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1. The National Health Service England Diabetes Prevention Program--A Narrative Review.

Author

Koning, Clare, Pelletier, Marc, and Spooner, Joanne

Subjects
MEDICAL databases, EVALUATION of human services programs, SYSTEMATIC reviews, STAKEHOLDER analysis, DIGITAL health, NATIONAL health services, TYPE 2 diabetes, RISK assessment, COST effectiveness, HEALTH behavior, WEIGHT loss, PREDIABETIC state, BEHAVIOR modification, DISEASE risk factors
Abstract

The National Health Service (NHS) Diabetes Prevention Program (DPP) is a comprehensive initiative in the United Kingdom aimed at preventing type 2 diabetes (T2DM) among individuals with prediabetes. The NHS DPP emphasizes early intervention and underscores the potential for preventing or delaying T2DM. Currently, it operates since 2015 at 44 geographically defined sites, serving an estimated annual volume of 200,000 patients. This narrative review evaluates the NHS DPP. A literature search, adhering to the Participants, Concept, and Context review framework, was conducted in various databases and sources, limited to the period from 2015 to 2023. Data were categorized based on publication date, study type, program indicators, and focus areas, forming the framework for the review discussion. The review search yielded a total of 18,357 articles, of which 45 were included, with a predominant focus on program effectiveness. The NHS DPP demonstrates strengths in risk reduction and cost-effectiveness but faces challenges related to fidelity and the needs of diverse populations. The review highlights the importance of evidence-based service delivery, stakeholder engagement, and digital innovation in future DPP programs. While a centralized approach provides structure, local flexibility is essential to cater to population-specific needs. This review underscores the importance of strategic planning, political support, partnerships, and robust data collection in DPP implementation. It recommends targeting high-risk individuals, intensive lifestyle interventions, and embracing digital solutions for program delivery. Ongoing research, including analysis of long-term data and user perspectives, will further enhance the evidence base for DPP programs worldwide. [ABSTRACT FROM AUTHOR]

Published
2023
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2. A systematic review and utilization study of digital stethoscopes for cardiopulmonary assessments

Author

Koning​, Clare, Lock, Adinet, Koning​, Clare, and Lock, Adinet

Abstract

Objectives: The demand for cardiopulmonary assessment via real-time live streaming is prevalent in remote communities of British Columbia, Canada. Digital stethoscopes enable remote assessments, but the difference in quality compared to conventional assessments is unknown. Objectives were to explore published literature for real-time remote audio and video streaming of cardiopulmonary assessments via digital stethoscopes, and evaluate the quality of digital stethoscopes for remote cardiopulmonary assessments as compared to conventional stethoscopes in a Cardiac Virtual health Assessments (CaViAs) project. Materials and Methods: CaViAs included evaluation of quality and utility of three digital stethoscope devices, three digital platforms/applications, three noise-cancelling headsets, and two Internet-enabled devices with one technical operator and one evaluator. A comprehensive search for “digital stethoscope*” was conducted in PubMed, Science Direct, CINAHL, TRIP, Open Grey and ClinicalTrials.gov in February 2021 for relevant peer reviewed studies. Studies were screened for eligibility and inclusion based on population, intervention, comparator, outcome and study design criteria and utilizing Preferred Reporting Items for Systematic reviews and Meta-Analysis, and assessed for methodological quality using Critical Appraisal Skills Programme for Randomized Controlled Trials. Studies were eligible if they included adult humans undergoing cardiopulmonary assessment with digital stethoscopes compared to conventional stethoscopes to test the audio quality and ease of use of digital stethoscopes via real-time remote audio and video streaming across a distance. Results: Of 238 articles identified, only one study of poor methodological quality was found that fulfilled all inclusion criteria. This study rated the quality of digital stethoscopes as good or very good. In the CaViAs project, the Eko Duo digital stethoscope in combination with the Eko ECG applicat

Published
2022

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