Comparative Judgement Modeling to Map Forced Marriage at Local Levels

Forcing someone into marriage against their will is a violation of their human rights. In 2021, the county of Nottinghamshire, UK, launched a strategy to tackle forced marriage and violence against women and girls. However, accessing information about where victims are located in the county could compromise their safety, so it is not possible to develop interventions for different areas of the county. Comparative judgement studies offer a way to map the risk of human rights abuses without collecting data that could compromise victim safety. Current methods require studies to have a large number of participants, so we develop a comparative judgement model that provides a more flexible spatial modelling structure and a mechanism to schedule comparisons more effectively. The methods reduce the data collection burden on participants and make a comparative judgement study feasible with a small number of participants. Underpinning these methods is a latent variable representation that improves on the scalability of previous comparative judgement models. We use these methods to map the risk of forced marriage across Nottinghamshire thereby supporting the county's strategy for tackling violence against women and girls

Exploring nursing outcomes for patients with advanced cancer following intervention by Macmillan specialist palliative care nurses

Background. Little information exists about the outcomes from nursing interventions, and few studies report new approaches to evaluating the complex web of effects that may result from specialist nursing care.Aims. The aim of this study was to explore nursing outcomes for patients with advanced cancer that may be identified as resulting from the care of a Macmillan specialist palliative care nurse.Methods/instruments. Seventy-six patients referred to 12 United Kingdom Macmillan specialist palliative care nursing services participated in a longitudinal study of their care over 28 days. Patients were interviewed and completed the European Organization for Research on Treatment of Cancer Quality of Life Scale and the Palliative Care Outcomes Scale at referral, and 3, 7 and 28 days following referral to a Macmillan specialist palliative care nursing service. A nominated carer was interviewed at baseline and 28 days. Notes recorded by Macmillan specialist palliative care nurses in relation to each patient case were analysed.Findings. Significant improvements in emotional (P = 0·03) and cognitive functioning (P = 0·03) were identified in changes in patients' European Organization for Research on Treatment of Cancer Quality of Life Scale scores, and in Palliative Care Outcomes Scale patient anxiety scores (P = 0·003), from baseline to day 7. Analysis of case study data indicated that overall positive outcomes of care from Macmillan specialist palliative care nursing intervention were achieved in 42 (55%) cases.Study limitations. Sample attrition due to patients' deteriorating condition limited the value of data from the quality of life measures. The method developed for evaluating nursing outcomes using data from patient and carer interviews and nursing records was limited by a lack of focus on outcomes of care in these data sources.Conclusions. A method was developed for evaluating outcomes of nursing care in complex situations such as care of people who are dying. Positive outcomes of care for patients that were directly attributable to the care provided by Macmillan specialist palliative care nurses were found for the majority of patients. For a small number of patients, negative outcomes of care were identified