• Methodological approaches to evaluating the practice of radiographers¿ interpretation of images: A review.

      Brealey, S.; Scally, Andy J. (2008)
      Recent initiatives to modernise the National Health Service describe how improving pay structures and staff working lives can be achieved in the form of advanced practitioner and consultant posts. Role development in Radiography represents a fundamental change to professional practice of radiographers and is subject to the provisions of the statutory and professional codes of conduct which govern such practice. In Diagnostic Radiography the response to Government initiatives has led to a change in practice so that radiographers in these new posts provide reports for a variety of imaging modalities. At the same time as there have been changes in the practice of Radiography, the discipline of evidence-based medicine has emerged. Changes in clinical practice should be underpinned by evidence from research. The purpose of this paper is to discuss the methodological approaches used to conduct research that evaluates one of the most salient areas of development in Radiography practice, that is the role of radiographers as advanced or consultant practitioners when interpreting plain radiographs. We begin by discussing what an evaluation is and two broad approaches for conducting health services research, and then appraise the evidence about radiographer reporting in the context of these methods of evaluation. We then suggest future considerations about the methodological approaches to evaluating radiographer reporting practice and identify where there are evidence gaps and the need for further research to inform evidence-based Radiography.
    • Methodological Challenges of Researching Positive Action Measures

      Archibong, Uduak E.; Darr, Aliya; Eferakorho, Jite; Scally, Andy J.; Atkin, K.; Baxter, C.; Johnson, M.R.D.; Bell, M.; Waddington, L.; Wladasch, K.; et al. (2009)
      This paper highlights some ofthe methodological challenges which have arisen in collecting data for an international study on positive action measures. It will describe strategies employed to encourage participation in the study from as wide a range of organisations and individuals using a mixed method approach. The paper will also discuss the methodological and sensitive issues related to this type of research in organisations and strategies adopted by the research team to ameliorate any problems that have arisen whilst maintaining trustworthiness and rigour in the study.
    • Methodological standards in radiographer plain film reading performance studies.

      Brealey, S.; Scally, Andy J.; Thomas, N. (2002)
      The objectives of this paper are to raise awareness of the methodological standards that can affect the quality of radiographer plain-film reading performance studies and to determine the frequency with which these standards are fulfilled. Multiple search methods identified 30 such studies from between 1971 and the end of June 1999. The percentage of studies that fulfilled criteria for the 10 methodological standards were as follows. (1) Performance of a sample size calculation, 3%; (2) definition of a normal and abnormal report, 97%; (3) description of the sequence of events through which films passed before reporting, 94%; (4) analysis of individual groups of observers within a combination of groups, 50% (5) appropriate choice of reference standard, 80%; (6) appropriate choice of arbiter, 57%; (7) appropriate use of a control, 22%; (8) analysis of pertinent clinical subgroups, e.g. body areas, patient type, 44%; (9) availability of data for re-calculation, 59%; and (10) presentation of indeterminate results, 69%. These findings indicate variation in the application of the methodological standards to studies of radiographer's film reading performance. Careful consideration of these standards is an essential component of study quality and hence the validity of the evidence base used to underpin radiographic reporting policy.
    • Methods for the analysis of ordinal response data in medical image quality assessment

      Keeble, C.; Baxter, P.D.; Gislason-Lee, Amber J.; Treadgold, L.A.; Davies, A.G. (2016-04)
      The assessment of image quality in medical imaging often requires observers to rate images for some metric or detectability task. These subjective results are used in optimization, radiation dose reduction or system comparison studies and may be compared to objective measures from a computer vision algorithm performing the same task. One popular scoring approach is to use a Likert scale, then assign consecutive numbers to the categories. The mean of these response values is then taken and used for comparison with the objective or second subjective response. Agreement is often assessed using correlation coefficients. We highlight a number of weaknesses in this common approach, including inappropriate analyses of ordinal data and the inability to properly account for correlations caused by repeated images or observers. We suggest alternative data collection and analysis techniques such as amendments to the scale and multilevel proportional odds models. We detail the suitability of each approach depending upon the data structure and demonstrate each method using a medical imaging example. Whilst others have raised some of these issues, we evaluated the entire study from data collection to analysis, suggested sources for software and further reading, and provided a checklist plus flowchart for use with any ordinal data. We hope that raised awareness of the limitations of the current approaches will encourage greater method consideration and the utilization of a more appropriate analysis. More accurate comparisons between measures in medical imaging will lead to a more robust contribution to the imaging literature and ultimately improved patient care.
    • Micro-cultures in health case: Perspectives of NHS managers

      Sirriyeh, R. (See also Harrison, R.); Lawton, R.; Armitage, Gerry R.; Gardner, Peter H.; Ferguson, S. (2012)
    • Mirror Therapy for the Alleviation of Phantom Limb Pain Following Amputation: A literature review

      Timms, J.; Carus, Catherine (2015-03)
      Introduction: Phantom Limb pain (PLP) affects up to 85% of all patients following an amputation, causing debilitating effects on their quality of life. Mirror Therapy (MT) has been reported to have potential success for the alleviation of PLP. Current understanding of PLP and the efficacy of MT for its alleviation are still unclear, therefore guidelines for treatment protocols are lacking. This literature review assesses the current best evidence for using MT to alleviate PLP of patients with amputation. Method: The authors systematically searched the academic databases Medline, Amed, CINAHL and Google Scholar, using key search terms with inclusion and exclusion criteria to identify relevant articles on the use of MT in populations of patients suffering PLP after unilateral limb amputation. Findings: Seven primary papers were identified and appraised. All the articles reported significant PLP alleviation after using MT with a trend for achieving phantom limb movement (PLM) prior to pain relief. Conclusions: Mirror Therapy is a promising intervention for PLP. Regular MT sessions are required to maintain treatment effect. Causes of PLP and pathways to its alleviation may be multifactorial; therefore further well-conducted RCTs are required to identify best practice.
    • Missed opportunities: the role of community pharmacy after discharge from cardiology wards.

      Fylan, Beth; Blenkinsopp, Alison; Armitage, Gerry R.; Naylor, Deirdre (2014)
      This research aims to develop a better understanding of how cardiology patients experience the care provided by community pharmacy after discharge from hospital. • Contact with community pharmacists is infrequent and can be via a proxy. Patients’ experiences of community pharmacy care are limited and many patients have unmet medicines use support needs. • Community pharmacy misses opportunities to support patients in their medicines use after hospital discharge
    • Mixing Students Mixing Methods

      Dearnley, Christine A.; Owens, Melissa; Greasley, Peter; Plews, Caroline M.C. (2010)
    • Mobile Enabled Research.

      Dearnley, Christine A.; Walker, Stuart A.; Fairhall, John R. (2008)
    • Mobile translators for non-English-speaking women accessing maternity services.

      Haith-Cooper, Melanie (2014)
      It is becoming increasingly common for midwives to care for women who do not speak English, and UK interpreting services are often inadequate and underused. Persistent language barriers have been found to contribute to maternal and perinatal mortality thus it is essential that these barriers are overcome to provide safe maternity care. This article reports on a two-stage study undertaken to address this. The study aimed to: • Identify difficulties midwives experience when communicating with non-English-speaking women. Through undertaking a group interview with 11 senior students, four themes emerged: accessing interpreters, working with interpreters, cultural barriers and strategies to address persistent language barriers • Explore the feasibility of using mobile devices with a translation application to communicate in clinical practice. Google Translate was tested in a simulated clinical environment with multi-lingual service users. Google Translate was not adequately developed to be safely used in maternity services. However, a maternity-specific mobile application could be built to help midwives and women communicate in the presence of a persistent language barrier.
    • Moderate-to-vigorous physical activity in primary school children: inactive lessons are dominated by maths and English

      Daly-Smith, Andrew; Hobbs, M.; Morris, J.L.; Defeyter, M.A.; Resaland, G.K.; McKenna, J. (MDPI, 2021-01)
      Background: A large majority of primary school pupils fail to achieve 30-min of daily, in-school moderate-to-vigorous physical activity (MVPA). The aim of this study was to investigate MVPA accumulation and subject frequency during academic lesson segments and the broader segmented school day. Methods: 122 children (42.6% boys; 9.9 ± 0.3 years) from six primary schools in North East England, wore uniaxial accelerometers for eight consecutive days. Subject frequency was assessed by teacher diaries. Multilevel models (children nested within schools) examined significant predictors of MVPA across each school-day segment (lesson one, break, lesson two, lunch, lesson three). Results: Pupils averaged 18.33 ± 8.34 min of in-school MVPA, and 90.2% failed to achieve the in-school 30-min MVPA threshold. Across all school-day segments, MVPA accumulation was typically influenced at the individual level. Lessons one and two—dominated by maths and English—were less active than lesson three. Break and lunch were the most active segments. Conclusion: This study breaks new ground, revealing that MVPA accumulation and subject frequency varies greatly during different academic lessons. Morning lessons were dominated by the inactive delivery of maths and English, whereas afternoon lessons involved a greater array of subject delivery that resulted in marginally higher levels of MVPA.
    • The Moral Imperative: the case of the English education system

      Spangenberg, S.; McIntosh, Bryan (2014)
      In England, social choice in education faces trade-offs between equity and efficiency. The scope of these trade-offs ranges from the introduction of choice to correcting 'market failures' to reduce inequalities and restrict social injustices. The article analyses the English school education system and its relationship with social preferences. The authors argue that the moral and legal need for non-discriminatory education supersedes perceptions of cost-effectiveness and utilitarianism. They consider that the current system has failed owing to inappropriate processes within social and public choice and that a reformed system based on a social democratic imperative will allow closer social integration on the basis of ability rather than privilege.
    • Motherhood and its impact on career progression

      McIntosh, Bryan; McQuaid, R.; Munro, A.; Dabir-Alai, P. (2012)
      Purpose: After many years of equal opportunities legislation, motherhood still limits womens' career progress even in a feminized occupation such as nursing. While the effect of motherhood, working hours, career breaks and school aged children upon career progression has been discussed widely, its actual scale and magnitude has received less research attention. The purpose of this paper is to examine the impact of these factors individually and cumulatively. Design/methodology/approach: This paper considers the impact of the above through a longitudinal analysis of a demographically unique national database, comprising the 46,565 registered nursing workforces in NHS Scotland from 2000-2008. The variables examined include gender, employment grades, number and length of career breaks, lengths of service, age, working patterns, the number and age of dependent children. Findings: The results indicate: motherhood has a regressively detrimental effect on women's career progression. However, this is a simplistic term which covers a more complex process related to the age of dependent children, working hours and career breaks. The degree of women's restricted career progression is directly related to the school age of the dependent children: the younger the child the greater the detrimental impact. Women who take a career break of greater than two years see their careers depressed and restricted. The results confirm that whilst gender has a relatively positive effect on male career progression; a women's career progression is reduced incrementally as she has more children, and part-time workers have reduced career progression regardless of maternal or paternal circumstances. Originality/value: This paper is the only example internationally, of a national workforce being examined on this scale and therefore its findings are significant. For the first time the impact of motherhood upon a women's career progression and the related factors; dependent children, career breaks and part-time working are quantified. These findings are relevant across many areas of employment and they are significant in relation to broadening the debate around equal opportunities for women. Purpose - After many years of equal opportunities legislation, motherhood still limits womens' career progress even in a feminized occupation such as nursing. While the effect of motherhood, working hours, career breaks and school aged children upon career progression has been discussed widely, its actual scale and magnitude has received less research attention. The purpose of this paper is to examine the impact of these factors individually and cumulatively. Design/methodology/approach - This paper considers the impact of the above through a longitudinal analysis of a demographically unique national database, comprising the 46,565 registered nursing workforces in NHS Scotland from 2000-2008. The variables examined include gender, employment grades, number and length of career breaks, lengths of service, age, working patterns, the number and age of dependent children. Findings - The results indicate: motherhood has a regressively detrimental effect on women's career progression. However, this is a simplistic term which covers a more complex process related to the age of dependent children, working hours and career breaks. The degree of women's restricted career progression is directly related to the school age of the dependent children: the younger the child the greater the detrimental impact. Women who take a career break of greater than two years see their careers depressed and restricted. The results confirm that whilst gender has a relatively positive effect on male career progression; a women's career progression is reduced incrementally as she has more children, and part-time workers have reduced career progression regardless of maternal or paternal circumstances. Originality/value - This paper is the only example internationally, of a national workforce being examined on this scale and therefore its findings are significant. For the firs time the impact of motherhood upon a women's career progression and the related factors - dependent children, career breaks and part-time working are quantified. These findings are relevant across many areas of employment and they are significant in relation to broadening the debate around equal opportunities for women.
    • Motivating and engaging others: Driving practice change

      Snaith, Beverly; Hardy, Maryann L. (2014)
    • Mourning

      Small, Neil A. (2014)
    • Moving and handling and managing physiological deterioration of deceased children in hospice cool rooms: practice guidelines for care after death

      Tatterton, Michael J.; Honour, A.; Billington, D.; Kirkby, L.; Lyon, J.A.; Lyon, N.; Gaskin, G. (2021)
      Children’s hospices provide a range of services for babies, children and young people who have life-shortening conditions, including care after death in specialist ‘cool bedrooms’. Caring for children after death is a challenging area of hospice care, with variation seen within, and between organisations. The study aims to identify current practices and to produce guidelines that promote safe practice in moving and handling and managing physiological deterioration of children after death. An electronic questionnaire was sent to all 54 British children’s hospices; 33 responded (=62% of hospices). Variation in the way in which children’s hospices delivered care after death was identified, in terms of the length of stay, care provision and equipment used, owing to demands of individual families and the experience and confidence of practitioners. Internal variation in practice can lead to practitioner anxiety, and risk-taking when providing care, particularly in the presence of family members. Practice recommendations have been made that reflect the practical demands of caring for a child’s body after death; these have been split into two parts: moving and handling considerations and managing physiological deterioration. These recommendations should be used to support the development of policy and practice, allowing organisations to standardise staff expectations and to support practitioners when caring for children after death.
    • Moving and handling children after death: an inductive thematic analysis of the factors that influence decision-making by children’s hospice staff

      Tatterton, Michael J.; Honour, A.; Kirby, L.; Billington, D. (Lippincott Wolters Kluwer, 2022-02)
      Hospices for children and adolescents in the United Kingdom provide care to the bodies of deceased children, in specially-designed chilled bedrooms called ‘cool rooms’. In an effort to develop resources to support hospice practitioners to provide this specialist area of care, the study aimed to identify the factors that influence decision-making when moving and handling children’s bodies after death in a hospice cool bedroom. An internet-based survey was sent to all practitioners employed by one children’s hospice. A total of 94.9% of eligible staff responded (n=56). An inductive approach to thematic analysis was undertaken, using a six-phase methodological framework. Three core themes were identified that inform practitioners’ perception of appropriateness of moving and handling decisions: care of the body, stages of care, and method of handling. The complexity of decision-making and variation in practice was identified. Practitioners relied on both analytical and initiative decision-making, with more experienced practitioners using an intuitive approach. Evidence-based policy and training influence the perception of appropriateness, and the decisions and behaviour of practitioners. The development of a policy and education framework would support practitioners in caring for children’s bodies after death, standardising expectations and measures of competence in relation to moving and handling tasks.
    • Moving towards culturally competent dementia care, Have we been barking up the wrong tree?

      Mackenzie, Jennifer; Bartlett, Ruth L.; Downs, Murna G. (2005)
      In the UK it is established that health and social care services for people with dementia from black and minority ethnic communities need to move towards providing evidence-based culturally appropriate care. At present, however, the evidence base available to guide professionals working with people with dementia from diverse ethnic and cultural groups is limited, and beliefs about dementia and the type of treatment and support needed have received little attention. Consequently this creates problems for service providers faced with appropriately supporting people with dementia and their families from black and minority ethnic communities.