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Supporting adult unpaid carers via an online dancing intervention: a feasibility/acceptability study
Get PDFUnpaid carers often experience poor mental and physical health linked to their caring role. Engagement in physical activity has been shown to alleviate these negative health outcomes, but it is harder for carers to find the time, energy and space to exercise. This qualitative study, based in the UK, explored the feasibility of an online, dance-based physical activity intervention with six female unpaid carers. Five themes resulted from the thematic analysis of the pre- and post-intervention interviews: Perceived physical health benefits of the intervention; Perceived mental health benefits of the intervention; Satisfactoriness of the dance classes; Impact of caring responsibilities on participation; and Suggestions for future classes. Further research is required to measure the effectiveness of the dance intervention in improving mental and physical wellbeing with larger samples including a wider mix of carers in terms of gender, age and health conditions of the care recipients, as well as international samples. Future research should also consider the barriers that some carers may face when accessing an online intervention, and alternative forms of exercise that may appeal to other groups of carers (e.g., male carers, older adult carers)
The effects of adapted mind-body exercises on physical function, quality of life and wellbeing for older people: a systematic review and meta-analysis
Get PDFBackground: Participating in physical activity programmes is one way to optimise wellbeing and quality of life in older adults. Mind–body exercises could provide greater benefits than other forms of traditional physical activity and can be easily adapted for older people who are starting to develop functional decline. Objectives: To synthesise the literature looking at the effects of adapted mind–body interventions on older people. Design: A systematic review and meta-analysis was conducted on articles from Web of Science, MEDLINE, SPORTDiscus, AMED and CINAHL that were searched up to 13 September 2023. Studies were extracted and assessed by two authors and included if they were adapted mind-body quasi experimental trials (QET) or randomised controlled trials (RCT) evaluating physical function, quality of life or wellbeing in community dwelling older adults aged 60 years and over. The Cochrane Risk of Bias 2 scale was used for quality appraisal. Analysis of the results included calculating standardised effect sizes (Hedge's g) and a narrative synthesis of results not included in meta-analysis. Results: 18 studies (8 quasi-experimental trial designs, n = 310; 10 randomised control trials, n = 1829) were included in the systematic review, with 14 studies (9 RCT, n = 1776, 5 QET, n = 100) retained for meta-analysis. For the RCT studies, some improvement was noted in mobility (ES 0.36: 95% CI: 0.01, 0.71), flexibility (ES 0.36: 0.01, 0.70), well-being (ES 0.54: 0.18, 0.91) and quality of life (ES 0.50: 0.21, 0.79). No positive effect was observed for leg power (ES 0.09: −0.33, 0.51), leg endurance (ES 0.16: −0.72, 1.03), back scratch test (ES 0.24: −0.10, 0.59), or balance, (ES 0.05: −0.06, 0.15). Heterogeneity varied from 0%–87% across the different outcomes. For the QET studies, gait velocity was shown to improve (ES 0.54: 0.18, 0.91), while fear of falling showed no significant improvements (ES 0.82: −0.06, 1.69). A meta-regression for quality of life in which the total physical activity of the intervention, in hours, was used as a covariate, showed ES = 1.1 for every 100 h of physical activity. Conclusion: There is scope for adapted mind-body physical activity interventions to play a role in improving quality of life, wellbeing, and physical function in older adults. The provision of adapted interventions for older people might improve uptake of and engagement with physical activity interventions in older people with limited or reduced abilities.</p
Comparing leaving-care policy and practice across the four nations of the United Kingdom:exploring similarities, differences, and implementation gaps
Get PDFFrom an international comparative perspective, the four nations of the UK have robust legal and policy frameworks governing care-leaving. Measures taken include: access to aftercare workers; pathway planning; introduction of extended care arrangements (permitting young people to remain in placement beyond 18 years); and specific types of financial support. The paper explores commonalities and differences in approaches across the UK and illuminates how resource constraints, placement availability, workforce challenges and cultural norms may result in implementation gaps and a post-code lottery of provision. Findings lend weight to calls for attentiveness to, and systematic evaluation of, the implementation process to understand the challenges encountered in embedding effective support for care leavers. They also highlight the value of further comparative studies that explore the systems and subsystems of law, policy and practice in the four nations to contribute to more informed leaving care policy and practice
Effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering: a systematic review
Get PDFThe care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants between 0 and 6 months. We searched nine electronic databases from January 2000 to August 2021, included interventional studies, evaluated the quality of evidence for seven outcome domains (anthropometric recovery, child development, anthropometric outcomes, mortality, readmission, relapse, and non-response) and followed the GRADE approach for certainty of evidence. We identified thirteen studies with preterm and/or low birth weight infants assessing effects of breastfeeding counselling or education (n = 8), maternal nutrition supplementation (n = 2), mental health (n = 1), relaxation therapy (n = 1), and cash transfer (n = 1) interventions. The evidence from these studies had serious indirectness and high risk of bias. Evidence suggests breastfeeding counselling or education compared to standard care may increase infant weight at one month, weight at two months and length at one month; however, the evidence is very uncertain (very low quality). Maternal nutrition supplementation compared to standard care may not increase infant weight at 36 weeks postmenstrual age and may not reduce infant mortality by 36 weeks post-menstrual age (low quality). Evidence on the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering is limited and of ‘low’ to ‘very low’ quality. This emphasizes the urgent need for future research. The protocol was registered with PROSPERO (CRD42022309001)
Workplace productivity, health and wellbeing: findings from a cluster randomised controlled trial of a workplace intervention to reduce sitting in office workers
Get PDFOBJECTIVE To evaluate the feasibility and potential effects of a workplace intervention to reduce and break up sitting. METHODS Office workers were randomised in clusters to intervention (=22) or control (n = 22). The intervention included a height-adjustable workstation, education, computer prompt software and line manager support. Outcomes included device-measured workplace sitting and ecological momentary assessed (EMA) workplace productivity. Recruitment, retention and data completion rates were assessed. RESULT Recruitment (n = 44), retention (91%) and workplace sitting measurement rates demonstrated study feasibility. At 8 weeks, workplace sitting was 11% lower (95% CI: -20.71, -1.30) in the intervention group compared with control participants. Intervention participants were also more engaged, motivated and productive while sitting (p ≤ 0.016). CONCLUSIONS It was feasible to implement and evaluate this office workplace intervention, with potential benefits on workplace sitting and EMA-measured productivity
Utilization of a blockchainized reputation management service for performance enhancement of Smart Grid 2.0 applications
Get PDFBlockchain has become the technology enabler in delivering modern Smart Grid 2.0 functionalities. Many services including Peer-to-Peer energy trading, distribution network management, financial settlements, and energy data management are catered through blockchain-enabled platforms. However, areas such as service quality-based pricing strategies, supply–demand balancing in distribution system to attain enhanced reliability and consumption-oriented rewarding mechanisms need improving in order to achieve the full benefits of the envisaged grid architecture. In response, this study proposes a novel Blockchain-as-a-Service for Energy Trading (BaaSET) platform, which offers reputation-based services, executed through smart contracts for smart grid applications. Reputation-based grid operations are automatically executed through smart contracts deployed onto a blockchain. The reputation is estimated using power quality and reliability indices, obtained through grid measurements. Further, tests have been conducted to evaluate the associated latency and the implementation cost of the proposed blockchainized service architecture. Test results signify the performance to be comparatively better considering the state-of-the-art. The results further suggest alternatives to improve the scalability of the architecture, to cater the increasing number of stakeholders in the SG 2.0 environment
Implementation of step-down Intermediate Care (IC) in Buckinghamshire, UK: a qualitative evaluation study of healthcare professionals' experiences and perspectives
Get PDFStep-down intermediate care aims to offer short-term care for people who are medically optimised for discharge but needing a period for further assessment and/or rehabilitation. The aim of this study, which was nested in a larger evaluation project, was to explore the experiences and perspectives of healthcare professionals to understand the implementation of a step-down IC service in Buckinghamshire, UK. The evidence is used to inform the service providers of what elements worked well and what areas require improvement. A qualitative study using semistructured interviews was conducted in May 2022. Ten healthcare professionals participated. Interviews were transcribed verbatim and reflexive thematic analysis was used to analyse the data. The following five core themes were developed: (1) the developmental period of step-down IC, (2) providing care together, (3) perceived functions of the integrated hub, (4) communication, and (5) resources. Findings from the interviews highlighted the excellent working relationships among healthcare professionals from different disciplines, which contributed to their job satisfaction and the efficiency of the service. In addition, healthcare professionals stressed the importance of the integrated hub, as it facilitated the communication between the teams and speeded up the decision-making. Several organisational challenges, such as communication issues, healthcare professionals’ capacity, and the need for further funding were also voiced. Involving staff in the evaluation of a step-down intermediate care service has provided useful information on the service’s implementation process and will inform the development of a long-term strategy for intermediate care
Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial:study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children
Get PDFBackground: A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention (‘E-PLAYS’) aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools. Methods: The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools’ teaching assistants. Teachers will select suitable children (ages 5–7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual. The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS. Discussion: The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children. Trial registration: ISRCTN 17561417, registration date 19th December 2022. Protocol version: v1.1 19th June 2023.</p
Use of keystroke logging to collect cognitive validity evidence for integrated writing tests
Get PDFIntegrated writing tasks are commonly used for teaching, learning and assessment purposes in most higher education contexts. These tasks are cognitively demanding as they require students to transform knowledge by engaging in processes of discourse synthesis, i.e. selecting, organising, and connecting information from multiple source texts into a new or synthesis text. The purpose of the present exploratory study was to investigate L2 writers’ discourse synthesis processes underlying the performance of an integrated reading-writing task. The participants were three university students who completed an integrated reading-writing task as part of a postadmission academic literacy test at a British university. Data were collected using a variety of qualitative research techniques: analysis of keystroke logs, retrospective interviews, and text quality analysis. Data analysis revealed distinct engagement in discourse synthesis processes among L2 writers. The study proposes a qualitative approach to analysing keystroke logging data to collect cognitive validity evidence (i.e. test takers’ engagement in discourse synthesis) underlying integrated writing test performance. The other major implications of the findings are the need for explicit teaching and assessment of these discourse synthesis processes, i.e. selecting, connecting and organising relevant ideas from multiple reading stimuli to produce a text, and the need to construct specific rating descriptors which reflect skills of discourse synthesis for integrated writing tasks
Barriers and facilitators of deceased organ donation among Muslims living globally: an integrative systematic review
Get PDFAim To identify the barriers and facilitators of deceased organ donation among the Muslim community living globally. Method A systematic search was undertaken in databases such as CINAHL, Medline with full text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed via US National Library of Medicine National Institute of Health were used to retrieve the studies on the 31st of December 2023. Apart from these databases two other journals, the Saudi Journal of Kidney Diseases and Transplantation, and the Journal of Experimental and Clinical Transplantation were also used to search for relevant studies. Quantitative and qualitative studies that addressed the aim of the present review published from the 30th of April 2008 were included. Results Of the 10,474 studies, 95 studies were included in the review. The following five themes were generated based on narrative synthesis: 1) knowledge of organ donation, 2) willingness to donate, 3) community influence, 4) bodily influence, and 5) religious influence. While individuals view organ donation as a noble act, societal influences significantly impact their decision to register. Concerns include religious permissibility, potential misuse for commercial purposes, and the dignity and respect given to the deceased donor's body. Conclusions This review finds deceased organ donation decisions in this population are collective, influenced by religious views, and hindered by uncertainty. Interventional studies on strategies to address uncertainty could help us identify best practices for this population to improve deceased organ donation. Rather than an individual approach among this population, a whole-system approach, tailored-made evidence-guided community engagement could improve donation rates
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