• Dealing with comparability problem of cross-cultural data

      Ertubey, Candan; Russell, R.J.H.; University of Bedfordshire (PSYCHOLOGY PRESS, 1996-01-01)
    • The defining constituents of adult attachment and their assessment

      Sochos, Antigonos (Springer, 2013-06-04)
      Reviewing the major issues regarding the definition of adult attachment and the nature of the attachment representations, this paper points out that attachment theory approaches intimate interpersonal processes using three fundamental dichotomies: self versus other, autonomy versus relatedness, and dependent versus depended-on positions. When these three dichotomies are intersected, eight components emerge to define the attachment representation: the autonomy and relatedness requests and autonomy and relatedness provisions of self and other. Moreover, as the main methodologies assessing adult attachment are also reviewed, it is argued that these have not yet provided an exhaustive empirical assessment of these eight components individually. It is suggested that such an approach to assessment may yield interesting findings. © 2013 Springer Science+Business Media New York.
    • Disowned recollections: denying true experiences undermines belief in occurrence but not judgments of remembering

      Mazzoni, Giuliana; Clark, Andrew; Nash, Robert A.; University of Hull; University of Surrey (Elsevier, 2013-12-15)
      Recent research findings have illustrated that false memories induced in the laboratory can be dissociated from the beliefs that the events had in fact occurred. In this study we assessed whether this dissociability is a quality peculiar to false memory, or whether it represents a general characteristic of autobiographical memory. To this end we examined whether people can be induced to stop believing in memories for true experiences. Participants observed and performed simple actions, and were later falsely informed that they had not performed some of them-that false memories for these actions had been implanted through the use of fabricated evidence. Before and after receiving this misinformation, participants rated their belief in and memory of performing those actions, other actions that they had also performed, and actions that they had not performed. Whereas the misinformation substantially undermined participants' beliefs in the specific performed actions about which they had been misinformed, it had little effect on their endorsement of remembering those actions. The misinformation thus boosted the proportion of occasions in which participants rated their memories as stronger than their beliefs, and it weakened the correlation between belief and memory ratings. Thus, this study provides the first experimental demonstration of non-believed memories of true experiences. We discuss our findings with reference to the small literature concerning the use of socially-communicated misinformation to undermine event memories, and with reference to the structure of autobiographical memory. © 2013 Elsevier B.V.
    • Drink wise, age well; reducing alcohol related harm among people over 50: a study protocol

      Seddon, Jennifer L.; Wadd, Sarah; Wells, E.; Elliott, L.; Madoc-Jones, I.; Breslin, J.; University of Bedfordshire; Drink Wise, Age Well Programme; Glasgow Caledonian University; Glyndŵr University (BioMed Central Ltd., 2019-02-28)
      Background: Evidence suggests that the use of alcohol among older adults (defined as those aged 50+) has increased in recent years, with people aged 55-64 now more likely to exceed the recommended weekly guidelines than any other age group. Methods/ design: This is a quasi-experimental study with a before-after design. A postal questionnaire will be sent to 76,000 people aged 50 and over registered with a general practice in five different 'demonstration' (intervention) and control areas in the UK. Multiple interventions will then be delivered in demonstration areas across the UK. At the end of the programme, a postal questionnaire will be sent to the same individuals who completed it pre-programme to establish if there has been a reduction in alcohol use, at-risk drinking and alcohol related problems. Qualitative interviews with clients and staff will explore how the interventions were experienced; how they may work to bring about change and to identify areas for practice improvements. Discussion: This study protocol describes a multi-level, multi-intervention prevention-to-treatment programme which aims to reduce alcohol-related harm in people aged 50 and over.
    • The effect of ANKK1 Taq1A and DRD2 C957T polymorphisms on executive function: a systematic review and meta-analysis

      Klaus, Kristel; Butler, Kevin; Curtis, Ffion; Bridle, Christopher; Pennington, Kyla; ; University of Lincoln (Elsevier Ltd, 2019-03-02)
      Research in healthy adults suggests that C957T polymorphism of the dopamine D2 receptor encoding DRD2 and the Taq1A polymorphism of the neighbouring gene ankyrin repeat and kinase domain containing 1 (ANKK1) alter dopaminergic signalling and may influence prefrontally-mediated executive functions. A systematic review and meta-analysis was carried out on the evidence for the association of DRD2 C957T and ANKK1 Taq1A polymorphisms in performance on tasks relating to the three core domains of executive function: working memory, response inhibition and cognitive flexibility in healthy adults. CINAHL, MEDLINE, PsycARTICLES and PsychINFO databases were searched for predefined key search terms associated with the two polymorphisms and executive function. Studies were included if they investigated a healthy adult population with the mean age of 18–65 years, no psychiatric or neurological disorder and only the healthy adult arm were included in studies with any case-control design. Data from 17 independent studies were included in meta-analysis, separated by the Taq1A and C957T polymorphisms and by executive function tests: working memory (Taq1A, 6 samples, n = 1270; C957 T, 6 samples, n = 977), cognitive flexibility (C957 T, 3 samples, n = 620), and response inhibition (C957 T, 3 samples, n = 598). The meta-analyses did not establish significant associations between these gene polymorphisms of interest and any of the executive function domains. Theoretical implications and methodological considerations of these findings are discussed.
    • The effect of HVP training in vowel perception on bilingual speech production

      Kangatharan, Jayanthiny; Giannakopoulou, Anastasia; Uther, Maria; University of Winchester; University of Bedfordshire; University of Wolverhampton (Conscientia Beam, 2021-02-25)
      Prior investigations (Giannakopoulou et al., 2013) have indicated high variability phonetic training intervention can help L2 English adult learners change the perception of vowels such that they shift their attention to primary cues (spectral features) rather than secondary cues (e.g. duration) to correctly identify vowels in L2. This experiment explores if high-variability training impacts on L2 adult learners’ production of L2 speech. Production samples from a prior experiment were used to conduct ratings of accuracy (Giannakopoulou, 2012). In the current experiment, the production samples were transcribed and rated for accuracy by twenty native English listeners. The intelligibility levels of L2 learners’ speech samples as indexed by higher accuracy in transcription were observed as having been rated higher following training than prior to training. The implications of the results are considered with regard to theories on the connection between speech production and perception, and Flege’s (1995) Speech Learning Model.
    • Effectiveness of non-pharmacological interventions for insomnia in children with Autism Spectrum Disorder: a systematic review and meta-analysis

      Keogh, Sophie; Bridle, Christopher; Siriwardena, Niroshan A.; Nadkarni, Amulya; Laparidou, Despina; Durrant, Simon J.; Kargas, Niko; Law, Graham A.; Curtis, Ffion; Lincolnshire Partnership Foundation Trust; et al. (Public Library of Science, 2019-08-22)
      Background Autism spectrum disorders (ASD) are a set of neurodevelopmental disorders characterised by behavioural, communication and social impairments. The prevalence of sleep disturbances in children with ASD is 40–80%, with significant effects on quality of life for the children and carers. This systematic review aimed to synthesise evidence of the effects of behavioural interventions to improve sleep among children with ASD. Methods Databases (MEDLINE, PsycINFO, CINAHL, ScienceDirect, Autism Data, CENTRAL, ClinicalTrials.gov and Current Controlled Trials) were searched for published, unpublished and ongoing randomised controlled trials evaluating the effect of non-pharmacological interventions for insomnia in children with autism spectrum conditions. Results Three studies met the inclusion criteria, one provided actigraphy data, one Children’s Sleep Habits Questionnaire (CSHQ) data, and one both actigraphy and CSHQ data for use in meta-analyses. There were significant differences between the behavioural intervention and comparison groups (actigraphy data) for total sleep time (24.41 minutes, 95% CI 5.71, 43.11, P = 0.01), sleep latency (-18.31 minutes, 95% CI -30.84, -5.77, P = 0.004) and sleep efficiency (5.59%, 95% CI 0.87, 10.31, P = 0.02). There was also a favourable intervention effect evident for the subjective CSHQ data (-4.71, 95% CI -6.70, -2.73, P<0.00001). Risk of bias was low across several key domains (randomisation, allocation concealment and reporting), with some studies being unclear due to poor reporting. Conclusions There are very few high quality randomised controlled trials in this area. Here we provide initial synthesised quantitative evidence of the effectiveness of behavioural interventions for treating sleep problems in children with ASD.
    • Effects of cognitive behavioural therapy on insomnia in adults with tinnitus: systematic review and meta-analysis of randomised controlled trials

      Curtis, Ffion; Laparidou, Despina; Bridle, Christopher; Law, Graham R.; Durrant, Simon J.; Rodriguez, Alina; Pierzycki, Robert H.; Siriwardena, Aloysius N.; ; University of Lincoln; et al. (Elsevier, 2020-12-01)
      Insomnia is common in patients with tinnitus and negatively affects tinnitus symptoms and quality of life. This systematic review aimed to synthesise evidence of the effectiveness of cognitive behavioural therapy (CBT) based interventions on insomnia in adults with tinnitus. We conducted a comprehensive database search (MEDLINE, CINAHL, Web of Science, CENTRAL, ClinicalTrials.gov and PROSPERO) for published, unpublished and ongoing randomised controlled trials of CBT in adults with tinnitus. Five trials met the inclusion criteria for the systematic review, with four of these providing data for the meta-analysis. This demonstrated a statistically significant reduction in Insomnia Severity Index (a standard diagnostic questionnaire of insomnia used in clinical settings) following CBT (−3.28, 95% CI -4.51, −2.05, P=&lt;0.001). There was no evidence of statistical heterogeneity (I2 = 0%). Risk of bias was considered low in all categories except blinding of participants, personnel, and/or the assessment of outcomes. Here, for the first time, we demonstrate that CBT-based interventions can significantly improve sleep in adults with tinnitus.
    • The effects of dream rebound: evidence for emotion-processing theories of dreaming

      Malinowski, Josie; Carr, Michelle; Edwards, Christopher; Ingarfill, Anya; Pinto, Alexandra; University of East London; Swansea University; University of Bedfordshire (Blackwell Publishing Ltd, 2019-03-12)
      Suppressing thoughts often leads to a “rebound” effect, both in waking cognition (thoughts) and in sleep cognition (dreams). Rebound may be influenced by the valence of the suppressed thought, but there is currently no research on the effects of valence on dream rebound. Further, the effects of dream rebound on subsequent emotional response to a suppressed thought have not been studied before. The present experiment aimed to investigate whether emotional valence of a suppressed thought affects dream rebound, and whether dream rebound subsequently influences subjective emotional response to the suppressed thought. Participants (N = 77) were randomly assigned to a pleasant or unpleasant thought suppression condition, suppressed their target thought for 5 min pre-sleep every evening, reported the extent to which they successfully suppressed the thought, and reported their dreams every morning for 7 days. It was found that unpleasant thoughts were more prone to dream rebound than pleasant thoughts. There was no effect of valence on the success or failure of suppression during wakefulness. Dream rebound and successful suppression were each found to have beneficial effects for subjective emotional response to both pleasant and unpleasant thoughts. The results may lend support for an emotion-processing theory of dream function.
    • Effects of intradialytic cycling exercise on exercise capacity, quality of life, physical function and cardiovascular measures in adult haemodialysis patients: a systematic review and meta-analysis

      Young, Hannah M.L.; March, Daniel S.; Graham-Brown, Matthew P.M .; Jones, Arwel; Curtis, Ffion; Grantham, Charlotte S.; Churchward, Darren R.; Highton, Patrick; Smith, Alice C.; Singh, Sally J.; et al. (Oxford University Press, 2018-03-28)
      Background. Intradialytic cycling (IDC), delivered during haemodialysis (HD), has the potential to improve many health issues. This systematic review and meta-analysis examine the evidence on the effects of IDC on exercise capacity, quality of life (QoL), physical function and cardiovascular health. Methods. Twenty-four databases were searched alongside Internet and hand searching, and consultation with experts. Eligibility criteria were cluster randomized, randomized and quasi-randomized controlled trials (RCTs) of IDC versus usual care in prevalent adult HD patients. Primary outcome measures were exercise capacity (VO2 peak and field tests) and QoL. Secondary measures were cardiac and physical function. Results. Thirteen RCTs were eligible. Eight provided data for use in meta-analyses, which indicated no significant change in VO2 peak (mean difference, MD 1.19 mL/kg/min, 95% confidence interval 1.15 to 3.52, P ¼ 0.3), physical (mean change, MC 1.97, 8.27 to 12.22, P ¼ 0.7) or mental component (MC 3.37, 7.94 to 14.68, P ¼ 0.6) summary scores of the Medical Outcomes Short Form 36, pulse wave velocity (MD 0.57 m/s, 1.55 to 0.41, P ¼ 0.4), systolic (MD 2.28 mmHg, 14.46 to 9.90, P ¼ 0.7) or diastolic blood pressure (MD 2.25 mmHg, 3.01 to 7.50, P ¼ 0.4) following IDC. IDC, however, leads to an improvement in performance on the 6-min walk test (MD 87.84 m, 39.60-136.09, P ¼ 0.0004). All included studies were considered to have high risk of bias. Conclusions. There is insufficient evidence demonstrating whether cycling exercise during HD improves patient outcomes. High-quality, adequately powered RCTs of IDC are required.
    • Efficacy of supervised maintenance exercise following pulmonary rehabilitation on health care use: a systematic review and meta-analysis

      Jenkins, Alex R.; Gowler, Holly; Curtis, Ffion; Holden, Neil S.; Bridle, Christopher; Jones, Arwel; ; University of Lincoln (Dove Medical Press Ltd., 2018-01-10)
      Introduction: The clinical benefit of continued supervised maintenance exercise programs following pulmonary rehabilitation in COPD remains unclear. This systematic review aimed to synthesize the available evidence on the efficacy of supervised maintenance exercise programs compared to usual care following pulmonary rehabilitation completion on health care use and mortality. Methods: Electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, and PEDro) and trial registers (ClinicalTrials.gov and Current Controlled Trials) were searched for randomized trials comparing supervised maintenance exercise programs with usual care following pulmonary rehabilitation completion. Primary outcomes were respiratory-cause hospital admissions, exacerbations requiring treatment with antibiotics and/or systemic corticosteroids, and mortality. Results: Eight trials (790 COPD patients) met the inclusion criteria, six providing data for meta-analysis. Continued supervised maintenance exercise compared to usual care following pulmonary rehabilitation completion significantly reduced the risk of experiencing at least one respiratory-cause hospital admission (risk ratio 0.62, 95% confidence interval [CI] 0.47–0.81, P,0.001). Meta-analyses also suggested that supervised maintenance exercise leads to a clinically important reduction in the rate of respiratory-cause hospital admissions (rate ratio 0.72, 95% CI 0.50–1.05, P=0.09), overall risk of an exacerbation (risk ratio 0.79, 95% CI 0.52–1.19, P=0.25), and mortality (risk ratio 0.57, 95% CI 0.17–1.92, P=0.37). Conclusion: In the first systematic review of the area, current evidence demonstrates that continued supervised maintenance exercise compared to usual care following pulmonary rehabilitation reduces health care use in COPD. The variance in the quality of the evidence included in this review highlights the need for this evidence to be followed up with further high-quality randomized trials.
    • Effort-reward imbalance in academic employees: examining different reward systems

      Kinman, Gail; University of Bedfordshire (APA, 2019-05-01)
      This study draws upon the effort-reward imbalance (ERI) model of job stress to predict mental and physical health in academic employees working in UK universities. It examines the main and interactive effects of extrinsic efforts over time and the three reward systems of the ERI model independently (i.e. promotion, esteem and security rewards). The main and interactive effects of intrinsic effort (known as overcommitment) in predicting health status are also examined. A sample of 458 academic employees completed ERI scales at baseline and the health measures 14 months later. The results showed that higher extrinsic effort, lower esteem and security rewards and an imbalance between efforts and esteem rewards assessed at Time 1 predicted mental health status on follow-up. Physical health symptoms were predicted by higher extrinsic effort and lower security rewards. Overcommitment was an independent risk factor for both mental and physical health. No further contribution was made to the variance in either outcome by the other effort-reward ratios independently or by their interactions with overcommitment. Interventions are suggested that have potential to reduce extrinsic and intrinsic efforts and increase rewards in the university sector.
    • Effort–reward imbalance and overcommitment in UK academics: implications for mental health, satisfaction and retention

      Kinman, Gail (Taylor & Francis (Routledge), 2016-05-09)
      This study utilises the effort–reward imbalance (ERI) model of job stress to predict several indices of well-being in academics in the UK: mental ill health, job satisfaction and leaving intentions. This model posits that (a) employees who believe that their efforts are not counterbalanced by sufficient rewards will experience impaired well-being and (b) feelings of ERI are more frequent and damaging in employees who are overcommitted to the job. A sample of 649 academic employees working in UK higher education institutions completed validated measures. Findings showed that academics who found their work more demanding, who perceived greater rewards and who were less overcommitted typically reported poorer well-being across all measures. Rewards related to esteem/support and financial/status appeared to be particularly important in protecting academics from the negative impact of work-related efforts. Potential interventions are discussed that draw on the ERI framework to improve mental health, satisfaction and retention in the sector.
    • Eligibility for interventions, co-occurrence and risk factors for unhealthy behaviours in patients consulting for routine primary care: results from the Pre-Empt study

      Randell, Elizabeth; Pickles, Timothy; Simpson, Sharon A.; Spanou, Clio; McCambridge, Jim; Hood, Kerenza; Butler, Christopher C. (BioMed Central, 2015-10-09)
      Smoking, excessive drinking, lack of exercise and a poor diet remain key causes of premature morbidity and mortality globally, yet it is not clear what proportion of patients attending for routine primary care are eligible for interventions about these behaviours, the extent to which they co-occur within individuals, and which individuals are at greatest risk for multiple unhealthy behaviours. The aim of the trial was to examine 'intervention eligibility' and co-occurrence of the 'big four' risky health behaviours - lack of exercise, smoking, an unhealthy diet and excessive drinking - in a primary care population. Data were collected from adult patients consulting routinely in general practice across South Wales as part of the Pre-Empt study; a cluster randomised controlled trial. After giving consent, participants completed screening instruments, which included the following to assess eligibility for an intervention based on set thresholds: AUDIT-C (for alcohol), HSI (for smoking), IPAQ (for exercise) and a subset of DINE (for diet). The intervention following screening was based on which combination of risky behaviours the patient had. Descriptive statistics, χ2 tests for association and ordinal regressions were undertaken. Two thousand sixty seven patients were screened: mean age of 48.6 years, 61.9 % female and 42.8 % in a managerial or professional occupation. In terms of numbers of risky behaviours screened eligible for, two was the most common (43.6 %), with diet and exercise (27.2 %) being the most common combination. Insufficient exercise was the most common single risky behaviour (12.0 %). 21.8 % of patients would have been eligible for an intervention for three behaviours and 5.9 % for all four behaviours. Just 4.5 % of patients did not identify any risky behaviours. Women, older age groups and those in managerial or professional occupations were more likely to exhibit all four risky behaviours. Very few patients consulting for routine primary care screen ineligible for interventions about common unhealthy behaviours, and most engage in more than one of the major common unhealthy behaviours. Clinicians should be particularly alert to opportunities to engaging younger, non professional men and those with multi-morbidity about risky health behaviour. ISRCTN22495456. BACKGROUND METHODS RESULTS CONCLUSION TRIAL REGISTRATION
    • Emotional demands, compassion and mental health in social workers

      Kinman, Gail; Grant, Louise (Oxford Journals, 2020-01-31)
      Background: Compassion, described as the act of providing care based on empathy, dignity and respect, is intrinsic to effective health and social care.  Although delivering compassionate care has wide-ranging benefits for service users, more insight is needed into its effects on health and social care professionals. The emotional demands of ‘helping’ work can engender compassion fatigue that may impair wellbeing, whereas compassion satisfaction and feelings of compassion towards the self could be protective.  Aims: To examine the effects (direct and indirect) of compassion satisfaction, compassion fatigue and self-compassion on mental health in a cohort of social workers. Methods: We used validated scales to measure emotional demands, compassion satisfaction and fatigue, and self-compassion and the General Health Questionnaire-12 to assess mental health. We tested the main and moderating effects of emotional demands and the three facets of compassion using hierarchical regression analysis. Results: The study sample comprised 306 social workers (79% female). Participants who reported higher levels of compassion satisfaction and self-compassion tended to report better mental health, whereas compassion fatigue was a significant risk factor for wellbeing. The models explained 44% - 53% of the variance in mental health symptoms.  We found some evidence that compassion satisfaction and self-compassion buffer the negative effects of emotional demand on mental health, contributing 2% and 3% respectively to the incremental variance. Conclusions:  Our findings suggest that evidence-based interventions are needed to reduce compassion fatigue and enhance compassion satisfaction and self-compassion in social care work. We consider ways to accomplish this using targeted interventions. 
    • Emotional expressivity and somatization symptoms in clinically depressed patients

      Kaviani, Hossein; Tabrizi, Maryam Kompani (OMICS International, 2016-07-06)
      Somatization might be defined as a process by which psychological, emotional pains and distress is expressed as physical symptoms without a known organic basis. This study aims to examining somatization symptoms among clinically depressed patients with White-American and Hispanic background. Participants diagnosed with major depressive disorder without psychotic features (DSM-V) completed self-report measures for somatization, depression, emotional expressivity (EE), and demographics. The findings suggest that patients low on emotional expressivity may tend to experience and report more bodily pains and complains than those who are emotionally expressive. No link between EE and depression was observed. Women scored higher on somatization then men in this study. In addition, Hispanics reported more somatization symptoms than their White American counterparts. The results of this study might contribute to provision of a clearer picture to distinguish between somatization syndrome and other actual physical conditions.
    • Emotional labour and wellbeing: what protects nurses?

      Kinman, Gail; Leggetter, Sandra; University of Bedfordshire (MDPI, 2016-11-30)
      Although compassionate care has wide-ranging benefits for patients, it can be emotionally demanding for healthcare staff. This may be a particular problem for those with little experience in a caring role. This study utilises the job demands-resources model to examine links between “emotional labour” and emotional exhaustion in student nurses. In line with the triple-match principle—whereby interactive effects are more likely when job demands, resources, and outcomes are within the same qualitative domain—the protective role of emotional support and emotion-focused coping (i.e., emotional venting) in the relationship between emotional labour and exhaustion is also explored. An online questionnaire was completed by 351 student nurses with experience working in healthcare settings. A strong positive relationship was found between emotional labour and emotional exhaustion, and some support was found for the moderating effects of emotional support and emotion-focused coping. Ways to help student and qualified nurses develop the emotional resilience required to protect their wellbeing, while providing high-quality compassionate care to patients are considered.
    • Epigenetic-based hormesis and age-dependent altruism: additions to the behavioural constellation of deprivation

      Brown, William Michael; Olding, Rose Jyoti; University of Bedfordshire (Cambridge University Press, 2017-10-22)
      We support Pepper and Nettle’s (P&N’s) hypothesised adaptive responses to deprivation. However, we argue that adaptive responses to stress shift with age. Specifically, present-oriented behaviours are adaptive for young people (e.g., in terms of mating and reproduction) but costly for older people in deprived communities who would benefit from investing in grandchildren. Epigenetic mechanisms may be responsible for age-related tactical shifts.    
    • Evaluating follow-up and complexity in cancer clinical trials (EFACCT): an eDelphi study of research professionals' perspectives

      Jones, Helene Markham; Curtis, Ffion; Law, Graham A.; Bridle, Christopher; Boyle, Dorothy; Ahmed, Tanweer; University of Lincoln; United Lincolnshire Hospitals NHS Trust; University of Bedfordshire; South East Scottish Cancer Research Network (SESCRN) (BMJ Publishing Group, 2020-02-18)
      To evaluate patient follow-up and complexity in cancer clinical trial delivery, using consensus methods to: (1) identify research professionals' priorities, (2) understand localised challenges, (3) define study complexity and workloads supporting the development of a trial rating and complexity assessment tool (TRACAT). A classic eDelphi completed in three rounds, conducted as the launch study to a multiphase national project (evaluating follow-up and complexity in cancer clinical trials). Multicentre online survey involving professionals at National Health Service secondary care hospital sites in Scotland and England varied in scale, geographical location and patient populations. Principal investigators at 13 hospitals across nine clinical research networks recruited 33 participants using pre-defined eligibility criteria to form a multidisciplinary panel. Statements achieving a consensus level of 70% on a 7-point Likert-type scale and ranked trial rating indicators (TRIs) developed by research professionals. The panel developed 75 consensus statements illustrating factors contributing to complexity, follow-up intensity and operational performance in trial delivery, and specified 14 ranked TRIs. Seven open questions in the first qualitative round generated 531 individual statements. Iterative survey rounds returned rates of 82%, 82% and 93%. Clinical trials operate within a dynamic, complex healthcare and innovation system where rapid scientific advances present opportunities and challenges for delivery organisations and professionals. Panellists highlighted cultural and organisational factors limiting the profession's potential to support growing trial complexity and patient follow-up. Enhanced communication, interoperability, funding and capacity have emerged as key priorities. Future operational models should test dialectic Singerian-based approaches respecting open dialogue and shared values. Research capacity building should prioritise innovative, collaborative approaches embedding validated review and evaluation models to understand changing operational needs and challenges. TRACAT provides a mechanism for continual knowledge assimilation to improve decision-making.
    • Evaluation of an collision-involved driver improvement scheme

      Guppy, Andrew; Adams-Guppy, Julie Rachel (Emerald, 2021-03-01)
      The purpose of this study was to compare driver knowledge, attitudes and perceptions (in terms of hazard, risk, accident, offence detection and driving skill perceptions) and self-reported driving style in a sample of 461 drivers before and after attending a UK Driver Improvement Scheme for culpable collision-involved drivers, in order to inform future directions in the design of driver retraining programmes. Participants were a sample of 461 drivers attending a UK 1.5 day Driver Improvement Scheme course for culpable collision-involved drivers. The course contained classroom-based training and a practical driving component. Participants completed a Driver Improvement Scheme Questionnaire (DISQ) before and immediately after attending the 1.5 day course, and again 3 months later. Results indicated significant pre and post course effects in terms of increased driving safety with respect to driving knowledge, perceptions of control, perceived likelihood of accident-involvement, hazard perception and reported risk-taking. Key positive effects of reduced risk-taking and nearmisses persisted three months after course completion. One limitation of this study is that at the 3-month follow-up there was a reduction in the response rate (44.69%) which included significantly fewer young drivers. Results indicate positive behavioural, perceptual and behavioural changes, along with specific age, gender and driving experience effects which have implications for the design of future driving courses. This study has implications for community safety through enhanced road safety training measures. The analysis of age, gender and driving experience effects of the impact of this Driver Improvement Scheme will allow targeted training methods for specific groups of drivers.