Liverpool study will address barriers to sweetener use

University of Liverpool| January 2019 | Liverpool study will address barriers to sweetener use

A collaboration between the University of Liverpool and Copenhagen will study the risks and benefits of sweeteners and sweetness enhancers ( S&Es) in the diet. Researchers will review evidence on long term benefits and potential risks involved in using sugar replacements in  the context of public health and safety, obesity, and sustainability.

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As part of this project the research team will also conduct a two-year randomised controlled trial, which will recruit over 600 adult and child participants with overweight or obesity from four European countries. The participants will undertake a two-month weight loss diet. During this period, they will be randomly assigned to one of two treatments:  either consuming food and drink with sweeteners or without (Source: University of Liverpool).

Full details of the research from the University of Liverpool

Study sheds light on how people form memories

University of Edinburgh | December 2018 | Study sheds light on how people form memories

Psychologists from the University of Edinburgh say their findings will inform scientific debate about memory because often there is an assumption that memory works in more or less the same way for everyone.  Their article published in Journal of Applied Research in Memory and Cognition challenges this, claiming in actuality there are different ways in which our brains can remember. Although the brain has a range of memory tools available, and how each memory tool works might be the same for everyone, individuals could vary in which combination of memory tools they use when remembering in everyday life. 

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In their review of over 100 previous research studies, with adults that investigated the different ways in which people remember words, letters, numbers and pictures; they were able to review how people remember things, but also how they forget things too.  This study also considered how people use mental imagery, for instance through strategies that include memorising a word, connecting it to prior knowledge such as as similarity to a known word alongside methods such as visualizing the word or using its meaning. That is people may use their cognition in different ways to perform the same task.  People used ordering to help them remember a PIN number where a ‘chain’ method was used; or learned representation where each digit is learned discretely.

Researchers also looked at how memory changes as people get older and the influence of intelligence on memory.

Read the press release from Edinburgh here 

The full article is available to read and download from Journal of Applied Research in Memory and Cognition

 

 

Serious loneliness spans the adult lifespan but there is a silver lining

Science Daily | December 2018 | Serious loneliness spans the adult lifespan but there is a silver lining

A research team from the University of California San Diego studied loneliness, their findings suggest loneliness is more widespread than previous research indicated. They found that experiencing loneliness was particularly pronounced at three points in life:  in late-20s, mid-50s and late-80s. Three quarters of participants reported moderate to high levels of loneliness, using a well-established assessment scale: the UCLA Loneliness Scale Version 4. This statistic shows a substantial increase from previously reported prevalence estimates in the U.S. general population, which have ranged from 17 to 57 per cent (via Science Daily)

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Lead author Ellen Lee, characterized the study’s findings as both bad news and good news. On the negative side, she said, moderate to severe loneliness appears to be highly prevalent throughout adult life. “And loneliness seems to be associated with everything bad. It’s linked to poor mental health, substance abuse, cognitive impairment, and worse physical health, including malnutrition, hypertension and disrupted sleep.”

Another finding was more positive linking wisdom to being less lonely (Source: Science Daily).

Lee, E. E. et al |2018|  High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor| International Psychogeriatrics| 1 |DOI: 10.1017/S1041610218002120

Objectives:This study of loneliness across adult lifespan examined its associations with sociodemographics, mental health (positive and negative psychological states and traits), subjective cognitive complaints, and physical functioning.

Design:Analysis of cross-sectional data

Participants:340 community-dwelling adults in San Diego, California, mean age 62 (SD = 18) years, range 27–101 years, who participated in three community-based studies.

Measurements:Loneliness measures included UCLA Loneliness Scale Version 3 (UCLA-3), 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation Scale, and a single-item measure from the Center for Epidemiologic Studies Depression (CESD) scale. Other measures included the San Diego Wisdom Scale (SD-WISE) and Medical Outcomes Survey- Short form 36.

Results:Seventy-six percent of subjects had moderate-high levels of loneliness on UCLA-3, using standardized cut-points. Loneliness was correlated with worse mental health and inversely with positive psychological states/traits. Even moderate severity of loneliness was associated with worse mental and physical functioning. Loneliness severity and age had a complex relationship, with increased loneliness in the late-20s, mid-50s, and late-80s. There were no sex differences in loneliness prevalence, severity, and age relationships. The best-fit multiple regression model accounted for 45% of the variance in UCLA-3 scores, and three factors emerged with small-medium effect sizes: wisdom, living alone and mental well-being.

Conclusions:The alarmingly high prevalence of loneliness and its association with worse health-related measures underscore major challenges for society. The non-linear age-loneliness severity relationship deserves further study. The strong negative association of wisdom with loneliness highlights the potentially critical role of wisdom as a target for psychosocial/behavioral interventions to reduce loneliness. Building a wiser society may help us develop a more connected, less lonely, and happier society.

Rotherham NHS staff can request the journal article here

Enabling NHS staff to contribute to research Reflecting on current practice and informing future opportunities

RAND Corporation | December 2018 |Enabling NHS staff to contribute to research Reflecting on current practice and informing future opportunities

The Healthcare Improvement Studies (THIS) commissioned RAND Corporation to produce a rapid review of the evidence base on engaging NHS staff in healthcare research.  

RAND used four questions to guide their review:

  1. Why do NHS staff engage with research?
  2. How do NHS staff engage with research?
  3. What are the challenges to NHS staff involvement in research and how can they be addressed so that contributions are effectively enabled and rewarded?
  4. What is the impact of engaging NHS staff in healthcare research?

The report Enabling NHS staff to contribute to research Reflecting on current practice and informing future opportunities, has now been published by RAND.  It finds that NHS staff S have important expertise to contribute to healthcare research. However, they also face competing demands on their time, not least delivering patient care. 

 

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Key Findings

  • NHS staff choose to engage with research for a variety of reasons, including: (i) personal interest in a research or evaluation topic; (ii) cultural expectations in some clinical disciplines that involvement in research is part of the job; (iii) a belief that research and evidence can improve the quality and safety of healthcare and patient outcomes; (iv) a positive prior experience with research; and (v) prospects for career development.
  • NHS staff can contribute to research in a variety of ways (e.g. responding to requests for views or for advice, in advisory board roles or as members of clinical research networks, as co-researchers or members of project steering committees).
  • While there are a range of challenges to effective NHS staff engagement with research (e.g. time-related, skills-related, organisational governance-related), there is an evolving evidence base on enabling mechanisms and rewards that could be pursued. The rewards for engagement that matter most to NHS staff include career progression and professional development opportunities related to learning new skills, recognition in professional communities and reputational awards, and seeing the impact of their research contributions on clinical practice.
  • Key impacts from NHS involvement in research include impact on research studies (e.g. on identifying research priorities, on the quality and relevance of study designs, on influential communications and dissemination); impact on the wider research system (e.g. attracting funding); influence on clinical practice (e.g. promoting the uptake of evidence) and personal impact (e.g. professional development and career progression).

Recommendations

  • Identify the most meaningful types of contribution on a case-by-case basis.
  • Ensure that research roles and responsibilities are clear and well defined.
  • Frame opportunities for involvement in a way that aligns with what motivates NHS staff to engage with health research.
  • Consider how best to use established and trusted professional networks, in combination with online or other types of direct awareness-raising and recruitment.
  • Make engagement opportunities user friendly.
  • Establish and nurture relationships with leadership in healthcare provider organisations
  • Ensure that opportunities to recognise and reward involvement in research are created and communicated to healthcare professionals. (Source: RAND Corporation)

Full report is available as an eBook  from RAND Corporation 

Domestic abuse victims suffering in silence at work

University of Central Lancashire | December 2018 | Domestic Abuse Victims suffering in silence at work 

University of Central Lancashire (UCLAN) and Sheffield Hallam University researchers have found that victims of domestic abuse working in both the public and private sector generally do not discuss their experiences with their employers. Victims found that in most instances victims of domestic abuse will only disclose this if they are being faced with disciplinary action or sanctions, which are a consequence of the abuse. 

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The researchers interviewed trade almost 40 trade union officers from across the north of England about their views on and experience of working with line managers and HR staff who had supported victims of domestic violence.

A key finding of the study is that the workplace is a haven for many victims, financially, physically and emotionally. It also highlights that many managers were still unaware of the signs that their employees are suffering  domestic abuse (Source: UCLAN).

 

Noise pollution in hospitals

Xyrichis, A. Wynne, J., Mackrill, J.Rafferty, A. M.Carlyle, A.| 2018 | Noise pollution in hospitals| 

A new editorial in the BMJ calls for more qualitative research into the issue of noise in hospitals. An NHS Inpatient survey has previously stated that 4 in 10 patients are upset by noise levels during their stay in hospital. It is a problem not limited to patients as staff are also affected by noise levels, as it impacts on the ability to interpret speech, impairing communicating and also causes annoyance, irritation, and fatigue ultimately reducing the quality and safety of healthcare. Similarly, in intensive care noise levels have been measured at 100 decibels (DB) equivalent to listening to loud music through headphones. 

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The researchers  from King’s College London and University of the Arts London (UAL) suggest that the following areas need to be addressed:

  • Noise is often incorrectly associated with high sound pressure levels (SPLs). Dripping taps for example, may register low SPLs yet still be considered noisy. Prioritising SPL reduction does not ensure improved noise perception. Therefore, a new approach is needed, one that views the hospital soundscape as a positive and malleable component of the environment.
  • There are a number of potential sources of noise in hospitals. Alarms, televisions, rattling trolleys, and ringing phones, as well as staff, visitor, and patient conversations. However, not all of them are perceived as noise by patients – for example, some find the sound of the tea trolley pleasing, associating it with receiving a warm drink. Research has also shown that some ICU patients welcome ringing telephones as a sign that they are not alone. So far ways to measure patients’ perceptions of noise are limited, and more research investment is needed in this area.
  • Patients and families need clear information about likely noise levels during admissions, so they are better prepared in advance, and can consider simple solutions such as headphones with their own choice of audio content. Education for staff is also needed, to encourage a culture that considers noise reduction an integral part of safe high quality healthcare. (Source: King’s College London)

Read the King’s College press release  Noise pollution in hospitals – a rising problem

Describing noise pollution as “an intractable problem”, the authors argue that patient partnership in future research will help progress what has been a slow moving field.

The full editorial is available using OpenAthens  login

In the media:

The Telegraph Patients discharging themselves while still sick because wards are too noisy at night, research finds

ITV News Patients asking for early discharge to escape noisy hospital wards

 

How should health policy respond to the growing challenge of multimorbidity?

University of Bristol | November 2018 | Experts call for health system change to tackle the challenge of multimorbidity in the NHS

A new report produced by the Universities of Bristol, Manchester, Dundee and Glasgow calls on policymakers to alter the health system to address the challenge of multi morbidity, where patients with one or more long-term health condition, are much higher users of both primary care and hospital services compared with the general population.

The research team’s hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention.The study is one of the largest ever trials of a person-centred approach to caring for patients with multimorbidity in primary care; it involved 34 practices in England and Scotland randmoly allocated to continue usual care (17 practices), with the remaining practices (16 practices)  to provide 6-monthly comprehensive 3D reviews, incorporating patient-centred strategies that reflected international consensus on best care.

To this end the researchers have produced the reeport ‘How should health policy respond to the growing challenge of multimorbidity?’. 

The report makes a series of policy recommendations including:

  • Promoting patient-centred approaches to the management of multimorbidity in primary care, which requires training, support and changes in incentives.
  • Developing and evaluating new approaches to managing patients with multimorbidity within hospitals.
  • Exploring new models of integration of primary and community care, hospital care and social care which enable better coordination and support for people with multimorbidity, which is likely to require substantial changes in commissioning and funding mechanisms, and a rebalancing of resources.
  • Changes to professional education, training, and regulation to prepare professionals to manage patients with multimorbidity in new and more integrated systems.
  • Engaging and enabling people to manage their own health and long-term conditions, requiring coordinated action across many aspects of government and public life.
  • More research to understand and improve care for multimorbidity. (Source University of Bristol)

Related: 

Read the full University of Bristol press release 

Easy to read summary [CLAHRC Bite]

The study has been recently published in The Lancet 

Read the NIHR Signal