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A personalised intervention program aimed at improving adherence to oral antidiabetic and/or antihypertensive medication in people with type 2 diabetes mellitus, the INTENSE study: study protocol for a randomised controlled trial
Get PDFBackground: Medication non-adherence is a prevalent health problem in people with type 2 diabetes mellitus (T2DM). Interventions have previously been developed to improve medication adherence, but inconsistent outcomes have been reported. A potential explanation for this inconsistency is a ‘one size fits all’ approach, with interventions not tailored to the needs and preferences of individuals. Therefore, the aim of this study is to evaluate the effectiveness of a personalised intervention program aimed at improving adherence to oral antidiabetic and/or antihypertensive medication in people with T2DM.
Methods: A parallel-group randomised controlled trial will be conducted in 40-50 community pharmacies in the Netherlands and the United Kingdom (UK). A total of 300 participants will be included and followed-up for a period of six months. Participants will be people with T2DM identified as non-adherent to oral antidiabetic and/or antihypertensive medication, aged 35-75 years and mobile phone users. The intervention group will receive a personalised intervention program that is based on one or more of the participants’ predefined non-adherence profile(s), namely (I) Knowledge and perceptions, (II) Practical problems, (III) Side effects, and (IV) Negative mood and beliefs. The intervention comprises of one or more supporting modules, namely (I) Brief messaging, (II) Clinical medication review, (III) Medication schedule, (IV) Reminding messaging, (V) Medication dispensing systems, (VI) Smart messaging, (VII) Referral to general practitioner and (VIII) Unguided web-based Self Help Application for low mood. The control group will receive usual care including access to a publicly available informative diabetes website. The primary study outcome is medication adherence measured with a telephone pill count. Secondary outcomes are systolic blood pressure, HbA1c level, self-reported medication adherence, attitude and beliefs toward medication, satisfaction with diabetes treatment, health status and medical consumption and productivity cost. In addition, a process evaluation will be undertaken to establish the fidelity, reach and the extent to which intervention delivery is normalised in the daily practice of community pharmacy teams.
Discussion: The study can lead to a personalised intervention program that improves medication adherence in people with T2DM that are non-adherent to oral antidiabetic and/or antihypertensive medication
Recommendations for the design of randomized controlled trials in strength and conditioning. Common design and data interpretation
Get PDFThe effectiveness of cognitive behavioural therapy for patients with concurrent hand and psychological disorders
No full textWe investigated the effectiveness of cognitive behavioural therapy (CBT) for patients with psychological disorders thought to be influencing recovery from elective and traumatic hand conditions. Demographic data and psychological assessment scores (Primary Health Questionnaire 9 (PHQ9), General Anxiety Disorder Assessment (GAD7), Impact of Event Scale (IES)) were prospectively collected before and after CBT treatment. One hundred and fourteen patients underwent CBT with 81 completing treatment. Full data was available for 78 (68%) patients. Mean age was 43 (range 13–84) and 63% were women. Sixty-one per cent had sustained a traumatic hand injury. PHQ9, GAD7 and IES scores decreased significantly following treatment. Many patients with hand conditions have associated psychological problems that may influence outcome. CBT in a hand unit setting appears to be an effective treatment. Further research with a control group should investigate whether CBT improves psychological health or if this may occur as patients recover from their physical hand disorder regardless of CBT
Rape stereotype acceptance in the general population of England and Wales
Get PDFThe #MeToo movement has facilitated a growing awareness in the UK of rape stereotypes but there has been little research on how accurately rape is perceived in this region, especially regarding demographics such as ethnicity and age. This study recruited 1000 participants, representative of the UK population, to complete an online survey prompting beliefs about rape perpetrators, rape victims, rape allegations, male rape, and motives for and consequences of rape. After carrying out frequency analyses on agree-incorrect and disagree-incorrect statements, we found that, generally, accuracy was high, although there were higher levels of stereotype acceptance for perpetrator related stereotypes. Further analysis found that in terms of demographic differences, Black and Asian participants and men were significantly more likely to accept stereotypes than other demographic groups. Implications for policy and practice are discussed, including potential for jury education, and educational media campaigns aimed at the demographics most likely to accept stereotypes
Development of a self-report measure to assess sleep satisfaction: protocol for the Suffolk Sleep Index (SuSI)
Get PDFGood sleep is essential for health but there is no consensus on how to define and measure people’s understanding of good sleep. To date, people’s perceptions of a good night’s sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to objective characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. A related, yet different construct, sleep satisfaction, refers to perceived positive affect about one’s sleep experience and has, to date, received little attention. This research focuses on sleep satisfaction, rather than sleep quality, and aims to develop a self-report measure to assess sleep satisfaction in an English adult population. As the measure will be developed in Suffolk, England, and its primary intended users are Suffolk community members, it is labelled the Suffolk Sleep Index (SuSI). The SuSI will draw from principles of community-based participatory research, following a seven-phase developmental process comprising literature review, interviews with Suffolk community members, synthesis of literature review and interview findings, pre-testing, pilot-testing, scale evaluation, and refinement. The present research will also investigate indices related to sleep satisfaction, including the community’s general health status, lifestyle factors and socio-economic status. The research will add to the limited, yet emerging body of research on perceived sleep satisfaction and its measurement. To our knowledge, a valid and reliable sleep satisfaction self-report measure has not been developed in the United Kingdom previously
Thames Estuary English Academic
No full textIn this chapter, I reflect on the impact my Estuary English accent has had on me, both personally and professionally as a former social worker, now social work academic, and the impact it appears to have on others. From parental chastisement for dropping my ‘T’s, attributions of being ‘Cockney’ and ‘Essex’, with associated assumptions made about my educational background, class and indeed my very moral character. My accent appears at times, to disrupt some peoples’ presuppositions – about who or what I am. I discuss some of the linguistic features of my accent and some ‘critical accent incidents’. I reflect on the challenges of managing academia as someone with an accent that I argue, is underpinned by gendered and classist assumptions. I argue why a critical focus on accentism remains important, generally and within social work education. The chapter utilises theory from a wide range of disciplines, including cultural theory, linguistics, education studies and autoethnography
Online safeguarding and personal cyberskills for students
No full textThe COVID-19 pandemic has driven universities to deliver education online, making use of digital platforms for both formal and informal learning. This move has accelerated concerns regarding institutions’ capabilities to protect students from online abuse and support those who fall victim to its many forms. Empirical data drawn from UK universities prior to the pandemic highlight the lack of policy and practice across the university sector around both awareness of, and support from, online abuse among the student body. Further concerns during the pandemic, which highlight failures not just of safeguarding policy, but cybersecurity practice, demonstrate the need for universities to not only recognise their duty of care regarding student welfare but also to provide training and education for all, making use of online and hybrid higher education
Extinction rebellion: greening vanguardism?
No full textThis profile offers an analysis of Extinction Rebellion (XR) from the vantage point of vanguardism. Vanguardism is a Leninist approach that marshals universal(isable) grievances to mobilise mass-constituencies. XR is used as a conduit through which to raise awareness of vanguardism’s environmental applications. XR is introduced before a theoretical framework for understanding vanguardism is offered. The article then discusses XR’s politics, before discussing its protest repertoire. It is found that whilst vanguardism is ordinarily associated with the left, XR contributes to its ‘greening’, taking the pursuit of uprising beyond the left
Smarter Suffolk Live Lab Project: Street Lighting Central Management System User Interfaces
No full textThis report report discusses a comparative usability review of several street lighting central management (CMS) systems which have been operated as part of the Smarter Suffolk Live Labs trial, run by Suffolk County Council. It describes the purpose of street lighting CMS systems, and how a structured usability test has been applied to review them comparatively and the tasks that were selected and the results of the testing. The report presents and discusses the usability tests undertaken, and feedback provided by the test participant and observer and, presents conclusions and recommendations from this set of usability tests