Avoidance as a strategy of (not) coping: qualitative interviews with carers of Huntington's Disease patients

Peer reviewedPublisher PD

Using a business model approach and marketing techniques for recruitment to clinical trials

Peer reviewedPublisher PD

Strength in numbers : patient experiences of group exercise within hospice palliative care

Background: Exercise is increasingly recognized as a core component of palliative rehabilitation. The group exercise model is often adopted as a means of reaching more patients with limited resource. Despite the growth of quantitative research examining this area of practice, few qualitative studies have looked at the patient experience of participating in group exercise in a palliative setting, and most exclude patients with a non-cancer diagnosis. Methods: The aim of this study was to explore patients’ experiences of participating in group exercise classes in a hospice setting. In this qualitative, phenomenological study, nine patients participating in a group exercise programme at a South London hospice completed semi-structured interviews. Participants were purposively sampled by gender, age, ethnicity and diagnosis; to include diagnoses across cancer, respiratory and neurological conditions. Transcripts were interpreted using thematic analysis. Results: All patients reported positive experiences of participating in group exercise classes. Improvements reported in physical function had a positive effect on ability to complete activities of daily living and enhanced patient mood. Other reported psychosocial benefits included: promotion of self-management; space and opportunity for reflection; supportive relationships; sharing of information; and a deeper appreciation of patients’ own abilities. Conclusion: This study highlights the positive experiences and value of group exercise classes to groups of people with diverse cancer and non-cancer conditions. The physical, emotional and psychosocial benefits suggest hospices and other palliative services should explore similar programmes as part of their rehabilitation services. The recognition that exercise groups can be mixed and need not be bespoke to one condition has positive cost and staff resource ramifications

Multiple sclerosis outpatient future groups: improving the quality of participant interaction and ideation tools within service improvement activities

BackgroundImproving the patient experience is a key focus within the National Health Service. This has led us to consider how health services are experienced, from both staff and patient perspectives. Novel service improvement activities bring staff and patients together to use design-led methods to improve how health services are delivered. The Multiple Sclerosis Outpatient Future Group study aimed to explore how analogies and props can be used to facilitate rich interactions between staff and patients within these activities. This paper will consider how these interactions supported participants to share experiences, generate ideas and suggest service improvements. MethodQualitative explorative study using ‘future groups,’ a reinterpretation of the recognised focus groups method directed towards exploring future alternatives through employing analogies and physical props to engage participants to speculate about future service interactions and health experiences. Participants were people with multiple sclerosis (PwMS) and outpatient staff: staff nurses, nursing assistants, junior sisters and reception staff. ResultsUse of future groups, analogies and physical props enabled PwMS and outpatient staff to invest their own ideas and feelings in the service improvement activity and envisage alternative health care scenarios. The combination of participants in the groups with their diverse perspectives and knowledge of the service led to a collaborative approach in which staff highlighted potential practical problems and patients ensured ideas were holistic. Service improvements were prototyped and tested in the outpatient clinic. ConclusionDesign-led methods such as future groups using analogies and physical props can be used to facilitate interactions between staff and patients in service improvement activities, leading to the generation of meaningful ideas. It is hoped that improving the quality of ideation tools within design-led methods can contribute to developing successful service interventions in service improvement activities. <br/

The effects of peripheral movement and flicker

Contrast sensitivity functions were obtained in the presence of temporally modulated surrouads. Sensitivity to low spatial frequencies was depressed below that found with a steady surround when the surround was either a sinusoidally flickering field or a drifting vertical square-wave grating. This effect was observed both with 1-sec presentations of 5- and 0.5-Hz counterphase flicker and with 60-msec pulsed gratings. In addition, reaction time histograms became more characteristic of sustained mechanisms in the presence of temporal modulation. The data were considered in terms of the activity of a nonlinear network of retinal subunit

The effects of the contrast, spatial frequency, and

Three experiments, in which the temporal and spatial characteristics of square-wave gratings surrounding a central test field were varied, are reported. The detection thresholds of 1-sec presentations of a 5-Hz counterphase flickering .5-cycle/deg (cpd) sinusoidal grating were measured under the different surround conditions. Threshold was found to increase with increasing surround contrast, and to be confined to surround spatial frequencies of 2 cpd and below. Maximum threshold elevation occurred with surround drift frequencies at about 8 Hz, irrespective of spatial frequency. It was concluded that the surround effect is probably due to an inhibitory interaction between transient-type mechanisms in the central visual field and the pheriphery

The effect of stimulus duraton on the persistence of gratings

The persistence of gratings varying in spatial frequency and exposure duration was measured using a stimulus-blank alternation method. Persistence was found to lengthen with increasing spatial frequency and to shorten with increasing exposure duration. For each spatial frequency, persistence decreased linearly with a slope of approximately -.75 as duration increased for short stimulus durations. For longer stimulus durations, the rate of decline in persistence with increasing duration was reduced, the slope being approximately -.13. The stimulus duration at which the change in slope of the persistence-duration relationship occurred was shown to increase with increasing spatial frequency and was approximately equivalent to the critical duration for each spatial frequency. The data were consistent with an interpretation of persistence in terms of a temporal integration component and a second, possibly cortically located, component