United Kingdom National Survey Research Articles

Physical Activity Mobile App (CareFit) for Informal Carers of People With Dementia: Protocol for a Feasibility and Adaptation Study.

Physical activity is a critical component of both well-being and preventative health, reducing the risk of both chronic mental and physical conditions and early death. Yet, there are numerous groups in society who are not able to undertake as much physical activity as they would like to. This includes informal (unpaid) carers, with the United Kingdom national survey data suggesting that 81% would like to do more physical activity on a regular basis. There is a clear need to develop innovations, including digital interventions that hold implementation potential to support regular physical activity in groups such as carers. This study aims to expand and personalize a cross-platform digital health app designed to support regular physical activity in carers of people with dementia for a period of 8 weeks and evaluate the potential for implementation. The CareFit for dementia carers study was a mixed methods co-design, development, and evaluation of a novel motivational smartphone app to support home-based regular physical activity for unpaid dementia carers. The study was planned to take place across 16 months in total (September 1, 2022, to December 31, 2023). The first phase included iterative design sprints to redesign an initial prototype for widespread use, supported through a bespoke content management system. The second phase included the release of the "CareFit" app across Scotland through invitations on the Apple and Google stores where we aimed to recruit 50 carers and up to 20 professionals to support the delivery in total. Partnerships for the work included a range of stakeholders across charities, health and social care partnerships, physical activity groups, and carers' organizations. We explored the implementation of CareFit, guided by both Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and the Complex Intervention Frameworks. Project processes and outcomes were evaluated using mixed methods. The barriers and enablers for professional staff to signpost and use CareFit with clients were assessed through interviews or focus groups and round stakeholder meetings. The usability of CareFit was explored through qualitative interviews with carers and a system usability scale. We examined how CareFit could add value to carers by examining "in-app" data, pre-post questionnaire responses, and qualitative work, including interviews and focus groups. We also explored how CareFit could add value to the landscape of other online resources for dementia carers. Results from this study will contribute new knowledge including identifying (1) suitable pathways to identify and support carers through digital innovations; (2) future design of definitive studies in carer populations; and (3) an improved understanding of the Reach, Effectiveness, Adoption, Implementation, and Maintenance across a range of key stakeholders. DERR1-10.2196/53727.

A Re-audit of the Management of Diabetic Ketoacidosis (DKA): The Importance of the Seven-Day Working Inpatient Diabetes Specialist Nurse Service.

Background Diabetic ketoacidosis (DKA) is a life-threatening metabolic emergency due to insulin deficiency in patients with diabetes mellitus. The United Kingdom national survey and local audits of the management of DKA have revealed several areas of suboptimal care, and room for improvement, necessitating the need for intensified education, updating local guidelines, and increased recruitment of seven-day working inpatient diabetes specialist nurses. Therefore, this project aimed to re-audit our adherence to the DKA treatment guidelines. Methodology A retrospective re-audit examining patient admissions with DKA between October 2022 and September 2023. A list of 18 standards/criteria, adopted from the Joint British Diabetes Society (JBDS) DKA treatment guidelines was used for this re-audit. Results were compared with that of the previous audit. Results We had 126 patients admitted with DKA between October 2022 and September 2023. There were 62 males and 64 females with an average (range) age of 46.5 (19-92) years. Eighty percent had type 1 diabetes, and common precipitating factors for admission included infection and poor adherence to insulin treatment. The median (IQR) length of hospital stay was 2.1 (1.0-5.1) days. Compared to the previous audit, improvements occurred in 11 of 18 standards/criteria. This included timely commencement of intravenous fluids and fixed-rate insulin, commencing glucose infusion to prevent hypoglycemia,potassium replacement, continuation of long-acting insulin during treatment, timely conversion to variable-rate insulin infusion, and conversion to the usual subcutaneous insulin regimen. Additionally, 124 patients (98.4%) were reviewed at least once by the inpatient diabetes specialist nurses (DSN) during their admission. Complications of treatment, namely, iatrogenic hypoglycemia and transient hypokalemia occurred in 13 (10.3%) and 40 (31.7%) patient admissions, respectively. Conclusions This re-audit demonstrated improved adherence to the guidelines during several steps in the management of DKA. It also demonstrated room for improvement regarding other aspects of care. The importance of continued education, accurate documentation, and the presence of seven-day working inpatient DSN cover cannot be overemphasized.

Management of prenatally detected vascular rings: a United Kingdom national survey - ERRATUM.

Management of prenatally detected vascular rings: a United Kingdom national survey - ERRATUM.

Management of prenatally detected vascular rings: a United Kingdom national survey.

To investigate UK variability in prenatal and postnatal management strategy of right aortic arch and double aortic arch (RAA/DAA). Online surveys were sent to senior physicians (consultants) of the National Fetal Cardiology Working Group regarding prenatal diagnosis, counselling, and perinatal management of antenatally diagnosed RAA/DAA and to the British Congenital Cardiovascular Association regarding postnatal management strategies. There were 28 prenatal and 90 postnatal surveys completed. Prenatally, there was consensus for potential associated chromosomal/genetic anomalies, but there was variation in the risk quoted. Confidence in defining aortic arch morphology was reported by 43% (12/28) of fetal cardiologists. There was variation in what was felt to be possible symptoms/signs of a compressive vascular ring, postnatal investigation, postnatal management, follow-up duration of asymptomatic patients, and indications for surgical intervention. This study has highlighted important areas for future research: improving accuracy of prenatal diagnosis, clarification of potential symptoms, optimal investigation strategies, and indications for surgery.

Work participation, mobility and foot symptoms in people with systemic lupus erythematosus: findings of a UK national survey

ObjectiveThe aim of this study was to investigate whether foot and lower limb related symptoms were associated with work participation and poor mobility in people with Systemic Lupus Erythematosus (SLE).MethodA quantitative, cross-sectional, self-reported survey design was utilised. People with SLE from six United Kingdom (UK) treatment centres and a national register were invited to complete a survey about lower limb and foot health, work participation and mobility. Data collected included work status and the prevalence of foot symptoms. The focus of the analyses was to explore potential associations between poor foot health work non-participation.ResultsIn total, 182 useable surveys were returned. Seventy-nine respondents reported themselves as employed and 32 reported work non-participation. The remaining were retired due to age or reported work non-participation for other reasons. Work non-participation due to foot symptoms was significantly associated with difficulty walking (p = 0.024), past episodes of foot swelling (p = 0.041), and past episodes of foot ulceration (p = 0.018). There was a significant increase in foot disability scores amongst those not working (mean 18.13, 95% CI: 14.85–21.41) compared to those employed (mean 10.16, 95% CI: 8.11–12.21).ConclusionsTwenty-nine% of people with SLE reported work non-participation because of lower limb or foot problems. Our results suggest that foot health and mobility may be important contributors to a persons’ ability to remain in work and should be considered as part of a clinical assessment.

Attitudes towards epilepsy in the UK population: Results from a 2018 national survey

PurposeTo measure stigma resulting from negative attitudes toward epilepsy in the United Kingdom (UK) population. MethodsAn online survey of a stratified quota sample of UK adults in July 2018. The primary outcome measure was the 46-item Attitudes and Beliefs about Living with Epilepsy (ABLE) scale, scored on a five-point Likert scale. Items on sociodemographic characteristics, experience of epilepsy, and knowledge of epilepsy were also included. Mean scores were calculated for the ABLE and subscales: risk and safety concerns, personal fear and social avoidance, work and role expectations, and negative stereotypes. Hierarchical regressions tested the association between mean ABLE and subscale scores with sociodemographic and epilepsy related factors. Results4000 responded, 3875 responses were included in the analysis. Mean ABLE score was 2.28 (95% CI: 2.26–2.29) (1=no stigma, 5=high stigma). Subscales: risk and safety concerns 3.22 (95% CI:3.20–3.25), personal fear and social avoidance 2.13 (95% CI: 2.11–2.16), work and role expectations 2.07 (95% CI: 2.05–2.09), and negative stereotypes 1.67 (95% CI: 1.65–1.69). Mean knowledge score was 78% (95% CI: 76.15–77.02). ConclusionFindings of the first UK national survey of attitudes and beliefs about living with epilepsy suggest relatively low stigma among the sampled population. The subscale with the least stigma was negative stereotypes. Risk and safety concerns were associated with highest stigma. Improving public knowledge about epilepsy has potential to reduce stigma, however this may also raise risk and safety concerns. The results from this project could inform future work to improve awareness and understanding of epilepsy.

Consumer Perspectives on Longevity and Reliability: A National Study of Purchasing Factors Across Eighteen Product Categories

Increasing global demand for durable goods prevents the decoupling of economic growth from natural resource use required to achieve sustainable consumption and production. Presently, most consumers in the United Kingdom (UK) exhibit a strong preference for purchasing new durable goods. Therefore, short-to-medium term strategies that seek to engender sustainable consumption of durable goods should focus on encouraging consumers to choose longer-lasting, reliable products. This paper outlines the importance consumers place on six purchasing factors (appearance, brand, guarantee length, longevity, price and reliability) across eighteen categories of durable goods. Data was collected from a UK national survey of consumer satisfaction with product lifetimes (n=2207). The research identified that most consumers consistently emphasise the importance of longevity and reliability when purchasing new products. If consumer preference for longer-lasting, reliable products can be translated into purchasing behaviour, progress can be made towards engendering sustainable consumption, enacting the circular economy and reducing national ecological footprints.

A United Kingdom national survey of trends in ectopic pregnancy management

Our national survey demonstrates increased use of medical and laparoscopic management of ectopic pregnancy in the UK. In the UK in 2000, 35% of cases were managed by laparoscopy, 63% by laparotomy and 1% with medication. A recent review in the USA revealed increasing rates of medical management and decreasing rates of laparotomy; a trend driven by both cost-effectiveness and patient choice. A total of 119 early pregnancy units were surveyed regarding the nature and management of the three most recent cases of ectopic pregnancy; in addition, feasibility of training residents was also requested. Participants reported on 124 cases with a median of five cases per month per department. A total of 57% of cases were managed laparoscopically, 31% medically, 5% by laparotomy and 6% conservatively. Out of 44 centres, 29 have the facilities for training in both intermediate laparoscopic surgery and early pregnancy ultrasound.

Working on the Weekend: Fathers' Time With Family in the United Kingdom

Whereas most resident fathers are able to spend more time with their children on weekends than on weekdays, many fathers work on the weekends spending less time with their children on these days. There are conflicting findings about whether fathers are able to make up for lost weekend time on weekdays. Using unique features of the United Kingdom's National Survey of Time Use 2000 (UKTUS) I examine the impact of fathers' weekend work on the time fathers spend with their children, family, and partners (N = 595 fathers). I find that weekend work is common among fathers and is associated with less time with children, families, and partners. Fathers do not recover lost time with children on weekdays, largely because weekend work is a symptom of overwork. Findings also reveal that even if fathers had compensatory time, they are unlikely to recover lost time spent as a family or couple.

A United Kingdom National Survey of Breast Surgeons on Primary Endocrine Therapy of Early Operable Breast Cancer

Introduction: A significant proportion of elderly breast cancer patients in the UK have no surgical treatment recorded (All Breast Cancer Reports 2006 and 2007) and appears to be treated with primary endocrine therapy (PET) only. Despite this, PET remains one of the poorly studied areas in breast cancer therapy and very little is known about its practice in the UK.

46 A United Kingdom National Survey of Breast Surgeons o Primary Endocrine Therapy of Early Operable Breast Cancer

46 A United Kingdom National Survey of Breast Surgeons o Primary Endocrine Therapy of Early Operable Breast Cancer

Continuous Improvement Methodology Applied to United Kingdom Academic Library Websites Via National Survey Results

This article analyzes the possibilities of applying Continuous Improvement principles to the management and maintenance of academic library websites. Current practice is mapped onto Continuous Improvement principles, with evidence distilled from a United Kingdom national survey of academic library web practitioners. The survey data informs a website organizational framework and operational model. The framework describes the setting within which library websites are managed, while the model focuses on library specific aspects to the management and development of their site.

Patterns of interphalangeal hand joint involvement of osteoarthritis among men and women: a British cohort study.

To characterize the pattern of involvement of osteoarthritis (OA) of the hand among men and women of the same age. Structured hand examinations were performed on 1,467 men and 1,519 women who were age 53 years and born in England, Scotland, or Wales during the first week of March 1946 (identified through the United Kingdom National Survey of Health and Development). OA at each joint site was characterized using a previously validated examination schedule. The interrelationship of involvement of different hand joints was analyzed by logistic regression and cluster analyses. There was clear evidence of polyarticular involvement in the hand joints of both the men and the women. Among the women, 161 subjects had >/=4 joints involved, compared with only 41 subjects expected in this category (P < 0.001). Among the men, 87 subjects were observed to have >/=4 joints involved, in contrast with only 7 subjects expected (P < 0.001). The pattern of hand joint involvement (characterized by clustering primarily by row and symmetric joint involvement, rather than clustering by ray) was found to be almost identical between the men and the women. This study confirms the existence of a polyarticular subset of OA among men that has characteristics similar to those of the variant observed among women. The data suggest that the genetic or metabolic influences underlying this particular variant of OA acts similarly in both sexes.

United Kingdom national survey of the views of geriatric psychiatrists on the administration of electroconvulsive therapy to patients with fractures.

Traditionally, psychiatrists have been cautious in administering electroconvulsive therapy (ECT) to patients with recent fractures. Drawing on the collective experience of geriatric psychiatrists in the United Kingdom may allow a better understanding of the use of ECT in fractures. The opinions of UK consultant geriatric psychiatrists on the use of ECT in the presence of recent fracture were acquired by a detailed questionnaire survey. Questionnaires were sent to 551 geriatric psychiatrists, and 306 (56%) usable responses were received. Twelve percent of geriatric psychiatrists had used ECT in fractures, and 55% would be prepared to administer ECT in the presence of fractures. They would seek specialist advice from anesthetists and orthopedic surgeons before, during, and after the administration of ECT. Geriatric psychiatrists generally did not seek advice from specialist ECT consultants. The researchers concluded that geriatric psychiatrists are prepared to administer ECT in the presence of fractures after seeking specialist advice from anesthetists and orthopedic surgeons.

Diagnostic boundaries, reasoning and depressive disorder, II. Application of a probabilistic model to the OPCS general population survey of psychiatric morbidity in Great Britain.

Reliable prevalence and risk estimation of psychiatric disorder is a cornerstone to achieving objectives in public health psychiatry. Research strategies have increasingly depended, therefore, upon the progressive evolution and refinement of diagnostic approaches designed to reflect better current knowledge concerning prognosis, course and outcome but essentially the need to improve agreement between users of the various schemes. This paper contrasts a conventional with a probabilistic approach to the diagnosis of depression based upon the OPCS United Kingdom National survey of psychiatric morbidity. The probabilistic approach, while designed to mimic current diagnostic practice in relation to the depressive disorders, naturally includes provision for the allocation of respondents on a scale of diagnostic uncertainty according to the severity of their presenting condition. Findings are reported arising from the application of the probabilistic method to three areas of research interest in public health psychiatry, namely; an evaluation of additivity of event exposure and depressive morbidity, secondly use of the approach for investigating psychosocial models of depressive disorder and thirdly for assessing the agreement between depressive disorder when classified according to competing diagnostic schemes. The results show application of the probabilistic approach to provide a firm basis for achieving gains in both the stability and precision of risk profile estimation for depressive conditions.

A three year survey of clinical isolates in the United Kingdom and their antimicrobial susceptibility

A United Kingdom national survey of clinical isolates and their antimicrobial susceptibility was performed, with 61 participating hospital laboratories, between 1986 and 1989. Each centre used Microbe Base, a commercial suite of micro-computer programs which can record and analyse antimicrobial susceptibility data Informative on 366,853 bacterial isolates and their antimicrobial susceptibility was received from hospital and domiciliary specimens; Candida spp. accounted for a further 9121 isolates. The sites of origin were urine 51%, skin and soft tissue 21%, lower respiratory tract 8%, genital tract 7%, ear, nose and throat 6%, eye 3%, blood 1.5% and faeces 1%. Gram-negative bacteria accounted for 242,307 isolates, the main species were Escherichia coli 48%, Proteus spp. 9%, Pseudomonas spp. 7%, Haemophilus influenzae 6% and Klebsiella spp. 4%. Gram-positive bacteria numbered 124,546 with a predominance of Staphylococcus aureus 42%, beta-haemolytic streptococci 20%, Enterococcus spp. 12%, coagulase negative staphylococci 10% and Streptococcus pneumoniae 5%. All pneumococci were sensitive to penicillin, and methicillin resistant in Staph. aureus was only 2%. Twelve per cent of H. influenzae strains were resistant to ampicillin. There were no significant levels of gentamicin resistance in Gram-negative bacilli.