178 research outputs found
The mental health needs of gang affiliated young people : A briefing produced as part of the Ending Gang and Youth Violence programme
Keeping the Name on the Land: the Family Farm and its Survival Through Periods of Postwar Agricultural Change
PhD is about the family farm in the United Kingdom. It investigates the reasons behind their survival since the end of World War Two and the current day. The research is situated in a gap in knowledge within agricultural geography that exists due to an inadequacy to explore effectively the family farm and its continuation. This is related to two strands of research. First, analysts of the era between the mid-1940s and early-mid 1980s argued that the inability of the family farm to access funding through external connections to fund technology would result in their extinction. Second, activities such as farm diversification, which have been suggested by proponents of agricultural phases since the early-mid 1980s such as 'post-productivism', have failed to provide real options for family farmers to survive without food production.
This PhD acknowledges the role of the family farm itself, technology and external connections to its persistence. It creates a theoretical framework grounded in an appreciation of the everyday and mundane, which justifies concentration on a single family farm located in Ceredigion, Wales, UK. The study implemented ethnography and multi-sited ethnography by living and working on a family farm and using the complementary methods of participant observation, focused discussions and in-the-field interviewing. The study found that family farmers utilise their own creativity, resources and abilities to engage with technology and external connections in diverse, multiple and unexpected ways. These practices were related to motivations such as maintaining a good way of life, producing food and supporting the local community. In turn, these motivations were connected to a deeply embedded emotional longing to survive and keep the name on the land
Exploring Collaborative Professionalism as a Means of Virtually Supporting Rural Teachers
Thirty percent of US teachers work in rural schools where geographic isolation and lack of peers can make it difficult for them to engage in collaborative professional relationships with colleagues. Facilitated professional development can be used as a way to build these networks. Using a situative perspective in which teachers are viewed as experts and agents in their own professional learning and by capitalizing on the rapid increase in understanding and use of video conferencing in 2021, the research team developed an open-enrollment, co-designed series of workshops for rural teachers in the intermountain West. The team was interested in how collaborative professionalism (Hargreaves & O’Connor, 2018a) could be built and used to bring these rural teachers together to support each other as they explored their own identified problems of practice. The analysis of the collected qualitative and quantitative data (including videos, reflections, and documents used and created in the sessions) revealed initial trends that supported the development of solidarity and solidity in this group of teachers and facilitators. The authors posit that this perspective could be productive in connecting rural teachers in collaborative professional relationships despite their isolation
‘Chaucer’s World’ study days in Oxford for post-16 students: enhancing learning and encouraging wonder
This collaborative essay, structured as a collection of tales akin to Chaucer’s, provides a multiperspectival reflection on enhancement study days, entitled ‘Chaucer’s World’, co-organised by the University of Oxford, the Ashmolean Museum, the Bodleian Library, and secondary schools from the area. The event is aimed at UK secondary school students in their final two years of study, and is intended not only to help students with their preparation for the A-Level English Literature exam but also to instil in them appreciation for Chaucer’s works, as well as for medieval literature and culture in general
Target: Wellbeing Evaluation - Annual Report (2010)
Target: Wellbeing (TWB) aims to help people across the North West live healthier and happier lives. TWB is delivered through a portfolio of community based programmes and projects, and has been funded by the National Lottery for the period October 2007 to March 2012 through the Big Lottery Fund, with funding linked to health outcomes.
This evaluation update of the TWB portfolio provides reach analysis and evidence of behaviour change from the ten local programmes between January 2009 and August 2010, and provides an update to last year’s Target: Wellbeing Evaluation – Annual Report February 2010.
The analysis relates to the area based community projects within the TWB portfolio and covers the TWB participants and their evidence of behaviour change. Reach analysis is produced via the registration database with behaviour change evidence from analysis of welcome and exit questionnaires. Forty-four projects have contributed responses to this evaluation, about half of the total number, and sixty-six have used the participant database, contributing to the reach analysis
Web-based technologies to support carers of people living with dementia:a protocol for a mixed methods stepped-wedge cluster randomized controlled trial
BACKGROUND: Informal carers play a significant role in supporting people living with dementia; however, carers in rural areas are often isolated, with limited access to support services. Although dementia-friendly communities provide valued support for carers, access to them is limited as they are few and geographically dispersed. OBJECTIVE: This study’s aim was to increase support and services for rural informal carers of people living with dementia by using information and communication technologies accessed through an integrated website and mobile app—the Verily Connect app. The objective of this protocol is to detail the research design used in a complex study that was situated in a challenging real-world setting integrating web-based and on-ground technology and communication. Therefore, it is anticipated that this protocol will strengthen the research of others exploring similar complex concepts. METHODS: A stepped-wedge, open-cohort cluster randomized controlled trial was conducted to implement Verily Connect across 12 rural Australian communities. The Verily Connect intervention delivered web-based, curated information about dementia, a localized directory of dementia services and support, group and individual chat forums, and peer support through videoconference. During the implementation phase of 32 weeks, Verily Connect was progressively implemented in four 8-weekly waves of 3 communities per wave. Usual care, used as a comparator, was available to carers throughout the study period. Participants and researchers were unblinded to the intervention. There were 3 cohorts of participants: carers, volunteers, and staff; participants were recruited from their communities. The primary outcome measure was perceived carer social support measured using the Medical Outcomes Study-Social Support Survey. Volunteers and staff provided feedback on their participation in Verily Connect as qualitative data. Qualitative data were collected from all cohorts of participants through interviews and focus groups. Process evaluation data were collected through interviews and memos written by research staff. Data on the costs of implementing Verily Connect were collected by the research team members and evaluated by a health economist. RESULTS: Between August 2018 and September 2019, a total of 113 participants were recruited. There were 37 (32.7%) carers, 39 (34.5%) volunteers, and 37 (32.7%) health service staff. The study was complex because of the involvement of multiple and varied communities of carers, volunteers, health service staff, and research team members originating from 5 universities. Web-based technologies were used as intervention strategies to support carers and facilitate the process of undertaking the study. CONCLUSIONS: The Verily Connect trial enabled the testing and further development of a web-based approach to increasing support for carers of people living with dementia across a diverse rural landscape in Australia. This protocol provides an example of how to conduct a pragmatic evaluation of a complex and co-designed intervention involving multiple stakeholders. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618001213235; https://tinyurl.com/4rjvrasf INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/3302
Social skill and social cognition in adolescents at genetic risk for psychosis
Adolescents at genetic high risk (GHR) for schizophrenia have shown social skill impairments and there is some evidence to suggest they have Theory of Mind (ToM) deficits; however no research has used a standardized, performance-based behavioral measure to assess social functioning in this population nor evaluated ToM with a well-validated measure. We evaluated the psychometric properties of a new, theoretically-derived assessment of social functioning in GHR adolescents: the "High-Risk Social Challenge" task (HiSoC). The second aim was to explore whether GHR adolescents would show social skill and ToM deficits as compared to a nonpsychiatric control (NPC) group. The present study evaluated social functioning with the HiSoC and ToM with the Eyes Test in 23 GHR adolescents and 31 NPCs. The HiSoC demonstrated high levels of reliability and validity. The GHR adolescents showed social skill impairments, but not ToM deficits. The results suggest that the HiSoC is a potentially useful new measure of social functioning in GHR adolescents. Furthermore, the findings add to the current body of literature that indicates that social skill impairments are related to schizophrenia vulnerability
CARer-ADministration of as-needed subcutaneous medication for breakthrough symptoms in homebased dying patients (CARiAD):study protocol for a UK-based open randomised pilot trial
Legal framework. (DOCX 23 kb
Carer administration of as-needed sub-cutaneous medication for breakthrough symptoms in people dying at home: the CARiAD feasibility RCT
Background
Most people who are dying want to be cared for at home, but only half of them achieve this. The likelihood of a home death often depends on the availability of able and willing lay carers. When people who are dying are unable to take oral medication, injectable medication is used. When top-up medication is required, a health-care professional travels to the dying person’s home, which may delay symptom relief. The administration of subcutaneous medication by lay carers, although not widespread UK practice, has proven to be key in achieving better symptom control for those dying at home in other countries.
Objectives
To determine if carer administration of as-needed subcutaneous medication for common breakthrough symptoms in people dying at home is feasible and acceptable in the UK, and if it would be feasible to test this intervention in a future definitive randomised controlled trial.
Design
We conducted a two-arm, parallel-group, individually randomised, open pilot trial of the intervention versus usual care, with a 1 : 1 allocation ratio, using convergent mixed methods.
Setting
Home-based care without 24/7 paid care provision, in three UK sites.
Participants
Participants were dyads of adult patients and carers: patients in the last weeks of their life who wished to die at home and lay carers who were willing to be trained to give subcutaneous medication. Strict risk assessment criteria needed to be met before approach, including known history of substance abuse or carer ability to be trained to competency.
Intervention
Intervention-group carers received training by local nurses using a manualised training package.
Main outcome measures
Quantitative data were collected at baseline and 6–8 weeks post bereavement and via carer diaries. Interviews with carers and health-care professionals explored attitudes to, experiences of and preferences for giving subcutaneous medication and experience of trial processes. The main outcomes of interest were feasibility, acceptability, recruitment rates, attrition and selection of the most appropriate outcome measures.
Results
In total, 40 out of 101 eligible dyads were recruited (39.6%), which met the feasibility criterion of recruiting > 30% of eligible dyads. The expected recruitment target (≈50 dyads) was not reached, as fewer than expected participants were identified. Although the overall retention rate was 55% (22/40), this was substantially unbalanced [30% (6/20) usual care and 80% (16/20) intervention]. The feasibility criterion of > 40% retention was, therefore, considered not met. A total of 12 carers (intervention, n = 10; usual care, n = 2) and 20 health-care professionals were interviewed. The intervention was considered acceptable, feasible and safe in the small study population. The context of the feasibility study was not ideal, as district nurses were seriously overstretched and unfamiliar with research methods. A disparity in readiness to consider the intervention was demonstrated between carers and health-care professionals. Findings showed that there were methodological and ethics issues pertaining to researching last days of life care.
Conclusion
The success of a future definitive trial is uncertain because of equivocal results in the progression criteria, particularly poor recruitment overall and a low retention rate in the usual-care group. Future work regarding the intervention should include understanding the context of UK areas where this has been adopted, ascertaining wider public views and exploring health-care professional views on burden and risk in the NHS context. There should be consideration of the need for national policy and of the most appropriate quantitative outcome measures to use. This will help to ascertain if there are unanswered questions to be studied in a trial.
Trial registration
Current Controlled Trials ISRCTN11211024.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 25. See the NIHR Journals Library website for further project information
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