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Purpose:This paper examined the production of intonation patterns in children with developmental dysarthria associated with cerebral palsy (CP) prior to and after speech intervention focussing on respiration and phonation. The study further sought to establish whether intonation performance might be related to changes in speech intelligibility. Method:Intonation patterns were examined using connected speech samples of 15 older children with moderate to severe developmental dysarthria due to CP (9 females; age range: 11–18). Recordings were made prior to and after speech intervention based on a systems approach. Analyses are focussed on the use of intonation patterns, pitch accentuation and phrasing. Result:Group analyses showed a significant increase in the use of rising intonation patterns after intervention. There were also some indications that this increase might have been related to gains in speech intelligibility for some of the children. No changes were observed regarding pitch accentuation and phrasing following intervention. Conclusion:The findings highlight that changes can occur in the use of intonation patterns in children with dysarthria and CP following speech systems intervention. It is hypothesised that the emergence of the rising pattern in some of the children’s intonational inventories possibly reflected improved breath support and control of laryngeal muscles. [ABSTRACT FROM PUBLISHER]

Application of the Leg Activity measure in acquired brain injury spasticity intervention to identify areas for goal setting prior to treatment, document the treatments applied and evaluate outcome. A prospective cohort from three specialist spasticity management centres was used. Primary outcome measures were, Leg Activity Measure, Modified Ashworth Scale and Goal Attainment Scaling – light. Measurement was completed at baseline, 6 and 12 weeks. The Leg-Therapy recording Schedule was used to record physical therapy intervention. Participants (n = 64) included had a mean age of 51 (18–84) years, half (n = 32) were men. Significant changes were demonstrated over the 12-week period in MAS (Xr2 = 35.4; p < 0.001), the Leg Activity passive function scale (Xr2 = 32.2; p < 0.001) (e.g., improved ease of dressing, hygiene) and Leg Activity impact on quality of life scale (Xr2 = 32.2; p < 0.001). No change was identified in the Leg Activity active function scale. Goal achievement was demonstrated at 6 weeks and further improved at 12 weeks (Xr2 = 65.7; p < 0.001) and was associated with change in the relevant scale. Physical interventions were captured at each time-point. Significant gains in passive-function and quality-of-life were recorded by the Leg Activity measure scales at 6 weeks, and at 12 weeks post-injection in the context of on-going physical treatment, primarily by self-management. The Leg Activity measure is able to detected changes in passive function and impact on quality of life. Measurement of change in active function is also likely to be detected, but was not seen in the cohort studied. The Leg Activity measure was effective in this study in identifying problem areas to enable setting of treatment goals and planning of treatment intervention. [ABSTRACT FROM AUTHOR]

A task carried out in error creates a latent condition that can result in a future undesirable outcome if the error is not detected later. The paper presents a study of the relatively under-researched phenomenon of post-task latent error detection. Focusing on UK naval aircraft maintenance, it was hypothesised that time, location and systems cues influence individual latent error detection amongst naval air engineers who experience the phenomenon. The systems view of human error is combined with a multi-process approach to post-task latent error research, for which findings suggest that distributed cognition across the entire socio-technical system may be influential in post-task latent error detection. Directions for future research will be of benefit to those interested in furthering safety resilience using a systems approach to minimise the consequences arising from latent error. Relevance to human factors/ergonomics theoryThe nature and extent of post-task latent error detection is explored using a systems approach, for which distributed cognition across the entire socio-technical system appears influential. The aim of current research is to develop interventions to further mitigate for latent errors and thus advance the systems application of ergonomics theory. [ABSTRACT FROM PUBLISHER]

In-car route guidance is automatic, requiring a minimum of time and thinking. This paper explores the use of personalised information when providing instructions for navigating a journey. We focus on older women with a lifetime of experience. Ten female participants were interviewed to elicit their comfort zone with respect to navigating in a car from their own home. Two routes were then devised for each participant, which extended beyond this comfort zone, and presented to them in two different formats. Participants then navigated the route of their least preferred format. Questionnaires and interviews were used to explore the effects of the formats on their confidence, cognitive effort and use of cognitive mapping facilities. The questionnaire data showed that the more detailed instructions supported cognitive mapping processes and the interviews suggested that this support was valued prior to executing the route. [ABSTRACT FROM PUBLISHER]

This paper reports on a feasibility study and evaluation of a new type of cultural consultation service (CCS). This multi-component and systemic complex intervention was offered over 18 months to specialist mental health providers in one of the poorest regions of the UK. The service received 900 clinically related contacts and 99 in-depth consultations. Service users who were referred to the CCS had high levels of clinical needs with an average score of 15.9 on the Health of the Nation Outcomes Scale. Overall, Global Assessment of Function scores improved and there were trends for improvements in symptoms. The level of routine care (and by implication associated costs) significantly reduced after CCS intervention, due to a reduction in use of accident and emergency (A&E) services, psychiatrists and community psychiatric nurses (CPNs)/case managers. Cost analysis indicates that savings amounted to £497 per patient. The cost of intervention was no greater than usual care, and may reduce spend per patient over a 3-month follow-up and perhaps longer. More specifically, clinicians felt the cultural consultation service helped to improve the treatment plan (71%), engagement (50%), medication compliance (21%) and earlier discharge (7%). [ABSTRACT FROM AUTHOR]

Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the perceptions of antisocial behaviour on the use of the social media platform Twitter. We extend the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Perception of Antisocial Behaviour as a risk factor, and two supporting constructs: Strategic Self-Presentation and Protective Self-Presentation. We call this extended model Technology Acceptance and Use under Risk (TAUR). We investigate two groups via an online questionnaire, contrasting Anglophone countries (the UK, USA, and Canada, 200 responses), with Saudi Arabia (540 responses). In both cases the data shows that the Perception of Antisocial Behaviour impacts Twitter use, but not directly, rather it negatively impacts the influence of other factors such as Behavioural Intention – it also shows that this affects Anglophones more than Saudis. This indicates that future work should differentiate between different cultural groups, and different solutions may be needed to assuage users' fears in different parts of the world. [ABSTRACT FROM AUTHOR]

To assess the benefits of the Ida Institute's Why improve my hearing? Telecare Tool used before the initial hearing assessment appointment. A prospective, single-blind randomised clinical trial with two arms: (i) Why improve my hearing? Telecare Tool intervention, and (ii) standard care control. Adults with hearing loss were recruited from two Audiology Services within the United Kingdom's publicly-funded National Health Service. Of 461 individuals assessed for eligibility, 57 were eligible to participate. Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (primary outcome) scores did not differ between groups from baseline to post-assessment (Mean change [Δ]= −2.28; 95% confidence interval [CI]= −6.70, 2.15, p=.307) and 10-weeks follow-up (Mean Δ= −2.69; 95% CI= −9.52, 4.15, p =.434). However, Short Form Patient Activation Measure scores significantly improved in the intervention group compared to the control group from baseline to post-assessment (Mean Δ= −6.06, 95% CI= −11.31, −0.82, p =.024, ES=.61) and 10-weeks follow-up (Mean Δ= −9.87, 95% CI= −15.34, −4.40, p =.001, ES= −.97). This study demonstrates that while a patient-centred telecare intervention completed before management decisions may not improve an individual's self-efficacy to manage their hearing loss, it can lead to improvements in readiness. [ABSTRACT FROM AUTHOR]

To investigate listening skills in infant hearing aid users using the LittlEARS® Auditory Questionnaire (LEAQ). Caregivers completed the LEAQ, and hearing aid data logging was recorded, at infant age 3–7 months and 7–21 months. Seventy infant hearing aid users with permanent bilateral hearing loss, no developmental comorbidities, aged 3–7 months at first visit. Infants with mild and moderate losses tended to have scores within the normative range at the early time point (88%), but 29% were below the normative range when older. Thirty percent of infants with severe hearing loss were outside the normative range at the early time point and 60% outside the normative range when older. Infants with profound loss were almost always (95%) outside the normative range. At the later time point, and for infants with severe-to-profound loss, low LEAQ scores were associated with fewer daily hours hearing aid use. Scores were poorer than previous reports in the literature for infant hearing aid users. This study provides further knowledge on infant listening performance and hearing aid use over time that can be used to guide management of individual cases and to develop and audit service quality improvements. [ABSTRACT FROM AUTHOR]

To explore the prevalence of health anxiety in stroke survivors and its relative impact on quality of life. A cross-sectional design was used including between group comparisons of high and low health anxious stroke survivors. Stroke survivors (n = 105) were recruited via online stroke community forums. Participants completed measures of health anxiety (Short Health Anxiety Inventory), general anxiety and depression (Hospital and Anxiety and Depression Scale), disability (WHO Disability Assessment Schedule), and quality of life (Quality of Life Index). Demographics and medical histories were also assessed. Thirty percent of the sample scored above the clinical cut off for health anxiety. Stroke survivors with high health anxiety (HiHA) were found to have significantly lower quality of life (p < 0.001) and higher rates of depression (p < 0.001). Regression analysis found health anxiety to be a significant predictor of quality of life (β = –0.12; p < 0.05) in addition to levels of depression (β = –0.33; p < 0.001) and disability (β = –0.53; p < 0.001). Almost a third of stroke survivors were experiencing clinical levels of health anxiety, with HiHA significantly associated with lower quality of life. Future research should explore the use of existing evidence based psychological interventions for health anxiety in this population. Our findings suggest almost one in three stroke survivors residing in the community have clinical levels of health anxiety. High health anxiety in stroke survivors was significantly related to lower levels of quality of life. Given this finding, evidence-based treatments for health anxiety may improve quality of life and reduce distress for a significant proportion of stroke survivors. Rehabilitation approaches aimed at improving overall quality of life for stroke survivors should consider both physical and psychological interventions, with levels of physical disability, depression and anxiety all significantly associated with quality of life. [ABSTRACT FROM AUTHOR]

The Manchester Musculoskeletal Screening Tool (MMST) is used internationally to screen for pain, postural changes, and urinary incontinence in adults with cystic fibrosis (CF). The tool has been validated for the outcome measures of pain and incontinence but not for the thoracic movement section. The aim of this study was to assess intra (single rater) and inter-rater (between rater) reliability of the thoracic movement screen section of the MMST. This is a prospective reliability study. Digital videos of thoracic movement were taken of adults with CF during their annual musculoskeletal screening at a large UK Adult CF Center. Twelve physiotherapists independently watched the videos and scored the movements on two occasions, 2 weeks apart, using MMST. Cohen's kappa and Krippendorff alpha were used to establish intra- and inter-rater reliability. Intra-rater reliability using Cohen's kappa calculation ranged between 0.35 and 0.93. Eleven out of 12 physiotherapists had a moderate-substantial reliability score as assessed by the Landis Koch criteria. Percentage agreement for each physiotherapist ranged from 67%-97%. The inter-rater reliability was poor (Krippendorff alpha score = 0.422 (CI: 0.24–0.60)). The thoracic section of the MMST is reliable in adults with CF to highlight changes in posture and thoracic mobility that may go undetected or under-reported by the patient when repeated by the same clinician. However, the inter-rater variability is high, and it should not be considered reliable when carried out by different clinicians over time. [ABSTRACT FROM AUTHOR]

Understanding users' individual differences may provide clues to help identify computer users who are prone to act insecurely. We examine factors that impact home users' reported computer security behaviour. We conducted two online surveys with a total of 650 participants to investigate the relationship between self-reported security behaviour and users' knowledge, motivation, confidence, risk propensity and sex-typed characteristics. We found that all of these factors impacted security behaviour, with knowledge as the most important predictor. We further show that a user's affinity to feminine or masculine characteristics is a better determinant of security behaviour than using binary male/female descriptors. Our study enabled us to confirm earlier results in the literature in a non-organisational setting, and to extend the literature by studying additional factors and by comparing the relative importance of each factor as a predictor of security behaviour. [ABSTRACT FROM AUTHOR]

Humans are good at recognizing familiar faces, but are more error-prone at recognizing an unfamiliar person across different images. It has been suggested that familiar and unfamiliar faces are processed qualitatively differently. But are unfamiliar faces at least processed differently from monkey faces? Here we tested 366 volunteers on a face matching test – two images presented side-by-side with participants judging whether the images show the same identity or two different identities – comparing performance with familiar and unfamiliar human faces, and monkey faces. The results showed that performance was most accurate for familiar faces, and was above chance for monkey faces. Although accuracy was higher for unfamiliar humans than monkeys on different identity trials, there was no unfamiliar human advantage over monkeys on same identity trials. The results give new insights into unfamiliar face processing, showing that in some ways unfamiliar faces might as well be another species. [ABSTRACT FROM AUTHOR]

Measuring the physical activity of adults with progressive muscle diseases is important to inform clinical practice, for activity recommendations and for outcomes meaningful to participants in clinical trials. Despite its wide use, the measurement properties of the International Physical Activity Questionnaire (IPAQ) have not been established in a muscle disease population. The sample of 103 adults with progressive muscle diseases included independently mobile participants and wheelchair users. Their home-based activity measured by the IPAQ was compared to simultaneous weeks of accelerometer activity data collected remotely in a longitudinal, measure evaluation study. Validity, reliability, and responsiveness were evaluated for the IPAQ alone, and for the IPAQ used in conjunction with a smart activity monitor. The IPAQ did not demonstrate satisfactory criterion validity, reliability or responsiveness and it systematically overestimated moderate and vigorous physical activity time by 161 minutes per week. Measurement properties of the IPAQ were improved when it was used in combination with a smart activity monitor. The IPAQ did not have satisfactory measurement properties compared to accelerometry in adults with progressive muscle disease. Combining self-report and objective activity measures might improve the accuracy of physical activity assessment in this and other comparable populations. Physical activity is a meaningful health outcome for adults with progressive muscle diseases, for whom precise activity quantification is important because of the potential for activity-related disease exacerbation. The International Physical Activity Questionnaire (IPAQ) had unsatisfactory measurement properties compared to accelerometry; however, these were improved by adjunctive smart activity monitoring. Objective or combined physical activity measurement is recommended over self-report alone for clinical assessment of physical activity as part of rehabilitation and self-management programmes. [ABSTRACT FROM AUTHOR]

This study aimed to provide a comprehensive assessment of upper limb kinetics and kinematics and shoulder movements during wheelchair propulsion while negotiating a speed bump of 6 cm height using four different wheelchair configurations. 16 healthy males aged 30.8 ± 5.7 years participated in the experiment. The kinetic and kinematic data during wheelchair propulsion were recorded. A smart system was used to collect the push forces and a motion capture system was used to collect upper limb movements. The results show that approximately 50% more pushing force was required to negotiate the speed bump than that of level ground propulsion. At the upward-forward axle position, peak total forces were 95.17 ± 5.70 N which resulted in significantly improved propulsion ergonomics, but 129.36 ± 6.68 N was required at the upward-back axle position at the speed bump push. The findings could help manufactures to design protective gloves for wheelchair users and provide useful rehabilitation information to clinicians and patients. Practitioner summary: This study investigated pushing forces and movements during wheelchair propulsion over a speed bump. Approximately 50% more pushing force was required to negotiate the bump than a level surface propulsion. The upper-forward axle position was found to be reasonably better than other positions during wheelchair propulsion. Abbreviations: UF: upper and forward position; UB: upper and back position; DF: down and forward position; DB: down and back position; ROM: range of motion [ABSTRACT FROM AUTHOR]

Persons with profound intellectual disability (PID) are mostly not able to use assistive technology (AT) independently. Caregivers play an important mediating role in implementing AT in the daily life of persons with PID. Both first-order barriers, extrinsic to caregivers, and second-order barriers, intrinsic to caregivers, influence the attitudes and behaviors of caregivers with regard to AT-use. It could be asked if increased knowledge on and experience with AT may impact the effect of first- and second-order barriers. This study investigated how knowledge and experience influence the professional caregivers' beliefs about which factors may impact the AT use in persons with PID and their intentions to use AT for persons with PID. A questionnaire on the experienced limitations and successes in using AT was developed. The questionnaire was send to professionals working with or responsible for persons with PID in various countries in Europe. In total the answers of 195 respondents were included in this study. This study's results demonstrate that AT is used for various reasons in persons with PID, mostly to support communication and interaction or for fun or relaxation. Based on the answers of the respondents can be concluded that both experience and knowledge of caregivers seem to influence first- and second-order barriers. Besides, a possibility to overcome the second-order barriers is to provide professionals with possibilities to increase their knowledge and experience. AT for persons with PID is mostly used for communication and interaction or for fun and relaxation. Professional caregivers belief that AT-use may positively influence various aspects in the life of persons with PID, especially communication and interaction, active engagement and participation in activities, and self-esteem of the person. Caregivers need to have sufficient experience in order to rate the barriers of AT-use as less limited in the group of persons with PID. In order to overcome the barriers experienced in implementing AT in persons with PID, knowledge of caregivers is essential. [ABSTRACT FROM AUTHOR]

Introduction: Borderline regression (BRM) is considered problematic in small cohort OSCEs (e.g. n < 50), with institutions often relying on item-centred standard setting approaches which can be resource intensive and lack defensibility in performance tests. Methods: Through an analysis of post-hoc station- and test-level metrics, we investigate the application of BRM in three different small-cohort OSCE contexts: the exam for international medical graduates wanting to practice in the UK, senior sequential undergraduate exams, and Physician associates exams in a large UK medical school. Results: We find that BRM provides robust metrics and concomitantly defensible cut scores in the majority of stations (percentage of problematic stations 5, 14, and 12%, respectively across our three contexts). Where problems occur, this is generally due to an insufficiently strong relationship between global grades and checklist scores to be confident in the standard set by BRM in these stations. Conclusion: This work challenges previous assumptions about the application of BRM in small test cohorts. Where there is sufficient spread of ability, BRM will generally provide defensible standards, assuming careful design of station-level scoring instruments. However, extant station cut-scores are preferred as a substitute where BRM standard setting problems do occur. [ABSTRACT FROM AUTHOR]

Purpose: This first psychometric evaluation of the Patient Categorisation Tool examined its properties as an instrument to measure complexity of needs in a mixed population of patients presenting for specialist neurorehabilitation. Materials/methods: Analysis of a large multicentre cohort of patients (n = 5396) from the national clinical dataset representing 63 specialist rehabilitation services across England. Structural validity was examined using exploratory and confirmatory factor analysis. Concurrent and criterion-validity were tested through a priori hypothesized relationships with other validated measures of resource requirements and dependency. Results: All but two items loaded strongly onto a single principal component with Cronbach's alpha 0.88. A total score of ≥30 identified patients with complex (category A) needs with sensitivity 76% and specificity 75%. However, confirmatory factor analysis provided a better fit when the scale was split into two subscales – a 'Cognitive/psychosocial' and a 'Physical' sub-scale (alpha 0.83 and 0.84, respectively). Moderate convergent and discriminant correlations were consistent with hypothesized relationships. Conclusions: The findings provide some overall support for the Patient Categorisation Tool as a unidimensional tool for measuring complexity of needs for neurorehabilitation, but the subscales may be more suitable for certain groups of patients. Further analysis is now required to evaluate its performance in different conditions. A psychometrically robust tool for measuring the complexity of rehabilitation needs has potential value, both at an individual level for treatment planning, and at a population level for planning and commissioning rehabilitation services. The Patient Categorisation Tool now forms part of the United Kingdom national clinical dataset mandated by the National Health Service in England This psychometric analysis from a large national multicentre cohort representing a diverse range of conditions, provides evidence for its validity as a means to identity patients with complex rehabilitation needs requiring specialist rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: To explore exercise beliefs and behaviours of individuals with Joint Hypermobility syndrome/Ehlers-Danlos syndrome - hypermobility type and to explore patient experiences of physiotherapy. Methods: A cross sectional questionnaire survey design was used to collect quantitative and qualitative data from adult members of the Hypermobility Syndromes Association and Ehlers-Danlos Syndrome Support UK. Descriptive and inferential statistics were used to analyse the data. Qualitative data was analysed thematically. Results: 946 questionnaires were returned and analysed. Participants who received exercise advice from a physiotherapist were 1.75 more likely to report high volumes of weekly exercise (odds ratio [OR] = 1.75, 95% confidence interval [CI] = 1.30-2.36, p < 0.001) than those with no advice. Participants who believed that exercise is important for long-term management were 2.76 times more likely to report a high volume of weekly exercise compared to the participants who did not hold this belief (OR = 2.76, 95% CI = 1.38-5.50, p = 0.004). Three themes emerged regarding experience of physiotherapy; physiotherapist as a partner, communication - knowledge, experience and safety. Conclusion: Pain, fatigue and fear are common barriers to exercise. Advice from a physiotherapist and beliefs about the benefits of exercise influenced the reported exercise behaviours of individuals with Ehlers-Danlos syndrome - hypermobility type in this survey. Implications for rehabilitation: Exercise is a cornerstone of treatment for Ehlers-Danlos syndrome/Ehlers-Danlos syndrome - hypermobility type. Pain, fatigue and fear of injury are frequently reported barriers to exercise. Advice from physiotherapists may significantly influence exercise behaviour. Physiotherapists with condition specific knowledge and good verbal and non-verbal communication facilitate a positive therapeutic experience. [ABSTRACT FROM AUTHOR]

What does social work supervision help with? There are many different models of supervision and an increasing amount of research. Much of this is concerned with the content of supervision and how supervisors (and supervisees) should behave — and these are important concerns. But even more important is the question of who or what supervision helps with. Supervision is widely considered to have many different functions but in the context of UK local authority social work, must ultimately prove itself as a method for helping people who use services. This article reports on a survey of 315 social workers from UK local authorities. Most reported that supervision helps primarily with management oversight and accountability. However, the small number of practitioners who received regular group supervision and those who received supervision more frequently said it helped with a much broader range of things. [ABSTRACT FROM AUTHOR]

Overlaying a building with images from the past can be an engaging way to explore a historic site. However, little is known about what type of content functions well when using augmented reality (AR) in outdoor contexts. This research investigates how different types of AR content - such as text or image - can affect the flow experience as well as other user affective and behavioural responses. We ran an experimental study with 85 participants at a university campus, where three groups used different apps - AR app with overlaid textual information, AR app with overlaid both textual information and images and an app with audio guide - to explore the area's historic and cultural background. The results show that overlaying images in addition to the text was clearly the most successful way of attracting attention and providing stronger flow in comparison to the apps that overlaid only text or delivered audio. However, we also discovered that users occasionally interpreted the overlaid imagery to be cues for something else other than what they were designed to represent. Finally, we discuss how AR content can enlarge otherwise invisible details, depict historic elements and unveil interiors of buildings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to psychometrically test the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions. Materials and methods: One thousand and two hundred people with ankylosing spondylitis; osteoarthritis; systemic lupus erythematosus; systemic sclerosis; chronic pain; chronic upper limb disorders; or Primary Sjögren’s syndrome completed the Evaluation of Daily Activity Questionnaire, Health Assessment Questionnaire and Short-Form Health Survey v2. We examined internal construct validity using Rasch analysis, internal consistency, concurrent validity with the Health Assessment Questionnaire and Short-Form Health Survey v2. Participants repeated the Evaluation of Daily Activity Questionnaire to assess test-retest reliability. Results: The 12 domains satisfied Rasch model expectations for fit, local dependency, unidimensionality and invariance by age and gender, in each musculoskeletal condition. Internal consistency was consistent with individual use (Cronbach’s α > 0.90); concurrent validity was strong (Health Assessment Questionnaire: rs = 0.60-0.92; Short-Form Health Survey v2 Physical Function: rs = −0.61 to −0.91) and test-retest reliability excellent (Intra-Class Correlation Coefficient(2,1) = 0.77-0.96). Conclusion: The Evaluation of Daily Activity Questionnaire satisfied Rasch model requirements for construct validity and has good reliability and validity in each MSC. The Evaluation of Daily Activity Questionnaire can be used as a measure of everyday activity in practice and research with people with musculoskeletal conditions. Implications for rehabilitation: The Evaluation of Daily Activity Questionnaire evaluates users’ ability to perform common daily activities (in 12 domains) that were identified as problematic by people with seven musculoskeletal conditions (i.e., osteoarthritis, systemic lupus, ankylosing spondylitis, chronic pain, chronic upper limb conditions, systemic sclerosis, Sjogren’s syndrome). Most patients considered the Evaluation of Daily Activity Questionnaire was the right length and would be helpful for discussing everyday problems with an occupational therapist. The 12 domains have good reliability and validity and can be combined into two components: Self-Care and Mobility. The Evaluation of Daily Activity Questionnaire is suitable for use both in clinical practice and research and a User Manual is available for therapists and researchers. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation professionals typically use motor imagery (MI) or action observation (AO) to increase physical strength for injury prevention and recovery. Here we compared hamstring force gains for MI during AO (AO + MI) against two pure MI training groups.Materials and methods: Over a 3-week intervention physically fit adults imagined Nordic hamstring exercises in both legs and synchronized this with a demonstration of the same action (AO + MI), or they purely imagined this action (pure MI), or imagined upper-limb actions (pure MI-control). Eccentric hamstring strength gains were assessed using ANOVAs, and magnitude-based inference (MBI) analyses determined the likelihood of clinical/practical benefits for the interventions.Results: Hamstring strength only increased significantly following AO + MI training. This effect was lateralized to the right leg, potentially reflecting a left-hemispheric dominance in motor simulation. MBIs: The right leg within-group treatment effect size for AO + MI was moderate and likely beneficial (d = 0.36), and only small and possibly beneficial for pure MI (0.23). Relative to pure MI-control, effects were possibly beneficial and moderate for AO + MI (0.72), although small for pure MI (0.39).Conclusions: Since hamstring strength predicts injury prevalence, our findings point to the advantage of combined AO + MI interventions, over and above pure MI, for injury prevention and rehabilitation. Implications for rehabilitation While hamstring strains are the most common injury across the many sports involving sprinting and jumping, Nordic hamstring exercises are among the most effective methods for building eccentric hamstring strength, for injury prevention and rehabilitation.In the acute injury phase it is crucial not to overload damaged soft tissues, and so non-physical rehabilitation techniques are well suited to this phase.Rehabilitation professionals typically use either motor imagery or action observation techniques to safely improve physical strength, but our study shows that motor imagery during observation of Nordic hamstring exercises offers a safe, affordable and more effective way to facilitate eccentric hamstring strength gains, compared with pure motor imagery.Despite using bilateral imagery and observation training conditions in the present study, strength gains were restricted to the right leg, potentially due to a left hemispheric dominance in motor simulation. [ABSTRACT FROM AUTHOR]

The Lawn Tennis Association's mini tennis (MT) is a modified version of tennis consisting of progressive stages; however, there have been few attempts to evaluate how MT might shape performance behaviours. Here, we examine effects of playing MT on the emergence of children's match-play behaviours in 48 junior tennis players. Performance in 1010 match-play points were filmed and coded across 4 tennis stages (MT Red, MT Orange, MT Green and Full Ball), using a notational analysis system. Recorded performance variables included rally length, first serve percentage and shot type, for the purpose of analysing inter-stage comparisons. Results showed a series of specific adaptations to playing characteristics across the stages, including rally length, shot variety and serve success. MT Red rallies (7.36 ± 6.06) were longer than Full Ball rallies (3.83 ± 2.40), and a higher percentage of forehands were played at MT Red (66.40 ± 8.49%) than at Full Ball stage (45.96 ± 6.47%). Findings suggested that MT stages can afford children more opportunities to develop their skills and elicit different match-play characteristics than Full Ball task constraints. Coaches, therefore, should consider the nature of emergent adaptations when designing practice environments to facilitate learning in young tennis players. [ABSTRACT FROM AUTHOR]

Introduction:OSCEs are commonly conducted in multiple cycles (different circuits, times, and locations), yet the potential for students’ allocation to different OSCE cycles is rarely considered as a source of variance—perhaps in part because conventional psychometrics provide limited insight. Methods:We used Many Facet Rasch Modeling (MFRM) to estimate the influence of “examiner cohorts” (the combined influence of the examiners in the cycle to which each student was allocated) on students’ scores within a fully nested multi-cycle OSCE. Results:Observed average scores for examiners cycles varied by 8.6%, but model-adjusted estimates showed a smaller range of 4.4%. Most students’ scores were only slightly altered by the model; the greatest score increase was 5.3%, and greatest score decrease was −3.6%, with 2 students passing who would have failed. Discussion:Despite using 16 examiners per cycle, examiner variability did not completely counter-balance, resulting in an influence of OSCE cycles on students’ scores. Assumptions were required for the MFRM analysis; innovative procedures to overcome these limitations and strengthen OSCEs are discussed. Conclusions:OSCE cycle allocation has the potential to exert a small but unfair influence on students’ OSCE scores; these little-considered influences should challenge our assumptions and design of OSCEs. [ABSTRACT FROM PUBLISHER]

Background:Evidence suggests that college students are often unclear about how much alcohol is present in different drinks.Objectives:To evaluate the abilities of students to estimate the alcohol contents of drinks, both in relative and absolute terms, and to examine how alcohol strength informs behavior.Methods:For 10 popular drinks that varied by alcohol content, beverage and volume, 209 UK university students rank-ordered the drinks according to total alcohol content and then estimated, for each drink, the number of UK “units” of alcohol contained and its percentage alcohol-by-volume (% ABV). Participants also reported the importance of drink strength as a factor in drink choice, and its influence in different scenarios.Results:There was low but significant concordance between participants’ rank-orderings of drinks by strength, and the correlation of mean ranks with correct ranks was also significant. However, their explicit estimates of the numbers of “units” in the drinks, and their % ABV values, often diverged dramatically from actual values. Participants tended to overestimate the unit contents of spirit-based drinks but underestimated the unit contents of beers and wine; women were consistently less accurate than men, typically making greater underestimates for commonly-consumed drinks. Over one-third of the sample reported that strength influenced drink choice, but its importance ranked below flavor and cost; drink strength might contribute to drink choice depending on the drinking situation.Conclusion/Importance:Young drinkers (women especially) have a poor awareness of the alcohol contents of different drinks, particularly wines and beers, but they make better judgments of relative strength. [ABSTRACT FROM PUBLISHER]

Objective: The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury. Methods: A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4. Results: The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up. Conclusions: This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort. [ABSTRACT FROM PUBLISHER]

Objective: To assess (1) the feasibility of incorporating the Ida Institute’s Motivation Tools into a UK audiology service, (2) the potential benefits of motivational engagement in first-time hearing aid users, and (3) predictors of hearing aid and general health outcome measures. Design: A feasibility study using a single-centre, prospective, quasi-randomized controlled design with two arms. The Ida Institute’s Motivation Tools formed the basis for motivational engagement. Study sample: First-time hearing aid users were recruited at the initial hearing assessment appointment. The intervention arm underwent motivational engagement (M+, n = 32), and a control arm (M-, n = 36) received standard care only. Results: The M+ group showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting. Hearing-related communication scores predicted anxiety, and social isolation scores predicted depression for the M+ group. Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group. Hearing sensitivity was not a predictor of outcomes. Conclusions: There were some positive results from motivational engagement early in the patient journey. Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between deficits associated with traumatic brain injury (TBI) and case management (CM) and care/support (CS) in two UK community samples. Research design: Prospective descriptive study. Method: Case managers across the UK and from a single UK CM service contributed client profiles to two data sets (Groups 1 and 2, respectively). Data were entered on demographics, injury severity, functional skills, functional-cognition (including executive functions), behaviour and CM and CS hours. Relationships were explored between areas of disability and service provision. Results: Clients in Group 2 were more severely injured, longer post-injury and had less family support than clients in Group 1. There were few significant differences between Groups 1 and 2 on measures of Functionalskill, Functional-cognition and Behaviour disorder. Deficits in Functionalskills were associated with CS, but not CM. Deficits in measures of executive functions (impulsivity, predictability, response to direction) were related to CM, but not to CS. Insight was related to both CM and CS. Variables related to behaviour disorder were related to CM, but were less often correlated to CS. Conclusions: The need for community support is related not only to Functionalskills (CS), but also to behaviour disorder, self-regulatory skills and impaired insight (CM). [ABSTRACT FROM PUBLISHER]

Primary objective: To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. Research design: A retrospective case note review assessed total rehabilitation unit admission. Methods and procedures: Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge. Main outcomes and results: A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = −6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36–68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002–0.35). Conclusions: There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort. [ABSTRACT FROM AUTHOR]

Background: UK social firms are under-researched but are a potentially important vocational option for people with mental health problems. Aims: To describe the clinical profile, satisfaction levels and experiences of social firms employees with mental health problems. Method: Clinical, work and service use characteristics were collected from social firms' employees with mental health problems in England and Wales. Workplace experience and satisfaction were explored qualitatively. Results: Predominantly, social firms' employees (N = 80) report that they have a diagnosis of depression (56%) and anxiety (41%). People with schizophrenia (20%) or bipolar disorder (5%) were a minority. Respondents had low symptom and disability levels, high quality of life and job satisfaction and experienced reductions in secondary mental health service use over time. High-workplace satisfaction was related to flexibility, manager and colleague support and workplace accommodations. Conclusions: The clinical profile, quality of life and job satisfaction level of employees with mental health problems suggest social firms could be a useful addition to UK vocational services for some people. Current employees mainly have common mental disorders, and social firms will need to shift their focus if they are to form a substantial pathway for the vocational recovery of people currently using community mental health teams. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables.Background:Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth.Methods:UK (N= 193) and Croatian (N= 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies.Results:Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth.Conclusion:This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth. [ABSTRACT FROM PUBLISHER]

Background: Prospective memory is a common deficit following brain injury that can reduce an individuals' ability to complete everyday tasks. The smartphone is a device that may compensate for these difficulties using the calendar's prompting function. Reminders can be programmed remotely using email to phone synchronization. Objective: To explore whether smartphone reminders help people complete pre-identified tasks as compared to when reminders are not provided. Methods: An ABAB case series design compared reminder present vs. reminder absent phases with regards completion of pre-set tasks. Six participants aged 24-55 with Acquired Brain Injury (ABI) and five caregivers participated in the study. Both completed a series of questionnaires looking at the impact of the smartphone reminders on everyday memory functioning at pre, post and follow-up. A 3-month follow-up questionnaire assessed continued use of the system. Results: There was a significant improvement in task completion rates when smartphone reminders were provided. A thematic analysis identified that smartphone reminders improved independence, confidence in coping with memory difficulties and general mood. All participants were still using the system at 3-month follow-up. Conclusions: Smartphone reminders may provide a cost-effective, accessible and non-stigmatizing tool for participants to compensate for prospective memory difficulties. [ABSTRACT FROM AUTHOR]

Introduction: Widening participation in Medicine is a key policy priority as it helps promote a diverse and representative workforce and improves patient care. The selection process employed can influence the socio-economic composition of the student cohort and this study therefore evaluated whether Multiple Mini Interview (MMI) performance was influenced by school type or area-level Higher Education (HE) participation rates. Methods: MMI performance for all UK applicants was recorded and consent to link performance with socio-economic data was requested using an applicant questionnaire. Station-level and total MMI scores, and offer rates were compared between applicants from non-selective, non-fee-paying schools and from selective and/or fee-paying schools; and between applicants from each quintile of area-level HE participation. Results: 793 applicants were included in the analysis. MMI performance and offer rates were slightly higher for applicants from non-selective, non-fee-paying schools and/or from lower HE participation quintiles, but the effects were small and not statistically significant. Conclusions: The MMI did not favour applicants from selective and/or fee-paying schools, or from areas with high HE participation rates. Work to evaluate whether the relationship between MMI and medical school performance is the same for all sub-groups of students is now required. [ABSTRACT FROM AUTHOR]

Sperm donor profiles in catalogues exhibited in commercial sperm bank websites provide health information about each donor, both explicitly and implicitly. Donors' anonymity poses a great challenge to signalling credibility. Inspired by both Spence's signalling theory and Walther and Park's warranting theory, the study explores the way sperm donors add credibility to their self-presentations. Profiles of 135 donors from nine sperm banks in Europe and North America were content analysed; 36 of these donors' baby photos were visually analysed. Donors compensated for the paucity of usable warrants by adding intensified emotional context to the profile and inviting potential recipients to join a fantasy family. The article concludes with some practical recommendations aimed at facilitating the process of donor selection for the benefit of donor insemination users, as well as fertility practitioners, and sperm donors. [ABSTRACT FROM AUTHOR]

In the UK,low-intensitycognitive-behavioural therapy (LICBT) is offered as cost-effective intervention for anxiety and depression in primary care. Whilst research with Latino migrants in the USA highlights the suitability of CBT interventions with this group, these findings may not be generalisable to the UK, due to different sociopolitical circumstances. This mixed-method study explores theeffectivenessandmeaningof an LICBT group-intervention for Latino migrants in London. Eight participants attended a four-week workshop on anxiety management in Spanish, and pre- and post-intervention scores in CORE-OM, PHQ-9 and GAD-7 were compared. Additionally, focus groups about the intervention were thematically analysed. Although not statistically significant, a trend towards decreasing anxiety levels was identified (p= 0.06). Three of the four themes generated from participants' analysis of their experience are summarised and discussed. These include positive aspects of the intervention and its limitations. Whilst valuing LICBT interventions, participants considered further input necessary. Potential clinical implications as well as recommendations for further research are discussed. [ABSTRACT FROM PUBLISHER]

Within the clinical literature it is accepted that there is a strong connection between eating disorders and depression; however the nature of the casual relationship is somewhat unclear. Therefore the aim of the present study was to determine the prospective relationship between eating psychopathology and depressive symptoms among competitive British athletes. A total of 122 athletes completed the Eating Disorder Examination Questionnaire and the depression subscale of the Symptom Checklist-90R over a 6-month period. Partial correlations revealed that when controlling for baseline eating psychopathology, athletes’ baseline depressive symptoms was not related to their eating psychopathology 6 months later. However, when controlling for baseline depressive symptoms, athletes’ initial eating psychopathology was positively and significantly related to depressive symptoms 6 months later. Subsequent hierarchical multiple regression analyses revealed athletes’ initial levels of eating psychopathology significantly predicted depressive symptoms 6 months later. The current findings support the assertion that elevated eating psychopathology serves as a potential risk factor for the development of depression in athletes. Thus, National Governing Bodies, athletic clubs, sport organisations and universities need to recognise and be aware that exposure to the factors that increase the risk of eating disorders inadvertently serves to increase athletes’ vulnerability for depression. [ABSTRACT FROM AUTHOR]

A series of laboratory experiments was carried out to assess transfer of liquids (vinegar) and powders (calcium acetate and magnesium carbonate) from hands, arms, gloves, respirators, clothing, and pens to the oral cavity or the perioral area (the area surrounding the mouth). Experiments were carried out with four volunteers. Thedonorarea (the hands, arms, gloves, and so on) was loaded with a known mass of the test substance and was then brought into contact thereceiverarea (the oral cavity or the perioral area). The percentage of the substance on thedonorthat transferred to thereceiver(the transfer efficiency or TE) was assessed using saliva samples and gauze wipes of the perioral area. Magnesium carbonate was measured on gauze and in saliva using inductively coupled plasma/atomic emission spectrometry. Calcium acetate and vinegar were measured using ion chromatography/electrochemical detection. Average transfer efficiencies were calculated for each substance and transfer scenario; these were compared using ANOVA and Kruskal-Wallis tests. Overall, direct transfer from the hands to the oral cavity was significantly higher (mean TE = 51.6) than indirect transfer from the hands to the oral cavity via the perioral area by licking the lips (mean TE = 11.5). The results suggested higher TEs for liquids than for solids and that hand-to-mouth TEs may increase with water solubility. Transfer from bare arms to the perioral area was higher than from arms covered by cotton sleeves for both liquids and powders. Although TE data are often required by models estimating exposure by inadvertent ingestion, relatively few published data are available. This study has provided evidence of some factors that may influence transfer of chemicals from hands or objects to the mouth (physical form, use of clothing, and so on) and has provided data that are essential for the development of predictive exposure models of inadvertent ingestion exposure. [ABSTRACT FROM AUTHOR]