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Objective: Qualitative research is increasingly valued as part of the evidence for policy and practice, but how it should be appraised is contested. Various appraisal methods, including checklists and other structured approaches, have been proposed but rarely evaluated. We aimed to compare three methods for appraising qualitative research papers that were candidates for inclusion in a systematic review of evidence on support for breast-feeding. Method: A sample of 12 research papers on support for breast-feeding was appraised by six qualitative reviewers using three appraisal methods: unprompted judgement, based on expert opinion; a UK Cabinet Office quality framework; and CASP, a Critical Appraisal Skills Programme tool. Papers were assigned, following appraisals, to 1 of 5 categories, which were dichotomized to indicate whether or not papers should be included in a systematic review. Patterns of agreement in categorization of papers were assessed quantitatively using κ statistics, and qualitatively using cross-case analysis. Results: Agreement in categorizing papers across the three methods was slight (κ =0.13; 95% CI 0.06–0.24). Structured approaches did not appear to yield higher agreement than that by unprompted judgement. Qualitative analysis revealed reviewers' dilemmas in deciding between the potential impact of findings and the quality of the research execution or reporting practice. Structured instruments appeared to make reviewers more explicit about the reasons for their judgements. Conclusions: Structured approaches may not produce greater consistency of judgements about whether to include qualitative papers in a systematic review. Future research should address how appraisals of qualitative research should be incorporated in systematic reviews. [ABSTRACT FROM AUTHOR]

Within multi-national research collaborations, power dynamics often shape who is involved in which parts of the research process. The analysis phase of research has historically been framed as requiring expert perspective, excluding national or local researchers whose role is often limited to collecting data and transferring it to others to analyze. In this paper, we describe and reflect on the process of collaborative coding across a multi-national team based in Lebanon and the United Kingdom, as part of a broader approach to co-production. We explore the value and benefit of collaborative coding, reflecting on how coding together enabled greater inclusion, teamwork, improved analysis as well as improved future data collection. We also discuss the technical and logistical challenges we faced in coding within a team and using internet-based software, including the complications involved in navigating power dynamics between researchers and coming to final decisions about codes. Over time, we found collaborative coding became a smoother process, however working in this way is not straight-forward. Our paper contributes a reflexive analysis on the power dynamics and decision-making complexities involved in collaborative coding. It emphasizes the importance of investing in interpersonal relationships over time and prioritizing less-centralized decision-making within research collaborations. [ABSTRACT FROM AUTHOR]

Background: Transfers from hospital or 'hospice palliative care units' to care homes for end-of-life care are an increasingly common part of clinical practice but are a source of anxiety and distress for patients, relatives and healthcare professionals. Aim: To understand the experiences of patients discharged to care homes for end-of-life care. Design: Systematic review and narrative synthesis of the UK literature concerning inpatient transfer from a hospital or hospice palliative care unit to a care home for end-of-life care. Results: The published literature is very limited: only three papers and one conference abstract were identified, all of low quality using Gough's weight of evidence assessment. No papers examined transfer from hospital: all were of transfers from hospices and were retrospective case note reviews. Many patients were reported to have been negative or ambivalent about moving and experienced feelings of anxiety or abandonment when transferred. Relatives were often either vehemently opposed or ambivalent. Although some came to accept transfer, others reported the transfer to have seriously affected their loved one's quality of life and that the process of finding a care home had been traumatic. No studies investigated patients' views prospectively, the views of staff or the processes of decision-making. Conclusion: The UK literature is very limited, despite such transfers being an increasingly common part of clinical practice and a source of concern to patients, relatives and staff alike. Further research is urgently needed in this area, especially studies of patients themselves, in order to understand their experiences and views. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Ego Resiliency Scale-Revised (ER89-R). Though support exists for a multidimensional conceptualisation using classical test theory approaches (i.e., a higher-order model comprising Openness to Life Experiences and Optimal Regulation factors), this measure has not been subjected to Rasch analysis. Accordingly, this paper evaluated the higher-order model via confirmatory factor analysis (CFA) before assessing Openness to Life Experiences and Optimal Regulation components using Rasch analysis. CFA, using a general population sample (N = 2009), supported the higher-order factor structure. Openness to Life Experiences and Optimal Regulation scales met Rasch model assumptions. Specifically, good item/person fit and item/person reliability, and evidence of unidimensionality. Moreover, most items displayed gender invariance. Overall, findings supported the higher-order conceptualisation of the ER89-R, and indicated that the Openness to Life Experiences and Optimal Regulation scales are relatively useful measures of ego resiliency components in a general population sample. [ABSTRACT FROM AUTHOR]

Background: The Health of the Nation Outcomes Scales for people with Learning Disabilities (HoNOS-LD) is an 18-item measure which provides a structured and standardized approach to rating various clinical and psychosocial outcomes and has been in use nationally since 2002. Aims: To revise and improve the HoNOS-LD's utility in contemporary intellectual disability (ID) services whilst retaining its original objectives and five-point severity ratings. Method: ID clinicians were invited to complete an online survey, rating each item on the existing measure for being fit for purpose, identifying issues and suggesting improvements based on their experience of using the HoNOS-LD in practice. Scales were then assessed and revised sequentially; survey responses were used to inform discussion and revisions to the HoNOS-LD by the Advisory Board. Results: A total of 75 individuals replied. Respondents had used HoNOS-LD for an average of 8.0 years (S.D. 5.28 years) and 88% found the scale to be useful in their practice. On average, respondents used HoNOS-LD ratings to inform care 42.4% of the time (S.D. 33.5%). For each scale there was a significant negative correlation between the percentage of positive/very positive respondent ratings and the number of changes proposed. Common changes included simplifying terms, reducing ambiguity and replacing anachronistic language. Conclusion: The changes outlined in this paper are based on the advisory group's expert consensus. These changes are intended to improve reliability and validity but now need empirical testing as well as review by service users. [ABSTRACT FROM AUTHOR]

In societies where solidarity and cohesion are experienced primarily via shared national identity, immigration raises questions regarding how non-nationals can gain social membership, so that they are not perceived as undermining solidarity and cohesion. A key aspect of immigrants' experiences is thus whether they embrace the national identity of the destination country. Governments in many destination countries increasingly seek to ensure that they do, via policy initiatives that impose specific requirements for gaining legal citizenship: applicants for naturalization are commonly required to pass a test (ensuring sufficient knowledge of e.g. 'life in the UK') and attend a ceremony that includes a pledge of loyalty. This paper considers whether the British version of these requirements is effective in leading immigrants to embrace British national identity. It uses data drawn from the UK household panel survey ('Understanding Society') to facilitate a comparison between those immigrants who become citizens and those who do not. The main finding is that those who become citizens significantly increase their attachment to British identity. Whether they do so specifically because of the policy requirements (the test and ceremony) is debatable, but it seems clear that these requirements do not inhibit development of a sense of Britishness among the immigrants who meet them. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the use of the Hirsch's (h)-index in measuring the quality of the output of health services researchers. Topics discussed include the increase in the h-index of qualitative researchers and statisticians, the calculation of pairwise Spearman's rank correlations for the number of publications, number of citations and 10-index and the results of a quantile regression to predict the median, 90th and 95th quantiles for h-index.

The involvement of people living with dementia in research has traditionally been located in the realms of 'subject' or 'participant'. However, there has been an increase in demand for greater transparency by academic bidding teams (particularly within the UK) in demonstrating how people with a lived experience have been and will be involved in the research process. Located within the Economic and Social Research Council/National Institute for Health Research (ESRC/NIHR)-funded Neighbourhoods and Dementia Study (2014–2019), led by The University of Manchester (UK), this paper outlines the development of the CO-researcher INvolvement and Engagement in Dementia (COINED) Model, which was co-produced alongside three independent groups of people living with dementia: Open Doors, the Scottish Dementia Working Group and EDUCATE. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this clinical audit was to assess patient demographics, outcomes and experience with care in patients who received acupuncture in a private practice setting in the United Kingdom. Methods: Demographic and clinical data were extracted from patients' records over a 7-year period. The Measure Yourself Medical Outcomes Profile (MYMOP) questionnaire and an adapted Patient Global Impression of Change (PGIC) scale were used routinely to monitor patient outcomes over an 18-month period. Finally, a retrospective questionnaire was used to assess patient beliefs regarding treatment effectiveness, adverse events and overall experience with care. Patients not providing consent or known to be deceased were excluded. Results: Data were collected for 306 patients presenting with 376 separate health complaints, 58% of which were musculoskeletal. Follow-up outcomes (MYMOP scores (n = 51) and PGIC scale responses (n = 50)) showed a clinically significant improvement compared to baseline for the majority of health complaints (93% of PGIC scores were 'improved' and 79% MYMOP demonstrated > 1 point change). Total mean MYMOP severity scores were reduced by almost 50% (p < 0.001) after 1–4 weeks, and this was sustained in the medium-to-long term. There was a strong negative correlation (r = −0.767, p < 0.001) between the MYMOP and PGIC scores. A total of 118 health complaints were reported by 85/255 patients who responded to a retrospective questionnaire. Over 84% of patients believed that the treatments they received were 'effective' at addressing their health complaints. Seven minor adverse events were reported and four patients experienced negative treatment outcomes. Conclusions: Although musculoskeletal conditions were the most common, this audit found that patients sought treatment for a wide range of predominantly chronic health complaints, for many of which there is a currently a lack of quality evidence to support the use of acupuncture. Overall, the small sample of patients who responded to outcome questionnaires reported clinically meaningful and sustained improvements. [ABSTRACT FROM AUTHOR]

Aims and objectives/purpose/research questions: This paper investigates whether sustained immersion in a dominant second-language (L2) environment alters morphological processing strategies compared to those of L1-immersed speakers. Furthermore, we assess the methodological usefulness of a language-mode task in light of the validity of conducting native processing research on L2-immersed speakers. Design/methodology/approach: We use the design and stimuli of a previous long-lag visual lexical decision task conducted with native German speakers in Germany and use this group as a control. Thirty-two native German speakers resident in the UK (>2 years; minimal day-to-day German use) participated in two experimental sessions (one containing a 20-minute conversation task in German). Data and analysis: The data shows clear differences between facilitation patterns of L1 and L2-immersed participants. L2-immersed speakers display decreased sensitivity to subtle morphological differences as well as facilitation in a form condition similar to effects seen in L2 processing. Lexical decisions of pseudowords based on plausibility, however, remain similar. While the pre-experiment language-mode task resulted in overall faster responses, there was no effect on processing patterns. Findings/conclusions: L1 morphological processing is affected by continued exposure to a dominant second language with sensitivity to the internal structure or differences of morphologically complex items decreasing. The attrition group shows certain similarities to L2 morphological processing. Our findings also call for caution in the recruitment of L2-immersed experiment participants. Originality: Research on morphological processing in language attrition is scarce and no previous work has examined complex derived words. The addition of a principled manipulation of the pre-experiment task is also uncommon. Significance/implications: The possible similarity of L1-attrition and L2-learner processing challenges the concept of 'native' processing and the notion of 'nativeness' as a stable property. Further comparison of these populations may lead to a more thorough understanding of the adaptability of our processing system. [ABSTRACT FROM AUTHOR]

Peer research has the potential to empower young people to participate in research by minimising power imbalances between researchers and participants; this may reduce bias and promote improved understanding to inform policy and practice. However, these benefits are not automatic; the relative inexperience of peer researchers adds layers of complexity to the research process. Moreover, the validity of findings from research adopting less traditional methods may be questioned and policy makers may be cautious about accepting this evidence, thus limiting its contribution and impact. This paper explores the advancement of participatory peer researcher methodology in research with children in and leaving care and ethical, practical and data quality issues that arose in two studies exploring young people’s transitions from care to adulthood. It concludes that the peer research methodology can yield rich data but that adequate resources and effective research management are crucial. The authors also caution against a reductionist approach that privileges peer research methodology above other methods of inquiry in the study of transitions from care to adulthood. [ABSTRACT FROM AUTHOR]

The article presents a research paper on the use of adaptive equipment after a total knee replacement. Studied population include total knee replacement patients from a general hospital through the assessment from occupational therapy staff. Also evaluated are optimal functional outcomes after surgery.

This paper describes a test of Perceptual Control Theory (PCT), which views motor control as part of a process of controlling perceptual inputs rather than motor outputs. Sixteen undergraduate students ( M age = 19.9 yr.) were asked to control one of three different perceptual aspects of an animated display-a shape, a motion or a sequence-using the same motor output, a key press. Animation rate was varied while quality of control was measured in terms of the proportion of time that the perception was maintained in the goal state. The results showed that increased animation rate made it hardest to control the more complex perceptions (motion and sequence) even though the same output was used to control all perceptions. This result is consistent with PCT, which predicts that the temporal constraints on control are ultimately a function of the type of perception controlled rather than the type of output used to control it. [ABSTRACT FROM AUTHOR]

The National Health Service Staff Survey is an annual, England-wide survey of staff employed by National Health Service organisations. It is administered using online and paper questionnaires. Response rates have fallen over time, while the proportion of staff receiving the online version – which historically has a lower response rate – has increased. Three interventions to increase online response were tested using an experimental design: more reminders; change of signatory to the invitation to participate and concise messaging in the invitation. Thirteen thousand staff members in five National Health Service trusts received the online survey. Results were analysed using contingency tables and logistic regression to determine the effect of interventions independently and in combination. More reminders improved response by six percentage points (odds ratio 1.33, 95% CI 1.23–1.43) and concise messaging by two percentage points (odds ratio 1.08, 95% CI 1.00–1.17). Change of signatory had no statistically significant effect and neither did any combination of the interventions. Given that costs for the successful interventions were minimal, more reminders in combination with concise messaging are recommended as a strategy to improve online response to the survey. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate health professionals’ views about palliative care provision in prisons in the counties of Cumbria and Lancashire in the North West of England. Seventeen prison healthcare staff and nine specialist palliative care staff participated in semi-structured interviews and 16 prison healthcare staff completed a questionnaire designed to measure knowledge, skills and confidence in relation to palliative care. The findings highlighted tensions between the philosophies of care and custody, and the many challenges in providing palliative care in a custodial setting. This paper presents two illustrative case study examples, and suggests ways in which some of these challenges can be overcome in practice. [ABSTRACT FROM PUBLISHER]

This paper reports on data from the initial phase of a UK-wide study exploring life-limiting conditions (LLCs) in children where, because of their rarity, little is understood regarding the significant symptom challenges of families and care professionals who support them. In this initial phase, care professionals (n = 43) and families (n = 16) completed a survey to identify which rare LLCs present symptom challenges and which individual symptoms prove difficult to manage. Findings led to the prioritization of mucopolysaccharidoses, Batten Disease and leukodystrophy. Care professionals’ rationales for selecting these conditions included the presence of symptoms that are very difficult to manage, a requirement for additional clinical evidence to support symptom management, and the progressive nature of these diseases where symptoms frequently change and are difficult to predict. Families identified symptoms such as behavioural difficulties, visual impairments and communication impairments as those being most difficult to manage and having most impact on quality of life for children and families. [ABSTRACT FROM PUBLISHER]

In economically developed countries there is a rapidly increasing number of older people living and dying in care homes. The relative isolation of nursing care homes from the development of palliative care, the poor retention and recruitment of staff, and the lack of medical cover, hinder the provision of quality end-of-life care. End-of-life care strategies internationally highlight the benefit of using tools to help improve end-of-life care in care homes. All seven private nursing care homes within one district in Scotland undertook to implement, as a package, two end-of-life care tools, namely, the Gold Standards Framework for Care Homes (GSFCH) and an adapted Liverpool Care Pathway for Care Homes (LCP). A model of high facilitation, visiting the homes every 10—14 days with significant in-house staff training, was used to implement the 18-month programme. The notes of 228 residents who had died prior to and during the project were examined, alongside a staff audit looking at the effect that the project had on practice. A nurse researcher undertook qualitative interviews of bereaved relatives, pre-/post-implementation. This paper reports the results of an in-depth evaluation of professional practices and residents outcomes. There was a highly statistically significant increase in use of Do Not Attempt Resuscitation (DNAR) documentation, advance care planning and use of the LCP. An apparent reduction in unnecessary hospital admissions and a reduction in hospital deaths from 15% deaths pre-study to 8% deaths post-study were also found. Further work is needed to assess the optimum input required for successful implementation. [ABSTRACT FROM PUBLISHER]

Wei, Lin and Weissfeld (WLW) have applied an elaboration of Cox's proportional hazards regression to the analysis of recurrent events data. This application is controversial and has attracted criticism in a piecemeal fashion over 15 years. A frequently raised concern is the method's 'risk set': each individual is considered to be at risk of all recurrent events from the start of the observation period. The WLW method often gives estimates that exceed those provided by alternative approaches. This paper investigates whether the estimates are a consequence of biased estimation, or reflect a particular aspect of the treatment effect. Simulation studies show that the WLW method infringes the proportional hazards assumption when applied to recurrent events data, but that the bias this may cause is not behind the distinctive effect estimates. Instead, the method's risk set is demonstrated to be responsible, leading to discussion of the interpretation of the treatment effect being estimated. Analyses of medical data indicate that the infringement of the proportional hazards assumption is not necessarily greater than that experienced with other applications of proportional hazards regression and need not prohibit the application of WLW's method to recurrent events data. [ABSTRACT FROM AUTHOR]

Background: Reiki is a biofield therapy which is based on the explanatory model that the fields of energy and information of living systems can be influenced to promote relaxation and stimulate a healing response. Objective: To conduct a pragmatic within-subject pilot trial of a remote Reiki program for frontline healthcare workers' health-related symptoms during the COVID-19 pandemic. Methods: Healthcare professionals in the UK (eg, physicians, nurses, and paramedics) were eligible to sign up for a distance Reiki program and were also invited to participate in the research study. Eight Reiki practitioners simultaneously gave each participant Reiki remotely for 20 minutes on 4 consecutive days. Feasibility of the research was assessed, including recruitment, data completeness, acceptability and intervention fidelity, and preliminary evaluation of changes in outcome measures. Participants' stress, anxiety, pain, wellbeing, and sleep quality were evaluated with 7-point numerical rating scales. Measures were completed when signing up to receive Reiki (pre) and following the final Reiki session (post). Pre and post data were analyzed using Wilcoxon signed ranks tests. Results: Seventy-nine healthcare professionals signed up to receive Reiki and took the baseline measures. Of those, 40 completed post-measures after the 4-day intervention and were therefore included in the pre-post analysis. Most participants were female (97.5%), and the mean age was 43.9 years old (standard deviations = 11.2). The study was feasible to conduct, with satisfactory recruitment, data completeness, acceptability, and fidelity. Wilcoxon signed ranks tests revealed statistically significant decreases in stress (M = −2.33; P <.001), anxiety (M = −2.79; P <.001) and pain (M = −.79; P <.001), and significant increases in wellbeing (M = −1.79; P <.001) and sleep quality (M = −1.33; P =.019). Conclusions: The Reiki program was feasible and was associated with decreased stress, anxiety and pain, and increased wellbeing and sleep quality in frontline healthcare workers impacted by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Using data from a cross-national survey conducted on representative samples of populations from 10 European countries (n = 10,766), the present study is the first one to empirically measure the validity of Christie's influential ideal victim model. We use a range of scenarios built around common types of anti-LGBT violence to verify the extent to which the public's empathy for victims is contingent on the victim's identity and the circumstances of the crime. The results provide strong evidence that, when applied to this group of victims, the rules of the ideal victim work, adequately moderating the public's emotional reactions. We found that all victims receive relatively high levels of empathy, but the further the victim is from the ideal, the less support they can count on. Thus, even though no victim is "rejected," a clear hierarchy of victimization emerges. As a group, LGBT people suffer from an empathy deficit, but there also are considerable variations within this group, with a lesbian attacked by extremists receiving the most, and a drunk transgender person receiving the least empathy from the public. The study contributes to the development of theory by embedding the ideal victim model in a broader sociological paradigm of dramaturgical analysis. Since our research shows that the victim's LGBT status decreases the levels of empathy (being seen as a type of stigma), we call for more attention to be paid to the actor's identity in Goffman's framework. Implications for practice and further research are offered. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic placed additional demands and stressors on UK obstetric sonographers, who were required to balance parent safety and service quality, alongside staff safety. Increased pressure can negatively impact a healthcare worker's well-being and the provision of person-centred care. The aim of this study was to explore obstetric sonographers' experiences of performing pregnancy ultrasound scans during the pandemic and to assess the impact on burnout, role satisfaction and clinical practice. Methods: An online, anonymous cross-sectional survey was created to capture sonographers' experience alongside using the Oldenburg Burnout Inventory to evaluate burnout and Clinical Outcomes in Routine Evaluation 10 (CORE-10) to measure psychological distress. Results: Responses were received from 138 sonographers. Of those completing the Oldenburg Burnout Inventory (n = 89), 92.1% and 91.0% met the burnout thresholds for exhaustion and disengagement, respectively. Sonographers with a higher burnout score also perceived that COVID-19 had a greater, negative impact on their practice (p < 0.05). The mean CORE-10 score of 14.39 (standard deviation = 7.99) suggests mild psychological distress among respondents. A significant decrease in role satisfaction was reported from before to during the pandemic (p < 0.001), which was associated with higher scores for burnout and psychological distress (p < 0.001). Change in role satisfaction was correlated with sonographers' perception of safety while scanning during the pandemic (R 2 = 0.148, p < 0.001). Sixty-five sonographers (73.9%) reported they were considering leaving the profession, changing their area of practice or working hours within the next 5 years. Conclusion: Job and context-specific interventions are required to mitigate burnout and its consequences on the workforce and service provision beyond the pandemic. [ABSTRACT FROM AUTHOR]

This article explores the experiences of young adults with a life-shortening condition in the first wave of the Coronavirus (COVID-19) pandemic in the UK. It presents the findings from an inclusive qualitative research study using constructivist grounded theory which aimed to examine the unintended consequences of pandemic control measures (lockdown and 'shielding') on this population. Purposive and theoretical sampling methods were used to recruit young adults with a life-shortening condition, employing a range of recruitment methods such as social media, advertising in newsletters and snowballing. Twenty-six young adults (aged 22–40 years), with a wide range of life-shortening conditions participated in the study. Seventeen participants were female and nine male. The majority identified as White British/Other and the remainder as Black British (2), Mixed Race (2) or Latin American (1). Data were generated iteratively using in-depth guided interviews and analysed collectively by an inclusive research team using the constant comparative method. The article explores a theory of embodied precariousness of living with a life-shortening condition during the first wave of the Coronavirus pandemic in relation to three categories: the rationing of life-saving treatment, the deterioration of health and retraction of healthcare provision, and the disruption of typical care arrangements. The findings show that the pandemic control measures introduced to keep people safe have intensified the precarity of this group promoting inequalities in healthcare and health outcomes. The article identifies some implications for practice to support the future management of unexpected and unwanted change. [ABSTRACT FROM AUTHOR]

Mediation analysis is a useful tool to illuminate the mechanisms through which an exposure affects an outcome but statistical challenges exist with time-to-event outcomes and longitudinal observational data. Natural direct and indirect effects cannot be identified when there are exposure-induced confounders of the mediator-outcome relationship. Previous measurements of a repeatedly-measured mediator may themselves confound the relationship between the mediator and the outcome. To overcome these obstacles, two recent methods have been proposed, one based on path-specific effects and one based on an additive hazards model and the concept of exposure splitting. We investigate these techniques, focusing on their application to observational datasets. We apply both methods to an analysis of the UK Cystic Fibrosis Registry dataset to identify how much of the relationship between onset of cystic fibrosis-related diabetes and subsequent survival acts through pulmonary function. Statistical properties of the methods are investigated using simulation. Both methods produce unbiased estimates of indirect and direct effects in scenarios consistent with their stated assumptions but, if the data are measured infrequently, estimates may be biased. Findings are used to highlight considerations in the interpretation of the observational data analysis. [ABSTRACT FROM AUTHOR]

This study assessed physical activity (PA) and wellbeing during lockdown. UK adults reported their PA in the previous week, perception of PA importance (more, less, same) and wellbeing, depression, anxiety and stress. One-way ANOVA compared PA and wellbeing by PA importance. The 'less' importance group did less PA than the 'more' and 'same' (p < 0.05) importance group; and scored worse on all wellbeing measures than the 'same' importance group (p < 0.01). They also had worse wellbeing, depression and anxiety than the 'more' importance group (p < 0.05). Strategies to overcome the impact of the pandemic should aim to increase PA. [ABSTRACT FROM AUTHOR]

Enhancing Audio Description is a research project that explores how sound design, first-person narration, and binaural audio could be utilised to provide accessible versions of films for visually impaired audiences, presenting an alternative to current audio description (AD) practices. This article explores such techniques in the context of the redesign of the short film 'Pearl', by discussing the creative process as well as evaluating the feedback supplied by visually impaired audiences. The research presented in this article demonstrates that the methods proposed were as successful as traditional AD in terms of providing information, enjoyment, and accessibility to audiences, demonstrating that both practices can coexist and, as a result, cater for the different stylistic preferences of end users. [ABSTRACT FROM AUTHOR]

This paper describes a test of Perceptual Control Theory (PCT), which views motor control as part of a process of controlling perceptual inputs rather than motor outputs. Sixteen undergraduate students ( M age = 19.9 yr.) were asked to control one of three different perceptual aspects of an animated display-a shape, a motion or a sequence-using the same motor output, a key press. Animation rate was varied while quality of control was measured in terms of the proportion of time that the perception was maintained in the goal state. The results showed that increased animation rate made it hardest to control the more complex perceptions (motion and sequence) even though the same output was used to control all perceptions. This result is consistent with PCT, which predicts that the temporal constraints on control are ultimately a function of the type of perception controlled rather than the type of output used to control it. [ABSTRACT FROM AUTHOR]

Background: Reactions to treatment are common following acupuncture. Understanding how these reactions are interpreted by patients is largely unexplored. Objective: To examine patients' ratings of the severity and bothersomeness of a range of common treatment reactions, and to assess their impact on willingness to try acupuncture again. Methods: Self-reported ratings of the frequency, severity and bothersomeness of treatment reactions from 133 patients in the acupuncture arm of a pragmatic randomised controlled trial of acupuncture for chronic back pain are described and analysed. Results: A total of 133 acupuncture patients reported at 3 months reactions that they had experienced at any time during a course of up to 10 acupuncture treatment sessions. They received a total of 1150 treatments, an average of 8.6 sessions per patient. All patients reported treatment reactions, most commonly relaxation (84%, n = 112), which was significantly associated with willingness to try acupuncture again, {%2 = 7.860, df = 1,p = 0.005). Only 16% (n=21) were unwilling to experience a specific treatment reaction again, and 9% (n = 12) were unwilling to try acupuncture again. The most 'bothersome' reaction was a temporary worsening of symptoms (29%, n=38), though this was not associated with an unwillingness to try acupuncture again [%2 = 0.382, df = 1, p>0.536). Those unwilling to try acupuncture again reported significantly less reduction in their pain at 3 months (mean (SE) SF-36 bodily pain score at 3 months 30.453 (3.598) vs 19.30 (1.128); p = 0.003). Conclusion: Among this group of patients seeking help for low back pain, the experience of treatment reactions was universal. There was no evidence that the bothersomeness of treatment reactions was associated with patient's willingness to try acupuncture again. The benefit of pain reduction over the course of treatment appeared to outweigh self-rated bothersome reactions to treatment. [ABSTRACT FROM AUTHOR]

Background Insertion of an acupuncture needle into an acupuncture point typically generates a range of sensations called 'de qi'. Most acupuncturists are taught that obtaining de qi is important when treating patients with pain but this can be quite uncomfortable for patients. Objective This study assesses the importance of the strength of de qi, on the clinical outcome in osteoarthritic pain. Method This study was part of a larger randomised, single-blind, multifactorial trial involving three interventions: real acupuncture (RA), Streitberger needle (SN) and mock electrical stimulation for the treatment of patients with osteoarthritis (OA) of the hip and knee. Patients were treated twice a week for 4 weeks. The two outcomes relevant to this study were pain reduction assessed by visual analogue scale and the Park needling sensation questionnaire, both measured at completion of the study. Two arms of the trial were analysed (RA and SN). Reduction in pain was correlated against strength of de q¡ for both RA and SN. Those who felt de qi were compared with those who did not. Results 147 patients were recruited to the study (140 completed) with a mean pain reduction of 15.2 mm and mean de qi score of 6.2. There was no significant correlation between the strength of de qi and improvement in pain (p = 0.49). There was also no significant difference in pain relief (p = 0.52) between those who felt de qi and those who did not using the de qi subscale of the Park questionnaire. Conclusion These data suggest that the presence and intensity of de qi has no effect on the pain relief obtained for patients with OA. This result may have implications for both acupuncture treatment and for future trial methodology. [ABSTRACT FROM AUTHOR]

Much of the literature on rape, victim blaming, and rape myth acceptance is focused on the United States, and there is a general dearth of such scholarly activity in other countries. This article offers insights on university students' perspectives in two new country contexts—India and the United Kingdom. A total of 693 students contributed to the data collection for this study. Rape myth acceptance was fairly low for both countries, however, students in India were more likely to endorse rape myths. Several demographic characteristics were significant for rape myth acceptance in each country. This study makes an important contribution to the extant literature to address paucity of knowledge and promote understandings to help develop country-specific and appropriate policy, practice, and education and awareness programs. In particular, the study provides novel comparative findings on rape myth acceptance in new country contexts to help advance academic thinking in this area of work. [ABSTRACT FROM AUTHOR]

This article proposes that the psychological experience of unemployed persons is determined by the stressfulness of the environment. The detailed description and justification of the stress model used to predict variations in the psychological experience of the long-term unemployed is described. The model is reproduced to indicate the variables used. Since variables were added and subtracted at stages 2 and 3 of this longitudinal study, some of the variables were not measured at all phases of the study. In the present paper, there is no reference to opportunities, coping, or perceived threat of remaining unemployed though they were included in a cross-sectional analysis of phase 1 of this data set. As indicated, neuroticism was added to this data set at time 3 and, conceptually, it would be classified within the model as a personal attribute variable. The data are all self-report and were collected by trained interviewers of a survey research organization. At phase 1, two samples of unemployed men were drawn from those registered at 54 Unemployment Benefit Offices in the mainland Great Britain. The interviewers were allocated to interview only white, nondisabled men, aged 25-39 who had been unemployed for between 6-11 months, inclusive.

This paper describes the use of a field research method called group feedback analysis (GF4) applied in two British companies. The study used two phases of questionnaire administration separated by over 12 months. Three major functions of GFA are elaborated and analyzed with examples based, in part, on tape-recorded sessions: (1) validation of the results; (2) producing a deeper understanding of the data; and (3) providing an opportunity for mutual learning. [ABSTRACT FROM AUTHOR]

The issue of men's sexual victimization in the context of intimate partner violence (IPV) where the perpetrator is female has received minimal attention. This article brings together and analyses data from two empirical studies conducted in the United Kingdom—one exploring men's experiences of being forced-to-penetrate women and another investigating men's experiences of female-perpetrated IPV. Analysis of the data found that men experienced sexual violence alongside a range of other abusive behaviors, but that there was a clear relationship between the sexual violence and physical violence/ force, and coercive and controlling behaviors that they experienced. These novel insights improve our understanding about men's sexual and domestic violence victimization, as well as challenge gender and sex-role stereotypes around men and masculinity and the (im)possibility of them experiencing sexual and domestic abuse from a female partner. [ABSTRACT FROM AUTHOR]

Previous work suggests that written text produced by university students with dyslexia is scored lower than that produced by their peers. The present study used a digital writing tablet to examine the writing process and the quality of text written by university students with dyslexia. Revision behavior during and after writing was also investigated. Thirty-two university students with dyslexia (mean age, 20 years), were compared with 32 typically developing (TD) students matched by age. Students composed a written text in response to an expository essay prompt. In line with previous research, students with dyslexia made a higher number of spelling errors and their essays were rated as poorer than TD students. However, students with dyslexia were comparable to their peers on measures of time spent writing, amount of text produced, and the temporal analyses (handwriting execution, pause times). Students with dyslexia made significantly more revisions to spelling during and after transcription than their peers, although other revision behavior was similar across groups. Explanations for the finding of poor writing quality are explored. Importantly, the findings suggest that continued support with spelling and writing is needed for university students with dyslexia. Instruction directed toward effective revision strategies may also prove useful. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Comparative international data on patterns of inequality in child welfare interventions, for example, the proportion of children about whom there are substantiated child protection concerns or who are in out-of-home care, are far less developed than data about inequalities in health. Few countries collect reliable, comprehensive information and definitions, methods of data collection and analysis are rarely consistent. The four UK countries (England, Northern Ireland, Scotland and Wales) provide a potential 'natural experiment' for comparing intervention patterns. This study reports on a large quantitative, descriptive study focusing on children in contact with children's services on a single date in 2015. It found that children's chances of receiving a child protection intervention were related to family socio-economic circumstances, measured by neighbourhood deprivation, within all four countries. There was a strong social gradient which was significantly steeper in some countries than others. Ethnicity was another important factor underlying inequalities. While inequalities in patterns of intervention between the four countries were considerable, they did not mirror relative levels of deprivation in the child population. Inequalities in intervention rates result from a combination of demand and supply factors. The level and extent of inequity raise profound ethical, economic and practical challenges to those involved in child protection, the wider society and the state. [ABSTRACT FROM AUTHOR]

The NHS routinely evaluates the quality of life of patients receiving hip or knee replacement surgery using patient-reported outcome measures (PROMs), but some hospital completion rates are only 30%, restricting data usefulness. Statistics limit insights into how and why data are missing, so qualitative methods were used to explore this issue. Observation periods preceded semistructured interviews with 34 preoperative patients attending an orthopedic outpatient clinic. Interview themes covered: completion time/timing, orientation, setting, measures, and practicalities. Triangulated against observations, pragmatic barriers, and facilitators were considered. Refined themes included completion conditions, patient support, and national delivery. Simple improvements (e.g., quiet zone) could improve completion rates and reducing missing data. Reorganizing preoperative leaflets and their systematic distribution via standardized procedures could reassure patients, enhancing PROMs acceptance, while reducing inquiries and subsequent staff burden. Findings have implications for interpreting national statistics. They indicate that further debate about mandating preoperative PROMs is due. [ABSTRACT FROM AUTHOR]

Objective: To establish the prevalence of unmet need for spasticity management in care home residents in two counties of the United Kingdom. Design: Cross-sectional observational study with a six-month follow-up arm for participants with identified unmet needs. Setting: 22 care homes in Derbyshire and Nottinghamshire. Subjects: 60 care home residents with upper motor neuron syndrome–related spasticity. Interventions: No intervention. When unmet needs around spasticity management were identified, the participant's general practitioner was advised of these in writing. Main measures: Resistance to Passive Movement Scale to assess spasticity; recording of (a) the presence of factors which may aggravate spasticity, (b) potential complications of spasticity, (c) spasticity-related needs and (d) current interventions to manage spasticity. Two assessors judged the presence or absence of needs for spasticity management and whether these needs were met by current care. Results: Out of 60 participants, 14 had no spasticity-related needs; 46 had spasticity-related needs; 11 had needs which were being met by current care and 35 participants had spasticity-related needs at baseline which were not being met by their current care. These were most frequently related to the risk of contracture development or problems with skin hygiene or integrity in the upper limb. In total, 6 participants had one or more pressure sores and 35 participants had one or more established joint contractures. A total of 31 participants were available for follow-up. Informing general practitioners of unmet needs resulted in no change to spasticity management in 23/31 cases. Conclusion: Care home residents in this study had high levels of unmet need for spasticity management. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine prevalence of pre-stroke frailty in acute stroke and describe validity of a Frailty Index–based assessment. Design: Cross-sectional. Setting: Single UK urban teaching hospital. Subjects: Consecutive acute stroke unit admissions, recruited in four waves (May 2016–August 2018). We performed the assessments within first week and attempted to include all admissions. Main measures: Our primary measure was a Frailty Index, based on cumulative disorders. A proportion of participants were also assessed with the 'Frail non-disabled' questionnaire. We evaluated concurrent validity of Frailty Index against variables associated with frailty in non-stroke populations. We described predictive validity of Frailty Index for stroke severity and delirium. We described convergent validity, quantifying agreement between frailty assessments and a measure of pre-stroke disability (modified Rankin Scale) using kappa statistics and correlations. Results: We included 546 patients. A Frailty Index–defined frailty syndrome was observed in 427 of 545 patients (78%), of whom, 151 (28%) had frank frailty and 276 (51%) were pre-frail. Phenotypic frailty was observed in 72 of 258 patients (28%). We demonstrated concurrent validity via significant associations with all variables (all p < 0.01). We demonstrated predictive validity for stroke severity and delirium (p < 0.01). Agreement between the frailty measures was poor (kappa = –0.06) and convergent validity was moderate (Frail non-disabled 'Cramer's V' = 0.25; modified Rankin Scale 'Cramer's V' = 0.47). Conclusion: Frailty is present in around one in four patients with acute stroke; if pre-frailty is included, then a frailty syndrome is seen in three out of four patients. The Frailty Index is a valid measure of frailty in stroke; however, there is little agreement between this scale and other measurements of frailty. [ABSTRACT FROM AUTHOR]

Qualitative researchers are increasingly reanalyzing and synthesizing data sets from different studies, and this method has now been used across trials to inform trial methodology and delivery. Despite this work, however, limited guidance exists about how this method should be employed. This article details an example in which interview data collected during three primary care depression trials were brought together to explore trial participants' study and treatment journeys. It details the process involved and the decisions made. It also presents findings from this synthesis to illustrate how this method can be used to inform the development of future trials and complex interventions, through raising questions about how researchers currently define and design treatment arms and indicating what factors may improve or hinder participants' engagement with their allocated treatment. [ABSTRACT FROM AUTHOR]

Most study samples show less variability in key variables than do their source populations due most often to indirect selection into study participation associated with a wide range of personal and circumstantial characteristics. Formulas exist to correct the distortions of population-level correlations created. Formula accuracy has been tested using simulated normally distributed data, but empirical data are rarely available for testing. We did so in a rare data set in which it was possible: the 6-Day Sample, a representative subsample of 1,208 from the Scottish Mental Survey 1947 of cognitive ability in 1936-born Scottish schoolchildren (70,805). 6-Day Sample participants completed a follow-up assessment in childhood and were re-recruited for study at age 77 years. We compared full 6-Day Sample correlations of early-life variables with those of the range-restricted correlations in the later-participating subsample, before and after adjustment for direct and indirect range restriction. Results differed, especially for two highly correlated cognitive tests; neither reproduced full-sample correlations well due to small deviations from normal distribution in skew and kurtosis. Maximum likelihood estimates did little better. To assess these results’ typicality, we simulated sample selection and made similar comparisons using the 42 cognitive ability tests administered to the Minnesota Study of Twins Reared Apart, with very similar results. We discuss problems in developing further adjustments to offset range-restriction distortions and possible approaches to solutions. [ABSTRACT FROM AUTHOR]

Smartphones with their rising popularity and versatile software ‘apps’ have great potential for revolutionising healthcare services. However, this was soon overshadowed by concerns highlighted by many studies over quality. These were subject and/or discipline specific and mostly evaluated compliance with a limited number of information portrayal standards originally devised for health websites. Hence, this study aimed to take a broader approach by evaluating the most popular apps categorised as medical in the United Kingdom for compliance with all of those standards systematically using the Health On the Net (HON) Foundation principles.The study evaluated top 50 free and paid apps of the ‘medical’ category on both iTunes and Google stores for evidence of compliance with an app-adapted version of the HON Foundation code of conduct. The sample included 64 apps, 34/64 (53%) were on Google Play and 36/64 (56%) were free. None of the apps managed to comply with the entire eight principles. Compliance with seven principles was achieved by only one app (1.6%), and the rest were compliant with three, two, and one (14.7%, 27%, and 38%, respectively).In conclusion, this study demonstrated that most popular apps on the medical category that are available in the United Kingdom do not meet the standards for presenting health information to the public, and this is consistent with earlier studies. Improving the situation would require raising the public awareness, providing tools that would assist in quality evaluation, encouraging developers to use robust development process, and facilitating collaboration and engagement among the stakeholders. [ABSTRACT FROM AUTHOR]

The nature of qualitative research means that the personal values of an individual researcher can and do (unwittingly) shape the way in which they analyse data sets, and the resultant conclusions drawn. However this phenomenon is under-studied in social research and this article seeks to help rectify this. This article presents findings from a small research project focused on discourses of class, masculinity and work among British male comedians from working-class backgrounds, interviewed on the popular BBC Radio 4 radio programme Desert Island Discs. Six different researchers, from varying disciplinary, methodological and theoretical groundings, as well as from varying personal backgrounds, analysed three interview recordings and transcripts separately. All the researchers wrote up their individual analyses of these interviews and wrote reflexive pieces examining why they thought they approached the data as they did. The researchers then came together as a group to compare and contrast findings and approaches. The results from this study, including the discrepancies and distinctions and final group analysis, are reported alongside a thorough discussion of the project’s methodology. We find that the project evidenced how a diverse research team can bring out deeper and richer analyses, and was a refreshing way to try and answer questions of individual and collective positionality [ABSTRACT FROM AUTHOR]

Based on life history narratives of 57 women in India and interviews with 21 practitioners, we document the neglect, abuse, and instrumental deprivation of women’s rights through the process of transnational abandonment. While gendered local sociocultural milieus and economic norms contribute to these harms, they are crucially enabled and sustained by transnational formal-legal frameworks. Widening the explanatory lens for understanding domestic violence beyond the family and community, we argue that in a globalized world, (inter)state policies serve to construct these women as a subordinate category of citizens—“disposable women”—who can be abused and abandoned with impunity. [ABSTRACT FROM AUTHOR]

Background: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. Aim: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. Design: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale–symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Setting/participants: Breathless patients with advanced malignant and non-malignant disease. Results: A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14–67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach’s alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Conclusion: Psychometric analyses suggest that the London Chest Activities of Daily Living Scale is acceptable, reliable and valid in patients with advanced disease and refractory breathlessness. [ABSTRACT FROM AUTHOR]

The article discusses the use of syndromic surveillance in the Emergency Care Data Set (ECDS) project initiated by the Royal College of Emergency Medicine in England. Topics covered include the goal of improving the collection and quality of data in emergency departments, the mandated changes to national clinical emergency care data sets and the driving factors for implementation of ECDS.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer's risk into bereavement. Aim: To determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer's bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who registered the death of a person between 1 December 2011 and 31 May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire 6 weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre- or post-bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively affected bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased. [ABSTRACT FROM AUTHOR]

Background: A UK charity, Macmillan Cancer Support has funded a local intervention, whereby carers of people affected by cancer and other long-term conditions at end of life are offered a bespoke package of support. Aim: This short report describes the qualitative experiences of carers in receipt of the intervention. Design: Qualitative research utilising in-depth interviews. Discussions were digitally recorded and transcribed verbatim. Data were analysed using thematic analysis. Setting/participants: Participants were carers (n = 10) in receipt of the intervention. Interviews were conducted between August and September 2014 in Lincolnshire (England). Results: Five themes from the interviews were identified: (1) Awareness and advertising, (2) focus of support on the carer, (3) modes of communication, (4) personal attributes and skills of the support worker (5) streamlining and signposting. Conclusion: The intervention was successful within a social care setting. The participants had no overtly negative opinions on the service in its current format and all held it in high regard. Carers felt a sense of reassurance from having background support and maintained that their situation would have been worse had this support not been there. [ABSTRACT FROM AUTHOR]

The author reflects on the publicized research and press releases about DNA variations, limitations in screening tests, and risks in developing cancer. He explains the immaterial impact of poor screening performance of a risk factor to justify the complexities and influences of genetic variations. The author suggests that organizations supporting research must avoid overstating the expectation of screening benefits and implications of the findings.

This study analyses data obtained from the UK Labour Force Survey (LFS) 2002–2013 to examine the ethno-religious differences in the gross hourly pay within the British salariat occupational class. It explores the extent to which these differences are associated with ethnicity, religion or both. The findings suggest that substantial between-group differences do exist, but these differences cannot be attributed to a pure religious or ethnic discrimination. Although two of the Muslim groups experience a greater penalty than many of the other groups, there was no evidence for an overarching ‘Muslim penalty’. There also was no evidence for an overarching ‘Black penalty’. It is possible that within the salariat class, mechanisms other than pure colour and cultural racism are at work. [ABSTRACT FROM AUTHOR]