Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology

BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities. RESULTS: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability. CONCLUSIONS: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature

Acceptability of healthcare interventions : an overview of reviews and development of a theoretical framework

Abstract Background It is increasingly acknowledged that \u2018acceptability\u2019 should be considered when designing, evaluating and implementing healthcare interventions. However, the published literature offers little guidance on how to define or assess acceptability. The purpose of this study was to develop a multi-construct theoretical framework of acceptability of healthcare interventions that can be applied to assess prospective (i.e. anticipated) and retrospective (i.e. experienced) acceptability from the perspective of intervention delivers and recipients. Methods Two methods were used to select the component constructs of acceptability. 1) An overview of reviews was conducted to identify systematic reviews that claim to define, theorise or measure acceptability of healthcare interventions. 2) Principles of inductive and deductive reasoning were applied to theorise the concept of acceptability and develop a theoretical framework. Steps included (1) defining acceptability; (2) describing its properties and scope and (3) identifying component constructs and empirical indicators. Results From the 43 reviews included in the overview, none explicitly theorised or defined acceptability. Measures used to assess acceptability focused on behaviour (e.g. dropout rates) (23 reviews), affect (i.e. feelings) (5 reviews), cognition (i.e. perceptions) (7 reviews) or a combination of these (8 reviews). From the methods described above we propose a definition: Acceptability is a multi-faceted construct that reflects the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. The theoretical framework of acceptability (TFA) consists of seven component constructs: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Conclusion Despite frequent claims that healthcare interventions have assessed acceptability, it is evident that acceptability research could be more robust. The proposed definition of acceptability and the TFA can inform assessment tools and evaluations of the acceptability of new or existing interventions

Promoting a culture of curiosity within nursing practice

The professional status of nursing requires that nurses have access to and can understand a knowledge base at the correct academic level. Over the last 15 years there has been an explosion in the amount of best practice evidence available to nurses. There has also been an increasing emphasis on independent life-long learning and an expectation that nurses should be able to teach themselves. This article argues that a culture of curiosity is a key requirement of these demands. It examines the origins and nature of curiosity and proposes teaching techniques that can be used in higher education institutions and in clinical practice to promote a culture of curiosity in nursing

Promoting curiosity through the enhancement of competence

Because of the political and professional expectation that nurses engage in independent lifelong learning, nurses have to be able to teach themselves. Furthermore, their learning needs to be at the correct educational level. A culture of curiosity is therefore a key requirement of modern nursing. This article analyses a theory that cyclically links curiosity to competency and argues that curiosity thrives in an environment that maximizes competency. The nature and dimensions of competency are discussed. The article examines the importance of competence in nursing practice. It discusses what the principles of best practice are in relation to using competency to maximise curiosity in the clinical learning environment

Molecular boronic acid-based saccharide sensors

Boronic acids can reversibly bind diols, a molecular feature that is ubiquitous within saccharides, leading to their use in the design and implementation of sensors for numerous saccharide species. There is a growing understanding of the importance of saccharides in many biological processes and systems; while saccharide or carbohydrate sensing in medicine is most often associated with detection of glucose in diabetes patients, saccharides have proven to be relevant in a range of disease states. Herein the relevance of carbohydrate sensing for biomedical applications is explored, and this review seeks to outline how the complexity of saccharides presents a challenge for the development of selective sensors and describes efforts that have been made to understand the underpinning fluorescence and binding mechanisms of these systems, before outlining examples of how researchers have used this knowledge to develop ever more selective receptors

Los Alamos geostationary orbit synoptic data set: a compilation of energetic particle data

Energetic electron (30 to 2000 keV) and proton (145 keV to 150 MeV) measurements made by Los Alamos National Laboratory sensors at geostationary orbit 6.6 R/sub E/ are summarized. The data are plotted in terms of daily average spectra, 3-h local time averages, and in a variety of statistical formats. The data summarize conditions from mid-1976 through 1978 (S/C 1976-059) and from early 1977 through 1978 (S/C 1977-007). The compilations correspond to measurements at 35/sup 0/W, 70/sup 0/W, and 135/sup 0/W geographic longitude and, thus, are indicative of conditions at 9/sup 0/, 11/sup 0/, and 4.8/sup 0/ geomagnetic latitude, respectively. Most of this report is comprised of data plots that are organized according to Carrington solar rotations so that the data can be easily compared to solar rotation-dependent interplanetary data. As shown in prior studies, variations in solar wind conditions modulate particle intensity within the terrestrial magnetosphere. The effects of these variations are demonstrated and discussed. Potential uses of the Synoptic Data Set by the scientific and applications-oriented communities are also discussed