Check Programme Research Articles

Synthesis and structure of 4-{[(E)-(7-meth-oxy-1,3-benzodioxol-5-yl)methyl-idene]amino}-1,5-dimethyl-2-phenyl-2,3-di-hydro-1H-pyrazol-3-one.

In the title compound, C20H19N3O4, the dihedral angles between the central pyrazole ring and the pendant phenyl and substituted benzene rings are 50.95 (8) and 3.25 (12)°, respectively, and an intra-molecular C-H⋯O link generates an S(6) ring. The benzodioxolyl ring adopts a shallow envelope conformation with the methyl-ene C atom as the flap. In the crystal, the mol-ecules are linked by non-classical C-H⋯O inter-actions, which generate a three-dimensional network. Solvent-accessible voids run down the c-axis direction and the residual electron density in these voids was modelled during the refinement process using the SQUEEZE algorithm [Spek (2015 ▸). Acta Cryst. C71, 9-18] within the structural checking program PLATON.

Addressing Health Inequalities Through the NHS Health Check Programme in England

Addressing Health Inequalities Through the NHS Health Check Programme in England

Kidney Check Point-of-Care Testing—Furthering Patient Engagement and Patient-Centered Care in Canada’s Rural and Remote Indigenous Communities: Program Report

Purpose of program:Access to health care services remains a significant barrier for many Indigenous people’s living in rural and remote regions of Canada. Driven by geographical isolation and compounded by socioeconomic and environmental disparities, individuals living under these circumstances face disproportionately poor health outcomes. Kidney Check is a comprehensive screening, triage, and treatment initiative working to bring culturally safe preventive care to rural and remote Indigenous communities across Manitoba, Ontario, BC, Alberta, and Saskatchewan. The project’s patient-oriented approach addresses concerns raised by kidney patients and their caregivers using culturally safe practices. Using the various expertise of their multidisciplinary team, Kidney Check seeks to further collaborative efforts to improve access to preventive health care for these groups. Meaningful engagement with patients, communities, and local health care stakeholders ensures Indigenous voices are heard and incorporated into the project in a way that promotes shared decision-making and sustainability.Sources of information:As an affiliate program of the Can-SOLVE CKD Network, Kidney Check’s guiding priorities were developed over 3 years of patient consultation and finalized during 2 workshops held with more than 30 patients, caregivers, Indigenous peoples, researchers, and policy makers using a modified Delphi process. Today, patients continue to participate in project development via 2 governing bodies: The Patient Governance Circle and the Indigenous Peoples Engagement and Research Council (IPERC).Methods:Modeled after the Indigenous-led 2015 FINISHED project in Manitoba, Kidney Check employs point-of-care testing to identify diabetes, hypertension, and chronic kidney disease (CKD) in individuals, ages 10 and above, regardless of pre-existing risk factors. The Kidney Check team consists of 4 working groups: project leadership, provincial management, local community partners, and patient partners. By using and building on existing relationships between local and provincial health care stakeholders and various Indigenous communities, the program furthers collaborative efforts to bridge gaps in health equity.Key findings:The Kidney Check program has established an infrastructure that integrates patient engagement at all stages of the program from priority setting to deployment and dissemination strategies.Limitations:While we encourage and offer screening services to all, many still choose not to attend for a variety of reasons which may introduce selection bias. Kidney Check uses patient engagement as a foundational component of the program; however, there is currently a limited amount of research documenting the benefits of patient engagement in health care settings. More formal qualitative evaluations of these activities are needed. In addition, as the COVID-19 pandemic has halted screening procedures in most communities, we currently do not have quantitative data to support the efficacy of the Kidney Check program.Implications:For many Indigenous people, lack of accessibility to health care services is compounded by sociopolitical barriers that disrupt relationships between patients and providers. Meaningful engagement presents one opportunity to ensure the voices and perspectives of Indigenous patients and communities are incorporated into health services. In addition, this screening paradigm has shown to be cost effective as shown by analyses done on the FINISHED screening program.

NHS Health Checks catch patients who would benefit from statins but majority are not prescribed them

The NHS Health Check programme is an effective way of identifying patients who would benefit from statins, and those who attend a health check are more likely to begin treatment with statins, according to a study published in the British Journal of General Practice. The study, published on 15 June 2021, said that, of eligible […]

Factors Related to Attitudes toward Responses to Stress Survey in Stress Check Program in Financial Industry

The purpose of this study is to clarify the factors related to attitudes toward responses to a stress survey in the Stress Check Program, which is used to screen for workers with high psychosocial stress at the workplace. An anonymous self-administered questionnaire survey was conducted on 1,800 regular staff member of a financial industry (valid response rate: 72.0%). The questionnaire items were the brief job stress questionnaire (BJSQ), the sense of coherence (SOC-13), the Japanese version of the Utrecht work engagement scale (UWES-J), attitudes toward responses to the stress survey, and the concerns of subjects regarding the stress check program. The stress in interpersonal relationships at the workplace in the BJSQ, "concerns about leaking results to the company", "concerns about receiving persistent calls for an interview", and "concerns about a disadvantageous treatment by the company" were positively related to 'writing general truths', whereas the support from the boss in the BJSQ and the subscales of SOC-13 were negatively related to 'writing general truths'. The stress in interpersonal relationships at the workplace and "concerns about receiving persistent calls for an interview" were positively related to 'writing falsehoods', but the "dedication" in UWES-J was negatively related to 'writing falsehoods'. To obtain authentic answers in the stress survey, it is important (1) to smooth relationships at the workplace, (2) to devise operation systems such as an interview guidance, and (3) to provide support that enhances the ability of workers to cope with stress and work engagement.

Moving from Assessing Cardiovascular Risk to Altering Risk Trajectories: Opportunities Revealed by England’s NHS Health Check Programme

Moving from Assessing Cardiovascular Risk to Altering Risk Trajectories: Opportunities Revealed by England’s NHS Health Check Programme

A Comprehensive Quality Assurance Platform in Canada for National Point-of-Care Chronic Kidney Disease Screening: The Kidney Check Program

A Comprehensive Quality Assurance Platform in Canada for National Point-of-Care Chronic Kidney Disease Screening: The Kidney Check Program

Synthesis of Full Functional Check Programs for Train Traffic Management Systems on a Railway Station

The article describes the technology for synthesis of full functional check programs for train traffic management systems. Algorithms for synthesis of a full set of safety functions and synthesis of minimized set of safety functions are also presented.

Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 2011–2016

BackgroundU.S. research examining the illicit drug supply remains rare even though the information could help reduce overdoses. Relatively little is known regarding how often opioids are found in stimulants and whether temporal and geographic trends exist. We examined trends in fentanyl-cocaine and fentanyl-methamphetamine combinations in the national illicit drug supply. MethodsWe analysed serial cross-sectional data from the National Forensic Laboratory Information System (NFLIS) collected between January 2011 and December 2016. We restricted the analysis to cocaine (N = 1,389,968) and methamphetamine (n = 1,407,474) samples and calculated proportions containing fentanyl (including 23 related analogs) over time. ResultsThe combined presence of fentanyl and cocaine steadily increased nationally between 2012–2016 (p = 0.01), and the number of such samples tripled from 2015 to 2016 (n = 423 to n = 1,325). Similarly, the combined presence of fentanyl and methamphetamine increased 179 % from 2015 to 2016 (n = 82–n = 272). Patterns varied widely by state; in 2016, fentanyl-cocaine samples were most common in New Hampshire (7.2 %), Connecticut (5.4 %), Ohio (2.6 %) and Massachusetts (2.1 %), whereas fentanyl-methamphetamine samples were most often in New Hampshire (6.1 %), Massachusetts (5.6 %), Vermont (2.4 %) and Maine (1.2 %). ConclusionsAlthough relatively uncommon, the presence of fentanyl in the stimulant supply increased significantly between 2011 and 2016, with the greatest increases occuring between 2015–2016; the presence of these products was concentrated in the U.S. Northeast. Given these trends, strengthening community-based drug checking programs and surveillance within the public health infrastructure could help promote timely responses to novel threats posed by rapid shifts in the drug supply that may lead to inadvertent exposures.

NHS Health Check Programme: a qualitative study of prison experience.

NHS Health Checks began in England in 2009 and were subsequently introduced into English prisons. Uptake has been patchy and there is limited understanding about factors that may limit or enhance uptake in prison settings. Uptake of this programme is a key policy in reducing the risk of cardiovascular disease and death in these settings. Semi-structured focus groups were conducted with groups of prisoners (attendees and non-attendees to the health check), prison healthcare staff, custodial staff and ex-prisoners (n=50). Participants were asked about their awareness and experiences of the NHS Health Check Programme in prison. All groups highlighted barriers for not attending a health check appointment, such as poor accessibility to the healthcare department, stigma and fear. The majority of participants expressed a lack of awareness and discussed common misconceptions regarding the health check programme. Methods of increasing the uptake of health checks through group-based approaches and accessibility to healthcare were suggested. This study reports on prisoner, staff and ex-prisoner perspectives on the implementation of NHS Health Checks within a restrictive prison environment. These findings have potentially substantial implications for successful delivery of care within offender healthcare services.

Abstract 15148: The Impact of the Covid-19 Pandemic on the Mental Distress of Health Care Providers Working in the Coronary Care Unit

Introduction: Medical workers fighting current COVID-19 pandemic are considered facing a mental health crisis. However, there is a paucity of data regarding mental distress in those who caring non-COVIT patients. To assess the mental distress of health care provider working in a coronary care unit during the COVID-19 pandemic, we evaluated the changes in occupational stress before and during the pandemic based on Stress Check Program, which was conducted by Japanese government to screen for workers with high psychosocial stress in the workplace. Methods: Between January 2019 and March 2020, a total of 115 healthcare providers working in our hospital participated in the routine Stress Check Program. Of those, 30 participants working in the coronary care unit underwent a follow-up stress check between May and June 2020. The mean age of the participants was 36.3 ± 9.23 years, and 24 of them (80%) were women. We used the Brief Job Stress Questionnaire, which comprises four components with a total of 57 items: psychological stressors (17 items), psychological and physiological stress reactions (29 items), social support in the workplace (9 items), and personal satisfaction (2 items). Each item was rated on a 4-point scale ranging from 1 to 4. Scores were expressed as mean ± SD for analysis. The changes in scores from before to during the pandemic in terms of the four components and 57 items were analyzed. Results: The mean scores before and during the pandemic for 4 components; psychological stressors, psychological and physiological stress reaction, social support in the workplace, and personal satisfaction were 2.67 ± 0.93 vs. 2.76 ± 0.95 ( p = 0.14); 1.99 ± 0.94 vs. 2.23 ± 1.01 ( p < 0.001); 2.18 ± 0.89 vs. 2.18 ± 0.83 ( p = 0.92); and 2.05 ± 0.65 vs. 2.20 ± 0.78 ( p = 0.09), respectively. Conclusion: Significant worsening during the pandemic was observed for psychological and physiological reactions without no significant change in psychological stressors, social support in the workplace, or personal satisfaction. These results may indicate that the current COVID-19 pandemic was the sole factor contributing to the worsened stress reactions in healthcare providers.

Evaluation of the uptake and delivery of the NHS Health Check programme in England, using primary care data from 9.5 million people: a cross-sectional study

ObjectivesTo describe the uptake and outputs of the National Health Service Health Check (NHSHC) programme in England.DesignObservational study.SettingNational primary care data extracted directly by NHS Digital from 90% of general...

Investigation of Cardiovascular Health and Risk Factors Among the Diverse and Contemporary Population in London (the TOGETHER Study): Protocol for Linking Longitudinal Medical Records.

BackgroundGlobal trends in cardiovascular disease (CVD) exhibit considerable interregional and interethnic differences, which in turn affect long-term CVD risk across diverse populations. An in-depth understanding of the interplay between ethnicity, socioeconomic status, and CVD risk factors and mortality in a contemporaneous population is crucial to informing health policy and resource allocation aimed at mitigating long-term CVD risk. Generating bespoke large-scale and reliable data with sufficient numbers of events is expensive and time-consuming but can be circumvented through utilization and linkage of data routinely collected in electronic health records (EHR).ObjectiveWe aimed to characterize the burden of CVD risk factors across different ethnicities, age groups, and socioeconomic groups, and study CVD incidence and mortality by EHR linkage in London.MethodsThe proposed study will initially be a cross-sectional observational study unfolding into prospective CVD ascertainment through longitudinal follow-up involving linked data. The government-funded National Health System (NHS) Health Check program provides an opportunity for the systematic collation of CVD risk factors on a large scale. NHS Health Check data on approximately 200,000 individuals will be extracted from consenting general practices across London that use the Egton Medical Information Systems (EMIS) EHR software. Data will be analyzed using appropriate statistical techniques to (1) determine the cross-sectional burden of CVD risk factors and their prospective association with CVD outcomes, (2) validate existing prediction tools in diverse populations, and (3) develop bespoke risk prediction tools across diverse ethnic groups.ResultsEnrollment began in January 2019 and is ongoing with initial results to be published mid-2021.ConclusionsThere is an urgent need for more real-life population health studies based on analyses of routine health data available in EHRs. Findings from our study will help quantify, on a large scale, the contemporaneous burden of CVD risk factors by geography and ethnicity in a large multiethnic urban population. Such detailed understanding (especially interethnic and sociodemographic variations) of the burden of CVD risk and its determinants, including heredity, environment, diet, lifestyle, and socioeconomic factors, in a large population sample, will enable the development of tailored and dynamic (continuously learning from new data) risk prediction tools for diverse ethnic groups, and thereby enable the personalized provision of prevention strategies and care. We anticipate that this systematic approach of linking routinely collected data from EHRs to study CVD can be conducted in other settings as EHRs are being implemented worldwide.International Registered Report Identifier (IRRID)PRR1-10.2196/17548

Fidelity of the delivery of NHS Health Checks in general practice: an observational study.

BackgroundThe NHS Health Check programme aims to reduce the risk of common preventable diseases by providing risk information and behaviour change advice. Failure to deliver the consultation appropriately could undermine its efficacy. To date, to the authors’ knowledge, there are no published data on the fidelity of delivery of NHS Health Checks.AimTo assess the fidelity of delivery of NHS Health Checks in general practice.Design & settingFidelity assessment of video and audio recordings of NHS Health Check consultations conducted in four GP practices across the East of England.MethodA secondary analysis of 38 NHS Health Check consultations, which were video or audio recorded as part of a pilot study of introducing discussions of cancer risk into NHS Health Checks. Using a checklist based on the NHS Health Check Best Practice Guidance, fidelity of delivery was assessed as the proportion of key elements completed during the consultations.ResultsThe mean number of elements of the NHS Health Check completed across all consultations was 14.5/18 (80.6%), with a range of 10 to 17 (55.6% to 94.4%). The mean fidelity for risk assessment, risk communication, and risk management sections was 8.7/10 (87.0%), 4.1/5 (82.0%), and 1.7/3 (56.7%), respectively. Clinically appropriate lifestyle advice was given in 34/38 consultations. Elements with the lowest fidelity were ethnicity assessment (n = 12/38; 31.6%), family history of cardiovascular disease (CVD) assessment (n = 25/38; 65.8%), AUDIT-C communication (n = 13/38; 34.2%), and dementia risk management (n = 6/38; 15.8%).ConclusionAlthough fidelity of delivery was high overall, important elements of the NHS Health Check were being regularly omitted. Opportunities for behaviour change, particularly relating to alcohol consumption and dementia risk management, may be being missed.

The national Targeted Lung Health Checks programme: Focusing on the lungs does not mean missing adrenal lesions

Recently, the UK's national Targeted Lung Health Checks programme produced recommendations for the management of incidental findings identified during the scans performed as part of the lung cancer screening programme. We identified significant discrepancies between the recommendations for adrenal incidentaloma management and those currently implemented into UK practice (2016 European Society of Endocrinology guidelines).This may create conflict and confusion between referrers (respiratory clinicians) and receivers (endocrinologists), with potential negative impact on patients, delay and inefficient use of resources. We also address the potential cost implications of adopting a more vigilant approach as advised by the European Society of Endocrinology.Urgent multidisciplinary and unified guidelines should be established in the interest of clinical- and cost-effectiveness.

Health Information Technology and Doctor Shopping: A Systematic Review.

Doctor shopping is the practice of visiting multiple physicians to obtain multiple prescriptions. Health information technology (HIT) allows healthcare providers and patients to leverage records or shared information to improve effective care. Our research objective was to determine how HIT is being leveraged to control for doctor shopping. We analyzed articles that covered a 10-year time period from four databases and reported using preferred reporting items for systematic reviews and meta-analysis (PRISMA). We compared intervention, study design, and bias, in addition to showing intervention interactions with facilitators, barriers, and medical outcomes. From 42 articles published from six countries, we identified seven interventions, five facilitator themes with two individual observations, three barrier themes with six individual observations, and two medical outcome themes with four individual observations. Multiple HIT mechanisms exist to control for doctor shopping. Some are associated with a decrease in overdose mortality, but access is not universal or compulsory, and data sharing is sporadic. Because shoppers travel hundreds of miles in pursuit of prescription drugs, data sharing should be an imperative. Research supports leveraging HIT to control doctor shopping, yet without robust data sharing agreements, the efforts of the system are limited to the efforts of the entity with the least number of barriers to their goal. Shoppers will seek out and exploit that organization that does not require participation or checking of prescription drug monitoring programs (PDMP), and the research shows that they will drive great distances to exploit this weakest link.

Implementation and effectiveness of the Stress Check Program, a national program to monitor and control workplace psychosocial factors in Japan: a systematic review. Translated secondary publication

PurposeThe purpose of this paper is to conduct a comprehensive review on the implementation and the effect of Japan's Stress Check Program, a national program to monitor and control workplace psychosocial factors that was initiated in December 2015.Design/methodology/approachWe comprehensively reviewed articles published in Japanese and English, assessed the performance of the Stress Check Program and summarized future challenges. We also discussed the implications for practice.FindingsThe available literature presented a scientific basis for the efficiency and validity of predictions using the Brief Job Stress Questionnaire, which is the instrument recommended to screen workers with high stress in the program. No study has verified the effect of the program on workers' mental health by using group analysis of stress check results. There is room for improvement in tools that contribute to identifying workers with high stress and in measures for improving the work environment. The Stress Check Program contrasts with risk management of psychosocial factors at work, widely adopted in European countries as a strategy for improving workers' mental health by focussing on the psychosocial work environment.Practical implicationsAlthough the effectiveness of the Japanese program needs further evaluation, future developments of the program would provide insight for national policies on psychosocial risks/psychosocial stress at work.Originality/valueThis paper is the first systematic review on the implementation and effects of Japan's Stress Check Program.

How to Teach Online? Recommendations for the assessment of online exams with University students in the USA in times of pandemic

We evaluated 350 US University Business Students, comparing in-class and online exams to see differences in type of student and class and evaluating possible cheating impact. After basic statistical analysis (T-Student and correlations), we found that differences in grades related to type of students and type of class are more significant that those associated to online with in-class exams. Results are aligned with literature. In accordance with the results of this and previous studies, we do not expect significant higher level of cheating in online exams versus traditional in-class exams. We justify this based upon the reality, broadly reflected in the literature, that cheating is already quite present, before the coronavirus pandemic Many countries have 50%-85% of University students reporting cheating at least once. Cheating is not an specific online problem. Teaching online brings new challenges and opportunities. We recommend to re-evaluate pedagogical methods and engage more in continuous evaluations, relaying less in exams. Code of Conducts, the use of cheating detection algorithms, data analytics from the online Learning Management Systems for assessment and cheating checking programs available (Turnitin and others) to review online exams is recommended. We should help students understand the importance of learning over grades. Also faculty should online teaching faster be at the same level than students in technology and digital capabilities; the closer we are with our students the more effective we can assess them and, more important, we can contribute more and better to their learning and education.

Impact of Metabolic Syndrome on the Mortality Rate among Participants in a Specific Health Check and Guidance Program in Japan.

Objective In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) program was started in 2008 to decrease the social burden related to metabolic syndrome (MetS). However, so far this program has not been found to have any impact on the mortality rate. Methods The subjects consisted of individuals who participated in the Tokutei-Kenshin in seven districts between 2008 and 2015. Using a National database of death certificates, we identified those who might have died and then further confirmed such deaths with the collaboration of the regional National Health Insurance agency and public health nurses. The diagnosis of MetS was made according to the Japanese criteria. The causes of death were classified by ICD-10. Mortality risk was evaluated after adjusting for age, sex, smoking, alcohol intake and past medical history such as stroke, heart disease and kidney disease. Results Among the total of 664,926 subjects, we identified 8,051 fatal cases by the end of 2015. The crude death rate was 1.6% for those with MetS, 1.3% for those with preliminary metabolic syndrome, and 1.1% those without MetS. In MetS, the adjusted hazard ratio (95% confidence interval) was 1.08 (1.02-1.15) for all-cause and 1.39 (1.22-1.58) for cardiovascular disease mortality when the reference was for those without MetS. Conclusion The death rate was found to be significantly higher among the participants with MetS.

The Effect of Self-administered Check Program on Rehabilitative Motivation and Functional Recovery of Stroke Patients

The Effect of Self-administered Check Program on Rehabilitative Motivation and Functional Recovery of Stroke Patients