Waves and walks: the raw, romantic allure of Cornwall's Badlands

An article for the Guardian on the north coast of Cornwall

The Fatal Tree by Jake Arnott review – a double helping of love and loss

A book review of Jake Arnott's The Fatal Tree

Book Review: As Kingfishers Catch Fire

A book review of Alex Preston's book, As Kingfishers Catch Fire

A local’s guide to Falmouth, Cornwall: 10 top tips

An article in The Guardian on my top ten visitor attractions to Falmouth

Taking flight: an Isles of Scilly family holiday adventure

Article for the Travel supplement of the Guardian on the Isles of Scilly

Personality traits and psychopathology over the course of six months of outpatient psychotherapy : a prospective observational study

There is a lack of prospective studies that test pre-specified hypotheses on the role of personality traits in outpatient psychotherapy. A total of 47 patients with a broad range of psychopathological syndromes were enrolled in a prospective 6-month observational study conducted in Zurich, Switzerland. We found evidence for remarkably high differential stability in all Big Five personality traits during the first 6 months of psychotherapy. Mean-level stability was very high in agreeableness and conscientiousness, while modest changes were observed in neuroticism, extraversion and openness. Baseline scores in neuroticism and conscientiousness at the beginning of therapy predicted modest change in self-reported severity of psychopathology over 6 months, but no effect was found in association with therapist-rated functional deficits. We conclude that personality trait levels may change slightly over the course of 6 months of psychotherapy and that both neuroticism and conscientiousness may have weak associations with the self-perceived improvement in psychopathology

HoNOSCA-D as a measure of the severity of diagnosed mental disorders in children and adolescents : psychometric properties of the German translation

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach's alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported

Enrollment and Retention of Participants in Remote Digital Health Studies: Scoping Review and Framework Proposal

BACKGROUND Digital technologies are increasingly used in health research to collect real-world data from wider populations. A new wave of digital health studies relies primarily on digital technologies to conduct research entirely remotely. Remote digital health studies hold promise to significant cost and time advantages over traditional, in-person studies. However, such studies have been reported to typically suffer from participant attrition, the sources for which are still largely understudied. OBJECTIVE To contribute to future remote digital health study planning, we present a conceptual framework and hypotheses for study enrollment and completion. The framework introduces 3 participation criteria that impact remote digital health study outcomes: (1) participant motivation profile and incentives or nudges, (2) participant task complexity, and (3) scientific requirements. The goal of this study is to inform the planning and implementation of remote digital health studies from a person-centered perspective. METHODS We conducted a scoping review to collect information on participation in remote digital health studies, focusing on methodological aspects that impact participant enrollment and retention. Comprehensive searches were conducted on the PubMed, CINAHL, and Web of Science databases, and additional sources were included in our study from citation searching. We included digital health studies that were fully conducted remotely, included information on at least one of the framework criteria during recruitment, onboarding or retention phases of the studies, and included study enrollment or completion outcomes. Qualitative analyses were performed to synthesize the findings from the included studies. RESULTS We report qualitative findings from 37 included studies that reveal high values of achieved median participant enrollment based on target sample size calculations, 128% (IQR 100%-234%), and median study completion, 48% (IQR 35%-76%). Increased median study completion is observed for studies that provided incentives or nudges to extrinsically motivated participants (62%, IQR 43%-78%). Reducing task complexity for participants in the absence of incentives or nudges did not improve median study enrollment (103%, IQR 102%-370%) or completion (43%, IQR 22%-60%) in observational studies, in comparison to interventional studies that provided more incentives or nudges (median study completion rate of 55%, IQR 38%-79%). Furthermore, there were inconsistencies in measures of completion across the assessed remote digital health studies, where only around half of the studies with completion measures (14/27, 52%) were based on participant retention throughout the study period. CONCLUSIONS Few studies reported on participatory factors and study outcomes in a consistent manner, which may have limited the evidence base for our study. Our assessment may also have suffered from publication bias or unrepresentative study samples due to an observed preference for participants with digital literacy skills in digital health studies. Nevertheless, we find that future remote digital health study planning can benefit from targeting specific participant profiles, providing incentives and nudges, and reducing study complexity to improve study outcomes

What is public trust in national electronic health record systems? A scoping review of qualitative research studies from 1995 to 2021

Objective: Public trust in national electronic health record systems is essential for the successful implementation within a healthcare system. Research investigating public trust in electronic health records is limited, leading to a lack of conceptual clarity. In response, the objective of this study is to gain a clearer understanding on the conceptualizations of public trust in electronic health records, which can support the implementation of national electronic health record systems. Methods: Guided by the PRISMA-ScR checklist, a scoping review of 27 qualitative studies on public trust in electronic health records found between January 2022 and June 2022 was conducted using an inclusive search method. In an iterative process, conceptual themes were derived describing the promoters and outcomes of public trust in electronic health records. Results: Five major conceptual themes with 15 sub-themes were present across the literature. Comprehension, autonomy, and data protection promote public trust in electronic health record; while personal and system benefits are the outcomes once public trust in electronic health records exists. Additional findings highlight the pivotal role of healthcare actors for the public trust building process. Conclusions: The results underscore comprehension, autonomy, and data protection as important themes that help ascertain and solidify public trust in electronic health records. As well, health system actors have the capacity to promote or hinder national electronic health record implementation, depending on their actions and how the public perceives those actions. The findings can assist researchers, policymakers, and other health system actors in attaining a better understanding of the intricacies of public trust in electronic health records

Aging - Workforce : das Potenzial erkennen und mobilisieren

Die Schweizer Wirtschaft sieht sich mit den Herausforderungen des demografischen Wandels und politischen Unsicherheiten bezüglich des Zugangs zu ausländischen Fachpersonen konfrontiert. Gleichzeitig hat sie durchaus Potenzial, die Aging Workforce stärker und besser in den  Erwerbsprozess zu integrieren.  Die vorliegende metrobasel-Studie ist im Rahmen des von der Kommission für Technologie und Innovation (KTI) geförderten Forschungsprojekts „Das Potenzial der Ageing Workforce mobilisieren: Ein interdisziplinärer Ansatz zur Freisetzung der Eigeninitiative der älteren Mitarbeitenden und zum besseren „Match“ zwischen Arbeitnehmern und Arbeitgebern“ entstanden. Sie präsentiert Teilergebnisse aus der ersten Projektphase (Analyseteil), die für ein breiteres Publikum von Interesse sind. Der Bericht stützt sich auf Ergebnisse, die bei Novartis Schweiz und der SBB und damit einerseits in einem international tätigen und andererseits in einem binnenmarktorientierten, staatsnahen Konzern gewonnen wurden. Eine quantitative Umfrage wurde in beiden Firmen online durchgeführt und ergab einen Datensatz von insgesamt 2‘837 Mitarbeitenden. Zusätzlich wurden 14 einstündige, transkribierte Interviews qualitativ ausgewertet, die bei der SBB durchgeführt werden konnten. In beiden Verfahren wurden sowohl Mitarbeitende ohne Führungsfunktion als auch Mitarbeitende mit Führungsfunktion befragt. Bei den Auswertungen wurden folgende drei Schwerpunkte gesetzt: •   Mitarbeiterseitige Voraussetzungen für die Erwerbstätigkeit in späteren Berufsjahren •   Bedeutung der Eigeninitiative der Mitarbeitenden für eine längere Erwerbsätigkeit •   Bedeutung der Mitarbeitenden-Vorgesetzten-Beziehung für eine längere Erwerbstätigkeit Im Themenbereich der arbeitnehmer- bzw. mitarbeiterseitigen Voraussetzungen für die Erwerbstätigkeit in späteren Berufsjahren zeigt sich ein grosses Potenzial an gesunden, kompetenten und leistungsfähigen älteren  Mitarbeitenden in beiden Unternehmen, das weiter erschlossen werden kann. Im zweiten Themenbereich wurde der Einfluss der Eigeninitiative der Mitarbeitenden im Hinblick auf eine längere Erwerbstätigkeit untersucht. Die Auswertungen zeigen, dass Mitarbeitende, die aktiv Einfluss auf die Arbeitsinhalte und -umgebung nehmen, insgesamt länger im Erwerbsprozess bleiben.Der dritte Themenbereich fokussiert auf das Arbeitsumfeld. Die Auswertungen der Daten weisen darauf hin, dass die Mitarbeitenden-Vorgesetzten-Beziehung als treibende Kraft für eine längere Erwerbsarbeit betrachtet werden kann. Zentral ist die Förderung der Mitarbeitenden seitens der Vorgesetzten. Dabei scheint weniger der Zugang zu vorhandenen, formellen Weiterbildungsangeboten relevant, als vielmehr die individuelle Personalentwicklung.