Publications by authors named "R F FLETCHER"

Background: Engaging fathers(to-be) can improve maternal, newborn, and child health outcomes. However, father-focused interventions in low-resource settings are under-researched. As part of an integrated early childhood development pilot cluster randomised trial in Nairobi's informal settlements, this study aimed to test the feasibility of a text-only intervention for fathers (SMS4baba) adapted from one developed in Australia (SMS4dads).

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Background: The health-care sector is responsible for 5·2% of global emissions, however, little data exist regarding the environmental impact of disease management strategies. SGLT2 inhibitors are now widely used to reduce the risk of hospital admission and kidney failure in people with type 2 diabetes and chronic kidney disease. This study aimed to estimate the impact of SGLT2 inhibitors on greenhouse gas emissions using data from the CREDENCE trial.

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Objective: To evaluate the feasibility and effectiveness of integrating Making Every Contact Count (MECC) using Healthy Conversation Skills (HCS) into an undergraduate medical curriculum and test the performance of an associated assessment.

Methods: Concepts were introduced to second year students through lectures, small group seminars, role-plays and a new Objective Structured Clinical Examination (OSCE).station.

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Introduction: The prevalence of smoking remains stubbornly high in the UK despite comprehensive tobacco control measures. A national quality improvement (QI) approach to enhance the treatment of an estimated 1,000,000 annual hospital admissions of tobacco smokers could provide a new opportunity to improve population health and reduce healthcare demand. Barriers to QI include knowledge, costs and competing demands.

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Background: Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.

Methods: In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital.

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