• What sources of bereavement support are perceived helpful by bereaved people and why? Empirical evidence for the compassionate communities approach

      Aoun, S.M.; Breen, Liz; White, I.; Rumbold, B.; Kellehear, Allan (2018-09)
      Aims: To determine who provides bereavement support in the community, what sources are perceived to be the most or least helpful and for what reason, and to identify the empirical elements for optimal support in developing any future compassionate communities approach in palliative care. Design: A population-based cross-sectional investigation of bereavement experiences. Sources of support (informal, community and professional) were categorised according to the Public Health Model of Bereavement Support; most helpful reasons were categorised using the Social Provisions Scale, and least helpful were analysed using inductive content analysis. Setting and participants: Bereaved people were recruited from databases of funeral providers in Australia via an anonymous postal survey (2013–2014). Results: In total, 678 bereaved people responded to the survey. The most frequently used sources of support were in the informal category such as family, friends and funeral providers. While the professional category sources were the least used, they had the highest proportions of perceived unhelpfulness whereas the lowest proportions of unhelpfulness were in the informal category. The functional types of helpful support were Attachment, Reliable Alliance, Social Integration and Guidance. The five themes for least helpful support were: Insensitivity, Absence of Anticipated Support, Poor Advice, Lack of Empathy and Systemic Hindrance. Conclusion: A public health approach, as exemplified by compassionate communities policies and practices, should be adopted to support the majority of bereaved people as much of this support is already provided in informal and other community settings by a range of people already involved in the everyday lives of those recently bereaved. This study has provided further support for the need to strengthen the compassionate communities approach, not only for end of life care for dying patients but also along the continuum of bereavement support.
    • What you see is what you step: the horizontal-vertical illusion increases toe clearance in older adults during stair ascent.

      Foster, Richard J.; Whitaker, David J.; Scally, Andy J.; Buckley, John G.; Elliott, David B. (2015-05)
      Purpose.: Falls on stairs are a significant cause of morbidity and mortality in elderly people. A simple safety strategy to avoid tripping on stairs is increasing foot clearance. We determined whether a horizontal–vertical illusion superimposed onto stairs to create an illusory perceived increase in stair-riser height would increase stair ascent foot clearance in older participants. Methods.: Preliminary experiments determined the optimum parameters for the horizontal–vertical illusion. Fourteen older adults (mean age ± 1 SD, 68.5 ± 7.4 years) ascended a three-step staircase with the optimized version of the horizontal–vertical illusion (spatial frequency: 12 cycles per stair riser) positioned either on the bottom or top stair only, or on the bottom and top stair simultaneously. These were compared to a control condition, which had a plain stair riser with edge highlighters positioned flush with each stair-tread edge. Foot clearance and measures of postural stability were compared across conditions. Results.: The optimized illusion on the bottom and top stair led to a significant increase in foot clearance over the respective stair edge, compared to the control condition. There were no significant decreases in postural stability. Conclusions.: An optimized horizontal–vertical visual illusion led to significant increases in foot clearance in older adults when ascending a staircase, but the effects did not destabilize their postural stability. Inclusion of the horizontal–vertical illusion on raised surfaces (e.g., curbs) or the bottom and top stairs of staircases could improve stair ascent safety in older adults.
    • When is visual information used to control locomotion when descending a kerb?

      Buckley, John G.; Timmis, Matthew A.; Scally, Andy J.; Elliott, David B. (2011)
      Background: Descending kerbs during locomotion involves the regulation of appropriate foot placement before the kerb-edge and foot clearance over it. It also involves the modulation of gait output to ensure the body-mass is safely and smoothly lowered to the new level. Previous research has shown that vision is used in such adaptive gait tasks for feedforward planning, with vision from the lower visual field (lvf) used for online updating. The present study determined when lvf information is used to control/update locomotion when stepping from a kerb. Methodology/Principal Findings: 12 young adults stepped down a kerb during ongoing gait. Force sensitive resistors (attached to participants' feet) interfaced with an high-speed PDLC 'smart glass' sheet, allowed the lvf to be unpredictably occluded at either heel-contact of the penultimate or final step before the kerb-edge up to contact with the lower level. Analysis focussed on determining changes in foot placement distance before the kerb-edge, clearance over it, and in kinematic measures of the step down. Lvf occlusion from the instant of final step contact had no significant effect on any dependant variable (p>0.09). Occlusion of the lvf from the instant of penultimate step contact had a significant effect on foot clearance and on several kinematic measures, with findings consistent with participants becoming uncertain regarding relative horizontal location of the kerb-edge. Conclusion/Significance: These findings suggest concurrent feedback of the lower limb, kerb-edge, and/or floor area immediately in front/below the kerb is not used when stepping from a kerb during ongoing gait. Instead heel-clearance and pre-landing-kinematic parameters are determined/planned using lvf information acquired in the penultimate step during the approach to the kerb-edge, with information related to foot placement before the kerb-edge being the most salient.
    • When it comes round to marking assignments: how to impress and how to 'distress' lecturers ...

      Greasley, Peter; Cassidy, Andrea M. (2010)
      What do lecturers look for when marking essays? What impresses them and what frustrates them? In this paper, we present the results of a survey which asked lecturers to address these questions. Thirty-two lecturers responded to an email survey in which they listed the problems they found most frustrating when marking essays and the factors which most impressed them. This resulted in 206 comments related to sources of frustration and 139 comments listing factors which impress them. The comments were then coded into themes and ranked in order of importance by 16 lecturers from the original sample. The results highlight a range of issues that may be useful for lecturers when discussing assignments, and instructive for students when writing their assignments.
    • When Pain Memories Are Lost: A Pilot Study of Semantic Knowledge of Pain in Dementia

      Oosterman, J.M.; Hendriks, H.; Scott, S.; Lord, Kathryn; White, N.; Sampson, E.L. (2014)
      Objective It has been documented that pain in people with dementia is often under-reported and poorly detected. The reasons for this are not clearly defined. This project aimed to explore semantic concepts of pain in people with dementia and whether this is associated with clinical pain report. Design Cohort study with nested cross-sectional analysis. Setting Acute general hospital medical wards for older people. Subjects People with dementia (N = 26) and control participants (N = 13). Methods Two subtests of semantic memory for pain: 1) Identifying painful situations from a standardized range of pictures; 2) Describing the concept of pain. Participants also indicated whether they were in pain or not, were observed for pain (PAINAD scale) and completed the Wong–Baker FACES scale to indicate pain severity. Results Compared with the control group, people with dementia were less able to identify painful situations and used fewer categories to define their concept of pain. In turn, the performance on these two measures was related to the reported presence and, albeit less strongly, to the reported severity of pain, indicating that a reduction in semantic memory for pain is associated with a decline in reported pain. Conclusions This study is the first to show that semantic memory for pain is diminished in dementia patients. When using clinical pain tools, clinicians should consider these effects which may bias clinical pain ratings when they evaluate and manage pain in these patients. This might improve the recognition and management of pain in people with dementia.
    • When two worlds collide: corporate and clinical governance

      Gupte, A.; McIntosh, Bryan; Sheppy, B. (2012)
      Clinical and corporate governance have been an area of ongoing concerns in the NHS. Since the Bristol Royal Infirmary scandal of the 1990s and the events concerning Sir Jimmy Savile there has been a dilemma of its true nature and relationship. Clinical and corporate governance are closely related as the two of them share similar processes such as openness, performance review, striving for effective end results, and accountability in the use of resources and power within healthcare management.
    • Why do fish produce so many eggs?

      Ashelford, Sarah L. (2009)
    • Why do patients with low back pain choose not to engage with physiotherapy following assessment?

      Hinchliffe, N.C.; Lavin, Nicole (2018-03)
      Background/Aims: This research explored the reasons why patients with low back pain chose not to return to physiotherapy following an assessment. Methods: Qualitative, semi-structured interviews were conducted using five participants with low back pain. Data were analysed to produce codes, categories and themes. Findings: Data analysis produced expectations, communication and satisfaction as key themes. Findings suggest that expectations may and may not be linked to previous physiotherapy experience, with no clear link between expectations and satisfaction. Communication including sufficient time, listening skills, empathy, and caring qualities were highly regarded. Satisfaction levels were rated highly, despite not returning to physiotherapy. Participants reported pain resolution and personal choice as reasons for not returning. Conclusions: Findings support previous research suggesting expectations are multifaceted and individualised and not always linked to previous experience. Findings suggest the physiotherapist's excellent communication skills ensured an overall positive patient experience, maintaining high satisfaction levels.
    • Why education is 'riding the tiger'

      Sheppy, B.; Evans, P.; McIntosh, Bryan (2013)
      The Chinese idiom ‘riding a tiger’ relates to being stuck in a difficult position with no way out. Bruce Sheppy, Paul Evans and Bryan McIntosh discuss why this might apply to political leadership in education.
    • Why part-time nurses should be valued

      McIntosh, Bryan; Archibong, Uduak E. (2020-02)
      The article discusses how nurses are increasingly being valued as autonomous decision makers and co-ordinators of patient care. Topics include relating to the age of the dependent children, a woman's working hours and any successive career breaks, woman's career progression directly related to the school age of the dependent children, and children being inhibit and is driven in part by a determination to maintain traditional employment practices.
    • Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success

      Wray, J.; Archibong, Uduak E.; Walton, Sean (2017-01)
      Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers’ competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers’ confidence and competence, and contributes to the understanding of research.
    • Why written objectives need to be really SMART.

      Ogbeiwi, Osahon (2017)
      All successful programmes share goal-setting as a standard practice, and many write their goal statements to satisfy the S.M.A.R.T. criteria. To be SMART, objective statements should be constructed to specify four components: Outcome, Indicator, Target-level and Timeframe (O.I.T.T.). This study reviewed the goal framework of published objective statements to determine the extent to which they are SMART. The statements of 17 published examples of SMART objectives found in literature of mainly four major health organisations: CDC, WHO, NHS and Save the Children, were structurally analysed to measure the completeness of their goal framework according to the OITT components. Only four examples are outcome objectives. 13 (76%) are process or task oriented. The structure of two thirds of the statements shows the similar objective-writing templates used within CDC. All objective statements have an incomplete set of OITT components. The commonest framework has 3 components of indicator, target and timeframe (75% completeness) in 12 statements. Almost all statements specify a timeframe; three-quarter of them mention a target and three-fifth an indicator, but less than 1 in 5 state an outcome. Thus, none of the objective statement is really SMART, and goal-setters are significantly less likely to specify an outcome, than indicator, target or timeframe in their objectives. A high prevalence of non-SMART objectives with low potential for goal attainment in healthcare projects is proposed.
    • Wise Up to Cancer Bradford: Improving cancer prevention and earlier diagnosis for South Asian women in Bradford

      Almas, Nisa; Haith-Cooper, Melanie; Nejadhamzeegilani, Z.; Payne, D.; Rattray, Marcus (University of Bradford, 2019-09)
    • 'Wise up to cancer’; adapting a community-based health intervention to increase UK South Asian women’s uptake of cancer screening

      Payne, Daisy; Haith-Cooper, Melanie; Almas, Nisa (2021)
      UK South Asian women are less likely to engage with cancer screening than the general population and present later with more advanced disease. Tailored interventions are needed to address barriers to these women accessing screening services. 'Wise up to cancer' is a community-based health intervention designed to increase cancer screening uptake. It has been implemented within the general population and a study was undertaken to implement it within a South Asian female community. This paper explores one workstream of the wider 'Wise up to Cancer' study which involved working out how best to adapt the baseline questionnaire (the first part of the intervention) for South Asian women in an inner-city location in Northern England. The aim of this workstream was to evaluate what worked well when implementing the adapted 'Wise up to Cancer' with South Asian women. In 2018, we conducted qualitative semi-structured interviews and focus group with 14 key stakeholders; women who had received the intervention, health champions and community workers to explore their perspectives on how the adapted intervention worked within a South Asian female community. The interviews were audio recorded or (notes taken), data were transcribed verbatim and the dataset was thematically analysed. We found that training peers as community health champions to deliver the intervention to address language and cultural barriers increased participant engagement, was beneficial for the peers and supported participants who revealed difficult social issues they may not have otherwise discussed. Accessing women in established community groups, following planned activities such as English language classes worked but flexibility was needed to meet individual women's needs. Further research is needed to explore the impact of adapting 'Wise up to Cancer' for this community in terms of engaging with cancer screening.
    • Witches or wise women

      MacVane Phipps, Fiona E. (2013)
      This article presents findings from my PhD study entitled Midwifery knowledge and the medical student experience. The research study sought to explore the question: ‘What do medical students learn from midwives?’ In the first part of this dual-phase project I conducted a Delphi study with an international panel of midwives to examine the concept of ‘midwifery knowledge’ (MacVane 2013a). Data from the Delphi survey were used to inform the second phase, which employed a longitudinal case study approach to explore medical students’ experiences of working with midwives during a specialist obstetric rotation. Thirteen medical students, who were recruited from a fourth-year cohort, participated in interviews at the start, middle and end of their specialist obstetric rotation. The students spent the majority of the rotation at their local teaching hospital (LTH), but also spent an interim two-week period at a variety of district general hospitals (DGH).
    • A worked example of initial theory-building: PARTNERS2 collaborative care for people who have experienced psychosis in England

      Gwernan-Jones, R.; Britten, N.; Allard, J.; Baker, E.; Gill, L.; Lloyd, H.; Rawcliffe, T.; Sayers, R.; Plappert, H.; Gibson, J.; et al. (2020-01)
      In this article, we present an exemplar of the initial theory-building phase of theory-driven evaluation for the PARTNERS2 project, a collaborative care intervention for people with experience of psychosis in England. Initial theory-building involved analysis of the literature, interviews with key leaders and focus groups with service users. The initial programme theory was developed from these sources in an iterative process between researchers and stakeholders (service users, practitioners, commissioners) involving four activities: articulation of 442 explanatory statements systematically developed using realist methods; debate and consensus; communication; and interrogation. We refute two criticisms of theory-driven evaluation of complex interventions. We demonstrate how the process of initial theory-building made a meaningful contribution to our complex intervention in five ways. Although time-consuming, it allowed us to develop an internally coherent and well-documented intervention. This study and the lessons learnt provide a detailed resource for other researchers wishing to build theory for theory-driven evaluation.
    • Working Longer: Hours of Work and Health.

      Giga, Sabir I.; Jain, A.K.; Cooper, C.L. (2010)