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IMPAACT: IMproving the PArticipAtion of older people in policy decision-making on common health CondiTions - a study protocol

Por: Ambagtsheer · R. C. · Hurley · C. J. · Lawless · M. · Braunack-Mayer · A. · Visvanathan · R. · Beilby · J. · Stewart · S. · Cornell · V. · Leach · M. J. · Taylor · D. · Thompson · M. · Dent · E. · Whiteway · L. · Archibald · M. · O'Rourke · H. M. · Williams · K. · Chudecka · A.
Introduction

Rapid population ageing is a demographic trend being experienced and documented worldwide. While increased health screening and assessment may help mitigate the burden of illness in older people, issues such as misdiagnosis may affect access to interventions. This study aims to elicit the values and preferences of evidence-informed older people living in the community on early screening for common health conditions (cardiovascular disease, diabetes, dementia and frailty). The study will proceed in three Phases: (1) generating recommendations of older people through a series of Citizens’ Juries; (2) obtaining feedback from a diverse range of stakeholder groups on the jury findings; and (3) co-designing a set of Knowledge Translation resources to facilitate implementation into research, policy and practice. Conditions were chosen to reflect common health conditions characterised by increasing prevalence with age, but which have been underexamined through a Citizens’ Jury methodology.

Methods and analysis

This study will be conducted in three Phases—(1) Citizens’ Juries, (2) Policy Roundtables and (3) Production of Knowledge Translation resources. First, older people aged 50+ (n=80), including those from traditionally hard-to-reach and diverse groups, will be purposively recruited to four Citizen Juries. Second, representatives from a range of key stakeholder groups, including consumers and carers, health and aged care policymakers, general practitioners, practice nurses, geriatricians, allied health practitioners, pharmaceutical companies, private health insurers and community and aged care providers (n=40) will be purposively recruited for two Policy Roundtables. Finally, two researchers and six purposively recruited consumers will co-design Knowledge Translation resources. Thematic analysis will be performed on documentation and transcripts.

Ethics and dissemination

Ethical approval has been obtained through the Torrens University Human Research Ethics Committee. Participants will give written informed consent. Findings will be disseminated through development of a policy brief and lay summary, peer-reviewed publications, conference presentations and seminars.

Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study

Por: Lesaine · E. · Francis · F. · Domecq · S. · Miganeh-Hadi · S. · Sevin · F. · Sibon · I. · Rouanet · F. · Pradeau · C. · Coste · P. · Cetran · L. · Vandentorren · S. · Saillour · F. · AVICOVID group · Faucheux · Leca Radu · Seignolles · Chazalon · Dan · Lucas · Peron · Wong-So · Martinez
Objective

This study aims to evaluate whether the first wave of the COVID-19 pandemic resulted in a deterioration in the quality of care for socially and/or clinically vulnerable stroke and ST-segment elevation myocardial infarction (STEMI) patients.

Design

Two cohorts of STEMI and stroke patients in the Aquitaine neurocardiovascular registry.

Setting

Six emergency medical services, 30 emergency units, 14 hospitalisation units and 11 catheterisation laboratories in the Aquitaine region in France.

Participants

This study involved 9218 patients (6436 stroke and 2782 STEMI patients) in the neurocardiovascular registry from January 2019 to August 2020.

Primary outcome measures

Care management times in both cohorts: first medical contact-to-procedure time for the STEMI cohort and emergency unit admission-to-imaging time for the stroke cohort. Associations between social (deprivation index) and clinical (age >65 years, neurocardiovascular history) vulnerabilities and care management times were analysed using multivariate linear mixed models, with an interaction on the time period (pre-wave, per-wave and post-first COVID-19 wave).

Results

The first medical contact procedure time was longer for elderly (p

Conclusions

This study revealed pre-existing inequalities in care management times for vulnerable STEMI and stroke patients; however, these inequalities were neither accentuated nor reduced during the first COVID-19 wave. Measures implemented during the crisis did not alter the structured emergency pathway for these patients.

Trial registration number

NCT04979208

Social network trajectory of young adults aged 18-35 years diagnosed with a brain tumour: a protocol for a mixed methods study

Por: Guldager · R. · Nordentoft · S. · Bruun-Pedersen · M. · Hindhede · A. L.
Introduction

Research indicates that social networks and roles are disrupted throughout the entire trajectory of someone living with a brain tumour. Young adults aged 18–35 years are particularly vulnerable to such disruption because they are in a process of establishing themselves. Pre-existing social roles and support networks of young adults living with a primary brain tumour may change. This study aims to identify the social networks of young adults aged 18–35 years diagnosed with a primary brain tumour and to map how the diagnosis and disease course affects the social network in relation to changes in relationships and roles over time.

Methods and analysis

The study adopts a longitudinal design with a convergent mixed methods approach to describe the social network of young adults. The study utilizes a quantitative approach to social network analysis to measure network size, composition and density and a qualitative approach with interviews to gain insight into young adult’s narratives about their network. Network maps will be produced, analysed and all the findings will then be compared and integrated. Interviews and network drawing will take place at the time of the diagnoses, with follow-up interviews 6 and 12 months later. This will shed light on transformations in network compositions and network support over time.

Ethics and dissemination

The study has been approved by the Danish Data Protection Agency (ID P-2022-733). Written informed consent will be obtained from all patients. The results will be disseminated through a peer-reviewed journal and reported at local, national and international conferences on brain cancer.

Supporting older nurses and midwives in the Australian healthcare workplace—A qualitative descriptive study

Abstract

Aim

To explore support strategies for older nurses and midwives in Australian healthcare workplaces.

Design

A qualitative descriptive study.

Method

Participants were 50 older nurses and midwives and 20 healthcare managers recruited from a broad range of Australian healthcare settings. Data were collected using semi-structured interviews from November 2018 to April 2021. The interviews were recorded, transcribed and thematically analysed.

Results

The limited number of identified sedentary roles and inequitable distribution of workload responsibilities were identified as constraints that impact the provision of workplace support for older nurses and midwives in healthcare settings. Three major themes were identified: Workplace support, Personal support and Doing more. A small number of participants reported support was available at work, but most said there was not. Of the reported strategies some were offered exclusively to a cohort that met an age criterion, while others were open to all staff regardless of age. Personal support strategies were employed outside of the workplace while others used strategies during working hours. Doing more related to suggestions about how organizations could do more to support older nurses and midwives at work.

Conclusion

Support mechanisms like adjustments in workload, employment fraction, practice location, upskilling and wellness programs in workplaces are limited. To facilitate retention and support older nurses and midwives in the workforce, health workplaces should consider implementing support mechanisms that can be tailored to the individual needs of the nurse or midwife over the life course of their career.

Impact

The findings of this study highlight the lack of support for many older nurses and midwives in Australian healthcare workplaces, emphasizing the need for further research into innovative practices on how to better support healthcare staff as they age.

Reporting Method

This study adhered to the COREQ reporting method.

Patient or Public Contribution

No patient or public contribution.

Shift length and working practices in UK hospital settings: an online survey of Heads of Midwifery

There is currently a lack of data that records how midwives are expected to work in hospital settings. The aim of this study was to determine the prevalence of 12-hour shifts and current working practices of hospital-based midwives.
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