Primary care professionals and social marketing of health in neighbourhoods: A case study approach to identify, target and communicate with ‘at risk’ populations

Aim: In this article the authors illustrate using a case study approach how primary care professionals can use the combination of geodemographic data with hospital episode statistics (HES) to predict the location of people yat risk’ of diabetes mellitus (Type 2 diabetes) in the population of England. This approach facilitates social marketing of those yat risk'. Method: Geodemographic segmentation data for all households was combined with HES for 2001–2002, to predict population groups yat risk’ of Type 2 diabetes. Using a case study approach and quantitative data analysis techniques a profile of the undiagnosed and yat risk’ population of Slough Primary CareTrust was created at town, ward and street levels. Recent literature on social marketing was applied to predicate a discussion of the theory and practice of social marketing that was most likely to succeed in dealing with the prevention of Type 2 diabetes, via the reduction of obesity and overweight in the population. Discussion: The increase in lifestyle-related diseases, such as,Type 2 diabetes that are linked with the rise in overweight and obesity and create large disease management costs for the National Health Service (NHS) are of great concern to primary healthcare professionals and governments throughout the westernized world. Until recently, public and government responses have been very reactive in respect of population groups most in need of lifestyle change. Approaches to the identification of ‘sub-populations' most at risk of Type 2 diabetes and targeting of these is of direct relevance to the preventive work of primary care professionals. Conclusion: Geodemographic data overlaid onto official NHS and other routinely collected data, can aid the identification and targeting of groups most vulnerable to over-weight and obesity, through social marketing approaches including direct mail, telephone canvassing and door-to-door communication channels. © 2007, Cambridge University Press. All rights reserved

What Ambitious Donors Can Learn From The Atlantic Philanthropies' Experience Making Big Bets

By the time The Atlantic Philanthropies closes its doors in 2020, it will have distributed more than $8 billion—its entire endowment—to advance opportunity and lasting change for disadvantaged and vulnerable people worldwide. Founded in 1982, it was Founder Chuck Feeney's intention to champion "giving while living" and when the foundation closes, Atlantic will make history by becoming the largest foundation to complete its giving in the donor's lifetime.In its grant making, over 60 percent of Atlantic's overall giving ranks as big bets, investments of$10 million or more. Thirty percent of those bets went to social change causes, including gifts to human services, the environment, and international development. Such big bets have the potential to have big impacts on advancing social change goals. Yet as Bridgespan reported in the December 2015 Stanford Social Innovation Review article, "Making Big Bets for Social Change," investments of this size for social change are rare. Just 20 percent of philanthropic big bets went to social change causes between 2000 and 2012.Why? A number of barriers exist: it's hard to find and structure big bets, "shovel-ready" opportunities are few and far between, personal relationships between donors and nonprofit leaders can take years to nurture, and the long time horizons required for change and often-murky results make it difficult to measure success. In short, big bets on social change can feel risky.The story of Atlantic, however, illustrates what can happen when donors take that risk. This report, What Ambitious Donors Can Learn From The Atlantic Philanthropies' Experience Making Big Bets, looks at a number of big bets Atlantic made and how those achieved significant results. It identified four themes that ran through Atlantic's work and that were particularly evident in its most influential big bets:Pick distinctive investment spots and funding gaps in the landscape.Support organizations and strong leaders, often with unrestricted or capacity-building funding.Pursue advocacy in a complex social, policy and legal environment, and use both traditional grant funding and 501(c)(4) funding as tools.Give with the foundation's end in sight and sustainability in mind.The report also highlights the challenges and failures Atlantic faced along the way. Despite the inherent risk in big bets, Atlantic held the belief that a big bets strategy would be the best way to achieve lasting impact. It is a promising path that is yielding strong results, and Atlantic's experience offers potential strategies for other donors seeking similar goals

World of Viruses: the Frozen Horror

https://digitalcommons.unmc.edu/coph_books/1000/thumbnail.jp

How Well are Cardiopulmonary Resuscitation and Automated External Defibrillator Skills Retained Over Time? Results from the Public Access Defibrillation (PAD) Trial

Background: The current standard for cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) retraining for laypersons is a four‐hour course every two years. Others have documented substantial skill deterioration during this time period. Objectives: To evaluate 1) the retention of core CPR and AED skills among volunteer laypersons and 2) the time required to retrain laypersons to proficiency as a function of time since initial training. Methods: This was an observational follow‐up study evaluating CPR and AED skill retention and testing/retraining time up through 17 months after initial training. The study took place at 1,260 facilities recruited by 24 North American clinical research centers, and included 6,182 volunteer laypersons participating in the Public Access Defibrillation (PAD) Trial. Training to proficiency in either CPR only (N= 2,426) or CPR+AED (N= 3,756) was followed by testing/retraining provided three to 17 months later. Retraining was done in brief, one‐on‐one, individualized, interactive sessions. The outcome studied was instructors\u27 global assessments of performance of CPR and AED skill adequacy, i.e., whether CPR actions would likely result in perfusion (yes/no) and whether AED actions would result in a shock through the heart (yes/no). Results: For global CPR performance, 79%, 73%, and 71% of volunteers tested for the first time since initial training three to five, six to 11, and 12 to 17 months after initial training, respectively, were judged by their instructors as having adequate performance (p \u3c 0.001, chi‐square for linear trend). For global AED performance, 91%, 86%, and 84% of volunteers, respectively, were judged as having adequate performance (p \u3c 0.001). The mean (± standard deviation) times required to test and retrain volunteers to proficiency were 5.7 (± 4.0) minutes for CPR skills and 7.7 (± 4.6) minutes for CPR+AED skills. Conclusions: Among PAD Trial volunteer laypersons participating in a simulated resuscitation, the proportions of volunteers judged by instructors to have adequate CPR and AED skills demonstrated small declines associated with longer intervals between initial training and subsequent testing. However, based on instructors\u27 judgment, large majorities of volunteers still retained both CPR and AED core skills through 17 months after initial training. Furthermore, individual testing and retraining for CPR and AED skills were usually accomplished in less than 10 minutes per volunteer. Additional research is essential to identify training and evaluation techniques that predict adequate CPR and AED skill performance of laypersons when applied to an actual cardiac arrest

Food for life: A social return on investment analysis of the locally commissioned programme. Full Report

A Social Return on Investment Analysis of two locally commissioned Food for Life programme

Evaluation of Food for Life 2013-15: Summary and synthesis report

This is the final report of the phase two evaluation of Food for Life undertaken by the University of the West of England, Bristol 2013-15. The research encompassed five workstreams: 1.Long term impacts and durability - understanding how and why the Food for Life approach is embedded in schools for the medium to long-term. 2.Review of local commissions - understanding strategic support for Food for Life, and recommending monitoring and evaluation systems.3.Cross sectional study of pupils’ diets in Food for Life local commissions - evaluating Food for Life’s impact on healthy eating behaviours in schools in local commission areas. 4.New settings - exploring innovative approaches to extending the Food for Life whole setting approach beyond schools.5.Social value of Food for Life in local authority commissions – understanding the social, health, economic and environmental value of Food for Life commissions. The report presents summaries of the findings of each workstream, discusses themes emerging across the research, and sets out recommendations for Food for Life and associated evaluation activity

In-hospital versus out-of-hospital presentation of life-threatening ventricular arrhythmias predicts survival Results from the AVID registry

AbstractOBJECTIVESThis study describes the outcomes of patients from the Antiarrhythmics Versus Implantable Defibrillators (AVID) Study Registry to determine how the location of ventricular arrhythmia presentation influences survival.BACKGROUNDMost studies of cardiac arrest report outcome following out-of-hospital resuscitation. In contrast, there are minimal data on long-term outcome following in-hospital cardiac arrest.METHODSThe AVID Study was a multicenter, randomized comparison of drug and defibrillator strategies to treat life-threatening ventricular arrhythmias. A Registry was maintained of all patients with sustained ventricular arrhythmias at each study site. The present study includes patients who had AVID-eligible arrhythmias, both randomized and not randomized. Patients with in-hospital and out-of-hospital presentations are compared. Data on long-term mortality were obtained through the National Death Index.RESULTSThe unadjusted mortality rates at one- and two-year follow-ups were 23% and 31.1% for patients with in-hospital presentations, and 10.5% and 16.8% for those with out-of-hospital presentations (p < 0.001), respectively. The adjusted mortality rates at one- and two-year follow-ups were 14.8% and 20.9% for patients with in-hospital presentations, and 8.4% and 14.1% for those with out-of-hospital presentations (p < 0.001), respectively. The adjusted long-term relative risk for in-hospital versus out-of-hospital presentation was 1.6 (95% confidence interval [CI] 1.3–1.9).CONCLUSIONSCompared with patients with out-of-hospital presentations of life-threatening ventricular arrhythmias not due to a reversible cause, patients with in-hospital presentations have a worse long-term prognosis. Because location of ventricular arrhythmia presentation is an independent predictor of long-term outcome, it should be considered as an element of risk stratification and when planning clinical trials

Parent-clinician communication intervention during end-of-life decision making for children with incurable cancer.

Background: In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents\u27 rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child\u27s clinicians in time to be of use in the family\u27s care. Methods: Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life communication with their child\u27s clinicians. They completed the questionnaire again two to three weeks later and responded to three open-ended questions to assess the benefit:risk ratio of their study participation three months after the intervention. Clinicians received the interview data within hours of the parent interview and evaluated the usefulness of the information three weeks later. Results: All preestablished intervention feasibility criteria were met; 77.3% of families consented; and in 100% of interventions, information was successfully provided individually to 3 to 11 clinicians per child before the child died. No harm was reported by parents as a result of participating; satisfaction and other benefits were reported. Clinicians reported moderate to strong satisfaction with the intervention. Conclusion: The communication intervention was feasible within hours of decision making, was acceptable and beneficial without harm to participating parents, and was acceptable and useful to clinicians in their care of families

RELATÓRIO DE ESTÁGIO EM PSICOLOGIA CLÍNICA E DA SAÚDE

Este relatório descreve em grande parte, o processo de estágio, nomeadamente, a caracterização dos Serviços onde este decorreu. Por outro lado, descreve as respetivas intervenções e atividades realizadas na enfermaria consoante as demandas. Os estudos de casos, e as avaliações psicológicas realizadas, neste Serviço, estão aqui apresentados com as devidas, fundamentações, compreensibilidades, e as respetivas hipóteses diagnósticas

Abundance trends for river macroinvertebrates vary across taxa, trophic group and river typology

There is mounting evidence that terrestrial arthropods are declining rapidly in many areas of the world. It is unclear whether freshwater invertebrates, which are key providers of ecosystem services, are also declining. We addressed this question by analysing a long-term dataset of macroinvertebrate abundance collected from 2002 to 2019 across 5009 sampling sites in English rivers. Patterns varied markedly across taxonomic groups. Within trophic groups we detected increases in the abundance of carnivores by 19% and herbivores by 14.8%, whilst we estimated decomposers have declined by 21.7% in abundance since 2002. We also found heterogeneity in trends across rivers belonging to different typologies based on geological dominance and catchment altitude, with organic lowland rivers having generally higher rates of increase in abundance across taxa and trophic groups, with siliceous lowland rivers having the most declines. Our results reveal a complex picture of change in freshwater macroinvertebrate abundance between taxonomic groups, trophic levels and river typologies. Our analysis helps with identifying priority regions for action on potential environmental stressors where we discover macroinvertebrate abundance declines