In real life: evaluating primary care based undergraduate dental education in Northwest England

Aim: To explore how working at Dental Education Centres (DECs), away from the university campus, has influenced the attitudes of dental students towards providing dental care in a primary setting, and whether students feel that this model of dental education meets their perceived training needs. Design: Exploratory, qualitative interview study. Methods: Semi-structured interviews with five 4th BDS students analysed using thematic analysis. Results: The main theme identified was ‘real life dentistry’ as students described how their clinical experiences and the teaching at DECs would prepare them for life as a general dental practitioner. Students felt they had a positive impact on their patients, and although some felt they could not comment on the impact to the community, others thought that this was likely to be positive. Discussion: Students believed they experienced ‘real life dentistry’ which would prepare them well for their foundation year and future practice. They also believed they had a positive impact on their patients

Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review protocol

Introduction: Overweight and obesity are growing public health problems worldwide. Both diet and physical activity have been the primary interventions for weight reduction over the past decade. With increasing rates of overweight and obesity, it is evident that a primary focus on diet and exercise has not resulted in sustained obesity reduction within the global population. There is now a case to explore other weight management strategies, focusing on psychological factors that may underpin overweight and obesity. Psychological therapy interventions are gaining recognition for their effectiveness in addressing underlying emotional factors and promoting weight loss. However, there is a dearth of literature that has mapped the types of psychological interventions and the characteristics of these interventions as a means of achieving weight reduction and sustained weight reduction in adults with overweight or obesity. Methods and analysis: The review will combine the methodology outlined by Arksey and O’Malley with the PRISMA-ScR guidelines. A total of six databases will be searched using a comprehensive search strategy. Intervention studies will be included if participants are 18 years and over, classified as overweight or obese (≥BMI 25kg/m2), and have received a psychological therapy intervention. The review will exclude studies that are not available in English, not full text, none peer reviewed or combine a lifestyle and/or pharmacological intervention with a psychological intervention. Data will be synthesised using a narrative synthesis approach. Ethics and dissemination: Ethical approval is not required to conduct this scoping review. The findings will be disseminated through journal publication(s), social media, and a lay summary for key stakeholders

The effectiveness of neonatal early supported transfer to home interventions for parents and preterm infants in neonatal intensive care units: A systematic review and meta-analysis.

Background Preterm infants often need admission to a neonatal unit causing prolonged stress for parents. Evidence has shown that neonatal early supported transfer to home interventions may reduce stress levels. This systematic review investigates effectiveness of neonatal early supported transfer to home interventions for parents and preterm infants in neonatal intensive care units. Methods Six databases and two trials registries were searched from inception to February 2022. Risk of bias was assessed using the RoB2 and ROBINS I tool. Results Ten studies were included. Neonatal early supported transfer to home interventions reduced duration of hospital stay by up to 11 days compared to usual care, without significantly increasing hospital re-admission rates (p= >0.05). Studies were judged to have moderate to serious risk of bias. Conclusions The findings indicate that early supported transfer to home interventions may reduce hospital stay with no evidence of difference in hospital admission rates, infants weight gain or breastfeeding rates (compared to standard care). However, due to the dearth of high-quality evidence it is not possible to make recommendations for implementation

Regional Differences in Post-discharge Stroke Care in India: A Qualitative Study

Background: Stroke is the fourth leading cause of death and fifth leading cause of disability in India. Stroke rehabilitation can reduce mortality and improve outcomes, but India has limited resources to provide comprehensive stroke care after hospitalisation. Consequently, stroke survivors and family carers experience a range of challenges with long-term care and support. Secondary prevention and stroke rehabilitation services are important in post-discharge stroke care; however, there is insufficient information on post-discharge stroke services in India. Aim: This study aims to explore the clinical staff perspectives of post-discharge stroke services across different regions of India. Methods: Semi-structured interviews were undertaken with a purposive sample of health professionals from multidisciplinary stroke teams at the All India Institute of Medical Sciences, New Delhi (North), Baptist Christian Hospital (North-East), Sree Chitra Tirunal Institute for Medical Sciences and Technology (South) between July and August 2021. The interviews were conducted, translated, and transcribed by the research team. Data were analysed thematically using NVivo software. Results: Twenty-six health professionals participated: 9 Nurses, 7 Doctors, 5 Physiotherapists, 2 Speech and Language Therapists, and 1 Social Worker, Dietician, and Palliative Care team member. Four themes were identified: Integrated Inpatient Discharge Care Planning; Patient and Caregiver Engagement; Post-Discharge Care and Support; Resources and Workforce. Conclusion: Patient and caregiver engagement is an integral part of post-discharge processes; however, regional variation exists in the discharge planning, staff, resources, and services available for post-discharge support. Moreover, patient and caregiver challenges vary across geographical locations, educational backgrounds, financial status, family, and support networks

CLINICAL STAFF PERSPECTIVES OF POST-DISCHARGE STROKE CARE IN SOUTHERN INDIA

Background: As one of the most common non-communicable diseases in India, stroke results in significant residual disability and high mortality. Stroke care in India is often fragmented, exacerbated by a lack of public resources, information, and awareness. Survivors experience a range of disabilities and are cared for by their families long-term. Rehabilitation combined with secondary prevention is critical to post-discharge stroke care, in reducing recurrence, mortality, and improve outcomes. This study explores key components and challenges of post-discharge stroke services with clinical staff. Methods: We undertook ten semi-structured interviews with a purposive sample from health professionals, representing the multidisciplinary stroke teams (MDTs) from National Institute of Mental Health And Neuro Sciences, Bengaluru (NIMHANS) between September and November 2021. The research team conducted interviews, before translating, transcribing, and thematically analysing data (using NVivo). Institution ethical approval was granted, and informed consent obtained from participants. Results: Ten participants (3 nurses, 2 occupational therapists, 1 physiotherapist, 1doctor, 1 psychiatric social worker, 1 speech pathologist/audiologist, and 1 dietician) indicated that a comprehensive MDT contributed to individualised, comprehensive post-discharge planning; however, there was no specific discharge protocol. Patient/caregiver training and education was provided during hospitalisation and continued through follow-up. Health education material was verbal or written; pamphlets/leaflets were in multiple languages including English, Kannada and Hindi. Patients/caregivers faced various challenges including stigma, financial constraints, availability of supportive family members, patient transportation from rural areas and psychological impact of stroke. Stroke care services in the community were restricted to urban populations, however rural patients that do not have adequate stroke support services could access tele-consultation services. We identified four themes: integrated Inpatient Discharge Care Planning; Patient and Caregiver Engagement; Post discharge Care and Support; and Working with Challenges. Conclusion: Stroke care is continuous and faces multiple challenges which require multidisciplinary care and planning to improve outcomes

CLINICAL STAFF PERSPECTIVE OF POST-DISCHARGE STROKE CARE IN NORTH-WEST INDIA

Background: As one of the most common non-communicable diseases in India, stroke results in significant residual disability and high mortality rates. Stroke care in India is often fragmented, exacerbated by a lack of public resources, information, and awareness. Stroke survivors experience a range of disabilities and are cared for by their families long-term. Rehabilitation combined with secondary prevention is critical to post-discharge stroke care, in reducing recurrence, mortality, and improve outcomes. This study explores key components, and challenges of post-discharge stroke services with clinical staff. Methods: We undertook ten semi-structured qualitative interviews with a purposive sample from health professionals, representing the multidisciplinary stroke teams from Christian Medical College and Hospital, Ludhiana (CMCL) between July 2021 and January 2022. As a tertiary-level teaching hospital, CMCL serves a diverse patient population. The research team conducted interviews, before translating, transcribing, and thematically analysing data (using NVivo software). Results: Ten participants (3 nurses, 2 neurologists, 2 physiotherapists, 2 occupational therapists, and 1 dietician) indicated the multi-disciplinary stroke team enabled individualised comprehensive post discharge plan. Patient/caregiver training and education is provided during hospitalisation and continues through follow-up, with verbal/written information supported by videos or leaflets in Hindi, Punjabi, and English. Adherence to prescribed medication, diet, rehabilitation, and follow-up visits were impacted by challenges in patient literacy, stroke awareness, financial resources, or post discharge care. Community stroke care was provided through tele-stroke services, home-based physiotherapists, and community health workers. We identified four themes: Integrated Inpatient Discharge Care Planning; Patient and Caregiver Engagement; Post discharge Care and Support; and Working with Challenges. Conclusion: Key components of CMCL stroke services include treatment by a multi-disciplinary stroke care team, individualised post-discharge plan, patient-caregiver training and education, and postdischarge community care and tele-stroke services. Post-discharge care weighs heavily on family/caregivers facing various challenges (literacy, finances, local language education and availability)

CLINICAL STAFF PERSPECTIVE OF POST-DISCHARGE STROKE CARE IN NORTH INDIA

Background Stroke rehabilitation can reduce mortality and improve outcomes1,2, but India has limited resources to provide comprehensive stroke care post-discharge. This study explores the key components and challenges of post discharge stroke services with clinical staff. Methods Semi-structured interviews were undertaken with a purposive sample of health professionals from the All India Institute of Medical Sciences, New Delhi. The interviews were conducted, translated and transcribed by a Research Associate. Data were analysed thematically using NVivo software. Results Ten healthcare professionals participated: 6 Nurses, 2 Neurologists, 1 Physiotherapist, 1 Consultant (Research). Four key themes were identified (see table). Conclusion The multidisciplinary team empowers patients and caregivers by providing tailored and targeted education, training and support. The existing post-discharge management system could be formally documented at AIIMS to facilitate a more consistent and comprehensive approach

CLINICAL STAFF PERSPECTIVE OF POST-DISCHARGE STROKE CARE IN SOUTH INDIA

Background Stroke rehabilitation can reduce mortality and improve outcomes1,2, but India has limited resources to provide comprehensive stroke care post-discharge. The aim of this study was to explore the key components and challenges of post-discharge stroke services with clinical staff. Methods Semi-structured interviews were undertaken with a purposive sample of health professionals from Sree Chitra Tirunal Institute of Medical Sciences and Technology (SCTIMST), Kerala. The interviews were conducted, translated and transcribed by a Research Associate and data analysed thematically using NVivo software. Results A total of 10 healthcare professionals participated: 2 neurologists, 3 nurses, 2 physiotherapists, 2 speech therapists and 1 medico-social worker. Four themes were identifie