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Louisa Lawrie

University of Aberdeen, School of Psychology, Graduate Student

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Daniel D. Hutto

University of Wollongong

The University of Texas at Austin

Harvard University

Julian Kiverstein

Academic Medical Centre/ Universiteit van Amsterdam

Macquarie University

Eric S . Kim (UBC)

University of British Columbia

Shaun Gallagher

University of Memphis

Pennsylvania State University

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New York University

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Papers by Louisa Lawrie

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage

JAMA

ImportanceBleeding is the most common cause of preventable death after trauma.ObjectiveTo determi... more ImportanceBleeding is the most common cause of preventable death after trauma.ObjectiveTo determine the effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) when used in the emergency department along with standard care vs standard care alone on mortality in trauma patients with exsanguinating hemorrhage.Design, Setting, and ParticipantsPragmatic, bayesian, randomized clinical trial conducted at 16 major trauma centers in the UK. Patients aged 16 years or older with exsanguinating hemorrhage were enrolled between October 2017 and March 2022 and followed up for 90 days.InterventionPatients were randomly assigned (1:1 allocation) to a strategy that included REBOA and standard care (n = 46) or standard care alone (n = 44).Main Outcomes and MeasuresThe primary outcome was all-cause mortality at 90 days. Ten secondary outcomes included mortality at 6 months, while in the hospital, and within 24 hours, 6 hours, or 3 hours; the need for definitive hemorrhage c...

It wasn’t me: The role of perspective in self-perceptions of responsibility

Consciousness and Cognition, Aug 1, 2018

Perceiving oneself as agentic is dependent upon the integration of conscious intention, a corresp... more Perceiving oneself as agentic is dependent upon the integration of conscious intention, a corresponding outcome, and body-congruent sensorimotor information. Altering these critical cues, such as the vantage point from which an event is viewed, can have a notable impact on one's sense of agency, including an increased sense of ownership over another person's actions or a reduced sense of responsibility (or control) over one's own actions. In three studies, we investigated whether mentally simulated and written perspectives could have similar effects. Participants were asked to consider ambiguous actions from either a first-person or a third-person perspective. Results revealed that third-person perspectives reduced judgments of personal responsibility for positive and negative actions. Perceptions of personal action execution as well as the perceived overlap between one's real and imagined self were identified as mediators of the reduced sense of responsibility that characterized negative, but not positive, events constructed from a third-person perspective.

A maturing picture of emotion

Psychologist, Dec 31, 2016

on how we process emotions in ourselves and others as we age The Psychologist is the monthly publ... more on how we process emotions in ourselves and others as we age The Psychologist is the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, 'to promote the advancement and diffusion of a knowledge of psychology pure and applied'.

The Effects of Adult Ageing and Culture on the Tower of London Task

Frontiers in Psychology, Feb 22, 2021

Planning ability is important in everyday functioning, and a key measure to assess the preparatio... more Planning ability is important in everyday functioning, and a key measure to assess the preparation and execution of plans is the Tower of London (ToL) task. Previous studies indicate that older adults are often less accurate than the young on the ToL and that there may be cultural differences in performance on the task. However, potential interactions between age and culture have not previously been explored. In the current study we examined the effects of age on ToL performance in an Asian culture (Malaysia) and a Western culture (British) (n = 191). We also explored whether working memory, age, education, and socioeconomic status explained variance in ToL performance across these two cultures. Results indicated that age effects on ToL performance were greater in the Malaysian sample. Subsequent moderated mediation analysis revealed differences between the two cultures (British vs Malaysians), in that the age-related variance in ToL accuracy was accounted for by WM capacity at low and medium education levels only in the Malaysian sample. Demographic variables could not explain additional variance in ToL speed or accuracy. These results may reflect cultural differences in the familiarity and cognitive load of carrying out complex planning tasks.

The Effects of Adult Aging and Culture on Theory of Mind

The Journals of Gerontology: Series B, May 24, 2021

Objectives: Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts... more Objectives: Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (UK versus Malaysia). Method: We used two ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status (SES), and WM. A total of 298 participants from UK and Malaysia completed faux pas, false belief, and WM tasks. Results: Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating effects of WM on the age and ToM relationship occurred at the lowest levels of education. Discussion: This pattern of results may reflect changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive aging. Cultural differences in education and working memory should be considered when researching age differences in theory of mind.

The Effects Of Adult Ageing And Culture On Theory Of Mind

Older adults tend to have poorer mental state understanding (Theory of Mind, ToM) than their youn... more Older adults tend to have poorer mental state understanding (Theory of Mind, ToM) than their younger counterparts, including in both Western and Asian cultures. The current study aimed to directly investigate whether there are any cultural differences in the pattern of age effects on ToM tasks. Given evidence of cultural differences in the development of ToM across childhood, we predicted that older Asian adults would find the mental state tasks particularly resource-demanding. We used two ToM tests which made differing demands on updating multiple mental states (the false belief task) and applying social rules to mental state processing (the faux pas task). We also looked at the role of education, socioeconomic status, individualism versus collectivism and working memory (WM). A total of 298 participants from UK and Malaysia completed faux pas, false belief, and WM tasks. Results showed that interacting effects of age and culture were evident in faux pas detection, some aspects of false belief reasoning, and WM tasks, with older Malaysian participants performing poorly compared to the other groups. We also found that WM fully mediated age differences in ToM in the Malaysian sample. High levels of individualism were associated with poorer faux pas detection, but education and socioeconomic status did not explain additional variance in the ToM tasks. This pattern of results may reflect generational changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive ageing.

Effects of induced sad mood on facial emotion perception in young and older adults

Aging Neuropsychology and Cognition, Feb 15, 2018

Older adults perceive less intense negative emotion in facial expressions compared to younger cou... more Older adults perceive less intense negative emotion in facial expressions compared to younger counterparts. Prior research has also demonstrated that mood alters facial emotion perception. Nevertheless, there is little evidence which evaluates the interactive effects of age and mood on emotion perception. This study investigated the effects of sad mood on younger and older adults' perception of emotional and neutral faces. Participants rated the intensity of stimuli while listening to sad music and in silence. Measures of mood were administered. Younger and older participants' rated sad faces as displaying stronger sadness when they experienced sad mood. While younger participants showed no influence of sad mood on happiness ratings of happy faces, older adults rated happy faces as conveying less happiness when they experienced sad mood. This study demonstrates how emotion perception can change when a controlled mood induction procedure is applied to alter mood in young and older participants.

A qualitative process evaluation within a clinical trial that used healthcare technologies for children with asthma–insights and implications

PLOS ONE

Background Healthcare technologies are becoming more commonplace, however clinical and patient pe... more Background Healthcare technologies are becoming more commonplace, however clinical and patient perspectives regarding the use of technology in the management of childhood asthma have yet to be investigated. Within a clinical trial of asthma management in children, we conducted a qualitative process evaluation that provided insights into the experiences and perspectives of healthcare staff and families on (i) the use of smart inhalers to monitor medication adherence and (ii) the use of algorithm generated treatment recommendations. Methods We interviewed trial staff (n = 15) and families (n = 6) who were involved in the trial to gauge perspectives around the use of smart inhalers to monitor adherence and the algorithm to guide clinical decision making. Findings Staff and families indicated that there were technical issues associated with the smart inhalers. While staff suggested that the smart inhalers were good for monitoring adherence and enabling communication regarding medication...

Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

BMJ Open

ObjectivesThe effective implementation of a fast-changing healthcare delivery innovation, such as... more ObjectivesThe effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to ‘current issues’ as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.DesignSemi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participantsThe interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introductio...

Challenges and opportunities for conducting pre-hospital trauma trials: a behavioural investigation

Background: Trials in pre-hospital trauma care are relatively uncommon. There are logistical and ... more Background: Trials in pre-hospital trauma care are relatively uncommon. There are logistical and methodological challenges related to designing and delivering trials in this setting. Previous studies have assessed challenges reported in individual trials rather than across the pre-hospital trial landscape to identify over-arching factors. The aim of this study was to investigate the challenges and opportunities related to the set-up, design and conduct of pre-hospital trauma trials. Methods: Semi-structured interviews were conducted with research personnel who had experience of pre-hospital trials, either through direct involvement in conduct or through strategic oversight of national initiatives (n = 7), and clinical staff (n = 16) involved in recruitment to a pre-hospital trauma feasibility study. Thematic analyses were used to assess the barriers and enablers of conducting pre-hospital trauma trials. Two frameworks (The Capability Opportunity Motivation - Behaviour and the Theore...

Barriers and enablers to the effective implementation of robotic assisted surgery

PLOS ONE

Background Implementation of Robotic Assisted Surgery (RAS) is complex as it requires adjustments... more Background Implementation of Robotic Assisted Surgery (RAS) is complex as it requires adjustments to associated physical infrastructure, but also changes to processes and behaviours. With the global objective of optimising and improving RAS implementation, this study aimed to: 1) Explore the barriers and enablers to RAS service adoption, incorporating an assessment of behavioural influences; 2) Provide an optimised plan for effective RAS implementation, with the incorporation of theory-informed implementation strategies that have been adapted to address the barriers/enablers that affect RAS service adoption. Methods Semi-structured interviews were conducted with RAS personnel and stakeholders, including: surgeons, theatre staff, managers, industry representatives, and policy-makers/commissioners. The Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR) was used to identify barriers and enablers that represent individual behaviours, ca...

$Research paper thumbnail of Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma: the RAACENO RCT$

Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma: the RAACENO RCT

Efficacy and Mechanism Evaluation

Background The role of fractional exhaled nitric oxide in guiding asthma treatment in children is... more Background The role of fractional exhaled nitric oxide in guiding asthma treatment in children is uncertain. Objective To compare treatment guided by both fractional exhaled nitric oxide and symptoms (intervention) with treatment guided by symptoms alone (standard care) in children with asthma who are at risk of an asthma exacerbation, in terms of the number of asthma exacerbations over 12 months. Design This was a pragmatic, multicentre, randomised controlled trial with embedded cost-effectiveness and qualitative process evaluations. Randomisation (1 : 1) was carried out using a remote web-based system and was minimised on recruitment centre, age, sex and British Thoracic Society treatment step. Clinical teams and participants were not blind to treatment allocation. Setting The trial took place in 35 hospitals and seven primary care practices in the UK. Participants Children aged 6–15 years with a diagnosis of asthma who were currently prescribed inhaled corticosteroids and who had...

Behavioural optimisation to address trial conduct challenges: case study in the UK-REBOA trial

Trials

Background Clinical trials comprise multiple processes at various stages of the trial lifecycle. ... more Background Clinical trials comprise multiple processes at various stages of the trial lifecycle. These processes often involve complex behaviours such as recruiting vulnerable patient populations and clinicians having to deliver complex trial interventions successfully. Few studies have utilised a behavioural framework to assess challenges and develop strategies for effective trial recruitment and delivery of trial interventions. This study reports the application of an innovative methodological approach to understand core trial processes, namely recruitment and intervention delivery, using a behavioural science approach to develop strategies designed to mitigate trial process problems. Methods The UK-REBOA trial aims to evaluate the clinical and cost-effectiveness of resuscitative endovascular balloon occlusion of the aorta (a novel intervention) in injured patients with exsanguinating haemorrhage. A behavioural investigation (‘diagnosis’) was conducted using theory-informed (Theor...

Behavioural approaches to recruitment and retention in clinical trials: a systematic mapping review

BMJ Open, 2022

ObjectivesTo identify studies that applied behavioural approaches to issues of recruitment and/or... more ObjectivesTo identify studies that applied behavioural approaches to issues of recruitment and/or retention to trials; to describe these approaches; and to identify gaps for future research.DesignSystematic mapping review of research undertaken in clinical trials within peer-reviewed sources. Review participants were individuals involved in clinical trials, including trial staff, participants, potential participants and former participants.Data sourcesMEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Web of Science and ASSIA from inception to 15 January 2020 with no date or language restrictions.Eligibility criteriaStudies within the context of clinical trials reporting the barriers/facilitators to recruitment and retention, or developing/evaluating solutions to said barriers/facilitators, using a behavioural approach.Results31 articles were included. Recruitment-focused studies (n=22, 71%) represented the majority. Studies tended to focus on participant behaviours (n=22, 71%). Underserved p...

Using a behavioural approach to explore the factors that affect questionnaire return within a clinical trial: a qualitative study based on the theoretical domains framework

BMJ Open, 2021

ObjectivesTo identify barriers and enablers to participant retention in trials requiring question... more ObjectivesTo identify barriers and enablers to participant retention in trials requiring questionnaire return using the theoretical domains framework (TDF).Study design and settingWe identified and subsequently invited participants who did not return at least one questionnaire during their participation in a clinical trial for one-to-one semi-structured telephone interviews. We used a behavioural framework (TDF) to explore whether any of the behavioural domains (eg, beliefs about consequences, emotion) affected questionnaire return. Thereafter, we generated a series of belief statements which summarised the content of participants’ main responses and coded these under separate themes.ParticipantsWe distributed invites to 279 eligible individuals and subsequently interviewed 9 participants who took part in the C-Gall trial. The C-Gall trial required participants to complete five postal questionnaires during their participation.ResultsNine participants were interviewed. We developed 7...

Theory-guided interviews identified behavioral barriers and enablers to healthcare professionals recruiting participants to maternity trials

Journal of Clinical Epidemiology, 2022

OBJECTIVE To conduct a behavioural investigation, using the Theoretical Domains Framework (TDF), ... more OBJECTIVE To conduct a behavioural investigation, using the Theoretical Domains Framework (TDF), to identify barriers and enablers to maternity healthcare professionals (HCP) inviting all eligible women to participate in a maternity care trial. STUDY DESIGN AND SETTING We invited HCP recruiters from maternity care trials in high priority research areas including, diabetes, preeclampsia and breastfeeding, from across Ireland and the UK, to take part in a semi-structured interview. Data collection was informed by the TDF, followed by inductive thematic analysis and deductive mapping to the TDF. RESULTS Twenty-two recruiters including midwives, nurses, allied health professionals and doctors were interviewed online or by telephone phone. Thematic analysis generated four global themes; Availability and accessibility of resources, Navigating the recruitment pathway, Prioritising clinical responsibilities over research responsibilities and The influence of colleagues and peers. Themes were mapped to the TDF, identifying 13 domains relevant to the behaviour. CONCLUSION This paper identifies the factors enabling or inhibiting maternity HCP recruiters to invite all eligible women to participate in a maternity care trial. The findings provide guidance for researchers designing trials for this population and the essential first step in developing a recruiter-focused behaviour change intervention to support recruitment to trials in maternity care.

The Effects of Adult Aging and Culture on Theory of Mind

The Journals of Gerontology: Series B, 2021

Objectives Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts,... more Objectives Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (the United Kingdom vs. Malaysia). Methods We used 2 ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status, and WM. A total of 298 participants from the United Kingdom and Malaysia completed faux pas, false belief, and WM tasks. Results Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief, and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating ...

Including a pen and/or cover letter, containing social incentive text, had no effect on questionnaire response rate: a factorial randomised controlled Study within a Trial [version 1; peer review: 1 approved with reservations]

F1000Research, 2020

Peer Review Report For: A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research [version 1; peer review: 1 approved, 1 approved with reservations]

A maturing picture of emotion

Psychologist, 2016

on how we process emotions in ourselves and others as we age The Psychologist is the monthly publ... more on how we process emotions in ourselves and others as we age The Psychologist is the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, 'to promote the advancement and diffusion of a knowledge of psychology pure and applied'.

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage

JAMA

ImportanceBleeding is the most common cause of preventable death after trauma.ObjectiveTo determi... more ImportanceBleeding is the most common cause of preventable death after trauma.ObjectiveTo determine the effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) when used in the emergency department along with standard care vs standard care alone on mortality in trauma patients with exsanguinating hemorrhage.Design, Setting, and ParticipantsPragmatic, bayesian, randomized clinical trial conducted at 16 major trauma centers in the UK. Patients aged 16 years or older with exsanguinating hemorrhage were enrolled between October 2017 and March 2022 and followed up for 90 days.InterventionPatients were randomly assigned (1:1 allocation) to a strategy that included REBOA and standard care (n = 46) or standard care alone (n = 44).Main Outcomes and MeasuresThe primary outcome was all-cause mortality at 90 days. Ten secondary outcomes included mortality at 6 months, while in the hospital, and within 24 hours, 6 hours, or 3 hours; the need for definitive hemorrhage c...

It wasn’t me: The role of perspective in self-perceptions of responsibility

Consciousness and Cognition, Aug 1, 2018

Perceiving oneself as agentic is dependent upon the integration of conscious intention, a corresp... more Perceiving oneself as agentic is dependent upon the integration of conscious intention, a corresponding outcome, and body-congruent sensorimotor information. Altering these critical cues, such as the vantage point from which an event is viewed, can have a notable impact on one's sense of agency, including an increased sense of ownership over another person's actions or a reduced sense of responsibility (or control) over one's own actions. In three studies, we investigated whether mentally simulated and written perspectives could have similar effects. Participants were asked to consider ambiguous actions from either a first-person or a third-person perspective. Results revealed that third-person perspectives reduced judgments of personal responsibility for positive and negative actions. Perceptions of personal action execution as well as the perceived overlap between one's real and imagined self were identified as mediators of the reduced sense of responsibility that characterized negative, but not positive, events constructed from a third-person perspective.

A maturing picture of emotion

Psychologist, Dec 31, 2016

on how we process emotions in ourselves and others as we age The Psychologist is the monthly publ... more on how we process emotions in ourselves and others as we age The Psychologist is the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, 'to promote the advancement and diffusion of a knowledge of psychology pure and applied'.

The Effects of Adult Ageing and Culture on the Tower of London Task

Frontiers in Psychology, Feb 22, 2021

Planning ability is important in everyday functioning, and a key measure to assess the preparatio... more Planning ability is important in everyday functioning, and a key measure to assess the preparation and execution of plans is the Tower of London (ToL) task. Previous studies indicate that older adults are often less accurate than the young on the ToL and that there may be cultural differences in performance on the task. However, potential interactions between age and culture have not previously been explored. In the current study we examined the effects of age on ToL performance in an Asian culture (Malaysia) and a Western culture (British) (n = 191). We also explored whether working memory, age, education, and socioeconomic status explained variance in ToL performance across these two cultures. Results indicated that age effects on ToL performance were greater in the Malaysian sample. Subsequent moderated mediation analysis revealed differences between the two cultures (British vs Malaysians), in that the age-related variance in ToL accuracy was accounted for by WM capacity at low and medium education levels only in the Malaysian sample. Demographic variables could not explain additional variance in ToL speed or accuracy. These results may reflect cultural differences in the familiarity and cognitive load of carrying out complex planning tasks.

The Effects of Adult Aging and Culture on Theory of Mind

The Journals of Gerontology: Series B, May 24, 2021

Objectives: Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts... more Objectives: Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (UK versus Malaysia). Method: We used two ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status (SES), and WM. A total of 298 participants from UK and Malaysia completed faux pas, false belief, and WM tasks. Results: Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating effects of WM on the age and ToM relationship occurred at the lowest levels of education. Discussion: This pattern of results may reflect changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive aging. Cultural differences in education and working memory should be considered when researching age differences in theory of mind.

The Effects Of Adult Ageing And Culture On Theory Of Mind

Older adults tend to have poorer mental state understanding (Theory of Mind, ToM) than their youn... more Older adults tend to have poorer mental state understanding (Theory of Mind, ToM) than their younger counterparts, including in both Western and Asian cultures. The current study aimed to directly investigate whether there are any cultural differences in the pattern of age effects on ToM tasks. Given evidence of cultural differences in the development of ToM across childhood, we predicted that older Asian adults would find the mental state tasks particularly resource-demanding. We used two ToM tests which made differing demands on updating multiple mental states (the false belief task) and applying social rules to mental state processing (the faux pas task). We also looked at the role of education, socioeconomic status, individualism versus collectivism and working memory (WM). A total of 298 participants from UK and Malaysia completed faux pas, false belief, and WM tasks. Results showed that interacting effects of age and culture were evident in faux pas detection, some aspects of false belief reasoning, and WM tasks, with older Malaysian participants performing poorly compared to the other groups. We also found that WM fully mediated age differences in ToM in the Malaysian sample. High levels of individualism were associated with poorer faux pas detection, but education and socioeconomic status did not explain additional variance in the ToM tasks. This pattern of results may reflect generational changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive ageing.

Effects of induced sad mood on facial emotion perception in young and older adults

Aging Neuropsychology and Cognition, Feb 15, 2018

Older adults perceive less intense negative emotion in facial expressions compared to younger cou... more Older adults perceive less intense negative emotion in facial expressions compared to younger counterparts. Prior research has also demonstrated that mood alters facial emotion perception. Nevertheless, there is little evidence which evaluates the interactive effects of age and mood on emotion perception. This study investigated the effects of sad mood on younger and older adults' perception of emotional and neutral faces. Participants rated the intensity of stimuli while listening to sad music and in silence. Measures of mood were administered. Younger and older participants' rated sad faces as displaying stronger sadness when they experienced sad mood. While younger participants showed no influence of sad mood on happiness ratings of happy faces, older adults rated happy faces as conveying less happiness when they experienced sad mood. This study demonstrates how emotion perception can change when a controlled mood induction procedure is applied to alter mood in young and older participants.

A qualitative process evaluation within a clinical trial that used healthcare technologies for children with asthma–insights and implications

PLOS ONE

Background Healthcare technologies are becoming more commonplace, however clinical and patient pe... more Background Healthcare technologies are becoming more commonplace, however clinical and patient perspectives regarding the use of technology in the management of childhood asthma have yet to be investigated. Within a clinical trial of asthma management in children, we conducted a qualitative process evaluation that provided insights into the experiences and perspectives of healthcare staff and families on (i) the use of smart inhalers to monitor medication adherence and (ii) the use of algorithm generated treatment recommendations. Methods We interviewed trial staff (n = 15) and families (n = 6) who were involved in the trial to gauge perspectives around the use of smart inhalers to monitor adherence and the algorithm to guide clinical decision making. Findings Staff and families indicated that there were technical issues associated with the smart inhalers. While staff suggested that the smart inhalers were good for monitoring adherence and enabling communication regarding medication...

Current issues and future considerations for the wider implementation of robotic-assisted surgery: a qualitative study

BMJ Open

ObjectivesThe effective implementation of a fast-changing healthcare delivery innovation, such as... more ObjectivesThe effective implementation of a fast-changing healthcare delivery innovation, such as robotic-assisted surgery (RAS), into a healthcare system, can be affected (both positively and negatively) by external contextual factors. As part of a wider project investigating ways to optimise the implementation of RAS, this qualitative study aimed to uncover current issues of RAS and predictions about the future of robotic surgery. We refer to ‘current issues’ as the topical and salient challenges and opportunities related to the introduction of RAS in the UK healthcare system, from the perspectives of key stakeholders involved in the delivery and implementation of RAS.DesignSemi-structured interviews and focus groups were conducted. A thematic analysis was conducted to summarise salient issues that were articulated by the participants.Setting and participantsThe interview sample (n=35) comprised surgeons, wider theatre staff and other relevant personnel involved in the introductio...

Challenges and opportunities for conducting pre-hospital trauma trials: a behavioural investigation

Background: Trials in pre-hospital trauma care are relatively uncommon. There are logistical and ... more Background: Trials in pre-hospital trauma care are relatively uncommon. There are logistical and methodological challenges related to designing and delivering trials in this setting. Previous studies have assessed challenges reported in individual trials rather than across the pre-hospital trial landscape to identify over-arching factors. The aim of this study was to investigate the challenges and opportunities related to the set-up, design and conduct of pre-hospital trauma trials. Methods: Semi-structured interviews were conducted with research personnel who had experience of pre-hospital trials, either through direct involvement in conduct or through strategic oversight of national initiatives (n = 7), and clinical staff (n = 16) involved in recruitment to a pre-hospital trauma feasibility study. Thematic analyses were used to assess the barriers and enablers of conducting pre-hospital trauma trials. Two frameworks (The Capability Opportunity Motivation - Behaviour and the Theore...

Barriers and enablers to the effective implementation of robotic assisted surgery

PLOS ONE

Background Implementation of Robotic Assisted Surgery (RAS) is complex as it requires adjustments... more Background Implementation of Robotic Assisted Surgery (RAS) is complex as it requires adjustments to associated physical infrastructure, but also changes to processes and behaviours. With the global objective of optimising and improving RAS implementation, this study aimed to: 1) Explore the barriers and enablers to RAS service adoption, incorporating an assessment of behavioural influences; 2) Provide an optimised plan for effective RAS implementation, with the incorporation of theory-informed implementation strategies that have been adapted to address the barriers/enablers that affect RAS service adoption. Methods Semi-structured interviews were conducted with RAS personnel and stakeholders, including: surgeons, theatre staff, managers, industry representatives, and policy-makers/commissioners. The Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR) was used to identify barriers and enablers that represent individual behaviours, ca...

$Research paper thumbnail of Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma: the RAACENO RCT$

Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma: the RAACENO RCT

Efficacy and Mechanism Evaluation

Background The role of fractional exhaled nitric oxide in guiding asthma treatment in children is... more Background The role of fractional exhaled nitric oxide in guiding asthma treatment in children is uncertain. Objective To compare treatment guided by both fractional exhaled nitric oxide and symptoms (intervention) with treatment guided by symptoms alone (standard care) in children with asthma who are at risk of an asthma exacerbation, in terms of the number of asthma exacerbations over 12 months. Design This was a pragmatic, multicentre, randomised controlled trial with embedded cost-effectiveness and qualitative process evaluations. Randomisation (1 : 1) was carried out using a remote web-based system and was minimised on recruitment centre, age, sex and British Thoracic Society treatment step. Clinical teams and participants were not blind to treatment allocation. Setting The trial took place in 35 hospitals and seven primary care practices in the UK. Participants Children aged 6–15 years with a diagnosis of asthma who were currently prescribed inhaled corticosteroids and who had...

Behavioural optimisation to address trial conduct challenges: case study in the UK-REBOA trial

Trials

Background Clinical trials comprise multiple processes at various stages of the trial lifecycle. ... more Background Clinical trials comprise multiple processes at various stages of the trial lifecycle. These processes often involve complex behaviours such as recruiting vulnerable patient populations and clinicians having to deliver complex trial interventions successfully. Few studies have utilised a behavioural framework to assess challenges and develop strategies for effective trial recruitment and delivery of trial interventions. This study reports the application of an innovative methodological approach to understand core trial processes, namely recruitment and intervention delivery, using a behavioural science approach to develop strategies designed to mitigate trial process problems. Methods The UK-REBOA trial aims to evaluate the clinical and cost-effectiveness of resuscitative endovascular balloon occlusion of the aorta (a novel intervention) in injured patients with exsanguinating haemorrhage. A behavioural investigation (‘diagnosis’) was conducted using theory-informed (Theor...

Behavioural approaches to recruitment and retention in clinical trials: a systematic mapping review

BMJ Open, 2022

ObjectivesTo identify studies that applied behavioural approaches to issues of recruitment and/or... more ObjectivesTo identify studies that applied behavioural approaches to issues of recruitment and/or retention to trials; to describe these approaches; and to identify gaps for future research.DesignSystematic mapping review of research undertaken in clinical trials within peer-reviewed sources. Review participants were individuals involved in clinical trials, including trial staff, participants, potential participants and former participants.Data sourcesMEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Web of Science and ASSIA from inception to 15 January 2020 with no date or language restrictions.Eligibility criteriaStudies within the context of clinical trials reporting the barriers/facilitators to recruitment and retention, or developing/evaluating solutions to said barriers/facilitators, using a behavioural approach.Results31 articles were included. Recruitment-focused studies (n=22, 71%) represented the majority. Studies tended to focus on participant behaviours (n=22, 71%). Underserved p...

Using a behavioural approach to explore the factors that affect questionnaire return within a clinical trial: a qualitative study based on the theoretical domains framework

BMJ Open, 2021

ObjectivesTo identify barriers and enablers to participant retention in trials requiring question... more ObjectivesTo identify barriers and enablers to participant retention in trials requiring questionnaire return using the theoretical domains framework (TDF).Study design and settingWe identified and subsequently invited participants who did not return at least one questionnaire during their participation in a clinical trial for one-to-one semi-structured telephone interviews. We used a behavioural framework (TDF) to explore whether any of the behavioural domains (eg, beliefs about consequences, emotion) affected questionnaire return. Thereafter, we generated a series of belief statements which summarised the content of participants’ main responses and coded these under separate themes.ParticipantsWe distributed invites to 279 eligible individuals and subsequently interviewed 9 participants who took part in the C-Gall trial. The C-Gall trial required participants to complete five postal questionnaires during their participation.ResultsNine participants were interviewed. We developed 7...

Theory-guided interviews identified behavioral barriers and enablers to healthcare professionals recruiting participants to maternity trials

Journal of Clinical Epidemiology, 2022

OBJECTIVE To conduct a behavioural investigation, using the Theoretical Domains Framework (TDF), ... more OBJECTIVE To conduct a behavioural investigation, using the Theoretical Domains Framework (TDF), to identify barriers and enablers to maternity healthcare professionals (HCP) inviting all eligible women to participate in a maternity care trial. STUDY DESIGN AND SETTING We invited HCP recruiters from maternity care trials in high priority research areas including, diabetes, preeclampsia and breastfeeding, from across Ireland and the UK, to take part in a semi-structured interview. Data collection was informed by the TDF, followed by inductive thematic analysis and deductive mapping to the TDF. RESULTS Twenty-two recruiters including midwives, nurses, allied health professionals and doctors were interviewed online or by telephone phone. Thematic analysis generated four global themes; Availability and accessibility of resources, Navigating the recruitment pathway, Prioritising clinical responsibilities over research responsibilities and The influence of colleagues and peers. Themes were mapped to the TDF, identifying 13 domains relevant to the behaviour. CONCLUSION This paper identifies the factors enabling or inhibiting maternity HCP recruiters to invite all eligible women to participate in a maternity care trial. The findings provide guidance for researchers designing trials for this population and the essential first step in developing a recruiter-focused behaviour change intervention to support recruitment to trials in maternity care.

The Effects of Adult Aging and Culture on Theory of Mind

The Journals of Gerontology: Series B, 2021

Objectives Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts,... more Objectives Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (the United Kingdom vs. Malaysia). Methods We used 2 ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status, and WM. A total of 298 participants from the United Kingdom and Malaysia completed faux pas, false belief, and WM tasks. Results Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief, and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating ...

Including a pen and/or cover letter, containing social incentive text, had no effect on questionnaire response rate: a factorial randomised controlled Study within a Trial [version 1; peer review: 1 approved with reservations]

F1000Research, 2020

Peer Review Report For: A protocol for the establishment and evaluation of an older adult stakeholder panel for health services research [version 1; peer review: 1 approved, 1 approved with reservations]

A maturing picture of emotion

Psychologist, 2016

on how we process emotions in ourselves and others as we age The Psychologist is the monthly publ... more on how we process emotions in ourselves and others as we age The Psychologist is the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, 'to promote the advancement and diffusion of a knowledge of psychology pure and applied'.