Fighting spirit: Victorian women's ghost stories

Abstract available: p. i-i

Treatment satisfaction and psychological well-being with insulin glargine compared with NPH in patients with Type 1 diabetes

Aims: To assess satisfaction with treatment and psychological well-being associated with insulin glargine and NPH. Insulin glargine, a new long-acting insulin analogue, provides constant, peakless insulin release following once-daily administration and is associated with fewer hypoglycaemic episodes, despite metabolic control equivalent to that achieved with NPH human basal insulin. Methods: The Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Well-being Questionnaire (W-BQ) were completed at baseline and at weeks 8, 20 or 28 by 517 patients with Type 1 diabetes participating in a randomized, controlled European trial comparing insulin glargine and NPH. Analysis of covariance was performed on change from baseline scores (main effects: treatment and pooled site; covariate: baseline scores). Results: Treatment Satisfaction improved with insulin glargine at all time points, including endpoint, but deteriorated slightly with NPH. These differences were significant throughout the study (change from baseline to endpoint: +1.27 vs. –0.56; p = 0.0001). Outcomes were better with insulin glargine for the DTSQ items, Perceived Frequency of Hyperglycaemia and Hypoglycaemia, with statistically significant differences at week 28 and endpoint for hyperglycaemia (p = 0.0373 and 0.0379) and at week 20 for hypoglycaemia (p = 0.0024). There was no difference in psychological well-being between the treatment groups, with mean scores increasing in both. Conclusions: Study participants had treatment-independent improvements in General Well-being. Advantages for insulin glargine were seen in significantly improved Treatment Satisfaction throughout the study, together with lower Perceived Frequency of Hyperglycaemia than for patients on NPH, without a significant increase in Perceived Frequency of Hypoglycaemia

New Audiences for the Arts: The New Audiences Programme Report

This 269 page report gives a detailed overview of a £20 million funding programme ‘New Audiences’, designed to foster new practice in audience development by arts organisations in England. It was the culmination of a five-year scheme which supported 1200 audience development initiatives across the country. Glinkowski was one of a team of seven researchers who compiled the report: ACE Research Officers, Clare Fenn, Adrienne Skelton and Alan Joy compiled the statistical information for the report appendices; the main body of the report, from Executive Summary to Conclusions, was written by a team of three consultant researchers, Glinkowski, Pam Pfrommer and Sue Stewart, working under the supervision of the ACE Head of New Audiences, Gill Johnson. The report was a summary, compilation and interpretation of key themes emerging from the material contained within around 1150 evaluations of projects funded by the £20 million ‘New Audiences’ programme during the 5-year period from 1998-2003. The interpretative work and writing up was undertaken collaboratively by the consultant researchers and Glinkowski’s particular input was to the Executive Summary; Introduction; General Audiences; Disability; Social Inclusion; Rural; Older People; General Findings; and Conclusion sections of the report. He was also the principal author (although in keeping with ACE practice on advocacy material, not formally credited) of the ‘New Audiences Advocacy Document’ (ISBN 0728710331), produced in conjunction with the main report with introduction by Tessa Jowell, Secretary of State, Department of Culture, Media and Sport and Peter Hewitt, Chief Executive of Arts Council England. The full report is published online, with a companion volume summarising all projects undertaken within the ‘New Audiences’ programme. Additionally, Glinkowski was commissioned to contribute case studies to the ‘New Audiences’ website (http://www.newaudiences.org.uk/index.php), including 'Open Studios/Artists Presentation Research' (http://www.newaudiences.org.uk/project.php?id=680)

The Capstone Journey: Exploring Design, Delivery and Evaluation in an Undergraduate Management Discipline Context

The focus of this paper is the development of a capstone management course and the application of educational action research through continual learning. In this article, we use the continual learning frame of plan, do, study, and act to underpin an educational action research design on the development of a capstone management course. As part of an Active Learning Trial, the development of the capstone experience has been captured in the embodiment of that experience. Our aim is to guide other academics in developing their own capstone course, particularly, within management with extension into other disciplines. Through continual improvement, we stress the importance of integrating the primary voice of the students, to emphasize the active learning and to optimize a meaningful experience in connecting theory to practice – the key to the capstone experience. Examples of how to gain feedback and integrate classroom improvements are given. To do this we present two cycles where we applied and practiced continual learning and educational action research to understand and evoke improvements within the course. These changes are evidenced through aggregated student feedback

Organisation and design of healthcare for generalism

This chapter examines how traditional, existing and future healthcare systems can support or undermine generalism in practice. We discuss current issues within UK general practice, although our reflections and suggestions on the crucial contribution of generalism to healthcare systems are by no means limited to this context. The relevance of generalism within all healthcare systems is emphasised. We provide historical examples from medicine with relevance to generalist clinical learning and practice today and beyond. Drawing on Don Berwick’s seminal paper published in 2016 ‘Era 3 for Medicine and Health Care’ (1), we describe how the ‘epic collision of two eras with incompatible beliefs’ has undermined generalism, and emphasise the achievable changes required in the organisation and delivery of care to make ‘Era 3’ a reality with generalism at its core. We highlight the importance of generalism and Era 3 approaches now and in the future, as healthcare systems worldwide face the increasing challenges posed by mobile and ageing populations, isolation, multimorbidity and frailty. We describe how and why the organisation and design of healthcare systems, and their surrounding social, political and physical environments, are crucial to enabling effective and efficient generalist care. Generalism is not a panacea for poverty, poor housing, unemployment, insecurity, abuse or injustice and will never fully mitigate health inequalities. However, generalism can help work towards ensuring health services work best where they are needed most. We highlight the key partnerships required – between health and social care providers and between care providers, care users and the general public – for generalism to flourish in the interests of the people that need it, now and in the future

Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease and cancer : a systematic review and meta-analysis

We thank Associate Professor Andrew Grey for helping to resolve discrepancies in data extraction and interpretation for cardiovascular events and cancer events. We thank trialists from 16 studies for clarifying or providing additional information for this review [Andrews 2011, Aveyard 2016, Bennett 2012, de Vos 2014, Finnish Diabetes Prevention Study 2009, Goodwin 2014, Green 2015, Horie 2016, Hunt (FFIT) 2014, Katula 2013, Li (Da Qing) 2014, Logue 2005, Ma 2013, O’Neil 2016, Rejeski (CLIP) 2011, Uusitupa 1993] and also others who provided information, but their trials were later found not to fulfil our inclusion criteria. Funding: The Health Services Research Unit is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.Peer reviewedPublisher PD

The clinical effectiveness of different parenting programmes for children with conduct problems : a systematic review of randomised controlled trials

Background Conduct problems are common, disabling and costly. The prognosis for children with conduct problems is poor, with outcomes in adulthood including criminal behaviour, alcoholism, drug abuse, domestic violence, child abuse and a range of psychiatric disorders. There has been a rapid expansion of group based parent-training programmes for the treatment of children with conduct problems in a number of countries over the past 10 years. Existing reviews of parent training have methodological limitations such as inclusion of non-randomised studies, the absence of investigation for heterogeneity prior to meta-analysis or failure to report confidence intervals. The objective of the current study was to systematically review randomised controlled trials of parenting programmes for the treatment of children with conduct problems. Methods Standard systematic review methods were followed including duplicate inclusion decisions, data extraction and quality assessment. Twenty electronic databases from the fields of medicine, psychology, social science and education were comprehensively searched for RCTs and systematic reviews to February 2006. Inclusion criteria were: randomised controlled trial; of structured, repeatable parenting programmes; for parents/carers of children up to the age of 18 with a conduct problem; and at least one measure of child behaviour. Meta-analysis and qualitative synthesis were used to summarise included studies. Results 57 RCTs were included. Studies were small with an average group size of 21. Meta-analyses using both parent (SMD -0.67; 95% CI: -0.91, -0.42) and independent (SMD -0.44; 95% CI: -0.66, -0.23) reports of outcome showed significant differences favouring the intervention group. There was insufficient evidence to determine the relative effectiveness of different approaches to delivering parenting programmes. Conclusion Parenting programmes are an effective treatment for children with conduct problems. The relative effectiveness of different parenting programmes requires further research