tactile IPAmagnet-board system:Atool for blind and visually impaired students in phonetics and phonology classrooms

This article describes a tool that can be used by blind and visually impaired students in phonetics and phonology classrooms: a tactile International Phonetic Alphabet (IPA) magnet-board system. This tool consists of IPA magnets and phonological rule symbols that are printed and embossed, so as to be readable by both sighted and visually impaired individuals. A user of the tool can lay out phonetic and phonological data on the magnet board for communicative, organizational, or problem-solving purposes. Since the magnet board can be read both visually and tactually, it can serve as a collaborative space that can be used by both sighted and visually impaired members of the classroom. Potential uses include group work in class and as an augmentation to chalkboard problem-solving demonstrations. The tool can complement already extant options for blind and visually impaired students and facilitate collaboration between sighted and visually impaired students. Here, we describe the tool, exemplify some potential uses, and offer suggestions for further improvement

Using the nominal group technique to involve young people in an evidence synthesis which explored 'risk' in inpatient mental healthcare

Background In this paper we demonstrate how our application of the nominal group technique was used as a method of involving young people with previous experience of using inpatient mental health services in an evidence synthesis. Methods Nominal group technique is an approach to group decision-making that places weight on all participants having an equal opportunity to express a view, and to influence decisions which are made. It is an effective way to enable people who might otherwise be excluded from decision-making to contribute. Results In this study, the focus of the evidence synthesis was significantly shaped following using the nominal group technique in our stakeholder advisory group meeting. The young people present in the group invited the research group to think differently about which ‘risks’ were important, to consider how young people conceptualised risk differently, focussing on risks with long term impact and quality of life implications, rather than immediate clinical risks. Conclusions Using the nominal group technique with young people did offer a method of promoting the equality of decision making within a stakeholder advisory group to an evidence synthesis project, but care needs to be taken to invite sufficient young people to attend so they can be proportionally represented

A rapid review of innovations for attraction, recruitment and retention of social care workers, and exploration of factors influencing turnover within the UK context

Context: The UK social care sector has come under increased pressure to combat workforce shortages. With international recruitment of professionals impacted by Brexit and the COVID-19 pandemic, social care is in need of innovations to attract, recruit and retain staff. Objectives: This review aimed to identify (1) innovations to attract, recruit, and retain social workers (professionals working with children and adults to protect them from harm, often as case managers) and the wider social care workforce (workers providing direct practical support to children and adults with their daily activities) and (2) factors influencing staff turnover in the UK context. Method: Pre-defined inclusion criteria were developed using the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework. Searches were conducted across three databases and 32 key United Kingdom third sector and government organisations from 2001. In total, 1,835 citations were retrieved and 40 met the eligibility criteria (13 for social workers and 28 for social care workforce). Thematic analysis was used to explore the data and presented across two evidence maps. Findings: Evaluation evidence was only available for a small portion of innovations identified. Practice learning, fast-track graduate programmes, and apprenticeships may support the retention of social workers, while pre-employment training, national recruitment campaigns, care work ambassadors, and values-based recruitment could help attraction, recruitment, and retention of the wider social care workforce. Limitations: Most of the included studies were conducted pre-pandemic and mainly relied on descriptive and explorative methodologies. Implications: Future policy initiatives should include an evaluation strategy from the outset to develop a more extensive evidence base. Funding bodies should offer schemes supporting research in this area

Deficient liver biosynthesis of docosahexaenoic acid correlates with cognitive impairment in Alzheimer\u27s disease

Reduced brain levels of docosahexaenoic acid (C22:6n-3), a neurotrophic and neuroprotective fatty acid, may contribute to cognitive decline in Alzheimer\u27s disease. Here, we investigated whether the liver enzyme system that provides docosahexaenoic acid to the brain is dysfunctional in this disease. Docosahexaenoic acid levels were reduced in temporal cortex, mid-frontal cortex and cerebellum of subjects with Alzheimer\u27s disease, compared to control subjects (P = 0.007). Mini Mental State Examination (MMSE) scores positively correlated with docosahexaenoic/α-linolenic ratios in temporal cortex (P = 0.005) and mid-frontal cortex (P = 0.018), but not cerebellum. Similarly, liver docosahexaenoic acid content was lower in Alzheimer\u27s disease patients than control subjects (P = 0.011). Liver docosahexaenoic/α-linolenic ratios correlated positively with MMSE scores (r = 0.78; P\u3c0.0001), and negatively with global deterioration scale grades (P = 0.013). Docosahexaenoic acid precursors, including tetracosahexaenoic acid (C24:6n-3), were elevated in liver of Alzheimer\u27s disease patients (P = 0.041), whereas expression of peroxisomal d-bifunctional protein, which catalyzes the conversion of tetracosahexaenoic acid into docosahexaenoic acid, was reduced (P = 0.048). Other genes involved in docosahexaenoic acid metabolism were not affected. The results indicate that a deficit in d-bifunctional protein activity impairs docosahexaenoic acid biosynthesis in liver of Alzheimer\u27s disease patients, lessening the flux of this neuroprotective fatty acid to the brain

A rapid evidence map of womens health

The rapid evidence map focuses on identifying the nature and extent of published literature on the following topic areas: healthcare professionals communication with women about womens health issues and broader health problems during clinical encounters; access to specialist healthcare; endometriosis; menopause; womens health and mental health issues, and mental health issues associated with specific conditions related to menopause or menstrual health (adenomyosis; endometriosis; fibroids; heavy menstrual bleeding, polycystic ovary syndrome and premenstrual dysphoric disorder). The purpose of this rapid evidence map was to identify research gaps and priorities that will be beneficial to womens health in Wales. The rapid evidence map uses abbreviated systematic mapping or scoping review methods to provide a description of the nature, characteristics and volume of the available evidence. There is a lack of primary and secondary research that explores communication between women and healthcare professionals within primary and secondary care settings. Secondary research evidence exists but there are gaps in the evidence base regarding access to services providing minor gynaecological procedures and pain management, or care for menstrual health and wellbeing, endometriosis, polycystic ovarian syndrome, menopause, heart conditions, autoimmune diseases, hypermobility spectrum disorders, myalgic encephalomyelitis, long COVID, fibromyalgia, skin conditions, or palliative and end of life care, which are priority areas identified by the Womens Health Wales Coalition (2022). There are no active funding calls exploring these topics. Regarding endometriosis, there is a lack of review evidence regarding education and resources for health care professionalsand doctors to reduce diagnostic times and improve care. There is an evidence gap for primary research regarding information, support interventions and tools for women with endometriosis to help them manage their symptoms and improve their quality of life.A substantial amount of secondary evidence exists on menopause along with a plethora of research priorities around treatment and symptom management. It was beyond the scope of this workto determine if any research had been conducted in these priority areas since the production of the guidelines and recommendations. There is a lack of research recommendations and review evidence that address mental health issues and specific issues that affect a womens menstrual health such as adenomyosis, fibroids, heavy menstrual bleeding and premenstrual dysphoric disorder

Prognostic factors for a change in eye health or vision: A rapid review

The general public are advised to have regular routine eye examinations to check their vision and ocular health; however current UK guidance on how often to have eye examinations is not evidence-based and was issued in 2002.This Rapid Review aims to provide an evidence base that stakeholders can use to form updated guidance for Wales by asking the question ‘What are the prognostic factors for a change in ocular status in the general population attending routine eye examinations?’The review included evidence available from January 2009 up until August 2023. Evidence was included from 2011 up until 2023. 19 studies were included: two systematic reviews; nine prospective cohort studies; three retrospective cohort studies; two longitudinal studies; two case-control studies; and one cross-sectional study were included.<br/

Relationship-centred care for people living with dementia in care homes

Dementia is a progressive degenerative disease, typically affecting older adults for which there is currently no cure. Dementia is characterised by progressive impairment to several cognitive functions including memory and orientation, practical abilities and mood changes, all of which can impact personality and social relationships. The theory of social death has been explored for people living with dementia as the ability to maintain social interactions are threatened leading to a loss of social identity and exclusion and withdrawal from the wider community. A relationship-centred care approach has been recommended to improve care for older people in long-term care, aiming to create environments conducive to relationships, considering the needs of the person living with dementia and also the staff and family members involved in their care. The ‘Senses Framework’ by Nolan was designed to promote relationships, acknowledging the experiences of all parties across six senses: security, continuity, belonging, purpose, fulfilment and significance. Utilising the Senses Framework has the potential to sustain meaningful relationships by fostering a sense of value and empowerment. This Rapid Evidence Summary aims to explore the evidence assessing the benefits of a relationship triad approach (Senses Framework and other relationship-centred care approaches) in long term care settings (including care homes) for people living with dementia. Nine primary studies and one systematic review were identified. The benefits of using a relationship-centred approach were mapped under each of the senses described within the Senses Framework, detailed separately for people living with dementia, relatives and care home staff. For people living with dementia, interventions using touch and music increased the sense of security and belonging reducing neuropsychiatric conditions such as agitation and aggression. Memory boxes were used to support a sense of significance and continuity and significant moments from the past brought pleasure and enabled meaningful conversations. For relatives and staff, improved communication and relationships increased confidence and trust and by working together they found that they could exert more influence and could develop into a powerful force for change

A rapid review of the effectiveness and cost effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas.

The cost-of-living across the UK has been on the increase since the start of 2021. Living in a rural community is often associated with additional costs compared to those in urban areas. For example, people living in rural areas are not always connected to the gas grid, often using oil and liquid petroleum gas for heating that are more expensive and not subjected to energy price caps. Moreover, housing in rural areas is generally older, not as well insulated and less energy efficient than houses in urban locations, leading to increased risk of fuel poverty. Home energy advice, energy efficiency measures, and financial support all have the potential to mitigate fuel poverty. The aim of this rapid evidence review was to determine the effectiveness of interventions that make homes warmer and cheaper to heat for households in fuel poverty in rural and remote areas. Fourteen studies and eight sources of grey literature were included in the review. The included studies and grey literature were published between 2007 and 2022. There was some evidence of effectiveness for interventions such as energy efficiency home improvements / retrofitting, home improvements (including replacing lightbulbs and electric heaters, external insulation, heating systems, loft insulation installing central heating), Welsh Government Arbed (home improvement and energy efficiency measures) and Nest (home improvements and advice) interventions, provision of energy and home energy advice, and referral for support and/or insulation measures or home improvements. Interventions such as social energy subsidies might not be effective in reducing fuel poverty, and energy efficient social housing was a more efficient method of alleviating fuel poverty. However, the certainty of the evidence is very low, primarily due to the study design and poor quality of the included studies. Policy makers and funding bodies need to make further investments into research focusing on measures to alleviate fuel poverty, with particular focus on economic analysis. There is a need for high quality, well-developed randomised controlled trials to investigate the effectiveness and cost-effectiveness of energy efficiency measures and advice. Future research should investigate which interventions are the most effective in what types of housing in rural areas to help the targeting of interventions better

A rapid review of the effectiveness of remote consultations versus face-to-face consultations in secondary care surgical outpatient settings

The use of remote consultations and telemedicine approaches significantly increased over the pandemic. There is evidence that some patients still prefer this mode of care delivery and time saving may also enable additional consultations and help to reduce waiting lists. However, the effectiveness of remote consulting for certain specialities, such as surgery, is unclear. The aim of this review was to investigate the effectiveness of video or telephone consultations, particularly focusing on clinical, patient reported and safety outcomes, in adult secondary surgical outpatient care during the COVID-19 pandemic. 14 studies were identified. These were published in 2021-2022. Evidence is low or very-low quality due to observational study designs, small sample sizes and patient selection. Policy and practice implications: Evidence is of low quality but suggests that for many surgical outpatient consultations, remote consultations are as effective as in-person consultations. There is potential for time and cost savings for remote consultations compared to in-person consultations. High quality research is needed to evaluate the effectiveness of remote consultations to understand which patients and which surgical specialities would benefit most