المؤلفون: Lindsey J. Reece, Paul Bissell, Pooja Sachdev, Neil Wright, Seema Mihrshahi, Robert J. Copeland

المصدر: BMC Pediatrics, Vol 21, Iss 1, Pp 1-9 (2021)

مصطلحات موضوعية: Adolescent, Severe obesity, Treatment, Pediatrics, RJ1-570

الوصف: Abstract Background Few treatments exist for adolescents living with severe obesity. This qualitative study explored the experiences of severely obese adolescents and their families who participated in the BOB study. Methods Twelve adolescents (5 males;7 females; mean age 15 years; BMI > 3.5 s.d; puberty stage 4 +) who were engaged with the research study BOB (a non-randomised, pilot novel obesity treatment programme that involved the insertion of an intra-gastric balloon coupled with a family lifestyle behavioural support programme). Adolescents attended weekly lifestyle sessions before, during and post balloon insertion. All participants were interviewed at 3 months, (halfway through intra-gastric balloon insertion) and at 12 months follow-up (6 months post intra-gastric balloon removal, 3 months post lifestyle intervention). Results All BOB participants had exhausted all treatment options deeming this study their final option. Many alluded to feelings of desperation and referred to a sense of hope that this intervention would be effective. Family involvement and attendance within the structured sessions differed significantly. Adolescents and parents perceived support from the research study ceased when the intra-gastric balloon was removed at 6-months despite attendance post balloon removal being poor. All participants emphasised a need for further support longer term with the integration of the family a critical factor. Conclusions Further research is needed to explore the specific role families play within treatment to optimise health and wellbeing outcomes. Adolescents perspectives should be integrated within treatment to inform and improve the effectiveness of future treatment programmes for severely obese adolescents and their families.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2431Test

الوصول الحر: https://doaj.org/article/967c84748cd645c3b2985121445c9b66Test

المؤلفون: David Walker, Pooja Sachdev, Jo-Fen Liu, Mark Brougham, Elizabeth Bayman, Rod T Mitchell, James Law, Madhumita Dandapani, Gemma Williams, Ross McLean, Timothy A Ritzmann, Nicholas T Conway, Alice Cunnington, Gbemi Ogunnaike, Karen Brougham

المصدر: BMJ Paediatrics Open, Vol 5, Iss 1 (2021)

مصطلحات موضوعية: Pediatrics, RJ1-570

وصف الملف: electronic resource

العلاقة: https://bmjpaedsopen.bmj.com/content/5/1/e001078.fullTest; https://doaj.org/toc/2399-9772Test

الوصول الحر: https://doaj.org/article/d164ff3a23b143c5bbb761c13c8e4c87Test

الوصف: A new perspective on tackling diversity and difference in the workplace.Rewire: A Radical Approach to Tackling Diversity and Difference takes a fresh look at the issue of equality, diversity and inclusion at work. It critiques the current thinking and practices that are responsible for slow progress in this area, while providing readers with a new, holistic and tactical perspective that leverages what we know about influencing and changing people's mind-sets.The issue of difference sits at the core of many of the world's crises. Large corporations are a microcosm of the globalized world we inhabit, and hold significant power in shaping our societies and ideas.Despite decades of work in diversity and inclusion, little progress has been made because current approaches focus on specific contexts, short-term results and commercial returns, rather than taking into account what we know about human behaviour and addressing the social and economic cultures in which we operate. This book argues that in order to achieve sustainable positive change, we need to focus on how to create a culture of openness, empathy and inclusion – which in turn enables corporate strategy and drives innovation.The authors, who have worked in a number of leading organizations, including Caterpillar, American Express, HSBC, Towers Watson and the NHS, put forward a new approach, based on years of experience of achieving both individual and organizational change. They present:· A causal map, which describes a wide range of social, biological, psychological, evolutionary and organizational factors that influence how we think and operate.· A unique step-by-step approach to rewiring our fundamental psychological processes and creating change at an individual, organizational and cultural level.This book offers corporate executives and social leaders a fresh perspective on diversity and difference, along with the tools to create more inclusive, effective and innovative environments.

المؤلفون: Chris Yates, Pooja Sachdev

نوع المادة: eBook.

الموضوعات: Organizational behavior, Corporate culture, Diversity in the workplace

تصنيفات: BUSINESS & ECONOMICS / Diversity & Inclusion, BUSINESS & ECONOMICS / Workplace Culture, BUSINESS & ECONOMICS / Organizational Development

المؤلفون: Manju Chandwani, Shehla Usman, James Law, Louise Denvir, Pooja Sachdev, Tabitha Randell, Isaque Qureshi

المصدر: Endocrine Abstracts.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::77f4a2447d89fa9d83c28729dd1e6c34Test
https://doi.org/10.1530/endoabs.85.p10Test

المؤلفون: Ross McLean, Rod Mitchell, Pooja Sachdev, Nicky Conway, Jo-Fen Liu

المصدر: Endocrine Abstracts.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::e5f7dafa936461a8f0c48b7d0848ad37Test
https://doi.org/10.1530/endoabs.78.oc7.2Test

المؤلفون: Rabbi Swaby, James Greening, Pooja Sachdev, Holly Blake

المصدر: Endocrine Abstracts.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::225bb5a72a577af3aa1d5d22bec3b911Test
https://doi.org/10.1530/endoabs.78.oc8.6Test

المؤلفون: Rabbi Swaby, Sai-Kalyani Kanthagnany, Jessica Gladwell, Pooja Sachdev

المصدر: Endocrine Abstracts.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::604a657f3170e69b00a12a7518c9263dTest
https://doi.org/10.1530/endoabs.78.p65Test

المؤلفون: Gemma Williams, Ross McLean, Jo-Fen Liu, Rod T. Mitchell, Mark F. H. Brougham, Karen Brougham, Madhumita Dandapani, James Law, Gbemi Ogunnaike, David Walker, Pooja Sachdev, Timothy A Ritzmann, Dhurgshaarna Shanmugavadivel, Alice Cunnington, Nicholas Conway, Elizabeth Bayman

المصدر: BMJ Paediatrics Open
BMJ Paediatrics Open, Vol 5, Iss 1 (2021)

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Delayed Diagnosis, Coronavirus disease 2019 (COVID-19), Childhood cancer, Newly diagnosed, Delayed diagnosis, RJ1-570, General Paediatrics, Neoplasms, Pandemic, medicine, Humans, Child, Pandemics, Service (business), Type 1 diabetes, business.industry, SARS-CoV-2, COVID-19, medicine.disease, United Kingdom, Diabetes Mellitus, Type 1, Pediatrics, Perinatology and Child Health, Communicable Disease Control, Presentation (obstetrics), business, Pediatrics, Perinatology, and Child Health, COVID-19

الوصف: BackgroundThe COVID-19 pandemic led to changes in patterns of presentation to emergency departments. Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions.MethodsWe collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres and T1DM in four centres between 1 January and 31 July 2020 and the corresponding period in 2019. Total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity across different time periods were compared.ResultsFor CCs and T1DM, the route to diagnosis and severity of illness at presentation were unchanged across all time periods. Diagnostic intervals for CCs during lockdown were comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI in January–March 2020 (median 2.7 weeks). Diagnostic intervals for T1DM during lockdown were similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in January–March 2020 (median 21 days).ConclusionsThere is no evidence of diagnostic delay or increased illness severity for CC or T1DM, during the first phase of the pandemic across the participating centres. This provides reassuring data for children and families with these life-changing conditions.

وصف الملف: PDF

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c36ea9eb817ab7afb523319e43536ae4Test
http://europepmc.org/articles/PMC8587587Test

المؤلفون: David Walker, Ross McLean, Jo-Fen Liu, Timothy Ritzmann, Madhumita Dandapani, Dhurgshaarna Shanmugavadivel, Pooja Sachdev, Mark Brougham, Rod Mitchell, Nicholas Conway, James Law, Alice Cunnington, Gbemi Ogunnaike, Karen Brougham, Elizabeth Bayman, Gemma Williams

المصدر: Abstracts.

مصطلحات موضوعية: Type 1 diabetes, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Newly diagnosed, medicine.disease, Delayed diagnosis, Severity of illness, Pandemic, medicine, Presentation (obstetrics), Multi centre, business

الوصف: Background The COVID-19 pandemic led to changes in patterns of presentation to Emergency Departments. Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Objectives Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions. Methods We collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres between January-June 2020 and T1DM in four centres between January-July 2020. We compared these to the corresponding period in 2019. The impact of lockdown on total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity were evaluated. Results Children with new diagnosis of CC (n=253) and T1DM (n=187) were included in the analysis. Overall there was a 17% reduction (138 vs 115) in number of incident CC cases and 9% reduction (98 vs 89) in T1DM cases between 2019 and 2020, with some regional variation. No significant differences in gender, ethnic background or age at diagnosis between study periods were observed. The route to diagnosis and severity of illness at presentation were unchanged across all time periods. Median diagnostic interval for CCs during lockdown was comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI during pre-lockdown period Jan-Mar 2020 (2.7 weeks) (table 1). Median diagnostic interval for T1DM during lockdown was similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in pre-lockdown period Jan-Mar 2020 (21 days) (table 2). Conclusions There is no evidence of diagnostic delay or increased illness severity for CC or T1DM during the first lockdown in the participating centres. This provides reassuring data for children and families with these life-changing conditions. Data collection at a more comprehensive national level would provide greater clarity on diagnostic intervals.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::c687efb7b586cfe4455d8e8b68243be0Test
https://doi.org/10.1136/archdischild-2021-rcpch.459Test

المؤلفون: Alice Cunnington, Jo-Fen Liu, Pooja Sachdev, Timothy A Ritzmann, Ross McLean, Karen Brougham, James Law, Gbemi Ogunnaike, David Walker, Mark F. H. Brougham, Rod T. Mitchell, Dhurgshaarna Shanmugavadivel, Gemma Williams, Nicholas Conway, Madhumita Dandapani, Elizabeth Bayman

مصطلحات موضوعية: Type 1 diabetes, medicine.medical_specialty, Pediatrics, Referral, Diabetic ketoacidosis, business.industry, Public health, Context (language use), Emergency department, medicine.disease, Health care, Severity of illness, medicine, business

الوصف: BackgroundThe COVID-19 pandemic led to changes in patterns of presentation to Emergency Departments (ED). Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions.MethodsWe collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres, and T1DM in four centres between 1stJanuary – 31st July 2020 and the corresponding period in 2019. We assessed the impact of lockdown on total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity.FindingsFor CCs and T1DM, the route to diagnosis and severity of illness at presentation were unchanged across all time periods. Diagnostic intervals for CCs during lockdown were comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI in Jan-Mar 2020 (median 2.7 weeks). Diagnostic intervals for T1DM during lockdown were similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in Jan-Mar 2020 (median 21 days).InterpretationThere is no evidence of diagnostic delay or increased illness severity for CC or T1DM, during the first phase of the pandemic across the participating centres. This provides reassuring data for children and families with these life-changing conditions.Research in ContextEvidence before this studyThis project was initiated after the first national lockdown in March 2020 during COVID-19 pandemic in the UK. At the design stage, Medline was searched (with no language limit), using the keywords ((Cancer) OR (neoplasm) OR (Type 1 diabetes mellitus)) AND ((Covid-19) OR (SARS-CoV-2) OR (Pandemics)) AND ((Emergency department attendances) OR (diabetes ketoacidosis) OR (Delayed diagnosis) OR (interval) OR (wait)) to identify publications reporting the impact of the pandemic and public health measures on both overall and paediatric healthcare services. Significant changes in service utilisation in the UK were reported following the commencement of the first lockdown, including a 49% reduction in emergency department attendances in the week following the lockdown; and two adult studies reported that referral via the urgent two-week wait cancer referral diagnoses decreased by 84% from Mar-May and 60% in June 2020. As for Type 1 diabetes (T1DM), a 30 patient UK-study reported an increase in newly diagnosed T1DM during the first six weeks of lockdown. Increased proportions of severe diabetic ketoacidosis (DKA) at presentation were also reported in an Italian survey involving 53 paediatric diabetes centres. Through the search we identified a need for multi-centre, more thorough assessment on referral pathways, time taken from symptom onset to diagnosis, and its association with severity at presentation for children diagnosed with life-changing conditions during the national lockdown.Added value of this studyOur findings suggest that the first national lockdown in the UK were not associated with delayed diagnosis of childhood cancer or type 1 diabetes at participating centres. This provides reassuring information for children and families with these life-changing conditions.ImplicationWe believe that our study can play a key role in allaying parental and professional concern. it is important to establish whether subsequent public health measures have impacted the diagnostic interval in the context of an evolving backlog of patient referrals across the UK.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::46b6b21d9fca2da04b42a136cee9fd3fTest
https://doi.org/10.1101/2021.02.09.21251149Test