Self-management programme of activity coping and education-SPACE for COPD(C)-in primary care: a pragmatic randomised trial.

Introduction: We have previously developed a supported self-management programme (SMP): Self-management Programme of Activity, Coping and Education for chronic obstructive pulmonary disease (COPD), which was successfully delivered on an individual basis. Payers expressed an interest in delivering the intervention in groups.

Aim: To explore the feasibility, acceptability and clinical effectiveness of the intervention delivered and supported by healthcare professionals (HCPs) in groups within primary care.

Ethnic variations in referrals to the Leicester memory and dementia assessment service, 2010 to 2017.

Background: The incidence of dementia in Black, Asian and minority ethnic (BAME) groups is increasing in the UK, with concern about underdiagnosis and late presentation.

Aims: By reviewing referrals to memory clinics from Leicester City we examined whether the following differed by ethnicity: the proportion with a diagnosis of dementia, type of dementia and severity at presentation.

Method: We examined referrals between 2010 and 2017: all those whose ethnicity was recorded as Black (n = 131) and a random sample of 260 Asian and 259 White British referrals.

Representation of Black, Asian and minority ethnic patients in secondary care mental health services: analysis of 7-year access to memory services in Leicester and Leicestershire.

Aims And Method: We aimed to explore access by Black, Asian and minority ethnic (BAME) elders to the memory services in Leicester and Leicestershire, examining any trends over time. We then compared the odds of referral by ethnicity, using observed versus expected referrals for the city of Leicester. We gathered data on a comprehensive county-wide memory clinic used by people with suspected dementia and memory problems from the Trust electronic record system during the period 2011-2017.

Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach.

Aim: To examine system characteristics associated with variations in unplanned admission rates in those aged 85+.

Design: Mixed methods.

Setting: Primary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three 'improving' sites where rates had declined by more than 4% and three 'deteriorating' sites where rates had increased by more than 20%.

Socioeconomic deprivation scores as predictors of variations in NHS practice payments: a longitudinal study of English general practices 2013-2017.

Background: A previous study found that variables related to population health needs were poor predictors of cross-sectional variations in practice payments.

Aim: To investigate whether deprivation scores predicted variations in the increase over time of total payments to general practices per patient, after adjustment for potential confounders.

Design And Setting: Longitudinal multilevel model for 2013-2017; 6900 practices (84.

The relationship between symptoms of autism spectrum disorder and visual impairment among adults with intellectual disability.

The higher prevalence of autism reported in blind children has been commonly attributed to the confounding effects of an underlying intellectual disability. The aim of this study was to explore the relationship between symptoms of autism and blindness in adults with intellectual disability. We hypothesized that blindness can increase the probability of the autism phenotype, independent of known risk factors, that is, severity of intellectual disability and gender.

Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in primary care.

Background: Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction, and fewer hospital admissions. Greater socioeconomic deprivation is associated with lower levels of continuity, as well as poorer health outcomes.

Aim: To investigate whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors.

Levels of detection of hypertension in primary medical care and interventions to improve detection: a systematic review of the evidence since 2000.

Objectives: In England, many hypertensives are not detected by primary medical care. Higher detection is associated with lower premature mortality. We aimed to summarise recent evidence on detection and interventions to improve detection in order to inform policies to improve care.

Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial.

Objectives: The aim of this study was to determine if an interactive web-based pulmonary rehabilitation (PR) programme is a feasible alternative to conventional PR.

Design: Randomised controlled feasibility trial.

Setting: Participants with a diagnosis of chronic obstructive pulmonary disease were recruited from PR assessments, primary care and community rehabilitation programmes.

Epidemiology of autism in adults across age groups and ability levels.

Background: The epidemiology of autism in adults has relied on untested projections using childhood research.

Aims: To derive representative estimates of the prevalence of autism and key associations in adults of all ages and ability levels.

Method: Comparable clinical diagnostic assessments of 7274 Adult Psychiatric Morbidity Survey participants combined with a population case-register survey of 290 adults with intellectual disability.

Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial.

Background: Repeated epidemiological surveys show no decline in depression although uptake of treatments has grown. Universal depression prevention interventions are effective in schools but untested rigorously in adulthood. Selective prevention programmes have poor uptake.

The evaluation of an interactive web-based Pulmonary Rehabilitation programme: protocol for the WEB SPACE for COPD feasibility study.

Introduction: Pulmonary Rehabilitation (PR) is an evidence-based intervention that has been recommended in guidelines to be available to those who may benefit. However, not all patients with chronic obstructive pulmonary disease (COPD) have access to this service. Healthcare services have shown the need for the provision of PR in other forms to enable patient choice and service capacity.

A self-management programme for COPD: a randomised controlled trial.

Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care. A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD.

Improving consultations in oncology: the development of a novel consultation aid.

Background: The way in which patients receive bad news in a consultation can have a profound effect in terms of anxiety, depression and subsequent adjustment. Despite investment in well-researched communication skills training and availability of decision-making aids, communication problems in oncology continue to be encountered.

Methods: We conducted a mixed-methods study in a large UK Cancer Centre to develop a novel consultation aid that could be used jointly by patients and doctors.

Independent effects of systemic and peritoneal inflammation on peritoneal dialysis survival.

Systemic inflammation, as evidenced by elevated inflammatory cytokines, is a feature of advanced renal failure and predicts worse survival. Dialysate IL-6 concentrations associate with variability in peritoneal small solute transport rate (PSTR), which has also been linked to patient survival. Here, we determined the link between systemic and intraperitoneal inflammation with regards to peritoneal membrane function and patient survival as part of the Global Fluid Study, a multinational, multicenter, prospective, combined incident and prevalent cohort study (n=959 patients) with up to 8 years of follow-up.

Age-specific normal values for the incremental shuttle walk test in a healthy British population.

Purpose: The Incremental Shuttle Walk Test (ISWT) is an important functional and prognostic marker in chronic disease. Aging has a detrimental effect on exercise performance. The objective of this study was to produce normal age-specific values for the ISWT in a healthy British population and to explore whether additional variables improve the accuracy of a predictive equation.

Pulmonary rehabilitation and interstitial lung disease: aiding the referral decision.

Background: Limited evidence exists regarding the effectiveness of pulmonary rehabilitation (PR) within interstitial lung disease (ILD). Oxygen is frequently prescribed for these patients but has not been explored in the context of PR. The aim of this study was to compare short-term outcomes of PR and 2-year mortality in patients with ILD, who use home oxygen against those without oxygen.

School-based survey of psychiatric disorders among Pakistani children: a feasibility study.

A cross-sectional survey of children aged 5-11 years attending 22 primary schools was carried out in Karachi, Pakistan. In the first (screening) phase, broad morbidity rates were measured using the Strengths and Difficulties Questionnaire (SDQ). A total of 968 parents and 793 teachers participated.

Prescribing in pregnancy for women with diabetes: use of potential teratogenic drugs and contraception.

Aims: To describe contraception use and the prescription of drugs that are either not recommended in pregnancy or are potentially teratogenic by diabetes type in women of child-bearing age.

Methods: Retrospective, cross-sectional chart review undertaken in 22 general practices in Warwickshire, UK. Demographic, anthropometric, medical history, medication and contraception data were extracted from women aged 14 to 49 years with pre-existing diabetes.