This article reports an evaluation of the NHS Health Check in an area of Birmingham. The NHS Health Check is available for anyone aged 40-74 and assesses their risk of cardiovascular diseases including heart disease, stroke, diabetes and kidney disease. It also helps provide support for people who need to make lifestyle changes to help reduce their risk to these conditions. This is particularly relevant to people as they get older because our risk to cardiovascular disease increases as we age. Be SMART: examining the experience of implementing the NHS Health Check in UK primary care Rachel Shaw*, Helen M Pattison, Carol Holland and Richard Cooke * Corresponding author: Rachel L Shaw email@example.com
Author Affiliations School of Life & Health Sciences, Aston University, Birmingham B4 7ET, UK
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2296/16/1
The NHS Health Check was designed by UK Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change. It constituted biomedical testing, personalised advice and lifestyle support. The objective of the study was to explore Health Care Professionals’ (HCPs) and patients’ experiences of delivering and receiving the NHS Health Check in an inner-city region of England.
Patients and HCPs in primary care were interviewed using semi-structured schedules. Data were analysed using Thematic Analysis.
Four themes were identified. Firstly, Health Check as a test of ‘roadworthiness’ for people. The roadworthiness metaphor resonated with some patients but it signified a passive stance toward illness. Some patients described the check as useful in the theme, Health check as revelatory. HCPs found visual aids demonstrating levels of salt/fat/sugar in everyday foods and a ‘traffic light’ tape measure helpful in communicating such ‘revelations’ with patients. Being SMART and following the protocol revealed that few HCPs used SMART goals and few patients spoke of them. HCPs require training to understand their rationale compared with traditional advice-giving. The need for further follow-up revealed disparity in follow-ups and patients were not systematically monitored over time.
HCPs’ training needs to include the use and evidence of the effectiveness of SMART goals in changing health behaviours. The significance of fidelity to protocol needs to be communicated to HCPs and commissioners to ensure consistency. Monitoring and measurement of follow-up, e.g., tracking of referrals, need to be resourced to provide evidence of the success of the NHS Health Check in terms of healthier lifestyles and reduced CVD risk.
Older drivers who lack confidence on the road could benefit from a new training plan being developed by researchers at Aston University.
The project will target older drivers’ ability to pay attention to different locations when moving at speed – known as their ‘attentional switching flexibility’. As people age, this ability, essential for safe driving, can slow down, with serious implications for drivers and others on the road. Although older drivers are reported to have fewer collisions and pose a lower safety risk to other road users than other age groups, it is known they are much more likely to suffer from a lack of attentional switching flexibility, which can severely affect their confidence. Aston researchers believe the extra time it takes older people to shift their attention from one thing to another may be a major source of this problem, and have developed a new training plan to tackle the issue. A team, led by Dr Carol Holland, Director of the Aston Research Centre for Healthy Ageing at Aston University’s School of Life and Health Sciences, will test participants with a series of visual prompts designed to gradually increase the speed at which they can focus their attention. They will then be placed in a driving simulator and asked to tackle difficult traffic situations such as at virtual roundabouts and road intersections. Their performance on the simulator will be measured over a period of time to assess the degree of their improvement. Dr Holland said: “Many older drivers give up driving because of concerns about their safety and a general loss of confidence on the road. We hope to be able to keep them on the road for longer because they tend not to be bad drivers at all – far from it. The issue is one of confidence; if this can be built up through a specifically-designed training programme such as the one we are developing, it will improve the safety not only of older drivers, but of other road users as well. “No one has studied the impact of attentional switching costs on the proficiency of older drivers before. We want to change the untrue stereotype of older drivers as unsafe and help enable them to feel more confident and competent on the road.” Delaying the point when people give up driving could have significant general health benefits. Early driver cessation is often a precursor of depression and isolation. Loss of independent mobility is also associated with ‘life space constriction’, which is linked to frailty and loss of independence. It is also known that maintaining or increasing the proportion of older drivers on the roads in any area or region has a positive influence on the road transport environment and overall incident frequency. A recent RAC study estimated that of the 500,000 drivers who turned 70 in 2013 in the UK, 170,000 of them will give up driving before they need to. The project is part funded by the Rees Jeffreys road fund as a PhD studentship and will be conducted in collaboration with Professor Klaus Kessler of the Aston Brain Centre.
For further media information, please contact Jonathan Garbett, Aston University Communications on 0121 204 4552 or firstname.lastname@example.org
Paper published in the Journal of Materials Chemistry B Bioactive Organic-Inorganic Hybrids with Improved Mechanical Performance
Human tissue including both soft tissue (e.g. skin) and hard tissue (e.g. bones) are continuously remodelled and regenerated throughout our lifetime. However, as we age our bodies’ ability to repair and regenerate significantly reduces. Healing in older adults can be particularly slow due to reduced cellular activity. As we age our bones become brittle and weaker and reduced bone density can be problematic for post-menopausal women. Consequently bone is the most widely transplanted material with the exception of blood. It is therefore very important to develop new and improved biomaterials for bone regeneration. Effective implant biomaterials can help tissue regenerate and significantly improve the quality of life of older adults in later life. Recently there has been a change in philosophy moving away from traditional materials (e.g. large metal plates that are inserted for life) towards developing new smart biomaterials that can help the body self-heal and eventually become absorbed and replaced by the body. Solid glass particles containing calcium and phosphorous (the main building blocks of bone) are now used widely clinically to treat small bone defects (e.g. orthopaedic bone grafting in non-load bearing sites, ossicular replacement, head and neck surgery, tooth root implants). The latest drive is to mimic nature by developing highly porous scaffolds which enhance blood flow and cell ingrowth to increase the rate of healing. However these materials are usually mechanically weak. Dr Richard Martin (ARCHA & EAS) in collaboration with colleagues at the Chinese Academy of Science have developed novel sol-gel polymer hybrids for bone replacement applications with vastly improved mechanical properties whilst still maintaining this porosity. A key feature of this work was ensuring that the organic and inorganic phases are strongly bonded together to stop the polymer from rapidly washing out from the hybrid which would reduce the strength. The work was recently published in the Journal of Materials Chemistry B; full details can be found at http://pubs.rsc.org/en/content/articlelanding/2014/tb/c4tb01776e#!divAbstract
The work was supported by ARCHA and a Royal Society/Natural Science Foundation of China international exchange grant (IE131323, 513111170).
ARCHA staff awarded European funding Dr Carol Holland and a team from ARCHA including colleagues from psychology, biology and computer science have been awarded funding from the European 3 rd Health programme in collaboration with European colleagues from Spain, Portugal, Italy, the Netherlands and Poland. The project is to extend the work of the European Innovation Partnership on Active & Healthy Ageing in the subtopic of Frailty and Cognitive Decline. The title of the two year programme is “Frailty Management Optimisation through EIP AHA Commitments and Utilisation of Stakeholders input”, or “FOCUS”.
16th October 2013 The British Neuroscience Association and the Society of Biology West Midlands Branch are co-hosting the Dr Christopher Smith Memorial Lecture on the 16th October 2013 at Aston University. The lecture entitled "Reducing dementia risk through lifestyle changes: when to do what?" is being given by Professor Eef Hogervorst from the University of Loughborough.
Please register intention to attend lecture: email email@example.com noting your name and telephone number and indicate if you will be able to join us for refreshments (served 6.15 -7.15pm). For groups please provide total number in your party.
15 March 2013 Alex Thomson from Channel 4 News hosts today's Google Hangout on 'Meeting the challenge of an ageing population'. Taking part:
View the Channel 4 website for more information
A research matching event in the style of “Speed Dating” took place on 13th December 2012. Open to all Aston research staff, it aimed to help bring together researchers from different areas with mutual interests in ageing. For further information please contact Wendy Overton. If you would like to discuss any possible research ideas, please contact the ARCHA Director, Dr Carol Holland.
An interview with 74-year-old veteran sports star, Sheila Champion, one of 50 inspirational athletes featured in a free photo exhibition at Aston.
Click here to read the interview.
As part of Wellbeing Week 2012, a Wellbeing Fair open to all staff and students took place on 13th November 2012 at Aston.
There were a wide range of internal and external exhibitors including Sport and Recreation * DANU * the Health & Safety Unit *Quest Vitamins * Boots the Chemist *Alzheimer’s Society * Environment and Sustainability *AstBUG *Fairtrade Group * Counselling Service * MLK Chaplaincy * the Advice and Representation Centre (ARC) * the Hub * Optometry * Audiology * Aston Research Centre for Healthy Ageing (ARCHA) * Halcyon Medical Centre * Ruth Hickinbotham – Complementary Therapies *Catering and Conference Aston * Sustrans - all demonstrating the goods and services on offer locally to help you maintain a healthy lifestyle and sense of wellbeing.
A diverse range of other activities to promote health and wellbeing to staff and students also took place across the campus between 12th and 16th November 2012. See the Wellbeing posters or www.aston.ac.uk/staff/hr/wellbeing/ for details.
Aston University hosted a photograph exhibition of veteran athletes who still compete at an international level.
Photographer, Alex Rotas, showcased her work at Aston University from 31st October, which featured photographs of competitive pole-vaulters, long jumpers and hurdlers in their 60s, 70s and 80s. The exhibition was designed to challenge potential stereotypes of older men and women within the UK.
The exhibition featured as part of Aston University’s Well-Being Week an initiative for staff which aimed to encourage healthier lifestyles at work. Aston Research Centre for Healthy Ageing (ARCHA) at Aston University, whose research focuses on older people’s wellbeing, also showcased their research at the event.
Dr Carol Holland, Director of ARCHA, said; “Alex’s work not only challenges perceptions of older people but also raises awareness of there are still very much abled older people in our society. Aston’s well-being week encourages staff to keep active and lead healthier working lives, we are happy that ARCHA can be involved with upcoming events. Alongside ARCHA’s focus on scientific research into Ageing we also explore the impact of changes in political and social environment on older people. ARCHA’s Ageing Lives cluster not only looks at impact of health and care policies, but also attitudes and beliefs towards ageing such as managing medicines and keeping active”.
For further information and to view the picture gallery visit alexrotasphotography.com.
The news messages were:
1. Official figures may under estimated the use of anti-psychotics in dementia.2. A medication review by a clinical pharmacist may be able to limit the prescribing of inappropriate anti-psychotics.
Ian Maidment, a senior lecturer in clinical pharmacy from Aston University, said: “The true scale of antipsychotic usage in dementia may be underestimated.”
Click HERE to read more.
The first journal article from the dementia project was published in the Medical Law Review. The article is called "He was like a zombie": Off-label prescription of antipsychotic drugs in dementia.
Click HERE to read the abstract.
Scientists analyse retirement village residents
University Researchers Study the Impact of Charity's Healthy Ageing Programme
View the article - Click on the middle tab and go to page 182.
Tackling obesity and diabetes in an ageing population
Tackling road safety in an ageing population
Tackling falls, fractures and mobility in an ageing population
Aston University new release (European Year of Active Ageing 2012)
News Article 1
News Article 2
Fibre-optic implants could be used to monitor healing wounds for signs of infection if research by Aston University scientists is successful.
A team of researchers plans to study how to turn fibre-optic technology that can measure temperature and detect biological signs of disease into a device for implanting into a wound at surgery.
Doctors currently tend to check for infection by monitoring a patient’s temperature, but catching the problem before it has had a chance to affect the whole body could stop it becoming more serious. Click HERE to read more.
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