Making Every Contact Count: Evaluation of the use of MECC within the outpatient MSK Physiotherapy service and Bury Integrated MSK Service at Fairfield General Hospital, part of the Bury and Rochdale Care Organisation which is part of the Northern Care Alliance Group

This report presents the findings of a commissioned study to evaluate the use of Making Every Contact Count (MECC) within the outpatient MSK Physiotherapy service and Bury Integrated MSK Service at Fairfield General Hospital, part of the Bury and Rochdale Care Organisation which is part of the Northern Care Alliance Group (hereafter referred to as Fairfield MSK Physiotherapy Services). The study was a three–stage evaluation to include: an initial service description analysis for musculoskeletal (MSK) treatment a secondary data analysis of data related to MECC referrals made by Fairfield MSK Physiotherapy Services and a patient questionnaire relating to experiences of MECC within Fairfield MSK Physiotherapy Services</ol

Biases incurred from non-random repeat testing of haemoglobin levels in blood donors

To help prevent anaemia, it is a requisite for blood donors to undergo a haemoglobin test to ensure levels are not too low before donation. It is therefore important to have an accurate testing device and strategy to ensure donors are not being inappropriately bled. A recent study in blood donors used a selective testing strategy where if a donor’s haemoglobin level is below the level required for donation, then another reading is taken and if this occurs again, a third and final reading is used. This strategy can reduce the average number of readings required per donor compared to taking three measurements for all donors. However, the final decision-making measurement will on average be higher than a single measurement. In this paper, a selective testing strategy is compared against other strategies. Individual-level biases are derived for the selective strategy and are shown to depend on how close a donor’s true haemoglobin level is to the donation threshold and the magnitude of error in the testing device. A simulation study was conducted using the distribution of haemoglobin levels from a large donor population to investigate the effects different strategies have on population performance. We consider scenarios based on varying the measurement device bias and error, including differential biases that depend on the underlying haemoglobin level. Discriminatory performance is shown to be affected when using the selective testing strategies, especially when measurement error is large and when differential bias is present in the device. We recommend that the average of a number of readings should be used in preference to selective testing strategies if multiple measurements are available

Charities’ use of Twitter : exploring social support for women living with and beyond breast cancer

Twitter is one social media platform that enables those experiencing breast cancer to access support from others. This study explores how cancer charities provide support to women living with and beyond breast cancer (LWBBC) through their Twitter feeds. Seven hundred and seventy-two tweets from seven purposively sampled cancer charities were used to explore Twitter posts made relating to social support. Two questions were posed: (1) what type of support is positioned by cancer charities on Twitter for women LWBBC and (2) what themes emerge from tweet content pertaining to support for women LWBBC? Using a peer-reviewed typology of ‘social support’ [Rui, J., Chen, Y., & Damiano, A. (2013). Health organizations providing and seeking social support: A twitter-based content analysis. Cyberpsychology, Behavior, And Social Networking, 16(9), 669–673. doi:10.1089/cyber.2012.0350], a deductive content analysis was utilised to identify informational, instrumental or emotional social support tweets (n = 199). Over half (56%) of tweets offered informational support; 27% provided or sought instrumental support and 18% related to emotional support. Interestingly, 74.3% (n = 573) of tweets were not related to providing or seeking social support. An inductive qualitative thematic analysis of the 199 tweets identified the focus (i.e., themes) of support. Three themes were identified: (1) raising awareness, (2) focusing on the future and (3) sharing stories. Cancer charities predominantly use Twitter to signpost women to informational resources and to seek instrumental support to meet charitable objectives. As the number of women LWBBC continues to increase, this study provides valuable insight into how charities represent themselves on Twitter in relation to the social support needs of women LWBBC

HAVE WE REACHED PEAK DESIGN THINKING? Are we entering a new paradigm for how it is used within practice and business?

Design Thinking has gained recognition as an acclaimed process for generating innovative, human centred solutions at a social and business level. It has also gained notoriety amongst many designers, who claim that its success as an exported element of the design process has resulted in its commodification, and led to it becoming a diluted series of processes that lack criticality. As design disciplines and the role of designers continue to evolve, we should reflect on design thinking’s original context and understand its progression into a non-design world. Our hypothesis is that design thinking has reached a ‘peak’ in contemporary practice, and as the term 'design' is further adapted and conformed to suit a business function, this conversational will elicit a constructive debate on the future of design thinking and its positioning within design and non-design industries. Has Design Thinking’s commodification and consumption as a step by step road map to innovation reduced it to a mainstream approach? Can we use the undoubted successes of design thinking as a catalyst for future design research? It is anticipated that through analysis and discussion, this conversation will inform the conceptualisation of enhanced methodological frameworks that aim to support innovation across divergent industry practices

Using e-cigarettes for smoking cessation : evaluation of a pilot project in the North West of England

Aims: E-cigarettes have been advocated as an effective smoking cessation intervention, with evidence indicating that they are substantially less harmful than conventional cigarettes. As a result, a pilot to encourage people to swap from conventional cigarettes to e-cigarettes was conducted in 2018 in a socially deprived area in the North West of England. This evaluation highlights the key findings from the pilot. Methods: An analysis of secondary data at 4 weeks (n = 1022) was undertaken to predict those who used solely used e-cigarettes (i.e. had quit tobacco, as confirmed by a carbon monoxide test, CO < 10 ppm) from baseline characteristics, using chi-square tests and logistic regression. Baseline data were demographics, smoking levels and service provider type. Results: Of the 1022 participants who engaged with the pilot 614 were still engaged at 4 weeks, of whom 62% had quit; quitting was more likely in younger participants (aged 18–24) and less likely in those who were sick and disabled. Of those who still smoked tobacco at week 4 (n = 226), smoking had reduced from a baseline of 19.1 cigarettes/day to 8.7. Overall, 37% (381) of those initially enrolled were confirmed to be using an e-cigarette on its own at follow-up. Successful quit was associated with occupation (unemployed, 33% vs intermediate, 47%, p = .023) and residing in the less deprived quintiles of deprivation (50% vs 34% in the most deprived quintile, p = .016). Conclusions: Making the conservative assumption that all those not in contact at 4 weeks were still smoking tobacco, for every five people entering the scheme, three people stayed on the programme and reduced their cigarette smoking and one person cut out tobacco altogether. E-cigarettes appear to be an effective nicotine replacement therapy; however, further research is required to determine whether e-cigarette users are more likely to reduce their overall nicotine consumption in the longer term

Revisiting the De-Radicalisation or Disengagement Debate: Public Attitudes to the Re-Integration of Terrorists

The article reports on the findings of an experimental survey which was conducted to ascertain the level of support and perceived effectiveness of using de-radicalisation programmes to re-integrate returning foreign fighters. Public support (or the lack of opposition) for re-integration programmes can be important in ensuring the programmes have the time, resources and opportunity to be successful however we know little about what wider society thinks about re-integration programmes. The article explores the extent to which the inclusion of de-radicalisation – in name and content – changes attitudes to a re-integration programme. This is relevant in showing attitudes to de-radicalisation over disengagement and whether de-radicalisation, while perhaps not more effective at the programme-level, is or is not more effective at generating public support for re-integration (and thereby facilitating the process itself). We find that the inclusion of de-radicalisation in the name and content of a re-integration programme to a small extent increases support for re-integration over a programme that uses the terms disengagement and desistance. However, we also find that while de-radicalisation increases support, it also decreases perceived effectiveness, leading respondents to feel it makes the country less safe and less likely to reduce the re-offending rate than if the programme excludes de-radicalisation. We argue this polarising effect is reflective of wider reasons for supporting the policies (e.g. de-radicalisation may be seen as a form of ideational/normative punishment) and that the term de-radicalisation may shift the framing of the problematic to entrenched social structures, thus rendering itself ineffective as a policy treatment. In terms of policy, we argue there is a necessity for greater openness about re-integration programmes and that governments would benefit from selling the programmes to the public. We conclude our paper with a justification of focusing further research on understanding public/community attitudes to re-integration programmes and understanding the PR of counter-terrorism policies more generally

A novel mixed-method approach to assess children's sedentary behaviours

Purpose: Accurately measuring sedentary behavior (SB) in children is challenging by virtue of its complex nature. While self-report questionnaires are susceptible to recall errors, accelerometer data lacks contextual information. This study aimed to explore the efficacy of using accelerometry combined with the Digitising Children’s Data Collection (DCDC) for Health application (app), to capture SB comprehensively. Methods: 74 children (9–10 years old) wore ActiGraph GT9X accelerometers for 7 days. Each received a SAMSUNG Galaxy Tab4 (SM-T230) tablet, with the DCDC app installed and a specially designed sedentary behavior study downloaded. The app uses four data collection tools: 1) Questionnaire, 2) Take a photograph, 3) Draw a picture, and 4) Record my voice. Children self-reported their SB daily. Accelerometer data were analyzed using R-package GGIR. App data were downloaded and individual participant profiles created. SBs reported were grouped into categories and reported as frequencies. Results: Participants spent, on average, 629 min (i.e., 73% of their waking time) sedentary. App data revealed most of their out-of-school SB consisted of screen time (112 photos, 114 drawings, and screen time mentioned 135 times during voice recordings). Playing with toys, reading, arts and crafts, and homework were also reported across all four data capturing tools on the app. On an individual level, data from the app often explained irregular patterns in physical activity and SB observed in accelerometer data. Conclusion: This mixed methods approach to assessing SB adds context to accelerometer data, providing researchers with information needed for intervention design