Behind the masks:A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to anxiety and wellbeing during the COVID-19 pandemic

Early findings suggest the COVID-19 pandemic and related containment measures negatively impact mental wellbeing. This study compared the contribution and relations of three factors to anxiety and wellbeing during the pandemic in June 2020. These factors were: i) Contextual factors (e.g. exposure to COVID-19, being a keyworker, feeling lonely); ii) Cognitive appraisals: perceived vulnerability to disease (PVD) and intolerance of uncertainty (IU); and iii) psychological flexibility (PF). 603 participants aged 18 or older completed an online survey of self-report measures. Hierarchical regression analyses demonstrated PVD, IU and PF predicted state anxiety, and IU and PF predicted mental wellbeing. Some, but not all of the contextual factors also predicted state anxiety and wellbeing. The findings support cognitive appraisal theories and the PF model, lending support to an acceptance and commitment therapy (ACT) approach to public health during pandemics

Use of the nominal group technique to identify UK stakeholder views of the measures and domains used in the assessment of therapeutic exercise adherence for patients with musculoskeletal disorders

OBJECTIVES: The objective was to the undertake nominal group technique (NGT) to evaluate current exercise adherence measures and isolated domains to develop stakeholder consensus on the domains to include in the measurement of therapeutic exercise adherence for patients with musculoskeletal disorders. DESIGN: A 1-day NGT workshop was convened. Six exercise adherence measures were presented to the group that were identified in our recent systematic review. Discussions considered these measures and isolated domains of exercise adherence. Following discussions, consensus voting identified stakeholder agreement on the suitability of the six offered adherence measures and the inclusion of isolated domains of exercise adherence in future measurement. SETTING: One stakeholder NGT workshop held in Sheffield, UK. PARTICIPANTS: Key stakeholders from the UK were invited to participate from four identified populations. 14 participants represented patients, clinicians, researchers and service managers. RESULTS: All six exercise adherence measures were deemed not appropriate for use in clinical research or routine practice with no measure reaching 70% group agreement for suitability, relevance, acceptability or appropriateness. Three measures were deemed feasible to use in clinical practice. 25 constructs of exercise adherence did reach consensus threshold and were supported to be included as domains in the future measurement of exercise adherence. CONCLUSION: A mixed UK-based stakeholder group felt these six measures of exercise adherence were unacceptable. Differences in opinion within the stakeholder group highlighted the lack of consensus as to what should be measured, the type of assessment that is required and whose perspective should be sought when assessing exercise adherence. Previously unused domains may be needed alongside current ones, from both a clinician's and patient's perspective, to gain understanding and to inform future measurement development. Further conceptualisation of exercise adherence is required from similar mixed stakeholder groups in various socioeconomic and cultural populations

How do regulations affect SMEs? A review of the qualitative evidence and a research agenda

The effects of regulations on SMEs have garnered significant political attention internationally yet, in the academic literature, these effects remain contested. This article presents findings from a systematic literature review of qualitative evidence on the effects of regulation on SMEs. We set out the strengths of qualitative approaches in relation to other, more dominant and influential quantitative approaches. We conduct a thematic synthesis of the qualitative research to develop a conceptual framework that provides a processual, embedded understanding of the effects of regulations on SMEs. The conceptual framework highlights four key, interconnected processes: identification-interpretation; strategisation; negotiation; adaptation. This conceptual framework generates insights into dynamic and potentially indirect effects of regulations in relation to a complex array of influences external to and within the business. On the basis of these insights we propose a new research agenda

A survey of clinical nursing skills in intellectual disability nursing

In this study the question asked is: what clinical nursing skills are predominantly used in intellectual disability nursing? A survey of the nursing needs of people with moderate to severe intellectual disability in both residential and community units was undertaken with a questionnaire.The measure was a Likert design scale ranging across: skills used more than once a day, skills used daily, skills used weekly, skills used monthly, skills very rarely used, and skills never used.The results of the study help to identify, plan, and direct the type and level of nursing skills taught to the intellectual disability nursing students and provides an insight into the current nursing skills used in the intellectual disabilities field

Earthquake Risk and U.S. Highway Infrastructure: Frequently Asked Questions

This report addresses frequently asked questions about the risk from earthquakes to highway systems, including bridges, tunnels, pavements, and other highway components. Particular attention is given to highway bridges, which often are the most vulnerable highway structures. The report also discusses federal and nonfederal actions to reduce seismic risk to the U.S. highway system