• Satisfaction of using a nurse led telephone helpline among mothers and caregivers of young children

      Cook, Erica Jane; Randhawa, Gurch; Large, Shirley; Ali, Nasreen; Chater, Angel M.; Guppy, Andy (Elsevier, 2015-12-28)
      Objectives This research aimed to explore user’s experiences of using a nurse led telephone based healthcare service (NHS Direct) among mothers and caregivers of young children to uncover the core factors, which influence the level of satisfaction of using this type of service. Methods Focus groups were held with a subgroup of NHS Direct high ‘users’ (N=17), which included mothers and grandmothers of young children aged between 21 and 54 years old. Qualitative data analysis was undertaken using the thematic framework approach. Results The findings revealed a high level of satisfaction towards this service and this was based on high levels of trust and reassurance that this service provides. Findings also uncovered that users believed that the service would be improved by the utilisation of more person-centred decision-making tools. Conclusion This research demonstrates the increasing role that telephone based healthcare services can play on empowering patients to take more control of their health.
    • A segmentation approach to long duration surface EMG recordings

      El Falou, Wassim; Duchêne, Jacques; Hewson, David; Khalil, Mohamad; Grabisch, Michel; Lino, Frédéric; Universitè de technologie de Troyes; Lebanese University; Universite Paris I – Pantheon-Sorbonne; Renault Group (Elsevier, 2005-02-28)
      The purpose of this study was to develop an automatic segmentation method in order to identify postural surface EMG segments in long-duration recordings. Surface EMG signals were collected from the cervical erector spinae (CES), erector spinae (ES), external oblique (EO), and tibialis anterior (TA) muscles of 11 subjects using a bipolar electrode configuration. Subjects remained seated in a car seat over the 150-min data-collection period. The modified dynamic cumulative sum (MDCS) algorithm was used to automatically segment the surface EMG signals. Signals were rejected by comparison with an exponential mathematical model of the spectrum of a surface EMG signal. The average power ratio computed between two successive retained segments was used to classify segments as postural or surface EMG. The presence of a negative slope of a regression line fitted to the median frequency values of postural surface EMG segments was taken as an indication of fatigue. Alpha level was set at 0.05. The overall classification error rate was 8%, and could be performed in 25 min for a 150-min signal using a custom-built software program written in C (Borland Software Corporation, CA, USA). This error rate could be enhanced by concentrating on the rejection method, which caused most of the misclassification (6%). Furthermore, the elimination of non-postural surface EMG segments by the use of a segmentation approach enabled muscular fatigue to be identified in signals that contained no evidence of fatigue when analysed using traditional methods.
    • Self-stigma among carers of autistic people

      Papadopoulos, Chris (Network Autism, 2016-03-21)
    • Self-stigma experiences among older adults with mental health problems residing in long term care facilities: a qualitative study

      Tzouvara, Vasiliki; Papadopoulos, Chris; Randhawa, Gurch; King's College London; University of Bedfordshire (Taylor & Francis, 2017-12-29)
      Self-stigma is linked with a variety of deleterious consequences for the stigmatised individual. Much of the past research on self-stigma focuses on younger adults; however, little is known about the self-stigma experience among institutionalised older adults with mental health problems. This study aims to explore experiences of self-stigma among older adults with mental health problems in long-term care facilities. Ten semi-structured interviews were conducted. Insight into mental illness was identified as having a key influence upon the self-stigma experiences among this group. Participants shared common understandings, views, and behavioural reactions towards mental health problems. Lacking control, public stigma, sympathy, disinterest, avoidance, and fear were key themes among them. Re-conceptualising self-stigma theories and implementing interventions that aim at reducing stigmatising attitudes among this group are essential.
    • Service user outcomes of a social prescribing programme in general practice

      Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch; University of Bedfordshire (2018-12-31)
    • A set of technological tools for physical frailty assessment

      Jaber, Rana; Hewson, David; Duchêne, Jacques; Université de Technologie (Springer, 2012-12-31)
      Early detection of frailty in the elderly is an important issue, to ensure appropriate interventions can be undertaken to improve the outcome for frail elderly. Among the various models proposed for frailty detection, physical criteria described by Fried et al can be fed by very simple and friendly devices usable in any uncontrolled environment. This paper proposes a set of such technological tools providing a measure of these physical and physiological indices of frailty.
    • Shared attention for action selection and action monitoring in goal-directed reaching

      Mahon, Aoife; Bendžiūtė, Solveiga; Hesse, Constanze; Hunt, Amelia R.; University of Bedfordshire; University of Aberdeen (Springer, 2018-08-10)
      Dual-task studies have shown higher sensitivity for stimuli presented at the targets of upcoming actions. We examined whether attention is directed to action targets for the purpose of action selection, or if attention is directed to these locations because they are expected to provide feedback about movement outcomes. In our experiment, endpoint accuracy feedback was spatially separated from the action targets to determine whether attention would be allocated to (a) the action targets, (b) the expected source of feedback, or (c) to both locations. Participants reached towards a location indicated by an arrow while identifying a discrimination target that could appear in any one of eight possible locations. Discrimination target accuracy was used as a measure of attention allocation. Participants were unable to see their hand during reaching and were provided with a small monetary reward for each accurate movement. Discrimination target accuracy was best at action targets but was also enhanced at the spatially separated feedback locations. Separating feedback from the reaching targets did not diminish discrimination accuracy at the movement targets but did result in delayed movement initiation and reduced reaching accuracy, relative to when feedback was presented at the reaching target. The results suggest attention is required for both action planning and monitoring movement outcomes. Dividing attention between these functions negatively impacts action performance.
    • The Shoreham Airshow crash: personal reflections of the immediate medical responders

      Eastman, Karen; Kemp, Anthony (Royal College of General Practitioners, 2016-03-31)
    • Should the family have a role in deceased organ donation decision-making? a systematic review of public knowledge and attitudes towards organ procurement policies in Europe

      Molina-Pérez, Alberto; Delgado, Janet; Frunza, Mihaela; Morgan, Myfanwy; Randhawa, Gurch; Reiger-Van de Wijdeven, Jeantine; Schicktanz, Silke; Schiks, Eline; Wöhlke, Sabine; Rodríguez-Arias, David; et al. (Elsevier, 2021-11-26)
      Goal: To assess public knowledge and attitudes towards the family's role in deceased organ donation in Europe. Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection were performed by two or more independent reviewers for each record. Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. Conclusions: Public views on the authority of the family in organ donation decision-making requiere further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation.
    • Should we decolonise midwifery education?

      Beckford-Procyk, Chelsea; University of Bedfordshire (All4Holdings Ltd, 2020-11-30)
      This year the Black Lives Matter movement gained momentum globally and more people are having uncomfortable but necessary conversations around race. While the recent focus on racism within healthcare has largely been on outcomes because of inequality, we must also examine how the education of healthcare professionals can also play a part in dismantling racism in clinical practice. In this article, Chelsea Beckford-Procyk discusses the ways in which student midwives, birthing people and society as a whole would benefit from the decolonisation of midwifery education.
    • The Sign 4 Big Feelings intervention to improve early years outcomes in preschool children: outcome evaluation

      Davidson, Rosemary; Randhawa, Gurch; ; University of Bedfordshire (JMIR Publications, 2022-05-20)
      Any delays in language development may affect learning, profoundly influencing personal, social, and professional trajectories. The effectiveness of the Sign 4 Big Feelings (S4BF) intervention was investigated by measuring changes in early years outcomes (EYOs) after a 3-month period. This study aims to determine whether children's well-being and EYOs significantly improve (beyond typical, expected development) after the S4BF intervention period and whether there are differences between boys and girls in progress achieved. An evaluation of the S4BF intervention was conducted with 111 preschool-age children in early years settings in Luton, United Kingdom. Listening, speaking, understanding, and managing feelings and behavior, in addition to the Leuven well-being scale, were assessed in a quasi-experimental study design to measure pre- and postintervention outcomes. Statistically and clinically significant differences were found for each of the 7 pre- and postmeasures evaluated: words understood and spoken, well-being scores, and the 4 EYO domains. Gender differences were negligible in all analyses. Children of all abilities may benefit considerably from S4BF, but a language-based intervention of this nature may be transformational for children who are behind developmentally, with English as an additional language, or of lower socioeconomic status. ISRCTN Registry ISRCTN42025531; https://doi.org/10.1186/ISRCTN42025531.
    • 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.
    • Signature pedagogies and the HOTSHOT educator: a systematic literature review

      Beckwith, Philip (CASA, 2018-01-01)
      Higher Education Institutions have made considerable investments both fiscally and in staff engagement with clinical simulation. Professional bodies such as the Royal College of Surgeons, the Royal College of Anaesthetists and the College of Operating Department Practice endorse the use of clinical simulation. Claims that clinical simulation stimulates Higher Order Thinking and therefore contributes to increased patient safety will be examined.
    • Signs and symptoms preceding the diagnosis of Alzheimer’s disease: a systematic scoping review of literature from 1937 to 2016

      Bature, Fidelia; Guinn, Barbara-Ann; Pang, Dong; Pappas, Yannis; University of Bedfordshire (British Medical Journal, 2017-08-28)
      Objective Late diagnosis of Alzheimer’s disease (AD) may be due to diagnostic uncertainties. We aimed to determine the sequence and timing of the appearance of established early signs and symptoms in people who are subsequently diagnosed with AD. Methods We used systematic review methodology to investigate the existing literature. Articles were reviewed in May 2016, using the following databases: MEDLINE, PsycINFO, CINAHL, British Nursing Index, PubMed central and the Cochrane library, with no language restriction. Data from the included articles were extracted independently by two authors and quality assessment was undertaken with the quality assessment and diagnostic accuracy tool-2 (QUADAS tool-2 quality assessment tool). Results We found that depression and cognitive impairment were the first symptoms to appear in 98.5% and 99.1% of individuals in a study with late-onset AD (LOAD) and 9% and 80%, respectively, in early-onset AD (EOAD). Memory loss presented early and was experienced 12 years before the clinically defined AD dementia in the LOAD. However, the rapidly progressive late-onset AD presented predominantly with 35 non-established focal symptoms and signs including myoclonus (75%), disturbed gait (66%) and rigidity. These were misdiagnosed as symptoms of Creutzfeldt-Jacob disease (CJD) in all the cases. The participant with the lowest mini-mental state examination score of 25 remained stable for 2 years, which is consistent with the score of the healthy family members. Conclusions The findings of this review suggest that neurological and depressive behaviours are an early occurrence in EOAD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in LOAD. Misdiagnosis of rapidly progressive AD as CJD and the familial memory score can be confounding factors while establishing a diagnosis. However, the study was limited by the fact that each one of the findings was based on a single study. * Alzheimer's disease (AD) * systematic scoping review * early signs and symptoms * mild cognitive impairment (MCI) * early stage of AD
    • Sleep disorders and the sleeping environment: a neurological approach

      Bezzina, Neville; Trevisan, Adrian Attard; Randhawa, Gurch; Papadopoulos, Chris (Postive Health Online, 2012-05-01)
    • Social prescribing: implementation and delivery

      Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch; University of Bedfordshire (Ubiquity Press, 2018-10-23)
      Introduction: Social prescription is an innovative approach that aims to link patients in primary care with sources of support within the community and voluntary sector to help improve their health, wellbeing, and care experience. Social prescription provides healthcare professionals with a non-medical referral option, which can operate alongside medical treatments, to address non-clinical factors that precipitate and perpetuate ill health and often lead to frequent primary and secondary care visits. It is based on the bio-psycho-social model of health that considers physical, as well as psychological and social factors as determinants of health and wellbeing. Research on social prescription indicates that there is a potential for psychosocial benefits and health and wellbeing improvements for service users. While most attention has been paid to outcome evaluations, there is a lack of research on factors affecting the implementation process of social prescription interventions. This study aimed to explore factors facilitating and hindering the implementation and delivery of a social prescription intervention in the East of England Luton. The Luton social prescribing programme is based in primary care and involves navigators, who support and work with referred patients to identify their non-medical needs. Methods: A qualitative study was conducted including 22 semi-structured interviews with managers and policy-makers 9, GPs 3, navigators 4, and service providers in the third sector 6 involved in the Luton social prescribing programme. Thematic analysis was used to analyse the data. Results: Due to the differences in stakeholders’ experiences and views, barriers and facilitators were often two sides of the same coin e.g. good communication/ poor communication. Therefore, the identified issues are presented by theme, rather than separately for barriers and facilitators. Identified issues include the availability of resources, stakeholder involvement and engagement, information technology, organisational culture and readiness, existing infrastructures, leadership, staff turnover, support and supervision, planning, communication, and relationships between stakeholders. Discussion: This study contributes to the development of an evidence base on barriers and facilitators to the implementation and delivery of social prescribing programmes. Some of the identified barriers and facilitators seem to be similar to those of other integrated care pilots in the UK, whereas others are specific to social prescribing interventions. Thus, it is important to conduct more robust and transparent research on social prescribing, to address potential barriers to implementation. Conclusion: This study produced evidence on factors that hinder and facilitate the implementation of a social prescription programme in the East of England. Findings can contribute to the development of an evidence base for social prescription programmes in the UK, and inform practice, policy, and future research in the field.
    • Social prescribing: primary care patient and service user engagement

      Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch; University of Bedfordshire (Ubiquity Press, 2018-10-23)
      Introduction: Social Prescribing provides healthcare professionals with a non-medical referral option, in order to address the non-medical factors that determine patients’ health, wellbeing, and often lead to frequent primary and secondary care visits. To meet the non-medical needs of people, social prescribing links primary care patients with sources of support usually provided within the third sector. Research on social prescription indicates that there is a potential for psychosocial benefits, health, and wellbeing improvements for patients who engaged with the service. However, there is no research on factors affecting primary care patients’ decision to take part, or not to take part, in social prescribing. In addition, it is unclear why service users engage, and disengage, with the prescribed services. This study aimed to explore factors affecting the participation of primary care patients (uptake) and engagement of service users (adherence) with a social prescription intervention in the East of England (Luton). Methods: A qualitative study was conducted including 17 semi-structured interviews with GPs (3), navigators (4), and service users (10), analysed using thematic analysis. Results: Factors relating to perceived needs and benefits, the role of GPs, stigmatisation, the entrenchment in the medical model, and the nature of the social prescribing programme affected the participation of primary care patients. Changes in health and wellbeing, rewards, motivation, trust, perceived benefits, service provider-, family-, and navigator support, and the accessibility and availability of services were factors related to the engagement and disengagement of service users. Discussions: Findings of this study fill the existing knowledge gap on factors affecting primary care patients’ participation and engagement in social prescribing interventions. Identified factors can inform policy and practice and, if considered in the social prescribing pathway, potentially improve patient uptake and service user adherence in existing and future programmes. A limitation of this study is that primary care patients who refused to be referred into the social prescribing programme were not interviewed. Due to a lack of recording primary care patients who refused to be referred into the social prescribing programme, this patient group could not be identified. To gain an understanding of potential reasons for refusal, in this study GPs were asked about reasons for refusal in this patient group. However, to gain a deeper understanding of barriers to initial participation, more robust and transparent research in this field, including primary care patients who refused to get involved with social prescribing, is needed. Conclusions: This study produced evidence on factors affecting the participation of primary care patients and service user engagement in a social prescribing intervention in the UK. Findings can contribute to the development of an evidence base for social prescription programmes in the UK, and inform practice, policy, and future research in the field.
    • Social support needs for equity in health and social care: a thematic analysis of experiences of people with chronic fatigue syndrome/myalgic encephalomyelitis

      de Carvalho Leite, Jose C.; Drachler, Maria de L; Killett, Anne; Kale, Swati; Nacul, Luis; McArthur, Maggie; Hong, Chia Swee; O'Driscoll, Lucy; Pheby, Derek; Campion, Peter; et al. (BioMed Central, 2011-11-01)
      Background Needs-based resource allocation is fundamental to equitable care provision, which can meet the often-complex, fluctuating needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This has posed challenges both for those providing and those seeking support providers, in building shared understanding of the condition and of actions to address it. This qualitative study reports on needs for equity in health and social care expressed by adults living with CFS/ME. Methods The participants were 35 adults with CFS/ME in England, purposively selected to provide variation in clinical presentations, social backgrounds and illness experiences. Accounts of experienced needs and needs-related encounters with health and social services were obtained through a focus group (n = 6) and semi-structured interviews (n = 35). These were transcribed and needs related topics identified through data-led thematic analysis. Findings Participants emphasised needs for personalised, timely and sustained support to alleviate CFS/ME impacts and regain life control, in three thematic areas: (1) Illness symptoms, functional limitations and illness management; (2) practical support and social care; (3) financial support. Access of people with CFS/ME to support from health and social services was seen to be constrained by barriers stemming from social, cultural, organisational and professional norms and practices, further heightened for disadvantaged groups including some ethnic minorities. These reduced opportunities for their illness to be explained or associated functional limitations and social disadvantages to be addressed through social support. Participants sought more understanding of bio-psycho-social aspects of CFS/ME, of felt needs of people with CFS/ME and of human rights and disability rights, for providing person-centred, equitable care. Conclusions Changes in attitudes of health practitioners, policy makers and general public and more flexibly organised health and social care provision are needed to address equity issues in support needs expressed by people with CFS/ME, to be underpinned by research-based knowledge and communication, for public and professional education. Policy development should include shared decision-making and coordinated action across organizations working for people with CFS/ME, human rights and disadvantaged groups. Experiences of people with CFS/ME can usefully inform an understanding of equity in their health and social care.
    • 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.
    • SOLACE: a psychosocial stigma protection intervention to improve the mental health of parents of autistic children: a feasibility randomised controlled trial

      Lodder, Annemarie; Papadopoulos, Chris; Randhawa, Gurch (Springer, 2020-04-22)
      This study presents findings from a feasibility trial, testing an 8-week psychosocial stigma protection intervention (SOLACE) designed to improve the mental health of parents of autistic children. Seventeen parents were stratified then randomly assigned to either SOLACE (n = 9) or control group (n = 8). Retention and adherence rates were excellent with minimal missing data suggesting SOLACE had good acceptability and feasibility. Quantitative analysis revealed that mental health scores had significantly improved for those who took part in SOLACE compared to no significant changes for control group participants. In addition, changes in secondary outcome measures (e.g. stigma, self-esteem and self-compassion) were in favour of SOLACE. Focus group interviews revealed that SOLACE was acceptable to parents. Results suggest that a full randomised controlled trial is warranted.