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Process evaluation of a new psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family)
No full textIntroduction:We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year.
Methods: In 2021–2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data.
Results:174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) ‘Someone to talk to helps dyads feel supported’; (B) ‘NIDUS-Family helps carers change their perspective’; (C) ‘Personalisation helps people living with dementia maintain their identity’ and (D) ‘Small steps help dyads move forward’.
Conclusion: Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities.</p
Cross-cultural determinants of global account management: Findings from B2B services
No full textThe present study investigates the role of cross-culture differences on the under-researched area of global account management (GAM). Based on a review of key account management, GAM, and related research areas, we identify cultural factors influencing GAM implementation at the organizational and individual levels. Then, we report on empirical data from 432 global account managers in business-to-business (B2B) services firms in different cultural contexts. The findings show that sales organizations experience cross-cultural challenges in their GAM programmes. The variances in the respective cultural dimensions between sales organizations and strategic (global) accounts require a ‘learning organization’ to ensure that cross-cultural challenges within the GAM process are timely identified and adequately managed. In addition, the institutionalization of GAM programmes can reduce the cross-culture variance that exists between sales organizations and global accounts due to intangibility, especially in B2B services; GAM institutionalization also ensures effective relationships with global accounts. The study contributes to B2B research by providing a configurational framework of cross-cultural GAM that considers psychic and cultural distance as crucial elements in a learning organization to serve their strategic customers across different cultural contexts.</p
Investigating music therapy assessment and evaluation procedures for young people with intellectual disabilities in UK schools
No full textRoutine (every-day) music therapy assessment and evaluation procedures are essential in clinical work. UK Evidence Based Practice and stakeholders call for more robust procedures. One answer to this has been the development of music therapy assessment tools and measures with adequate psychometric properties, but this has been to the detriment of exploring the potential of routine assessment and evaluation procedures. Routine procedures are important (i) because standardised tools cannot replace all the necessary functions of assessment and evaluation, (ii) many tools do not fit clinical practice and (iii) they are used but under-researched.In this research, a Modified Nominal Group Technique (M-NGT) was used, to investigate key routine music therapy assessment and evaluation procedures with music therapists and stakeholders looking at priority procedures and principles for young people with moderate or severe intellectual disabilities (YP-ID M/S) in schools. Twenty-five purposively sampled ‘expert’ music therapists and stakeholders engaged in NGT group meetings. Music therapists (16), completed a preliminary questionnaire and YP-ID M/S (2), took part in a multi-perspective questionnaire with their therapist, parent, and teacher. By identifying priority procedures and evaluating their quality, relevance and rigour, this research aims to benefit therapists, stakeholders, and clients.Main findings reveal a framework (CASCADE) of prioritised routine music therapy assessment and evaluation procedures that align with the context of individual music therapy for YP-ID M/S in schools. Procedures have breadth and depth across an expanded music therapy treatment process with a blend of theoretical perspectives. Findings also support a model of Best Practice with seven elements: Integrated, Clearly evidenced and Evidenced-based, Client-centred, Ethical, Collaborative, Multiple-perspectives, Consistent and Systematic. Main YP-ID M/S client groups were found to be autism and co-existing conditions, social, emotional and mental health needs, developmental delay and genetic conditions, physical, neurological and biological, and sensory needs, and difficulties in their family background. YP-ID (S) were found to have the potential to evaluate their music therapy with the help of a structured questionnaire, musical extracts, and augmented communication aids, administered by an adult. Not all music therapists carry out all procedures. These findings contribute to the growing call for music therapy to be more accountable, especially within the education sector.</p
Alcohol and arterial stiffness in middle-aged and older adults: Cross-sectional evidence from the UK Biobank study
No full textBACKGROUND: The association between arterial stiffness and alcohol consumption is still controversial. We investigated this relationship by performing continuous analysis in men drinking only beer/cider, and women drinking only red wine.
METHODS: This cross-sectional study involved participants aged 40-69 years consisting of 9029 men who drank only beer/cider, and 6989 women drinking only red wine. Alcohol consumption was captured by self-reported questionnaire and reported as units per week, where one unit is equal 10 ml pure ethanol. Arterial stiffness index (ASI) was estimated using photoplethysmography.
RESULTS: In men consuming a mean 17.8 (5th and 95th percentiles, 2.6–76.7) units/week, ASI increased by heptiles (sevenths) of alcohol captured from beer/cider consumption and after adjusting for age (9.14, 9.40, 9.51, 9.53, 9.80, 9.80, 10.00 m/s; p-trend
CONCLUSIONS: Positive linear relationships exist between arterial stiffness and alcohol, irrespective of whether captured from beer/cider consumption in men or red wine consumption in women. No evidence existed to support the notion that our arteries benefit from any level of alcohol consumption.</p
Corporate Due Diligence and Human Rights Legislation in Chile: International Influences in an Eminent National Debate
No full textAccording to the United Nations Guiding Principles on Business and Human Rights, all companies have a responsibility to respect human rights. This responsibility goes beyond the mere fact of refraining from violating the human rights of third parties, but requires proactive measures to prevent and redress the harmful effects of their activities. The mechanism prescribed in the Guiding Principles for companies to implement their responsibility to respect human rights due diligence, which is an ongoing management process through which a company addresses the negative consequences it may have on human rights in the context of its operations and products and in all its commercial relations. However, in the face of the limited voluntary implementation of this process, they have recently emerged or are in the process of being developed in the process of legal framework for mandatory due diligence. In Europe, there is a particular impetus for the creation of such rules, with laws already adopted in countries such as France, Germany, the Netherlands and Norway. Thus, this collective work aims to offer an overview of the obligatory due diligence in human rights, from the precise legal analysis of the normative context, integrating constructive proposals towards the future that is to come in Europe and Latin America, and even to cover the study of the most recent and relevant casuistics in this area. </p
Causal interactions and dynamic stability between limbs while walking with imposed leg constraints
No full textThe paper reports on the investigation of the dynamics of the motor control system during walking by examining the complexity, stability, and causal relationships of leg motions. Specifically, the study focuses on gait under both bilateral and unilateral constraints induced by a passive exoskeleton designed to replicate gastrocnemius contractures.</p
Sport students’ experiences of teaching and learning in the United Kingdom: A comparison between further and higher education settings
No full textFew studies have investigated teaching and learning experiences of university sports students which is surprising considering the high annual numbers recruited to sport degree programmes and consequent non-completion rates. This study compared teaching and learning experiences of 350 first-year sport students at a post-92 English University with how they were taught at their further education institutions. Key findings showed the teaching and learning methods at university were less structured and tutor-led but with more teaching staff involved. Practical implications for developing rich modes of university provision that best support the needs and expectations of newly arrived sports students are provided
Prenatal and infant exposure to antibiotics and subsequent risk of neuropsychiatric disorders in children: a nationwide birth cohort study in South Korea
No full textWe aimed to assess the association between antibiotic exposure in fetal and postnatal life (within six months after birth) and the risk of neuropsychiatric disorders in childhood. A nationwide, population-based birth cohort study (infants, n = 3,163,206; paired mothers, n = 2,322,735) was conducted in South Korea, with a mean follow-up duration of 6.8 years, using estimates of hazard ratio [HR] and 95 % confidence intervals (CIs). Following propensity score matching including the baseline variables, antibiotic exposure in both fetal (HR,1.07 [95 % CI, 1.05–1.08]) and postnatal life (1.05 [1.03–1.07]) was associated with an increased risk of overall childhood neuropsychiatric disorders. A synergistic effect was observed with prenatal and postnatal exposures (1.12 [1.09–1.15]). The risk increases with the increasing number and duration of prescriptions. Significant associations were found for both common (1.06 [1.05–1.08]) and severe outcomes (1.17 [1.09–1.26]), especially for intellectual disability (1.12 [1.07–1.17]), ADHD (1.10 [1.07–1.13]), anxiety (1.06 [1.02–1.11]), mood (1.06 [1.00–1.12]), and autism (1.03 [1.01–1.07]). When comparing siblings with different exposure statuses to consider familial factors, prenatal and postnatal exposure risk increased to 10 % (95 % CI, 6–12) and 12 % (7–17), respectively. Similar results were observed in the unmatched and health screening cohort, which considers maternal obesity, smoking, and breastfeeding. Based on these findings, clinicians may consider potential long-term risks when assessing the risk-benefit of early-life antibiotic prescription. </p
A Hybrid Segmentation Algorithm for Rheumatoid Arthritis Diagnosis Using X-ray Images
No full textRheumatoid Arthritis (RA) is a chronic autoimmune illness that occurs in the joints, resulting in inflammation, pain, and stiffness. X-ray examination is one of the most common diagnostic procedures for RA, but manual X-ray image analysis has limitations because it is a time-consuming procedure and is prone to errors. A specific algorithm aims to a lay stable and accurate segmenting of carpal bones from hand bone images, which is vitally important for identifying rheumatoid arthritis. The algorithm demonstrates several stages, starting with Carpal bone Region of Interest (CROI) specification, dynamic thresholding, and Gray Level Co-occurrence Matrix (GLCM) application for texture analysis. To get the clear edges of the image, the component is first converted to the greyscale function and thresholding is carried out to separate the hand from the background. The pad region is identified to obtain the contours of it, and the CROI is defined by the bounding box of the largest contour. The threshold value used in the CROI method is given a dynamic feature that can separate the carpal bones from the surrounding tissue. Then the GLCM texture analysis is carried out, calculating the number of pixel neighbors, with the specific intensity and neighbor relations of the pixels. The resulting feature matrix is then employed to extract features such as contrast and energy, which are later used to categorize the images of the affected carpal bone into inflamed and normal. The proposed technique is tested on a rheumatoid arthritis image dataset, and the results show its contribution to diagnosis of the disease. The algorithm efficiently divides carpal bones and extracts the signature parameters that are critical for correct classification of the inflammation in the cartilage images.</p
“You can stay now, you are trusted”: navigating qualitative fieldwork in sport coaching
No full textThe study tells my story [Harley-Jean] as an ethnographic researcher, addressing the complexities within qualitative coaching fieldwork. I story how, during a season-long ethnographic study on basketball coaches’ decision-making, I negotiated the space as a researcher and became an integral and trusted member of their coaching context. Drawing on my arts-based reflective diary, I reflect on how I navigated my interactions with the coaches and negotiated the research space. My story contains three central plots: (1) “Who is [Harley-Jean]?” highlights how I started my journey in my selected research field. (2) “Passing Coach’s test” illustrates how I presented my worth within the Basketball context and negotiated trust, and (3) “You are trusted now, you can stay” captures how I became a trusted member of the team. The stories artfully convey the interactions and messiness of negotiating the position of a researcher and how building trusting relationships is central to high-quality fieldwork. </p
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