Background:Bone-anchored hearing aids improve hearing for patients for whom conventional behind-t... more Background:Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case.Method:A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed.Results:Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids.Conclusion:Important avenues for further res...
, A. (2016). Do evidence based interventions for chronic fatigue syndrome improve sleep? A system... more , A. (2016). Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis. Sleep Medicine Reviews.
Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) ... more Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) intake and infant cognition has yet to assess whether there is a critical trimester for the observed effects. We used a comprehensive Food Frequency Questionnaire to estimate DHA levels during both the second and third trimesters of pregnancy, in a sample of 125 pregnant women. Infants were assessed at 4.5 months and 9 months post-partum using specific tests of visual acuity, habituation, and visual attention. Based on maternal DHA levels during pregnancy, mothers were subdivided into high, medium, and low groups, and their infants compared for task performance using one-way ANOVAs with maternal DHA groups. On the 9 month visual acuity test, infants whose mothers were in the medium DHA group performed significantly better than those with mothers in the low or high DHA groups (p = 0.008). However, no significant finding was found for any of the other cognitive assessment measures. Despite a number of studies reporting a positive effect of higher DHA levels on cognitive development, this study fails to support those conclusions. We can, however, conclude that it appears to be DHA intake in the third trimester specifically, which is influencing the development of visual acuity towards the end of the first postnatal year.
Adolescence is a difficult time for people with diabetes and it is often accompanied by a deterio... more Adolescence is a difficult time for people with diabetes and it is often accompanied by a deterioration in blood glucose control. This article looks at the effect the attitudes of peers can have on adolescents with diabetes. Three focus groups of 12-14 year olds were asked about their knowledge of diabetes and were then presented with realistic vignettes about the condition, which they discussed. They then took part in a myth-busting session to help address misconceptions. The research team identified themes that emerged from the focus groups. Their findings suggest that a positive peer group may be an important factor in good management of diabetes in young people. The research team suggest that more education about the condition is needed in schools, and should be designed in collaboration with young people with diabetes.
OBJECTIVES To identify interventions aimed at increasing physical activity (PA) levels among Sout... more OBJECTIVES To identify interventions aimed at increasing physical activity (PA) levels among South Asian (SA) adults and identify the specific changes in the content and delivery mode of interventions designed to increase PA levels among SA people aged ≥18 years. DESIGN A systematic review of quantitative studies. DATA SYNTHESIS Extracted data were synthesized using a narrative approach. DATA SOURCES ASSIA, CINHAL, EMBASE, Medline, SPORTDiscus and PsychINFO were searched. Included articles met the following criteria: (1) population: community-dwelling SA adults aged ≥18 years and (2) outcome: reporting determinants of PA, exercise, or a combination of the two, measured objectively or using self-report. The search was restricted to articles published in the English language up to 31 January 2017. RESULTS Fifteen trials/programmes (16 articles) met the review criteria. The findings show that involving the target community in developing culturally appropriate interventions appears to b...
In the present research, we examined whether attachment anxiety and avoidance in support recipien... more In the present research, we examined whether attachment anxiety and avoidance in support recipients were related to preferences for specific types of support. In addition, we examined whether stress moderated the relationship between attachment and support needs. Two-hundred and forty-five first-time mothers, currently involved in romantic relationships, participated in study 1, in which support needs and stress were appraised over the previous month using self-reports. High levels of attachment avoidance were related to needing less support, but attachment anxiety was not associated with support needs. There was no hyperactivation or deactivation of the attachment system in response to stress. It is possible that recall bias, associated with cross-sectional methods, may have confounded the results. In study 2, we sought to replicate these hypotheses using an ambulatory method to examine the association between attachment and momentary support needs in the daily life of mothers with...
Background/Aims There is evidence for non-pharmacological interventions to support patients to s... more Background/Aims There is evidence for non-pharmacological interventions to support patients to self-manage fatigue, however implementation in clinical practice is a challenge. LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using a remotely delivered cognitive-behavioural approach (CBA) or personalized exercise programme (PEP) interventions, in addition to usual care, compared to normal care alone. Interventions were delivered to patients by rheumatology health professionals using a manual, after training. The aim of this nested qualitative evaluation was to understand their perspectives of delivering the interventions. Methods A subgroup of rheumatology healthcare professionals who had delivered the CBA and PEP interventions took part in semi-structured telephone interviews to explore their experiences of training and delivery, the challenges and benefits of learning new skills, and the bar...
Background/Aims Fatigue is a substantial, disabling symptom of inflammatory rheumatic diseases (... more Background/Aims Fatigue is a substantial, disabling symptom of inflammatory rheumatic diseases (IRDs). LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using remotely delivered cognitive-behavioral approach (CBA) and personalised exercise programme (PEP) interventions, compared to normal care alone, with the aim to lessen the impact of fatigue in patients with IRDs. Most sessions were delivered by telephone. This nested qualitative study explored patients’ experiences of taking part in the interventions. Methods A subgroup of patients who had completed follow-up after the LIFT trial took part in semi-structured telephone interviews to discuss their views and experiences of the interventions and subsequent impact on their lives. Results Participants were purposively sampled from six UK research sites to include variation in gender, age and IRDs. A total of 47 participants (33 women, 14 men) f...
OBJECTIVES Bone conduction hearing implants (BCHIs) are an effective option to rehabilitate heari... more OBJECTIVES Bone conduction hearing implants (BCHIs) are an effective option to rehabilitate hearing for people who cannot use conventional, air conduction hearing aids. However, the uptake of such devices in the United Kingdom is lower than might be expected, and the reasons for this are not fully understood. The present study used qualitative methods to explore decision-making about whether to accept or reject BCHIs. DESIGN Semistructured telephone interviews were conducted with 17 BCHI candidates who had recently accepted or rejected BCHIs. RESULTS A thematic analysis identified four overarching themes: participants wanted to look and feel normal; potential risks were weighed against rewards; participants felt that there was a "right time" to have a BCHI; and information from clinicians and BCHI users was treated differently. Participants' perceptions of normality were influential in the final decision, and the BHCI was seen either as a barrier or facilitator of this. Participants consistently weighed up potential advantages and disadvantages of BCHIs, with potential for hearing improvement typically used as a benchmark against which other factors were measured. Some participants who rejected BCHIs felt that they could reconsider having a BCHI when they felt the time was right for them. Participants highly valued advice from clinicians, but felt that their expertise lacked validity as clinicians typically did not have experience of using BCHIs themselves. CONCLUSIONS The decision to accept or reject a BCHI was highly individual. Each participant considered a range of factors; the influence of each factor depended on the individual's perceptions and experiences. This work highlights the importance of clinical staff being able to explore the individual priorities and concerns of each patient to ensure that patients feel happy and confident with the decision that they make.
Background The transition onto dialysis is a stressful time that affects both patients and their ... more Background The transition onto dialysis is a stressful time that affects both patients and their partners. Research suggests that psychological and interpersonal characteristics within the couple are related to how well they adapt to dialysis. The aim of this multi-phase, mixed methods study was to develop a measure, the Starting Dialysis Questionnaire (SDQ), that is applicable to both patients and their partners and assesses their own thoughts and feelings about these constructs. Methods Data from semi-structured interviews with patients and their partners (n = 22 couples) were analysed using theoretical thematic analysis to identify and define constructs related to quality of life (QOL). Next, items addressing these constructs were derived from the interviews. Then, cognitive interviews were conducted with patients with chronic kidney disease and their partners (n = 5 couples) to assess the face validity and comprehensibility of the items. Lastly, preliminary psychometric properti...
Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) ... more Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) intake and infant cognition has yet to assess whether there is a critical trimester for the observed effects. We used a comprehensive Food Frequency Questionnaire to estimate DHA levels during both the second and third trimesters of pregnancy, in a sample of 125 pregnant women. Infants were assessed at 4.5 months and 9 months post-partum using specific tests of visual acuity, habituation, and visual attention. Based on maternal DHA levels during pregnancy, mothers were subdivided into high, medium, and low groups, and their infants compared for task performance using one-way ANOVAs with maternal DHA groups. On the 9 month visual acuity test, infants whose mothers were in the medium DHA group performed significantly better than those with mothers in the low or high DHA groups (p = 0.008). However, no significant finding was found for any of the other cognitive assessment measures. Despite a number of studies reporting a positive effect of higher DHA levels on cognitive development, this study fails to support those conclusions. We can, however, conclude that it appears to be DHA intake in the third trimester specifically, which is influencing the development of visual acuity towards the end of the first postnatal year.
Running head: Male HHD patients' experiences of self-cannulation How an ordeal becomes the norm: ... more Running head: Male HHD patients' experiences of self-cannulation How an ordeal becomes the norm: A qualitative exploration of experiences of selfcannulation in male home haemodialysis patients.
OBJECTIVE: High prevalence of sedentary behaviour is seen in most immigrant groups in Western cou... more OBJECTIVE: High prevalence of sedentary behaviour is seen in most immigrant groups in Western countries, particularly in those from the Indian subcontinent. The primary objective of this study was to determine the socio-cognitive associations with intention to undertake physical activity (PA) among separate groups of Indian, Pakistani and Bangladeshi older adults aged ≥60 in the North West of England, UK. STUDY DESIGN: Cross-sectional survey. METHODS: Using a cross-sectional survey, informed by the Theory of Planned Behaviour (TPB), 138/964 South Asian (SA) older adults completed a mailed questionnaire that assessed self-reported PA and TPB variables. RESULTS: Associations were seen in beliefs about PA and the amount of PA undertaken (rho=0.18, p=0.04). Attitude was correlated with intention (rho = 0.29, p = 0.01) and amount of PA undertaken (rho=0.21, p=0.02). Subjective norm was correlated with intention to undertake PA (rho=0.21, p=0.02). Between-group differences were seen between: (1) Indian and Pakistani group's in subjective norm (2) all ethnicities in intention to undertake PA and (3) in the amount and attitude to undertaking PA between men and women. Co-morbidity was associated with beliefs about PA uptake. CONCLUSIONS: Subgroup differences between Indian, Pakistani and Bangladeshi older adults in subjective norm and intention to undertaking PA highlight the importance of tailoring interventions to accommodate for subgroup differences when developing culturally appropriate PA interventions aimed at increasing uptake and adherence.
Background:Bone-anchored hearing aids improve hearing for patients for whom conventional behind-t... more Background:Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case.Method:A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed.Results:Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids.Conclusion:Important avenues for further res...
, A. (2016). Do evidence based interventions for chronic fatigue syndrome improve sleep? A system... more , A. (2016). Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis. Sleep Medicine Reviews.
Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) ... more Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) intake and infant cognition has yet to assess whether there is a critical trimester for the observed effects. We used a comprehensive Food Frequency Questionnaire to estimate DHA levels during both the second and third trimesters of pregnancy, in a sample of 125 pregnant women. Infants were assessed at 4.5 months and 9 months post-partum using specific tests of visual acuity, habituation, and visual attention. Based on maternal DHA levels during pregnancy, mothers were subdivided into high, medium, and low groups, and their infants compared for task performance using one-way ANOVAs with maternal DHA groups. On the 9 month visual acuity test, infants whose mothers were in the medium DHA group performed significantly better than those with mothers in the low or high DHA groups (p = 0.008). However, no significant finding was found for any of the other cognitive assessment measures. Despite a number of studies reporting a positive effect of higher DHA levels on cognitive development, this study fails to support those conclusions. We can, however, conclude that it appears to be DHA intake in the third trimester specifically, which is influencing the development of visual acuity towards the end of the first postnatal year.
Adolescence is a difficult time for people with diabetes and it is often accompanied by a deterio... more Adolescence is a difficult time for people with diabetes and it is often accompanied by a deterioration in blood glucose control. This article looks at the effect the attitudes of peers can have on adolescents with diabetes. Three focus groups of 12-14 year olds were asked about their knowledge of diabetes and were then presented with realistic vignettes about the condition, which they discussed. They then took part in a myth-busting session to help address misconceptions. The research team identified themes that emerged from the focus groups. Their findings suggest that a positive peer group may be an important factor in good management of diabetes in young people. The research team suggest that more education about the condition is needed in schools, and should be designed in collaboration with young people with diabetes.
OBJECTIVES To identify interventions aimed at increasing physical activity (PA) levels among Sout... more OBJECTIVES To identify interventions aimed at increasing physical activity (PA) levels among South Asian (SA) adults and identify the specific changes in the content and delivery mode of interventions designed to increase PA levels among SA people aged ≥18 years. DESIGN A systematic review of quantitative studies. DATA SYNTHESIS Extracted data were synthesized using a narrative approach. DATA SOURCES ASSIA, CINHAL, EMBASE, Medline, SPORTDiscus and PsychINFO were searched. Included articles met the following criteria: (1) population: community-dwelling SA adults aged ≥18 years and (2) outcome: reporting determinants of PA, exercise, or a combination of the two, measured objectively or using self-report. The search was restricted to articles published in the English language up to 31 January 2017. RESULTS Fifteen trials/programmes (16 articles) met the review criteria. The findings show that involving the target community in developing culturally appropriate interventions appears to b...
In the present research, we examined whether attachment anxiety and avoidance in support recipien... more In the present research, we examined whether attachment anxiety and avoidance in support recipients were related to preferences for specific types of support. In addition, we examined whether stress moderated the relationship between attachment and support needs. Two-hundred and forty-five first-time mothers, currently involved in romantic relationships, participated in study 1, in which support needs and stress were appraised over the previous month using self-reports. High levels of attachment avoidance were related to needing less support, but attachment anxiety was not associated with support needs. There was no hyperactivation or deactivation of the attachment system in response to stress. It is possible that recall bias, associated with cross-sectional methods, may have confounded the results. In study 2, we sought to replicate these hypotheses using an ambulatory method to examine the association between attachment and momentary support needs in the daily life of mothers with...
Background/Aims There is evidence for non-pharmacological interventions to support patients to s... more Background/Aims There is evidence for non-pharmacological interventions to support patients to self-manage fatigue, however implementation in clinical practice is a challenge. LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using a remotely delivered cognitive-behavioural approach (CBA) or personalized exercise programme (PEP) interventions, in addition to usual care, compared to normal care alone. Interventions were delivered to patients by rheumatology health professionals using a manual, after training. The aim of this nested qualitative evaluation was to understand their perspectives of delivering the interventions. Methods A subgroup of rheumatology healthcare professionals who had delivered the CBA and PEP interventions took part in semi-structured telephone interviews to explore their experiences of training and delivery, the challenges and benefits of learning new skills, and the bar...
Background/Aims Fatigue is a substantial, disabling symptom of inflammatory rheumatic diseases (... more Background/Aims Fatigue is a substantial, disabling symptom of inflammatory rheumatic diseases (IRDs). LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a multi-centre three-arm randomised trial using remotely delivered cognitive-behavioral approach (CBA) and personalised exercise programme (PEP) interventions, compared to normal care alone, with the aim to lessen the impact of fatigue in patients with IRDs. Most sessions were delivered by telephone. This nested qualitative study explored patients’ experiences of taking part in the interventions. Methods A subgroup of patients who had completed follow-up after the LIFT trial took part in semi-structured telephone interviews to discuss their views and experiences of the interventions and subsequent impact on their lives. Results Participants were purposively sampled from six UK research sites to include variation in gender, age and IRDs. A total of 47 participants (33 women, 14 men) f...
OBJECTIVES Bone conduction hearing implants (BCHIs) are an effective option to rehabilitate heari... more OBJECTIVES Bone conduction hearing implants (BCHIs) are an effective option to rehabilitate hearing for people who cannot use conventional, air conduction hearing aids. However, the uptake of such devices in the United Kingdom is lower than might be expected, and the reasons for this are not fully understood. The present study used qualitative methods to explore decision-making about whether to accept or reject BCHIs. DESIGN Semistructured telephone interviews were conducted with 17 BCHI candidates who had recently accepted or rejected BCHIs. RESULTS A thematic analysis identified four overarching themes: participants wanted to look and feel normal; potential risks were weighed against rewards; participants felt that there was a "right time" to have a BCHI; and information from clinicians and BCHI users was treated differently. Participants' perceptions of normality were influential in the final decision, and the BHCI was seen either as a barrier or facilitator of this. Participants consistently weighed up potential advantages and disadvantages of BCHIs, with potential for hearing improvement typically used as a benchmark against which other factors were measured. Some participants who rejected BCHIs felt that they could reconsider having a BCHI when they felt the time was right for them. Participants highly valued advice from clinicians, but felt that their expertise lacked validity as clinicians typically did not have experience of using BCHIs themselves. CONCLUSIONS The decision to accept or reject a BCHI was highly individual. Each participant considered a range of factors; the influence of each factor depended on the individual's perceptions and experiences. This work highlights the importance of clinical staff being able to explore the individual priorities and concerns of each patient to ensure that patients feel happy and confident with the decision that they make.
Background The transition onto dialysis is a stressful time that affects both patients and their ... more Background The transition onto dialysis is a stressful time that affects both patients and their partners. Research suggests that psychological and interpersonal characteristics within the couple are related to how well they adapt to dialysis. The aim of this multi-phase, mixed methods study was to develop a measure, the Starting Dialysis Questionnaire (SDQ), that is applicable to both patients and their partners and assesses their own thoughts and feelings about these constructs. Methods Data from semi-structured interviews with patients and their partners (n = 22 couples) were analysed using theoretical thematic analysis to identify and define constructs related to quality of life (QOL). Next, items addressing these constructs were derived from the interviews. Then, cognitive interviews were conducted with patients with chronic kidney disease and their partners (n = 5 couples) to assess the face validity and comprehensibility of the items. Lastly, preliminary psychometric properti...
Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) ... more Previous research suggesting an association between maternal prenatal docosahexaenoic acid (DHA) intake and infant cognition has yet to assess whether there is a critical trimester for the observed effects. We used a comprehensive Food Frequency Questionnaire to estimate DHA levels during both the second and third trimesters of pregnancy, in a sample of 125 pregnant women. Infants were assessed at 4.5 months and 9 months post-partum using specific tests of visual acuity, habituation, and visual attention. Based on maternal DHA levels during pregnancy, mothers were subdivided into high, medium, and low groups, and their infants compared for task performance using one-way ANOVAs with maternal DHA groups. On the 9 month visual acuity test, infants whose mothers were in the medium DHA group performed significantly better than those with mothers in the low or high DHA groups (p = 0.008). However, no significant finding was found for any of the other cognitive assessment measures. Despite a number of studies reporting a positive effect of higher DHA levels on cognitive development, this study fails to support those conclusions. We can, however, conclude that it appears to be DHA intake in the third trimester specifically, which is influencing the development of visual acuity towards the end of the first postnatal year.
Running head: Male HHD patients' experiences of self-cannulation How an ordeal becomes the norm: ... more Running head: Male HHD patients' experiences of self-cannulation How an ordeal becomes the norm: A qualitative exploration of experiences of selfcannulation in male home haemodialysis patients.
OBJECTIVE: High prevalence of sedentary behaviour is seen in most immigrant groups in Western cou... more OBJECTIVE: High prevalence of sedentary behaviour is seen in most immigrant groups in Western countries, particularly in those from the Indian subcontinent. The primary objective of this study was to determine the socio-cognitive associations with intention to undertake physical activity (PA) among separate groups of Indian, Pakistani and Bangladeshi older adults aged ≥60 in the North West of England, UK. STUDY DESIGN: Cross-sectional survey. METHODS: Using a cross-sectional survey, informed by the Theory of Planned Behaviour (TPB), 138/964 South Asian (SA) older adults completed a mailed questionnaire that assessed self-reported PA and TPB variables. RESULTS: Associations were seen in beliefs about PA and the amount of PA undertaken (rho=0.18, p=0.04). Attitude was correlated with intention (rho = 0.29, p = 0.01) and amount of PA undertaken (rho=0.21, p=0.02). Subjective norm was correlated with intention to undertake PA (rho=0.21, p=0.02). Between-group differences were seen between: (1) Indian and Pakistani group's in subjective norm (2) all ethnicities in intention to undertake PA and (3) in the amount and attitude to undertaking PA between men and women. Co-morbidity was associated with beliefs about PA uptake. CONCLUSIONS: Subgroup differences between Indian, Pakistani and Bangladeshi older adults in subjective norm and intention to undertaking PA highlight the importance of tailoring interventions to accommodate for subgroup differences when developing culturally appropriate PA interventions aimed at increasing uptake and adherence.
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