A grounded theory analysis of the occupational impact of caring for a partner who has multiple sclerosis

Chronic progressive conditions such as multiple sclerosis impact engagement in and orchestration of daily occupations by people with the condition, and their family members. This qualitative study addressed the way in which multiple sclerosis can affect family life, particularly exploring how it affects the occupations of the partner of a person with the condition. The study involved in-depth interviewing and grounded theory analysis to explore the occupational nature of being a partner of someone who has multiple sclerosis. Findings reveal how partners’ occupations are affected over time, with occupational opportunities inspired by multiple sclerosis and occupational constraints provoked by the disorder, including nostalgia for an multiple sclerosis free existence, the transition to being a carer and an occupationally uncertain future

Research and education to understand fire risks associated with dementia: a collaborative case study (Innovative Practice)

This paper reports on outcomes from the evaluation of a collaborative project between a University and a Fire and Rescue Service where research and education were developed to inform understanding of fire risks associated with dementia. Project outcomes were determined using a mixed methods approach (survey, reports, statistics, case studies, course evaluation forms). Main outputs were a research report that identified dementia specific fire risks and safety strategies, and an education package for Fire and Rescue Service staff and volunteers. The evaluation demonstrates the value of collaborative partnerships to develop understanding of risks pertinent to particular vulnerable groups and research informed educatio

A protocol for co-creating research project lay summaries with stakeholders:Guideline development for Canada's AGE-WELL Network

Background Funding bodies increasingly require researchers to write lay summaries to communicate projects’ real-world relevance to the public in an accessible way. However, research proposals and findings are generally not easily readable or understandable by non-specialist readers. Many researchers find writing lay summaries difficult because they typically write for fellow subject specialists or academics rather than the general public or a non-specialist audience. The primary objective of our project is to develop guidelines for researchers in Canada’s AGE-WELL Network of Centres of Excellence, and ultimately various other disciplines, sectors, and institutions, to co-create lay summaries of research projects with stakeholders. To begin, we produced a protocol for co-creating a lay summary based on workshops we organized and facilitated for an AGE-WELL researcher. This paper presents the lay summary co-creation protocol that AGE-WELL researchers will be invited to use. Methods Eligible participants in this project will be 24 AgeTech project researchers who are funded by the AGE-WELL network in its Core Research Program 2020. If they agree to participate in this project, we will invite them to use our protocol to co-produce a lay summary of their respective projects with stakeholders. The protocol comprises six steps: Investigate principles of writing a good lay summary, identify the target readership, identify stakeholders to collaborate with, recruit the identified stakeholders to work on a lay summary, prepare for workshop sessions, and execute the sessions. To help participants through the process, we will provide them with a guide to developing an accessible, readable research lay summary, help them make decisions, and host, and facilitate if needed, their lay summary co-creation workshops. Discussion Public-facing research outputs, including lay summaries, are increasingly important knowledge translation strategies to promote the impact of research on real-world issues. To produce lay summaries that include information that will interest a non-specialist readership and that are written in accessible language, stakeholder engagement is key. Furthermore, both researchers and stakeholders benefit by participating in the co-creation process. We hope the protocol helps researchers collaborate with stakeholders effectively to co-produce lay summaries that meet the needs of both the public and project funders

COVID-19 and domestic violence: impact on mental health

Purpose This paper aims to explore the mental health impact of domestic violence and abuse within the context of the global pandemic. This paper will explore factors contributing to rising rates of violence and mental health problems exacerbated by stressors related to the global pandemic, including public health measures implemented to prevent the spread of coronovirus disease (COVID-19). It will also explore what can be learnt from the current pandemic situation to prevent domestic violence and abuse in future emergency situations and pandemics and will provide suggestions, for policy, practice and future research. Design/methodology/approach This paper is informed by discussion between authors as experts in the field, their reflection on the current situation and review of available literature. Synthesising information from best practice guidance across the global literature, this paper proposes a best practice framework using an ecological approach to address intimate partner violence in times of pandemic, crisis or natural disaster. Findings This paper aimed to explore the mental health impact of domestic violence and abuse within the context of the global pandemic. Originality/value This paper provides an analysis of available literature and explains impact of COVID-19 on domestic violence and abuse

Acceptability of a dyadic Tai Chi intervention for older people living with dementia and their informal carers

Exercise is effective in preventing falls amongst older adults. However, few studies have included people living with dementia and their carers and explored their experiences. The aim of this paper is to explore what affects the acceptability of exercise interventions to better meet the needs of people with dementia and their carers as a dyad. Observations, field notes containing participants and instructor’s feedback, and focus groups with 10 dyads involved in Tai Chi classes for 3 or 4 weeks in two sites in the South of England were thematically analysed to understand their experiences. Findings suggest that dyads’ determination to achieve the benefits of Tai Chi facilitated their adherence, whereas a member of the dyad’s low sense of efficacy performing the movements during classes was a barrier. Simplifying class content and enhancing the clarity of instructions for home-based practice will be key to support the design of future exercise interventions

Outcome measures for use in trials of paediatric otorrhoea:A systematic review

Introduction:Paediatric otorrhoea (PO) describes a middle ear infection that results in a perforation of the tympanic membrane and ear discharge, in children and young people (CYP). Prolonged infection may be associated with hearing loss and developmental delay. The current management of paediatric otorrhoea is variable, including non-invasive treatments (conservative, oral antibiotics, topical antibiotics) and surgery, reflecting the lack of a sufficiently strong evidence base. Outcome reporting is fundamental to producing reliable and meaningful evidence to inform best practice.Objectives:Primary objective: to determine which outcome measures are currently used to evaluate treatment success in studies of non-surgical treatments for paediatric otorrhoea. Secondary objectives: to identify outcome measurement instruments used in the literature and assess their applicability for use in clinical trials of PO.Methods:This systematic review was registered with PROSPERO (CRD42023407976). Database searches of EMBASE, MEDLINE and Cochrane was performed on June 6, 2023, covering from Jan 1995 to May 2023. Randomised controlled trials or study protocols involving CYP with PO were included following PRISMA guidelines. Risk of bias was assessed with Cochrane's tool.Results:Of the 377 papers identified, six were included in the systematic review. The primary outcome of five of the studies related to otorrhoea cessation; both time to cessation and proportion recovered at various time points were used as measures. Two measurement instruments were identified: Otitis Media-6 Questionnaire and the Institute for Medical Technology Assessment Productivity Cost Questionnaire. Both were shown to be applicable measurement instruments when used in clinical trials of PO.Conclusions:To promote homogeneity and facilitate meaningful comparison and combination of studies, we propose that time to cessation of otorrhoea from onset of otorrhoea should be used as the primary outcome in future studies. Further research is needed to establish if this is the most important outcome to children and their caregivers

Impact of ‘DEALTS2’ education intervention on trainer dementia knowledge and confidence to utilise innovative training approaches: A national pre-test – post-test survey

Background Gaps in acute care staff knowledge, skills, and attitudes towards dementia exist. Innovative training approaches that improve the delivery of care for people with dementia are needed. We were commissioned by Health Education England to develop and evaluate a new dementia education intervention ‘Dementia Education And Learning Through Simulation 2’ (DEALTS2), a simulation toolkit to enhance delivery of dementia training nationally across England. Objectives Evaluate differences in trainer dementia knowledge scores pre and post training, satisfaction with DEALTS2 Train-The-Trainer (TTT) workshops and simulation toolkit, confidence to use training approaches, and spread of implementation. Design A questionnaire survey using a pre-test – post-test design with measures completed: before (pre-test); after (T1); and 12 months post training (T2). Setting Twelve one-day DEALTS2 TTT workshops delivered across England in 2017. Participants National Health Service Trust staff employed in dementia training roles (n=199 trainers). Methods Trainers attended DEALTS2 TTT workshops and received the simulation toolkit. Data were collected between 2017 and 2018 using a questionnaire capturing differences in dementia knowledge scores, Likert scales and closed-ended questions measured satisfaction, confidence and implementation. Data were analysed using quantitative methods. Results Response rate was 92% (n=183) at pre-test/T1 and 26% (n=51) at T2. Trainer dementia knowledge scores increased from pre-test to T1 (p < 0.001) and were retained after 12 months in 5 of the 6 areas measured (pre-test to T2, p < 0.002); largest gains in ‘humanised approaches to dementia care’. 96% (n=176/183) were satisfied with DEALTS2 TTT workshops and simulation toolkit; 66.7% (n=34/51) felt confident to deliver dementia training informed by DEALTS2. Adherence rates were good with 45% (n=23/51) using the innovative training approaches within twelve months. Conclusions The results show DEALTS2 effectively increased trainer dementia knowledge and confidence to utilise innovative dementia training approaches. Implementation of DEALTS2 varied across organisations, therefore further research should explore factors determining successful implementation

Doing gender locally: The importance of ‘place’ in understanding marginalised masculinities and young men’s transitions to ‘safe’ and successful futures

Observable anxieties have been developing about the position of boys and young men in contemporary society in recent years. This is expressed as a crisis of masculinity, in which place is often implicitly implicated, but is rarely considered for its role in the shaping of young men’s practices, trajectories and aspirations. Drawing on research conducted with young people who accessed a range of social care support services, this article argues that transition means different things for young men in different locales and that local definitions of masculinity are required to better understand young men’s lives and the opportunities available to them. The authors argue that home life, street life, individual neighbourhoods, regions and nations all shaped the young men’s identities and the practices they (and the staff working with them) drew on in order to create successful futures and ‘safe’ forms of masculinity. It is suggested that this place-based approach has the potential to re-shape the ‘crisis’ discourse surrounding masculinity and the anxieties associated with young men

The Social Care and Support Needs of Adults with Concurrent Dementia and Visual Impairment

Over 100,000 people in the UK have concurrent visual impairment and dementia, resulting in isolation, falls and reduced independence. However, current models of care and support tend to focus on each condition separately, meaning that individual needs are rarely addressed. This can lead to high levels of anxiety and distress as well as placing great demands on carers, highlighting the need for support for informal carers and separate assessment of carer’s needs. This presentation reports on a new study exploring the lived experience of people with both dementia and visual impairment and the views of professionals. The aim was to investigate how best to provide care and support for adults living with both conditions in a range of housing settings, and develop evidence-based practice guidance to improve social care and support. 26 qualitative face-to-face interviews with people with dementia and sight loss, sometimes with their family carers, were conducted. In addition, focus groups were held involving a total of 47 health, social care and housing professionals, using a semi-structured topic guide developed by the project team. Participants were recruited across three sites in England: the North East, the South West and the Midlands. Each interview and focus group was analysed thematically using computer-assisted qualitative data analysis software, with emerging themes being compared and discussed by team members in order to validate the findings. The findings were discussed at a consensus event that included people with dementia and sight loss, family carers and professionals working in housing, health and social care. This led to the development of a set of recommendations for improving social care and support for people with visual impairment and dementia. These include timely diagnosis for both conditions, and a greater focus on holistic care rather than support for one condition over the other

Long Intergenic Noncoding RNAs Mediate the Human Chondrocyte Inflammatory Response and Are Differentially Expressed in Osteoarthritis Cartilage

Objective To identify long noncoding RNAs (lncRNAs), including long intergenic noncoding RNAs (lincRNAs), antisense RNAs, and pseudogenes, associated with the inflammatory response in human primary osteoarthritis (OA) chondrocytes and to explore their expression and function in OA. Methods OA cartilage was obtained from patients with hip or knee OA following joint replacement surgery. Non-OA cartilage was obtained from postmortem donors and patients with fracture of the neck of the femur. Primary OA chondrocytes were isolated by collagenase digestion. LncRNA expression analysis was performed by RNA sequencing (RNAseq) and quantitative reverse transcriptase-polymerase chain reaction. Modulation of lncRNA chondrocyte expression was achieved using LNA longRNA GapmeRs (Exiqon). Cytokine production was measured with Luminex. Results RNAseq identified 983 lncRNAs in primary human hip OA chondrocytes, 183 of which had not previously been identified. Following interleukin-1β (IL-1β) stimulation, we identified 125 lincRNAs that were differentially expressed. The lincRNA p50-associated cyclooxygenase 2-extragenic RNA (PACER) and 2 novel chondrocyte inflammation-associated lincRNAs (CILinc01 and CILinc02) were differentially expressed in both knee and hip OA cartilage compared to non-OA cartilage. In primary OA chondrocytes, these lincRNAs were rapidly and transiently induced in response to multiple proinflammatory cytokines. Knockdown of CILinc01 and CILinc02 expression in human chondrocytes significantly enhanced the IL-1-stimulated secretion of proinflammatory cytokines. Conclusion The inflammatory response in human OA chondrocytes is associated with widespread changes in the profile of lncRNAs, including PACER, CILinc01, and CILinc02. Differential expression of CILinc01 and CIinc02 in hip and knee OA cartilage, and their role in modulating cytokine production during the chondrocyte inflammatory response, suggest that they may play an important role in mediating inflammation-driven cartilage degeneration in OA