Project description:IntroductionCOVID-19 has impacted dentistry in unprecedented ways.ObjectiveThe following research aimed to investigate the impact of the COVID-19 pandemic on periodontal practice in the United Kingdom using the COM-B (Capability Opportunity Motivation-Behaviour) model as the basis for a questionnaire.Basic research designAn online survey link was sent to all members of the British Society of Periodontology and Implant Dentistry. A total of 358 responses were received and analysed.ResultsThe great majority of participants thought that the pandemic had an impact on their profession, while only 4.7 % had no concerns. The main worries related to financial concerns and ability to provide appropriate levels of care. More than 80 % of respondents agreed that their establishment was compliant with infection control procedures. Some participants felt benefits mainly in terms of more time for CPD activities. It was felt that some of the changes needed will need to be sustained long-term.ConclusionsRespondents were generally worried. However, they perceived they had the physical and psychological ability to effect changes to their practice, higher than the physical and social opportunities that they were afforded. Although the COVID-19 pandemic is causing profound changes and worries for the profession of Periodontology, clinicians are clear about their capability to control the situation and feel they have the motivation to make the required changes.Clinical significanceCOVID-19 has presented clinicians with novel challenges. Investigating the professional response to change and expected impact is of interest in the current climate as we navigate the 'new normal'. Assessing the results could be useful in informing support strategies moving forward.
Project description:The Illumina Infinium 27k Human DNA methylation Beadchip v1.2 was used to obtain DNA methylation profiles across approximately 27,000 CpGs in whole blood samples from 540 samples, of which 266 were samples taken from postmenopausal women with ovarian cancer and 274 were from age-matched healthy controls Keywords: DNA methylation
Project description:BackgroundThis study describes osteopathic practise activity, scope of practice and the osteopathic patient profile in order to understand the role osteopathy plays within the United Kingdom's (UK) health system a decade after our previous survey.MethodWe used a retrospective questionnaire survey design to ask about osteopathic practice and audit patient case notes. All UK registered osteopaths were invited to participate in the survey. The survey was conducted using a web-based system. Each participating osteopath was asked about themselves, their practice and asked to randomly select and extract data from up to 8 random new patient health records during 2018. All patient related data were anonymised.ResultsThe survey response rate was 500 osteopaths (9.4% of the profession) who provided information about 395 patients and 2,215 consultations. Most osteopaths were self-employed (81.1%; 344/424 responses) working alone either exclusively or often (63.9%; 237/371) and were able to offer 48.6% of patients an appointment within 3 days (184/379). Patient ages ranged from 1 month to 96 years (mean 44.7 years, Std Dev. 21.5), of these 58.4% (227/389) were female. Infants <1 years old represented 4.8% (18/379) of patients. The majority of patients presented with musculoskeletal complaints (81.0%; 306/378). Persistent complaints (present for more than 12 weeks before appointment) were the most common (67.9%; 256/377) and 41.7% (156/374) of patients had co-existing medical conditions. The most common treatment approaches used at the first appointment were soft-tissue techniques (73.9%; 292/395), articulatory techniques (69.4%; 274/395) and high velocity low amplitude thrust (34.4%; 136/395). The mean number of treatments per patient was 7 (mode 4).ConclusionOsteopaths predominantly provide care of musculoskeletal conditions, typically in private practice. To better understand the role of osteopathy in UK health service delivery, the profession needs to do more research with patients in order to understand their needs and their expected outcomes of care, and for this to inform osteopathic practice and education.
Project description:Both delayed cord clamping (DCC) and cord blood gas (CBG) analysis are recommended practices for preterm births. However, the compliance rates remain lower than expected, with a DCC rate of only 48.9% and CBG sampling of 66.6% in the preterm cohort. DCC was associated with a significant reduction in success rate of paired CBG analysis in both the term and preterm cohort of 8.3% and 7.7% respectively. Our study highlights the difficulty in achieving both recommendations.
Project description:The Illumina Infinium 27k Human DNA methylation Beadchip v1.2 was used to obtain DNA methylation profiles across approximately 27,000 CpGs in whole blood samples from 540 samples, of which 266 were samples taken from postmenopausal women with ovarian cancer and 274 were from age-matched healthy controls Keywords: DNA methylation Bisulphite converted DNA from the 540 samples were hybridised to the Illumina Infinium 27k Human Methylation Beadchip v1.2
Project description:BackgroundWorldwide, the use of prostate specific antigen (PSA) testing as a screen for prostate cancer is contentious. Whilst there is no National UK Screening programme, many men undergo opportunistic screening. This study investigates UK urologist's usage of PSA and the awareness surrounding the Department of Health (DoH) PSA guidelines.MethodsUrologists were sent a questionnaire regarding PSA cut-off values.ResultsOf the 733 urologists eligible to participate in this study 346 returned completed questionnaires giving a response rate of 47%. The most commonly generally used age-related PSA cut-off values (36% of respondents) are--3.5 ng/ml for 50 - 59 year olds, 4.5 ng/ml for 60 - 69 year olds and 6.5 ng/ml for over 70 year olds. Two-thirds (58%, 200/346) of respondents were aware of the DoH PSA guidelines but only 20% (n = 69/346) follow these guidelines. The majority of respondents (68%, n = 234/346) used higher PSA cut-offs than recommended by the DoH. The level of compliance showed marked regional variation with a range from 7% to 44% (median 19%). In addition, it was apparent that lower PSA cut-off values were used in private practice as opposed to the National Health Service.ConclusionA nationwide lack of agreement on PSA cut-off values may generate a variable standard of care both regionally and in NHS versus private practice. Generally, higher PSA cut-off values are being used than recommended by the DoH guidance.
Project description:ObjectivesTo identify the effect of the COVID-19 pandemic on UK herbal medicine practice and how herbal medicine practitioners are supporting people with COVID-19.DesignMixed-methods e-survey.MethodsThe survey link was distributed through professional associations and social media. Quantitative data were descriptively summarised and qualitative data were analysed using content analysis.ResultsResults from 59 responses indicated a profound effect of the pandemic on herbal medicine practice, with a move to remote working and a reduction in client numbers. Practitioners reported prescribing a wide range of medicinal plants, chiefly Glycyrrhiza glabra L. and Echinacea spp. alongside providing information and advice. Few reported inter-professional collaboration.ConclusionsHerbal practitioners need to build on current collaborations, research and experience to develop consistent approaches to support people with mild-moderate COVID-19 symptoms. More systematic exploration of herbal medicine practice during and as a consequence of the pandemic is needed.What is already known about the topic• The COVID-19 pandemic has had a large impact on all types of healthcare• The impact on herbal medicine practice is unclear.What this paper adds• The COVID-19 pandemic has substantially affected UK herbal medicine practice• A wide range of medicinal plants are currently used by herbal practitioners to support people with COVID-19• Herbal practitioners need to develop consistent holistic approaches to support people with mild-moderate symptoms of COVID-19.
Project description:Introduction: The ongoing care of transgender patients in United Kingdom (UK) general practice (GP) is hampered by a lack of UK primary care guidelines regarding the monitoring of treatments, despite the key role that general practice has in holistic lifelong care. This quality improvement project aimed to audit the monitoring of treatments and health screening in a GP practice population, across two large practices in southwest England, in order to drive local improvement and to identify gaps in wider healthcare support for this population. Methods: This project updated a previously published audit instrument, incorporating a novel, pragmatic standard, based on up-to-date UK gender clinic guidelines and the UK population screening programmes. National Health Service (NHS) Health Research Authority and Medical Research Council processes were used to confirm that this quality improvement project did not require formal ethics committee approval. An audit against this standard was performed for 176 transgender and gender-minority patients, to provide data on the consistency of the monitoring of gender hormonal treatments and reminders for appropriate population health screening programmes. Results: A total of 16% of those undergoing hormonal treatments had received optimal monitoring; 20% were missing the most basic hormone level monitoring. Reminders regarding appropriate health screening were rare in patients who had changed the gender markers on their electronic record. Long waiting lists, the use of private clinics, confusion around responsibilities shared between primary and secondary care and growing complex co-morbidity were demonstrated. Conclusions: This project supports previous calls for consistent evidence-based guidelines, improved data systems and adequately resourced primary and secondary care services to support the safe and effective lifelong care of transgender patients.