Visual data in qualitative research: The contribution of photography to understanding the mental health hospital environment

This thesis presents an in-depth investigation of the use of participatory photography in qualitative research in a mental health setting in one regional area of England, UK. Whilst the field of visual methods has been growing for several years, there are few in-depth explorations of the ways in which photographs taken by research participants are reviewed and analysed. In particular, very few studies have used participant-generated photography with inpatients and staff at mental health hospitals. This study aimed to address these gaps in knowledge. A methodological review of international studies where research participants took photographs as part of the research process was conducted. This included data extraction on 53 papers (52 individual studies) interrogating how photographs were used in processes of data collection, data analysis and dissemination. Several phases of visual data collection with participants from a mental health hospital followed. Following ethical approval, staff and service users [n=17] took photographs of the hospital environment. Focus group, photo-elicitation and mobile photo-interview data were collected between March 2007 and June 2011. Several participants were not interviewed, leaving some sets of photographs with no supporting text. Photographs [n=5] which could not be anonymised, or which had not been developed properly, were removed. All remaining photographs were analysed using a method of thematic visual analysis. This resulted in a thematic visual ‘thin description’ of the hospital environment. Focus group, photo-elicitation and mobile photo-interview data were coded thematically alongside the visual data and interpreted in terms of the discourses they constructed or reflected.Findings centred upon what these visual methods and forms of visual data contribute to qualitative research in the context of mental health hospital environments. It was found that whilst it is possible to construct a ‘thin description’ of the hospital environment using images alone, the addition of third party speculations, interview data and observational notes served to ‘thicken’ this description significantly. In particular, the sensorial nature of mobile photo-interviews enriched the interpretive process by submerging me in the lived experience of the participant, if only for a very short time

Performing the micro-social: using theatre to debate research findings on everyday life, health and wellbeing

This paper describes and critically assesses the use and development of a model of participatory theatre to re-appropriate the ways in which a place in the de-industrialised south Wales valleys is represented. Neo-liberal policies which focus on individual responsibility, conditionality, sanctions and incentives frame the production of statistics on health inequality and deprivation in particular ways. While ‘place’ can be a resource for expressing positive identities this presents people living in economically under resourced areas with a problem if that place based identity is also subject to vilification. In this paper we focus on three objectives: to explore negative stereotypes of a post-industrial community; to describe the methods and process of working alongside local people to offer alternative ways of understanding place; and to discuss the implications of using community theatre for policy and practice. We argue that theatre-based forms of place-making and dialogue can create spaces where policy issues, such as health and wellbeing, can be discussed in the context of everyday local concerns. Meanings in common are generated in ways that create affective understandings of place and the impact of economic change and crisis (Jones et al., 2013). These co-productive processes are uncertain, emergent, and risky and need to be managed carefully in the context of trustful relations

Poor places, powerful people? Co-producing cultural counter-representations of place.

This paper considers the ethical aspects of co-producing visual representations of communities in the context of economic deprivation, focusing on one case study within a UK-wide research study funded by the Arts and Humanities Research Council. The research explores how the arts and humanities can enable community members to better express aspects of their health and wellbeing to policy makers and service providers, looking in particular at the stigmatising and often shaming practices of representation that have dominated British mass media in recent years. The methodology for the research follows a participatory action research epistemology, whereby researchers work with participants and other stakeholders to co-produce data and artistic outputs. The ethical dimensions of this work are complex and go beyond issues of consent, confidentiality and ownership; although these were strongly present in the research. This paper presents data from focus groups, arts workshops and field notes to illustrate the complexity of working co-productively with visual methods, and the ethical challenges this presents, as well as the need to create ‘safe’ spaces for dialogue and social action

Detritus: An exhibition of art from recycled or found art materials

Catalog for the exhibition Detritus: An exhibition of art from recycled or found art materials held at the Seton Hall University Walsh Gallery, April 16 – May 25, 2007. Curated by Mark Schlemmer, Kelsey Quillen and Laura Browarney. Includes an essay by Mark Schlemmer, Kelsey Quillen and Laura Browarney. Includes color illustrations

An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom

<b>Background</b><p></p> To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation.<p></p> <b>Methods</b><p></p> An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews.<p></p> <b>Results</b><p></p> The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises.<p></p> <b>Conclusions</b><p></p> It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability

The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level

Template for Rapid Iterative Consensus of Experts (TRICE)

From MDPI via Jisc Publications RouterHistory: accepted 2021-09-03, pub-electronic 2021-09-29Publication status: PublishedBackground: Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, “mixed messaging” of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. Method: TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. Results: Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4–156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. Conclusion: TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Carprofen elicits pleiotropic mechanisms of bactericidal action with the potential to reverse antimicrobial drug resistance in tuberculosis

Background The rise of antimicrobial drug resistance in Mycobacterium tuberculosis coupled with the shortage of new antibiotics has elevated TB to a major global health priority. Repurposing drugs developed or used for other conditions has gained special attention in the current scenario of accelerated drug development for several global infectious diseases. In a similar effort, previous studies revealed that carprofen, a non-steroidal anti-inflammatory drug, selectively inhibited the growth of replicating, non-replicating and MDR clinical isolates of M. tuberculosis. Objectives We aimed to reveal the whole-cell phenotypic and transcriptomic effects of carprofen in mycobacteria. Methods Integrative molecular and microbiological approaches such as resazurin microtitre plate assay, high-throughput spot-culture growth inhibition assay, whole-cell efflux inhibition, biofilm inhibition and microarray analyses were performed. Analogues of carprofen were also synthesized and assessed for their antimycobacterial activity. Results Carprofen was found to be a bactericidal drug that inhibited mycobacterial drug efflux mechanisms. It also restricted mycobacterial biofilm growth. Transcriptome profiling revealed that carprofen likely acts by targeting respiration through the disruption of membrane potential. The pleiotropic nature of carprofen’s anti-TB action may explain why spontaneous drug-resistant mutants could not be isolated in practice. Conclusions This immunomodulatory drug and its chemical analogues have the potential to reverse TB antimicrobial drug resistance, offering a swift path to clinical trials of novel TB drug combinations

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention