones, I.R.; et al. (2022)
    Objectives: We aimed to examine change over time in self-rated quality of life (QoL) in people with mild-to-moderate dementia and identify sub-groups with distinct QoL trajectories. Method: We used data from people with mild-to-moderate dementia followed up at 12 and 24 months in the IDEAL cohort study (baseline n=1537). A latent growth model approach examined mean change over time in QoL, assessed with the QoL-AD scale, and investigated associations of baseline demographic, cognitive and psychological covariates with the intercept and slope of QoL. We employed growth mixture modelling to identify multiple growth trajectories. Results: Overall mean QoL scores were stable and no associations with change over time were observed. Four classes of QoL trajectories were identified: two with higher baseline QoL scores, labelled Stable (74.9%) and Declining (7.6%), and two with lower baseline QoL scores, labelled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher baseline levels of depression and loneliness, and lower levels of self-esteem and optimism, than the Stable class. The Stable Lower class was characterised by disadvantage related to social structure, poor physical health, functional disability, and low psychological well-being The Improving class was similar to the Stable Lower class but had lower cognitive test scores. Discussion: Understanding individual trajectories can contribute to personalised care planning. Efforts to prevent decline in perceived QoL should primarily target psychological well-being. Efforts to improve QoL for those with poorer QoL should additionally address functional impairment, isolation, and disadvantage related to social structure.
  • Effects of Maths on the Move on Children’s Perspectives, Physical Activity, and Maths Performance

    Morris, J.L.; Archbold, V.S.J.; Bond, S.J.; Daly-Smith, Andrew (2022-01)
    Purpose To assess the impact of a six-week ‘Maths on the Move’ (MOTM) physically active learning programme on primary school children’s physical activity (PA) levels and maths performance. Method Randomised control trial. Year 5 children’s PA was assessed using accelerometry for five consecutive school days at baseline and during the final intervention week (final sample: n=97, age M=9.61±0.29, 52.6% female). Two maths performance tests were used; one assessing mathematical content taught during MOTM and one assessing math’s fluency (MASSAT). Both tests were conducted at baseline and following the intervention (week seven). Focus groups were conducted in week seven with intervention children (n=12), randomly choosing an even split of children classified with pre-intervention low or high PA levels. Results On average, during a typical 45-49 minutes MOTM lesson, children obtained an additional five minutes of moderate-to-vigorous PA and 5.7 minutes of light PA counteracted by a reduction of 9.5 minutes of time spent sedentary compared to children that remained in the classroom (control condition). The maths attainment test performance significantly improved over time for children in the MOTM compared to the control (+6.1 versus +0.9, p≤0.0001, d=1.507). No significant improvements were found in the MASSAT total score. Seven emerging themes were derived from the child focus groups. Children felt the MOTM sessions resulted in social and environmental improvements, which improved learning during the sessions. Children described the MOTM sessions as enjoyable, fun, engaging and invigorating – resulting in positive associations to learning and activity. Conclusion Collectively, the findings identify the MOTM programme improves pupil’s PA levels, academic outcomes and identifies pupil’s willingness, enjoyment, and engagement.
  • Limited receipt of support services among people with mild-to-moderate dementia: findings from the IDEAL cohort

    O. van Horik, J.; Collins, R.; Martyr, A.; Henderson, C.; Jones, R.W.; Knapp, M.; Quinn, Catherine; Thom, J.M.; Victor, C.; Clare, L. (2022-03)
    Background: Global initiatives that promote public health responses to dementia have resulted in numerous countries developing new national policies. Current policy guidelines in England, for example, recommend that people diagnosed with mild-to-moderate dementia receive information and psychosocial interventions to improve their ability to ‘live well’. However, it remains unclear to what extent these recommendations are being achieved. Methods: Self-reported information from 1537 people living with dementia and informant-reported information from 1277 carers of people living with dementia was used to quantify receipt of community-based dementia support services, including health and social care services provided by statutory or voluntary-sector organisations, in Britain from 2014 to 2016. Demographic factors associated with differences in receipt of support services were also investigated to identify particularly vulnerable groups of people living with dementia. Results: Both self- and informant reports suggested that approximately 50% of people living with dementia received support services for dementia. Receipt of support services was lower among people living with dementia who are older, female, and have fewer educational qualifications. Receipt of support services also differed according to diagnosis and carer status, but was unrelated to marital status. Conclusions: Limited receipt of dementia support services among people living with dementia in Britain provides a baseline to assess the efficacy of current policy guidelines regarding provision of information and support. Targeted efforts to facilitate receipt of support services among the particularly vulnerable groups identified in the current study could improve the efficacy of dementia support services both in Britain and internationally, and should inform policy development.

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