The Faculty of Health and Social Care is one of the major providers of Health and Social Care education in the North West and offers a wide range of programmes at both undergraduate and postgraduate levels.

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  • The COVID-19 Pandemic as a Public Health Teacher—the Lessons We Must Learn

    Lombatti, Sofia; Magid, Avi; Davidovitch, Nadav; Middleton, John; Sheek-Hussein, Mohamud; Lopes, Henrique; Skhvitaridze, Natia; Agha, Hazem; Lopez-Acuña, Daniel; Martínez Olmos, José; et al. (Frontiers Media, 2024-05-07)
    Statement of the Association of Schools of Public Health in the European Region (ASPHER)
  • Building the Future One Health Workforce

    Codd, Mary; Valiotis, George; Davidovitch, Nadav; Kostoulas, Polychronis; Razum, Oliver; Mabhala, Mzwandile A.; Leighton, Lore; Otok, Robert; Signorelli, Carlo; University College Dublin; European Health Management Association, Brussels; Ben Gurion University of the Negev; University of Thessaly; Bielefeld University; University of Chester; ASPHER Secretariat, Brussels; University Vita-Salute San Raffaele (European Observatory on Health Care Systems, 2023-11-07)
    A ‘new normal’ in public health and healthcare has arisen with socioeconomic shifts, technological developments, political strife, climate change, environmental degradation, and COVID-19. Challenges cannot be solved by one discipline or profession alone, but requires multiple sectors coming together, combining knowledge, expertise and methods. One Health is an integrated epidemiological and economic approach aiming to sustainably optimise the health of people, animals and ecosystem. This article reflects on the roles of Association of Schools of Public Health in the European Region (ASPHER) and European Health Management Association (EHMA) and the concrete steps needed to address skills for One Health.
  • Economic and Humanistic Burden of Moderate and Severe Hemophilia A and B in Spain: Real-World Evidence Insights from the CHESS II Study

    Peral, Carmen; De Lossada Juste, Alfonso; Lwoff, Nadia; Espinoza-Cámac, Nataly; Casado, Miguel Ángel; Burke, Tom; Alvir, José; Thakkar, Sheena; Ferri Grazzi, Enrico (Scholastica, 2024-05-06)
    Background: Hemophilia is a congenital disorder characterized by deficiency or absence of clotting factor VIII in hemophilia A (HA) or clotting factor IX in hemophilia B (HB), resulting in frequent, repeated, and prolonged spontaneous or traumatic bleeding into joints or soft tissue. Severity is classified by the patient’s baseline level of clotting factor activity as mild (>5%-40%), moderate (1%-5%), or severe (<1%). In Spain, there is limited information on the societal economic burden of disease. Objective: To estimate the economic and humanistic burden of disease in adult patients with non-inhibitor moderate and severe HA and HB in Spain. Methods: Spanish data from the CHESS II study (2018-2020) on patients’ clinical characteristics, health-related quality of life (HRQoL) and hemophilia-related healthcare resource utilization were analyzed. Economic burden was determined by estimating condition-related annual per-patient direct (medical and nonmedical) and indirect costs, stratified according to hemophilia type and severity and presented as 2022 Euros. HRQoL was assessed via the EQ-5D-5L. Results: Of 341 patients in the Spanish CHESS II cohort, 288 patients met the inclusion criteria: 181 had HA (37% [n = 66] moderate and 63% [n=115] severe) and 107 had HB (26% [n = 28] moderate and 74% [n = 79] severe). Mean annual direct cost was higher in HB than in HA, and higher in severe than in moderate patients, resulting in an annual cost/patient of €17 251 (moderate HA), €17 796 (moderate HB), €116 767 (severe HA) and €206 996 (severe HB). The main direct cost component in all groups except moderate HA was factor replacement therapy. Mean per-patient indirect cost was €4089 (moderate HA), €797 (moderate HB), €8633 (severe HA) and €8049 (severe HB). Finally, the mean total cost (direct and indirect) for moderate and severe patients were €91 017 (HA) and €163 924 (HB). EQ-5D-5L [SD] scores were lower in patients with severe HA (0.77 [0.18]) and severe HB (0.70 [0.22]) compared with patients with moderate HA (0.81 [0.15]) and moderate HB (0.86 [0.17]). Conclusions: Independently of the type of hemophilia, greater condition severity was associated with increased costs and a decrease in HRQoL.
  • Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study

    Saeed, Muhammad Humza Bin; Raja, Ulfat Bashir; Khan, Yawar; Gidman, Janice; Niazi, Manahil; Riphah International University; NHS North Bristol Trust; University of Chester (BMJ Publishing Group, 2024-05-07)
    Objectives: The study aimed to study the association of leadership practices and patient safety culture in a dental hospital. Design: Hospital-based, cross-sectional study Setting: Riphah Dental Hospital (RDH), Islamabad, Pakistan. Participants: All dentists working at RDH were invited to participate. Main outcome measures: A questionnaire comprised of the Transformational Leadership Scale (TLS) and the Dental adapted version of the Medical Office Survey of Patient Safety Culture (DMOSOPS) was distributed among the participants. The response rates for each dimension were calculated. The positive responses were added to calculate scores for each of the patient safety and leadership dimensions and the Total Leadership Score (TLS) and total patient safety score (TPSS). Correlational analysis is performed to assess any associations. Results: A total of 104 dentists participated in the study. A high positive response was observed on three of the leadership dimensions: inspirational communication (85.25%), intellectual stimulation (86%), and supportive leadership (75.17%). A low positive response was found on the following items: ‘acknowledges improvement in my quality of work’ (19%) and ‘has a clear sense of where he/she wants our unit to be in 5 years’ (35.64%). The reported positive responses in the patient safety dimensions were high on three of the patient safety dimensions: organisational learning (78.41%), teamwork (82.91%), and patient care tracking/follow-up (77.05%); and low on work pressure and pace (32.02%). A moderately positive correlation was found between TLS and TPSS (r=0.455, p<0.001). Conclusions: Leadership was found to be associated with patient safety culture in a dental hospital. Leadership training programmes should be incorporated during dental training to prepare future leaders who can inspire a positive patient safety culture.
  • The psychosocial considerations for behaviour change, mental health and work-related satisfaction in pre-registration nurses, during coronavirus pandemic

    Mitchell, Andrew E. P.; University of Chester (Wiley, 2024-12-31)
    The mental health of healthcare workers was affected by physical and psychological challenges during the pandemic. The aim was to study how psychosocial considerations can help manage behaviour change, mental health, and work satisfaction of nurse trainees in the UK during the COVID-19 pandemic in 2021. This cross-sectional study involved ninety-nine students. Participants’ anxiety, fear of the coronavirus, and perceived work satisfaction were measured by GAD-7, FCV19S and COM-B scales and assessed using descriptive, correlational and linear regression analysis. The significant zero-order correlations between job satisfaction and fear, anxiety and psychosocial considerations were significant. They indicated moderate strength that allowed for further inferential development to find the best predictors of job satisfaction. The findings suggested that 50% of trainees showed anxiety above the suggested ≥ 8 cut-off on GAD-7, and 48% scored high for fear on FCV19S. There was a significant effect between year groups F (2, 99) = 4.25, p = .02, η 2 = .081, with a Tukey post hoc test showing a significant difference between training years 1 and 2 with a p = .015. A significant linear regression found that psychosocial variables in behaviour change p = <.001 and anxiety p = .011 were significant factors in job satisfaction, explaining 53.4% of the variance. Conclusion: Satisfaction was associated with higher levels of psychosocial considerations and low levels of anxiety and fear, which adds to previous literature on job satisfaction in nurse education. Future implications must examine ways to alleviate mental health effects and to support policy and curricula to address this need.
  • Co-creating prisons knowledge inspired by collective autoethnography

    Buck, Gillian; Rebecca, Page; Harriott, Paula; Tomczak, Philippa; University of Chester; Prison Reform Trust; University of Nottingham (HM Prison Service of England and Wales, 2024-05-01)
    This is a story, a kind of map, about a study we co-produced on prison peer support work. The social science community call these mapping stories methodology papers. We have tried to write this one in an informal (less academic) style to appeal to a broad audience – including people who live or have lived in prisons and who may not have had access to further education. ‘We’, the authors, are four people interested in prisons. Two of us became interested having lived parts of our lives in prison, two of us became interested by studying prisons at university. We met as part of a co-authorship project, which was originally made up of five former prisoner researchers and three academic researchers. Having published our original study in 2023, we decided to write about our pioneering work together. (All eight original co-authors were invited to co-write this methodology paper and four of the team decided to do so). We hope the method we introduce will be useful to those interested in capturing (often traumatic) lived experiences in a way that values and centres those most impacted, and that we address the concern that people with lived experience often only emerge in research as subjects, rather than authors.
  • Mobilizing Metaphors in Criminological Analysis: A Case Study of Emotions in the Penal Voluntary Sector

    Quinn, Kaitlyn; Buck, Gillian; Tomczak, Philippa; University of Missouri; University of Chester; University of Nottingham (Oxford University Press, 2024-05-04)
    Metaphors pervade media and political constructions of crime and justice, provoking responses and shaping actions. Scholarship in adjacent disciplines illustrates that emotion-metaphors offer unique insight into emotional and interpretive processes, valuably illuminating sense-making, problem solving and action. Yet, metaphors are rarely analysed within criminology, leaving an important opportunity for theorizing emotions and their implications largely unrealized. We explore the analytical and theoretical potential of emotion-metaphors for criminology, using empirical research conducted in the penal voluntary sectors of England and Scotland. Drawing on focus groups with volunteers and paid staff, we analyse the metaphors that non-profit practitioners mobilized to convey how their work felt: (1) absurd and unstable, (2) vulnerable and constrained, (3) devalued and discarded and (4) risky and all-consuming.
  • Photovoice with care: A creative and accessible method for representing lived experiences

    Ryan, Natasha; Ryan, Kemi; Buck, Gillian; Reformed development CIC; University of Chester (HM Prison Service of England and Wales, 2024-05-03)
    Photovoice is a research method with great promise as a tool for people looking to tell stories about their lives and work toward change, it also has much to offer criminology, creating insightful material from the perspectives of those most intimately connected to the research topic. This article reflects on photovoice as a resource for lived experience practitioners, activists, and leaders. The work we reflect upon is a co-designed, participatory study of a community-led crime prevention organisation: ‘Reformed’. We (Natasha and Kemi) founded Reformed after being released from prison to multiple barriers and low expectations from criminal justice professionals.
  • Disease Burden, Clinical Outcomes, and Quality of Life in People with Hemophilia A without Inhibitors in Europe: Analyses from CHESS II/CHESS PAEDs

    Chowdary, Pratima; Ofori-Asenso, Richard; Nissen, Francis; Ferri Grazzi, Enrico; Aizenas, Martynas; Moreno, Katya; Burke, Tom; Nolan, Beatrice; O'Hara, Jamie; Khair, Kate; et al. (Thieme, 2024-04-15)
    Introduction: Limited data relating to treatment burden, quality of life, and mental health burden of hemophilia A (HA) are currently available. Aim: To provide a comprehensive overview of unmet needs in people with HA (PwHA) using data generated from the Cost of Haemophilia in Europe: a Socioeconomic Survey-II (CHESS II) and CHESS in the pediatric population (CHESS PAEDs) studies. Methods: CHESS II and CHESS PAEDs are cross-sectional surveys of European males with HA or hemophilia B (HB) aged ≥18 and ≤17 years, respectively. Participants with FVIII inhibitors, mild HA, or HB were excluded from this analysis, plus those aged 18 to 19 years. Annualized bleeding rates (ABRs), target joints, and other patient-reported outcomes were evaluated. Results: Overall, 468 and 691 PwHA with available data for the outcomes of interest were stratified by hemophilia severity and treatment regimen in CHESS II and CHESS PAEDs, respectively. In these studies, 173 (37.0%) and 468 (67.7%) participants received FVIII prophylaxis, respectively; no participants received the FVIII mimetic emicizumab or gene therapy. ABRs of 2.38 to 4.88 were reported across disease severity and treatment subgroups in both studies. Target joints were present in 35.7 and 16.6% of participants in CHESS II and CHESS PAEDS; 43.8 and 23.0% had problem joints. Chronic pain was reported by a large proportion of PwHA (73.9% in CHESS II; 58.8% in CHESS PAEDs). Participants also reported low EQ-5D scores (compared with people without HA), anxiety, depression, and negative impacts on their lifestyles due to HA. Conclusions: These analyses suggest significant physical, social, and mental burdens of HA, irrespective of disease severity. Optimization of prophylactic treatment could help reduce the burden of HA on patients.
  • Real-world clinical and psychosocial outcomes among people with mild or moderate haemophilia A treated on-demand in the Italian CHESS II cohort: a real-world data analysis

    Castaman, Giancarlo; Mancuso, Maria Elisa; Di Minno, Matteo Nicola Dario; Sannino, Luigi; Tempre, Rosaria; Bendinelli, Sara; Blenkiron, Thomas; Burke, Tom; Ferri Grazzi, Enrico (Sciendo, 2024-04-22)
    Background: The burden of severe haemophilia A (HA) has been studied extensively owing to the higher bleeding frequency and associated treatment requirements, leaving a clear unmet need for research focused on the burden of mild and moderate HA. Aims: This study sought to characterise the clinical and psychosocial burden of mild and moderate HA in the Italian cohort of the CHESS II study. Methods: This was a retrospective analysis of clinical and psychosocial outcomes in a cohort of male adults (≥18 years old) with mild or moderate HA who participated in the cross-sectional CHESS II study (October 2019-November 2020). Treatment patterns, acute and chronic clinical outcomes and mental health indicators were collected via physician-completed forms. Psychosocial outcomes related to impact of HA on social activities, exercise, opportunities, and lifestyle were collected via a participant self-complete questionnaire. All results were reported descriptively. Results: A total of 113 people with haemophilia A (PwHA) were included, 79 (70%) with moderate HA and 34 (30%) with mild HA, with mean age of 41.4 and 36.6 years, respectively. No one in the sample was receiving a prophylaxis at the time of data capture, with factor VIII use in the 12 months prior reported in 30% and 29% of moderate and mild PwHA, respectively. Ninety-one PwHA (81%) experienced ≥1 bleeding event in the preceding 12 months. People with moderate HA had higher mean annual bleed rate (2.9 vs. 1.1, respectively) and higher prevalence of chronic pain (74% vs. 35%), anxiety (20% vs. 12%), and/or depression (15% vs. 3%). Target joints were reported in 22% and 12% of moderate and mild PwHA, and problem joints in 51% and 12%, respectively. Of 113 participants, 44 (39%) completed the self-complete form (moderate HA, 57%; mild HA, 43%). Overall, 40% vs. 10% of those with moderate vs mild HA reported reducing or giving up social activities, 44% vs. 21% reducing or giving up exercise, 36% vs. 26% missing out on opportunities, and 48% vs. 26% reported HA impacted their lifestyle. Conclusion: Moderate PwHA from the Italian CHESS II cohort appeared to have greater clinical morbidity and lifestyle impact than mild PwHA. Psychosocial outcomes were also worse among moderate PwHA, but significant burden was also observed among mild PwHA. These findings, and the absence of prophylactic treatment in the sample examined, highlight that improving management for potentially undertreated mild/moderate PwHA may aid the avoidance long-term clinical morbidity and negative psychosocial impact.
  • Anxiety and depression among adults with haemophilia A: Patient and physician reported symptoms from the real‐world European CHESS II study

    Ferri Grazzi, Enrico; Blenkiron, Thomas; Hawes, Charles; Camp, Charlotte; O'Hara, Jamie; Burke, Tom; O'Brien, Gráinne; HCD Economics, Knutsford; BioMarin Europe; University of Chester; Royal Infirmary of Edinburgh (Wiley, 2024-03-20)
    Introduction: The physical pain and disability affecting many people with haemophilia A (PwHA) are known detractors from psychological wellbeing. While psychosocial support is considered a core tenet of the haemophilia comprehensive care structure, the extent to which mental health challenges are detected and monitored by the individuals treating haematologist remains relatively unexplored. Aim: To describe prevalence of anxiety and depression in a real‐world cohort of adult PwHA and evaluate the congruence in reporting of anxiety or depression (A/D) between PwHA and their treating physicians. Methods: Data for PwHA without inhibitors was drawn from the European ‘Cost of Haemophilia: A Socioeconomic Survey II’ (CHESS II) study. Haematologist‐indicated comorbidities of anxiety and depression were unified into a single A/D indicator. The EQ‐5D‐5L health status measure was used to characterise self‐reported A/D, with individuals stratified into two non‐mutually exclusive subgroups based on level of A/D reported (Subgroup A: ‘some’ or above; Subgroup B: ‘moderate’ or above). Result: Of 381 PwHA with evaluable EQ‐5D‐5L responses, 54% (n = 206) self‐reported at least some A/D (Subgroup A) and 17% (n = 66) reported at least moderate A/D (Subgroup B). Patient‐physician congruence in A/D reporting was 53% and 76% for Subgroups A and B, respectively. Descriptive analysis suggested that individuals with physician‐ and/or self‐reported A/D experienced worse clinical outcomes (bleeding events, joint disease, chronic pain). Conclusion: While adverse clinical outcomes appear to correlate with A/D, self‐reports of moderate–severe symptoms occasionally lacked formal recognition from treating physicians. Cross‐disciplinary surveillance of mental health issues could improve both psychological and clinical outcomes among PwHA.
  • Designing an accessible and equitable conference and the evaluation of the barriers to research inclusion for rare disease communities

    Mitchell, Andrew E. P.; Butterworth, Sondra; University of Chester; RareQol Ltd, Wrexham (Salud, Ciencia y Tecnología, 2024-03-01)
    Introduction: The United Kingdom Rare Diseases Framework, published in 2021, addresses the lack of diversity in rare disease research, particularly in clinical trials, due to intersecting issues related to rare disease symptoms and health inequalities. The framework outlines the government's commitment to improving the lives of the 3.5 million people living with rare conditions in the United Kingdom. Objective: The primary objective is to advance equality, diversity, and inclusion in research by developing innovative methods to engage with communities, establish trust, and enhance the participation and voices of underrepresented and underserved communities. Methods: The conference was held in May 2023, bringing together voices with lived experiences from rare and diverse communities to meet and discuss with established researchers, policy influencers and advocates. The evaluation design was developed using the Program Logic Model and utilised a conference evaluation form on barriers to inclusion. Results: The Rare Disease Community identifies disability as the primary obstacle to inclusion. Social Care and Public Health Communities and Clinical Research Communities identified a need for more cultural competency. The Diverse Community selected psychosocial issues, and the Academic Community identified funding as the most significant barrier. Conclusions: The Community of Practice workshops showed the variety of lived experiences and potential barriers people confront for inclusion in research. Listening to individual viewpoints was crucial to creating or repairing community trust. The Academic Community felt that research funders and ethics review boards must adapt their institutional practices to include financial resources for outreach and participation in research design.
  • ‘One Is Too Many’ preventing self-harm and suicide in military veterans: a quantitative evaluation

    Finnegan, Alan; Salem, Kate; Ainsworth-Moore, Lottie; University of Chester (BMJ Publishing Group, 2024-03-05)
    Introduction: In 2021, the Armed Forces Covenant Fund Trust allocated over £2 million to programmes designed to have a clear and demonstrable impact on suicide prevention. Four grant holders delivered a combination of psychotherapeutic interventions, group activities, social prescribing, peer support mentoring, life skills coaching, educational courses and practical help with housing and employment. The evaluation was completed between August 2021 and July 2023. Methods: A survey was completed by 503 participants at entry and 423 at exit. It captured data regarding demographic and military-specific details, health status, situational stressors, predisposing symptoms, help-seeking behaviour, social engagement, housing, living arrangements and employment status. The questionnaire included a number of validated psychometric questionnaires. Results: This evaluation revealed reductions in situational stressors, symptoms and mental health illnesses. Seventy-six per cent of participants had completed an Operational Tour, and 77% were exposed to a traumatic event during service. It was the negative impact of unresolved traumatic effects that influenced service-users to require support. Forty-nine per cent delayed seeking help, and 36% self-referred to the One Is Too Many programme which demonstrates the importance of this option. There were improvements in the participants’ social networking, social activities, club membership and having people to rely on. Only 4% of participants were women which reinforces the requirement to explore initiatives to engage with female veterans. Conclusions: Timely therapeutic and social prescribing interventions in a safe environment lowered depression, anxiety and the associated situational stressors leading to self-harming and may have reduced suicide. It presented another option to veterans and their families regarding where they can obtain support, care and therapeutic interventions. The programme provided a strong foundation for delivery organisations to forge lasting collaborative partnerships that can be extended to working with other authorities and institutes. The results highlight pathways for prevention and intervention strategies to inform policymakers, healthcare professionals and third-sector organisations.
  • Mental Health and Well-being amongst Healthcare Professionals in Clinical Training

    Mitchell, Andrew E. P.; University of Chester
    Healthcare workers in clinical training are at a high risk of stress and burnout due to their dual clinical practice and academic components. The psychosocial clinical environment and personality traits contribute to healthcare workers' increased risk of psychological distress. The two-dimensional circumplex proposed by the complete state model of mental health suggests that people with mental illness symptoms can have mental well-being and are seen as traversing the circumplex from floundering to flourishing. Poverty is a significant predictor of mental illness, and COVID-19 has been linked to poorer mental health. The WHO's Global Mental Health Report identifies three paradigm-shifting strategies for enhancing mental health, including elevating those who are impacted and reshaping social and living conditions. The United Nation's action plan is to achieve sustainable health goals for 2030. The aim is to improve leadership and governance, responsive and integrated care, strategies for promotion and prevention, and the use of evidence and research to improve mental health.
  • A creative health placement: challenging student nurses to learn creatively

    Ridgway, Victoria; Henshaw, Russell; Davies, Cherelle; Faulkner, Gary; Marsh, Victoria; Stonley, Lou; University of Chester (EMAP, 2024-03-11)
    There is a drive to promote population health as a preventative measure. The use of creative health has been advocated to relieve pressures on healthcare services, but this can only be achieved by greater awareness of and immersion in such practices. The creative health placement at the University of Chester responded to this need, offering 60 nursing students the experience of an arts-based practice learning placement and the chance to explore their personal wellbeing. Such learning presented a challenge for students, requiring them to reflect on their expectations of nursing placements and respond creatively to the healthcare issues facing our profession.
  • A Student-Centered Approach: The Mobile Outreach Skills Clinic for Assessment

    Whaley, Viki; Knight, Kate; Caiger, Lee; Hay, Jonathan; University of Chester (MA Healthcare, 2024-03-21)
    In the last 3 years, the authors have developed and launched the Outreach Skills Clinic for Assessment (OSCA) at the University of Chester. OSCA has been established to help pre-registrant students overcome practice learning challenges, and particularly to ease the achievement of a range of more challenging proficiencies and skills within the Nursing and Midwifery Council’s (2018) Future Nurse: Standards of Proficiency for Registered Nurses. Using simulation as a learning and assessment strategy, OSCA offers learners an opportunity to experience and practice the realities of professional practice in a controlled and accessible environment.
  • Statement of the ASPHER Task Force on War and Public Health on the Conflict in Israel/Palestine

    Razum, Oliver; Barach, Paul; Bochenek, Tomasz; Cunningham, Colette; Davidovitch, Nadav; Kostoulas, Polychronis; Lindert, Jutta; Lopes, Henrique; Prikazsky, Vladimir; Reid, John; et al. (Frontiers Media, 2024-02-23)
  • Broadening Placement Opportunities for Nursing Students through an Indirect Supervision Model

    Knight, Kate; Hay, Jonathan; Arnold, Mark; Donaghy, Pamela; University of Chester; Liverpool John Moores University; Edge Hill University
    Background: Higher Education Institutions struggle to fill national deficits in student placement capacity, especially in social care and the voluntary sector. The Indirect Placement Supervision and Assessment Model and its holistic focus helps redress this deficit. Methods: A Microsoft Forms survey was distributed to a self-selecting sample of 50 students, placement providers, and university staff, all of whom had been involved in indirect supervision as either an assessor, student, or supervisor. Results: Three key themes emerged from the data collected; responses suggested that the model generated greater placement variety, increased placement capacity, and brought about reciprocal gains in the learner-supervisor matrix. Conclusion: The study’s key implication for healthcare institutions pertains to the study’s strong evidence base that the indirect supervision model providing an efficient means of broadening nursing placement variety and capacity alike.
  • Building the future workforce through indirect supervision

    Knight, Kate; Simpson, Angela; Hay, Jonathan; University of Chester (MA Healthcare, 2024-02-09)
    The NHS Long Term Workforce Plan highlights the need to expand and diversify placement capacity in line with future transformative healthcare delivery plans (NHS England, 2023). For Nursing and Midwifery Council-approved education institutions (AEIs), moving away from hospital centralised care involves exploring new placement opportunities in social care, the voluntary sector and emerging digital spaces. However, many of these ‘new’ settings do not employ the registered supervisors and assessors required by the regulators.
  • Errors in diabetic insulin therapy and the vitality of proper precautions in Bangladesh: Real-life insights from the developing world

    Tulsan, Suresh K.; Laila, Rona; Patel, Harshkumar; Dave, Vyapti; Mary, Rabeya M.; Sham, Sunder; Anjali, FNU; Jaladi, Soumya; Kumar, Sanjay Kirshan; Singhania, Priya; et al. (Medknow, 2024-02-08)
    Background: Insulin therapy errors can have life-threatening consequences in patients with diabetes. Given the increasing prevalence of diabetes and insulin therapy in Bangladesh, it is crucial to identify and prevent these errors. This study uses case-based clinical experiences to thematically analyze insulin therapy errors and propose preventive measures. The study aims to provide valuable insights into the challenges faced in managing insulin therapy in a developing country setting and the importance of involving various stakeholders. Materials and Methods: This is a qualitative research that used a case study approach to identify and analyze errors in insulin therapy in diabetic patients who had experienced adverse clinical consequences. The cases were thematically analyzed to generate insights into current global health problems resulting from erroneous insulin therapy. Results: The two case studies highlight potential risks of errors in insulin therapy, including poor glycemic control, complications, and death. The analysis also highlights the importance of careful monitoring, checks, and communication among health-care providers, patients, and pharmacists to prevent such errors. In addition, it emphasizes the need for education and awareness among patients and health-care providers to ensure safe and effective insulin therapy. Conclusion: Accurate insulin therapy is crucial for diabetes management and preventing adverse outcomes. Identified themes emphasize improved communication, education, and monitoring to minimize therapy errors. Insights from this study can inform policies and practices for better patient outcomes. Further research can identify the root causes and develop interventions to prevent errors, leading to improved quality of life for diabetics.

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