Attitudes to weight and weight management in the early teenage years : A qualitative study of parental perceptions and views

© 2014 The Authors. Health Expectations Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background: As most young teenagers grow up in families, parents might be well situated to facilitate and support their weight management and thereby prevent or manage obesity prior to adulthood. Aim: This paper explores parents’ perceptions of, and views about, their teenage children’s weight and the factors that influence parents’ weight management strategies. Design, setting and participants: We conducted two qualitative studies in Scotland, UK, involving in-depth interviews with the parents of overweight/obese and ‘normal’ weight 13-15 year olds (n=69). Findings: Parents’ concerns about their own weight provided useful context for understanding their attitudes or actions with regards to their teenage child. Some parents described their teenager’s weight as being of concern to them, although puberty often introduced confusion about a child’s weight status. Genetic explanations were very often put forward as a way of making sense of teenage weight or body size. Frustration about advising teenagers about weight management was expressed and some parents worried about giving their growing child a ‘problem’ if they directly raised concerns about weight with them. Discussion: Parents’ views about their own weight as well as social and moral norms about labelling a teenager as overweight or as needing help with their weight could usefully inform patient-centred service development. Parent/teenage partnerships and supporting parents to create a healthy home in which teenagers can make healthier choices are suggestions for intervention development. Conclusion: The study highlights the importance of taking parents’ perceptions into account when developing family-based interventions to address teenage overweight and obesity.Peer reviewe

A mixed methods evaluation of medical tattooing for people who have experienced a burn injury

Introduction: There are no existing studies examining the psychological merits of using facial medical tattooing (MT) following burn injury. This study evaluated an MT service supported by The Katie Piper Foundation. It examined accessibility, satisfaction and whether there were improvements in quality of life (QoL). Methods: Thirty-five service-users were invited to participate in a cross-sectional online survey. Twenty-five (71%) responded (24 women; age range = 21–64 years), and of these five (4 women; age range = 26–59 years) also participated in telephone interviews, which were analysed using descriptive thematic analysis. Findings: The service was largely considered easy to access (22/25) and convenient (25/25). Most service-users (22/25) were satisfied with the results of MT. Some areas of dissatisfaction were described, by a minority of service-users, including: the procedure being painful (1/25); the tattoo being below expectation or fading over time (3/25). The majority reported that MT had improved confidence (22/25); mood (19/25); and ability to socialise (19/25). The procedure improved some service-users’ ability to carry out essential activities (14/25) and enjoyable activities (16/25). The qualitative responses provided during interview, indicated that all respondents found the procedure useful to their adjustment, although a minority (3/5) found it painful and also commented on fading (1/5). All described MT as contributing to a sense of increased normality. Conclusions: MT had the largest impact on emotional wellbeing and interpersonal domains of QoL. MT services should now improve awareness of the procedure, lobby for further support to provide wider access to the procedure, and routinely use measures assessing psychosocial outcomes

Magnetic resonance imaging (MRI) scanning for research: the experiences of healthy volunteers and patients with remitted depressive illness

We report the findings from a study exploring the experiences of individuals undergoing MRI scanning for research. Semi structured interviews took place before and after scanning with 17 participants; 12 were healthy volunteers and 5 were patients with a diagnosis of remitted depression. Themes of apprehension and curiosity prior to scanning were common in both groups. Patients were often confused about the procedure. Negative feelings were an issue at the outset, characterised by shock related to the physical surroundings, after which positive feelings, for example relaxation, were often experienced, and in the case of patients, learning more about their brain. Written information about imaging was deemed satisfactory; however the ability to ‘experience’ aspects of scanning beforehand was suggested. Scanning may be viewed as a process beginning prior to the procedure itself and involving positive and negative emotions. Increased information, reassurance and a more interactive intervention to reduce anxiety may be beneficial and may improve individuals’ experience of this widely used procedure

What influences the speed of prototyping? An empirical investigation of twenty software startups

It is essential for startups to quickly experiment business ideas by building tangible prototypes and collecting user feedback on them. As prototyping is an inevitable part of learning for early stage software startups, how fast startups can learn depends on how fast they can prototype. Despite of the importance, there is a lack of research about prototyping in software startups. In this study, we aimed at understanding what are factors influencing different types of prototyping activities. We conducted a multiple case study on twenty European software startups. The results are two folds, firstly we propose a prototype-centric learning model in early stage software startups. Secondly, we identify factors occur as barriers but also facilitators for prototyping in early stage software startups. The factors are grouped into (1) artifacts, (2) team competence, (3) collaboration, (4) customer and (5) process dimensions. To speed up a startups progress at the early stage, it is important to incorporate the learning objective into a well-defined collaborative approach of prototypingComment: This is the author's version of the work. Copyright owner's version can be accessed at doi.org/10.1007/978-3-319-57633-6_2, XP2017, Cologne, German

Supporting the UN's Sustainable Development Goals: reconceptualising a 'sustainable development assessment tool' for the health and care system in England

Aims: As one of the biggest organisations in the world, the NHS in England can contribute considerably to the United Nations’ Global Sustainable Development Goals (SDGs). In order to optimise this, this study evaluated and reconceptualised a sustainable development assessment tool for health and care settings in England. Methods: A quantitative survey and user/expert discussion panels were conducted to evaluate and reconceptualise the existing sustainable development assessment tool used by the NHS in England, the so-called ‘Good Corporate Citizenship Assessment Tool’, between 2007 and 2016 including potential improvements such as the integration of the UN SDGs. Results: A reconceptualised self-assessment tool integrating the UN’s SDGs was developed and implemented online as the ‘Sustainable Development Assessment Tool (SDAT)’. Further improvements included a process orientated redesign and the creation of new modules and cross-sections aligning them with the leads responsible for the implementation of key initiatives in NHS organisations, which would contribute to achieving the targets of the SDGs. Conclusions: User/expert involvement has enabled an informed approach to a reconceptualisation of a sustainable assessment tool for health and care settings. The tool will support organisations to build their mandatory Sustainable Development Management Plans, as part of the national Public Health Outcomes Framework. Alignment of the tool to the UN Sustainable Development Goals provides an opportunity for health and care organisations to demonstrate accountability and progress against the UN’s set of transformational goals. Furthermore, the tool could be adapted to other public service providers

Interpreting and acting upon home blood pressure readings: A qualitative study

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Vasileiou et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Recent guidelines recognize the importance of home blood pressure monitoring (HBPM) as an adjunct to clinical measurements. We explored how people who have purchased and use a home blood pressure (BP) monitor make sense of, and act upon, readings and how they communicate with their doctor about the practice of home monitoring. Methods: A qualitative study was designed and participants were purposively recruited from several areas in England, UK. Semi-structured in-depth interviews were conducted with 18 users of home BP monitors. The transcribed data were thematically analysed. Results: Interpretation of home BP readings is complex, and is often characterised by uncertainty. People seek to assess value normality using ‘rules of thumb’, and often aim to identify the potential causes of the readings. This is done by drawing on lay models of BP function and by contextualising the readings to personal circumstances. Based on the perceived causes of the problematic readings, actions are initiated, mostly relating to changes in daily routines. Contacting the doctor was more likely when the problematic readings persisted and could not be easily explained, or when participants did not succeed in regulating their BP through their other interventions. Most users had notified their doctor of the practice of home monitoring, but medical involvement varied, with some participants reporting disinterest or reservations by doctors. Conclusions: Involvement from doctors can help people overcome difficulties and resolve uncertainties around the interpretation of home readings, and ensure that the rules of thumb are appropriate. Home monitoring can be used to strengthen the patient-clinician relationship

Assessment of the face validity, feasibility and utility of a patient-completed questionnaire for polymyalgia rheumatica: a postal survey using the QQ-10 questionnaire.

BACKGROUND: The development of a patient-reported outcome measure (PROM) for polymyalgia rheumatica (PMR), a condition that causes pain, stiffness and disability, is necessary as there is no current validated disease-specific measure. Initial literature synthesis and qualitative research established a conceptual framework for the condition along with a list of symptoms and effects of PMR that patients felt were important to them. These findings were used to derive the candidate items for a patient-completed questionnaire. We aim to establish the face validity of this initial "long form" of a PROM. METHODS: People with a current or previous diagnosis of PMR were recruited both from the community and from rheumatology clinics. They were asked to complete the PMR questionnaire along with the QQ-10 questionnaire, which is a measure used to assess the face validity, feasibility and utility of patient healthcare questionnaires. RESULTS: A total of 28 participants with an age range of 59-85 years and a length of time since diagnosis from 4 months to 18 years completed the QQ-10. The overall mean "value" score was 79% (SD 12), and the mean "burden" score was 21% (SD 18). The free-text comments were analysed thematically and were found to focus on layout, content, where in the clinical pathway the questionnaire would be most beneficial, specific items missing and other areas for consideration. CONCLUSIONS: The high mean value score and low burden score indicate that the questionnaire has good face validity and is acceptable to patients. The questionnaire now needs to undergo further psychometric evaluation and refinement to develop the final tool for use in clinical practice and research

The SABRTooth feasibility trial protocol: a study to determine the feasibility and acceptability of conducting a phase III randomised controlled trial comparing stereotactic ablative radiotherapy (SABR) with surgery in patients with peripheral stage I non-small cell lung cancer (NSCLC) considered to be at higher risk of complications from surgical resection.

Background Stage I non-small cell lung cancer (NSCLC) is potentially curable, and surgery is considered to be the standard of care for patients with good performance status and minimal co-morbidity. However, a significant proportion of patients with stage I NSCLC have a poorer performance status and significant medical co-morbidity that make them at higher risk of morbidity and mortality from surgery. Stereotactic ablative radiotherapy (SABR), which uses modern radiotherapeutic techniques to deliver large doses of radiation, has shown superiority over conventional radiotherapy in terms of local control and toxicity and is a standard of care for patients with stage I NSCLC who are at too high risk for surgery. However, it is not known whether surgery or SABR is the most effective in patients with stage I NSCLC who are suitable for surgery but are less fit and at higher risk surgical complications. Previous randomised studies have failed to recruit in this setting, and therefore, a feasibility study is required to see whether a full randomised control trial would be possible. Methods/design SABRTooth is a UK-based, multi-centre, open-label, two-group individually (1:1) randomised controlled feasibility study in patients with peripheral stage I NSCLC considered to be at higher risk from surgical resection. The study will assess the feasibility of conducting a definitive large-scale phase III trial. The primary objective is to assess recruitment rates to provide evidence that, when scaled up, recruitment to a large phase III trial would be possible; the target recruitment being 54 patients in total, over a 21-month period. There are multiple secondary and exploratory objectives designed to explore the optimum recruitment and data collection strategies to help optimise the design of a future phase III trial. Discussion To know whether SABR is a better, equivalent or inferior alternative to surgery for higher risk patients is a key question in lung cancer. Other studies comparing SABR to surgery have closed early due to poor recruitment, and therefore, the SABRTooth feasibility study has been designed around the UK National Health Service (NHS) cancer pathway incorporating many design features in order to maximise recruitment for a future definitive phase III trial