Narrating heritage: oral history and inclusive growth

Suzanne Joinson’s essay Narrating Heritage looks at the relationship between oral history and inclusive growth. In her essay, she provides an overview of oral history as a discipline and practice, and presents examples from Malaysia, Turkey, the UK, the USA and Vietnam. She draws conclusions about the value of oral history for cultural relations and people-centred, community-led development

Design and intermediate results of the Lower Extremity Arterial Disease Event Reduction (LEADER)* trial of bezafibrate in men with lower extremity arterial disease [ISRCTN41194621]

BACKGROUND: Raised levels of both triglycerides and fibrinogen, each of which are reduced by bezafibrate, may contribute to lower extremity arterial disease (LEAD). This condition is characterized by a particularly high incidence of coronary heart disease (CHD) and stroke, but is little studied thus far in randomised controlled trials. METHOD: Patients were recruited through 85 practices in the British Medical Research Council General Practice Research Framework and through nine hospital vascular clinics. The treatment regimen, which is double-blind and placebo-controlled, is bezafibrate 400 mg/day. The 1568 patients recruited represent 86% of those eligible at screening. RESULTS: None of the anticipated side effects (mainly gastrointestinal) differed between the two groups. Nearly 80% of the total person-years accrued at 3 years were spent on trial treatment. Bezafibrate significantly reduced total cholesterol by approximately 8.0% and low-density lipoprotein (LDL)-cholesterol by approximately 9.0%, and increased high-density lipoprotein (HDL)-cholesterol by approximately 11.0% initially, falling to about 6.0% at 3 years. Triglycerides were significantly reduced by about 23.0% and fibrinogen by about 14.0%. Plasma creatinine rose by approximately 11% in those on active treatment. All of these effects were highly significant (P < 0.0001). Bezafibrate had no effect on the level of C-reactive protein (CRP). CONCLUSION: The trial recruited an unusually high proportion of eligible patients, ensuring the general applicability of its results. The fibrinogen-lowering and lipid-modifying effects of bezafibrate were confirmed. Although bezafibrate lowers fibrinogen, it has no effect on CRP; this suggests that the reduction in fibrinogen is due to an effect on its metabolism rather than suppression of an inflammatory response

Paying clinicians to join clinical trials : a review of guidelines and interview study of trialists

Background: The motivations of clinicians to participate in clinical trials have been little studied. This project explored the potential role of payment for participation in publicly funded clinical trials in the UK. The aims were to review relevant guidelines and to collate and analyse views of clinical trialists on the role of payments and other factors that motivated clinicians to join clinical trials. Methods: Review of guidelines governing payments to clinicians for recruitment to trials. Semistructured interviews with a range of NHS clinical trial leaders, analysed using qualititative methods. Results: While UK guidelines had little to say specifically on payments linked to recruitment, all payments have become highly regulated and increasingly transparent. Interview participants believed that expenses arising from research should be covered. Payments in excess of expenses were seen as likely to increase participation but with the risk of reducing quality. Motivations such as interest in the topic, the scope for patients to benefit and intellectual curiosity were considered more important. Barriers to involvement included bureaucracy and lack of time. Discussion: Limited scope exists for paying clinicians over-and-above the cost of their time to be involved in research. Most trialists favour full payment of all expenses related to research. Conclusion: Payment of clinicians beyond expenses is perceived to be a less important motivating factor than researching important, salient questions, and facilitating research by reducing bureaucracy and delay

Professorial roles: a study of the professorial populations within nursing and midwifery, social work and allied health professions

The professorial populations in nursing/midwifery, social work and allied health are relatively new in academia compared to longer established professions such as medicine and dentistry. Less is known about the roles, career pathways, characteristics and career aspirations of the professoriate within these emerging professions. A survey was undertaken from sample populations in each of the three professorial groups in order to obtain qualitative and quantitative data on professorial roles and activities, career pathway information and support mechanisms for professorial positions. This paper discusses the findings of the survey which relate specifically to professorial roles and activities and whether the identified roles reflect the professorial activities proposed by the National Conference of University Professors (NCUP) Other aspects of this survey including career pathways, findings relating to gender and support mechanisms will form the basis of future papers. Result

Transnationalism and Social Work Education

Transnational movements, networks, and relationships are everywhere in this “world on the move” (Williams & Graham, 2014, p. i1). Transnational peoples maintain relationships of interdependence and support with families and communities in their places of origin, often returning regularly, while starting new lives and making new connections. Transnationalism is characterized by mobilities and networks, by social integration, and by extended and extensive relationship ties of family, neighborhood, religious faith, or combinations thereof (Valtonen, 2008). While disciplines across the world including sociology, human geography, and cultural anthropology engage with the implications of transnationalism (Bauböck & Faist, 2010), social work in England and mainland Europe has not achieved similar levels of engagement. As Cox and Geisen state: “the social world is being transformed by migration and social work is playing catch-up” (2014, p. i162)

Association between ultrasound assessment of glenohumeral subluxation and shoulder pain, muscle strength, active range of movement and upper limb function in people with stroke

Background: Glenohumeral subluxation (GHS) is a commonly reported post-stroke complication which has a negative effect on rehabilitation. Objective: To explore the association between GHS and other clinical outcomes in people with post-stroke hemiplegia. Methods: Patients with post-stroke hemiplegia (n=105, 71±11 years, median time since stroke 5.6 weeks), who gave informed consent, were recruited. GHS was assessed by the ultrasound method. Assessment of shoulder pain (visual analogue scale), active range of movement (AROM), muscle strength (Medical Research Council Scale), muscle tone (Modified Ashworth Scale) and the upper limb section of the Motor Assessment Scale (MAS) was undertaken. Results: GHS was present in 65 (62%) patients. There was a moderate negative correlation between GHS and muscle strength (r=-0.54,

Does resuscitation status affect decision making in a deteriorating patient? Results from a randomised vignette study

Aims and objectives: The aim of this paper is to determine the influence of do not attempt cardiopulmonary resuscitation (DNACPR) orders and the Universal Form of Treatment Options (‘UFTO’: an alternative approach that contextualizes the resuscitation decision within an overall treatment plan) on nurses' decision making about a deteriorating patient. Methods: An online survey with a developing case scenario across three timeframes was used on 231 nurses from 10 National Health Service Trusts. Nurses were randomised into three groups: DNACPR, the UFTO and no-form. Statements were pooled into four subcategories: Increasing Monitoring, Escalating Concern, Initiating Treatments and Comfort Measures. Results: Reported decisions were different across the three groups. Nurses in the DNACPR group agreed or strongly agreed to initiate fewer intense nursing interventions than the UFTO and no-form groups (P < 0.001) overall and across subcategories of Increase Monitoring, Escalate Concern and Initiate Treatments (all P < 0.001). There was no difference between the UFTO and no-form groups overall (P = 0.795) or in the subcategories. No difference in Comfort Measures were observed (P = 0.201) between the three groups. Conclusion: The presence of a DNACPR order appears to influence nurse decision making in a deteriorating patient vignette. Differences were not observed in the UFTO and no-form group. The UFTO may improve the way nurses modulate their behaviours towards critically ill patients with DNACPR status. More hospitals should consider adopting an approach where the resuscitation decisions are contextualised within overall goals of care

Hearing the silences: adult Nigerian women’s accounts of ‘early marriages’

‘Early marriage’ is a relatively common, but under-researched global phenomenon, associated with poor health, mental health, educational and occupational outcomes, particularly for young girls. In this article, we draw on qualitative interviews with 6 Nigerian women from Sokoto State, who were married between the ages of 8 and 15. The interviews explored young women’s experiences of the transition to marriage, being married, pregnancy and their understanding of the marital and parental role. Using Interpretive Phenomenological Analysis, we explore women’s constrained articulations of their experiences of early marriage, as they are constituted within a social context where the identity of ‘woman’ is bound up in values and practices around marriage and motherhood. We explore the complexity of ‘hearing’ women’s experiences when their identities are bound up in culturally overdetermined ideas of femininity that function explicitly to silence and constrain the spaces in which women can speak

Tips to make research teaching and learning enjoyable and productive for counsellors, psychotherapists and their tutors

© 2019 British Association for Counselling and Psychotherapy This article identifies the learning expectations and experiences of qualified counsellors and psychotherapists undertaking higher education awards with specific regard to research activity. Drawing on the current literature and some early findings from focus group research with students, combined with our personal and professional experiences, we identify what contributes to a productive research experience. This is used as a basis to provide tips for both teachers and those new to research to make counselling and psychotherapy research enjoyable and productive. A full research paper is in preparation