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The Perceptions, Attitudes and Experiences of Service Users with Telehealth Speech-Language Pathology Services
Get PDFAims
To investigate the perceptions, attitudes, and experiences of clients and caregivers towards telehealth Speech-Language Pathology (SLP) services.
Methods
A comprehensive questionnaire was developed and validated to investigate the perceptions, attitudes, and experiences of service users towards telehealth services. The questionnaire included questions related to telehealth experience, client's preferences, and the perceived facilitators, barriers, advantages, and disadvantages of telehealth. Phone survey was used to collect data from clients and caregivers of clients who received telehealth SLP services during and after the COVID-19 pandemic.
Results
A total of 293 clients and caregivers participated in this study. The findings indicated that 97.95 % of the respondents reportedly received telehealth SLP services for the first time during the COVID-19 pandemic, mainly through video-communication (51.2 %), and for different clinical services, with therapy (31.04 %) and monitoring (31.28 %) being the highest services. Of the total respondents, 54.95 % felt that telehealth appointments were similar to in-person appointments. However, 41.30 % of the respondents preferred receiving in-person appointments. Statistical analyses indicated that eight factors were perceived by service users as significant primary facilitators of telehealth (e.g., good internet connection, available resources, experience with technology), whereas only three factors were perceived as significant primary barriers (e.g., poor image/sound quality, and client's communication impairments). Furthermore, 10 factors were perceived as significant primary advantages of telehealth (e.g., reduced cost and travel time), while only one factor was identified as a significant primary disadvantage (inability to conduct a physical examination).
Conclusions
Service users identified numerous advantages of telehealth, including improved access to healthcare, and reduced costs, while only one disadvantage was identified (lack of physical examinations). The perceived facilitators and barriers of telehealth by service users can be classified into technology-related factors (e.g., comfort with technology, internet connection) and client-related factors (e.g., client's cognitive and sensory abilities). These technology and client-related factors should be considered by policy makers and funding bodies while planning the establishment or expansion of telehealth services
Are Bonobos Anxious When Others Are Ignorant of a Threat? Using an Affect Measure to Assess Theory-of-Mind Abilities in Bonobos
Get PDFPrevious studies have shown that bonobos, along with other great apes, possess certain theory-of-mind (ToM) abilities, such as the ability to attribute states of knowledge and belief to others. Our study is the first to assess ToM abilities in bonobos using scratching behavior, a widely used affective measure in great apes. Subjects watched two videos; one video showed a group member ignorant of a snake threat while the other video showed a group member knowledgeable of a snake threat. The ToM hypothesis predicted greater frequency of scratching in subjects watching the ignorance video compared to subjects watching the knowledge video. Results were consistent with this prediction. All but one subject scratched more while watching the ignorance video, and subjects scratched nearly 4 times more often on average while watching the ignorance video. Small sample size prevents any strong conclusions to be reached; however, the experimental design has the potential to be used to assess the relation between affective states and ToM abilities in great apes and other species of nonhuman animals with ToM abilities in which there are reliable behavioral indexes of affective states
The power of prevention – a lifeline for the NHS?
Get PDFGovernments all over the world are struggling to control the spiralling costs of healthcare – the UK government is no exception. Its long-term strategy includes a much greater focus on prevention: to keep people as healthy and productive as possible for longer. This paper asks whether a greater focus on prevention is a possible lifeline for the National Health Service (NHS) as is often claimed, but it also examines other benefits to society. After considering various examples of prevention and the metrics used to measure their effectiveness, we use tobacco consumption as a case study to evaluate the costs to the public purse and to wider society. We give further examples, including obesity, but in less depth. We find that whilst there are significant benefits to public expenditure, including the NHS, in both cases, these are dwarfed by wider benefits to society both in terms of tangible economic benefits and improved well-being. We offer several suggestions for improving our understanding of the effectiveness of prevention policies in general and how the Actuarial profession can contribute to this debate
Precision computerised cognitive behavioural therapy (cCBT) intervention for adolescents with depression (SPARX-UK): protocol for the process evaluation of a pilot randomised controlled feasibility trial
Get PDFIntroduction
While digital technologies can increase the availability and access to evidence-based interventions, little is known about how users engage with them and the mechanisms associated with effective outcomes. Process evaluations are an important component in understanding the aforementioned factors. The ‘SPARX-UK’ study is a randomised controlled pilot and feasibility trial evaluating personalised human-supported (from an ‘eCoach’) vs a self-directed computerised cognitive behavioural therapy intervention (cCBT), called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts), aimed at adolescents with mild to moderate depression. We are comparing supported vs self-directed delivery of SPARX to establish which format should be used in a proposed definitive trial of SPARX. The control is a waitlist group. We will conduct a process evaluation alongside the trial to determine how the intervention is implemented and provide context for interpreting the feasibility trial outcomes. We will also look at the acceptability of SPARX and how users engage with the intervention. This protocol paper describes the rationale, aims and methodology of the SPARX-UK trial process evaluation.
Methods and analysis
The process evaluation will use a mixed-methods design following the UK Medical Research Council’s 2015 guidelines, comprising quantitative and qualitative data collection. This will include analysing data usage of participants in the intervention arms; purposively sampled, semi-structured interviews of adolescents, parents/guardians, eCoaches and clinicians/practitioners from the SPARX-UK trial; and analysis of qualitative comments from a survey from those who dropped out early from the trial. Quantitative data will be analysed descriptively. We will use thematic analysis in a framework approach to analyse qualitative data. Quantitative and qualitative data will be mixed and integrated to provide an understanding of how the intervention was implemented and how adolescents interacted with the intervention. This process evaluation will explore the experiences of adolescent participants, parents/guardians, eCoaches and clinicians/practitioners in relation to a complex digital intervention.
Ethics
Ethical approval was granted by the National Health Service (NHS) Health Research Authority South West - Cornwall & Plymouth Research Ethics Committee (Ethics Ref: 22/SW/0149).
Dissemination
Contextualising how the intervention was implemented, and the variations in uptake and engagement, will help us to understand the trial findings in greater depth. The findings from this process evaluation will also inform the decision about whether and how to proceed with a full randomised controlled trial, as well as the development of more effective interventions which can be personalised more precisely via varying levels of human support. We plan to publish the findings of the process evaluation and the wider project in peer-reviewed journals, as well as disseminate via academic conferences
Project Bright Light: Transforming the police response to domestic abuse
Get PDFThe first briefing from Project Bright Light, an action research project on the police response to domestic abuse, focuses on national policy issues. The research, conducted in partnership with Avon and Somerset police, found significant systemic problems arising for operational policing in England and Wales based on both the national domestic abuse definition and current crime recording practices
Protocol for developing the nutrition dataset for the international spinal cord society: an international eDelphi approach
Get PDFStudy design
An eDelphi survey.
Objective
To develop the Spinal Cord Injury (SCI) basic and extended nutrition datasets for adults with SCI for the International Spinal Cord Society (ISCoS).
Setting
This international eDelphi study, administered in Australia, will be conducted virtually, overseen by a Research Advisory Group.
Methods
An expert panel will be recruited internationally to participate in a three-round eDelphi survey to develop the ISCoS basic and extended nutrition datasets. An a priori criterion will be implemented, defining strong consensus as an interquartile range (IQR) ≤ 1 and consensus as an IQR > 1/≤2. Mean and standard deviation will be calculated to measure convergence and stability depending on the data. Agreement will be determined as ≥ 80% per statement (Likert scale ratings of 4 and 5). A content analysis approach will be utilised to synthesise free-text responses
Evaluating Perinatal Health in Europe: A Comparison of Routine Population Birth Data Sources
Get PDFBackground
International comparisons of population birth data provide essential benchmarks for evaluating perinatal health policies.
Objectives
This study aimed to describe routine national data sources in Europe by their ability to provide core perinatal health indicators.
Methods
The Euro-Peristat Network collected routine national data on a recommended set of core indicators from 2015 to 2021 using a federated protocol based on a common data model with 16 data items. Data providers completed an online questionnaire to describe the sources used in each country. We classified countries by the number of data items they provided (all 16, 15–14, < 14).
Results
A total of 29 out of the 31 countries that provided data responded to the survey. Routine data sources included birth certificates (15 countries), electronic medical records (EMR) from delivery hospitalisations (16 countries), direct entry by health providers (9 countries), EMR from other care providers (7 countries) and Hospital Discharge Summaries (7 countries). Completeness of population coverage was at least 98%, with 17 countries reporting 100%. These databases most often included mothers giving birth in the national territory, regardless of nationality or place of residence (24 countries), whereas others register births to residents only. In 20 countries, routine sources were linked, including linkage between birth and death certificates (16 countries). Countries providing all 16 items (N = 8) were more likely to use EMRs from delivery hospitalisations (100%) compared to 50% and 11% in countries with 15–14 items (N = 12) and < 14 items (N = 9), respectively. Linkage was also more common in these countries (100%) versus 75% and 56%, respectively. Other data source characteristics did not differ by the ability to provide data on core perinatal indicators.
Conclusions
There are wide differences between countries in the data sources used to construct perinatal health indicators in Europe. Countries using EMR linking to other sources had the best data availability
Generative Rules for More Creative Thinking About Requirements
Get PDFThis issue highlights creativity in software engineering in light of the generative AI megatrend. I m enthusiastically delighted to introduce an absolute authority on creativity in the digital era. What makes this moment even more special is that our guest columnist is returning to share insights in the Requirements department. I have the honor of welcoming back our longest-serving editor (2005-2013), Prof. Neil Maiden. He now runs the Institute for Creativity and AI, which takes up all of his time. Get ready for a tour of the prelarge language model creativity topic that leads to actionable guidance for your requirements work today. Your future products and services deserve it
Biobanking in Sub-Saharan Africa: A Review of Data Protection Frameworks
Get PDFIntroduction: Biobanks are a foundational infrastructure supporting research at scale and contributing to scientific progress. The increasing collection of samples and associated data presents challenges in terms of both physical and digital storage and handling. In North America and Europe health data protection frameworks have been in place for several years, regulating the use of collected personal data, including health care data, as those typically used by human biobanks. Yet, regulatory frameworks for biobanking, particularly in low- and middle-income settings, are highly fragmented, and little is known in this area.
Objectives: This review focuses on identifying the health-related data protection frameworks in sub-Saharan African countries, as they are relevant to biobanking.
Methods: We used complementary literature review approaches to ensure the completeness of our results for biobanking identified as “African,” as well as for “disease-based,” “country-based,” and artificial intelligence-based approaches.
Results: In total, 56 articles were identified and reviewed in full, 31 health-related acts and frameworks relevant to biobanking, and 24 general data protection acts and frameworks from 37 countries. In some countries, such as Kenya and Zambia, these acts were implemented, in some others, they were not. In most cases, as these regulatory frameworks have been recently created and implemented, there are little or no data relating to the impact of their implementation.
Conclusion: Our findings confirm that regulatory frameworks for biobanking in sub-Saharan Africa are still in a consistent period of emergence, in an effort by national governments to address the existing fragmented landscape and support the development of research
The UK’s evolving copyright subject matter through the lens of John Cage’s 4’33
No full textThis article revisits the copyright status of John Cage’s 4’33" considering recent developments in UK copyright law. In doing so, the article makes two contributions. On a narrow level, the article argues that recent changes to copyrightable subject matter make it less likely, and not more, that a court today would find copyright in 4’33. On a broader level, the article uses 4’33 to explore current tensions in UK copyright law including: whether copyrightable subject matter is a closed list, the role of the merger doctrine, and the nature of identifiability. 4’33 therefore illustrates both the good, and the bad, aspects of contemporary copyrightable subject matter
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