Professional sports club and workplace Type 2 diabetes screening using the Leicester Diabetes Risk Score: Six-monthly results from the Leicester Changing Diabetes programme

Aim: Leicester is the first UK city to join the Cities Changing Diabetes global programme. City stakeholders drive the direction of the programme. The aim is to present results from Type 2 diabetes screening events requested by professional sports clubs and employers in Leicester City.Methods: Stakeholder meetings held between October 2017 and May 2018 included representatives from the four City professional sports clubs (football, rugby, basketball and cricket) and City employers. They requested Type 2 diabetes risk identification (screening) at their events. Trained staff from Leicester Diabetes Centre and the Centre for Black and Minority Health administered the Leicester Diabetes Risk Score (seven self-report questions). The validated scoring system assigns a low, medium, high and very high risk score to screeners. Events were promoted by the sports clubs (e.g. matchday programme, Twitter). Employee participation was supported by line managers.Results: Between May and October 2018, 303 adults completed a risk score and received their result at six events including a Leicester City FC Premier League game, a senior league football game, a test cricket match, a large call-centres and the City Council. Overall, 43% were at high or very high risk. The workplace gave the largest number of screeners (46%) and proportion of at risk people (44%).Conclusions: Professional sports clubs and employers are increasingly aware of the health of their fans, employees and the wider community. These are novel settings for screening events and are allowing new audiences to engage in Type 2 diabetes risk identification. </p

Location-specific reflex epilepsy: a novel reflex epilepsy phenotype

Reflex epilepsies are rare syndromes where seizures are triggered by particular stimuli or activities that may be motor, sensory or cognitive in nature. Triggers are diverse, may be extrinsic or intrinsic in nature and heterogeneous phenotypes have been described over the years. We give an account of a case of location-specific reflex epilepsy which we suggest is a novel reflex epilepsy phenotype relating to higher cortical function (HCF), and review the literature in relation to features of HCF reflex epilepsies described to date.</p

Reducing sitting at work: process evaluation of the SMArT Work (Stand More AT Work) intervention

Background: Office based workers accumulate high amounts of sitting time. Stand More AT (SMArT) Work aimed to reduce occupational sitting time and a cluster randomised controlled trial demonstrated it was successful in achieving this aim. The purpose of this paper is to present the process evaluation of the SMArT Work intervention.Methods: Questionnaire data were collected from intervention participants at 6 (n=58) and 12 months (n=55). Questionnaires sought feedback on the different components of the intervention (education, height-adjustable desk, Darma cushion, behaviour feedback, progress chats (coaching) with research team, action planning/goal setting diary) and experiences of evaluation measures. Control participants (n=37) were asked via questionnaire at 12 month follow up about the impact of the study on their behaviour and any lifestyle changes made during the study. Participants from both arms were invited to focus groups to gain a deeper understanding of their experiences upon completion of 12 month follow up.Results: Focus group and questionnaire data showed a positive attitude towards the height-adjustable workstation with a high proportion of participants using it every day (62%). Most participants (92%) felt the education seminar increased their awareness of the health consequences of too much sitting and motivated them to change their behaviour. Receiving feedback on their sitting time and support from the research team also encouraged behaviour change. The Darma cushion and action planning/goal setting diary were seen to be less helpful for behaviour change. Benefits experienced included fewer aches and pains, improved cognitive functioning, increased productivity, more energy, and positive feelings about general health.Conclusions: Key elements of the programme identified as facilitating behaviour change were: the educational seminar, the height-adjustable workstation, behavioural feedback and regular contact with research staff through regular progress chats. </p

National guidelines on the provision of outpatient parenteral antimicrobial therapy (OPAT)

Aim  Outpatient parenteral antimicrobial therapy (OPAT) is an option in patients who require parenteral antimicrobial administration and are clinically well enough for hospital discharge. This is an update of the Irish National OPAT guidelines which were last reviewed in 2011.  Methods  The guideline was devised through a collaborative process with the national OPAT Working Group and a review of the literature. It is intended for clinicians who prescribe any intravenous (IV) antimicrobials outside of the inpatient setting in the Republic of Ireland.  Results  Patient care while on OPAT should be provided by a designated OPAT service, with clear managerial and clinical governance lines of responsibility. It should be conducted using a team approach with a clinical lead on each site either as an infection specialist, or a general medical physician with infection specialist input and an OPAT nurse. An antimicrobial pharmacist is also desirable. Several factors must be considered when assessing patient’s suitability for OPAT including exclusion criteria, infection-specific factors, and patient specific factors such as physical, social and logistic criteria.  Conclusion  This updated guideline advocates a more individualised OPAT approach, with the recognition that specific antimicrobials and/or specific delivery models may be more appropriate for certain patient groups. Full guidelines are available through www.opat.ie.</p