ORCID Profile
0000-0002-1114-2456
Current Organisations
The University of Edinburgh
,
University of Cambridge
,
University of Cambridge Institute of Public Health
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Publisher: Springer Science and Business Media LLC
Date: 07-01-2022
DOI: 10.1186/S12877-021-02705-W
Abstract: Care homes provide long term care for older people. Countries with standardised approaches to residents’ assessment, care planning and review (known as minimum data sets (MDS)) use the aggregate data to guide resource allocation, monitor quality, and for research. Less is known about how an MDS affects how staff assess, provide and review residents’ everyday care. The review aimed to develop a theory-driven understanding of how care home staff can effectively implement and use MDS to plan and deliver care for residents. The realist review was organised according to RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines. There were three overlapping stages: 1) defining the scope of the review and theory development on the use of minimum data set 2) testing and refining candidate programme theories through iterative literature searches and stakeholders’ consultations as well as discussion among the research team and 3) data synthesis from stages 1 and 2. The following databases were used MEDLINE via OVID, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ASSIA [Applied Social Sciences Citation Index and Abstracts]) and sources of grey literature. Fifty-one papers informed the development of three key interlinked theoretical propositions: motivation (mandates and incentives for Minimum Data Set completion) frontline staff monitoring (when Minimum Data Set completion is built into the working practices of the care home) and embedded recording systems (Minimum Data Set recording system is integral to collecting residents’ data). By valuing the contributions of staff and building on existing ways of working, the uptake and use of an MDS could enable all staff to learn with and from each other about what is important for residents’ care Minimum Data Sets provides commissioners service providers and researchers with standardised information useful for commissioning planning and analysis. For it to be equally useful for care home staff it requires key activities that address the staff experiences of care, their work with others and the use of digital technology. PROSPERO registration number CRD42020171323.
Publisher: Oxford University Press (OUP)
Date: 29-07-2021
Abstract: With the emergence of healthy aging as a key societal issue in recent decades, technology has often been proposed as a solution to the challenges faced by aging societies. From a public health perspective, however, aging-related technologies have been inconsistently conceptualized and ill-defined. By examining how relevant concepts in “technology for aging” have been developed to date, we hope to identify gaps and begin clarifying the topic. We conducted a scoping review according to PRISMA-ScR, drawing on PubMed and Embase. We selected articles that directly reported concepts of technology for aging, or from which such concepts could be inferred. We identified 43 articles, most of which were narrative reviews (n = 31). Concepts of technology for aging were presented in erse ways with some overlap. Most studies provided some terminology (n = 36), but with little conceptual uniformity. Conceptual discourse was often focused on the aging agenda while technological aspects were poorly defined. A conceptual framework from a public health perspective was derived from 8 articles—it showed that technology strategies do not take a population approach. While the potential of “technology for aging” is vast, its real capacity to deliver a desirable life for older people remains underdeveloped. Clearer concepts and realistic goals at population level are lacking. Efficient investment must be made throughout the social system, and technology needs to be integrated via macro-level practices.
Publisher: Wiley
Date: 02-2003
DOI: 10.1046/J.1365-277X.2003.00414.X
Abstract: Those sugars in foods, which are potentially damaging to dental health, were classified by the Committee on Medical Aspects of Food Policy (COMA) as non-milk extrinsic sugars (NMES). The NMES include sugars outside the cellular structure of a food, excluding the sugars naturally present in milk and milk products. The NMES should contribute no more than 10% of energy intake (Department of Health, 1991). A number of studies have been published where NMES content of foods has been estimated. The purpose of this study was to carry out a comprehensive literature review using a methodical search strategy in order to identify the different methods that have been used for NMES estimation. Databases searched were MEDLINE, EMBASE, Health-CD and Health Management Information Consortium (HMIC) (as sources of UK government and other official publications). In total, 32 publications were found in which NMES values were reported and five different methods to estimate NMES were identified. No published method provided sufficient information to clearly differentiate between methods and inadequate detail was given to support replication of any of the methods. Of these five methods, The Ministry of Agriculture, Fisheries and Food (MAFF) have published three different descriptions of methods of NMES estimation used in UK national dietary surveys published since 1989. However, one method has been described consistently in the National Diet and Nutrition surveys published since 1994. A single, uniform approach to the estimation of NMES for application in nutritional surveys is essential for cross-comparison between surveys. The results show that there is a clear need for one standardized approach for the estimation of NMES in foods.
Publisher: SAGE Publications
Date: 09-12-2013
Abstract: A systematic review of studies in humans was conducted to update evidence on the association between the amount of sugars intake and dental caries and on the effect of restricting sugars intake to 10% and 5% energy (E) on caries to inform the updating of World Health Organization guidelines on sugars consumption. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Wanfang, and South African Department of Health. Eligible studies reported the absolute amount of sugars and dental caries, measured as prevalence, incidence, or severity. The review was conducted and reported in accordance with the PRISMA statement, and the evidence was assessed according to GRADE Working Group guidelines. From 5,990 papers identified, 55 studies were eligible – 3 intervention, 8 cohort, 20 population, and 24 cross-sectional. Data variability limited meta-analysis. Of the studies, 42 out of 50 of those in children and 5 out of 5 in adults reported at least one positive association between sugars and caries. There is evidence of moderate quality showing that caries is lower when free-sugars intake is 10% E. With the 5% E cut-off, a significant relationship was observed, but the evidence was judged to be of very low quality. The findings are relevant to minimizing caries risk throughout the life course.
Publisher: Cambridge University Press (CUP)
Date: 07-2005
DOI: 10.1079/BJN20051448
Abstract: Consistent information on the non-milk extrinsic sugars (NMES) content of foods and the NMES intake by the population is required in order to allow comparisons between dietary surveys. A critical appraisal of methods of NMES estimation was conducted to investigate whether the different published methods for estimating the NMES content of foods lead to significantly different values for the dietary intake of NMES by children and to consider the relative practicality of each method. NMES values of foods were calculated using three different published descriptions of methods of NMES estimation, and the values were compared within food groups. Dietary intake values for English children aged 11–12 years were calculated using each method and compared in terms of overall NMES intake and the contribution of different food groups to NMES intake. There was no significant difference in the dietary intake of NMES in children between the method used in the National Diet and Nutrition Surveys (NDNS) (81·9 g/d 95 % CI 79·0, 84·7) and a method developed by the Human Nutrition Research Centre (84·3 g/d 95 % CI 81·4, 87·2) at Newcastle University, UK, although the latter gave slightly higher values. An earlier method used by the Ministry of Agriculture, Food and Fisheries gave significantly higher values than the other two methods (102·5 g/d 95 % CI 99·3, 105·6 P ·05). The method used in the NDNS surveys and the method used by the Human Nutrition Research Centre at Newcastle University are both thorough and detailed methods that give consistent results. However, the method used in the NDNS surveys was more straightforward to apply in practice and is the best method for a single uniform approach to the estimation of NMES.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2015
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-040397
Abstract: Care homes provide nursing and social care for older people who can no longer live independently at home. In the UK, there is no consistent approach to how information about residents’ medical history, care needs and preferences are collected and shared. This limits opportunities to understand the care home population, have a systematic approach to assessment and documentation of care, identifiy care home residents at risk of deterioration and review care. Countries with standardised approaches to residents’ assessment, care planning and review (eg, minimum data sets (MDS)) use the data to understand the care home population, guide resource allocation, monitor services delivery and for research. The aim of this realist review is to develop a theory-driven understanding of how care home staff implement and use MDS to plan and deliver care of in idual residents. A realist review will be conducted in three research stages. Stage 1 will scope the literature and develop candidate programme theories of what ensures effective uptake and sustained implementation of an MDS. Stage2 will test and refine these theories through further iterative searches of the evidence from the literature to establish how effective uptake of an MDS can be achieved. Stage 3 will consult with relevant stakeholders to test or refine the programme theory (theories) of how an MDS works at the resident level of care for different stakeholders and in what circumstances. Data synthesis will use realist logic to align data from each eligible article with possible context–mechanism–outcome configurations or specific elements that answer the research questions. The University of Hertfordshire Ethics Committee has approved this study (HSK/SF/UH/04169). Findings will be disseminated through briefings with stakeholders, conference presentations, a national consultation on the use of an MDS in UK long-term care settings, publications in peer-reviewed journals and in print and social media publications accessible to residents, relatives and care home staff. CRD42020171323 this review protocol is registered on the International Prospective Register of Systematic Reviews.
Publisher: Cambridge University Press (CUP)
Date: 04-2007
DOI: 10.1017/S1368980007249729
Abstract: Dietary surveys of 11- to 12-year-old Northumbrian children in 1980 and 1990 revealed that consumption of non-milk extrinsic sugars (NMES) was 16–17% of energy intake. This study reports dietary sugars consumption in 2000 and compares it with data collected in 1980 and 1990, using identical methods. A repeat cross-sectional dietary survey of children aged 11–12 years attending the same schools as in the 1980 and 1990 surveys. Seven middle schools in south Northumberland. All children aged 11–12 years old attending the seven schools. Food consumption was recorded using two 3-day diet diaries. Food composition tables were used to calculate energy and nutrient intakes. NMES, and milk and intrinsic sugars were calculated using previously described methods. The numbers of children completing the surveys in 1980, 1990 and 2000 were 405, 379 and 424, respectively ~60–70% of eligible children. Total sugars provided 22% of energy consistently over the three surveys. NMES consumption in 2000 provided 16% of energy compared with 16% in 1980 and 17% in 1990. Sources of NMES changed over the three surveys. NMES from soft drinks doubled from 15 to 31 g day − 1 , and from breakfast cereals increased from 2 to 7 g day − 1 over the 20 years. Confectionery and soft drinks provided 61% of NMES. Over 20 years, the proportion of energy from fat decreased by 5% and from starch increased by 4%, creating a welcome tilt in the fat–starch see-saw, without an adverse effect on sugars intake. Consumption of NMES in 2000 was substantially higher than recommended, and there has been little change over 20 years. Continued and coordinated efforts are required at a national, community and in idual level to reduce the intake of NMES.
Publisher: Oxford University Press (OUP)
Date: 26-10-2015
Publisher: Public Library of Science (PLoS)
Date: 27-01-2016
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.BEEM.2005.04.008
Abstract: Childhood obesity is a complex disease with different genetic, metabolic, environmental and behavioural components that are interrelated and potentially confounding, thus making causal pathways difficult to define. Given the tracking of obesity and the associated risk factors, childhood is an important period for prevention. To date, evidence would support preventative interventions that encourage physical activity and a healthy diet, restrict sedentary activities and offer behavioural support. However, these interventions should involve not only the child but the whole family, school and community. If the current global obesity epidemic is to be halted, further large-scale, well-designed prevention studies are required, particularly within settings outside of the USA, in order to expand the currently limited evidence base upon which clinical recommendations and public health approaches can be formulated. This must be accompanied by enhanced monitoring of paediatric obesity prevalence and continued support from all stakeholders at global, national, regional and local levels.
Publisher: SAGE Publications
Date: 14-02-2019
Abstract: A systematic review of evidence on the impact of modifiable risk factors on early childhood caries (ECC) was conducted to inform recommendations in a World Health Organization manual on ECC prevention. To systematically review published evidence pertaining to the effect of modifiable risk factors on ECC. Twelve questions relating to infant feeding, diet, oral hygiene, and fluoride were addressed, as prioritized by a World Health Organization expert panel. Questions pertaining to the use of fluoride toothpaste were excluded due to its proven efficacy. The target population was children aged <72 mo. Data sources included Medline, Embase, CINAHL, and PubMed, and all human epidemiologic studies were included. The highest level of evidence was used for evidence synthesis and, where possible, meta-analysis. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, with evidence assessed via the GRADE method. Of the 13,831 papers identified, 627 were screened in duplicate of these, 139 were included. The highest-level evidence indicated that breastfeeding ≤24 mo does not increase ECC risk but suggested that longer-duration breastfeeding increases risk (low-quality evidence). Low-quality evidence indicated increased risk associated with consumption of sugars in bottles. Only 1 study had data on the impact of sugars in complementary foods, which increased risk. Moderate-quality evidence showed a benefit of oral health education for caregivers (odds ratio, 0.39 95% CI, 0.19 to 0.80, The best available evidence indicates that breastfeeding up to 2 y of age does not increase ECC risk. Providing access to fluoridated water and educating caregivers are justified approaches to ECC prevention. Limiting sugars in bottles and complementary foods should be part of this education. This research is being used by the World Health Organization in developing a toolkit on the prevention and management of early childhood caries. The information will guide 1) governments in developing national oral health plans and 2) clinicians when providing preventive advice, including that regarding infant feeding practices. It will help ensure that advice is in line with current World Health Organization guidelines and the best available evidence.
Publisher: Public Library of Science (PLoS)
Date: 25-01-2018
Publisher: SAGE Publications
Date: 18-03-2022
DOI: 10.1177/00220345221082918
Abstract: An update of the systematic review of evidence on the association between amount of sugars intake and dental caries, as well as on the effect of restricting sugars intake to % and % energy (E) on caries, was conducted, almost 10 y since the review that informed the World Health Organization (WHO) Guideline on Sugars. The aim was to systematically review epidemiological data published from 2011 to 2020 on the amount of sugars consumption and levels of caries and to report the findings for adults and children. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Scopus, and Google Scholar. Eligible studies reported the amount of sugars and caries, measured as prevalence, incidence, or severity. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Risk of bias was assessed using the Office of Health Assessment and Translation tool. Vote counting and harvest plots provided the basis for evidence synthesis. From 488 new papers identified, 23 studies were eligible: 4 cohort, 1 case-controlled, 12 cross-sectional, and 6 ecological. Eleven of 15 studies in children and 6 of 8 studies in adults reported at least 1 positive association between sugars and caries. Six of 7 studies in children and 4 of 4 studies in adults, with data enabling comparison of caries levels with sugars intakes %E and %E, showed lower caries when sugars intake was %E. Amalgamating with original studies yielded 64 of 78 studies showing at least 1 positive association, 20 of 78 a null association, and 3 of 78 a negative association between sugars and caries. GRADE profiles of new and original cohort data confirmed “moderate-quality” evidence that caries is lower when sugars intake is %E. Furthermore, new cohort data upgraded the quality of evidence (from “very low” to “low”) for lower caries when free sugars are %E. The findings support and strengthen original evidence underpinning the WHO recommendations for sugars.
Publisher: Elsevier BV
Date: 08-2012
DOI: 10.1016/J.JDENT.2012.04.025
Abstract: In order to fully assess the impact of prosthetic rehabilitation and to formulate appropriate dietary advice, in-depth information about patients' experiences of eating with dentures is needed. The objective of this study was to develop and validate a questionnaire that accurately reflected the real concerns of patients with dental prostheses about the aspects of their life related to eating, using detailed information derived from qualitative interviews with patients. Themes around factors related to eating with dentures were derived from interviews with patients (n=66) with either implant-supported mandibular over-dentures or conventional dentures. The themes were used to design a self-completed questionnaire with questions scored on a visual analogue scale and additionally questions answered using free text. The content and face validity of the questionnaire was tested on a different group of patients (n=10) with implant-supported mandibular over-dentures ('implant-supported') or conventional dentures. Test-retest reliability analysis was conducted on a further group of 30 patients (n=15 implant-supported n=15 conventional dentures). A questionnaire has been developed with 33 questions scored on a visual analogue scale and 31 open questions designed to collect further information as free text. Themes identified were around social, emotional and practical issues about eating. The instrument has good internal reliability with a Cronbach alpha values of 0.86-0.95 and good test-retest reliability with intra-class correlation coefficients 0.87-0.92 across the domains. A patient-based instrument has been developed to measure emotional and social issues related to eating with dentures (ESIRE questionnaire). The questionnaire will be a useful tool in future trials of prosthetic rehabilitation.
Publisher: Royal College of Psychiatrists
Date: 04-01-2019
DOI: 10.1192/BJB.2018.107
Abstract: The Prime Minister's challenge on dementia called for improved dementia diagnosis rates, based on assumptions of benefit to in iduals and those who care for them. Subsequent policies have led to increased target drives for clinical practice to achieve early diagnosis of dementia through intense case identification. However, the current evidence base and treatment options do not support screening for dementia, and there is little empirical evidence that such intensive case identification and early diagnosis for dementia is justified without a better understanding of the benefits, costs and potential harms to in iduals and services. None.
Publisher: Public Library of Science (PLoS)
Date: 20-12-2016
Publisher: Public Library of Science (PLoS)
Date: 04-02-2016
Publisher: Springer Science and Business Media LLC
Date: 25-07-2008
Abstract: To determine the opinions and attitudes of general dental practitioners and hygienists towards the role of nutrition in periodontal health. The study was completed by general dental practitioners and dental hygienists throughout the UK. A questionnaire was sent out with the British Dental Journal and BDA News together with explanatory information about the study. Postage was pre-paid for replies. Eight hundred and seventy-nine questionnaires were completed. Sixty-six percent of respondents believed nutrition plays a role in periodontal health. Dietary factors that were considered most important were vitamin C (70%), fruit and vegetables (64%) and antioxidant vitamins (45%). Forty-four percent had recommended nutrition supplements to their patients, with multivitamin and mineral supplements (37%) and vitamin C (30%) the most popular. Eighty-two percent of respondents sourced information from dental journals. Qualitative data highlighted uncertainty amongst respondents about the evidence base around nutrition and periodontal health and a lack of training opportunities. A majority of dentists consider that nutrition and dietary factors play a role in maintaining periodontal health. However, there was a need to increase awareness of the current state of the evidence for a role of nutrition in maintaining periodontal health. Concern regarding lack of an evidence base for the role of nutrition in the treatment of periodontal diseases suggests a need for further research into the therapeutic role of nutrition in periodontal disease management.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sarah Kelly.