An Examination of the Concept of Need and its Operational Uses in Applied Social Research

The concept of need is a central one in the development of social services and other aspects of social policy. Despite its significance, there is a lack of clarity about, and common understanding of, the concept. Concepts are abstractions from reality, and their use requires some shared understanding. A study of the literature shows that there are diverse elements to the meaning and use of the concept: needs may relate to individuals, groups, societies; they may be identified 'objectively' as universals, yet experienced subjectively in cultural contexts which vary in time and space. Social policy is, among other things, concerned with the way in which society acknowledges and responds to identified individual and social needs. It is developed and implemented through the political processes of government, at various levels. In this context the diverse meanings of the concept of need may be used; the extent to which understanding is shared is debatable. This poses problems for the researcher working to identify, survey or measure need in the social policy context. Operational definitions of need will have to be developed; they will be influenced by the political context in which the research is being undertaken. All such definitions will have political implications. Yet many research studies are carried out without acknowledging the nature or implications of the political context on their approach to their research, on their operational use of the concept need, or consequently on their results. Such results often carry a spurious validity and credibility. Researchers working in the social policy context should acknowledge its political nature, at the least try to present and explicate their methodology, including in particular the conceptualization process, to provide readers and users with the basis for evaluating their results

EXPLORING PUBLIC HEALTH NURSE PRECEPTORS ’ EXPERIENCE OF LEARNING

Exploring Public Health Nurse Preceptors’ Experience of Learning The preceptorship model is the leading approach to clinical teaching in undergraduate nursing programs. There is a need for community placements however a lack of preceptors. In preceptor-student relationships experienced nurses learn along with the students. This qualitative study utilized hermeneutic phenomenology to answer the questions: How do public health nurse preceptors experience learning within a preceptor-student relationship? What is the meaning of learning for public health nurse preceptors Seven public health nurse preceptors were recruited from health units in Ontario. Findings from this study reveal the tacit knowledge within experienced nurse preceptors. Preceptors learned from their preceptee, explored similarities and differences and were challenged by uncertainties in their practice. Preceptors experienced tensions between holding on and letting go, between work and home life, and within the ‘swamp’ of practice. This study reveals the experiential tacit knowledge, practical wisdom, reciprocal learning and professional development of nurses within preceptorships

It takes two? A randomised controlled pilot study to evaluate the feasibility and indicative effectiveness of joint physical activity consultations with colorectal cancer survivors and their partners

Title: A randomised controlled pilot study to assess the feasibility and indicative effectiveness of joint physical activity consultations with colorectal cancer survivors and their partners. Background: Colorectal cancer (CRC) is the third most common cancer in Scotland and five-year survival has increased to 60% in the past 30 years. Evidence suggests that physical activity (PA) can improve cancer-specific and overall survival, as well as general and cancer-specific health outcomes in colorectal cancer survivors (CRC-Ss). Partners are a potential source of social support for CRC-Ss who may also benefit from increased PA. Couples have also been shown to share health behaviours. Therefore, this pilot study aimed to examine the feasibility of a randomised controlled trial of a joint PA intervention (PA consultations) with CRC-Ss and their partners. Specific objectives were to assess the feasibility of trial methods, the feasibility of the intervention and indicative effectiveness of the intervention on PA level and other health outcomes in CRC-Ss and their partners. Method: This 6-month, parallel, randomised controlled pilot study took place in Glasgow. Participants were CRC-Ss who had completed all treatment for colorectal cancer in the previous 30 months and their partners. Participants were recruited by colorectal nurses from one hospital site and randomised using blocked SNOSE randomisation. This was not a blinded study. The intervention group received two home-based PA consultations, at baseline and three months. The control group received usual care. The main outcome measures were descriptions of trial protocol and intervention feasibility. Situational Analysis was conducted on intervention audio-recordings to inform feasibility. Data was also collected on PA level, mental well-being, quality of life, general self-efficacy and perceived relationship support. Results: Over 15 weeks, 199 CRC-Ss were screened for eligibility; 49 (64.5%) eligible CRC-Ss were telephoned and 29 (59.1%) were recruited and randomised to the study along with their partners; 15 couples in the intervention group and 14 couples in the control. Retention to the study and compliance with the intervention were both 100%. Compliance with objective measures of PA was acceptable (77.6%), although there was some attrition in certain self-reported outcome data. There were no large indicative effects of the intervention on PA level or health outcomes, although small changes were found in PA level in the intervention group. There were no adverse events related to study participation. Conclusions: Overall, trial protocol was feasible and joint PA consultations were feasible to deliver with CRC-Ss and their partners. There was a slight increase in PA at 3 months. Alone, this study does not provide sufficient evidence to proceed to a pilot trial. Future research should consider alternative sources of social support, alternative interventionist and systematic synthesis of feasibility research in this area

Negative-Parity Heavy Pentaquark States in 1/N_c

The 1/N_c expansion for negative-parity heavy pentaquarks is developed using the formalism introduced for excited baryons in large N_c. Relations are found between the mass splittings of these pentaquarks and those of nonexotic baryons.Comment: 14 pages, 3 figures; v2: footnotes and references added, typos corrected; v3: some entries in Table II and equation (12) correcte

Cost comparison of orthopaedic fracture pathways using discrete event simulation in a Glasgow hospital

Objective: Healthcare faces the continual challenge of improving outcome whilst aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway. Design:  Discrete event simulation was used to model and analyse cost and resource utilisation with an activity based costing approach. Data for a full comparison before the process change was unavailable so we utilised a modelling approach, comparing a Virtual Fracture Clinic (VFC) to a simulated Traditional Fracture Clinic (TFC). Setting:  The orthopaedic unit VFC pathway pioneered at Glasgow Royal Infirmary has attracted significant attention and interest and is the focus of this cost study. Outcome measures: Our study focused exclusively on non-operative trauma patients attending Emergency Department or the minor injuries unit and the subsequent step in the patient pathway. Retrospective studies of patient outcomes as a result of the protocol introductions for specific injuries in association with activity costs from the models.ResultsPatients are satisfied with the new pathway, the information provided and the outcome of their injuries (Evidence Level IV). There was a 65% reduction in the number of first outpatient face-to-face attendances in orthopaedics. In the VFC pathway, the resources required per day were significantly lower for all staff groups (p=<0.001). The overall cost per patient of the VFC pathway was £22.84 (95% CI: 21.74, 23.92) per patient compared with £36.81 (95% CI: 35.65, 37.97) for the TFC pathway.  Conclusions:  Our results give a clearer picture of the cost comparison of the virtual pathway over a wholly traditional face-to-face clinic system. The use of simulation-based stochastic costings in healthcare economic analysis has been limited to date, but this study provides evidence for adoption of this method as a basis for its application in other healthcare settings

The Effects of Using Mental Imagery as a Comprehension Strategy for Middle School Students Reading Science Expository Texts

This study investigated the effects of mental imagery instruction using science expository texts on middle school students. Using a quasi-experimental pretest-posttest design, four intact classes (56 students) were randomly assigned to either an experimental or comparison group. Students in the experimental group received instruction on mental imagery strategies while comparison group students received no mental imagery instruction. After the 2-week intervention, students took Posttest 1. The comparison group students then received mental imagery instruction. Throughout the rest of the school year, all students were prompted at least two to three times a week to use mental imagery strategies. At the end of the school year, all participants took Posttest 2. Results indicated that there was a statistically significant interaction of time and group for the selected response (SR) portion of expository science text comprehension measure. Both groups appeared to make gains between Posttest 1 and Posttest 2, once both had received mental imagery instruction. The comparison group, which by chance included stronger readers, outperformed the experimental group. There were no statistically significant differences on the brief constructed response (BCR) measure. Analysis of the performance of low-, middle-, and high-comprehenders revealed statistically significant main effects for time and for type of comprehender on the SR portion of the comprehension task. While all students appeared to make gains between Posttest 1 and 2, the high- and middle-comprehenders consistently outperformed the low-comprehenders. For the BCR, there were no statistically significant effects of time or interaction; however, there was a statistically significant effect for type of comprehender. Pearson's product moment correlations revealed a statistically significant positive relation between vividness of mental imagery and motivation to read for middle-comprehenders and a statistically significant negative correlation between comprehension and vividness of mental imagery for high-comprehenders. Both experimental and comparison groups showed no statistically significant difference in motivation to read before and after mental imagery intervention. These results suggest that middle school students may benefit from mental imagery strategies when reading science expository texts. It is recommended that these strategies be used as a continuous effort in the classroom rather than a short term "quick-fix.

The professional middle class and the social origins of progressivism : a case study of the New Education Fellowship

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