3,205 research outputs found
Just The Facts?: Historians And Novelists Discuss The Relationship Between History And Fiction
Just the Facts? Historians and novelists discuss the relationship between history and fiction Very few phrases can make an historian flinch like artistic license. Likewise, even a writer of the highest ...
Mrs. C.D. Carnes to Mr. Meredith (1 October 1962)
https://egrove.olemiss.edu/mercorr_pro/1363/thumbnail.jp
Pain management for chronic musculoskeletal conditions : the development of an evidence-based and theory-informed pain self-management course
Objective: To devise and test a self-management course for chronic pain patients based on evidence and underpinned by theory using the Medical Research Council (MRC) framework for developing complex interventions.
Design: We used a mixed method approach. We conducted a systematic review of the effectiveness of components and characteristics of pain management courses. We then interviewed chronic pain patients who had attended pain and self-management courses. Behavioural change theories were mapped onto our findings and used to design the intervention. We then conducted a feasibility study to test the intervention.
Setting: Primary care in the inner city of London, UK.
Participants: Adults (18 years or older) with chronic musculoskeletal pain.
Outcomes: Related disability, quality of life, coping, depression, anxiety, social integration and healthcare resource use.
Results: The systematic reviews indicated that group-based courses with joint lay and healthcare professional leadership and that included a psychological component of short duration (<8 weeks) showed considerable promise. The qualitative research indicated that participants liked relaxation, valued social interaction and course location, and that timing and good tutoring were important determinants of attendance. We used behavioural change theories (social learning theory and cognitive behaviour approaches (CBA)) to inform course content. The course addressed: understanding and accepting pain, mood and pain, unhelpful thoughts and behaviour, problem solving, goal setting, action planning, movement, relaxation and social integration/reactivation. Attendance was 85%; we modified the recruitment of patients, the course and the training of facilitators as a result of testing.
Conclusions: The MRC guidelines were helpful in developing this intervention. It was possible to train both lay and non-psychologists to facilitate the courses and deliver CBA. The course was feasible and well received
Fidelity in complex behaviour change interventions : a standardised approach to evaluate intervention integrity
Objectives: The aim of this study was to (1) demonstrate the development and testing of tools and procedures designed to monitor and assess the integrity of a complex intervention for chronic pain (COping with persistent Pain, Effectiveness Research into Self-management (COPERS) course); and (2) make recommendations based on our experiences.
Design: Fidelity assessment of a two-arm randomised controlled trial intervention, assessing the adherence and competence of the facilitators delivering the intervention.
Setting: The intervention was delivered in the community in two centres in the UK: one inner city and one a mix of rural and urban locations.
Participants: 403 people with chronic musculoskeletal pain were enrolled in the intervention arm and 300 attended the self-management course. Thirty lay and healthcare professionals were trained and 24 delivered the courses (2 per course). We ran 31 courses for up to 16 people per course and all were audio recorded.
Interventions: The course was run over three and a half days; facilitators delivered a semistructured manualised course.
Outcomes: We designed three measures to evaluate fidelity assessing adherence to the manual, competence and overall impression.
Results: We evaluated a random sample of four components from each course (n=122). The evaluation forms were reliable and had good face validity. There were high levels of adherence in the delivery: overall adherence was two (maximum 2, IQR 1.67–2.00), facilitator competence exhibited more variability, and overall competence was 1.5 (maximum 2, IQR 1.25–2.00). Overall impression was three (maximum 4, IQR 2.00–3.00).
Conclusions: Monitoring and assessing adherence and competence at the point of intervention delivery can be realised most efficiently by embedding the principles of fidelity measurement within the design stage of complex interventions and the training and assessment of those delivering the intervention. More work is necessary to ensure that more robust systems of fidelity evaluation accompany the growth of complex interventions
Social Justice and Social Order: Binding Moralities across the Political Spectrum
Two studies explored the relationship between political ideology and endorsement of a range of moral principles. Political liberals and conservatives did not differ on intrapersonal or interpersonal moralities, which require self-regulation. However differences emerged on collective moralities, which involve social regulation. Contrary to Moral Foundations Theory, both liberals and conservatives endorsed a group-focused binding morality, specifically Social Justice and Social Order respectively. Libertarians were the group without a binding morality. Although Social Justice and Social Order appear conflictual, analyses based on earlier cross-cultural work on societal tightness-looseness suggest that countries actually benefit in terms of economic success and societal well-being when these group-based moralities co-exist and serve as counterweights in social regulation
Effectiveness and cost-effectiveness of a novel, group self-management course for adults with chronic musculoskeletal pain: study protocol for a multicentre, randomised controlled trial (COPERS)
Introduction: Chronic musculoskeletal pain is a
common condition that often responds poorly to
treatment. Self-management courses have been
advocated as a non-drug pain management
technique, although evidence for their effectiveness
is equivocal. We designed and piloted a
self-management course based on evidence for
effectiveness for specific course components and
characteristics.
Methods/analysis: COPERS (coping with persistent
pain, effectiveness research into self-management) is
a pragmatic randomised controlled trial testing the
effectiveness and cost-effectiveness of an intensive,
group, cognitive behavioural-based, theoretically
informed and manualised self-management course
for chronic pain patients against a control of best
usual care: a pain education booklet and a relaxation
CD. The course lasts for 15 h, spread over 3 days,
with a –2 h follow-up session 2 weeks later. We aim
to recruit 685 participants with chronic
musculoskeletal pain from primary, intermediate and
secondary care services in two UK regions. The
study is powered to show a standardised mean
difference of 0.3 in the primary outcome, pain-related
disability. Secondary outcomes include generic
health-related quality of life, healthcare utilisation,
pain self-efficacy, coping, depression, anxiety and
social engagement. Outcomes are measured at 6 and
12 months postrandomisation. Pain self-efficacy is
measured at 3 months to assess whether change
mediates clinical effect.
Ethics/dissemination: Ethics approval was given
by Cambridgeshire Ethics 11/EE/046. This trial will
provide robust data on the effectiveness and
cost-effectiveness of an evidence-based, group
self-management programme for chronic
musculoskeletal pain. The published outcomes will
help to inform future policy and practice around such
self-management courses, both nationally and
internationally.
Trial registration: ISRCTN24426731
Analysis of passive acoustic ranging of helicopters from the joint acoustic propagation experiment
For more than twenty years, personnel of the U.S.A.E. Waterways Experiment Station (WES) have been performing research dealing with the application of sensors for detection of military targets. The WES research has included the use of seismic, acoustic, magnetic, and other sensors to detect, track, and classify military ground targets. Most of the WES research has been oriented toward the employment of such sensors in a passive mode. Techniques for passive detection are of particular interest in the Army because of the advantages over active detection. Passive detection methods are not susceptible to interception, detection, jamming, or location of the source by the threat. A decided advantage for using acoustic and seismic sensors for detection in tactical situations is the non-line-of-sight capability; i.e., detection of low flying helicopters at long distances without visual contact. This study was conducted to analyze the passive acoustic ranging (PAR) concept using a more extensive data set from the Joint Acoustic Propagation Experiment (JAPE)
Maximizing Influence in a Competitive Social Network: A Follower's Perspective
Maximizing Influence in a Competitive Social Network: A Follower's Perspectiv
Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study
Background and aims:
Hypersexuality and sexual addiction among females is a little understudied phenomenon. Shame is thought to be intrinsic to hypersexual behaviours, especially in women. Therefore, the aim of this study was to understand both hypersexual behaviours and consequences of hypersexual behaviours and their respective contributions to shame in a British sample of females (n = 102).
Methods:
Data were collected online via Survey Monkey.
Results:
Results showed the Sexual Behaviour History (SBH) and the Hypersexual Disorder Questionnaire (HDQ) had significant positive correlation with scores on the Shame Inventory. The results indicated that hypersexual behaviours (HBI and HDQ) were able to predict a small percentage of the variability in shame once sexual orientation (heterosexual vs. non-heterosexual) and religious beliefs (belief vs. no belief) were controlled for. Results also showed there was no evidence that religious affiliation and/or religious beliefs had an influence on the levels of hypersexuality and consequences of sexual behaviours as predictors of shame.
Conclusions:
While women in the UK are rapidly shifting to a feminist way of thinking with or without technology, hypersexual disorder may often be misdiagnosed and misunderstood because of the lack of understanding and how it is conceptualised. The implications of these findings are discussed
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An Analysis of the Effect of the Match Between Applicants and Openings on Selected Unemployment Rates
The purpose of this study was to classify unemployment by clearly defined, objectively measured categories which produced a consistent, empirical model identifying the structure of unemployment in Texas during the period 1973 to 1978. The models employed univariate hierarchical regression of Texas montly unemployment rates and changes in unemployment rates on measures of seasonality, cyclical fluctuations, the match of qualified applicants to available openings, and the interaction of these terms. The results of these models were reported
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