Does Pre-Operative Exercise Improve Quality of Life, Compared to Patient Education Alone, In Patients With Hip Osteoarthritis (OA) While Awaiting Total Hip Arthroplasty (THA)?

Objective: The objective of this selective EBM review is to determine whether or not pre-operative exercise improves quality of life, compared to patient education alone, in patients with hip osteoarthritis (OA) while awaiting total hip arthroplasty (THA). Study Design: Systematic review of three randomized controlled trials (RCTs) published in peer-reviewed journals between 2015 and 2016, all in the English language. Data Sources: Three randomized controlled trials were found using PubMed. Outcomes Measured: The change in ADL (activities of daily living), recreational function, and pain were measured in all trials using self-reported patient questionnaires (WOMAC) and a variety of physical activities before and after the patient completed the required pre-operative exercise program. Which were then presented as a change in mean from baseline and compared to the control group. Results: Study by Hermann et al. showed in increase in ADL function in the intervention group vs. control group (p-value \u3c0.001) after completing a pre-operative progressive explosive-type resistance training. Study by Svege et al. saw at long term follow up that the patients that performed the pre-operative exercise program prolonged their need for THA (p-value 0.034) and had an increase in ADL function compared to the control group (p-value 0.004). Study by Zeng et al. showed that the patients that performed pre-operative tai chi and strength training had an increase in ADL function compared to the control group (p-value \u3c0.01). However, none of the studies showed a significant change in pain outcomes between the intervention and control groups. Conclusions: Evidence supporting the use of pre-operative exercise regimens is feasible for increase in activities of daily living and function, but not for pain in patients with hip OA awaiting THA. Pre-operative exercise programs should be considered in patients that can tolerate it while awaiting their surgery, but the THA is what will ultimately improve pain

Older people with learning disabilities affected by cancer: Involvement and engagement work to inform a research agenda: Final Report

Summary: The Cancer Care Research Centre (CCRC) works with people affected by cancer to find out about their experiences of cancer and what they think about the treatment and care they have had. The CCRC has 16 Advisory Groups of people affected by cancer across Scotland. These groups help the Centre develop research plans by discussing their experiences and views of cancer services. This project worked with adults with learning disabilities affected by cancer. Four people with learning disabilities met with the researchers to talk about their experiences of cancer. Three people had a family member with cancer. One person had breast cancer and talked about her care. By speaking to the researchers, these people advised the researchers on the important issues to research for people with learning disabilities affected by cancer. The project found that new research should focus on: communication in hospitals between professionals and people with learning disabilities; how families cope when someone gets cancer; how to support people with learning disabilities, their families and staff when someone is very ill or dies from cancer; how many people with learning disabilities develop cancer

People with cancer and an intellectual disability: an international issue with local significance

Introduction: The workshop "People with cancer and an intellectual disability: an international issue with local significance" took place in Edinburgh on February 22nd 2008. The workshop was organised by the Centre for the Older Person's Agenda, Queen Margaret University and the Cancer Care Research Centre, University of Stirling. The workshop aims were to engage in a sharing of knowledge and experience and through discussion to drive forward change by creating agendas for policy, practice and research. The objectives were to: 1. present a range of current perspectives on policy, practice and research in cancer care for people with intellectual disabilities; sharing international perspectives; 2. identify and explore key issues; 3. share current practice and research concerns based on practitioner and personal experiences of cancer care; 4. to identify what a community of researcher, policy makers and practitioners would look like; 5. develop practice and research agendas with action plans for taking such agendas forward. The programme for the day revolved around five presentations and two group discussions. See appendix 1 for a copy of the programme, appendix 2 for a list of delegates and appendix 3 for copies of the presentations. This report is organised according to the main themes that emerged from the presentations and discussion sessions. They are linked to the four objectives outlined above and the overall aim of developing an international and comparative understanding of these issues

First in family students – what they say about being at university

This article is open access under a Creative Commons Attribution Licence (CC-BY).Exploring what students say in semi-structured, open-ended interviews provides a rich and personal understanding of their encounters with the university. The opportunity to discuss the experiences of First in Family (FiF) students as they progress through their degree or reach its end allows us to gain insight into their reasons for attending university, their determination to stay and what they believe helped them succeed. This paper discusses the three main themes related to the FiF student experience we uncovered as a result of a detailed literature review and through our interviews. These themes are, their ‘journey’ into and through higher education; their position as ‘student’ which includes the demographic aspects as well as their own concepts of themselves as students; and, the ‘networks’ they have used and developed to succeed at university. The students’ insights may be used to encourage and help future FiF students to complete their studies

Beyond the economics, benefit and cost of higher education: First in family student perspectives

This article is open access under a Creative Commons Attribution Licence (CC-BY).Internationally, higher education is considered key to individual and societal economic success. Using a narrative inquiry approach, this paper broadens our understanding of the benefit and cost of participating in higher education (HE) beyond employment opportunities and tuition fees. The qualitative study on which this paper is based explores the lived experience of eighteen First in Family (FiF) students to create a collection of narrative accounts. On the basis of this evidence, we argue that the benefit of HE extends to encompass the strengthening of FiF students’ sense of competencies and confidence, contributes towards broadening of social experiences, and transforms perspectives. Furthermore, associated non-monetary costs of HE includes the requirement to balance competing life demands and the adoption of poor health behaviours. The study highlights the importance of both monetary and non-monetary factors when assessing overall return on investment of HE

An Evaluation of the Rachel House at Home Service for the Children’s Hospice Association Scotland: Summary Public Report

First paragraph: The Children's Hospice Association Scotland (CHAS) was established in 1992 and is known across the country as a charity committed to specialist caring, support and respite for children and young people with palliative care needs and their families. The primary objective of CHAS is to offer hospice services, free of charge to every child and family who needs and wants them (CHAS, 2005). CHAS has two hospices, Rachel House in Kinross and Robin House in Balloch, and offers a home care service in the Central Belt area, a 24 hour telephone support and advice service and a small home care service called Rachel House at Home (RHAH) in the north of Scotland based at Highland Hospice, Inverness

Longitudinal social network analysis of peer, family and school contextual influences on adolescent drinking frequency

Purpose: The aim of the study was to identify the mechanisms relating to parental control, adolescent secrecy, and school context that shape patterns of adolescent drinking frequency and appraise the implications for systems-level intervention. Methods: The Belfast Youth Development Study collected information on friendship networks in schools, alcohol use, and Stattin and Kerr's parental monitoring subscales across 5 years of postprimary school education in annual waves from age 11–15 years. Stochastic Actor-Oriented Models were fitted to 22 schools (N = 3,220) to assess friendship formation and peer influence processes related to drinking frequency and their variation by parental control or child secrecy. Meta-regressions and summary statistic ego-alter selection tables assessed how network and behavior co-evolution varied according to school gender and the proportion of weekly or more frequent drinkers in each school. Results: Adolescents tended to mimic their peers' drinking levels, and frequent drinkers befriended those who drank similarly to them. Those with high parental control were less likely to befriend low-control peers, whereas low-control pupils were more likely to befriend each other. Adolescents with low-control parents nominated fewer friends in schools with higher proportions of drinking frequently. There was a tendency toward befriending highly secretive peers in boys schools only. Conclusions: Our results suggest that the optimal strategy for selecting seed nodes in a diffusion of innovations network intervention may vary according to school context, and that targeting family interventions around parent characteristics may modify the wider school network, potentially augmenting network intervention processes

Evidence for public health on novel psychoactive substance use: a mixed-methods study

Background: Novel psychoactive substances (NPSs) contribute to the public health impact of substance misuse. This report provides research evidence addressing 11 research questions related to NPSs, covering types, patterns and settings of use; supply sources; and implications for policy and practice. Methods: The study used a conceptually linked three-phase mixed-methods design with a shared conceptual framework based on multiple-context risk and protective factors. Phase 1 was a quantitative phase involving secondary data analysis of the longitudinal Belfast Youth Development Study (BYDS), a latent class analysis using the 2039 BYDS participants. Phase 2 was an extensive qualitative analysis via narrative interviews with participants, sampled from BYDS, drug/alcohol services and prisons, to explore NPS use trajectories. Phase 3 was the final quantitative phase; generalisability of the shared risk factor part of the model was tested using the manual three-step approach to examine risk factors associated with latent class membership. The quantitative and qualitative analyses were integrated, thus allowing emerging findings to be further explored. Results: The data suggest that NPSs have a place within a range of polydrug use trajectories. Models showed no distinctive NPS class, with no clear evidence of differential risks for NPS use compared with the use of other substances. From the qualitative analysis, a taxonomy of groups was derived that explored how and where NPSs featured in a range of trajectories. This taxonomy was used to structure the analysis of factors linked to use within a risk and protective framework. Drivers for use were considered alongside knowledge, perceptions and experience of harms. Suggestions about how interventions could best respond to the various patterns of use – with special consideration of synthetic cannabinoids (SCs), including how they relate to the use of heroin and the potential for NPSs to operate as a ‘snare’ to more problem use – were also presented. Limitations: The study was conducted during 2016/17; generalisability beyond this sample and time point is limited. The level of missing data for some of the BYDS analysis was a limitation, as was the fact that the BYDS data were collected in 2011, so in a different context from the data collected during the narrative interviews. The Psychoactive Substances Act 2016 (Great Britain. Psychoactive Substances Act 2016. London: The Stationery Office; 2016) came into force during qualitative fieldwork and, although not particularly influential in this study, may be influential in future work. It is acknowledged that many of the data related to SCs and mephedrone. Although drug use was measured by self-report, the strength of rapport within interviews, reflective diaries and methodological acceptability checks helped to mitigate self-report bias. Conclusions: NPSs continue to present significant challenges for legislation and monitoring, researching and developing interventions. Understanding of usage patterns remains poor, with most information based on populations and settings where problems have already occurred. This research contributes to the evidence base by providing much needed further empirical data on the lived experiences of NPS users across a range of settings. In the light of these data, implications for policy and practice are discussed. Future work: Future research must generate improved epidemiological data on the extent, patterns and motivations for use longitudinally. The uniqueness of the information concerning SC use points to a specific set of findings not evidenced in other literature (e.g. intensity of SC withdrawal). Future research should focus on the symbiotic link between SC and heroin use