A qualitative analysis of relatives', health professionals' and service users' views on the involvement in care of relatives in Bipolar Disorder

Background: Relatives of people with bipolar disorder report that services do not meet their own needs, despite clinical recommendations for the development of care plans for relatives, provision of information regarding their statutory entitlements, and formal involvement in decision making meetings. Further, there is now conclusive evidence highlighting the benefits of relatives' involvement in improving outcomes for service users, relatives, and the health system as a whole. This qualitative study explored the views of relatives of people with bipolar disorder, service users and healthcare professionals regarding the barriers and the facilitators to relatives' involvement in care. Methods: Thirty five people were interviewed (12 relatives, 11 service users and 12 healthcare professionals). Audio recordings were transcribed verbatim and common themes in participants' narratives emerged using framework analysis. Results: Participants' accounts confirmed the existence of opportunities for relatives to be involved. These, however, were limited and not always accessible. There were three factors identified that influenced accessibility namely: pre-existing worldviews, the quality of relationships and of communication between those involved, and specific structural impediments. Discussion: These themes are understood as intertwined and dependent on one another. People's thoughts, beliefs, attitudes, cultural identifications and worldviews often underlie the ways by which they communicate and the quality of their relationship. These, however, need to be conceptualised within operational frameworks and policy agendas in health settings that often limit bipolar relatives' accessibility to opportunities for being more formally involved. Conclusions: Involving relatives leads to clear benefits for relatives, service users, healthcare professionals, and the health system as a whole. Successful involvement of relatives, however, depends on a complex network of processes and interactions among all those involved and requires strategic planning from policy makers, operational plans and allocation of resources

Statistical evaluation of data from tractor guidance systems

Statistical tools are discussed for the analysis of data collected from tractor guidance systems. The importance of both accuracy and precision is discussed, and statistical tools for analysis are considered which incorporate important features of the data. In particular, accuracy is modelled using a generalized least squares model incorporating autocorrelation, and variances (inverse of precision) using a gamma generalized linear model. The methods are applied to data collected during an experiment conducted with a Trimble receiver used with a Beeline tractor guidance system. Three different scenarios are considered, then compared: a tractor simulating ploughing a field; the tractor pulling a plough with the receivers on the tractor; the tractor pulling a plough with the Trimble receiver on the plough. The change in the precision and accuracy between the scenarios is discussed. Data were recorded over repeated swaths for each scenario. After discussing specific statistical techniques for analysis of this type of data, the collected data are analysed; major conclusions are: The data from the Trimble receiver showed evidence of autocorrelation in the offsets; the plough recorded a variance about three times that recorded by the tractor