Remote consultations in mental health: collaborative evaluation applying learning health systems thinking.

Aims And Method: A collaborative evaluation of remote consultations in mental health services was undertaken by mental health service providers, experts by experience, academic institutions and a Health Innovation Network in south London, UK. 'Learning healthcare systems' thinking was applied. Workstream 1 reviewed international published evidence; workstream 2 synthesised findings from three health provider surveys of the perceptions and experiences of staff, patients and carers; and workstream 3 comprised an electronic survey on local projects.

Developing and testing Advance Choice Document implementation resources for Black African and Caribbean people with experience of compulsory psychiatric admission.

Background: Advance Choice Documents (ACDs) have been recommended for use in England and Wales based on evidence from trials that show that they can reduce involuntary hospitalisation, which disproportionately affects Black African and Caribbean people. Our aim was therefore to develop and test ACD implementation resources and processes for Black people who have previously been involuntarily hospitalised and the people that support them.

Methods: Resource co-production workshops were held to inform the development of the ACD template and two types of training for all stakeholders, comprising a Recovery College course and simulation training.

Longitudinal associations of loneliness and social isolation with care dependence among older adults in Latin America and China: A 10/66 dementia research group population-based cohort study.

Objectives: With increasing life expectancy and rapid ageing, there is an expanding number of older people who have functional declines, greater needs for care and support and who are at increased risk of insufficient social interaction. Longitudinal investigations on the interplay between loneliness, social isolation and care dependence remain limited. This study thus aimed to investigate the longitudinal reciprocal association between social isolation/loneliness and care dependence among older adults in Latin America and China.

Study protocol for a cross-sectional online survey investigating patient preferences and experiences of waiting for elective cardiac surgery.

Introduction: Being on a waiting list for elective (planned) cardiac surgery can be physically and psychologically challenging for patients. Research suggests that stress associated with waiting for surgery is dependent on different individual and contextual factors. However, most data on patients' experiences of waiting for surgery and preferences for waiting list management derives from non-cardiac clinical populations.

How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study.

Background: Return on Investment (ROI), whereby the ratio of costs to benefits is assessed, is encouraged in-order to justify the value of Quality Improvement (QI) programmes. We previously performed a literature review to develop a ROI conceptual framework for QI programmes. We concluded that, QI-ROI is conceptualised as any monetary and non-monetary benefit.

The Every Mind Matters campaign: changes in mental health literacy and its associations with campaign awareness.

Background: The aim of this study is to investigate the effects on population level mental health literacy (MHL) of Every Mind Matters over 30 months following campaign launch.

Methods: To observe changes in MHL over time, we conducted regression analyses on a nationally representative, repeated cross-sectional dataset of nine survey waves from September 2019 to March 2022 and an individual participant data meta-analysis with data from October 2019 to March 2021 to examine the association between campaign awareness and the outcomes.

Results: There were small improvements in knowledge of management of stress, depression and anxiety, mental health vigilance, sleep literacy and psychological wellbeing self-efficacy from September 2019 to March 2020 and a deterioration in most MHL outcomes from March 2020 compared with September 2019.

Advance Statements for Black African and Caribbean people (AdStAC): protocol for an implementation study.

Background: The UK government committed to legislating for Advance Choice Documents/Advance Statements (ACD/AS) following their recommendation by the Independent Review of the MHA (2018). ACDs/AS are yet to be implemented in routine practice despite evidence and high demand; they are associated with improved therapeutic relationships and a reduction (25%, RR 0.75, CI 0.

Interventions to enhance pre-pregnancy care for women with type 2 diabetes: A systematic review of the literature.

Aims: The aim of the study was to examine the content and impact of interventions that have been used to increase the uptake of pre-pregnancy care for women with type 2 diabetes, and their impact on maternal and fetal outcomes.

Methods: A systematic search of multiple databases was conducted in November 2021, and updated July 2022, to identify studies assessing interventions to enhance pre-pregnancy care for women with type 2 diabetes. Over 10% of articles were screened by two reviewers at title and abstract phase, after which all selected full-text articles were screened by two reviewers.

Evaluation of changes to work patterns in multidisciplinary cancer team meetings due to the COVID-19 pandemic: A national mixed-method survey study.

Background: It is not well understood the overall changes that multidisciplinary teams (MDTs) have had to make in response to the COVID-19 pandemic, nor the impact that such changes, in addition to the other challenges faced by MDTs, have had on decision-making, communication, or participation in the context of MDT meetings specifically.

Methods: This was a mixed method, prospective cross-sectional survey study taking place in the United Kingdom between September 2020 and August 2021.

Results: The participants were 423 MDT members.

Evaluating quality improvement at scale: A pilot study on routine reporting for executive board governance in a UK National Health Service organisation.

Background: Quality improvement (QI) in healthcare is a cultural transformation process. We explored how routine reporting could be developed to aid visibility of the process for QI governance.

Method: A retrospective evaluation of QI projects in a large healthcare organisation was conducted.

In Caring for Older People in Low- and Middle-Income Countries, Do Older Caregivers Have a High Level of Care Burden and Psychological Morbidity Compared to Younger Caregivers?

Caregivers have become older as longevity increases. Caregiving for older people can cause burdens and psychological morbidity, which are the chronic stresses perceived by informal caregivers. This study aimed to compare the levels of care burden and psychological morbidity between older and younger caregivers in low- and middle-income countries.

The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.

Background: Return on Investment (ROI) is increasingly being used to evaluate financial benefits from healthcare Quality Improvement (QI). ROI is traditionally used to evaluate investment performance in the commercial field. Little is known about ROI in healthcare.

Unpaid productive activities and loneliness in later life: Results from the Indonesian Family Life Survey (2000-2014).

Introduction: Contributing to society constitutes an essential part of healthy ageing. To date, however, it remains unclear how valuable contributions such as caregiving and volunteering, also described as unpaid productive activities, are related to older adults' loneliness. The present longitudinal study addresses this question in a lower-middle-income country, in Indonesia.

Psychometrics of the Pearlin Mastery Scale among Family Caregivers of Older Adults Who Require Assistance in Activities of Daily Living.

This study examined the psychometric properties of the seven-item mastery scale among 392 family caregivers of care dependent older adults in a tertiary hospital in Singapore. Item response theory (IRT) analysis and confirmatory factor analysis (CFA) were used to assess the scale's psychometric properties. Construct validity was assessed based on correlations between mastery and caregiver burden, depression, and quality of life.

An integrated primary care-based programme of PRE-Pregnancy cARE to improve pregnancy outcomes in women with type 2 Diabetes (The PREPARED study): protocol for a multi-method study of implementation, system adaptation and performance.

Background: The number of women of childbearing age with Type 2 diabetes(T2DM) is increasing, and they now account for > 50% of pregnancies in women with pre-existing diabetes. Diabetes pregnancies without adequate pre-pregnancy care have higher risk for poor outcomes (miscarriages, birth-defects, stillbirths) and are associated with increased complications (caesarean deliveries, macrosomic babies, neonatal intensive-care admissions). The risks and costs of these pregnancies can be reduced with pregnancy preparation (HbA1c, ≤ 6.

A multi-centre cohort study on healthcare use due to medication-related harm: the role of frailty and polypharmacy.

Objectives: To determine the association between frailty and medication-related harm requiring healthcare utilisation.

Design: Prospective observational cohort study.

Setting: Six primary and five secondary care sites across South East England, September 2013-November 2015.

Measuring functional ability in healthy ageing: a nationwide cross-sectional survey in the Philippine older population.

Objectives: To analyse the empirical support of the functional ability concept in the healthy ageing framework developed by the WHO in a sample of the Philippine older population. According to this framework, environmental factors may enhance or hinder functional ability, which is the person's ability to do what they value, broadly represented by subjective well-being. Moreover, this network of relationships may be moderated by personal characteristics such as gender.

Multifactorial Interventions to Reduce Duration and Variability in Delays to Identification of Serious Injury After Falls in Hospital Inpatients.

Objectives: Inpatient falls are the most commonly reported safety incidents and are associated with serious injuries. This study aimed to use multifactorial interventions to reduce the delays to the diagnosis of serious injury in a time series analysis after serious incidents relating to falls within a central London Trust.

Methods: A multiprofessional project team undertook process mapping to identify opportunities for improvement at different stages in the management of a fall.

Psychometric Evaluation of the Health State Description Questionnaire in Chile: A Proposal for a Latent Variable Approach for Valuating Health States.

Background: A few instruments that identify and valuate health states are based on the International Classification of Functioning, Disability and Health States of the World Health Organization. One of them is the Health State Description (HSD) questionnaire first used in the World Health Survey (WHS) initiative (HSD-WHS), whose psychometric properties have not been evaluated in Chile. Additionally, the use of latent variables for the valuation process of health states has been scarcely investigated in the context of population health metrics.

Psychometric properties of the PHQ-9 measure of depression among Brazilian older adults.

: To obtain evidence on the psychometric properties of the Patient Health Questionnaire - 9 (PHQ-9, one of the most extensively used tools for assessing depression) in the Brazilian older population. Data on 3,356 Brazilian adults aged 60+ years living in Guarulhos, São Paulo state were used. The factor structure of the questionnaire was analysed using a factor analysis approach.

Trajectories of healthy ageing among older adults with multimorbidity: A growth mixture model using harmonised data from eight ATHLOS cohorts.

Objectives: In this study we aimed to 1) describe healthy ageing trajectory patterns, 2) examine the association between multimorbidity and patterns of healthy ageing trajectories, and 3) evaluate how different groups of diseases might affect the projection of healthy ageing trajectories over time.

Setting And Participants: Our study was based on 130880 individuals from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) harmonised dataset, as well as 9171 individuals from Waves 2-7 of the English Longitudinal Study of Ageing (ELSA).

Methods: Using a healthy ageing index score, which comprised 41 items, covering various domains of health and ageing, as outcome, we employed the growth mixture model approach to identify the latent classes of individuals with different healthy ageing trajectories.

Socioeconomic position and use of hospital-based care towards the end of life: a mediation analysis using the English Longitudinal Study of Ageing.

Background: Many patients prefer to avoid hospital-based care towards the end of life, yet hospitalisation is common and more likely for people with low socioeconomic position. The reasons underlying this socioeconomic inequality are not well understood. This study investigated health, service access, and social support as potential mediating pathways between socioeconomic position and receipt of hospital-based care towards the end of life.

Multimorbidity patterns, all-cause mortality and healthy aging in older English adults: Results from the English Longitudinal Study of Aging.

Aim: This study aimed to investigate the relationships between multimorbidity, healthy aging and mortality.

Methods: Using data from 9171 individuals aged ≥50 years at wave 2 and mortality data at wave 5 of the English Longitudinal Study of Aging, a multiple linear regression model and a Cox proportional hazards model were used to investigate how multimorbidity patterns (identified as cardiorespiratory/arthritis/cataracts, metabolic and relatively healthy) were associated with a composite index of healthy aging (derived from 41 intrinsic capacity and functional ability items) and with mortality.

Results: A total of 60% of the sample with multimorbidity had a moderate or high level of healthy aging.

Cortisol levels in chronic fatigue syndrome and atypical depression measured using hair and saliva specimens.

Background: Several diagnostic criteria for major depressive disorder (MDE) overlap with those of Chronic Fatigue Syndrome (CFS). Furthermore, atypical MDE (A-MDE), a subtype of MDE characterised by profound fatigue and which has frequently been linked with CFS, exhibits similar low cortisol levels to CFS. However, this result has been only found in specimens designed for measuring acute cortisol levels.