Development and psychometric evaluation of a new patient -reported outcome measure for stroke self -management: The Southampton Stroke Self - Management Questionnaire (SSSMQ).

BACKGROUND: Self-management is important to the recovery and quality of life of people following stroke. Many interventions to support self-management following stroke have been developed, however to date no reliable and valid outcome measure exists to support their evaluation. This study outlines the development and preliminary investigation of the psychometric performance of a newly developed patient-reported outcome measure (PROM) of self-management competency following stroke; the Southampton Stroke Self-Management Questionnaire (SSSMQ). METHODS: A convenience sample of 87 people who had had a stroke completed responses to the SSSMQ, the Stroke Self-Efficacy Questionnaire and the Stroke Impact Scale. Scaling properties were assessed using Mokken Scale Analysis. Reliability and construct validity were assessed using intra-class correlation coefficient (ICC), Mokken and Cronbach's reliability coefficients and Spearman rank order correlations with relevant measures. RESULTS: Mokken scaling refined the SSSMQ to 28 scalable items. Internal consistency reliability (Mokken r = 0.89) and test-retest reliability (ICC = 0.928) were excellent. Hypotheses of expected correlations with additional measures held, demonstrating good evidence for construct validity. CONCLUSIONS: Early findings suggest the Southampton Stroke Self-Management Questionnaire is a reliable and valid scale of self-management competency. The SSSMQ represents a potentially valid PROM for the evaluation of self-management following stroke

Stroke patients' utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluation

Background Evidence indicates that post − stroke rehabilitation improves function, independence and quality of life. A key aspect of rehabilitation is the provision of appropriate information and feedback to the learner. Advances in information and communications technology (ICT) have allowed for the development of various systems to complement stroke rehabilitation that could be used in the home setting. These systems may increase the provision of rehabilitation a stroke survivor receives and carries out, as well as providing a learning platform that facilitates long-term self-managed rehabilitation and behaviour change. This paper describes the application of an innovative evaluative methodology to explore the utilisation of feedback for post-stroke upper-limb rehabilitation in the home. Methods Using the principles of realistic evaluation, this study aimed to test and refine intervention theories by exploring the complex interactions of contexts, mechanisms and outcomes that arise from technology deployment in the home. Methods included focus groups followed by multi-method case studies (n = 5) before, during and after the use of computer-based equipment. Data were analysed in relation to the context-mechanism-outcome hypotheses case by case. This was followed by a synthesis of the findings to answer the question, ‘what works for whom and in what circumstances and respects?’ Results Data analysis reveals that to achieve desired outcomes through the use of ICT, key elements of computer feedback, such as accuracy, measurability, rewarding feedback, adaptability, and knowledge of results feedback, are required to trigger the theory-driven mechanisms underpinning the intervention. In addition, the pre-existing context and the personal and environmental contexts, such as previous experience of service delivery, personal goals, trust in the technology, and social circumstances may also enable or constrain the underpinning theory-driven mechanisms. Conclusions Findings suggest that the theory-driven mechanisms underpinning the utilisation of feedback from computer-based technology for home-based upper-limb post-stroke rehabilitation are dependent on key elements of computer feedback and the personal and environmental context. The identification of these elements may therefore inform the development of technology; therapy education and the subsequent adoption of technology and a self-management paradigm; long-term self-managed rehabilitation; and importantly, improvements in the physical and psychosocial aspects of recovery

Between speaking out in public and being person-centred: collaboratively designing an inclusive archive of learning disability history

The Living Archive of Learning Disability History is being developed by an inclusive team of researchers both with and without learning disabilities. We argue the archive is important in making publicly visible the lives of people with learning disabilities. Yet – drawing on thinking that came out of our collaborative workshops – we also identify alternative imperatives, that you might want to have control over how you share your personal memories and stories, with whom, when you share them and for how long. We show how we are responding to these different ideas in the design of the Living Archive in order to create pathways between two traditions that have emerged through self-advocacy: ‘speaking out in public’ and ‘being person-centred’. We outline our research on consent processes to ensure that our archive builds capacity for as many people as possible to consent while also offering a legally compliant ‘Best Interests’ process in line with the requirements of the Mental Capacity Act, England and Wales (2005). We argue that deploying and actively navigating between the different political logics of ‘speaking out in public’ and ‘being person-centred’ offers a way forward for ongoing debates concerning community engagement in archives, museums and heritage

A cross-sectional study of frequency and factors associated with dog walking in 9-10 year old children in Liverpool

Westgarth C, Boddy LM, Stratton G, German AJ, Gaskell RM, Coyne KP, Bundred P,McCune S, Dawson S

Multinational enterprise subsidiaries and their CSR: A conceptual framework of the management of CSR in smaller emerging economies

There is a lack of theoretical consensus on how multinational enterprises (MNEs) should implement corporate social responsibility (CSR) to build legitimacy, particularly those operating in the smaller Asian emerging market context, where current growth in the global economy is being felt more acutely than elsewhere. This paper argues for theoretical integration of business ethics (BE) and international business (IB) research to address this concern. Hence, we explore the management of CSR strategies by MNE subsidiaries with specific interest on their proactive adoption of strategic CSR to obtain legitimacy in a foreign host country. Drawing on the recent CSR literature and related theories, including stakeholder theory and institutional theory, propositions and a conceptual framework are developed and presented. The framework integrates BE and IB concepts on the different dimensions of CSR and provides a theoretical derived explanation of the process for strategic adoption of global through to more local CSR strategies by MNE subsidiaries to build legitimacy in an emerging market context. In addition, the framework provides valuable insights into the adoption of different ethical approaches or CSR strategies based on the level of ethical pressure in a host country and the degree of CSR ingrainedness in the parent company.Kristin Hah, Susan Freema

Growth and Structure of Cu and Au on the Nonpolar ZnO(101̅0) Surface: STM, XPS, and DFT Studies

The morphology and electronic structure of Cu and Au clusters deposited via thermal evaporation onto ZnO(101̄0) substrates have been studied via scanning tunneling microscopy (STM) and X-ray photoelectron spectroscopy (XPS). The initial stages of nucleation and growth (∼0.2 ML) of both Cu and Au are compared with density functional theory (DFT) calculations, which show an excellent agreement with the cluster morphologies observed by STM, with Cu nucleating three-dimensional (3D) islands even at small coverage while Au nucleates single-layer islands that grow layer by layer. DFT also gives insight into the diffusion behavior of Cu and Au adatoms on the ZnO substrate, showing strongly anisotropic diffusion barriers for Cu atoms which results in the experimentally observed preferential cluster nucleation along [0001] step edges, whereas Au shows no such anisotropy and Au clusters are observed to have no preferred nucleation sites. XPS results show a slight positive charging of the small Cu clusters at 0.2 ML coverage, which disappears at higher coverage. The single-layer Au islands formed at low coverage show some evidence of positive charging as well, which likewise disappears with increasing cluster size. Additionally, the Au clusters show a trend of increasing metallicity as the clusters grow and transition from single-layer islands to 3D structures, demonstrated by the increasing asymmetry in the Au 4f line shape as a function of Au coverage. In general, the observed charge transfer trends are supported by Bader charge analysis. © 2013 American Chemical Society