Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 781
Filtrar
Más filtros

Tipo del documento
Intervalo de año de publicación
1.
BMC Public Health ; 24(1): 800, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38481177

RESUMEN

BACKGROUND: Local authorities in England have an important role in shaping healthy local environments contributing to childhood obesity. This study examined changes in diet and physical activity in primary school children following a three-year, complex, community-based intervention in Golborne ward, the second most deprived ward in London. METHODS: The Go-Golborne intervention aimed to shape the local environment across multiple settings with the engagement of a large number of local government and community stakeholders in a joint approach. Activities focused on six co-created themes to make changes to local environments and reduce sugary snacks and beverage consumption, increase fruit and vegetable intake, promote healthy snacks, increase active play and travel, and reduce screen time. We analysed changes in self-reported diet and physical activity, collected annually between 2016 and 2019, from 1,650 children aged 6-11 years through six local schools, who all received the intervention. We used multilevel, linear and logistic random-slope regression models adjusted for time on study, baseline age, gender, ethnicity, deprivation quintile, school, and baseline weight status. RESULTS: After three years of follow-up, there were reductions in sugar-sweetened beverage consumption (adjusted beta -0·43 occasions/day, 95% CI -0·55 to -0·32), fruit and vegetable consumption (adjusted beta -0.22 portions, 95% CI -0.44 to 0.001) and car travel to and from school (adjusted OR 0·19, 95% CI 0·06 to 0·66), while screen time increased (high versus moderate/low: OR 2·30, 95% CI 1·36 to 3·90). For other behavioural outcomes, there was no statistically significant evidence of changes. CONCLUSION: Local authorities have substantial powers to make positive changes to the obesogenic environment but programmes remain under-evaluated. Results from the ambitious Go-Golborne intervention demonstrated mixed results in health behaviours following programme implementation. These results underline the importance of a coordinated and comprehensive policy response to support changes in wider environmental and social conditions as well as appropriate and holistic evaluations of initiatives to inform local actions on obesogenic environments.


Asunto(s)
Obesidad Infantil , Niño , Humanos , Dieta , Ejercicio Físico , Londres/epidemiología , Obesidad Infantil/epidemiología , Obesidad Infantil/prevención & control , Proyectos Piloto , Masculino , Femenino
2.
Homeopathy ; 113(1): 49-52, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38286346

RESUMEN

The Homeopathy Research Institute's (HRI) 5th international research conference took place in the heart of London, from 16th to 18th June 2023. With 230 attendees from 27 countries, HRI's conferences remain truly international. HRI London 2023 will be remembered for its inspiring blend of 'old and new', with a programme notable for the maturity of the evidence presented by experienced names drawing on decades of work, as well as the enthusiasm and skill of up-and-coming researchers who took the floor to present their new findings. In this report, we present scientific highlights from the event.


Asunto(s)
Homeopatía , Londres
3.
BMJ Open ; 13(10): e076621, 2023 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-37802612

RESUMEN

INTRODUCTION: Patients undergoing prostate radiotherapy with an enlarged prostate can have short-term and long-term urinary complications. Currently, transurethral resection of the prostate (TURP) is the mainstay surgical intervention for men with urinary symptoms due to an enlarged prostate prior to radiotherapy. UroLift (NeoTract, Pleasanton, CA, USA) is a recent minimally invasive alternative, widely used in benign disease but is untested in men with prostate cancer. METHODS AND ANALYSIS: A multicentre, two-arm study designed in collaboration with a Patient Reference Group to assess the feasibility of randomising men with prostate cancer and coexisting urinary symptoms due to prostate enlargement to TURP or UroLift ahead of radiotherapy. 45 patients will be enrolled and randomised (1:1) using a computer-generated programme to TURP or UroLift. Recruitment and retention will be assessed over a 12 month period. Information on clinical outcomes, adverse events and costs will be collected. Clinical outcomes and patient reported outcome measures will be measured at baseline, 6 weeks postintervention and 3 months following radiotherapy. A further 12 in-depth interviews will be conducted with a subset of patients to assess acceptability using the Theoretical Framework of Acceptability. Descriptive analysis on all outcomes will be performed using Stata (StataCorp V.2021). ETHICS AND DISSEMINATION: The trial has been approved by the Research Ethics Committee (REC) NHS Health Research Authority (HRA) and Health and Care Research Wales (HCRW). The results will be published in peer-reviewed journals, presented at national meetings and disseminated to patients via social media, charity and hospital websites. TRIAL REGISTRATION NUMBER: NCT05840549.


Asunto(s)
Hiperplasia Prostática , Neoplasias de la Próstata , Resección Transuretral de la Próstata , Humanos , Masculino , Estudios de Factibilidad , Londres , Próstata , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/radioterapia , Hiperplasia Prostática/cirugía , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía , Neoplasias de la Próstata/complicaciones , Resección Transuretral de la Próstata/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
Nutrients ; 15(17)2023 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-37686708

RESUMEN

There is a longstanding interest in the relationship between diet and hot flash symptoms during midlife, especially in whether phytoestrogens ease menopausal symptoms. The purpose of this study was to examine hot flashes, night sweats, trouble sleeping, and vaginal dryness in relation to the intake of foods rich in phytoestrogens among Bangladeshi women aged 35 to 59 years who were living either in Sylhet, Bangladesh (n = 157) or as migrants in London (n = 174). Consumption ranges for phytoestrogens were constructed from food frequencies. We hypothesized that diets rich in isoflavones, lignans, and coumestrol would be associated with lower symptom frequencies. However, adjusted logistic regression results showed that with each incremental increase in general phytoestrogen consumption (scale of 0 to 10), the likelihood of hot flashes increased by 1.4%. Each incremental increase in lignan consumption raised the likelihood of hot flashes by 1.6%. In contrast, the odds of vaginal dryness decreased by 2%, with each incremental increase in phytoestrogen and lignan consumption, and by 4%, with each incremental increase in isoflavone consumption. Night sweats and trouble sleeping were not associated with phytoestrogen intake in logistic regressions. Our findings add to the conflicting data on relationships between phytoestrogens and symptoms associated with menopause.


Asunto(s)
Isoflavonas , Lignanos , Humanos , Femenino , Fitoestrógenos , Bangladesh/epidemiología , Londres/epidemiología , Sofocos/epidemiología
5.
Br Dent J ; 234(10): 739-745, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37237202

RESUMEN

Pressure on paediatric dental general anaesthetic (GA) waiting lists has recently been at its highest, further compounded by the COVID-19 pandemic. Project Tooth Fairy (PTF), a pan-London collaborative project, was conceived in response to this backlog. A dedicated day case GA suite was established within The Royal London Dental Hospital (Barts Health NHS Trust) for use by multiple trusts to enhance elective recovery.Over ten months, 895 patients were treated and discharged by PTF, averaging 101 patients per month. The majority required simple exodontia and comprehensive care and some patients were treated for surgery related to orthodontic treatment. Patient-reported experience measures highlighted an overall positive experience and appreciation for the service.Several governance domains were considered in the service development, including risk management, workforce recruitment and information governance. Training opportunities have arisen for team members to develop their skills. Patient-reported experience measures have guided the provision of service focusing on paediatric dentistry and paediatric GA.PTF has demonstrated the creation of a service centred around collaboration to successfully reduce GA waiting lists and therefore improving patient outcomes. The development of this service can be used as a template for the establishment of similar regional collaborative projects.


Asunto(s)
COVID-19 , Pandemias , Humanos , Niño , Londres , Odontología Pediátrica , Medición de Resultados Informados por el Paciente
6.
BMC Med ; 21(1): 91, 2023 03 13.
Artículo en Inglés | MEDLINE | ID: mdl-36907857

RESUMEN

BACKGROUND: Social prescribing (SP) usually involves linking patients in primary care with services provided by the voluntary and community sector. Preliminary evidence suggests that SP may offer a means of connecting patients with community-based health promotion activities, potentially contributing to the prevention of long-term conditions, such as type 2 diabetes (T2D). METHODS: Using mixed-methods realist evaluation, we explored the possible contribution of SP to individual-level prevention of T2D in a multi-ethnic, socio-economically deprived population in London, UK. We made comparisons with an existing prevention programme (NHS Diabetes Prevention Programme (NDPP)) where relevant and possible. Anonymised primary care electronic health record data of 447,360 people 18+ with an active GP registration between December 2016 and February 2022 were analysed using quantitative methods. Qualitative data (interviews with 11 primary care clinicians, 11 social prescribers, 13 community organisations and 8 SP users at high risk of T2D; 36 hours of ethnographic observations of SP and NDPP sessions; and relevant documents) were analysed thematically. Data were integrated using visual means and realist methods. RESULTS: People at high risk of T2D were four times more likely to be referred into SP than the eligible general population (RR 4.31 (95% CI 4.17-4.46)), with adjustment for socio-demographic variables resulting in attenuation (RR 1.33 (95% CI 1.27-1.39)). More people at risk of T2D were referred to SP than to NDPP, which could be explained by the broad referral criteria for SP and highly supportive (proactive, welcoming) environments. Holistic and sustained SP allowed acknowledgement of patients' wider socio-economic constraints and provision of long-term personalised care. The fact that SP was embedded within the local community and primary care infrastructure facilitated the timely exchange of information and cross-referrals across providers, resulting in enhanced service responsiveness. CONCLUSIONS: Our study suggests that SP may offer an opportunity for individual-level T2D prevention to shift away from standardised, targeted and short-term strategies to approaches that are increasingly personalised, inclusive and long-term. Primary care-based SP seems most ideally placed to deliver such approaches where practitioners, providers and commissioners work collectively to achieve holistic, accessible, sustained and integrated services.


Asunto(s)
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/prevención & control , Londres , Derivación y Consulta , Evaluación de Programas y Proyectos de Salud
7.
Epilepsy Behav ; 138: 109034, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36525922

RESUMEN

Status epilepticus is a frequent neurological emergency associated with a case fatality of about 10-15% depending on age, cause, and other factors, and a high burden for patients, caregivers, and society. In pregnancy, it can occur in two different clinical constellations: (1) In women with a history of epilepsy and (2) as new onset status epilepticus in pregnancy (NOSEP). Both entities are relatively rare but differ in terms of etiology. Here we describe the epidemiology, etiologies, diagnosis, clinical course with the maternal and fetal outcome, and the suggested management strategies for either manifestation. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.


Asunto(s)
Estado Epiléptico , Embarazo , Humanos , Femenino , Estado Epiléptico/diagnóstico , Estado Epiléptico/epidemiología , Estado Epiléptico/terapia , Convulsiones/diagnóstico , Familia , Atención Prenatal , Londres
8.
BMJ Sex Reprod Health ; 49(2): 112-117, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36410764

RESUMEN

BACKGROUND: Pregnancy planning and preconception care benefit women, their children, and future generations. The London Measure of Unplanned Pregnancy (LMUP) is a tool that can be used in antenatal care to identify women with unintended pregnancies who require improved access to such services. This tool was recently implemented into routine antenatal care in two maternity centres in New South Wales, Australia. This study explores midwives' attitudes to the LMUP 12 months after it was introduced into the booking visit and their understanding of its application to their scope of practice. METHODS: This is a qualitative study using in-depth semi-structured interviews with midwives from two maternity care centres in Australia. All midwives performing antenatal booking visits were eligible to take part. Interviews were transcribed, analysed, and coded to define key themes. Recruitment ceased when thematic saturation was reached. RESULTS: Ten midwives from two maternity centres were interviewed. Midwives support the inclusion of the LMUP into the booking visit and felt it was in their scope of practice to be using the tool. Time constraints, the impact of COVID-19 and the lack of structured referral pathways were identified as barriers to the implementation of the LMUP in routine care. CONCLUSIONS: Midwives support the inclusion of the LMUP into the antenatal booking visit and see that it falls within their scope of practice. Service barriers were identified at the individual, organisational and external context levels. These need to be addressed to enhance the potential of this tool.


Asunto(s)
COVID-19 , Servicios de Salud Materna , Partería , Niño , Femenino , Embarazo , Humanos , Embarazo no Planeado , Londres
9.
J Ment Health ; 32(2): 412-423, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35037548

RESUMEN

BACKGROUND: Team case formulation on acute psychiatric wards aims to support staff to manage significant levels of challenging behaviour. However, there is limited research on staff experience of case formulation in this setting. AIM: This study aimed to investigate staff experience of team case formulation sessions on acute psychiatric wards and their impact on staff wellbeing. METHODS: Eighteen multidisciplinary staff (nurses, doctors, occupational therapists, support workers, activities coordinators) from five acute wards at a South London psychiatric hospital completed a semi-structured interview and visual analogue scales on their experience of attending case formulation. Thematic analysis was employed to analyse qualitative data. RESULTS: Participants reported that case formulation supported staff to develop a holistic understanding of service users, provided a safe space for staff to discuss the impact of challenging behaviour and improved teamwork and communication. Participants reported that these benefits increased their ability to identify and support the needs of service users and improved therapeutic relationships. Challenges with establishing continuity of care were highlighted. CONCLUSION: Team case formulation is an important intervention to support ward staff and has significant benefits to staff wellbeing and quality of care. Greater integration with existing ward practices may benefit both staff and service users.


Asunto(s)
Médicos , Servicio de Psiquiatría en Hospital , Humanos , Londres , Hospitales Psiquiátricos
10.
Br J Cancer ; 127(7): 1289-1295, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35840733

RESUMEN

BACKGROUND: During the COVID pandemic, there was a paucity of data to support clinical decision-making for anticancer treatments. We evaluated the safety of radical treatments which were delivered whilst mitigating the risks of concurrent COVID-19 infection. METHODS: Using descriptive statistics, we report on the characteristics and short-term clinical outcomes of patients undergoing radical cancer treatment during the first COVID-19 wave compared to a similar pre-pandemic period. RESULTS: Compared to 2019, the number of patients undergoing radical treatment in 2020 reduced by: 28% for surgery; 18% for SACT; and 10% for RT. Within SACT, 36% received combination therapy, 35% systemic chemotherapy, 23% targeted treatments, 5% immunotherapy and 2% biological therapy. A similar proportion of RT was delivered in 2019 and 2020 (53% vs. 52%). Oncological outcomes were also similar to pre-COVID-19. The COVID-19 infection rates were low: 12 patients were positive pre surgery (1%), 7 post surgery (<1%), 17 SACT patients (2%) and 3 RT patients (<1%). No COVID-19-related deaths were reported. CONCLUSIONS: Whilst there were fewer patients receiving radical anticancer treatments, those who did receive treatment were treated in a safe environment. Overall, cancer patients should have the confidence to attend hospitals and be reassured of the safety measures implemented.


Asunto(s)
COVID-19 , Neoplasias , COVID-19/epidemiología , Humanos , Inmunoterapia , Londres/epidemiología , Neoplasias/tratamiento farmacológico , Neoplasias/terapia , Pandemias
11.
Midwifery ; 111: 103360, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35576866

RESUMEN

OBJECTIVES: Collaborative Learning in Practice (CLiP) is one way of addressing an increase in student placement capacity and potentially improving the student learning experience overall. The aim of this article is to report the findings of a CLiP pilot study undertaken in a London hospital maternity ante- and postnatal ward. DESIGN: A qualitative explorative study design employing a descriptive online survey and individual semi-structured interviews to evaluate the experiences. SETTING: A London based hospital maternity ante- and postnatal ward PARTICIPANTS: seven midwifery students from a mix of years (1-3) and six staff (all trained midwives) METHODS: The survey results and interview data were transcribed and thematically analysed to identify the barriers and enablers for CLiP RESULTS: Three themes emerged from the data: 1. Preparation for the CLiP pilot, 2. Peer-learning and collaboration as support and resource, 3. Independence and trust as drivers for learning. CONCLUSIONS: The results are in-line with previously conducted CLiP studies. This study contributes to the findings around the set-up of CLiP in a demanding London maternity ward. It demonstrates that adequate preparation is vital, including the role of the CLiP educator to raise awareness, provide training and to support CLiP midwives. The CLiP hour appears beneficial since it offers protected reflection time. CLiP appeared to increase the clinical confidence of students, particularly more experienced students, through peer learning and independence. Larger-scale research is needed.


Asunto(s)
Prácticas Interdisciplinarias , Partería , Estudiantes de Enfermería , Femenino , Hospitales , Humanos , Londres , Partería/educación , Proyectos Piloto , Embarazo , Investigación Cualitativa , Instrumentos Quirúrgicos
12.
Sci Rep ; 12(1): 5932, 2022 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-35396488

RESUMEN

Kohl, a dark eye cosmetic, is a well-known part of Ancient Egyptian culture. Modern chemical analyses of kohls have largely found lead-based inorganic constituents, whereas earlier studies argued for a much broader range of constituents. Furthermore, organic materials in kohls remain severely understudied. This raises questions regarding the true diversity of materials and recipes used to produce kohls. We analysed the contents of 11 kohl containers from the Petrie Museum collection in London. The objects selected cover a broad range of times and locations in Egypt. Our multi-analytical approach allowed us to characterise both inorganic and organic components. Our data show that inorganic ingredients in kohl recipes are not only lead-based but also manganese- and silicon-based. Our analyses also revealed that organic ingredients derived from both plant and animal sources were commonly used in kohl recipes and sometimes even represent the main constituent. All these findings point towards more varied recipes than initially thought and significantly shift our understanding of Ancient Egyptian kohls.


Asunto(s)
Cosméticos , Animales , Cosméticos/química , Egipto , Antiguo Egipto , Historia Antigua , Londres
13.
Ulster Med J ; 91(1): 45-49, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35169339

RESUMEN

James Alexander Logan, a second-year medical student at the Barts and The London School of Medicine and Dentistry, died in February 2001 after a distressing illness of three months duration. His family, friends and interested professionals subsequently set up the James Logan Trust to encourage doctors and others to have the confidence to recognise and treat cancer pain. The James Logan Trust has provided funds for an annual prize for the best essay on "The challenges of cancer pain assessment and management" to be submitted by a Queen's University of Belfast undergraduate medical student after the completion of their fourth-year palliative medicine teaching.


Asunto(s)
Dolor en Cáncer , Educación de Pregrado en Medicina , Neoplasias , Estudiantes de Medicina , Dolor en Cáncer/terapia , Humanos , Londres , Neoplasias/complicaciones , Neoplasias/terapia , Manejo del Dolor
14.
Health Soc Care Community ; 30(2): e388-e396, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-33152144

RESUMEN

In an attempt to support care integration that promotes joined up service provision and patient-centred care across care boundaries, local health and social care organisations have embarked on several initiatives and approaches. A key component of service integration is the co-location of different professional groups. In this study, we consider the extent to which co-location is an enabler for service integration by examining multi-professional community care teams. The study presents findings from a qualitative evaluation of integrated care initiatives in a borough of East London, England, undertaken between 2017 and 2018. The evaluation employed a participatory approach, the Researcher-in-Residence model. Participant observation (n = 80 hr) and both semi-structured individual (n = 16) and group interviews (six groups, n = 17 participants) were carried out. Thematic analysis of the data was undertaken. The findings show that co-location can be an effective enabler for service integration providing a basis for joint working, fostering improved communication and information sharing if conditions such as shared information systems and professional cultures (shared beliefs and values) are met. Organisations must consider the potential barriers to service integration such as differing professional identity, limited understanding of roles and responsibilities and a lack of continuity in personnel. Co-location remains an important facet in the development of multi-professional teams and local service integration arrangements, but as yet, has not been widely acknowledged as a priority in care practice. Organisations that are committed to greying care boundaries and providing joined up patient care must ensure that sufficient focus is provided at the service delivery level and not assume that decades of silo working in health and social care and strong professional cultures will be resolved by co-location.


Asunto(s)
Prestación Integrada de Atención de Salud , Atención Dirigida al Paciente , Comunicación , Inglaterra , Humanos , Londres , Grupo de Atención al Paciente
15.
J Investig Allergol Clin Immunol ; 32(5): 367-374, 2022 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-33949950

RESUMEN

BACKGROUND AND OBJECTIVES: Platanus acerifolia (London plane tree) is a deciduous tree of the Platanaceae family. Sensitization to this plant varies with geography. Madrid, located in central Spain, has one of the highest London plane tree pollen concentration levels on the Iberian Peninsula. We evaluated both the clinical characteristics and the molecular sensitization pattern of patients with allergy to London plane tree pollen in the region of Madrid. METHODS: Thirty-eight patients allergic to London plane tree pollen were selected according to their clinical symptoms and positive results in skin prick testing and/or specific IgE determination. Serum was collected, and allergen components were evaluated using immunodetection techniques as well as ImmunoCAP. The IgE-binding proteins detected were identified and characterized using mass spectrometry. RESULTS: Analysis of serum samples from allergic patients revealed 9 IgE-binding bands in London plane tree pollen extract. Among these, the 45-kDa protein, which corresponded to Pla a 2, was detected in 76.3% of patients. However, the 18-kDa (Pla a 1) and 9-kDa (Pla a 3) bands were detected in 44.7% and 23.7% of sera, respectively. These results were confirmed using purified proteins. Characterization of the allergen revealed the 27-kDa protein to be glutathione-S-transferase. CONCLUSIONS: The molecular profile of patients sensitized to London plane tree pollen differs from that reported in studies from other locations. In the population we studied, the prevalence of Pla a 2 was higher than that of Pla a 1 and Pla a 3. In addition, the minor allergen previously referred to as Pla a 4 was characterized as glutathione-S-transferase.


Asunto(s)
Alérgenos , Hipersensibilidad , Alérgenos/análisis , Antígenos de Plantas/análisis , Glutatión/análisis , Humanos , Hipersensibilidad/diagnóstico , Hipersensibilidad/epidemiología , Inmunoglobulina E , Londres , Extractos Vegetales , Polen , España/epidemiología , Transferasas/análisis , Árboles
16.
Schizophr Bull ; 48(2): 447-456, 2022 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-34757401

RESUMEN

Sleep and circadian rhythm dysfunction is prevalent in schizophrenia, is associated with distress and poorer clinical status, yet remains an under-recognized therapeutic target. The development of new therapies requires the identification of the primary drivers of these abnormalities. Understanding of the regulation of sleep-wake timing is now sufficiently advanced for mathematical model-based analyses to identify the relative contribution of endogenous circadian processes, behavioral or environmental influences on sleep-wake disturbance and guide the development of personalized treatments. Here, we have elucidated factors underlying disturbed sleep-wake timing by applying a predictive mathematical model for the interaction of light and the circadian and homeostatic regulation of sleep to actigraphy, light, and melatonin profiles from 20 schizophrenia patients and 21 age-matched healthy unemployed controls, and designed interventions which restored sleep-circadian function. Compared to controls, those with schizophrenia slept longer, had more variable sleep timing, and received significantly fewer hours of bright light (light > 500 lux), which was associated with greater variance in sleep timing. Combining the model with the objective data revealed that non 24-h sleep could be best explained by reduced light exposure rather than differences in intrinsic circadian period. Modeling implied that late sleep offset and non 24-h sleep timing in schizophrenia can be normalized by changes in environmental light-dark profiles, without imposing major lifestyle changes. Aberrant timing and intensity of light exposure patterns are likely causal factors in sleep timing disturbances in schizophrenia. Implementing our new model-data framework in clinical practice could deliver personalized and acceptable light-dark interventions that normalize sleep-wake timing.


Asunto(s)
Ritmo Circadiano/fisiología , Esquizofrenia/complicaciones , Actigrafía/métodos , Actigrafía/estadística & datos numéricos , Adulto , Femenino , Humanos , Londres , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Esquizofrenia/fisiopatología
17.
Nutrients ; 13(11)2021 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-34836167

RESUMEN

Behavioural weight management interventions are recommended for the treatment of obesity in children. However, the evidence for these is limited and often generated under trial conditions with White, middle-class populations. Healthy Eagles is a behavioural weight management intervention designed to treat excess weight in children. It ran in the London Borough of Croydon from 2017 to 2020 and was delivered in both school and community settings, providing a natural experiment to compare outcomes. A total of 1560 participants started the Healthy Eagles programme; 347 were in the community setting and 703 in the school setting. Data were analysed for those who completed 70% of the programme. In the school setting, there was a small but significant reduction in BMI z-score (M = -0.04, 95% CI = -0.08, -0.01) for participants above a healthy weight, especially in those with severe obesity (M = -0.09, 95% CI = -0.15, -0.03); there was no significant change in any subgroup in the community setting. Linear regression analysis showed the school setting was associated with a 0.26 (95% CI = 0.13, 0.49) greater reduction in BMI z-score than the community setting after adjusting for ethnicity, deprivation, age and gender. Across both programmes, the effect was somewhat greater in participants from a Black (African/Caribbean/Other) ethnic background (M = -0.06, 95% CI = -0.09, -0.02) and from the two most deprived quintiles (M = -0.06, 95% CI = -0.11, -0.01). Data were limited, but minimal changes were measured in nutrition and physical activity behaviours regardless of setting. This evaluation provides indirect evidence of a small but significant benefit to running weight management interventions in a school versus community setting.


Asunto(s)
Sobrepeso/terapia , Obesidad Infantil/terapia , Instituciones Académicas , Programas de Reducción de Peso/métodos , Adolescente , Animales , Índice de Masa Corporal , Niño , Preescolar , Ejercicio Físico , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Londres , Masculino , Terapia Nutricional/métodos , Características de la Residencia
18.
BMJ Open ; 11(11): e049991, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-34725078

RESUMEN

OBJECTIVES: (1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women. DESIGN: Retrospective observational cohort study. SETTING: Four council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse. PARTICIPANTS: All women booked for antenatal care under Guys and St Thomas' National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas. MAIN OUTCOME MEASURES: To explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes). RESULTS: There was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth. CONCLUSION: This study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater.


Asunto(s)
Partería , Nacimiento Prematuro , Cesárea , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Londres , Embarazo , Nacimiento Prematuro/epidemiología , Estudios Retrospectivos , Privación Social , Medicina Estatal
19.
Ann Palliat Med ; 10(8): 9251-9258, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34488409

RESUMEN

The large-scale exchange and spread of traditional Chinese medicine (TCM) in the West began in the 17th century. From the first English Chinese medicine book "gout collection" published in London in 1676, the British began to understand the mysterious and ancient oriental medicine of TCM. Britain is one of the earliest countries where TCM began to spread. TCM is an important carrier of China's excellent traditional culture. With the development of the world's medical technology and the continuous improvement of China's cultural soft power, the cross-cultural communication of TCM has become a characteristic business card for China to go to the world. For the research of a work, we must start from the source, so it is very important to first count the history of TCM external communication, and then systematically analyze and study the various phenomena in this history, so as to summarize the experience and inadequacy of TCM external communication process, and provide feasible guidance for future TCM research, And promote the effective development of TCM, and ultimately spread TCM culture to the international community more comprehensively and accurately. Although the greater than 300 hundred years' history of traditional Chinese medicine (TCM) spreading throughout Britain has been continuously mentioned in literature, studies on the historical development of TCM in Britain are rare. In this paper, the authors gathered information including the chronological statistics and stages of the 300 hundred years' dissemination of TCM in Britain, in order to provide more historical data and research materials for the spread of Chinese medicine in Britain.


Asunto(s)
Comunicación , Medicina Tradicional China , China , Londres
20.
Anaesth Intensive Care ; 49(1_suppl): 41-50, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34553610

RESUMEN

In 1683, a self-proclaimed apothecary physician and London professor of physick by the name of Guilelmus (William) Salmon authored a pharmacopoeia titled Doron medicum, the 'gift of medicine' (Greek/Latin translation). This text formulates an English supplement to the Latin Materia medica (16th century), discussing internal and external compound medicines of the late 17th century. This pharmacopoeia enabled those incapable of reading Latin to provide medical care to a challenging post-plague community. Opiology, mercury, dragon's blood, willow bark, animal preparations and therapies now considered obscure, provide insight into therapies at the time. Early critical care treatments in haemorrhage control and pain management are described.Doron medicum preceded the controversial opening by the College of Physicians of the first London Dispensary in 1698, and was published in a maturing period of medical governance and healthcare establishment in London. During the 17th century, great competition and debate existed between the Royal College of Physicians and the apothecaries. Throughout such debates, William Salmon advocated for access to medical care for the poor and recognition of an allied approach to healthcare.This paper discusses Salmon's contribution to medicine, which has been poorly transcribed in medical history. A selection of opiate-based analgesic therapies, early critical care strategies and animal preparations are revisited. A small chronicle of William Salmon's life and professional achievements will be reviewed. Debate surrounding the opening of the first London Dispensary will be discussed in relation to William Salmon's contribution, echoing ongoing contemporary challenges in healthcare over 300 years later.


Asunto(s)
Analgésicos , Cognición , Animales , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Humanos , Londres
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA