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The UK Biobank has made general practitioner (GP) data (censoring date 2016–2017) available for approximately 45% of the cohort, whilst hospital inpatient and death registry (referred to as "HES/Death") data are available cohort-wide through 2018–2022 depending on whether the data comes from England, Wales or Scotland. We assessed the importance of case ascertainment via different data sources in UKB for three diseases that are usually first diagnosed in primary care: Parkinson's disease (PD), type 2 diabetes (T2D), and all-cause dementia. Including GP data at least doubled the number of incident cases in the subset of the cohort with primary care data (e.g. from 619 to 1390 for dementia). Among the 786 dementia cases that were only captured in the GP data before the GP censoring date, only 421 (54%) were subsequently recorded in HES. Therefore, estimates of the absolute incidence or risk-stratified incidence are misleadingly low when based only on the HES/Death data. For incident cases present in both HES/Death and GP data during the full follow-up period (i.e. until the HES censoring date), the median time difference between an incident diagnosis of dementia being recorded in GP and HES/Death was 2.25 years (i.e. recorded 2.25 years earlier in the GP records). Similar lag periods were also observed for PD (median 2.31 years earlier) and T2D (median 2.82 years earlier). For participants with an incident GP diagnosis, only 65.6% of dementia cases, 69.0% of PD cases, and 58.5% of T2D cases had their diagnosis recorded in HES/Death within 7 years since GP diagnosis. The effect estimates (hazard ratios, HR) of established risk factors for the three health outcomes mostly remain in the same direction and with a similar strength of association when cases are ascertained either using HES only or further adding GP data. The confidence intervals of the HR became narrower when adding GP data, due to the increased statistical power from the additional cases. In conclusion, it is desirable to extend both the coverage and follow-up period of GP data to allow researchers to maximise case ascertainment of chronic health conditions in the UK. [ABSTRACT FROM AUTHOR]

Background: Lesbian, gay, bisexual and trans (LGBT) individuals have been shown to have poorer health when compared to those who identified as heterosexual. Additionally, they encounter barriers that deter participation in sports. Aim: To understand the experiences of LGBT individuals who participate in physical activity with peers. Method: An exploratory-descriptive qualitative (EDQ) study with data collected via face-to-face interviews from 12 participants. Data were thematically analysed to identify findings. Findings: exercising with peers represents a healthier way to meet people. Participants experienced improved physical, mental and social health. Conclusion: Engaging with a peer group for physical activity can have a transformational effect on members of the LGBT community, impacting on all aspects of their wellbeing. Nurses, and other health professionals, should be aware of the multifaceted benefits that exercising with a peer group can have, using their regular interactions with this patient group to recommend peer-supported exercise. [ABSTRACT FROM AUTHOR]

Aim: to examine ward staff perceptions on the role of the ‘hospital at day’ advanced nurse practitioner (ANP). This term is used locally to refer to a model first introduced into ‘hospital at night’ teams, in response to changes in working patterns of junior doctors, where an advanced nurse practitioner is based on the ward—the model was subsequently rolled out to daytime teams. Methods: a qualitative descriptive phenomenological approach was adopted to carry out this study with a purposive sample of ten participants. Participants were interviewed individually using semi-structured interviews to gain insights into their perceptions on the role of the ANP, following Colaizzi’s analytical model of data analysis. Findings: four major themes were identified. The first overarching theme was effectiveness of the ANP role. There was evidence that the role was not only clinically effective in the ward but also in relation to organisational priorities such as impact on patient flow. Secondly it was acknowledged that having an ANP based on the ward and as a ‘constant’ in the ward area, when medical teams rotate, provides team stability and improves the functioning of the ward area. Despite the positivity recognised, the third theme identified that having a ward-based ANP may affect skill acquisition and development and may lead to the ‘de-skilling’ of staff. Lastly it was acknowledged that there remains an overall confusion about the role of the ANP. Conclusion: the themes identified reflect what is already known about the wider perceived role of the ANP. Moreover, this study adds to the limited literature available specifically on the benefits of the ANP within ‘hospital at day’ roles. [ABSTRACT FROM AUTHOR]

The British National Health Service (NHS) is undergoing possibly the most far-reaching set of changes in its sixty-five-year history.While some commentators (like Rudolf Klein) insist that little of substance is likely to change, others consider that the politics of reform may prove quite different on this occasion. The coalition government is committed to restructuring the welfare state and public services and to rolling back the state. The NHS as a popular monopoly public service runs counter to its neoliberal ideology. While (for now) remaining committed to a publicly funded system of health care that is largely free at point of use, the government wishes to encourage much greater diversity in the provision of care, including a much larger role for the for-profit private sector. Despite significant opposition to its proposals, few concessions have been forthcoming, and the legislation that passed onto the statute book in March 2012 remained essentially unchanged.Notwithstanding the lack of convincing evidence, the government is wedded to encouraging greater competition and choice. Those who believe the changes will amount to far less than its architects hope for are being too complacent and overlooking the strength of the government's ideological convictions. These threaten to dismantle the NHS and replace it with a more costly, fragmented, and less effective system of care that is driven by profit in place of the public interest. [ABSTRACT FROM AUTHOR]