• Collaborative working in health and social care: a review of the literature

      Stepney, Paul M.; Callwood, Ingrid (University of Wolverhampton, 2006)
      The move towards collaborative working in Health and Social Care can be situated within a wider policy shift associated with de-institutionalisation and de-segregation (Payne, 1995). The change from institutional to community-based care (Barr et al, 1999; Sibbald, 2000) meant that the demarcations and hierarchical relations between professions were neither sustainable not appropriate. New ways of working that crossed professional boundaries had to be created, in order to allow a more flexible approach to care delivery (Malin et al, 2002). Collaboration in health and social care is a relatively new field of study, with the first major studies being undertaken in the 1980s (Roy, 2001). The term collaboration has hitherto lacked a clear definition and has been used synonymously with terms such as co-operation, co-ordination, participation and integration. Since the implementation of the 1990 NHS and Community Care Act (Department of Health, 1990), the concept has featured prominently in government policy documents to promote joint working, partnership and the creation of a ‘seamless service’ between health and social care (Maxwell, 1998; Payne, 1995). More recently, the term ‘communities of practice’ (CoPs) has permeated professional agendas (Lave and Wenger, 1991; Anning 2001). At its simplest the concept of collaboration infers that people from different professional and academic backgrounds form a working relationship for the purpose of enhanced service provision. However, the exact nature of the partnership is likely to be contested, whilst fully integrated ‘joined-up’ collaborative practice has so far proved elusive.
    • The effect of walking on risk factors for cardiovascular disease: an updated systematic review and meta-analysis of randomised control trials.

      Murtagh, Elaine M; Nichols, Linda; Mohammed, Mohammed A; Holder, Roger; Nevill, Alan M.; Murphy, Marie H (Elsevier, 2015-01-08)
      Objective To conduct a systematic review and meta-analysis of randomised control trials that examined the effect of walking on risk factors for cardiovascular disease.Methods Four electronic databases and reference lists were searched (Jan 1971–June 2012). Two authors identified randomised control trials of interventions ≥ 4 weeks in duration that included at least one group with walking as the only treatment and a no-exercise comparator group. Participants were inactive at baseline. Pooled results were reported as weighted mean treatment effects and 95% confidence intervals using a random effects model. Results 32 articles reported the effects of walking interventions on cardiovascular disease risk factors. Walking increased aerobic capacity (3.04 mL/kg/min, 95% CI 2.48 to 3.60) and reduced systolic (− 3.58 mm Hg, 95% CI − 5.19 to − 1.97) and diastolic (− 1.54 mm Hg, 95% CI − 2.83 to − 0.26) blood pressure, waist circumference (− 1.51 cm, 95% CI − 2.34 to − 0.68), weight (− 1.37 kg, 95% CI − 1.75 to − 1.00), percentage body fat (− 1.22%, 95% CI − 1.70 to − 0.73) and body mass index (− 0.53 kg/m2, 95% CI − 0.72 to − 0.35) but failed to alter blood lipids. Conclusions Walking interventions improve many risk factors for cardiovascular disease. This underscores the central role of walking in physical activity for health promotion.
    • Evidence of increased muscle atrophy and impaired quality of life parameters in patients with Uremic restless legs syndrome

      Giannaki, CD; Sakkas, GK; Karatzaferi, C; Hadjigeorgiou, GM; Lavdas, E; Liakopoulos, V; Tsianas, N; Koukoulis, GN; Koutedakis, Y; Stefanidis, I; et al. (Public Library of Science (PLoS), 2011-10-03)
      Background: Restless Legs Syndrome is a very common disorder in hemodialysis patients. Restless Legs Syndrome negatively affects quality of life; however it is not clear whether this is due to mental or physical parameters and whether an association exists between the syndrome and parameters affecting survival. Methodology/Principal Findings: Using the Restless Legs Syndrome criteria and the presence of Periodic Limb Movements in Sleep (PLMS/h >15), 70 clinically stable hemodialysis patients were assessed and divided into the RLS (n = 30) and non-RLS (n = 40) groups. Physical performance was evaluated by a battery of tests: body composition by dual energy X ray absorptiometry, muscle size and composition by computer tomography, while depression symptoms, perception of sleep quality and quality of life were assessed through validated questionnaires. In this cross sectional analysis, the RLS group showed evidence of thigh muscle atrophy compared to the non-RLS group. Sleep quality and depression score were found to be significantly impaired in the RLS group. The mental component of the quality of life questionnaire appeared significantly diminished in the RLS group, reducing thus the overall quality of life score. In contrast, there were no significant differences between groups in any of the physical performance tests, body and muscle composition. Conclusions: The low level of quality of life reported by the HD patients with Restless Legs Syndrome seems to be due mainly to mental health and sleep related aspects. Increased evidence of muscle atrophy is also observed in the RLS group and possibly can be attributed to the lack of restorative sleep. © 2011 Giannaki et al.
    • Factors influencing access to emergency obstetric care amongst women seen in one of the tertiary health facilities in Delta State, Nigeria

      Ekpenyong, Mandu Stephen (2017-10-01)
      Background/Aim: Historical evidences indicate that maternal health care by a skilled birth attendant is one of the key strategies for maternal survival. However, the rate of maternity care utilisation and reduction of maternal death is very low in Nigeria. This study was designed to investigate factors influencing access to emergency obstetric care with a view to guiding programmatic efforts targeted at overcoming these barriers and also contribute to health reforms in Nigeria. Hence, the need to understand factors influencing access to emergency obstetric care in Nigeria using the Socio-ecological Model (SEM) and Gender and Development (GAD) to identify associated factors operating at different levels. Methods: A mixed method was employed for this study. Data collection used questionnaires and in-depth interviews. Questionnaires were distributed to 330 respondents of which 318 of them were retrieved and qualitative in-depth interviews were conducted for 6 participants. Data collection were done using a sequential approach. The study was conducted in one of the tertiary health facilities in Nigeria from January-April, 2015, amongst mothers aged 15-45 years meeting the study inclusion criteria. Statistical Package for Social Sciences (SPSS) was used in analysing the quantitative data. Bivariate and logistic regressions were conducted for the quantitative data whilst a qualitative content analysis was done for the qualitative data. Results: The study established that education, income level, costs associated with seeking care, distance and time taken to travel were significantly associated with maternity healthcare services utilisation. Quality of service, staff attitude and women’s autonomy showed consistent significant association with maternal health care utilisation. Conclusions: The study concludes that; costs of treatment, distance and time, income level, staff attitude and women’s autonomy were critical in determining women utilisation of maternity care services. Recommendation: As an outcome of this research, best practice framework has been developed. The framework presents a coherent and systematic approach for achieving sustainable MH by providing a roadmap for instituting measures at the policy, health facility, community and at the individual levels, taking into account factors that are likely to promote or impede the achievement of sustainable MH.
    • Managers' work-life balance and health: the case of UK managers

      Worrall, Les; Cooper, Cary L. (Inderscience, 2007)
      The paper explores the effects of organisational change on UK managers' perceptions of their organisation and on their well-being. Cost reduction is the prime driver for change and has been implemented using delayering, redundancy, downsizing and off-shoring often supported by culture change programmes. These changes have resulted in work intensification, have not delivered productivity gains and have had a negative effect on managers' well-being. The effects of change were perceived differently by directors and other managers. Despite continuous cost reduction, productivity in the UK remains below that of European competitor nations. This calls into question the prevailing cost reduction ethos as a means of delivering increased productivity in the UK.
    • Passive smoking, asthma and allergy in children

      Metsios, Giorgos S.; Flouris, Andreas D.; Koutedakis, Yiannis (Bentham Science Publishers, 2009)
      Despite the recent campaigns to eliminate smoking and hinder the detrimental effects of passive smoking (PS), actual smoking rates still increase worldwide. Several physiological systems, with the respiratory being the primary, are disrupted by PS and progressively deteriorate through chronic exposures. This is of particular importance in children, given that respiratory complications during childhood can be transferred to adulthood and leading to significantly inferior health profiles. Hence, it is no surprise that children that are exposed to PS either in-utero or during their adulthood may increase prevalence of allergies and asthma. However, investigating the acute effects of PS in children is inherently limited by complexities pertaining mainly to ethical constrains. Knowledge of the acute effects could be very important as it is the dose-dependant acute effects of passive smoking that lead to the long-term adaptations linked with the development of allergy and asthma. Current available data show that the chemical and carcinogenic constituents of tobacco have profound effects on children’s health as they may disrupt normal biological development. PS appears to have pronounced effects on respiratory parameters that promote asthma development and persistent wheezing rather than other allergies. As such, PS exposure has to be eliminated and researchers have to develop interventions for supporting smoking cessation as well as minimised PS exposure either this is in-utero or during childhood.
    • Physiological demands of performance in Classical Ballet and their relationships with injury and aesthetic components

      Wyon, Matthew A.; Twitchett, Emily (University of Wolverhampton, 2009)
      At performance level, classical ballet is a form of high-intensity, intermittent exercise, requiring a strong aerobic foundation. Existing training methods have remained largely unchanged over the past century, resulting in poorly conditioned dancers who are prone to injury. The purpose of the thesis was to examine, through several inter-related studies, the demands of training and performance at professional level, and whether fitness levels of classical ballet dancers affect both aesthetic components of performance, and injury. All participants were either in the final year of elite vocational training or were professional dancers. Initial, observational, investigations indicated that both rehearsal and performance posed a variety of demands on different ranks of dancer within a company’s structure, and depicted daily workloads which supported previous complaints of fatigue. Before examination of fitness or performance could begin, novel tools to assess both aerobic fitness, and performance proficiency in ballet dancers were designed and tested for reliability and validity. Both tests met with test-retest reliability standards, with 95% limits of agreement of ±6.2 ml.kg.-1min-1 for the aerobic test, and ±1.5 points (out of 10) for the performance rating scale. High overall performance scores were then best predicted by high jumps of both legs and good active flexibility of the left leg (F=4.142, df=3, P=0.042). Following this, an intervention study investigated the effects of a period of supplemental fitness training, designed to enhance aerobic fitness, jump height and local muscular endurance, on the performance scores of a randomly assigned group of dancers. A control group continued with regular training. Performance scores at the outset of the study were compared to those following the intervention period. Overall scores for the intervention group increased by significantly more than those of the control group, (p=0.03), with greatest gains seen for control and skill, indicating that supplemental fitness training, specifically targeting aerobic and local muscular endurance, can help improve performance, particularly elements such as control and skill. Finally, two separate studies confirmed that low aerobic fitness and low body fat percentage were related to injury in ballet dancers. Further research needs to focus on fully ascertaining the physical demands of ballet, and whether better training dancers to meet these demands results in enhanced performance and reduction in injury.