• The Sign 4 Little Talkers intervention to improve listening, understanding, speaking, and behavior in hearing preschool children: outcome evaluation

      Davidson, Rosemary; Randhawa, Gurch; University of Bedfordshire (JMIR Publications, 2020-06-30)
      Gaining age-appropriate proficiency in speech and language in the early years is crucial to later life chances; however, a significant proportion of children fail to meet the expected standards in these early years outcomes when they start school. Factors influencing the development of language and communication include low income, gender, and having English as an additional language (EAL). This study aimed to determine whether the Sign 4 Little Talkers (S4LT) program improves key developmental outcomes in hearing preschool children. S4LT was developed to address gaps in the attainment of vocabulary and communication skills in preschool children, identified through routine monitoring of outcomes in early years. Signs were adapted and incorporated into storybooks to improve vocabulary, communication, and behavior in hearing children. An evaluation of S4LT was conducted to measure key outcomes pre- and postintervention in 8 early years settings in Luton, United Kingdom. A total of 118 preschool children were tested in 4 early years outcomes domains-listening, speaking, understanding, and managing feelings and behavior-as well as Leuven well-being scales and the number of key words understood and spoken. Statistically significant results were found for all measures tested: words spoken (P<.001) and understood (P<.001), speaking (P<.001), managing feelings and behavior (P<.001), understanding (P<.001), listening and attention (P<.001), and well-being (P<.001). Approximately two-thirds of the children made expected or good progress, often progressing multiple steps in educational attainment after being assessed as developmentally behind at baseline. The findings reported here suggest that S4LT may help children to catch up with their peers at a crucial stage in development and become school ready by improving their command of language and communication as well as learning social skills. Our analysis also highlights specific groups of children who are not responding as well as expected, namely boys with EAL, and who require additional, tailored support.
    • A qualitative study exploring the experiences of bereavement after stillbirth in Pakistani, Bangladeshi and White British mothers living in Luton, UK

      Garcia, Rebecca; Ali, Nasreen; Griffiths, Malcolm; Randhawa, Gurch; Open University; University of Bedfodshire; Luton & Dunstable University Hospital NHS Foundation Trust (Elsevier, 2020-08-29)
      This study aims to explore the experiences of bereavement after stillbirth of Pakistani, Bangladeshi and White British mothers in a town with multi-ethnic populations in England. A purposive sample of Pakistani, Bangladeshi and White British mothers aged over 16 (at time of infant birth), who suffered a stillbirth in the preceding 6-24 months and residing in a specified postcode area were invited to take part in the study, by an identified gatekeeper (audit midwife) from the local National Health Service Trust, in addition to local bereavement charities. Qualitative methods using face-to-face semi-structured interviews were undertaken, recorded and transcribed verbatim. Using framework analysis, several themes were identified. There were three main themes identified from the data; 1. knowledge and information of pregnancy and perinatal mortality; 2. attitudes and perceptions to pregnancy and perinatal mortality and 3. experiences with maternity care. The findings revealed mostly similarities in the bereavement experiences of the Pakistani, Bangladeshi and White British mothers. A few cultural and religious differences were identified. This study found important similarities in bereavement experiences of Pakistani, Bangladeshi and White British mothers and highlights considerations for policy makers and maternity services in how the timing of bereavement after care is provided, including advice surrounding the infant post-mortem.
    • Confidence and expectations about caring for older people with dementia: a cross-sectional survey of student nurses

      Baillie, Lesley; Merritt, Jane; Cox, Janet; Crichton, Nicola; ; University of Bedfordshire; South Bank University (Routledge, 2015-06-11)
      Older people who are living with dementia often need healthcare, including hospital admissions, due to additional health conditions. Caring for older people who are living with dementia is, therefore, a core nursing role. This study investigated student nurses’ expectations of, and confidence about, caring for older people with dementia and the effect of students’ age, precourse experience, and their academic year. The design was a cross-sectional survey using questionnaires to collect data. The participants (n = 328), based at one university in England, had all had at least one practice learning placement. Most student nurses (n = 202; 62%) had precourse contact with older people with dementia and had cared for them during the course (n = 291; 89%). The student's academic year significantly affected confidence about caring for older people with dementia (p = .006), but still only 52% (n = 26) of third-year students felt “generally confident.” Precourse contact with older people with dementia had a significant impact on expectations (p = .001) and confidence in caring for people with dementia (p = .002). Students who were >25 years were significantly more likely to have had precourse contact with older people with dementia (p = < .001). Nurse educators should ensure that students entering nurse education appreciate that caring for older people who are living with dementia will be a core part of their role. They must proactively prepare nursing students to care for people with dementia, recognizing that some students have no previous contact, which may affect their confidence and experiences.
    • Does intentional asphyxiation by strangulation have addictive properties?

      Chater, Angel M.; University of Bedfordshire (Wiley, 2020-09-04)
      Background and aims Intentional asphyxiation leads to cerebral hypoxia, starving the brain of oxygen and inducing hypoxic euphoria, but carries a serious risk of accidental death, especially if practised alone. This article raises the question as to whether it could usefully be regarded as having addictive properties. Methods and results A review of the literature, together with eight case study vignettes, are presented. Intentional asphyxiation can occur with or without sexual activity. Initiation often occurs in adolescence, with development in some cases of an entrenched behaviour pattern, driven by a strong euphoriant effect, without adequate safeguarding from serious harm, and being undertaken by people with co‐morbidities. There does not appear to be strong evidence of seeking support for cessation of the practice. Discussion Intentional asphyxiation behaviours may have addictive properties and understanding this aspect of the problem may be fruitful in guiding research and interventions aimed at addressing it.
    • A healthy contribution

      Johnston, Marie; Weinman, John; Chater, Angel M. (British Psychological Society, 2011-12-31)
      The Health Psychology Section of the British Psychological Society was inaugurated in December 1986. This special feature celebrates progress during those 25 years. An introduction by the founding chair, a founding committee member, and a current committee member is followed by a series of selections from some of the top figures in the field, as they choose a significant contribution to the discipline and the health of the nation.
    • Influences on antibiotic prescribing by non-medical prescribers for respiratory tract infections: a systematic review using the theoretical domains framework

      Chater, Angel M.; Family, Hannah; Lim, Rosemary; Courtenay, Molly; University of Bedfordshire; University of Bristol; University of Reading; Cardiff University (Oxford University Press, 2020-08-07)
      Background The need to conserve antibiotic efficacy, through the management of respiratory tract infections (RTIs) without recourse to antibiotics, is a global priority. A key target for interventions is the antibiotic prescribing behaviour of healthcare professionals including non-medical prescribers (NMPs: nurses, pharmacists, paramedics, physiotherapists) who manage these infections. Objectives To identify what evidence exists regarding the influences on NMPs’ antimicrobial prescribing behaviour and analyse the operationalization of the identified drivers of behaviour using the Theoretical Domains Framework (TDF). Methods The search strategy was applied across six electronic bibliographic databases (eligibility criteria included: original studies; written in English and published before July 2019; non-medical prescribers as participants; and looked at influences on prescribing patterns of antibiotics for RTIs). Study characteristics, influences on appropriate antibiotic prescribing and intervention content to enhance appropriate antibiotic prescribing were independently extracted and mapped to the TDF. Results The search retrieved 490 original articles. Eight papers met the review criteria. Key issues centred around strategies for managing challenges experienced during consultations, managing patient concerns, peer support and wider public awareness of antimicrobial resistance. The two most common TDF domains highlighted as influences on prescribing behaviour, represented in all studies, were social influences and beliefs about consequences. Conclusions The core domains highlighted as influential to appropriate antibiotic prescribing should be considered when developing future interventions. Focus should be given to overcoming social influences (patients, other clinicians) and reassurance in relation to beliefs about negative consequences (missing something that could lead to a negative outcome).
    • Culture and health

      Napier, A David; Ancarno, Clyde; Butler, Beverley; Calabrese, Joseph; Chater, Angel M.; Chaterjee, Helen; Guesnet, Francois; Horne, Robert; Jacyna, Stephen; Jadhav, Sushrut; et al. (Elsevier: Lancet, 2014-10-28)
    • Using a blended format (videoconference and face to face) to deliver a group psychosocial intervention to parents of autistic children

      Lodder, Annemarie; Papadopoulos, Chris; Randhawa, Gurch; University of Bedfordshire (Elsevier, 2020-08-26)
      Background Parents and carers of autistic children report poor mental health. Autism stigma is a strong contributing factor to poor parental mental health, yet there are currently no interventions available that are evidenced to improve parents' mental health in part through increasing resilience to stigma. Childcare and travel are well known barriers to attendance and attrition rates for this population are high. Methods A blended format psychosocial group support intervention was developed with the aim to improve parental mental health. Three sessions were delivered face to face, and five sessions via videoconference. A secret Facebook group was set up to support the intervention and increase retention rates. Mixed methods were used to assess the feasibility and acceptability of this mode of delivery for both the facilitator and service users. Attendance rates, fidelity and implementation issues are discussed. A qualitative focus group was conducted (n = 9) to explore the acceptability to the participants. Framework analysis was used to analyse the findings. Results Attendance rates were high with the online sessions having significantly higher attendance rates than the face to face sessions. The findings of the qualitative evaluation suggest that participants are positive about videoconferencing for a group support intervention. The facilitator reported sound quality, background distractions and late arrivals as challenges; the participants on the other hand, reported that the benefits far outweighed the negatives. Suggestions for improvement are made. Conclusions The results suggest that videoconference is a well-received method to provide a group support intervention to parents. Only preliminary conclusions can be drawn, owing to the small sample size.
    • A systematic review of the factors - barriers and enablers - affecting the implementation of clinical commissioning policy to reduce health inequalities in the National Health Service (NHS), UK

      Regmi, Krishna; Mudyarabikwa, Oliver; University of Bedfordshire; University of Dundee; Coventry University (Elsevier, 2020-08-29)
      Objective: The aim of the present study is two-fold. First, it attempts to identify the barriers and enablers of implementing clinical commissioning policy. Second, it synthesises how these barriers and enablers affect the success of National Health Service (NHS) efforts to reduce health inequalities in the UK. Methods: A systematic review was conducted. We searched large biomedical bibliographic databases, namely MEDLINE, EMBASE, CINAHL, Allied & Complementary Medicine, DH-DATA, Global Health and CINAHL for primary studies, conducted in the UK, that assessed the factors - barriers and enablers related to health inequalities, published from 2010 onwards and in English, and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We used Joanna Briggs Institute (JBI) Critical Appraisal and Mixed Methods Appraisal tools to assess the methodological qualities, and synthesised by performing thematic analysis. Two reviewers independently screened the articles and extracted data. Results: We included six primary studies (including a total of 1155 participants) in the final review. The studies reported two broad categories, under four separate themes: (1) the agenda of health inequalities has not been given priority; (2) there was very little evidence for reducing health inequalities through the clinical commissioning (CC) process; (3) CC was positively associated with the restructuring of NHS; and (4) CC brings better collaboration and engagement, which led to some improvements in health services access, utilisation and delivery at the local level. Conclusion: This study provides useful factors e barriers and enablers e to implement and deliver clinical commissioning policy in improving health and well-being. These factors could be assessed in future to develop objective measures and interventions to establish the link between commissioning and health inequalities.
    • Public, patient and carers’ views on palliative and end-of-life care in India

      Pallipalayam Varatharajan R; Ramasamy Venkatasalu, M.; Sirala Jagadeesh, N.; Elavally, S.; Pappas, Yannis; Mhlanga, Fortune; (Blackwell Publishing Ltd, 2017-08-30)
      Aim: To systematically review the existing evidence on the Indian public, patient and carers’ perspectives on palliative and end-of-life care. Background: With a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users’ (patients, family and public) perspectives is crucial in developing and sustaining successful community-centred palliative nursing policies and service models especially in countries like India with diverse population. Methods: An integrative review was performed on five databases, using hand searches of key journals and reference citation tracking for empirical studies published in English from 1990 to 2015. A thematic analysis framework was used to analyse and identify key themes. Results: Analysis of the six eligible studies revealed five themes. Themes describe how social, economic, cultural, religious, spiritual and traditional factors influenced the palliative and end-of-life care perspectives and experiences among Indians. They also illustrated preferences relating to place of care, as well as benefits and challenges of family caregiving during the last days of life. Conclusions: Although we found minimal evidence on user perspectives, nurses need to aware of those unique components of context-specific palliative and end-of-life care practices in India – socioeconomic, cultural and religious factors – on their nursing encounters. Nurses need to advocate same in policy development to enable accessibility and utility of palliative and end-of-life care services, which are scant in India. Implications for nursing and health policy: Nurses can be central in gathering the contextual evidence that advocate users’ perspectives to inform further studies and national palliative care policies in India. Emerging policies in nursing education need to focus on integrating family-centred palliative and end-of-life care within curricula, whereas nursing practice may promote nurse-led community models to address the patchy palliative and end-of-life service provision in India.
    • Implementing service improvement projects within pre-registration nursing education: a multi-method case study evaluation

      Baillie, Lesley; Bromley, Barbara; Walker, Moira; Jones, Rebecca Louise; Mhlanga, Fortune; ; London South Bank University; University College London Hospitals; University of Bedfordshire; University of Surrey (Elsevier, 2013-07-15)
      Background: Preparing healthcare students for quality and service improvement is important internationally. A United Kingdom (UK) initiative aims to embed service improvement in pre-registration education. A UK university implemented service improvement teaching for all nursing students. In addition, the degree pathway students conducted service improvement projects as the basis for their dissertations. Aim: The study aimed to evaluate the implementation of service improvement projects within a pre-registration nursing curriculum. Method: A multi-method case study was conducted, using student questionnaires, focus groups with students and academic staff, and observation of action learning sets. Questionnaire data were analysed using SPSS v19. Qualitative data were analysed using Ritchie and Spencer's (1994) Framework Approach. Results: Students were very positive about service improvement. The degree students, who conducted service improvement projects in practice, felt more knowledgeable than advanced diploma students. Selecting the project focus was a key issue and students encountered some challenges in practice. Support for student service improvement projects came from action learning sets, placement staff, and academic staff. Conclusion: Service improvement projects had a positive effect on students' learning. An effective partnership between the university and partner healthcare organisations, and support for students in practice, is essential.
    • Socially assistive robots, older adults and research ethics: the case for case-based ethics training

      Battistuzzi, Linda; Papadopoulos, Chris; Hill, Tetiana; Castro, Nina; Bruno, Barbara; Sgorbissa, Antonio (Springer, 2020-05-27)
      Most studies on socially assistive robots (SARs) in elder care are conducted in care homes and recruit participants with some degree of cognitive impairment. The ethical dimension in these studies thus requires careful attention, suggesting that the researchers involved should be offered specific research ethics training. To meet this need in CARESSES—an international multidisciplinary project that aims to design and evaluate the first culturally competent SAR for the care of older adults—a research ethics training module for the project researchers was developed. The training module is largely based on case-based learning (CBL), a widely recognized approach to learning and instruction that is regarded as highly effective across multiple disciplines. In this paper, we argue that research ethics training should be offered to robotics investigators involved in research on SARs in elder care, and we provide an overview of the ethical issues involved in conducting research with SARs and older adults in care homes. Finally, we show how CBL can be used for research ethics training in this context.
    • A fusion-based approach to identify the phases of the sit-to-stand test in older people

      Shukla, Brajesh K.; Jain, Hiteshi; Vijay, Vivek; Yadav, Sandeep; Hewson, David; Indian Institute of Technology Jodhpur; University of Bedfordshire (Institute of Electrical and Electronics Engineers Inc., 2020-04-06)
      Automated clinical tests that assess quality of geriatric screening tests such as the Five-Times-Sit- To-Stand (5STS) and the Timed-Up-and-Go (TUG) are being designed to assess the decline in functional ability of elderly. The existing techniques to assess the quality of these physical activities include sensor-based techniques including body mounted sensors, force sensors and, vision and imaging sensors. These sensors have their own advantages and disadvantages towards the task of clinical assessment. In this work, we introduce a fusion- based technique to combine multiple sensors leveraging advantages of individual sensors, in such a way that the resulting assessment is more accurate. We evaluate our technique for 5STS test using a fusion of a chair and RGB sensors. In a test of 15 older people, there was no significant difference in performance between the two sensors, obtaining 76% and 73% for the RGB and chair, respectively. However, a significant improvement was obtained for the fusion technique, with 90% accuracy for all the phases of the STS test. The proposed fusion technique was observed to be better than the individual sensor assessment.
    • 'Would you like to join the NHS Organ Donor Register?' a general practice feasibility study

      Penn-Jones, Catrin Pedder; Papadopoulos, Chris; Randhawa, Gurch; Asghar, Zeeshan; ; University of Bedfordshire; NHS Blood and Transplant (Royal College of General Practitioners, 2020-06-18)
      BACKGROUND: A shortage of organ donors exists in the UK and targeting family consent is key for increasing donation consent rates. Registration on the NHS Organ Donor Register (NHS ODR) facilitates this, as it guides families on their loved ones donation preference. In general practice, an opportunity to register is provided, however only to new patients. To improve access to registration opportunities, an intervention was designed where general practice staff asked their patients if they wished to register as an organ donor. AIM: To assess an organ donation registration intervention for feasibility and acceptability in a UK general practice setting. METHOD: One general practice, in Luton, UK, conducted the intervention for 3 months (April to July 2018). Training was held in March 2018, and leaflets and posters were displayed for the 3-month period. An embedded experimental mixed-methods design was used, with data collected via SystmONE questionnaires, surveys and focus groups. RESULTS: The intervention was found to be feasible and acceptable to conduct with some patients by some staff members. During the 3 months, patients were asked in 12.4% of face-to-face consultations (n=812). Nurses and healthcare assistants were more able to conduct the intervention than doctors. Lack of time, telephone consultations, and it not being appropriate were the most common reasons for not asking. Finally, 244 patients joined the NHS ODR; 30.4% of those asked. CONCLUSION: This study demonstrates that general practice could be a feasible location in which an intervention designed to increase NHS ODR registration could be conducted.
    • Barriers towards organ donor registration and consent among people of Indian origin living globally: a systematic review and integrative synthesis - protocol

      Vincent, Britzer Paul; Randhawa, Gurch; Cook, Erica Jane; University of Bedfordshire (BMJ Publishing Group, 2020-06-21)
      Introduction The need for organs is comparatively higher among people of Indian origin due to the higher prevalence of end-stage organ failure. In spite of the higher need, they have a lower number of organ donors. Studies have been carried out among people of Indian origin living globally to understand the reasons for the low donation rate, but there has been no systematic review that has integrated all of these studies to synthesise the current literature. Therefore, the purpose of this review is to examine the barriers towards organ donor registration and consent among Indians living globally. Methods and analysis A systematic search will be conducted using the following relevant databases namely CINHAL, MEDLINE, PsycINFO, Scopus, Web of Science, PubMed Central, Global Health and Grey literature. Studies from 1994 that satisfy our inclusion criteria will be included. Two reviewers will conduct the screening, data extraction and quality assessment of the studies; in event of any disagreement between the two reviewers at any stage, the third reviewer will reconcile any disagreements and consensus will be made. Ethics and dissemination As this study includes only secondary data, ethical approval for secondary data usage has been sought. This study will use Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines to report and the study outcomes will be disseminated through a relevant peer-review publication, related conferences and also to various non-governmental organisations globally which are working with this particular community; following which further research can be developed based on this evidence and also helps in building a culturally competent strategy. PROSPERO registration number CRD42019155274.
    • Improving access to organ donor registration in general practice: a feasibility study

      Penn-Jones, Catrin Pedder; Papadopoulos, Chris; Randhawa, Gurch; Asghar, Zeeshan; (Royal College of General Practitioners, 2020-06-25)
      Background Organ donor registration helps guide decision making for families. UK general practice provides the facility to register on the NHS Organ Donor Register, but only to new patients. An intervention was developed to present a registration opportunity to existing patients in this setting. Aim To assess the feasibility and acceptability of an organ donation intervention implemented in UK general practice. Design and setting The intervention ran in a large practice in Luton in the UK, for 3 months in 2018. A single practice feasibility study was conducted using an embedded experimental mixed methods design. Method Staff were trained to ask patients in consultations if they wished to join the register, and leaflets and posters were displayed in the waiting room. Data on feasibility and acceptability were captured using SystmONE questionnaires, surveys, and focus groups. Results Over 3 months, in 12.4% of face-to-face consultations, patients were asked if they would like to join the register (812 of 6569), and 244 (30.0%) of these patients joined the register. Common reasons staff did not ask patients were due to telephone consultations, lack of time, and it not being appropriate. Nurses and healthcare assistants performed prompted choice more than doctors (23.4%, 17.1%, and 1.6% respectively). Certain clinic types, such as phlebotomy or routine clinics, facilitated asking compared to those where patients presented with unknown or more serious issues. Conclusion The intervention was found to be feasible and acceptable by some staff and patients. Feasibility criteria were met; therefore, the intervention can progress to further testing.
    • Knowledge and attitude of healthcare professionals to frailty screening in primary care: a systematic review protocol

      Okpechi, Ijeoma; Randhawa, Gurch; Hewson, David; University of Bedfordshire (BMJ Publishing Group, 2020-07-02)
      Introduction Frailty is an increasingly common condition in which physiological decline as a result of accumulated deficits renders older people more vulnerable to adverse outcomes. An increasing range of frailty screening programmes have been introduced in primary care to identify frail older people in order to deliver appropriate interventions. However, limited information on the knowledge and attitude of healthcare professionals (HCPs) with respect to frailty screening is known. The aim of this systematic review is to provide evidence on the knowledge and attitude of HCP in terms of frailty screening, and potentially identify barriers and facilitators to frailty screening to improve implementation of frailty screening in primary care. Methods/design A systematic review of qualitative research will be conducted. Databases searched will be MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Web of Science from January 2001 to August 2019. Methods will be reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Population, interest, context and study design methodology was used to develop inclusion and exclusion criteria with HCPs as population, frailty screening as interest and knowledge or attitude of HCPs to frailty screening as context. Studies with a qualitative methodology or a mixed-method design where the qualitative component is analysed separately will also be included. Quality appraisal will be carried out using the Joanna Briggs Institute appraisal tool for qualitative studies. Data will be extracted from each selected study with thematic framework analysis used to synthesise findings. Ethics and dissemination This systematic review does not require ethical approval as primary data will not be collected. The findings will be disseminated at conferences and in a relevant academic journal. This review will assist HCPs and relevant stakeholders to tackle the challenges of frailty screening in primary care. PROSPERO registration number CRD42019159007.
    • Exploration of mindfulness in relation to compassion, empathy and reflection within nursing education

      Walker, Moira; Mann, Robert; University of Bedfordshire (Churchill Livingstone, 2016-03-12)
      Background: This article will look at the viability of the inclusion of mindfulness into the nursing curriculum. In nursing, the environment rarely allows the time for contemplation, though reflection is encouraged specifically in regard to the care we confer on our patients and how that impacts on us professionally. Student nurses are taught to hide their feelings to a point where they cannot find it themselves under their professional armour. Mindfulness is a possible way of bridging this gap. Discussion: Our nursing code is geared to safeguard the patient from any harm as well as our colleagues but little is done or said in support of our own personal psychological or emotional health. The helping professions are restricted by legislation which has had an impact of fostering caution and fearfulness. In using mindfulness it can be seen as a possibility in building a bridge between what actually happens in a nurse's professional life and the possibility of reengaging with that internal emotional space. If student nurses begin to incorporate mindfulness techniques, in reality this should make a difference. This was experienced with students doing these exercises, who reported anecdotally feeling more centred. As they have progressed in the course feedback from the students using the techniques has been positive not only for the students but also for them using the skills in a clinical setting, benefiting patients. Conclusion: Mindfulness has been used as a part of the modality of health care. It is clear that mindfulness is another way of dealing with the stressors of the modern heath service in which the students are being introduced. Incorporating this coping strategy into the curriculum ensures that students will have the tools to deal with the stressors of the course, which in turn will enhance the student experience.
    • Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

      Baillie, Lesley; Gallini, Andrew; Corser, Rachael; Elworthy, Gina; Scotcher, Ann; Barrand, Annabelle; ; London South Bank University; University College London Hospitals; Hospital of St John & St Elizabeth; et al. (Ubiquity Press Ltd, 2014-03-27)
      Introduction: Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services. Theory and methods: The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n = 17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings: Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions. Discussion and conclusions: A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other’s roles and build relationships and trust.
    • Using Twitter™ to drive research impact: a discussion of strategies, opportunities and challenges

      Schnitzler, Katy; Davies, Nigel; Ross, Fiona; Harris, Ruth; ; Kingston University; University of Bedfordshire; St George's, University of London; Leadership Foundation for Higher Education; King's College London (Elsevier Ltd, 2016-02-16)
      Researchers have always recognised the importance of disseminating the findings of their work, however, recently the need to proactively plan and drive the impact of those findings on the wider society has become a necessity. Firstly, this is because funders require evidence of return from investment and secondly and crucially because national research assessments are becoming powerful determinants of future funding. In research studies associated with nursing, impact needs to be demonstrated by showing the effect on a range of stakeholders including service users, patients, carers, the nursing workforce and commissioners. Engaging these groups is a well-known challenge influenced by lack of access to academic journals, lack of time to read long complex research papers and lack of opportunities to interact directly with the researchers. This needs to be addressed urgently to enable nursing research to increase the impact that it has on health delivery and the work of clinical practitioners. Social media is potentially a novel way of enabling research teams to both communicate about research as studies progress and to disseminate findings and research funders are increasingly using it to publicise information about research programmes and studies they fund. A search of the healthcare literature reveals that advice and guidance on the use of social media for research studies is not well understood or exploited by the research community. This paper, therefore, explores how using social networking platforms, notably Twitter™ offers potential new ways for communicating research findings, accessing diverse and traditionally hard-to-reach audiences, knowledge exchange at an exponential rate, and enabling new means of capturing and demonstrating research impact. The paper discusses approaches to initiate the setup of social networking platforms in research projects and considers the practical challenges of using Twitter™ in nursing and healthcare research. The discussion is illuminated with examples from our current research. In summary, we suggest that the use of social media micro-blogging platforms is a contemporary, fast, easy and cost effective way to augment existing ways of disseminating research which helps drive impact.