• A comparative study on the clinical decision making processes of nurse practitioners versus medical doctors using scenarios within a secondary care environment

      Barratt, Julian; Moorley, Calvin; Thompson, Stephen (Wiley, 2017-04-07)
      Subjects This study was conducted from May 2012 to January 2013.Aim To investigate the decision-making skills of secondary care nurse practitioners compared to those of medical doctors.Background A literature review was conducted, searching for articles published from 1990 to 2012. The review found that nurse practitioners are key to the modernisation of the National Health Service. Studies have shown that compared to doctors, nurse practitioners can be efficient and cost-effective in consultations.Design Qualitative research design. Methods The information processing theory and think-aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality, and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment.Results The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took three minutes longer to complete the scenarios. Conclusion This study suggests that nurse practitioner consultations are comparable to those of medical doctors within a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes.
    • A conversation analysis of asking about disruptions in method of levels psychotherapy

      Cannon, Caitlyn; Meredith, Joanne; Speer, Susan; Mansell, Warren (Wiley, 2019-06-17)
      Background: Method of Levels (MOL) is a cognitive therapy with an emerging evidence base. It is grounded in Perceptual Control Theory and its transdiagnostic nature means techniques are widely applicable and not diagnosis-specific. This paper contributes to psychotherapy process research by investigating a key technique of MOL, asking about disruptions, and in doing so aims to explore how the technique works and aid the understanding of related techniques in other psychotherapies. Method: Conversation Analysis (CA) is applied to asking about disruptions in twelve real-life therapeutic interactions. Findings: Analyses explore how and when therapists ask about disruptions, with examples presented according to their degree of adherence to the MOL approach. The majority of identified instances project responses consistent with MOL aims; encouraging further talk, focused on the client’s problem, and with a shift to meta-level commentary. Also presented are examples of therapist and client influence on disruptions. Conclusion: The paper provides support for a number of MOL practices, with clinical implications and links to other psychotherapies highlighted.
    • A multicentre community-based study of dementia cases and subcases in older people in China--the GMS-AGECAT prevalence and socio-economic correlates.

      Chen, Ruoling; Ma, Ying; Wilson, Ken; Hu, Zhi; Sallah, David; Wang, Jiaji; Fan, Lihua; Chen, Ruo-Li; Copeland, John R (Wiley, 2011-09-21)
      Previous studies indicated overall relatively low prevalence of dementia in older people in China, which may be biased by studied samples or methods. We determined the prevalence of dementia cases and subcases in China and examined their socio-economic correlates. Using the Geriatric Mental State interview, we examined random samples of 2917 participants aged ≥ 65 years in urban and rural Anhui, China in 2001-2003, and 3327 in four other provinces in 2008-2009. Dementia cases and subcases were diagnosed by Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy. Age-standardised prevalence for cases and subcases of dementia in the Anhui elders was 7.20% (95%CI 6.29%-8.20%) and 10.5% (9.38%-11.6%), and in the four provinces, 9.86% (8.80%-10.9%) and 8.51% (7.51%-9.52%). The matched figures among the participants who were literate were 3.05% (2.08%-4.02%) and 10.0% (8.38%-11.6%), and 4.92% (3.89%-5.96%) and 6.76% (5.55%-7.96%), respectively. There were higher prevalence rates of dementia cases and subcases in the rural elders than in the urban. Both the Anhui and four-province studies showed an obvious association of dementia with higher and lower incomes among elders who had lower educational levels or had the lowest occupational class. The highest risk of dementia was found in those who were illiterate but had the highest income or had the job of business/nonmanual labouring. People in China have a higher prevalence of dementia than previously reported. Its U-shaped relationship with income and the excess subcases prevalence predicates a significant burden of disease, both now and for the future, suggesting preventive strategy for dementia in China.
    • An analysis of the impact of suicide prevention messages and memorials on motorway bridges

      O'Neill, Siobhan; Potts, Courtney; Bond, Raymond; Mulvenna, Maurice; Ennis, Edel; McFeeters, Danielle; Boyda, David; Morrissey, Jacqui; Scowcroft, Elizabeth; Isaksen, Mette; et al. (Wiley, 2021-02-12)
      Recently there has been activity at public locations where people have died by suicide, including the erection of suicide prevention messages and memorials (decorations). This research looks at the impact of these decorations and associated media coverage of the decorations on suicidal behaviour at bridges. Incidents (n=160) of suicidal behaviour on 26 bridges across motorways in England were analysed. Overall, there was no significant difference in the proportion of incidents pre-decoration versus post-decoration (p-value=0.55). The incident rates were not significantly different pre- and post-decoration (p=0.46). Only one bridge had statistically significantly more incidents post-decoration and media reporting (p=0.03). However, following correction for multiple testing there was no significant difference in pre and post-incident rates at any of the bridges. In total, 58% of bridges had a greater frequency of incidents when decorations were absent, however this proportion was not statistically significant (p=0.41). Further research is required to establish how suicide prevention messages are perceived. There does not appear to be any benefit, but it often generates media coverage which has been shown to increase risk. Therefore, a precautionary approach is recommended on the use of suicide prevention messages as an intervention at bridges.
    • Approaches to communication assessment with children and adults with profound intellectual and multiple disabilities

      Goldbart, Juliet; Buell, Susan; Chadwick, Darren (Wiley, 2018-11-14)
      Communication assessment of people with profound intellectual and multiple disabilities (PIMD) has seldom been investigated. Here we explore approaches and decision making in undertaking communication assessments in this group of people. A questionnaire was sent to UK practitioners. The questionnaire elicited information about assessment approaches used and rationales for assessment choices. Fifty-five speech and language therapists (SLTs) responded. Findings revealed that the Preverbal Communication Schedule, the Affective Communication Assessment and the Checklist of Communication Competence were the most frequently used published assessments. Both published and unpublished assessments were often used. Rationales for assessment choice related to assessment utility, sensitivity to detail and change and their applicability to people with PIMD. Underpinning evidence for assessments was seldom mentioned demonstrating the need for more empirical support for assessments used. Variability in practice and the eclectic use of a range of assessments was evident, underpinned by practice-focused evidence based on tacit knowledge.
    • Balanced forced‐diuresis as a renal protective approach in cardiac surgery: Secondary outcomes of electrolyte changes

      Luckraz, Heyman; Giri, Ramesh; Wrigley, Benjamin; Nagarajan, Kumaresan; Senanayake, Eshan; Sharman, Emma; Beare, Lawrence; Nevill, Alan (Wiley, 2021-08-19)
      Objectives Forced-diuresis during cardiopulmonary bypass (CPB) can be associated with significant electrolyte shifts. This study reports on the serum electrolyte changes during balanced forced-diuresis with the RenalGuard® system (RG) during CPB. Methods Patients at risk of acute kidney injury (AKI)—(history of diabetes &/or anaemia, e-GFR 20–60 ml/min/1.73 m2, anticipated CPB time >120 min, Log EuroScore >5)—were randomized to either RG (study group) or managed as per current practice (control group). Results The use of RG reduced AKI rate (10% for RG and 20.9% in control, p = .03). Mean urine output was significantly higher in the RG group during surgery (2366 ± 877 ml vs. 765 ± 549 ml, p < .001). The serum potassium levels were maintained between 3.96 and 4.97 mmol/L for the RG group and 4.02 and 5.23 mmol/L for the controls. Median potassium supplemental dose was 60 (0–220) mmol (RG group) as compared to 30 (0–190) mmol for control group over first 24 h (p < .001). On Day 1 post-op, there were no significant differences in the serum sodium, potassium, calcium, magnesium, phosphate, and chloride levels between the two groups. Otherwise, postoperative clinical recovery was also similar. Conclusions Balanced forced-diuresis with the RG reduced AKI rates after on-pump cardiac surgery compared to controls. Although the RG group required higher doses of IV potassium replacement in the postoperative period, normal serum levels of potassium were maintained by appropriate intravenous potassium supplementation and the clinical outcomes between groups were similar.
    • Can Serial Rapists be Distinguished from One-off Rapists?

      Slater, Chelsea; Woodhams, Jessica; Hamilton-Giachritsis, Catherine; Chelsea Slater, School of Psychology, Frankland Building; University of Birmingham; Edgbaston Birmingham B15 2TT UK; University of Birmingham; UK; University of Birmingham; UK (Wiley, 2014-03)
      There are investigative advantages to being able to determine early in a police investigation whether a rape has been committed by a serial or one-off rapist. Previous research has found some differences in the crime-scene behaviours of serial and one-off rapists, however, this research suffers from the limitation of utilising a sample of rapes within which there was a mixture of victim-offender relationships. To address this limitation, this study sampled 38 serial (two or more convictions) and 50 one-off (one conviction) stranger rapists and compared their crime scene behaviour across four domains (control, sex, escape and style behaviours). Serial and one-off rapists differed in some control and sexual behaviours; in particular, in the type of victim targeted, the offence locations, methods of control and the sexual acts forced upon the victim. However, the results did not indicate a striking difference in the offending behaviour of the two groups. The implications of these findings for criminal investigations are discussed.
    • Can waist circumference provide a new “third” dimension to BMI when predicting percentage body fat in children? Insights using allometric modelling

      Nevill, Alan M.; Bryant, Elizabeth; Wilkinson, Kate; Gomes, Thayse Natacha; Chaves, Raquel; Pereira, Sara; Katzmarzyk, Peter T; Maia, José; Duncan, Michael J. (Wiley, 2018-12-27)
      Introduction: Body mass index (BMI) is often criticised for not being able to distinguish between lean and fat tissue. Waist circumference (WC), adjusted for stature, is proposed as an alternative weight-status index, as it is more sensitive to changes in central adiposity. Purpose: To combine the three dimensions of height, mass and WC to provide a simple, meaningful and more accurate index associated with percentage body fat (BF%). Methods: We employed a four independent sample design. Sample 1 consisted of 551 children (320 boys) (Mean ± S.D. of age = 7.2 ± 2.0 years), recruited from London, UK. Samples 2, 3 and 4 consisted of 5387 children (2649 boys) aged 7-17 years recruited from schools in Portugal. Allometric modelling was used to identify the most effective anthropometric index associated with BF%. The data from sample 2, 3 and 4 were used to confirm and cross validate the model derived in sample 1. Results: The allometric models from all four samples identified a positive mass exponent and a negative height exponent that was approximately twice that of the mass exponent and a waist circumference exponent that was approximately half the mass exponent. Consequently, the body-shape index most strongly associated with BF% was BMI√WC. The √WC component of the new index can simply be interpreted as a WC “weighting” of the traditional BMI. Conclusions: Compared to using BMI and WC in isolation, BMI√WC could provide a more effective and equally non-invasive proxy for BF% in children that can be used in public and community health settings.
    • ‘Career and Money Aside, What's the Point of University?’ A Comparison of Students’ Non-economic Entry Motives in Three European Countries

      Bartram, Brendan; University of Wolverhampton (Wiley, 2016-05-16)
      his paper explores students’ non-economic motives for attending university. Drawing on the results of a tri-national survey involving online questionnaires and email interviews with education students at English, German and Portuguese universities, it compares and discusses the extent to which the participants are motivated by a number of extrinsic and intrinsic factors. In contrast to certain other studies, the findings reveal a strong consensus across all three settings in relation to certain motivational elements—strong intrinsic desires for self-improvement and low motivations driven by social pressures or seeing university as a default option. More pronounced national differences emerge, however, regarding motives to contribute to society and the appeal of the social dimension of university life. The paper interprets the similarities and differences revealed and considers a number of conclusions.
    • Childhood maltreatment and psychotic experiences: exploring the specificity of early maladaptive schemas

      Boyda, David; McFeeters, Danielle; Dhingra, Katie; Rhoden, Laura (Wiley, 2018-08-13)
      Objective: One potential mechanism that has received limited attention within psychosis research, is early maladaptive schemas (EMS). Our aim was to examine if EMS acts as a potential mediating pathway between early trauma and psychotic symptomology. Methods: A quantitative survey was hosted online. N= 302 participants took part. The analysis employed a multiple mediation framework. Results: Analysis demonstrated significant specificity effects. Different forms of child maltreatment were significantly associated with psychosis experiences through specific dimensions of maladaptive schemas. Conclusions: Results indicated specificity effects in that specific types of maltreatment are associated with specific maladaptive schemas. From a practitioner’s perspective, these findings offer credence to cognitive theories of psychopathology, and support the validity of EMS identification and modification among clients with psychotic symptomology; both as a fundamental component of traditional CBT and within specialised schema focused therapy.
    • A cross-case comparison of the trauma and orthopaedic hospital experiences of adults with intellectual disabilities using interpretative phenomenological analysis

      Drozd, Mary; Chadwick, Darren; Jester, Rebecca (Wiley, 2020-12-10)
      Aim: To present the cross-case comparison component of a qualitative study exploring and describing the experiences of adults with an intellectual disability who have received trauma and orthopaedic hospital care for musculoskeletal conditions or injuries in the United Kingdom. Design A qualitative, exploratory study was conducted using 1:1 semi-structured interviews to describe the lived experiences of trauma and orthopaedic hospital care from the perspectives of people with intellectual disabilities and a carer of a person with profound and multiple intellectual disabilities. The data was analysed using interpretative phenomenological analysis. The Standards for Reporting Qualitative Research guidelines were applied. Results: There were common and interconnected experiences across the five participants: Communication challenges; lack of person-centred care; issues related to pain management; lack of confidence in hospital care; the valuable support and expertise of carers; incompetence of hospital staff and isolation and loneliness. Discussion: Although adults with intellectual disabilities are seldom included as participants in health research studies, their unique experiences provided valuable insights and informs the evidence base in relation to trauma and orthopaedic hospital care. Conclusions: This study revealed poor quality and unsafe trauma and orthopaedic hospital experiences as described by people with intellectual disabilities and a carer. Health care providers, commissioners and staff require urgent education and training to ensure that a person-centred approach, incorporating reasonable and achievable adjustments, is implemented to meet the currently unmet needs of adults with intellectual disabilities.
    • Defying geometric similarity: Shape centralization in male UK offshore workers.

      Stewart, Arthur D; Ledingham, Robert J; Furnace, Graham; Williams, Hector; Nevill, Alan M. (Wiley, 2016-11-01)
      Applying geometric similarity predictions of body dimensions to specific occupational groups has the potential to reveal useful ergonomic and health implications. This study assessed a representative sample of the male UK offshore workforce, and examined how body dimensions from sites typifying musculoskeletal development or fat accumulation, differed from predicted values.
    • Differences in the early stages of social information processing for adolescents involved in bullying

      Guy, Alexa; Lee, Kirsty; Wolke, Dieter (Wiley, 2017-06-07)
      Bullying victimization has commonly been associated with deficiencies in social information processing (SIP). In contrast, findings regarding bullying perpetration are mixed, with some researchers claiming that bullies may have superior SIP abilities than victimized or uninvolved youth. This study investigated the effects of bullying and victimization on early SIP; specifically the recognition and interpretation of social information. In stage 1, 2,782 adolescents (11–16 years) were screened for bullying involvement, and in stage 2, 723 of these participants (mean age = 13.95) were assessed on measures of emotion recognition, hostile attribution bias, and characterological self‐blame (CSB). No associations between bullying and early SIP were found. In contrast, victimization was associated with more hostile attribution bias and CSB attributions. Girls performed better than boys on the emotion recognition task while boys showed greater hostile attribution biases. No interaction effects of bullying or victimization with gender were found. Follow‐up categorical analyses that considered pure victims versus victims who also bullied (bully‐victims) on SIP, found a similar pattern of findings. These findings suggest that those who purely bully others are neither superior nor deficient in the early stages of SIP. Victimized adolescents, however, show biases in their interpretations of social situations and the intentions of others. These biases may lead to maladaptive responses and may increase risk for further victimization by peers.
    • Digital inclusion and participation of people with intellectual disabilities during COVID‐19: A rapid review and international bricolage

      Chadwick, Darren; Ågren, Kristin Alfredsson; Caton, Sue; Chiner, Esther; Danker, Joanne; Gómez‐Puerta, Marcos; Heitplatz, Vanessa; Johansson, Stefan; Normand, Claude L; Murphy, Esther; et al. (Wiley, 2022-01-14)
      The COVID-19 pandemic has meant a rapid transfer of everyday activities to the online world. Information and communication technologies (ICTs) have become more embedded than ever in people's lives. This investigation addresses how this change has affected the lives of people with intellectual disabilities (ID). A two-step design was used. A rapid review was conducted on empirical studies published between January 2019 and June 2021. Search terms related to ID, ICT use and COVID-19. A qualitative international bricolage was also conducted corresponding to author nationalities. Data gathered from the review and bricolage were analysed separately using thematic analysis and relationally synthesised. Digital solutions to provide access to COVID-19 information and guidance seemed inadequate but were seldom empirically studied. Digital poverty, literacy and exclusion remain significant issues for people with ID internationally. People and their carers experienced reduced and removed service provision, loneliness and impoverished daily lives during the pandemic; amelioration of which was facilitated by digital solutions. One solution often used was videoconferencing. Prior experience of digital participation, adequate finances, connection, support and digital literacy mentoring for both people with ID and those providing services and support facilitated digital inclusion. Digital exclusion during COVID-19 was exacerbated by sociopolitical, structural, individual and support-related barriers. Although awareness of digital exclusion appears to have been raised, the extent to which this has led to action and change remains unclear. Despite digital exclusion and digital participation benefitting continuation of life, social and emotional well-being and autonomy, COVID-19 has not provided the impetus to eradicate digital poverty for people with ID. Governmental support, digital education, creativity and problem solving are required to enable people with ID the human right to be included in the digital world at this essential time and into the future.
    • Dysphagia Management for People with Intellectual Disabilities: Practitioner Identified Processes, Barriers and Solutions

      Chadwick, Darren (Wiley, 2017-12-4)
      Background: Dysphagia is a significant problem for adults with intellectual disabilities which has received sparse attention in the research literature. Little is currently documented about how dysphagia management operates and the barriers and associated strategies to address barriers utilised in practice. Method: A brief survey containing open ended questions was completed by 38 practitioners about the way their service operates, the barriers they have faced in providing support around managing dysphagia and the solutions and strategies they have found useful. Results & Conclusions: The process of dysphagia management typically involved referral and assessment, development of an intervention strategy, communication and negotiation, education and training in safe dysphagia management and monitoring, evaluation and re-assessment. Barriers were numerous but stakeholder beliefs, knowledge and feelings underpinned many of them. Solutions varied but similarly were underpinned by good communication, building relationships, person centred practice and responsivity, pragmatism and innovation in training and disseminating dysphagia management information
    • Effect of seasonal programming on fetal development and longevity: links with environmental temperature.

      Flouris, Andreas D; Spiropoulos, Yiannis; Sakellariou, Giorgos J.; Koutedakis, Yiannis (Wiley, 2009)
      This study examined the effect of birth season on fetal development and longevity using two independent databases of all Greek citizens that were born (total: 516,874) or died (total: 554,101) between 1999 and 2003. We found significantly increased birth weight, gestational age, and longevity in individuals born during the autumn and winter seasons of the year. These individuals also demonstrated statistically significantly lower prevalence rates for fetal growth restriction and premature birth. Furthermore, we found that increased temperature at birth was associated with adverse effects on fetal development and longevity. In conclusion, our results show strong effects of season of birth on fetal development and longevity mediated, at least in part, by environmental temperature at time of birth.
    • The effects of physical activity or sport-based interventions on psychological factors in adults with intellectual disabilities: a systematic review

      Bondár, RZ; di Fronso, S; Bortoli, L; Robazza, C; Metsios, GS; Bertollo, M (Wiley, 2019-12-12)
      © 2019 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd Background: Inactivity is a major factor contributing to adverse health in people with intellectual disabilities (IDs). While it is generally agreed that physical activity (PA)/sport-based interventions promote cognitive and social development in the general population, little is known about their specific benefits in adults with ID. The aims of this systematic review were (a) to examine the effects of PA/sport-based interventions on intention, motivation and attitude regarding PA/sport participation in adults with ID and (b) to investigate the influence of these psychological factors on behavioural change (e.g. PA level) and quality of life. Methods: A systematic review has been conducted searching four electronic databases (i.e. SCOPUS, Web of Science, PubMed and Cochrane Library). Studies were included if written in English, peer reviewed, had primary research data, and measured intention, motivation, attitude, behavioural outcomes or quality of life. Results: Thirteen articles met our inclusion criteria of which 10 explored the effects of PA/sport as part of a multi-component intervention. Most investigated outcomes were exercise self-efficacy and quality of life. Five studies measured exercise self-efficacy, and four of them found significant changes. One study found a significant improvement in quality of life and another study in life satisfaction. We observed lack of sport-based interventions, few data about people with severe ID and limited psychological measures. Conclusions: Personal and environmental factors are key components of behavioural change. Support of caregivers and individualised instructions may benefit exercise self-efficacy. There is lack of information about the effects of psychological factors on behavioural change and quality of life in adults with ID.
    • Effects of situational variables on the physical activity profiles of elite soccer players in different score line states

      Redwood-Brown, Athalie J; O'Donoghue, Peter G; Nevill, Alan M; Saward, Chris; Dyer, Nicholas; Sunderland, Caroline (Wiley, 2018-07-28)
      The aim of this study were to investigate the effects of playing position, pitch location, team ability and opposition ability on the physical activity profiles of English premier league soccer players in difference score line states. A validated automatic tracking system (Venatrack Ltd.) was used to track players in real time (at 25 Hz) for total distance covered, high speed running distance and sprint distance. This is the first study to include every team from an entire season in the English premier league, resulting in 376 games, 570 players and 35 000 rows of data from the 2011-12 season being analyzed using multi-level modelling. Multi-level regression revealed an inverted "u" shaped association between total distance covered and goal difference (GD), with greater distances covered when GD was zero and reduced distances when GD was either positive or negative. A similar "u" shaped association was found with high speed distance covered at home. In addition distance covered (both at home and away) were predicted by playing position. All activity profiles (with the exception of sprint distance at home) were predicted by pitch location and time scored. Lastly, distance away from home and high speed running at home were predicted by opposition ability. Score line appears to effect player activity profiles across a number of situational factors and thus should be considered by managers when preparing and selecting teams to maximize performance. The current study also highlighted the need for more sensitive score line definitions in which to consider score line effects.
    • The experiences of adults with intellectual disabilities attending a mindfulness-based group intervention

      Croom, Sarah; Chadwick, Darren; Nicholls, Wendy; McGarry, Ali (Wiley, 2021-02-01)
      A growing body of research supports the efficacy of mindfulness-based intervention programmes (MBPs) for people with intellectual disabilities. Existing literature calls for focus on the experiences of people with intellectual disabilities participating in MBPs. This study explored the experiences of nine adults with intellectual disabilities attending an eightweek group MBP delivered within the community. Two audio-recorded group discussions and seven semi-structured interviews were thematically analysed. Themes were: participants’ experience of the group as a meaningful and enjoyable activity; opportunities for socialisation, sharing, friendship and support; the significance of participant-facilitator relationships; and how participants’ understood and experienced the mindfulness exercises and concepts. Some understanding of mindfulness was evident and participants demonstrated an ability to engage in mindfulness exercises. Findings inform the development of effective MBPs for people with intellectual disabilities.