6,712 research outputs found

    Undergraduate Catalog of Studies, 2023-2024

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    Taser and Social, Ethnic and Racial Disparities research programme

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    Report from the 'Taser use and its association with social, ethnic and racial disparities in policing (TASERD)' research project. The research project was initiated by the National Police Chiefs’ Council and commissioned by the College of Policing, after their Officer and Staff Safety Review (OSSR) in 2019 found there was growing evidence to suggest that Tasers were being used disproportionately in society. It was carried out by researchers from Keele University, UCL, The University of Exeter and Staffordshire University.National Police Chiefs’ CouncilLondon’s Mayor's Office for Policing and Crime (MOPAC

    Pragmatic randomised controlled trial of guided self-help versus individual cognitive behavioural therapy with a trauma focus for post-traumatic stress disorder (RAPID)

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    This is the final version. Available on open access from the NIHR Journals Library via the DOI in this recordData availability: All available data can be obtained from the corresponding author.BACKGROUND: Guided self-help has been shown to be effective for other mental conditions and, if effective for post-traumatic stress disorder, would offer a time-efficient and accessible treatment option, with the potential to reduce waiting times and costs. OBJECTIVE: To determine if trauma-focused guided self-help is non-inferior to individual, face-to-face cognitive-behavioural therapy with a trauma focus for mild to moderate post-traumatic stress disorder to a single traumatic event. DESIGN: Multicentre pragmatic randomised controlled non-inferiority trial with economic evaluation to determine cost-effectiveness and nested process evaluation to assess fidelity and adherence, dose and factors that influence outcome (including context, acceptability, facilitators and barriers, measured qualitatively). Participants were randomised in a 1 : 1 ratio. The primary analysis was intention to treat using multilevel analysis of covariance. SETTING: Primary and secondary mental health settings across the United Kingdom's National Health Service. PARTICIPANTS: One hundred and ninety-six adults with a primary diagnosis of mild to moderate post-traumatic stress disorder were randomised with 82% retention at 16 weeks and 71% at 52 weeks. Nineteen participants and ten therapists were interviewed for the process evaluation. INTERVENTIONS: Up to 12 face-to-face, manualised, individual cognitive-behavioural therapy with a trauma focus sessions, each lasting 60-90 minutes, or to guided self-help using Spring, an eight-step online guided self-help programme based on cognitive-behavioural therapy with a trauma focus, with up to five face-to-face meetings of up to 3 hours in total and four brief telephone calls or e-mail contacts between sessions. MAIN OUTCOME MEASURES: Primary outcome: the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, at 16 weeks post-randomisation. Secondary outcomes: included severity of post-traumatic stress disorder symptoms at 52 weeks, and functioning, symptoms of depression, symptoms of anxiety, alcohol use and perceived social support at both 16 and 52 weeks post-randomisation. Those assessing outcomes were blinded to group assignment. RESULTS: Non-inferiority was demonstrated at the primary end point of 16 weeks on the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [mean difference 1.01 (one-sided 95% CI -∞ to 3.90, non-inferiority p = 0.012)]. Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, score improvements of over 60% in both groups were maintained at 52 weeks but the non-inferiority results were inconclusive in favour of cognitive-behavioural therapy with a trauma focus at this timepoint [mean difference 3.20 (one-sided 95% confidence interval -∞ to 6.00, non-inferiority p = 0.15)]. Guided self-help using Spring was not shown to be more cost-effective than face-to-face cognitive-behavioural therapy with a trauma focus although there was no significant difference in accruing quality-adjusted life-years, incremental quality-adjusted life-years -0.04 (95% confidence interval -0.10 to 0.01) and guided self-help using Spring was significantly cheaper to deliver [£277 (95% confidence interval £253 to £301) vs. £729 (95% CI £671 to £788)]. Guided self-help using Spring appeared to be acceptable and well tolerated by participants. No important adverse events or side effects were identified. LIMITATIONS: The results are not generalisable to people with post-traumatic stress disorder to more than one traumatic event. CONCLUSIONS: Guided self-help using Spring for mild to moderate post-traumatic stress disorder to a single traumatic event appears to be non-inferior to individual face-to-face cognitive-behavioural therapy with a trauma focus and the results suggest it should be considered a first-line treatment for people with this condition. FUTURE WORK: Work is now needed to determine how best to effectively disseminate and implement guided self-help using Spring at scale. TRIAL REGISTRATION: This trial is registered as ISRCTN13697710. FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/97) and is published in full in Health Technology Assessment; Vol. 27, No. 26. See the NIHR Funding and Awards website for further award information.National Institute for Health and Care Research (NIHR

    An Ethnographic Study of Interprofessional Collaboration in Palliative Care

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    Background: The concept of the modern palliative care movement was initially developed by Cecily Saunders. She believed that the complex emotional, physical, and spiritual needs of dying patients and their families were best met by a team of professionals working together rather than a sole practitioner. Today local, national, and international definitions of palliative care remain grounded in the philosophy established by Saunders, where care is most effectively delivered by an interprofessional team working in a collaborative manner to support patient and family centred goals. Research Aim: The purpose of this study was to better understand the differences in interprofessional collaboration between palliative care teams in different clinical settings. The research questions were: 1) Do palliative care providers believe interprofessional collaboration is important? and 2) What are the contextual factors that act as either facilitators or barriers to the implementation of interprofessional collaboration in practice? Methods: A qualitative ethnographic methodology was used to understand the factors impacting interprofessional collaboration in three separate teams providing palliative care in different settings in a city in Western Canada. Data were collected and analyzed using Carspecken’s five step process for ethnographic research. Participant observation and focus groups were conducted with interprofessional team members responsible for providing direct care for palliative care patients/families. Findings: Five themes emerged from the data: Interprofessional Collaboration: A Central Tenet of Palliative Care; Interprofessional Communication: The Single Most Important Ingredient for Effective Interprofessional Collaboration; Professional Hierarchy Impacts Interprofessional Collaboration; Role Understanding and Valuing Others; and Facilitators and Barriers to Team Function. Discussion: Findings from this study can be used to better understand how individual, professional, and organizational culture impacts teamwork in the delivery of palliative care and supports opportunities for understanding and mitigating the barriers to interprofessional collaboration in palliative care settings. The structure and values of the team impact interprofessional collaboration: how communication is enacted; how the hierarchy of the team influences who is viewed as having the ultimate authority over care; and how role understanding and valuing others drives interactions with other members of the team

    The use of proxies in designing for and with autistic children: supporting friendship as a case study

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    Participatory Design (PD) is an approach for designing new technologies which involves end users in the design process. It is generally accepted that involving users in the design process gives them a sense of ownership over the final product which enhances its usability and acceptance by the target population. Employing a PD approach can introduce multiple challenges especially when working with autistic children. Many approaches for involving autistic children and children with special needs were developed to address these challenges. However, these frameworks introduce their own limitations as well. There is an ethical dilemma to consider in the involvement of autistic children in the design process. Although we established the ethical benefit of involving children, we did not address the ethical issues that will result from involving them in these research projects. Among other issues, the nature of design workshops we as a community currently run require working with unfamiliar researchers and communicating with them while social and communication differences are one of the main diagnostic criteria for autism. When designing for autistic children and other vulnerable populations an alternative (or most often an additional) approach is designing with proxies. Proxies for the child can be one of several groups of other stakeholders, such as: teachers, parents and siblings. Each of these groups may inform the design process, from their particular perspective, and as proxies for the target group of autistic children. Decisions need to be made about what stages in the design process are suited to their participation, and the role they play in each case. For this reason, we explore the role of teachers, parents, autistic adults and neurotypical children as proxies in the design process. To explore the roles of proxies we chose friendship between autistic and neurotypical children as the context we are designing for. We are interested in understanding the nature of children's friendships and the potential for technology to support them. Although children themselves are the ones who experience friendship and challenges around its development and peer interaction, they might find it difficult to articulate the challenges they face. Furthermore, it is unrealistic to expect children to identify strategies to help them overcome the challenges with friendship development that they are facing as it assumes children have the social skills to come up with these strategies in the first place. Hence, it is necessary in this context to consider proxies who can identify challenges and suggest ways to overcome them

    A Phenomenological Study of the High-Tech, High-Touch Pastor: Maximizing Personal Ministry in a Digital Age

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    This qualitative phenomenological study aimed to explore how high-tech, high-touch senior pastors who practice servant leadership establish and maintain personal contact with their church members and lead them using digital technology. This research was particularly relevant in an era of social distancing required by the COVID-19 pandemic. The theoretical framework for this study was Greenleaf\u27s servant leadership theory. Ten experienced pastors were interviewed to determine how they balanced the impersonal nature of streaming worship services while maintaining personal contact with their congregations. These interviews were transcribed, and important themes were identified to determine best practices for using technology while maintaining high levels of personal contact and individual attention. The objective was to gain more insight into the senior pastor taxonomy of rapidly expanding churches and to understand how to use technology to communicate with their congregation in the digital era through high-tech, high-touch ministry. Social scientists assert that the best setting for human growth and development is one that encourages social connection with other developing individuals (Lowe & Lowe, 2018). The study\u27s results may be helpful to pastors who want to use technology to minister to their flock and keep in touch with them personally. Pastors perceive that technology has allowed them to maintain relational connections with their congregation despite physical distance. They acknowledged technology limitations and the importance of in-person interactions and community development. Advantages include greater accessibility and efficiency. Disadvantages include the potential for shallow relationships. Pastors perceive in-person, face-to-face connections as crucial for spiritual connection and understanding

    Understanding U.S. Customers\u27 Intention to Adopt Robo-Advisor Technology

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    Finance and information technology scholars wrote that there is a literature gap on what factors drive investors in Western financial markets to use a Robo-advisor to manage their investments. The purpose of this qualitative, single case study with embedded units is to understand the adoption intentions of retail investors in U.S. markets to use a Robo-advisor instead of a human advisor. A single case study design addressed the literature gap, and qualitative data from seven semi=structured interviews, reflective field notes, and archival data were triangulated to answer the research question. This study was grounded in a theoretical framework that includes the theory of planned behavior, the technology acceptance model, the unified theory of acceptance, and the use of technology. Thematic analysis revealed nine themes of the study: a) awareness of Robo-advisory systems, (b) perceptions of risk connected to customer’s financial literacy, (c) data security risk lowers acceptance of Robo-advisor technology, (d) Robo-advisor is filtering out emotional customer biases, (e) customer ambivalence on Robo-advisor capabilities, (f) perceived ease of use, (g) trust in the Robo-advisor, (h) customer ambivalence on adoption intention, and (i) low adoption intention for customers with low financial literacy. This study’s results indicated that financial institutions must still earn customers’ trust by protecting their data through secure platforms and processes and customizing Robo advisor services, products, and offers, to their needs. By further understanding retail investors’ adoption intentions in using a Robo-advisor, this study’s results may drive positive social change by offering pathways to very low-cost, automated financial management advice to a broader segment of new and intermediate investors
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