• The EASR corpora of European Portuguese, French, Hungarian and Polish elderly speech

      Hamalainen, Annika; Avelar, Jairo; Rodrigues, Silvia; Dias, Miguel Sales; Kolesinski, Artur; Fegyo, Tibor; Nemeth, Geza; Csobanka, Petra; Lan, Karine; Hewson, David (European Language Resources Association, 2014-12-31)
      Currently available speech recognisers do not usually work well with elderly speech. This is because several characteristics of speech (e.g. fundamental frequency, jitter, shimmer and harmonic noise ratio) change with age and because the acoustic models used by speech recognisers are typically trained with speech collected from younger adults only. To develop speech-driven applications capable of successfully recognising elderly speech, this type of speech data is needed for training acoustic models from scratch or for adapting acoustic models trained with younger adults’ speech. However, the availability of suitable elderly speech corpora is still very limited. This paper describes an ongoing project to design, collect, transcribe and annotate large elderly speech corpora for four European languages: Portuguese, French, Hungarian and Polish. The Portuguese, French and Polish corpora contain read speech only, whereas the Hungarian corpus also contains spontaneous command and control type of speech. Depending on the language in question, the corpora contain 76 to 205 hours of speech collected from 328 to 986 speakers aged 60 and over. The final corpora will come with manually verified orthographic transcriptions, as well as annotations for filled pauses, noises and damaged words.
    • An economic–business approach to clinical risk management

      Comite, Ubaldo; Dong, Kechen; Li, Rita Yi Man; Crabbe, M. James C.; Shao, Xue-Feng; Yue, Xiao-Guang; University Giustino Fortunato; University of South Australia; Hong Kong Shue Yan University; Oxford University; et al. (MDPI, 2020-06-23)
      This paper introduces risk factors in the field of healthcare and discusses the clinical risks, identification, risk management methods, and tools as well as the analysis of specific situations. Based on documentary analysis, an ecient and coherent methodological choice of an informative and non-interpretative approach, it relies on “unobtrusive” and “non-reactive” information sources, such that the research results are not influenced by the research process itself. To ensure objective and systematical analysis, our research involved three macro-phases: (a) the first involved a skimming (a superficial examination) of the documents collected; (b) the second reading (a thorough examination) allowed a selection of useful information; (c) the third phase involved classification and evaluation of the collected data. This iterative process combined the elements of content and thematic analysis that categorised the information into di erent categories which were related to the central issues for research purposes. Finally, from the perspective of safety analysis and risk management, we suggest that comprehensive control and operation should be conducted in a holistic way, including patient safety, cost consumption, and organizational responsibility. An organizational strategy that revolves around a constant and gradual risk management process is an important factor in clinical governance which focuses on the safety of patients, operators, and organizations.
    • The effect of aircraft control forces on pilot performance during instrument landings in a flight simulator

      Hewson, David; McNair, P.J.; Marshall, R.N.; Universite de Technologie de Troyes (Aerospace Medical Association, 2001-07-31)
      BACKGROUND: Pilots may have difficulty controlling aircraft at both high and low force levels due to larger variability in force production at these force levels. The aim of this study was to measure the force variability and landing performance of pilots during an instrument landing in a flight simulator. METHODS: There were 12 pilots who were tested while performing 5 instrument landings in a flight simulator, each of which required different control force inputs. Pilots can produce the least force when pushing the control column to the right, therefore the force levels for the landings were set relative to each pilot's maximum aileron-right force. The force levels for the landings were 90%, 60%, and 30% of maximal aileron-right force, normal force, and 25% of normal force. Variables recorded included electromyographic activity (EMG), aircraft control forces, aircraft attitude, perceived exertion and deviation from glide slope and heading. Multivariate analysis of variance was used to test for differences between landings. RESULTS: Pilots were least accurate in landing performance during the landing at 90% of maximal force (p < 0.05). There was also a trend toward decreased landing performance during the landing at 25% of normal force. Pilots were more variable in force production during the landings at 60% and 90% of maximal force (p < 0.05). CONCLUSION: Pilots are less accurate at performing instrument landings when control forces are high due to the increased variability of force production. The increase in variability at high force levels is most likely associated with motor unit recruitment, rather than rate coding. Aircraft designers need to consider the reduction in pilot performance at high force levels, as well as pilot strength limits when specifying new standards.
    • Effect of e-learning on health sciences education: a protocol for systematic review and meta-analysis

      Regmi, Krishna; Jones, Linda; University of Bedfordshire; University of Dundee (Routledge, 2021-02-24)
      E-learning has been widely used in higher education as it provides better access to learning resources online, utilising technology to enhance learning. Despite growing evidence claiming that e-learning is as effective as traditional means of learning, the evidence is still very limited. This protocol aims to measure the impact of e-learning as compared to traditional face-to-face learning, both measured and perceived, on health sciences education – in terms of improving students’/health professionals’ satisfaction, knowledge, skills, and behaviours and patient-related outcomes. We will conduct a systematic review and meta-analysis of both randomised controlled trials and non-randomised controlled trials. Major databases will be searched for studies, and will be reported in accordance with PRISMA. A thematic analysis will be conducted for the included studies. If sufficient data are available, the random-effects model for meta-analysis will be performed. The outcome of this study will provide a basis for developing the best methods of e-learning in health sciences education.
    • Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews

      Puthussery, Shuby; Chutiyami, Muhammad; Tseng, Pei-Ching; Kilby, Lesley; Kapadia, Jogesh (BioMed Central, 2018-07-09)
      Background: Various intervention programs exist for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence of their effectiveness. These reviews are, however, limited to specific interventions, components, or outcomes, and a comprehensive evidence base is lacking. The aim of this meta-review was to appraise and meta-synthesise the evidence from existing SRs to provide a comprehensive evidence base on the effectiveness of interventions for parents of preterm infants on parental and infant outcomes. Methods: We conducted a comprehensive search of the following databases to identify relevant SRs: Cochrane library, Web of science, EMBASE, CINAHL, British Nursing Index, PsycINFO, Medline, ScienceDirect, Scopus, IBSS, DOAJ, ERIC, EPPI-Centre, PROSPERO, WHO Library. Additional searches were conducted using authors’ institutional libraries, Google Scholar, and the reference lists of identified reviews. Identified articles were screened in two stages against an inclusion criteria with titles and abstracts screened first followed by full-text screening. Selected SRs were appraised using the AMSTAR tool. Extracted data using a predesigned tool were synthesised narratively examining the direction of impact on outcomes. Results: We found 11 SRs eligible for inclusion that synthesised a total of 343 quantitative primary studies. The average quality of the SRs was ‘medium’. Thirty four interventions were reported across the SRs with considerable heterogeneity in the structural framework and the targeted outcomes that included maternal-infant dyadic, maternal/parental, and infant outcomes. Among all interventions, Kangaroo Care (KC) showed the most frequent positive impact across outcomes (n = 19) followed by Mother Infant Transaction Program (MITP) (n = 14). Other interventions with most consistent positive impact on infant outcomes were Modified-Mother Infant Transaction Program (M-MITP) (n = 6), Infant Health and Development Program (IHDP) (n = 5) and Creating Opportunities for Parent Empowerment (COPE) (n = 5). Overall, interventions with both home and facility based components showed the most frequent positive impact across outcomes. Conclusions: Neonatal care policy and planning for preterm babies should consider the implementation of interventions with most positive impact on outcomes. The heterogeneity in interventions and outcomes calls for the development and implementation of an integrated program for parents of preterm infants with a clearly defined global set of parental and infant outcomes.
    • Effectiveness of integrated chronic care interventions for older people with different frailty levels: a systematic review protocol

      Khan, Nimra; Hewson, David; Randhawa, Gurch; ; University of Bedfordshire (BMJ, 2020-09-10)
      INTRODUCTION: Frailty poses a huge burden to individuals, their families and to healthcare systems. Several interventions have been evaluated for the improvement of outcomes for older people with frailty, including integrated care interventions. Reviews synthesising evidence on the effectiveness of integrated care for older people with frailty have treated them as a single population, without considering the heterogeneity between different frailty levels such as non-frail, mild frailty, moderate frailty and severe frailty. Findings from these studies have shown inconsistent results on the various outcomes assessed. People with different frailty status have different care needs, which should be addressed accordingly. The aim of this study is to synthesise evidence on the effectiveness of integrated care interventions on older people with different frailty status who are community dwelling or living in retirement housing or residential setting but not in care homes or in nursing homes. METHODS AND ANALYSIS: This is a protocol for a systematic review assessing the effectiveness of integrated chronic care interventions on older people with different frailty status. A literature search will be conducted on the databases Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and clinical trial registers. Two authors will independently conduct search and screening for eligible studies. Full-text screening will be used to include only studies that fulfil the inclusion criteria. Data extraction will be done on a data extraction form and methodological quality of studies will be assessed using the Effective Practice and Organisation of Care risk of bias tool. The interventions will be described following Wagner's Chronic Care Model. ETHICS AND DISSEMINATION: Ethical approval for this study was obtained from the Institute for Health Research Ethics Committee of the University of Bedfordshire (IHREC934). The results of the review will be disseminated through a peer-reviewed journal article, conferences and also with local provider and user stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020166908.
    • Effectiveness of nutrition interventions in low and middle income countries: an evidence summary

      Menon, Kavitha; Puthussery, Shuby; Ravalia, Anal; Panchal, Pooja; Rana, Ritu; Mistry, Sabuj Kanti; Tseng, Pei-Ching; Bhandol, Janine; Mavalankar, Dileep; University of Bedfordshire; et al. (Indian Institute of Public Health Gandhinagar; Public Health Foundation of India; University of Bedfordshire,;BRAC, Bangladesh, 2018-05-24)
      This is an independent report commissioned under the DFID Systematic Review Programme for SouthAsia. This material has been funded by South Asia Research Hub, Research and Evidence Division,Department for International Development,Government of UK. The views expressed do not necessarilyreflect the UK Government’s official policies.
    • Effectiveness of nutrition interventions in low and middle income countries: an evidence summary

      Mavalankar, Dileep; Puthussery, Shuby; Menon, Kavitha; Rana, Ritu; Bhandol, Janine; Mistry, Sabuj Kanti; Ravalia, Anal; Tseng, Pei-Ching; Panchal, Pooja; Indian Institute of Public Health Gandhinagar; et al. (UK Department for International Development, 2016-06-30)
    • Effectiveness of nutrition interventions in low-and middle-income countries: a meta-review

      Rana, Ritu; Menon, Kavitha; Puthussery, Shuby; Ravalia, Anal; Panchal, Pooja; Vaze, Gauri; Tseng, Pei-Ching; Mavalankar, Dileep; ; Indian Institute of Public Health Gandhinagar; et al. (World Public Health Nutrition Association, 2020-03-24)
      Background: Undernutrition remains an unfinished agenda for a majority of low- and middle-income countries (LMICs). Numerous nutrition interventions have been implemented in LMICs and various indicators have been used to measure the impact of these interventions. The aim of this meta-review was to summarise the findings on the effectiveness of various nutrition interventions that have been implemented in LMICs on the WHO global nutrition targets-related outcomes. The six outcomes are- reducing stunting, wasting, anemia among women of reproductive age, low birthweight, childhood overweight, and improving exclusive breastfeeding. This study presents the results for one of the outcomes (stunting). Methods: We conducted a comprehensive search on 21 electronic databases, including six regional and four systematic reviews (SRs) specific databases. Two researchers independently screened identified records against the inclusion criteria. Quality of included SRs were assessed using the AMSTAR tool. Extracted data were narratively synthesised examining the direction of impact. The review protocol was registered with the EPPI-Centre. Results: Of 6,597 SRs initially identified, 28 SRs that assessed outcomes of WHO global nutrition targets-related outcomes were eligible for inclusion. We found 12 SRs that assessed stunting outcomes, these SRs synthesised 68 quantitative primary studies, from 29 LMICs. All included SRs were of high quality. Eight nutrition interventions were reported in the included SRs- five nutrition-specific (n=9) and three nutrition-sensitive (n=3). Among all interventions, two nutrition-specific (complementary feeding: n=1; dietary supplementation: n=2) interventions showed a positive effect. Conclusion: This meta-review identified, two interventions, complementary feeding and dietary supplementation, with most frequently reported evidence of positive impact on stunting. In LMICs, public health policymakers should consider these two interventions for scaling-up.
    • Effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering

      Rana, Ritu; Kirubakaran, Richard; Puthussery, Shuby; Lelijveld, Natasha; Kerac, Marko; Sirwani, Barkha; Choudhury, Prativa (PROSPERO International prospective register of systematic reviews, 2021-09-29)
      Protocol for an ongoing systematic review focussed on the following review question: What is the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering?
    • Embedding ethics in the design of culturally competent socially assistive robots

      Battistuzzi, Linda; Sgorbissa, Antonio; Papadopoulos, Chris; Papadopoulos, Irena; Koulouglioti, Christina; University of Genoa; University of Bedfordshire; Middlesex University (Institute of Electrical and Electronics Engineers Inc., 2019-01-07)
      Research focusing on the development of socially assistive robots (SARs) for the care of older adults has grown in recent years, prompting a great deal of ethical analysis and reflection on the future of SARs in caring roles. Much of this ethical thinking, however, has taken place far from the settings where technological innovation is practiced. Different frameworks have been proposed to bridge this gap and enable researchers to handle the ethical dimension of technology from within the design and development process, including Value Sensitive Design (VSD). VSD has been defined as a 'theoretically grounded approach to the design of technology that accounts for human values in a principled and comprehensive manner throughout the design process'. Inspired in part by VSD, we have developed a process geared towards embedding ethics at the core of CARESSES, an international multidisciplinary project that aims to design the first culturally competent SAR for the care of older adults. Here we describe that process, which included extracting key ethical concepts from relevant ethical guidelines and applying those concepts to scenarios that describe how the CARESSES robot will interact with individuals belonging to different cultures. This approach highlights the ethical implications of the robot's behavior early in the design process, thus enabling researchers to identify and engage with ethical problems proactively.
    • Emergency ventilation--an alternative to mouth-to-mouth resuscitation

      Kemp, Anthony (EMAP, 2004-09-07)
      The risk of infection being transmitted during mouth-to-mouth resuscitation is low, but health care professionals cite this as a reason for avoiding the procedure. Anthony Kemp discusses this issue and describes how the use of a pocket mask is a more acceptable alternative.
    • Emerging technologies for health communication

      Pappas, Yannis; Car, Josip; Hill, Sophie; Imperial College London (Wiley-Blackwell, 2011-09-22)
      The widespread use of consumer-oriented information communication technologies (ICTs) such as cell phones, iPods and other electronic data devices is changing the way consumers think about and interact with healthcare. In light of this technology boom, a new field for researching, planning and implementing ICTs in healthcare has emerged called ‘eHealth’. Effective eHealth implementation requires a patient-centred approach to care, with health professionals utilising technology to share clinical information and guide patient self-care. This may include the use of electronic health records (EHRs), phone and text messaging interactions and web-based communication applications. Anticipated benefits of eHealth are improved patient access and choice, enhanced communication between professionals and improved health outcomes. However, the introduction of ICTs to the complex healthcare environment may also lead to disruptions, distractions or errors. To implement eHealth in a safe and effective way, the development of a comprehensive agenda for research, planning and implementation is essential.
    • Enabling women to access preferred methods of contraception: a rapid review and behavioural analysis

      Ayorinde, Abimbola A.; Boardman, Felicity; McGranahan, Majel; Porter, Lucy; Eze, Nwamaka A.; Sallis, Anna; Buck, Rosanna; Hadley, Alison; Ludeke, Melissa; Mann, Sue; et al. (Biomed Central, 2021-11-27)
      Many pregnancies in the UK are either unplanned or ambivalent. This review aimed to (i) explore barriers and facilitators to women choosing and accessing a preferred method of contraception in the United Kingdom, and (ii) identify opportunities for behavioural interventions based on examination of interventions that are currently available nationally. Three databases were searched, and experts contacted to identify grey literature for studies presenting barriers and facilitators to women choosing and accessing a preferred method of contraception, conducted in the UK and published between 2009 and October 2019. Information on barriers and facilitators were coded into overarching themes, which were then coded into Mechanisms of Actions (MoAs) as listed in the Theory and Techniques Tool. National interventions were identified by consulting stakeholders and coded into the Behaviour Change Wheel. The match between barriers/facilitators and intervention content was assessed using the Behaviour Change Wheel. We included 32 studies and identified 46 barrier and facilitator themes. The most cited MoA was Environmental Context and Resources, which primarily related to the services women had access to and care they received. Social Influences, Beliefs about Consequences (e.g., side effects) and Knowledge were also key. The behavioural analysis highlighted four priority intervention functions (Modelling, Enablement, Education and Environmental Restructuring) that can be targeted to support women to choose and access their preferred method of contraception. Relevant policy categories and behaviour change techniques are also highlighted. This review highlights factors that influence women's choices and access to contraception and recommends opportunities that may be targeted for future interventions in order to support women to access preferred contraception. Protocol was registered with PROSPERO (an international database of prospectively registered systematic reviews in health and social care) in December 2019, CRD42019161156 .
    • Enacting whole-school relationships and sexuality education in England: context matters

      Bragg, Sara; Ponsford, Ruth; Meiksin, Rebecca; Lohan, Maria; Melendez-Torres, G. J.; Hadley, Alison; Young, Honor; Barter, Christine; Taylor, Bruce; Bonell, Chris; et al. (Wiley, 2022-03-30)
      Evidence from intervention evaluations suggests that achieving meaningful and lasting social, behavioural and attitudinal change from relationships, sex and health education (RSHE) in schools requires more than just a curriculum. Whole-school approaches appear particularly promising since they work at multiple levels. For instance, they may: engage with carers, communities and local services; address iniquitous cultures and norms; change school policies and practices; and actively involve young people themselves. They have also been advocated to tackle sexual harassment and abuse in schools. Currently, however, such approaches have not been rigorously evaluated in the UK. This article focuses on the whole-school elements of two recent RSHE pilot studies conducted in English secondary schools. We describe how these elements were variably enacted in different settings. We analyse contextual factors that help account for these differences, including: teacher and departmental professional identity and autonomy; broader education policy including high-stakes testing and school inspection judgements; the significance of support staff; and staff–student relationships and partnerships. We argue that the likely impact of whole-school approaches and RSHE in schools more generally will depend on attending to all of these factors. The paper contributes firstly to debates about the theory and practice of RSHE by highlighting the significance of processes and cultures beyond the classroom in enabling or constraining positive change. Secondly it contributes to scholarship that elucidates the role of contexts, broadly defined, in understanding the enactment of policy and practice.
    • Enhancing the health professional's role in requesting transplant organs

      Randhawa, Gurch; University of Bedfordshire (Mark Allen Healthcare, 1997-04-01)
      The shortfall in organs for transplant continues in the UK. To address this problem, methods of organ procurement are continuously widening with the recent development of protocols in elective ventilation and non-heart beating donors. Until recently, the nurse's role in the success of organ procurement was largely limited to those working in intensive care units involved in cadaveric transplant and community-based nurses working with patients on kidney dialysis who may become involved with live related transplant. Involvement in organ procurement has now extended to nurses working in general wards and accident and emergency centres. It is imperative that health professionals are aware of the large numbers of patients for whom donors have not been found. They need to be aware of the possible reasons which deter relatives from giving consent for potential donors and prevent relatives themselves from becoming potential live donors. Those who are involved in the organ request process need to be alerted to the factors that affect the decision to give consent. It is hoped that these efforts will help to reduce the drastic shortage of available organs for transplant in the UK.
    • Epidemiology and public health intelligence

      Bray, Isabelle; Regmi, Krishna (Springer International Publishing, 2016-12-31)
      This chapter provides an introduction to epidemiology. It covers the key epidemiological concepts such as bias and confounding, as well as providing an overview of the nature, history and types of epidemiology. The main epidemiological study designs are described, including case series, ecological, cross-sectional, case-control, cohort, randomised controlled trial and systematic review. The advantages and disadvantages of each are summarised, and some of the ethical issues in doing research are considered. The 'hierarchy of evidence' framework is contrasted with an approach which recognises the most appropriate study design to answer different questions about population health. This chapter will examine the role of epidemiology in public health intelligence and develop students' or learners' knowledge and skills to carry out thorough, rigorous and meaningful research and investigation relevant to public health. After reading this chapter you should be able to: • Define epidemiology and differentiate between descriptive epidemiology and analytical epidemiology • Describe the basic study designs, principles and methods used in epidemiology • Explore key issues related to the design and conduct of studies • Recognise the role of epidemiology in public health intelligence.
    • Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention

      Steed, Liz; Sohanpal, Ratna; James, Wai-Yee; Rivas, Carol; Jumbe, Sandra; Chater, Angel M.; Todd, Adam; Edwards, Elizabeth; Macneil, Virginia; Macfarlane, Fraser; et al. (BMJ Publishing Group, 2017-08-01)
      OBJECTIVE: To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. DESIGN: Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. METHODS: Phase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II: We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III: We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. SETTING: Eight community pharmacies in three inner east London boroughs. PARTICIPANTS: 12 Stop Smoking Advisers. INTERVENTION: Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. RESULTS: The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. CONCLUSIONS: We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial.
    • Estimation of grip force using the Grip-ball dynamometer

      Chkeir, Aly; Jaber, Rana; Hewson, David; Duchêne, Jacques (Elsevier, 2013-12-01)
      The Grip-ball is an innovative device that has been designed to measure grip strength. The Grip-ball consists of an airtight ball that contains a pressure sensor and Bluetooth communication system. The Grip-ball can be inflated to different initial pressures, with data available continuously in real time. The aim of this study was to build a model to predict the force applied to the Grip-ball dynamometer based only on the pressure measured by the Grip-ball and its initial pressure. Forces ranging from 2 to 70 kg were applied to a hybrid version of the device for 10 different initial pressures, ranging from atmospheric pressure of 100 kPa through to 190 kPa. A model was constructed to predict applied force, with force as a function of the initial pressure and the pressure measured. The error of the model was calculated as 1.29 kg across all initial pressures and forces applied. The results of the study are comparable with the errors observed for the gold standard in grip force measurement, the Jamar dynamometer. The best results for force prediction were obtained over the range in which frailty is typically detected. The Grip-ball will now be tested using a large population in order to establish clinical norms.