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Revised Hammersmith Scale for spinal muscular atrophy: Inter and intra-rater reliability and agreement
Get PDFThe Revised Hammersmith Scale (RHS) for Spinal Muscular Atrophy (SMA) was designed as a psychometrically robust clinical outcome assessment to assess physical abilities of patients with type 2 and 3 SMA. The reliability properties of the RHS have not yet been reported. A prospective RHS reliability study was undertaken in a UK cohort of experienced neuromuscular paediatric Physiotherapists. Reliability testing was conducted via a virtual survey platform two weeks apart. Through the virtual platform participants scored videos of two RHS assessments, one of a child with SMA 2 and one of a child with SMA 3. Inter and intra-rater reliability was analysed using a type 3 Intraclass Correlation Coefficient (ICC). Intra-rater agreement was further analysed using Bland Altman (BA) Limits of Agreement (LOA) and plots. The acceptable inter and intra-rater variability was set as a change of ± 2 by the international team of expert physiotherapists who developed the RHS. Inter-rater agreement, n = 22 raters, type 3 ICC was 0.989 (95% CI 0.944 to 1.00), 97.7% of scores were within the acceptable limits of ± 2 points. Intra-rater agreement, n = 21 raters, type 3 ICC ranged from 0.922 to 1.0, with 97.6% of scores within the acceptable limits of ± 2 points. The mean SMA 2 intra-rater difference was -0.10 (-0.6 to 0.4), with lower LOA -2.24 and upper LOA +2.04. Intra-rater difference between tests for SMA 3 intra-rater difference was -0.05 (-0.6 to 0.5), with lower LOA -2.48 and upper LOA +2.38. Intra-rater scoring precision fell within BA agreement limits of ±2 points. The results demonstrate that the RHS is highly reliable when used by experienced UK physiotherapists, and variability of test scores regarding inter and intra-rater reliability was confirmed to lie within ±2 points
Benefits of realist evaluation for rapidly changing health service delivery
Get PDFRealist evaluation is a methodology that addresses the questions: ‘what works, for whom, in which circumstances, and how?’. In this approach, programme theories are developed and tested against available evidence. However, when complex interventions are implemented in rapidly changing environments, there are many unpredictable forces that determine the programme’s scope and architecture, as well as resultant outcome. These forces can be theorised, in real time, and included in realist evaluation outputs for current and future optimisation of programmes. Reflecting on a realist evaluation of first-contact physiotherapy in primary care (the FRONTIER Study), five important considerations are described for improving the quality of realist evaluation outputs when studying rapidly changing health service delivery. These are: (1) ensuring that initial programme theories are developed through creative thinking sessions, empirical and non-empirical literature, and stakeholder consultation; (2) testing the causal impact of formal and informal (eg, emergent) components of service delivery models; (3) contrasting initial programme theories with rival theory statements; (4) envisioning broad system impacts
beyond the immediate implementation setting; and (5) incorporating rapidly evolving service developments and context changes into the theory testing process in real-time (eg, Additional Role Reimbursement Scheme, COVID-19). Through the reflections presented, the aim is to clarify the benefit of realist evaluation to assess emerging models of care and rapidly changing health service delivery
Smarter Suffolk Live Lab Project Gully Sensors Final Report
No full textThis report discusses the potential for sensors to be incorporated into the management of highways gullies. It describes Suffolk highway drainage management, including both the physical infrastructure and also the asset management software used to plan and record maintenance of that infrastructure. The report goes on to describes and reviews four commercially available remote sensors that can be used for gully monitoring with the intention of informing gully management decisions, details the acquisition of data from these installed sensors, and analyses the data acquired. It explores the information that can be gained from using sensors such as these, and its potential use. The report concludes with an assessment of assesses the financial, social and business case inputs for the potential use of gully sensors across Suffolk and overall conclusions and recommendations
Reclaiming the habitat: food, fire and affordance in designing and living the urban
No full textThis essay is a critical and radical proposition to reclaim habitats of life, investigating ecological and pedagogical models of critical and spatial design practices. We examine these in relation to commons which we associate to urbanism and life. We do so via politics of food, fire and affordance, which we explore as agents shaping the assemblage of sapiens life through design and reposition as cues for methods of thinking, learning, designing and constructing (conditions of life). The vilification of fire (when associated to fear) and food (when associated to desire) has a tremendous effect on how we think of and practice life, and presents ramifications for how we design, make and consume objects and environments. We must affirm such phenomena as effects of advanced capitalist networks and societies, and we may in response attempt ecologies and pedagogies of food and fire in urban design practice, promoting larval affordances between bodies, buildings and the commons as urban conflict. We approach affordance as conflict and the collective shaping agent allowing public sharing to form through dynamic and non-stagnant networks and patterns. As with urban commoning practices, these propositions may diverge from dominant institutions and can open up opportunities to rethink life and live differently. The proposal will therefore offer a space for theorisation, interrogating contemporary citizenship in learning to design for and by such experiences and events, and highlight pathologies of urban living
Block and Blend: a mixed method investigation into the impact of a pilot block teaching and blended learning approach upon student outcomes and experience.
Get PDFEvaluating a programme for the continuing professional development of STEM teachers working within inclusive secondary schools in the UK
Get PDFPreparing teachers to enhance students’ STEM education usually takes place via continuing professional (CPD) programmes. Many STEM-CPD programmes are criticised for short-term, information-dominated, and non-interdisciplinary approaches that lack critical consideration of learning communities, teaching contexts or STEM teaching is likely to take place in inclusive secondary schools/classrooms. We evaluate a UK-based, national, eight-year+ STEM-CPD programme targeting inclusive secondary schools, using a bootstrapped approach combining qualitative insights and quantitative comparisons. We found high levels of teachers’ STEM competence, desire for student inclusion and perceptions of student impact. Yet, shortcomings in the operations of teacher networks, lack of pedagogic/social pedagogic support and school-based disciplinary boundaries inhibited effects of the programme. Theoretical considerations were built into methods development and evaluation outcomes
Stallholder reflection - SE Barnet - management architecture research
No full textContributing author/stallholder to #TransActing: A Market of Values hosted by University of the Arts London, Chelsea College of Art and Design Research group Critical Practice. A bustling pop-up market exploring economies and ecologies of collaborative cultural production. It featured artists, designers, economists, civil-society groups, academics, ecologists, activists and others who creatively explore existing structures of evaluation and actively produce new ones.
Management Architecture Research performed at #TransActing: A Market of Values in which information in the form of posters was distributed through a roving delivery system. In exchange for the posters, response to a short survey was required. Through this informational transaction, MAR endeavoured to unpack policy and encourage debate surrounding current management configurations and activity in HE. Fundamentally, it asks where value lies within the organization and management of the educational institution
Translation and validation of the Czech Republic version of the Birth Satisfaction Scale-Revised (BSS-R)
Get PDFBackground: Satisfaction with the birth experience has been established to be critical for the wellbeing of the mother. The Birth Satisfaction Scale-Revised (BSS-R) is a brief and psychometrically robust multi-dimensional self-report tool designed to assess birth experience. The current investigation sought to translate and validate a Czech Republic version of the BSS-R (CZ-BSS-R).
Methods: Following translation psychometric assessment of the CZ-BSS-R was undertaken using a cross-sectional design. A between-subjects design was incorporated in order to evaluate known-groups validity evaluation of the translated measure. 465 Czech-speaking women within the Czech Republic took part in the study. Confirmatory factor analysis was undertaken and divergent and convergent validity and internal consistency characteristics also evaluated.
Results: The CZ-BSS-R was observed to have excellent psychometric properties and conceptually and measurement faithful to the original English-language measure. Consistent with previous investigations using the BSS-R significant differences were found in scores as a function of delivery type.
Conclusions: The CZ-BSS-R is a valid, robust and reliable measure of birth experience and suitable for use with Czech-speaking women in the Czech Republic. The study highlighted that instrument and emergency Caesarean section were associated with a lower level of birth satisfaction compared to vaginal delivery
Initial evaluation of the Optimal Health Program for people with diabetes: 12-month outcomes of a randomised controlled trial
Get PDFThis study aimed to evaluate if a new Mental health IN DiabeteS Optimal Health Program (MINDS OHP) compared with usual care in adults with Type 1 and Type 2 diabetes would improve psychosocial outcomes including self-efficacy and quality of life.
Design and Main Outcome Measures This initial randomised controlled trial evaluated MINDS OHP compared with usual care. Participants were recruited through outpatient clinics and community organisations. The intervention group received nine sessions with assessments over twelve months. Primary outcomes were self-efficacy and quality of life. Secondary outcomes included diabetes distress and anxiety.
Results
There were 51 participants in the control group (mean age = 52) and 55 in the intervention group (mean age = 55). There were significant main effects of time in general self-efficacy, diabetes distress, diabetes self-efficacy, and illness perceptions, however no significant between-group differences in primary or secondary outcomes. Post-hoc analyses revealed MINDS OHP improved diabetes self-efficacy for participants with mild to severe depression and anxiety, with a small effect.
Conclusion
Initial evaluation found MINDS OHP was associated with improved diabetes self-efficacy for adults with diabetes, for people with mild to severe levels of distress, with small effect. Further research is required to explore whether this disease-specific, collaborative care-focused intervention benefits the mental health of people with diabetes
Painting, writing, plasticity
Get PDFThis is essay is a response to Molly Warnock's book Simon Hantaï and the Reserves of Painting