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Background: Collaborative working between academic institutions and those who provide health and social care has been identified as integral in order to produce acceptable, relevant, and timely research, and for outputs to be useful and practical to implement. The ExCHANGE Collaboration aims to bring together researchers and people working, living in and visiting care homes to build capacity, share and mobilise knowledge, and identify key areas for future research. This paper describes an embedded, formative, realist and theory-driven evaluation which aims to gather information about how successful the ExCHANGE Collaboration is perceived to be in achieving its aims. An existing realist programme theory from the literature – Closer Collaboration – will be supplemented by two substantive theories: Co-production and Knowledge Brokering. This will result in an initial programme theory which will be tested by this formative evaluation to refine understanding of how the ExCHANGE Collaboration works. Methods: The evaluation will employ mixed qualitative methods, including: analysis of documents such as feedback forms, Knowledge Broker journal/diary, event attendance records, risk and issues logs and other relevant paperwork gathered as part of project delivery; observations of events/activities; and interviews with care home providers and staff, care home residents, residents' family members, and researchers who are involved in the project (both project design/delivery, and also attendance or involvement in project activities/events). Framework Analysis will be used to interpret the data collected; analysis will be strategic, by focusing on particular key areas of importance in the developing theory of how the ExCHANGE Collaboration might achieve change. Results: The results of this study are expected to be published in 2022. Discussion: This evaluation will investigate how successful the ExCHANGE Collaboration is perceived to be in achieving its aims, in what way, in which contexts, and how this may differ for those involved. It will do this by testing an initial programme theory about how the collaboration works, for whom, under which circumstances, and in what way. Findings will be shared through written publication, an end of project learning event for those involved/interested in the project, and a lay summary to be made publically available. [ABSTRACT FROM AUTHOR]

Many have argued that the development of evidence-based policing (EBP) depends on those in law enforcement agencies receiving appropriate training in research methodologies and data analysis. Despite this, there are few detailed accounts of such training and its delivery. This paper describes and evaluates the contribution of training workshops for police officers and staff in driving forward EBP. The workshops, developed based on a model used in healthcare, sought to provide attendees with the knowledge, skills, and confidence to engage with research evidence during their work, and sat within a wider plan for organisational change within one force in England. We outline the development and delivery of the workshops, which were undertaken using an action research approach, and assess their impact including subsequent changes to practice. Finally, we consider the role these workshops played within organisational change, and reflect on how EBP can be promoted within academic-police collaborations. [ABSTRACT FROM AUTHOR]

Although the relationship between fundamental movement skills (FMS) and physical behaviors has been established, differences between countries are scarcely explored. The impact of the whole physical behavior composition, in relation to FMS, has yet to be investigated in 9-11 y children. The aims were to investigate the associations of substitution of physical behaviors with FMS score and to compare traditional linear regression and compositional data analysis and compare between England and Iran. Measures included accelerometer-derived activity (sleep (SL), sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) and FMS, using the TGMD-2, in 119 children (64 boys) from Iran (mean (±SD) age: 9.8 ± 0.3 y; BMI of 18.2 ± 3.3 kg/m 2 ) and 139 (61 boys) children from England (mean (±SD) age: 9.5 ± 0.6 y; BMI of 17.7 ± 3.1 kg/m 2 ). Isometric log-ratio multiple linear regression models were used to discern the association between FMS and the mean activity composition, and for new compositions, where fixed durations of time were reallocated from one behavior to another, while the remaining behaviors were unchanged. In physical behaviors as a composition, FMS was significantly associated in both ethnicities. English children responded significantly positively to adding 5 or more minutes LPA at the expense of SB (FMS unit change from 0.05 [0.01, 0.09] at 5 minutes to 0.72 [0.01, 1.34] at 60 minutes). Adding 10 minutes or more of SL, at the expense of SB, was associated with a significant, positive change in FMS in all children. Investigation is needed to understand the composition of SB and its potential influence on FMS development., (© 2020 The Authors. Scandinavian Journal of Medicine & Science in Sports Published by John Wiley & Sons Ltd.)

Objectives: Examination of current temporal trends and clinical management patterns of eating disorders (ED) in primary care is lacking. We aimed to calculate annual incidence rates of EDs in primary care by age, sex and deprivation. We also explored the care received through referrals, psychotropic prescriptions and associated secondary care service use., Participants and Settings: A retrospective electronic cohort study was conducted using the Clinical Practice Research Datalink in those aged 11-24 years between 2004 and 2014 in England (n=1 135 038)., Results: A total of 4775 individuals with a first ever recorded ED diagnosis were identified. The crude incidence rate was 100.1 per 100 000 person years at risk (95% CI 97.2 to 102.9). Incidence rates were highest in females (189.3 per 100 000 person years, 95% CI 183.7 to 195.0, n=4336), 16-20 years of age (141.0 per 100 000 person years, 95% CI 135.4 to 146.9, n=2348) and individuals from the least deprived areas (115.8 per 100 000 person years (95% CI 109.3 to 122.5, n=1203). Incidence rates decreased across the study period (incidence rate ratio (IRR) 0.6, 95% CI 0.5 to 0.8), particularly for individuals with bulimia nervosa (IRR 0.5, 95% CI 0.3 to 0.7) and from the most deprived areas (IRR 0.5, 95% CI 0.4 to 0.7). A total of 17.4% (95% CI 16.3 to 18.5, n=831) of first ever recorded ED cases were referred from primary to secondary care. 27.1% (95% CI 25.9 to 28.4, n=1294) of individuals had an inpatient admission 6 months before or 12 months after an incident ED diagnosis and 53.4% (95% CI 52.0 to 54.9, n=2550) had an outpatient attendance. Antidepressants were the most commonly prescribed psychotropic medication., Conclusions: New ED presentations in primary care are reducing. Understanding the cause of this decrease (coding behaviours, changes in help-seeking or a genuine reduction in new cases) is important to plan services, allocate resources and deliver effective care., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Overactive bladder is a common condition that can be treated effectively in primary care by nurses. Supplementary nurse prescribing enables nurses with the appropriate qualification to provide holistic programmes of care for individuals with an overactive bladder. This article provides a summary of the current position of nurse prescribing in England and how it can be applied to this aspect of continence care.

Many nurses are extending their roles in line with the Government's NHS Plan. In the outpatient hysteroscopy service in one trust nurses are now undertaking diagnostic hysteroscopy. This has improved continuity of care for patients and allowed the nurses to combine their traditional nursing role of providing information and reassurance with performing the procedure.

Aim: To investigate the perceptions and experience of Pakistani women who have urinary incontinence problems., Method: Data were collected from a sample group of six Pakistani women with incontinence problems. A female Miripuri Punjabi speaker conducted and recorded semi-structured interviews with the women. The interviewer interpreted these recordings onto another tape. Data were then analysed and categorised., Results: The women had low self-esteem and also felt sinful because of their incontinence. Muslim women are obliged to perform ritual cleansing and prayer five times a day. If they pass urine or faeces, or experience incontinence, they become unclean and prayer is denied until the act of ritual cleansing is repeated. The women used prayer to relieve stress caused by incontinence, but being unclean denied them this comfort, thus increasing stress. Some participants had become secretive and isolated. The women had developed three strategies to help them live with incontinence: risk reduction to reduce the number of incidents; management, which focused on coping with incontinent episodes; and problem-sharing with other women. Their inhibitions and language limitations prevented them from disclosing their problems clearly to health professionals and fully understanding advice they received. These inhibitions were reduced when they were treated by a female health professional. Having an interpreter present also increased satisfaction with treatment., Conclusion: To provide an effective continence service to Pakistani women with incontinence, it is necessary for healthcare professionals to understand their cultural and religious identities.

Objectives: To audit interval from decision to delivery in urgent caesarean section to determine whether the current standard of 30 minutes is achievable routinely; to determine whether delay leads to an excess of admissions to special care., Design: Three audit cycles over four years followed by a continuous audit over 32 months., Setting: Large district general hospital delivering 5500 women each year., Participants: All women delivered by urgent caesarean section for abnormal fetal heart rate patterns, cord prolapse, failed instrumental delivery, or suspected placental abruption., Main Outcome Measures: Proportion of women delivered within 30 and 40 minutes of decision. Admission rates to special care by length of interval between decision and delivery., Results: In the continuous audit 478 of 721 (66.3%) women were delivered in 30 minutes and 637 (88.3%) within 40 minutes; 29 (4.0%) were undelivered at 50 minutes. If the woman was taken to theatre in 10 minutes, 409 of 500 (81.8%) were delivered in 30 minutes and 495 (97%) in 40 minutes. There was no significant difference in the proportion of babies born at 36 weeks or later who were admitted to special care, when analysed by interval from decision to delivery. 36/449 (8%) babies with an interval from decision to delivery of less than 30 minutes were admitted to special care and 3/23 (13%) with an interval of more than 50 minutes were admitted., Conclusions: The current recommendations for the interval between decision and delivery are not being achieved in routine practice. Failure to meet the recommendations does not seem to increase neonatal morbidity.