North Tyneside General Hospital

Abstract Background Making Every Contact Count (MECC) is a person-centred approach to health behaviour change, utilising behavioural science to promote healthy lifestyle choices. Weight-related conversations in mental health settings are particularly important, with users noting gaps in information on medication-related weight gain and support needs. MECC training can address these gaps by improving staff confidence and service delivery, enhancing weight management for individuals with serious mental illness. This study explores staff experiences of weight-related MECC conversations in a mental health setting. Methods This mixed-methods study involved healthcare staff from a National Health Service (NHS) mental health inpatient setting in Northeast England. A quantitative online survey administered pre- MECC training, post-MECC training, and 8-10 weeks later captured staff perspectives. Qualitative interviews were conducted with trained and non-trained staff to explore MECC implementation. Quantitative data were analysed using independent and paired-samples t-tests, while qualitative data underwent thematic analysis, using the COM-B framework that examines Capability, Opportunity, and Motivation as key drivers of behaviour. Results Thirty-six staff completed the pre-training survey, 20 completed the post-training survey, and 25 participated in interviews (15 trained, 10 non-trained staff). Quantitative analysis showed that training improved staff perceptions of confidence and motivation to deliver MECC, though most changes were not statistically significant. Perceptions around opportunity (time, resources, social support) declined at follow-up. Perceived importance and usefulness of MECC also declined over time (p < .05). Qualitative analysis identified barriers and facilitators, mapped to the COM-B model. Trained staff highlighted organisational resources, training structure, and wider determinants of health in supporting MECC delivery, alongside skills in rapport-building. Non-trained staff noted gaps in MECC awareness, recording systems, and training but recognised MECC importance and impact. Both groups identified time constraints, confidence, and the integration of MECC within their professional roles as key factors influencing delivery of weight-related conversations. Conclusion MECC training positively impacted healthcare professionals’ perceptions and confidence in delivering weight-related MECC conversations in mental health settings. While only confidence changes were evident in surveys, qualitative findings showed multifaceted influences on MECC implementation, emphasising the need for sustained support and system-level changes to overcome structural barriers and ensure long-term MECC delivery.

Global statistics from Pubmed suggests that young adults remain a significant but under-recognized population with Pulmonary tuberculosis (PTB). A systematic review found bacteriologically confirmed pulmonary TB prevalence ranging from 45 to 799 per 100,000 among adolescents and young adults in Asia-Pacific, and 160 to 462 per 100,000 in African settings. Snow, K. J., etal 2018). Globally, it is estimated that between 1.2 and 3.0 million people aged 10–24 years develop TB each year. This highlights the fact that young adult’s age bracket accounts for a substantial portion of the global Tuberclosis (TB) burden.

The Recruitment and Retention of Alzheimer's Disease Diversity Genetic Cohorts in the Alzheimer's Disease Sequencing Project (READD-ADSP) was established to bridge thegap inAlzheimer's disease and related dementias (ADRD) research in Africa. We examined the role of Community Advisory Boards (CABs) in improving participant recruitment and retention in ADRD research in Africa, by exploring how culturally sensitive engagement, community trust-building, and stakeholder involvement influence research participation. Amulti-site, multi-phased qualitative study approachthat involved establishment of CABs, initial planning meetings and community engagement cum recruitment activities. Twenty-one CABs (141 members) were established across 14 study sites in 9 African Dementia Consortium (AfDC)member countries. Co-creation planning meetings, culturally sensitive outreaches for brain health, dementia awareness creation, and recruitment were held. Establishing CABs within the READD-ADSP project has proven instrumental in co-creating culturally appropriate and community-centered strategies for recruitment and retention in ADRD research in Africa. The Recruitment and Retention of Alzheimer's Disease Diversity Genetic Cohorts in the Alzheimer's Disease Sequencing Project (READD-ADSP) project utilizes a community-engaged research (CER) framework to develop a community engagement program and establish Community Advisory Boards (CABs) to enhance participant recruitment and retention. There is a need to standardize CER practices and promote context-sensitive and culturally appropriate CE activities across African Dementia Consortium (AfDC) sites to ensure cultural sensitivity and enhance recruitment and retention. The project seeks to empower CABs to promote national dementia policies by collaborating with policy-makers and advancing equitable dementia scienced and care in Africa.

Abstract Background In early 2024, 25 research-ready nurses specialising in IBD joined the United Kingdom IBD Nurse Research Network (UK IBD NRN). This network is dedicated to collaborating on national service evaluation and research initiatives, aiming to enhance service delivery and improve patient experiences within IBD care. Each year, the network will undertake one project, with a ballot for ideas held towards the end of the project. The first initiative focuses on monitoring advanced therapies (AT-IBD) used in the UK for treating IBD. Current recommendations for monitoring advanced therapies in IBD remain ambiguous, and the efficacy of proactive therapeutic drug monitoring (TDM) is still uncertain. To address this, we sought to explore the variations in monitoring practices across IBD services in the UK, focusing on key areas such as access to medication, adherence to monitoring protocols, and the effectiveness of therapeutic drug monitoring. Methods Data collection instruments using REDCap were created and launched in November 2024. Data includes site demographics, a minimum of ten and a maximum of 25 reactively and proactively monitored cases. The case data is collected from retrospective monitoring events and anonymised. Descriptive statistics are used to report results. Results Seventeen unique users are entering data from 15 sites. The survey is open to all four nations of the UK. Responses have been received in England and Wales. Of the 17 users (15;82.4%) reported having had training to interpret blood results. IBD patient population was reported by seven out of eleven sites, with a total of 39,843 reported. Two sites shared the entire local population, and three were reported as unknown. The seven sites that reported the IBD patient population used an electronic health record. There is variance in the pre-screening undertaken (Figure 1); access to advanced therapies appears different, with some sites not having access to newer small-molecule medications (Figure 2). There is wide variation in routine and TDM frequency across all therapies. Conclusion The AT-IBD project is ongoing, with full results anticipated to provide insights into current practices for monitoring advanced therapies in the UK. The collected data may offer valuable insights regarding adherence and the effectiveness of advanced therapy monitoring, particularly concerning patient safety and outcomes. The UK IBD NRN remains committed to providing opportunities for training, collaboration, and research for IBD nurses across the UK.

The Parkinson’s Families Project is a UK-wide study aimed at identifying genetic variation associated with familial and early-onset Parkinson’s disease (PD). We recruited individuals with a clinical diagnosis of PD and age at motor symptom onset ≤45 years and/or a family history of PD in up to third-degree relatives. Where possible, we also recruited affected and unaffected relatives. We analysed DNA samples with a combination of single nucleotide polymorphism (SNP) array genotyping, multiplex ligation-dependent probe amplification (MLPA), and whole-genome sequencing (WGS). We investigated the association between identified pathogenic mutations and demographic and clinical factors such as age at motor symptom onset, family history, motor symptoms (MDS-UPDRS) and cognitive performance (MoCA). We performed baseline genetic analysis in 718 families, of which 205 had sporadic early-onset PD (sEOPD), 113 had familial early-onset PD (fEOPD), and 400 had late-onset familial PD (fLOPD). 69 (9.6%) of these families carried pathogenic variants in known monogenic PD-related genes. The rate of a molecular diagnosis increased to 28.1% in PD with motor onset ≤35 years. We identified pathogenic variants in LRRK2 in 4.2% of families, and biallelic pathogenic variants in PRKN in 3.6% of families. We also identified two families with SNCA duplications and three families with a pathogenic repeat expansion in ATXN2, as well as single families with pathogenic variants in VCP, PINK1, PNPLA6, PLA2G6, SPG7, GCH1, and RAB32. An additional 73 (10.2%) families were carriers of at least one pathogenic or risk GBA1 variant. Most early-onset and familial PD cases do not have a known genetic cause, indicating that there are likely to be further monogenic causes for PD.

Heart rate variability (HRV) correlates well with a person's overall physiological function. Clinically, HRV is successfully used in acute care to identify impending infections, but little is known about its potential in the management of chronic diseases like cognitive decline/dementia. The aim of this study was to identify the best available knowledge about HRV in cognitively impaired populations that might be applied to improve clinical practice in community settings. We conducted a systematic literature search in PubMed, Embase, and Cochrane databases published from January 2009 to August 2022. Eligible studies were selected using Covidence and each study underwent qualitative assessment using the Mixed Method Appraisal Tool. At each stage of selection, each study was reviewed independently by two members of the team, and any disputes were discussed along the way. The literature identified that the brain regions controlling HRV are also those affected by dementias of Alzheimer's type (AD) and Lewy body types (DLB). HRV was impaired in both types, with DLB showing greater impairment in all HRV parameters compared to AD. No studies explored the temporal changes of HRV or its use in the clinical management of people with cognitive impairment (CI). The current lack of standardization of HRV recording and analysis limits its use in clinical practice. HRV may emerge as a potentially useful tool to identify people with early/preclinical memory impairment and help to differentiate AD from DLB. Longitudinal HRV measurement is emerging as a useful way to monitor disease progression and treatment response, and continuous HRV measurement may prove useful in the early identification of sepsis and its complications in patients no longer able to communicate their illness experiences.

Current guidelines on the management of chronic cough do not provide recommendations for the operation of specialist cough clinics. The objective of the present study was to develop expert consensus on goals and standard procedures for specialist cough clinics. We undertook a modified Delphi process, whereby initial statements proposed by experts were categorised and presented back to panellists over two ranking rounds using an 11-point Likert scale to identify consensus. An international panel of 57 experts from 19 countries participated, with consensus reached on 15 out of 16 statements, covering the aims, roles and standard procedures of specialist cough clinics. Panellists agreed that specialist cough clinics offer optimal care for patients with chronic cough. They also agreed that history taking should enquire as to cough triggers, cough severity rating scales should be routinely used, and a minimum of chest radiography, spirometry and measurements of type 2 inflammatory markers should be undertaken in newly referred patients. The importance of specialist cough clinics in promoting clinical research and cough specialty training was acknowledged. Variability in healthcare resources and clinical needs between geographical regions was noted. The Delphi exercise provides a platform and guidance for both established cough clinics and those in planning stages.

BackgroundBetween 40 and 50% of patients with Parkinson’s disease (PD) experience anxiety and depression, associated with impaired physical function, high care dependency and mortality. Recently, the United States National Institutes of Health has urged the implementation of mindfulness practices in chronic illness care. Most research to date has examined the effects on chronically ill patients of complex interventions using a combination of mindfulness techniques. In PD patients, however, such complex modalities appear to hinder the technique mastery. Hence, the aim of this trial is to investigate the effects and underlying mechanism of individual mindfulness techniques among PD patients, as well as exploring participants’ experience in using individual mindfulness techniques as a lifestyle intervention for stress and symptom management.MethodsWe will conduct an assessor-blind three-arm randomized waitlist-controlled trial with a descriptive qualitative evaluation. Up to 168 PD patients will be recruited from community settings and out-patient clinics, and randomized to meditation, yoga, or usual care group. Meditation and yoga sessions of 90-minute are held weekly for 8 weeks. Primary outcomes include anxiety and depression. Secondary outcomes include PD-related motor and non-motor symptoms and quality-of-life; and level of mindfulness and biomarkers of stress and inflammatory responses will be measured as mediating variables. All outcome evaluations will be assessed at baseline, 8 weeks, and 24 weeks. Following the intention-to-treat principle, generalized estimating equation models and path analysis will be used to identify the treatment effects and the mediating mechanisms. A subsample of 30 participants from each intervention group will be invited for qualitative interviews.DiscussionThe study would also generate important insights to enhance the patients’ adaptation to debilitating disease. More specifically, symptom management and stress adaptation are highly prioritized healthcare agenda in managing PD. The research evidence will further inform the development of community-based, nurse-led compassionate care models for neurodegenerative conditions, which is complementary to existing health services.Trial registrationWHO Primary Registry – Chinese Clinical Trials Registry number: ChiCTR2100045939; registered on 2021/04/29 (https://www.chictr.org.cn/showproj.html?proj=125878).