• Cognitive behaviour therapy versus counselling intervention for anxiety in young people with high-functioning autism spectrum disorders: a pilot randomised controlled trial

      Murphy, Suzanne; Chowdhury, Uttom; White, Susan W.; Reynolds, Laura; Donald, Louisa; Gahan, Hilary; Iqbal, Zeinab; Kulkarni, Mahesh; Scrivener, Louise; Shaker-Naeeni, Hadi; et al. (Springer, 2017-08-02)
      The use of cognitive-behavioural therapy (CBT) as a treatment for children and adolescents with autism spectrum disorder (ASD) has been explored in a number of trials. Whilst CBT appears superior to no treatment or treatment as usual, few studies have assessed CBT against a control group receiving an alternative therapy. Our randomised controlled trial compared use of CBT against person-centred counselling for anxiety in 36 young people with ASD, ages 12–18. Outcome measures included parent- teacher- and self-reports of anxiety and social disability. Whilst each therapy produced improvements inparticipants, neither therapy was superior to the other to a significant degree on any measure. This is consistent with findings for adults.
    • Cognitive impairment and treatment outcomes among people attending an alcohol intervention service for those aged 50+

      Seddon, Jennifer L.; Wadd, Sarah; Madoc-Jones, Iolo; Elliott, Lawrie; University of Bedfordshire; Glasgow Caledonian University; Wrexham Glyndwr University (Emerald, 2021-05-28)
      Purpose: No studies have evaluated the relationship between cognitive impairment and alcohol treatment outcomes among older drinkers. This study sought to explore the extent of cognitive impairment among older adults seeking alcohol treatment, and examine the relationship between cognitive impairment, treatment retention and alcohol use following treatment. Design/ methodology/ approach: The study used data from the Drink Wise Age Well programme; an alcohol intervention service for older adults (aged 50+). The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairment; alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Findings: 531 participants completed assessment at treatment entry. Over half the sample were male (57%), with a mean age of 60 years (SD: 7.09). Almost half (48.4%) had cognitive impairment at entry to treatment: 51.6% had normal cognitive function, 41.4% had mild cognitive impairment, 5.8% had moderate cognitive impairment and 1.1% had severe cognitive impairment. Cognitive impairment was not associated with increased treatment drop-out and was not predictive of alcohol use following treatment. Alcohol treatment was associated with a significant improvement in cognitive functioning. Originality/ value: This study suggests there may be a significant amount of unidentified cognitive impairment among older adults attending alcohol treatment. Assessment and routine screening for cognitive impairment in drug and alcohol services may help in care planning and setting treatment goals; in the absence of routine screening opportunities for treatment planning and intervention may be missed.
    • A collaborative brief engagement with medically unexplained sexual and other persistent physical symptoms: a realist service evaluation

      Penman, Jean; Cook, Erica Jane; Randhawa, Gurch; University of Bedfordshire (Taylor & Francis, 2019-12-10)
      Attempts to secure improved outcomes with persistent medically unexplained physical symptoms (MUS/PPS) are in their early stages of development and effective implementation in the United Kingdom remains inconsistent. There are scant systematically examined process and outcome studies in this field published in peer reviewed journals. Moreover, persistent sexual symptoms no longer appear in listed examples of MUS/PPS in the professional literature and consequently few studies can be found on 'what works' for improved outcomes with this group of sufferers. A systematic evaluation of an NHS Community Psychosexual Counselling Service delivered within an Integrated Contraception and Sexual Health Service for adults with persistent sexual dysfunction is summarised. The findings from the synthesis of evaluated research, professional guidance and a particular practice, at clinic cohort and embedded case levels, revealed common themes of engagement across the therapy divides when addressing “medically unexplained” physical symptoms. This supports future research in this area and calls for the inclusion of persistent sexual symptoms. The extracted themes from the therapy process may be used as tools to enhance skills of engagement with unresolved PPS in similar settings in which the individual seeks help to achieve improved outcomes.
    • Communication as care at end of life: an emerging issue from an exploratory action research study of renal end-of-life care for ethnic minorities in the UK

      Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina; Gane, Maria Da Silva; Stoves, John; Warwick, Graham; Akhtar, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken (Wiley-Blackwell, 2014-09-01)
      South Asian people have a higher risk of developing kidney disease, are disproportionately represented in the patient population requiring renal replacement therapy and wait longer to receive a kidney transplant, compared with white Europeans. As a result, there is a demand for end-of-life care, which meets the needs of this group of patients. Providing end-of-life care to patients from different cultures is a challenge for renal services as there can be barriers to communication in the form of language, delegated decision-making within families and reluctance to discuss death. To explore end-of-life care for South Asians with kidney disease, 16 interviews with patients and 14 focus groups with care providers were conducted at four research sites in the UK with large South Asian populations. Using an action research design the data were analysed thematically and fed back to inform the research in a cyclical manner. If patients are not fully aware of their condition or of what end-of-life care is, it is less likely that they will be able to be involved in decision-making about their care and this is compounded where there are communication barriers. Variations in care provider awareness and experience of providing end-of-life care to South Asian patients, in turn, contributes to lack of patient awareness of end-of-life care. Communication as care at the end of life should be explored further. Researching the South Asian patient experience of end of life highlights many relevant and generalisable issues.
    • Communication between South Asian patients and GPs: comparative study using the Roter Interactional Analysis System

      Neal, Richard D.; Ali, Nasreen; Atkin, Karl; Allgar, Victoria L.; Ali, Shahid; Coleman, Tim; Cardiff University; University of Leeds; University of Nottingham (Royal College of General Practitioners, 2018-06-22)
      Background The UK South Asian population has poorer health outcomes. Little is known about their process of care in general practice, or in particular the process of communication with GPs. Go to: Aim To compare the ways in which white and South Asian patients communicate with white GPs. Go to: Design of study Observational study of video-recorded consultations using the Roter Interactional Analysis System (RIAS). Go to: Setting West Yorkshire, UK. Go to: Method One hundred and eighty–three consultations with 11 GPs in West Yorkshire, UK were video-recorded and analysed. Go to: Results Main outcome measures were consultation length, verbal domination, 16 individual abridged RIAS categories, and three composite RIAS categories; with comparisons between white patients, South Asian patients fluent in English and South Asian patients non-fluent in English. South Asians fluent in English had the shortest consultations and South Asians non-fluent in English the longest consultations (one-way ANOVA F = 7.173, P = 0.001). There were no significant differences in verbal domination scores between the three groups. White patients had more affective (emotional) consultations than South Asian patients, and played a more active role in their consultations, as did their GPs. GPs spent less time giving information to South Asian patients who were not fluent in English and more time asking questions. GPs spent less time giving information to South Asian patients fluent in English compared with white patients. Go to: Conclusions These findings were expected between patients fluent and non-fluent in English but do demonstrate their nature. The differences between white patients and South Asian patients fluent in English warrant further explanation. How much of this was due to systematic differences in behaviour by the GPs, or was in response to patients' differing needs and expectations is unknown. These differences may contribute to differences in health outcomes.
    • Community nursing and antibiotic stewardship: the importance of communication and training

      Chater, Angel M.; Courtenay, Molly; University of Bedfordshire; University College London; Cardiff University (MA Healthcare Ltd, 2019-07-02)
      Antimicrobial stewardship (using antimicrobials responsibly) can reduce the risk of antimicrobial resistance (AMR). Many health professionals identify themselves as ‘antibiotic guardians’, but patient expectations, time constraints, and a lack of confidence or underdeveloped communication skills can influence decisions to prescribe. Nurse prescribers have an important role to play in antibiotic stewardship, and their numbers continue to grow. While nurse prescribers welcome this extension to their traditional role, they are often faced with barriers to antibiotic stewardship activities. These barriers may relate to their Capability (knowledge/skill), Opportunity (norms of practice, influence of patients, environmental factors), and Motivation (attitudes and beliefs, concern over outcome, emotion and habit) [COM-B]. Education, training and enablement can help to overcome these barriers, and the development of knowledge, confidence and effective communication skills should be of priority. Further, communication skills can help nurse prescribers understand patient expectations, with the use of open-ended questions, active listening and creation of a patient-centred consultation that leads to a mutually agreed end goal and way forward.
    • A comparison of antenatal classifications of 'overweight' and 'obesity' prevalence between white British, Indian, Pakistani and Bangladeshi pregnant women in England; analysis of retrospective data

      Garcia, Rebecca; Ali, Nasreen; Guppy, Andy; Griffiths, Malcolm; Randhawa, Gurch; University of Bedfordshire; Luton & Dunstable University Hospital NHS Foundation Trust (BIOMED CENTRAL LTD, 2017-04-11)
      Background: Maternal obesity increases women's risk of poor birth outcomes, and statistics show that Pakistani and Bangladeshi women (who are born or settled) in the UK experience higher rates of perinatal mortality and congenital anomalies than white British or white Other women. This study compares the prevalence of maternal obesity in Indian, Pakistani, Bangladeshi and white British women using standard and Asian-specific BMI metrics.Method: Retrospective cross-sectional analysis using routinely recorded secondary data in Ciconia Maternity information System (CMiS), between 2008 and 2013. Mothers (n = 15,205) whose ethnicity was recorded as white British, Bangladeshi, Pakistani or Indian. Adjusted standardised residuals and Pearson Chi-square. Main outcome measures: Percentage of mothers stratified by ethnicity (Indian, Pakistani, Bangladeshi and white British) who are classified as overweight or obese using standard and revised World Health Organisation BMI thresholds.Results: Compared to standard BMI thresholds, using the revised BMI threshold resulted in a higher prevalence of obesity: 22.8% of Indian and 24.3% of Bangladeshi and 32.3% of Pakistani women. Pearson Chi-square confirmed that significantly more Pakistani women were classified as `obese' compared with white British, Indian or Bangladeshi women (X-2 = 499,88 df = 9, p < 0.001).Conclusions: There are differences in the prevalence of obese and overweight women stratified by maternal ethnicity of white British, Indian, Pakistani and Bangladeshi. Using revised anthropometric measures in Indian, Pakistani and Bangladeshi women has clinical implications for identifying risks associated with obesity and increased complications in pregnancy.
    • A comparison of four approaches to evaluate the sit-to-stand movement

      Shukla, Brajesh K.; Jain, Hiteshi; Vijay, Vivek; Yadav, Sandeep; Mathur, Arvind; Hewson, David; Indian Institute of Technology Jodhpur; Asian Centre for Medical Education, Research & Innovation, Jodhpur; University of Bedfordshire (IEEE, 2020-04-19)
      The sit-to-stand test (STS) is a simple test of function in older people that can identify people at risk of falls. The aim of this study was to develop two novel methods of evaluating performance in the STS using a low-cost RGB camera and another an instrumented chair containing load cells in the seat of the chair to detect center of pressure movements and ground reaction forces. The two systems were compared to a Kinect and a force plate. Twenty-one younger subjects were tested when performing two 5STS movements at self-selected slow and normal speeds while 16 older fallers were tested when performing one 5STS at a self-selected pace. All methods had acceptable limits of agreement with an expert for total STS time for younger subjects and older fallers, with smaller errors observed for the chair (-0.18 ± 0.17 s) and force plate (-0.19 ± 0.79 s) than for the RGB camera (-0.30 ± 0.51 s) and the Kinect (-0.38 ± 0.50 s) for older fallers. The chair had the smallest limits of agreement compared to the expert for both younger and older participants. The new device was also able to estimate movement velocity, which could be used to estimate muscle power during the STS movement. Subsequent studies will test the device against opto-electronic systems, incorporate additional sensors, and then develop predictive equations for measures of physical function.
    • Complementary and alternative medicine (CAM) use among South Asian patients with cancer in Britain

      Ali, Nasreen; Hussain-Gambles, Mahvash; University of Leeds (Insight Medical Publishing Group, 2005-03-03)
      Complementary and alternative medicines (CAM) form an increasing part of the cancer management programmes for some patients, despite the continuing marginalised status of such medicines within the Western medical model. Research highlights the use of CAM among South Asian settlers in the UK who also constitute a group prone to rising rates of cancer. This paper argues that it is important to establish the exact parameters and patterns of the use of CAM and its relationships to allopathic medicine among South Asian patients with cancer, in the light of patient-centred re-evaluations of the Western medical model as a way of investigating the impact of the relationship on health outcomes.   
    • Complementary and alternative medicine’s attempts at occupational closure: a thematic analysis driven by grounded theory

      Almeida, Joana; University of Bedfordshire (SAGE, 2017-03-03)
      When I embarked on my PhD in 2007, I embraced two research areas which became my main areas of sociological interest: health and the professions. I had decided to explore the topic of complementary and alternative medicine practitioners in Portugal. My decision was influenced by the fact that very little sociological analysis had been done on the dynamics of complementary and alternative medicine in Portugal, particularly from the perspective of the sociology of professions, an area within sociology which analyzes the role and status of professionals in society. In some countries, the “revival” of complementary and alternative medicine and the professionalization of complementary and alternative medicine practitioners were being increasingly discussed and analyzed. I decided to contribute to closing this knowledge gap by exploring these topics in Portugal. I analyzed complementary and alternative medicine practitioners’, medical doctors’, and institutional actors’ perspectives on complementary and alternative medicine regulation and adopted a sociological lens based on a neo-Weberian theory of the professions, a theory centered on the strategies used by occupational groups to gain and/or maintain professional standing in the marketplace. In this case study, I provide an account of how dominant strategies used by complementary and alternative medicine practitioners to gain professional status within health care in Portugal can be derived from a thematic analysis of 20 semi-structured interviews with traditional acupuncturists and traditional homeopaths. With this case, I illustrate (a) how thematic analysis embraces chaos and uncertainty but ends in a rewarding systematization of the data and engagement with theory, and (b) how I combined thematic analysis with grounded theory to simultaneously verify, validate, and generate theory.
    • Complementary and alternative medicine’s occupational closure in Portuguese healthcare: contradictions and challenges

      Almeida, Joana; University of Bedfordshire (SAGE, 2016-08-29)
      This article analyses strategies of closure recently enacted by complementary and alternative medicine practitioners in order to achieve occupational control over work domains in healthcare, taking Portugal as an example. A combination of the neo-Weberian occupational closure theory of the professions and Abbott’s jurisdictional vacancy theory is proposed as the framework for analysis. Acupuncture and homeopathy will be presented as case studies. Data are derived from in-depth interviews with 10 traditional acupuncturists and 10 traditional homeopaths. Data analysis suggests that (1) professionalisation, (2) alignment with biomedical science and (3) expressing ‘legitimating values’ of a countervailing nature have been three significant strategies complementary and alternative medicine practitioners have used in an attempt to achieve market closure. It is argued that these strategies are contradictory: some involve allegiances, while others involve demarcation from biomedical science. A further outcome of these strategies is the promotion of complementary and alternative medicine treatments and solutions in everyday life. The success of these strategies therefore, although helping to reinforce the biomedical model, may simultaneously help complementary and alternative medicine to demarcate from it, posing thus challenges to mainstream healthcare.
    • Computer-assisted history-taking systems (CAHTS) in health care: benefits, risks and potential for further development

      Pappas, Yannis; Anandan, Chantelle; Liu, Joseph; Car, Josip; Sheikh, Aziz; Majeed, Azeem (BCS, 2017-09-20)
      Background A computer-assisted history-taking system (CAHTS) is a tool that aids clinicians in gathering data from patients to inform a diagnosis or treatment plan. Despite the many possible applications and even though CAHTS have been available for nearly three decades, these remain underused in routine clinical practice. Objective Through an interpretative review of the literature, we provide an overview of the field of CAHTS, which also offers an understanding of the impact of these systems on policy, practice and research. Methods We conducted a search and critique of the literature on CAHTS. Using a comprehensive set of terms, we searched: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, Health Technology Assessment Database and the NHS Economic Evaluation Database over a ten-year period (January 1997 to May 2007) to identify systematic reviews, technical reports and health technology assessments, and randomised controlled trials. Results The systematic review of the literature suggests that CAHTS can save professionals' time, improve delivery of care to those with special needs and also facilitate the collection of information, especially potentially sensitive information (e.g. sexual history, alcohol consumption). The use of CAHTS also has disadvantages that impede the process of history taking and may pose risks to patients. CAHTS are inherently limited when detecting non-verbal communication, may pose irrelevant questions and frustrate the users with technical problems. Our review suggests that barriers such as a preference for pen-and-paper methods and concerns about data loss and security still exist and affect the adoption of CAHTS. In terms of policy and practice, CAHTS make input of data from disparate sites possible, which facilitates work from disparate sites and the collection of data for nationwide screening programmes such as the vascular risk assessment programme for people aged 40_74, now starting in England. Conclusions Our review shows that for CAHTS to be adopted in mainstream health care, important changes should take place in how we conceive, plan and conduct primary and secondary research on the topic so that we provide the framework for a comprehensive evaluation that will lead to an evidence base to inform policy and practice.
    • Computer-assisted versus oral-and-written dietary history taking for diabetes mellitus

      Wei, Igor; Pappas, Yannis; Car, Josip; Sheikh, Aziz; Majeed, Azeem; University of Edinburgh; Imperial College London (Wiley-Blackwell, 2011-12-07)
      Background: Diabetes is a chronic illness characterised by insulin resistance or deficiency, resulting in elevated glycosylated haemoglobin A1c (HbA1c) levels. Diet and adherence to dietary advice is associated with lower HbA1c levels and control of disease. Dietary history may be an effective clinical tool for diabetes management and has traditionally been taken by oral-and-written methods, although it can also be collected using computer-assisted history taking systems (CAHTS). Although CAHTS were first described in the 1960s, there remains uncertainty about the impact of these methods on dietary history collection, clinical care and patient outcomes such as quality of life. Objectives: To assess the effects of computer-assisted versus oral-and-written dietary history taking on patient outcomes for diabetes mellitus. Search methods: We searched The Cochrane Library (issue 6, 2011), MEDLINE (January 1985 to June 2011), EMBASE (January 1980 to June 2011) and CINAHL (January 1981 to June 2011). Reference lists of obtained articles were also pursued further and no limits were imposed on languages and publication status. Selection criteria: Randomised controlled trials of computer-assisted versus oral-and-written history taking in patients with diabetes mellitus. Data collection and analysis: Two authors independently scanned the title and abstract of retrieved articles. Potentially relevant articles were investigated as full text. Studies that met the inclusion criteria were abstracted for relevant population and intervention characteristics with any disagreements resolved by discussion, or by a third party. Risk of bias was similarly assessed independently. Main results: Of the 2991 studies retrieved, only one study with 38 study participants compared the two methods of history taking over a total of eight weeks. The authors found that as patients became increasingly familiar with using CAHTS, the correlation between patients' food records and computer assessments improved. Reported fat intake decreased in the control group and increased when queried by the computer. The effect of the intervention on the management of diabetes mellitus and blood glucose levels was not reported. Risk of bias was considered moderate for this study. Authors' conclusions: Based on one small study judged to be of moderate risk of bias, we tentatively conclude that CAHTS may be well received by study participants and potentially offer time saving in practice. However, more robust studies with larger sample sizes are needed to confirm these. We cannot draw on any conclusions in relation to any other clinical outcomes at this stage.
    • Computer-assisted versus oral-and-written history taking for the prevention and management of cardiovascular disease: a systematic review of the literature

      Pappas, Yannis; Všetečková, Jitka; Poduval, Shoba; Tseng, Pei-Ching; Car, Josip; University of Bedfordshire; Open University; City University London; Nanyang Technological University (Charles University, 2017-07-05)
      BACKGROUND AND OBJECTIVES: CVD is an important global healthcare issue; it is the leading cause of global mortality, with an increasing incidence identified in both developed and developing countries. It is also an extremely costly disease for healthcare systems unless managed effectively. In this review we aimed to: - Assess the effect of computer-assisted versus oral-and-written history taking on the quality of collected information for the prevention and management of CVD. - Assess the effect of computer-assisted versus oral-and-written history taking on the prevention and management of CVD. METHODS: A systematic review of randomised controlled trials that included participants of 16 years or older at the beginning of the study, who were at risk of CVD (prevention) or were either previously diagnosed with CVD (management). We searched all major databases. We assessed risk of bias using the Cochrane Collaboration tool. RESULTS: Two studies met the inclusion criteria. One comparing the two methods of history-taking for the prevention of cardiovascular disease n = 75. The study shows that generally the patients in the experimental group underwent more laboratory procedures, had more biomarker readings recorded and/or were given (or had reviewed), more dietary changes than the control group. The other study compares the two methods of history-taking for the management of cardiovascular disease (n = 479). The study showed that the computerized decision aid appears to increase the proportion of patients who responded to invitations to discuss CVD prevention with their doctor. The Computer- Assisted History Taking Systems (CAHTS) increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% and increased the proportion who had a specific plan to reduce their risk from 24% to 37%. DISCUSSION: With only one study meeting the inclusion criteria, for prevention of CVD and one study for management of CVD we did not gather sufficient evidence to address all of the objectives of the review. We were unable to report on most of the secondary patient outcomes in our protocol. CONCLUSIONS: We tentatively conclude that CAHTS can provide individually-tailored information about CVD prevention. However, further primary studies are needed to confirm these findings. We cannot draw any conclusions in relation to any other clinical outcomes at this stage. There is a need to develop an evidence base to support the effective development and use of CAHTS in this area of practice. In the absence of evidence on effectiveness, the implementation of computer-assisted history taking may only rely on the clinicians' tacit knowledge, published monographs and viewpoint articles.
    • Computer-assisted versus oral-and-written history taking for the prevention of cardiovascular disease

      Cash-Gibson, Lucinda; Pappas, Yannis; Car, Josip (John Wiley and Sons Ltd, 2015-05-19)
      This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of computer- assisted versus oral-and written lifestyle history taking on quality and completeness of collected information; To assess the effects of computer-assisted versus oral-and written lifestyle history taking for the prevention of CVD.
    • Conducting cross-cultural interviews and focus groups concerning healthcare with Polish migrants in the UK - Lessons from a study on organ donation

      Sharp, Chloe; Randhawa, Gurch (Urban and Partner, 2016-08-24)
      Introduction: The Polish migrant community in the UK are under-represented in health and social care research, and are specifically under-researched with the issue of organ donation. Aim: To investigate the views of this community further, a qualitative research study examined the attitudes of Polish migrants toward organ donation. Material and methods: A series of interviews and min-focus groups were conducted with three sample groups. For the first sample, the inclusion criteria was broad, the only requirement was that the participants were English speaking Poles who lived in Luton. The second sample had a tighter inclusion criterion and excluded highly skilled professionals and students and included low skilled workers and parents of young families who were English or Polish speaking and lived in Luton and Dunstable. The third sample was solely post-war Polish migrants who lived in Luton and Dunstable. Results and discussion: This paper addresses some of the challenges overcome when researching the Polish migrant community, such as withdrawal in the recruitment phase of data collection and the use of Polish translators/interpreters. Conclusions: The study contributes toward an understanding of the use of Polish migrant communities in health research, use of professional translator/interpreter and whispered interpreters in health research and the challenges of researching organ donation within an under-represented community. Patient education and communication with UK Polish communities is an under-researched area. This study offers some insights into the challenges of engaging with a rapidly growing section of the UK population.
    • 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 = &lt; .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.
    • Connecting health, health-related behaviours and place through the work of community gardening

      Church, Andrew; Ellaway, A.; Mitchell, R.; Moore, Niamh; Ravenscroft, Neil; AHRC (Connected Communities Cross Council Programme, 2012-01-01)
    • Consent rates for video-recording general practice consultations: effect of ethnicity and other factors

      Neal, Richard D.; Ali, Nasreen; Allgar, Victoria L.; Coleman, Tim (Oxford University Press, 2004-04-01)
      We sought consent for video-recording general practice consultations from 260 consecutive attenders in nine surgeries. Intensive fieldwork including language support, from both the researcher and professional interpreters, was undertaken. The overall consent rate was 77.3%. No significant differences in consent rates were found between white and south Asian patients, even after controlling for age, gender and self-reported understanding of English. No differences in consent rates were found with respect to age, gender and self-reported understanding of English.
    • Construct validity of a modified bathroom scale that can measure balance in elderly people

      Vermeulen, Joan; Neyens, Jacques C.L.; Spreeuwenberg, Marieke D.; van Rossum, Erik; Hewson, David; Duchêne, Jacques; de Witte, Luc P. (AMDA, 2012-10-01)
      To investigate the construct validity of a bathroom scale measuring balance in elderly people. Cross-sectional study. Participants were recruited via nursing homes and an organization that provides exercise classes for community-dwelling elderly people. Nursing home patients were compared with active community-dwelling elderly people. Eligibility criteria for both groups were: aged 65 years or older and being able to step onto a bathroom scale independently. The balance measurement of the bathroom scale was compared with the following three clinical balance measurements: Performance Oriented Mobility Assessment (POMA), Timed Up and Go (TUG), and Four Test Balance Scale (FTBS). An independent samples t-test was performed to determine whether nursing home patients scored lower on these four balance tests compared with community-dwelling elderly people. Correlations were calculated between the bathroom scale balance scores and those of the clinical balance tests for nursing home patients and community-dwelling elderly people separately. Forty-seven nursing home patients with a mean age of 81 years (SD 6.40) and 54 community-dwelling elderly people with a mean age of 76 years (SD 5.06) participated in the study. The results showed that nursing home patients had significantly lower scores on all four balance tests compared with community-dwelling elderly people. Correlations between the bathroom scale scores and the POMA, TUG, and FTBS in nursing home patients were all significant: .49, -.60, and .63, respectively. These correlations were not significant in active community-dwelling elderly people, -.04, -.42, and .33, respectively. Linear regression analyses showed that the correlations for the bathroom scale and POMA, bathroom scale and TUG, and bathroom scale and FTBS did not differ statistically between nursing home patients and community-dwelling elderly people. These results suggest that the modified bathroom scale is useful for measuring balance in elderly people. However, the added value of this assessment method for clinical practice remains to be demonstrated.