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Showing results for tags 'Research'.
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Content ArticleIn this longitudinal study, medication errors in the clinic, pharmacy, or at home among children with leukaemia or lymphoma over a 7-month period were common, and 10% suffered harm because of errors. Children on >13 medications had significantly more serious medication errors than those on fewer medications. Physician reviewers judged that improved communication among caregivers and between caregivers and clinicians may have prevented the most harm (66%). Improvements addressing communication with and among caregivers should be codeveloped with families and based on human-factors engineering.
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Scientists identify a molecular culprit behind medical implant rejections
Patient Safety Learning posted a news article in News
Every year, millions of people live fuller lives because of a medical device implanted somewhere in their body - from hip joints, to teeth, to heart valves. Known as Foreign Body Response (FBR), inflammation and scarring around an implant is natural, but in some cases, it can severely damage healthy tissue and can even lead to death if the implant is not removed. FBR-related implant failure rates range widely among different medical devices, but reducing those rates has been difficult because scientists still don’t understand the underlying biology that causes FBR. Now, researchers from the University of Maryland have discovered the molecular basis for FBR, identifying a key biological pathway that future drug therapies could target to reduce the risk of implant rejection. Shaik O. Rahaman, an associate professor in the Department of Nutrition and Food Science in the College of Agriculture and Natural Resources at UMD, and his colleagues identified a specific cellular signaling system that kicks in when the body recognises the inherent difference in stiffness between an implant and the surrounding tissue. This system detects the mismatch and triggers inflammation and scarring, which is part of the body’s normal defense system. But in FBR, the signaling system can set up a cycle of chronic inflammation and continual scar-tissue build-up that leads to implant rejection. “This is a huge leap forward in this field,” Rahaman said. “So far, the medical industry has been making biomedical implants randomly, out of materials they think might work without knowing the molecular basis of the foreign body response that leads to rejection. We don’t know why it happens, and until we do, we can’t effectively develop strategies to prevent it.” Read full story Source: College of Agriculture and Nature Resources, 19 January 2023 -
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Content ArticleKey points CVD is largely preventable. The risk factors for CVD apply also to other major conditions such as cancer, dementia and diabetes. Preventing and managing CVD and its risk factors therefore has the potential to improve population health, reduce health inequalities and ease pressures on overstretched health and care systems by reducing demand for services. The current national CVD policy landscape is fragmented. National leaders need urgently to deliver coherent CVD and public health strategies that focus on preventing and managing CVD and its risk factors. Given its high prevalence and large contribution to health inequalities, tackling CVD will be a relevant priority in most local areas. Integrated care systems (ICSs) can tackle CVD in their local areas by establishing strong local leadership and partnerships on CVD and public health, focusing on preventing and managing CVD and its risk factors, raising awareness of CVD, using data, tools and technology effectively, and reducing clinical variation.
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High levels of microplastics found in operating theatres
Patient Safety Learning posted a news article in News
High levels of microplastics have been found in operating theatres by researchers who highlighted the “astoundingly high” amounts of single-use plastic used in modern surgical procedures. A team from the University of Hull found the amount of microplastics in a cardiothoracic operating theatre was almost three times that found in homes, and said this identifies another route through which the tiny particles can enter the human body, with unknown consequences. The study, published in the journal Environment International, is the first to examine the prevalence of microplastics in surgical environments. The team analysed levels in the operating theatre and the anaesthetic room in cardiothoracic surgeries and discovered an average of 5,000 microplastics per metre squared when the theatre was in use. Jeanette Rotchell, professor of environmental toxicology at the university, said the types of microplastic particles identified relate to common plastic wrapping materials and could also come from blister packs, surgical gowns, hairnets and drapes for patients. Prof Rotchell said: “Although we know microplastics are in the air in a variety of settings, we can’t yet say what the consequences are or whether microplastics are harmful to health. Researchers have yet to establish this. Read full story Source: The Independent, 27 January 2023 -
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Content ArticleHe looks at the following claims: “The NHS has has plenty of money pumped into it by this Government and well above inflation.” “We are funded as well, if not better than many/most systems now, so resource is not an excuse” "This Government has recruited X thousand additional nurses and Y thousand additional doctors” “We need to move towards a European style social insurance based model as those systems have better outcomes and no other country has copied the NHS” “The NHS wastes far too much money on useless, overpaid managers and people in non-jobs” “People should take more responsibility for their own health so we can become a wellness service not an illness service" The NHS is in need of root and branch reform but always resists it." Ten point plan to tackle the problems faced by the NHS Train enough staff at home to meet future workforce needs Have a proper short, medium and long term workforce plan for health and social care Treat existing staff better and more flexibly to help retention and morale Use ethical immigration policy to attract and keep key workforce groups who trained overseas or come here for lower paid but vital care work Reverse the cuts in bed capacity and invest more in capital expenditure on buildings, facilities, equipment and functioning IT Come up with a long term sustainable plan for social care funding and provision, reverse the cuts and plan for future rises in care needs Invest properly in public health and prevention policy – addressing wider determinants of preventable ill health across the life course, health inequalities and inequalities in access to healthcare and ensure that health is a key part of all public policy making Accept that this focus on prevention does involve state intervention in key areas around housing, education, food, drink, obesity, smoking and mental health. Level with the public about what can realistically be expected in terms of access, wait time, staffing and the time it will take to recover from the disruption caused by covid. Better to under promise and over deliver rather than vice versa Restore annual funding increases to the NHS to at least the historic average
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Content ArticleHow to offer safety-netting advice Build safety-netting into the entire consultation; it should not be rushed at the end. Use simple terms and avoid jargon and abbreviations (but include appropriate technical terms); tailor advice and address potential sources of anxiety (for instance being young or a first-time parent). Consider grouping chunks of information to help the patient remember the advice. Give people the opportunity to share their expectations and concerns, and address these in the safety-netting plan. What advice to give: the safety-netting plan Explain and discuss uncertainties and the follow-up plan. Offer an initial diagnosis, explain how long you expect symptoms to last (or how they might change), give practical tips for self-care and symptom management (which give people a sense of control) and instructions for when they should be concerned. Personalise someone’s risk based on their characteristics (such as age or medical history) and not on population data. The plan should also be personalised and address factors that might make an individual less likely to follow advice (for instance if they have had a previous missed diagnosis). Give the patient the opportunity to ask questions and to share in decision-making. Actively check the patient’s understanding. Acknowledge the patient’s ability to make judgements about their own health, and to change their mind about a plan.
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Older patients on medley of drugs ‘at higher risk of adverse reactions’
Patient Safety Learning posted a news article in News
Older women are at higher risk than older men of experiencing adverse reactions to drugs prescribed by their family doctor, and older patients taking more than 10 medicines are at higher risk than those taking fewer, according to a study. Overall, one in four older people experience adverse drug reactions (ADRs) to pills prescribed by their GP, the research published in the British Journal of General Practice suggests. It has prompted calls for GPs to consider deprescribing ineffective medications and prioritise patients taking lots of drugs for a regular review of their prescriptions. The medicines most commonly associated with ADRs included those used to treat high blood pressure and other cardiac conditions, strong painkillers such as tramadol, and antibiotics such as amoxicillin, according to the study. The study monitored 592 patients aged 70 and older across 15 general practices in the Republic of Ireland over a six-year period. One in four experienced at least one ADR. Patients prescribed 10 or more medicines had a threefold increased risk of experiencing a reaction, researchers said. Women were at least 50% more likely to have ADRs than men, the study found. “ADRs can be difficult to identify in medically complex older adults as they often present as non-specific symptoms,” the researchers wrote in the British Journal of General Practice. “GPs are well placed to detect the occurrence of ADRs from drugs prescribed in primary care as well as in other care settings. Deprescribing of ineffective medications and those no longer clinically indicated is one approach to reducing the risk of ADRs in older patients.” Read full story Source: The Guardian, 24 January 2023 -
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Content ArticleRecommendations Disaster planning – No hospital had disaster plans for a prolonged, noninfluenza pandemic and all failed to imagine and plan for a second wave that might be worse than the first. The development of templates for local responses to major disasters, developed by experts, would relieve smaller organisations of tasks for which they do not have the appropriate staff, skills or experience. Estates – The problem of ageing and often inadequate infrastructure was a dominant theme. Problems with estates actually drove, and constrained, the pandemic response. A national stocktake of the shortcomings of hospital estates needs to be urgently undertaken, in preparation for any future pandemics. The Health Infrastructure Plan needs to be reviewed in light of the pandemic, with a view to ensuring robust supplies of oxygen and adequate ventilation and appropriate infection control measures in all hospitals, rather just in the planned new builds. Capacity – Concerns over capacity are tightly linked to the above issues with estates and buildings. Most organisations struggled with bed capacity in all clinical areas (ED, ICU and the downstream wards) even prior to the pandemic. Those that were able to readily expand capacity were those that, by chance, had unused spaces that could be rapidly repurposed. This points to the urgent need for the capacity of smaller hospitals to meet their current need, particularly with regard to intensive care provision, as well as giving consideration to how surge capacity can be embedded within organisations. Management – No organisation felt that all aspects of their management and communications were entirely right, and the interviews highlighted a number of problems with approaches taken by different organisations. The most pervasive issue was a failure to recognise that different stages of the pandemic would require different approaches. The transition out of the ‘emergency’ phase of the pandemic proved to be particularly problematic almost regardless of the approach taken. The other major issue was the extent to which organisations were able to put in place managerial structures which were robust and responsive, capable of both making short-term/tactical and long-term/strategic decisions. Few organisations actively built ‘learning loops’ into their pandemic response. These findings suggest that improving the ‘situational awareness’ of executive teams about what types of management ought to be used when, and how to switch modes, would be highly beneficial. The appreciation of streamlined processes and speedier decision-making suggests that thought ought to be given to how aspects of this can be retained, while still ensuring quality controls and good governance. Dealing with difficult behaviour – Even in organisations where operational issues could be considered to have been well managed, perverse behaviours were able to disrupt aspects of the pandemic response. Questions over who is responsible for the management of staff and to what extent staff can be compelled need to be explored at national and local levels, and the question of what the appropriate response is to such difficult behaviour needs to be answered. Mental health and wellbeing – All organisations took mental health and wellbeing seriously, putting in place programmes of support for staff. We had not expected the levels of distress that were shown from our cohort of interviewees, which strongly suggests the resources in place to support the emotional health and mental wellbeing of senior managers is s inadequate and this needs to be addressed urgently at local and national level.
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Content ArticleThe paper looks at diagnostic tools and treatments impact of vaccines, variants and reinfections challenges recommendations (relating to research, training and education, public communications campaigns and policies and funding). Authors conclude: Long COVID is a multisystemic illness encompassing ME/CFS, dysautonomia, impacts on multiple organ systems, and vascular and clotting abnormalities. It has already debilitated millions of individuals worldwide, and that number is continuing to grow. On the basis of more than 2 years of research on Long COVID and decades of research on conditions such as ME/CFS, a significant proportion of individuals with Long COVID may have lifelong disabilities if no action is taken. Diagnostic and treatment options are currently insufficient, and many clinical trials are urgently needed to rigorously test treatments that address hypothesized underlying biological mechanisms, including viral persistence, neuroinflammation, excessive blood clotting and autoimmunity. Read the paper in full via the link below.
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News ArticleA new state of the art institute for antimicrobial research is to open at Oxford University thanks to a £100 million donation from Ineos. Ineos, one of the world’s largest manufacturing companies, and the University of Oxford are launching a new world-leading institute to combat the growing global issue of antimicrobial resistance (AMR), which currently causes an estimated 1.5 million excess deaths each year- and could cause over 10m deaths per year by 2050. Predicted to also create a global economic toll of $100 trillion by mid-century, it is arguably the greatest economic and healthcare challenge facing the world post-Covid. It is bacterial resistance, caused by overuse and misuse of antibiotics, which arguably poses the broadest threat to global populations. The world is fast running out of effective antibiotics as bacteria evolve to develop resistance to our taken-for-granted treatments. Without urgent collaborative action to prevent common microbes becoming multi-drug resistant (commonly known as ‘superbugs’), we could return to a world where taken-for-granted treatments such as chemotherapy and hip replacements could become too risky, childbirth becomes extremely dangerous, and even a basic scratch could kill. The rapid progression of antibacterial resistance is a natural process, exacerbated by significant overuse and misuse of antibiotics not only in human populations but especially in agriculture. Meanwhile, the field of new drug discovery has attracted insufficient scientific interest and funding in recent decades meaning no new antibiotics have been successfully developed since the 1980s. Alongside its drug discovery work, the IOI intends to partner with other global leaders in the field of Antimicrobial Resistance (AMR) to raise awareness and promote responsible use of antimicrobial drugs. The academic team will contribute to research on the type and extent of drug resistant microbes across the world, and critically, will seek to attract and train the brightest minds in science to tackle this ‘silent pandemic’. Read full story Source: University of Oxford, 19 January 2021
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Content ArticleThis study looked at the frequency and types of harm in 11 hospitals in Massachusetts, considering a sample of 2809 randomly selected admissions. It identified at least one adverse event in 23.6% of these admissions. Among the adverse events, around 22.7% of these were judged to be preventable. Discussing the findings, the authors note that preventable adverse events were identified in approximately 7% of all admissions in this sample, with those categorised as serious, life-threatening or fatal identified in approximately 1%. The most common type of event was adverse drug events (39%), followed by adverse events related to a surgical or other procedure (30.4%).
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