Polymyalgia Rheumatica (PMR) Special Interest Group at OMERACT 11: outcomes of importance for patients with PMR

We worked toward developing a core outcome set for clinical research studies in polymyalgia rheumatica (PMR) by conducting (1) patient consultations using modified nominal group technique; (2) a systematic literature review of outcome measures in PMR; (3) a pilot observational study of patients presenting with untreated PMR, and further discussion with patient research partners; and (4) a qualitative focus group study of patients with PMR on the meaning of stiffness, using thematic analysis. (1) Consultations included 104 patients at 4 centers. Symptoms of PMR included pain, stiffness, fatigue, and sleep disturbance. Function, anxiety, and depression were also often mentioned. Participants expressed concerns about diagnostic delay, adverse effects of glucocorticoids, and fear of relapse. (2) In the systematic review, outcome measures previously used for PMR include pain visual analog scores (VAS), morning stiffness, blood markers, function, and quality of life; standardized effect sizes posttreatment were large. (3) Findings from the observational study indicated that asking about symptom severity at 7 AM, or "on waking," appeared more relevant to disease activity than asking about symptom severity "now" (which depended on the time of assessment). (4) Preliminary results were presented from the focus group qualitative study, encompassing broad themes of stiffness, pain, and the effect of PMR on patients' lives. It was concluded that further validation work is required before a core outcome set in PMR can be recommended. Nevertheless, the large standardized effect sizes suggest that pain VAS is likely to be satisfactory as a primary outcome measure for assessing response to initial therapy of PMR. Dissection of between-patient heterogeneity in the subsequent treatment course may require attention to comorbidity as a potential confounding factor

Digital times: Disseminating your work and networking

This fifth and final article in the Writing for Publication series aims to provide guidance on disseminating your work and increasing professional networks through the use of social media. We will outline a range of different ways in which nurses can write about their research via blogs, and use Twitter to both grow their professional networks, and disseminate their work. Increasingly, health professionals are using social media and online resources to communicate with each other; advantages include connecting with interested others worldwide, and being able to access an audience far beyond that which could be accessed locally or via conferences

Polymyalgia Rheumatica (PMR) Special Interest Group at OMERACT 11: outcomes of importance for patients with PMR

We worked toward developing a core outcome set for clinical research studies in polymyalgia rheumatica (PMR) by conducting (1) patient consultations using modified nominal group technique; (2) a systematic literature review of outcome measures in PMR; (3) a pilot observational study of patients presenting with untreated PMR, and further discussion with patient research partners; and (4) a qualitative focus group study of patients with PMR on the meaning of stiffness, using thematic analysis. (1) Consultations included 104 patients at 4 centers. Symptoms of PMR included pain, stiffness, fatigue, and sleep disturbance. Function, anxiety, and depression were also often mentioned. Participants expressed concerns about diagnostic delay, adverse effects of glucocorticoids, and fear of relapse. (2) In the systematic review, outcome measures previously used for PMR include pain visual analog scores (VAS), morning stiffness, blood markers, function, and quality of life; standardized effect sizes posttreatment were large. (3) Findings from the observational study indicated that asking about symptom severity at 7 AM, or "on waking," appeared more relevant to disease activity than asking about symptom severity "now" (which depended on the time of assessment). (4) Preliminary results were presented from the focus group qualitative study, encompassing broad themes of stiffness, pain, and the effect of PMR on patients' lives. It was concluded that further validation work is required before a core outcome set in PMR can be recommended. Nevertheless, the large standardized effect sizes suggest that pain VAS is likely to be satisfactory as a primary outcome measure for assessing response to initial therapy of PMR. Dissection of between-patient heterogeneity in the subsequent treatment course may require attention to comorbidity as a potential confounding factor

Developing and producing a focused conference poster

This fourth article in the Writing for Publication series aims to provide guidance on developing and producing a poster presentation for a conference. Most academic conferences offer opportunities for health professionals to present their work as an oral presentation or a poster; an earlier paper in this series discussed the submission of abstracts to conference organisers for consideration. Planning, preparing and producing a poster presentation requires different skills from those used when giving an oral presentation. These are examined in this paper by outlining what is meant by a poster presentation, and discussing key issues to consider when planning and producing a poster, and when presenting it at a conference

Enhancing communication and engagement between people living with dementia and health care professionals across the well pathway for dementia

This thesis is a submission of eight published papers with a critical commentary to meet the requirements for a DPhil in accordance with the regulations of the University of the West of England (UWE, Bristol). These papers have resulted from three projects that I have worked on over the last seven years as a trial manager at UWE Bristol.This thesis demonstrates how my work has generated new knowledge in the field of psychosocial approaches to dementia care. These projects share a common focus of person centred care in dementia. The findings from these projects add to the body of evidence for interventions to improve communication, interaction and engagement between health care professionals and people living with dementia within the different phases of the Well Pathway for Dementia. Project 1 adds to the knowledge around locating the assessment and diagnosis of dementia in primary care with a greater role for GPs and nurses in these processes. In project 2 I studied an intervention designed to improve support and engagement between staff and patients on older psychiatric inpatient units. Finally, in project 3 I researched ways in which the psychosocial threat of dementia can lead to a pattern of selective forgetting which inhibits communication and how nostalgic memories could alleviate this pattern of forgetting which could help people live well with dementia.Within this critical commentary I demonstrate my intellectual contributions to these projects and papers, how I have developed my research skills and competencies and how I fulfil the six UWE Bristol doctoral descriptors

The challenge of rescheduling nursing staff: Informing the development of a mathematical model decision tool

Executive Summary: This report presents the findings and recommendations from a preliminary investigation into how an NHS organisation manages sudden nursing staff shortfalls. Unexpected staff absences, which can occur on a daily basis, can impact on the optimum skill mix for safe effective care delivery. Ward managers would welcome methodological support for daily rescheduling staff (i.e., re-rostering) within electronic rostering system

Family presence during resuscitation: Validation of the risk–benefit and self-confidence scales for student nurses

© 2016, © The Author(s) 2016. Background. There is increasing debate about the advantages and disadvantages of family-witnessed resuscitation. Research about the views of healthcare providers depends upon reliable tools to measure their perceptions. Two tools have been developed for use with nurses (26-item cost-benefit tool, 17-item self-confidence tool). Objectives. Firstly, to validate these tools for use with student nurses in the UK. Secondly, to report on the perceived risks and benefits reported by student nurses, and their self-confidence in dealing with this situation. Methods. A sample of 79 student nurses were invited to complete the tools. Item-total correlations and Cronbach’s α were used to determine internal consistency. Factor analysis was computed to assess construct validity. The correlation between the two scales was explored. Results. 69 students completed a questionnaire. Very few had experience of family-witnessed resuscitation. Mean total scores were 3.16 (standard deviation 0.37; range 2.04–4.12) on the risk-benefit scale and 3.14 (standard deviation 0.66; range 1.94–4.82) on the self-confidence scale. Four of the original items were removed from the risk-benefit scale (Cronbach's α 0.86; 95% confidence interval ≥0.82). None were removed from the self-confidence scale (Cronbach's α 0.93; 95% confidence interval ≥0.91). There was a significant correlation between the two scales (r = 0.37, p = 0.002). Conclusions. There is growing evidence that these tools are valid and reliable for measuring student nurses’ perceptions about family-witnessed resuscitation

Physiotherapy management of lower limb osteoarthritis

© The Author 2017. Published by Oxford University Press. Background Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition. Sources of data Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK. Areas of agreement There is strongest evidence to support the use of exercise to improve pain, function and quality of life. Areas of controversy There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture. Growing points Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions. Areas timely for developing research Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation