When is choice a good thing?: An experimental study of the impact of choice on patient outcomes

The official published version can be obtained from the link below - Copyright @ Taylor & FrancisAlthough policy emphasises the benefits of choice, an increasing body of work points to times when choice may not always have positive consequences. The present experimental study aimed to explore the impact of choice on a number of patient outcomes in the health care setting. The study also explored the extent to which the influence of choice was affected by patient uncertainty and anticipated regret. Choice was conceptualized as consisting of two dimensions: ‘having choice’ which reflects the availability of a number of options and ‘making choice’ reflecting resolution and a desire for a choice to be made. Consecutive patients (n=427) from 4 General Practices in Surrey were asked to read one of 16 vignettes which varied in terms of 4 independent variables (having choice, making choice, uncertainty, anticipated regret) and to rate items relating to 4 outcome variables (patient satisfaction, perceived control, negative emotions, information seeking). The results showed that having more choice was consistently associated with more positive patient outcomes than having no choice. Having no choice was particularly detrimental for those experiencing anticipated regret and uncertainty. In contrast, whether or not a choice was made had no impact upon any of the outcome measures. In line with current policy having choice in the health care setting is related to improved patient outcomes. The results provide some insights into the factors which influence the direction of the impact of choice. They also indicate the importance of differentiating between ‘having choice’ and ‘making choice’.Funding received from ESRC award: RES-000-22-165

‘There is no choice apart from antibiotics…’: qualitative analysis of views on urinary infections in pregnancy and antimicrobial resistance

Background: Antimicrobial resistance (AMR) is a health risk as it can lead to life-threatening infections. There has been a rise in resistant urinary tract infections (UTIs) which is the most common infection in pregnancy. This can be challenging in pregnancy due to the additional need to safeguard foetal development. The study's aim was to explore views about AMR in women who experienced UTIs in pregnancy. Design: Fifteen semi-structured interviews were conducted in the UK and analysed using thematic analysis. Results: Results highlighted two themes: conceptualization of AMR and pregnancy as a deviation from the norm, with an overarching theme of ‘self-efficacy’. Results show that participants were concerned about AMR but uncertain about the effect on society compared to individual's taking antibiotics and about completing antibiotic courses. Participants reported an unsparing use of antibiotics was justified in pregnancy, and behaviours like drinking adequate water were ineffective at preventing UTIs. In summary, women had low self-efficacy regards tackling AMR and managing their health. Conclusion: Misconceptions about how AMR affects society vs the individual translated into viewing it as a future problem to be tackled by the health-care sector. Consequently, AMR requires reconceptualization as a current problem requiring collective action. This research also indicates women endorse a biomedical model of UTIs in pregnancy which attributes resolving illness to interventions such as medicines, implying an automatic reliance on antibiotics. Subsequently, there is a need for self-efficacy by focusing on a behavioural model which emphasizes behaviours for infection prevention, thus reducing the need for antibiotics

Abnormal long wave dispersion phenomena in a slightly compressible elastic plate with non-classical boundary conditions

A two parameter asymptotic analysis is employed to investigate some unusual long wave dispersion phenomena in respect of symmetric motion in a nearly incompressible elastic plate. The plate is not subject to the usual classical traction free boundary conditions, but rather has its faces fixed, precluding any displacement on the boundary. The abnormal long wave behaviour results in the derivation of non-local approximations for symmetric motion, giving frequency as a function of wave number. Motivated by these approximations, the asymptotic forms of displacement components established and long wave asymptotic integration is carried out

The Psychology of eating. From healthy to disordered behavior

With its primary focus on the psychology of eating from a social, health, and clinical perspective, the second edition of The Psychology of Eating: From Healthy to Disordered Behavior presents an overview of the latest research into a wide range of eating-related behaviors •Features the most up-to-date research relating to eating behavior •Integrates psychological knowledge with several other disciplines •Written in a lively, accessible style •Supplemented with illustrations and maps to make literature more approachabl

Employing pre-stress to generate finite cloaks for antiplane elastic waves

It is shown that nonlinear elastic pre-stress of neo-Hookean hyperelastic materials can be used as a mechanism to generate finite cloaks and thus render objects near-invisible to incoming antiplane elastic waves. This approach appears to negate the requirement for special cloaking metamaterials with inhomogeneous and anisotropic material properties in this case. These properties are induced naturally by virtue of the pre-stress. This appears to provide a mechanism for broadband cloaking since dispersive effects due to metamaterial microstructure will not arise.Comment: 4 pages, 2 figure

Southern Arizona riparian habitat: Spatial distribution and analysis

The objectives of this study were centered around the demonstration of remote sensing as an inventory tool and researching the multiple uses of riparian vegetation. Specific study objectives were to: (1) map riparian vegetation along the Gila River, San Simon Creek, San Pedro River, Pantano Wash, (2) determine the feasibility of automated mapping using LANDSAT-1 computer compatible tapes, (3) locate and summarize existing mpas delineating riparian vegetation, (4) summarize data relevant to Southern Arizona's riparian products and uses, (5) document recent riparian vegetation changes along a selected portion of the San Pedro River, (6) summarize historical changes in composition and distribution of riparian vegetation, and (7) summarize sources of available photography pertinent to Southern Arizona

Spacelab mission dependent training parametric resource requirements study

Training flows were developed for typical missions, resource relationships analyzed, and scheduling optimization algorithms defined. Parametric analyses were performed to study the effect of potential changes in mission model, mission complexity and training time required on the resource quantities required to support training of payload or mission specialists. Typical results of these analyses are presented both in graphic and tabular form

An analysis of pion-nucleon scattering at intermediate and high energies

A phenomenological analysis of pion nucleon scattering at intermediate and high energies is presented. The intermediate energy range (2-5 GeV) is discussed in terms of a 'new' phase shift analysis which has been constructed from a series of single energy fits to an energy dependent model partial wave analysis. This 'new' phase shift solution exhibits a similar resonance structure to the energy dependent model but enjoys a much better fit to the scattering data, comparable with previous single energy analyses. We discuss the difficulties encountered in previous single energy analyses and illustrate the advantages and feasibility of the energy dependent analysis in which the partial waves satisfy the required smoothness criteria, by construction. The high energy scattering data is discussed with reference to the Regge pole model and we exploit the analytic properties of the scattering amplitudes by the use of the Continuous Moment Sum Rules (C.M.S,R,), The sum rules provide a set of ' consistency equations between the high energy Regge parameters and the low and intermediate energy data which is represented by the phase shifts. In previous analyses of the C.M.S.R., the energy at which they are evaluated has been taken as 2 GeV which corresponded to the maximum energy of available phase shift data. 2 GeV is a long way from the region where we expect the Regge representation to be valid and the saturation of the C.M.S.R. with only those trajectories identified in the high energy region is not obvious, since we may expect lower lying trajectories to be important at these energies. We construct the CM.S.R. at a higher cut off (5 GeV) from the 'new' phase shift solution and compare the results from a simultaneous analysis of the scattering data and C.M.S.R. at the two cut offs. Several differences are apparent between the two analysis in particular we show that it is not possible to construct the A’¯ and B+ atamplitudes at 2 GeV via the C.M.S.R without considering trajectories other than those identified in the high energy scattering region. We present evidence for a new vacuum trajectory which we associate with the n(_0+) (700) meson and this single vacuum trajectory alone constructs the amplitudes b+ at high energies. The total cross-section data is adequately described by the three trajectories P,P' and ρ in the energy range 5-20 GeV but the extrpolations of their contributions to the energy range (20-70 GeV) does not exhibit the energy dependence of the recent Serpukhov pio-nucleon total cross-section data. There have beenseveral models to account for this apparent change in behaviour at 20 GeV which involve the addition of further contributions to the conventional Regge pole term and all these models give an adequate description of the total cross-section data over the whole energy range, which is not surprising considering their increased parameter freedom. We consider two different possibilities of asymptopia which involve the addition of multi-pomeron cuts and dipole contributions respectively to the P,P', ρ Regge poles and we increase our information input to the analysis by the use of the F.E.S.R. as a series of constrait equations on the parameters of the fit. We show that the size of the multi-pomeron cuts identified from the scattering data and the C.M.S.R. are incompatible where as a dipole solution satisfies both the scattering data and C.M.S.R., we consider the possibility of pomeranchuk theorem violation by the inclusion of an odd-signature dipole like term in the amplitude A'¯ but we are unable to reach a decisive conclusion on the possible violation because of the large experimental errors on the Serpukhov data

How meaningful are data from Likert scales?: an evaluation of how ratings are made and the role of the response shift in the socially disadvantaged.

Likert scales relating to quality of life were completed by the homeless (N = 75); first year students (N = 301) and a town population (N = 72). Participants also completed free text questions. The scale and free text data were often contradictory and the results highlighted three processes to account for these disparities: i) frame of reference: current salient issues influenced how questions were interpreted; ii) within-subject comparisons: ratings were based on expectations given past experiences; iii) time frame: those with more stable circumstances showed habituation to their level of deprivation. Likert scale data should be understood within the context of how ratings are made

Mastering the Lawless Science of Our Law : A Story of Legal Citation Indexes

Ms. Ogden presents a history of American legal citation indexes, covering early nineteenth-century attempts, the development of modern citator systems by Frank Shepard and others, online citation systems, and the potential for future improvements in an essential tool of legal research