ORCID Profile
0000-0002-4123-8248
Current Organisations
University of Aberdeen
,
Københavns Universitet
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Publisher: BMJ
Date: 10-2023
Publisher: BMJ
Date: 17-08-2010
DOI: 10.1136/BMJ.C3838
Publisher: Public Library of Science (PLoS)
Date: 11-01-2013
Publisher: Royal College of General Practitioners
Date: 02-2009
Publisher: Royal College of General Practitioners
Date: 09-2009
Publisher: Springer Science and Business Media LLC
Date: 09-08-2012
Publisher: BMJ
Date: 03-2007
Publisher: Springer Science and Business Media LLC
Date: 19-12-2018
Publisher: BMJ
Date: 17-02-2023
DOI: 10.1136/ARCHDISCHILD-2022-324986
Abstract: There has been a rise in urgent paediatric hospital admissions and interventions to address this are required. To systemically review the literature describing community (or non-hospital)-based interventions designed to reduce emergency department (ED) visits or urgent hospital admissions. MEDLINE, Embase, OVIS SP, PsycINFO, Science Citation Index Expanded/ISI Web of Science (1981–present), the Cochrane Library database and the Database of Abstracts of Reviews of Effectiveness. Randomised controlled trials (RCTs) and before-and-after studies. In iduals aged years. Papers were independently reviewed by two researchers. Data extraction and the Critical Appraisals Skills Programme checklist was completed (for risk of bias assessment). Seven studies were identified. Three studies were RCTs, three were a comparison between non-randomised groups and one was a before-and-after study. Interventions were reconfiguration of staff roles (two papers), telemedicine (three papers), pathways of urgent care (one paper) and point-of-care testing (one paper). Reconfiguration of staff roles resulted in reduction in ED visits in one study (with a commensurate increase in general practitioner visits) but increased hospital admissions from ED in a second. Telemedicine was associated with a reduction in children’s admissions in one study and reduced ED admissions in two further studies. Interventions with pathways of care and point-of-care testing did not impact either ED visits or urgent admissions. New out-of-hospital models of urgent care for children need to be introduced and evaluated without delay. CRD42021274374.
Publisher: BMJ
Date: 02-08-2022
DOI: 10.1136/ARCHDISCHILD-2021-321884
Abstract: Admission rates are rising despite no change to burden of illness, and interventions to reduce unscheduled admission to hospital safely may be justified. To systematically examine admission prevention strategies and report long-term follow-up of admission prevention initiatives. MEDLINE, Embase, OVID SP, PsychINFO, Science Citation Index Expanded/ISI Web of Science, The Cochrane Library from inception to time of writing. Reference lists were hand searched. Randomised controlled trials and before-and-after studies. In iduals aged years. Studies were independently screened by two reviewers with final screening by a third. Data extraction and the Critical Appraisals Skills Programme checklist completion (for risk of bias assessment) were performed by one reviewer and checked by a second. Twenty-eight studies were included of whom 24 were before-and-after studies and 4 were studies comparing outcomes between non-randomised groups. Interventions included referral pathways, staff reconfiguration, new healthcare facilities and telemedicine. The strongest evidence for admission prevention was seen in asthma-specific referral pathways (n=6) showing 34% (95% CI 28 to 39) reduction, but with evidence of publication bias. Other pathways showed inconsistent results or were insufficient for wider interpretation. Staffing reconfiguration showed reduced admissions in two studies, and shorter length of stay in one. Short stay admission units reduced admissions in three studies. There is little robust evidence to support interventions aimed at preventing paediatric admissions and further research is needed.
Publisher: BMJ
Date: 09-09-2022
DOI: 10.1136/ARCHDISCHILD-2022-324171
Abstract: This study identified the referral source for urgent short-stay admissions (SSAs) and compared characteristics of children with SSA stratified by different referral sources. Routinely acquired data from urgent admissions to Scottish hospitals during 2015–2017 were linked to data held by the three referral sources: emergency department (ED), out-of-hours (OOH) service and general practice (GP). There were 171 039 admissions including 92 229 (54%) SSAs. Only 171 (19%) of all of Scotland’s GP practices contributed data. Among the subgroup of 10 588 SSAs where GP data were available (11% all SSA), there was contact with the following referral source on the day of admission: only ED, 1853 (18%) only GP, 3384 (32%) and only OOH, 823 (8%). Additionally, 2165 (20%) had contact with more than one referral source, and 1037 (10%) had contact with referral source(s) on the day before the admission. When all 92 229 SSAs were considered, those with an ED referrer were more likely to be for older children, of white ethnicity, living in more deprived communities and diagnosed with asthma, convulsions or croup. The odds ratio for an SSA for a given condition differed by referral source and ranged from 0.07 to 1.9 (with reference to ED referrals). This study yielded insights and potential limitations regarding data linkage in a healthcare setting. Data coverage, particularly from primary care, needs to improve further. Evidence from data linkage studies can inform future intervention designed to provide safe integrated care pathways.
Publisher: Public Library of Science (PLoS)
Date: 16-12-2022
DOI: 10.1371/JOURNAL.PONE.0278777
Abstract: Numbers of urgent short stay admissions (SSAs) of children to UK hospitals are rising rapidly. This paper reports on experiences of SSAs from the perspective of parents accessing urgent care for their acutely unwell child and of health professionals referring, caring for, or admitting children. A qualitative interview study was conducted by a multi-disciplinary team with patient and public involvement (PPI) to explore contextual factors relating to SSAs and better understand pre-hospital urgent care pathways. Purposive s ling of Health Board areas in Scotland, health professionals with experience of paediatric urgent care pathways and parents with experience of a SSA for their acutely unwell child was undertaken to ensure maximal variation in characteristics such as deprivation, urban-rural and hospital structure. Interviews took place between Dec 2019 and Mar 2021 and thematic framework analysis was applied. Twenty-one parents and forty-eight health professionals were interviewed. In the context of an urgent SSA, the themes were centred around shared outcomes of care that matter. The main outcome which was common to both parents and health professionals was the importance of preserving the child’s safety. Additional shared outcomes by parents and health professionals were a desire to reduce worries and uncertainty about the illness trajectory, and provide reassurance with sufficient time, space and personnel to undertake a period of skilled observation to assess and manage the acutely unwell child. Parents wanted easy access to urgent care and, preferably, with input from paediatric-trained staff. Healthcare professionals considered that it was important to reduce the number of children admitted to hospital where safe and appropriate to do so. The shared outcomes of care between parents and health professionals emphasises the potential merit of adopting a partnership approach in identifying, developing and testing interventions to improve the acceptability, safety, efficiency, and cost-effectiveness of urgent care pathways between home and hospital.
Publisher: BMJ
Date: 09-2023
Publisher: BMJ
Date: 2022
DOI: 10.1136/BMJPO-2021-001324
Abstract: Low language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is universally offered in many countries, but there has been little evaluation of assessment tools. We planned to compare the screening performance of two commonly used language assessment instruments. A pragmatic diagnostic accuracy study was carried out in five areas of England comparing the performance of two screening tools (Ages and Stages Questionnaire (ASQ) and Sure Start Language Measure (SSLM)) against a reference test (Preschool Language Scale, 5th edition). Results were available for 357 children aged 23–30 months. The ASQ Communication Scale using optimal cut-off values had a sensitivity of 0.55, a specificity of 0.95 and positive and negative predictive values of 0.53 and 0.95, respectively. The SSLM had corresponding values of 0.83, 0.81, 0.33 and 0.98, respectively. Both screening tools performed relatively poorly in families not using English exclusively in the home. The very widely used ASQ Communication Scale performs poorly as a language screening tool, missing over one-third of cases of low language ability. The SSLM performed better as a screening tool.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: Springer Science and Business Media LLC
Date: 29-09-2023
Publisher: BMJ
Date: 16-10-2018
DOI: 10.1136/BMJSTEL-2018-000341
Abstract: The study of decision making in complex naturalistic environments poses several challenges. In response to these, video-stimulated cued-recall-debrief was developed. It involves an in idual wearing a head-mounted camera which records a task from their point of view. Afterwards, footage captured is reviewed along with a facilitated debrief to help externalise cognitive processes. In theory, motion, audio and visual cues generate a high level of experiential immersion which helps the expert to articulate previously hidden thoughts and actions. To examine the current evidence for video-stimulated cued-recall-debrief as a means of explicating expert thoughts and feelings in complex tasks in a range of environments. MEDLINE, EMBASE, Education Resources Information Center, SPORTDiscus, PsycINFO and Google Scholar were searched for articles containing the key terms ‘cued-recall (debrief)’, ‘decision making’, ‘skills’ and ‘video recording’. Studies were included if they examined the following outcomes: (1) feasibility, (2) extent of experiential immersion, (3) ability to generate unique insight into decision-making processes and (4) current applications. 1831 articles were identified initially, and 9 studies were included in the final review. Video-stimulated cued-recall-debrief is associated with a high level of experiential immersion and generates between two and four times the number of recollections compared with free recall. It can be used to build models of cognitive activity and to characterise the way in which more and less skilled in iduals tend to think and feel. The technique could be used to explicate expertise within medicine: these insights into performance could be used as a training tool for other practitioners. CRD42017057484.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/13814780802632683
Abstract: Antidepressant prescribing has dramatically increased in Scotland, and the cause is unknown. To investigate if the increase in antidepressant prescribing coincided with a reduction in prescribing of anxiolytics and hypnotics to investigate this relationship at practice level and to explore whether general practitioners (GPs) explain the increase by their increased use for anxiety. analysis of routine prescribing data and interviews with GPs. Scottish general practices. 942 practices included in the analysis. Sixty-three GPs in 30 practices completed interviews. Quantity of antidepressants, anxiolytics, and hypnotics prescribed. Relationship at practice level between anxiolytic/hypnotic and antidepressant prescribing. Spontaneous comments by GPs about prescribing antidepressants for anxiety. Antidepressant prescribing increased from 28.9 million defined daily doses (DDDs) in 1992/3 to 128.3 million in 2004/5. Anxiolytic/hypnotic prescribing fell from 64.2 million to 55.1 million DDDs. There was a weak, positive correlation between levels of antidepressant and anxiolytic/hypnotic prescribing (+0.084, p=0.010). GPs treated anxiety with antidepressants, although many described an overlap between anxiety and depression. Some spontaneously identified a relationship with benzodiazepine prescribing when asked to explain the increase in antidepressant prescribing. A small part of the increase in antidepressant prescribing is due to substitution for benzodiazepines to treat anxiety.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Philip Wilson.