Publications
238 results found
Greenfield G, Poots A, Hiles S, et al., 2016, G345(P) Changes in respiratory diagnoses in pre-schoolers – a 10 year observational study, Archives of Disease in Childhood, Vol: 101, Pages: A201.2-A202, ISSN: 0003-9888
Blair M, Watson M, klaber R, et al., 2016, G311 How exactly does integrated paediatric care work? A theoretical research framework, Archives of Disease in Childhood, Vol: 101, Pages: A178-A179, ISSN: 1468-2044
Background Many areas in the UK are experimenting with different models of care delivery to improve integration of services and experiences of children young people and their carers. One such initiative “Connecting Care for Children” (CC4C) is based on three key components:- specialist outreach to a number of GP “hubs”, open access for advice and referrals and public and patient engagement. Robust evaluation of such health system change is desirable but often complex to conceptualise and achieve.Aim To develop an agreed conceptual framework to facilitate measurement of the quality of health system delivery in a defined population and to support research on proposed mediating factors.Methods A number of methods were used including stakeholder mapping, experiential “word cloud” capture, and “Action Effect Diagram” (AED) development.1 Engagement of staff, patients and young people at a number of collaborative events over a two year period. A joint workshop with academics from a number of institutions helped to refine specific measures and identify gaps in current knowledge. Over 100 individuals have been involved in drawing up the final model.Results Word cloud highlighted clinical and organisational issues (See Figure 1). There was considerable consistency across populations. An AED was developed over a series of iterations which elucidated the possible theoretical mechanisms for cause and effect of the three key components of the CC4C model. This was subsequently redrawn in a standardised logic model format to aid understanding (Figure 2). We have highlighted those elements which we believe are common to all such developments in integrated care and those which are for local determination and adaptation. Potential metrics for each of these segments are highlighted in Table 1.Conclusions We found a high degree of agreement for a conceptual framework which explains how integrated care processes might be mediated. Local aca
Gritz A, Sen A, Hiles S, et al., 2016, G241(P) More under-fives now seen in urgent care centre than A&E- should we shift our focus?, Archives of Disease in Childhood, Vol: 101, Pages: A132.1-A132, ISSN: 0003-9888
Ibrahim R, Blair M, 2016, G633(P) Nurses’ role in promoting maternal and children’s oral health: Key messages from a Systematic Review, Archives of Disease in Childhood, Vol: 101, Pages: A372.2-A373, ISSN: 0003-9888
Crehan C, Kugler B, Boreham C, et al., 2016, G341(P) “Very frequent flyers” in A and E and urgent care centres – clinical characteristics of those who attend 9 or more times per annum, Archives of Disease in Childhood, Vol: 101, Pages: A199-A200, ISSN: 0003-9888
Daly H, Baum A, Ritchie J, et al., 2016, G317 Baby buddy app – A public health opportunity for new parents; evaluation of the first 46,000 downloads, Archives of Disease in Childhood, Vol: 101, Pages: A184-A185, ISSN: 0003-9888
Lim V, Poots A, Greenfield G, et al., 2016, G233(P) "Frequent flyers" in A and E and Urgent Care Centres – sociodemographic and practice characteristics of preschoolers who attend 4 or more times in a year, Archives of Disease in Childhood, Vol: 101, Pages: A128.1-A128, ISSN: 0003-9888
Liyanage H, Luzi D, De Lusignan S, et al., 2016, Accessible Modelling of Complexity in Health (AMoCH) and associated data flows: asthma as an exemplar., J Innov Health Inform, Vol: 23
Background Modelling is an important part of information science. Models are abstractions of reality. We use models in the following contexts: (1) to describe the data and information flows in clinical practice to information scientists, (2) to compare health systems and care pathways, (3) to understand how clinical cases are recorded in record systems and (4) to model health care business models.Asthma is an important condition associated with a substantial mortality and morbidity. However, there are difficulties in determining who has the condition, making both its incidence and prevalence uncertain.Objective To demonstrate an approach for modelling complexity in health using asthma prevalence and incidence as an exemplar.Method The four steps in our process are:1. Drawing a rich picture, following Checkland's soft systems methodology;2. Constructing data flow diagrams (DFDs);3. Creating Unified Modelling Language (UML) use case diagrams to describe the interaction of the key actors with the system;4. Activity diagrams, either UML activity diagram or business process modelling notation diagram.Results Our rich picture flagged the complexity of factors that might impact on asthma diagnosis. There was consensus that the principle issue was that there were undiagnosed and misdiagnosed cases as well as correctly diagnosed. Genetic predisposition to atopy; exposure to environmental triggers; impact of respiratory health on earnings or ability to attend education or participate in sport, charities, pressure groups and the pharmaceutical industry all increased the likelihood of a diagnosis of asthma. Stigma and some factors within the health system diminished the likelihood of a diagnosis. The DFDs and other elements focused on better case finding.Conclusions This approach flagged the factors that might impact on the reported prevalence or incidence of asthma. The models suggested that applying selection criteria may improve the specificity of new or confirmed diagnosis.
Liyanage H, Luzi D, De Lusignan S, et al., 2016, Accessible Modelling of Complexity in Health (AMoCH) and associated data flows: asthma as an exemplar, Journal of Innovation in Health Informatics, Vol: 23, Pages: 476-484, ISSN: 2058-4555
Background Modelling is an important part of information science. Models are abstractions of reality. We use models in the following contexts: (1) to describe the data and information flows in clinical practice to information scientists, (2) to compare health systems and care pathways, (3) to understand how clinical cases are recorded in record systems and (4) to model health care business models.Asthma is an important condition associated with a substantial mortality and morbidity. However, there are difficulties in determining who has the condition, making both its incidence and prevalence uncertain.Objective To demonstrate an approach for modelling complexity in health using asthma prevalence and incidence as an exemplar.Method The four steps in our process are:1. Drawing a rich picture, following Checkland's soft systems methodology;2. Constructing data flow diagrams (DFDs);3. Creating Unified Modelling Language (UML) use case diagrams to describe the interaction of the key actors with the system;4. Activity diagrams, either UML activity diagram or business process modelling notation diagram.Results Our rich picture flagged the complexity of factors that might impact on asthma diagnosis. There was consensus that the principle issue was that there were undiagnosed and misdiagnosed cases as well as correctly diagnosed. Genetic predisposition to atopy; exposure to environmental triggers; impact of respiratory health on earnings or ability to attend education or participate in sport, charities, pressure groups and the pharmaceutical industry all increased the likelihood of a diagnosis of asthma. Stigma and some factors within the health system diminished the likelihood of a diagnosis. The DFDs and other elements focused on better case finding.Conclusions This approach flagged the factors that might impact on the reported prevalence or incidence of asthma. The models suggested that applying selection criteria may improve the specificity of new or confirmed diagnosis.
Blair M, Sayani S, Wortley E, 2015, Challenges and Solutions for the Safety of Children in the Community, Current Treatment Options in Pediatrics, Vol: 1, Pages: 262-274
Blair M, 2015, What we know and don't know about ‘best’, European Journal of Public Health, Vol: 25, ISSN: 1101-1262
Blair M, Rigby M, 2015, Seeking to optimise children’s primary health care – a European study, European Journal of Public Health, Vol: 25, ISSN: 1101-1262
Blair M, Stewart-Brown S, Waterston T, et al., 2015, Population Child Health in Practice, Child Health, Publisher: Oxford University Press, Pages: 181-208
Blair M, Stewart-Brown S, Waterston T, et al., 2015, Concepts in Population Child Health, Child Health, Publisher: Oxford University Press, Pages: 209-254
Kuo A, Coller R, Stewart-Brown SL, et al., 2015, Child Health A Population Perspective, Publisher: OUP Us, ISBN: 9780199309375
Historical and policy perspectives / Katherine Henry, Mienah Zulfacar Sharif -- Current state of child health in the U.S. / Mienah Zulfacar Sharif, Katherine Henry, Bergen Nelson -- Children, families, and communities / Ryan Coller, Alice ...
Sayani S, Blair M, 2015, G504(P) Below the tip of the iceberg – life before tier 3. a study of mental health provision in schools, Archives of Disease in Childhood, Vol: 100, Pages: A216.2-A217, ISSN: 0003-9888
McArdle AJ, Stilwell PA, Kwong H, et al., 2015, G101(P) Time for better normal ranges? the impact of discontinuities in normal ranges for heart and respiratory rate in paediatric a&e, Archives of Disease in Childhood, Vol: 100, Pages: A44.1-A44, ISSN: 0003-9888
Jubraj B, Blair M, 2015, Use of a medication passport in a disabled child seen across many care settings., BMJ Case Rep, Vol: 2015
Written information for patients about their medicines has demonstrable benefits for their understanding and adherence. In the UK, no single, complete record of medications for individual patients can be guaranteed. Therefore, patients and carers are often relied on to recall the complete medication list, which can be a challenge given multiple and potentially stressful appointments. Wide-ranging feedback suggests that a medication 'passport' developed by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West London (NIHR CLAHRC NWL) has benefited elderly patients, who often attend many appointments where the current medication list may not be available. We describe the use of this passport (known as 'My Medication Passport'--MMP) in a child with multiple disabilities. The practical advantages are explored, including the potential for a paediatric version to facilitate discussions around the administration of medicines. MMP is an early example of a useful tool to help children and young people, parents and carers to manage medicines more effectively.
Rudolf MC, Reis S, Gibbs TJ, et al., 2014, How can medical schools contribute to bringing about health equity?, Israel Journal of Health Policy Research, Vol: 3, ISSN: 2045-4015
The role of medical schools is in a process of change. The World Health Organization has declared that they can no longer be ivory towers whose primary focus is the production of specialist physicians and cutting edge laboratory research. They must also be socially accountable and direct their activities towards meeting the priority health concerns of the areas they serve. The agenda must be set in partnership with stakeholders including governments, health care organisations and the public. The concept of social accountability has particular resonance for the Bar Ilan Faculty of Medicine in the Galilee, Israel’s newest medical school, which was established with a purpose of reducing health inequities in the Region. As a way of exploring and understanding the issues, discussions were held with international experts in the field who visited the Galilee. A symposium involving representatives from other medical schools in Israel was also held to extend the discourse. Deliberations that took place are reported here. The meaning of social accountability was discussed, and how it could be achieved. Three forms of action were the principal foci - augmentation of the medical curriculum, direct action through community engagement and political advocacy. A platform was set for taking the social accountability agenda forward, with the hope that it will impact on health inequalities in Israel and contribute to discussions elsewhere.
Costa-Fernandes N, Adodra A, Blair M, et al., 2014, G60 Awareness, knowledge and practice of Vitamin D deficiency amongst Health Care Professionals in Northwest London, Archives of Disease in Childhood, Vol: 99, Pages: A25-A25, ISSN: 0003-9888
Heys M, Rajan M, Blair M, 2014, G478(P) Socio-economic position, service configuration and length of inpatient stay for paediatrics: what matters?, Archives of Disease in Childhood, Vol: 99, Pages: A198-A199, ISSN: 0003-9888
Staines A, Rigby M, Leonardi M, et al., 2014, RICHE – Research Inventory, Indicators, Gaps and Roadmaps for Child Health in Europe - an EU FP7 project
<jats:p><jats:bold>Background </jats:bold>There is a substantial amount of research in child health published each year in the European Union. Much of this work is paid for from public funds, or from charitable donations. This work covers many areas, but it is fragmented, and a great deal of it, especially the material not published in the indexed scientific literature, is hard to find, and harder to access. <jats:bold>Response </jats:bold>The EU, as one of the major funders of child health research, has funded a project, the Research Inventory of Child Health in Europe (RICHE), to prepare a roadmap for the future of child health research in Europe. Using a life course perspective, the project sought to identify the research done, define the gaps in the research, and make recommendations for future research funding priorities. <jats:bold>Content </jats:bold>RICHE is an FP7 funded project (contract no. 242181) tasked with preparing roadmaps for the future of child health research across Europe. Using a life-course perspective, the project has designed, and carried out, an open, transparent, and justifiable process to make recommendations for future research funding. We acknowledge that such recommendations are value judgements, and our aim was to present carefully justified value judgements. The project, which had 25 partners, in 19 countries, was organised into six workpackages – WP1 an inventory of child health research, including funded projects, reports, funders, and people; WP2 on ways of measuring child health, and indicators for child health; WP3 on gaps in child health research; WP4 on the roadmaps for future research; WP5 maintains a platform at http://childhealthresearch.eu/ ; WP6 was responsible for project management. <jats:bold>Results </jats:bold>The project has finished, and launched a report on 'Roadmaps for the Future of Child Health Research in Europe'. A key recommendation is the establish
Staines A, Rigby M, Leonardi M, et al., 2014, RICHE – Research Inventory, Indicators, Gaps and Roadmaps for Child Health in Europe - an EU FP7 project
<jats:p><jats:bold>Background </jats:bold>There is a substantial amount of research in child health published each year in the European Union. Much of this work is paid for from public funds, or from charitable donations. This work covers many areas, but it is fragmented, and a great deal of it, especially the material not published in the indexed scientific literature, is hard to find, and harder to access. <jats:bold>Response </jats:bold>The EU, as one of the major funders of child health research, has funded a project, the Research Inventory of Child Health in Europe (RICHE), to prepare a roadmap for the future of child health research in Europe. Using a life course perspective, the project sought to identify the research done, define the gaps in the research, and make recommendations for future research funding priorities. <jats:bold>Content </jats:bold>RICHE is an FP7 funded project (contract no. 242181) tasked with preparing roadmaps for the future of child health research across Europe. Using a life-course perspective, the project has designed, and carried out, an open, transparent, and justifiable process to make recommendations for future research funding. We acknowledge that such recommendations are value judgements, and our aim was to present carefully justified value judgements. The project, which had 25 partners, in 19 countries, was organised into six workpackages – WP1 an inventory of child health research, including funded projects, reports, funders, and people; WP2 on ways of measuring child health, and indicators for child health; WP3 on gaps in child health research; WP4 on the roadmaps for future research; WP5 maintains a platform at http://childhealthresearch.eu/ ; WP6 was responsible for project management. <jats:bold>Results </jats:bold>The project has finished, and launched a report on 'Roadmaps for the Future of Child Health Research in Europe'. A key recommendation is the establish
Heys M, Kwong H-M, Reed J, et al., 2014, What do we really know about infants who attend Accident and Emergency departments?, Perspectives in Public Health, Vol: 134, Pages: 93-100, ISSN: 1757-9147
Aims: Accident and Emergency attendances continue to rise. Infants are disproportionately represented. This study examines the clinical reasons infants attend UK Accident and Emergency departments. Methods: A retrospective review of 6,667 infants aged less than one year attending Accident and Emergency at two district general hospitals in London from 1(st) April 2009 to 30(th) March 2010. All infants had been assigned to a diagnostic category by the medical coding department according to National Health Service (NHS) data guidelines, based on the clinical diagnoses stated in the medical records. The Accident and Emergency case notes of a random subsample of 10% of infants in each of the top five recorded diagnostic categories (n = 535) were reviewed in detail and audited against the standard national NHS data set. Results: The top 5 clinical diagnoses were ’infectious diseases’, ’gastrointestinal’, ’respiratory’, ’unclassifiable’ and ’no abnormality detected’ (NAD). A third of infants were originally given a diagnosis of unclassifiable (21.5%) or NAD (11.5%). After detailed case-note review, we were able to reduce this to 9.7% (95% confidence interval (CI): 9.0, 10.4) and 8.8% (95% CI: 8.1, 9.5), respectively. Conclusion: This study demonstrates the importance of providing a clear clinical diagnosis and coding system for Accident and Emergency attendances and understanding that system fully. This would allow for better informed health service evaluation, planning and research as each of these relies on the interpretation of routine health-care data. Furthermore, the relatively high proportion (10%) of infants attending with no discernible underlying medical abnormality suggests the health needs of a significant proportion of infants attending Accident and Emergency departments may be better addressed by alternative service provision and/or improved education and support to parents.
Blair M, Michie C, 2014, Child health, PERSPECTIVES IN PUBLIC HEALTH, Vol: 134, Pages: 72-72, ISSN: 1757-9139
Blair M, Macaulay C, 2014, The healthy child programme: How did we get here and where should we go?, Paediatrics and Child Health (United Kingdom), Vol: 24, Pages: 118-123, ISSN: 1751-7222
A Child Health Promotion programme has developed over the last century. Its remit and content has been revised and updated over the last 50 years. The current programme, the Healthy Child Programme, enshrined in law, offers a comprehensive schedule of checks, reviews and support from pregnancy to 19 years of age. This is the first nationally agreed programme, and yet we are not clear whether it is achieving what it sets out to do. We review the aims of the HCP and ask whether it is doing too little or too much? We explore the outcomes that matter and assert that we often don’t have the data to make this judgement. We call for more data and argue for the importance of getting to know your local data, in advocating for children and young people. We ask paediatricians to step up and take a role in the promotion of health and wellbeing of families in their care: child public health is everybody’s business. © 2013 Elsevier Ltd.
Blair PM, 2014, Child public health in 21st-century practice: Examples of collaborative working with the paediatrician, Journal of Health Visiting, Vol: 2, Pages: 268-271
Blair M, 2014, Getting evidence into practice–implementation science for paediatricians., Archives of disease in childhood, Vol: 99, Pages: 307-9, ISSN: 1468-2044
SUMMARY It is estimated that on average it takes 17 years to get research findings used in day to day practice. Nearly two million scientific articles are published every year. There is a knowledge-practice gap which requires closing if we are to make optimum and timely use of the best evidence to inform and change our clinical practice. This article explores the theoretical background to knowledge translation and knowledge dis- covery and gives child health examples of how diffusion and dissemination of knowl- edge occurs in practice. It is suggested that there is a unique role for knowledge brokers in paediatrics to facilitate change and outlines how various barriers to change might be overcome.
Wood R, Blair M, 2014, A comparison of Child Health Programmesrecommended for preschool children in selectedhigh-income countries, Child: Care, Health and Development, Vol: 40, Pages: 640-653
Lorenc A, Blair M, Robinson N, 2014, Personal and professional influences on practitioners’ attitudes to traditional and complementary approaches to health in the UK, Journal of Traditional Chinese Medical Sciences, Vol: 1, Pages: 148-155, ISSN: 2095-7548
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