Changing characteristics of hospital admissions but not the children admitted—a whole population study between 2000 and 2013

Funding: The data were hosted in the safe haven thanks to funding by the FARR institution. Open Access via Springer Compact Agreement.Peer reviewedPublisher PD

Physician and Parental Decision—Making Prior to Acute Medical Paediatric Admission

Supplementary Materials: The following are available online at http://www.mdpi.com/2227-9032/6/3/117/s1, Table S1: characteristics of referring clinicians, Table S2: characteristics of receiving clinicians, Table S3: characteristics of parents/caregivers and their child. Funding: This research received no external funding. Acknowledgments: The authors are grateful to the participants for their time.Peer reviewedPublisher PD

Very young children in need or at risk of significant harm: issues affecting parenting capacity.

Introduction This workshop is based on preliminary findings from ‘Protecting and Promoting the Wellbeing of Very Young Children: A prospective study of babies in need or at risk of significant harm’. The study traces the decision-making process influencing the life pathways of very young children at high risk of significant harm from birth until age two

Experiences of support garments following bowel stoma formation:analysis of free-text responses in a cross-sectional survey

Aim To explore the experiences of support garments when adjusting to bodily change following bowel stoma formation. Design Thematic analyses of free-text responses in a cross-sectional survey of the stoma population in 2018. Methods Free-text responses were invited so that respondents could describe their experiences in more detail. A process of induction was chosen to allow for themes to emerge directly from the data. The concept a €a embodiment' was used as a theoretical framework during interpretation. Results 1425 people with a bowel stoma responded to the survey, of whom 598 provided free-text responses. Four themes about experiences of support garments in the context of changed bodily experiences following stoma formation were identified: body complications, which is about experiences of using support garments to prevent or self-manage parastomal hernia; body appearance, which is about hiding the stoma and stoma appliance; body function, which is about managing stoma appliance complications; and body sensation, which is mainly about negative experiences of ill-fitting garments. Conclusion Support garments can be understood as items that are used by people during an ongoing process of adjusting to bodily changes following stoma formation and as part of an ongoing process of reconstructing new embodied selves. Impact This is the first study to explore people's experiences of support garments following bowel stoma formation. Support garments are used in the self-management of body complications, appearance, function and sensations. Stoma nurses may draw on the findings of this study to advise patients about the benefits of garments for adjusting to bodily change, and garment suppliers should address people's negative experiences by improving garments.</p

A physical activity intervention to improve the quality of life of patients with a stoma:a feasibility study protocol

Background: Physical activity (PA) is positively associated with quality of life. People with a stoma are less likely to engage in PA than those without a stoma. Methods: In this feasibility intervention study, we will perform the following: (1) Develop a PA intervention for people with a stoma. An Expert Working Group of behavioural scientists, exercise scientists, clinicians and a Patient Advisory Group of people with a bowel stoma will meet with the research team to inform the development of a PA intervention for people with a stoma. A manual of the intervention will be the main output. (2) Explore PA instructors' experiences of delivering the PA intervention. PA instructors will record on paper the number of PA consultations with each patient and a researcher will interview the PA instructors about their experiences of delivering the intervention. (3) Assess the level of patient (bowel cancer or inflammatory bowel disease (IBD) patients with a stoma between 6 weeks and 24 months postsurgery) engagement with the PA intervention and their views on intervention acceptability and usefulness. Patients will keep a PA diary to record daily pedometer recorded step count and type and duration of activities. A researcher will interview patients about their experiences of the PA intervention. (4) Assess screening, eligibility, consent, data completion, loss to follow up, and missing data rates, representativeness of participants and potential treatment effects. A researcher will record on paper all study procedure parameters. Quality of life (stoma-quality of life; Functional Assessment of Cancer Therapy, Short IBD questionnaire), fatigue (FACIT fatigue scale) and PA (accelerometer) will be measured pre- and post-intervention in patients. For IBD patients only, blood will be taken to measure systemic inflammation. Discussion: We hypothesise that a PA intervention will be an effective means of improving the quality of life of people with a stoma. Before embarking on a full randomised controlled trial to test this hypothesis, a PA intervention needs to be developed and a feasibility study of the proposed PA intervention conducted.</p

A systematic review and meta‐analysis of the effectiveness of self‐management interventions in people with a stoma

Aims: Explore the evidence from randomized controlled trials for the effect of self management interventions on quality of life, self-management skills and self-efficacy, and to explore which intervention characteristics are associated with effectiveness.Design: Systematic review.Data sources: A search of the literature was conducted in these databases: MEDLINE (OVID), EMBASE (OVID) and PsychINFO (OVID) from January 2000 to February 2020.Review methods: Studies were included if participants had a bowel stoma, were over the age of 18 and the design was a randomized controlled trial of a self-management programme. The outcome measures for this review were quality of life, self management skills and self-efficacy. The Behaviour Change Technique Taxonomy was used to code interventions for underlying components and alongside other intervention characteristics, associations with improvements in outcomes were explored.Results: The search identified 3141 articles, 16 of which were eligible. A meta-analysis of self-efficacy scores from five studies (N = 536) found an improvement in those that received the self-management intervention at follow-up with a 12-point meandifference compared with the usual care group. Effects on quality of life and self management skills were mixed, and meta-analyses of these data were not possible. Across 13 studies an average of 10 behaviour change techniques were used with, credible source (e.g. nurse, doctor, therapist) (n = 13), instruction on how to perform the behaviour (n = 13), demonstration of the behaviour (n = 12) used most often. The behaviour change technique of self-monitoring was associated with an improvement in quality of life. The involvement of a nurse was associated with higher self-efficacy and self-management skills.Conclusion: This review suggests that self-management interventions can increase peoples’ self-efficacy for managing their stoma.Impact: A standardized approach to the reporting of interventions and the measures used is needed in future studies to better understand the effect on quality of life and self-management skills

Mortality and other outcomes after paediatric hospital admission on the weekend compared to weekday

Storage of the data was funded by the FARR Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability Statement: The data underlying this study belong to the Scottish government and cannot be shared publicly. Readers can contact the electronic Data Research and Innovation Service (eDRIS) on http://www.isdscotland.org/Productsand-Services/eDRIS/ to apply for access to these restricted data sets. With the appropriate approvals in place, readers would be able to access these data in the same manner as the authors. The authors did not have any special privileges in obtaining the data set.Peer reviewedPublisher PD

Divergent effects of listening demands and evaluative threat on listening effort in online and laboratory settings

ObjectiveListening effort (LE) varies as a function of listening demands, motivation and resource availability, among other things. Motivation is posited to have a greater influence on listening effort under high, compared to low, listening demands.MethodsTo test this prediction, we manipulated the listening demands of a speech recognition task using tone vocoders to create moderate and high listening demand conditions. We manipulated motivation using evaluative threat, i.e., informing participants that they must reach a particular “score” for their results to be usable. Resource availability was assessed by means of working memory span and included as a fixed effects predictor. Outcome measures were indices of LE, including reaction times (RTs), self-rated work and self-rated tiredness, in addition to task performance (correct response rates). Given the recent popularity of online studies, we also wanted to examine the effect of experimental context (online vs. laboratory) on the efficacy of manipulations of listening demands and motivation. We carried out two highly similar experiments with two groups of 37 young adults, a laboratory experiment and an online experiment. To make listening demands comparable between the two studies, vocoder settings had to differ. All results were analysed using linear mixed models.ResultsResults showed that under laboratory conditions, listening demands affected all outcomes, with significantly lower correct response rates, slower RTs and greater self-rated work with higher listening demands. In the online study, listening demands only affected RTs. In addition, motivation affected self-rated work. Resource availability was only a significant predictor for RTs in the online study.DiscussionThese results show that the influence of motivation and listening demands on LE depends on the type of outcome measures used and the experimental context. It may also depend on the exact vocoder settings. A controlled laboratory settings and/or particular vocoder settings may be necessary to observe all expected effects of listening demands and motivation