CaHRU presents research on sleep at college summer showcase

BrayfordThe annual research showcase, featuring speakers from the College of Social Science took place on 6 June 2018. Professor Niro Siriwardena presented on CaHRU’s work on sleep. Sleep is fundamental to our wellbeing, from birth to old age. Poor sleep affects health, sickness, life, death, productivity, and the wider economy. Sleep is as important to health as other lifestyle factors such as diet and exercise but, compared to these, is under-researched and under-invested in. There are effective psychological treatments for insomnia but these are not widely available, whereas less effective and potentially harmful drug treatments are commonly used.

CSSsummershowcase2He described the work of members of CaHRU together with partners at the University of Lincoln and other academic institutions (Oxford, Manchester, Glasgow, Ghent), in partnership with service users, staff and healthcare organisations, locally, nationally and internationally. Over the past 15 years, using systematic reviews, observational and qualitative studies, quasi-experiments and trials, staff in CaHRU have explored the problem of primary care for sleep, how this might be improved, and what effect this is having on sleep, prescribing, and health outcomes.

INB2The work has led to a major multicentre trial, funded by the National Institute for Health Research (£1.8M), investigating the effectiveness and cost-effectiveness of sleep restriction therapy, a behavioural treatment for insomnia, delivered in primary care. These studies and the wider impacts of this work were presented to those present.

 

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/07/Sleep_Siriwardena.pdf” width=”660″]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

Rapid review published on effectiveness of different models of delivering urgent care

TEMAS - A&E 5he NIHR commissioned rapid evidence review to assess the nature and quality of the existing evidence on delivery of emergency and urgent care services and to identify gaps for future research was published last week: Phung V-H (2015) Chapter 6 – Delivery of emergency department services in Turner J, Coster J, Chambers D, Cantrell A, Phung V-H, Knowles E, Bradbury D, Goyder (eds.). What evidence is there on the effectiveness of different models of delivering urgent care? A rapid review. Health Serv Deliv Res 2015;3(43). The team, from the School of Health And Related Research (ScHARR) at the University of Sheffield with Viet-Hai Phung, research assistant and doctoral researcher at CaHRU, undertook five separate literature reviews linked to themes in the NHS England review in 2013, which latter drove the need for this rapid evidence review. The review, which took six months to complete, incorporated findings from 45 systematic reviews and 102 primary research studies across all five reviews

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Viet-Hai Phung wrote the review in Chapter 6 on the Delivery of Emergency Department (ED) services. This review included literature from 2009 to 2015. Nine papers were included in the review: two systematic reviews, which included 28 individual papers, and seven additional papers. Of the 35 included studies, there were only five randomised control trials and many uncontrolled before-and-after studies, which cannot control for other system effects.

NThere were three themes to this part of the review: Managing ED flow; Workforce; and managing the frail and the elderly in EDs. In the first review, interventions that aimed to increase access to primary care and ED cost-sharing were found to be effective in reducing ED use. For the Workforce review, the evidence suggested that supplementing existing ED staff with NPs can help to manage demand more effectively, especially in high-volume EDs. For the final review, there was mixed evidence about the effectiveness of Comprehensive Geriatric Assessment (CGA): CGA did not have a significant impact on outcomes nor mortality, while other studies suggested that use of CGA to inform interventions could reduce functional decline.

Viet-Hai Phung