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This paper describes the research underpinning the development and evaluation of a brain computer interface (BCI) system designed to be suitable for domestic use by people with acquired brain injury in order to facilitate control of their home environment. The purpose of the research is to develop a robust and user‐friendly BCI system which was customisable in terms of user ability, preferences and functionality. Specifically the human interface was designed to provide consistent visual metaphors in usage, while applications change, for example, from environmental control to entertainment and communications.

The research took a user centred design approach involving representative end‐users throughout the design and evaluation process. A qualitative study adopting user interviews alongside interactive workshops highlighted the issues that needed to be addressed in the development of a user interface for such a system. User validation then underpinned prototype development.

The findings of the research indicate that while there are still significant challenges in translating working BCI systems from the research laboratories to the homes of individuals with acquired brain injuries, participants are keen to be involved in the deign and development of such systems. In its current stage of development BCI is multi‐facetted and uses complex software, which poses a significant usability challenge. This work also found that the performance of the BCI paradigm chosen was considerably better for those users with no disability than for those with acquired brain injury. Further work is required to identify how and whether this performance gap can be addressed.

The research had significant challenges in terms of managing the complexity of the hardware and software set‐up and transferring the working systems to be tested by participants in their home. Furthermore, the authors believe that the development of assistive technologies for the disabled user requires a significant additional level of personalisation and intensive support to the level normally required for non‐disabled users. Coupled with the inherent complexity of BCI, this leads to technology that does not easily offer a solution to both disabled and non‐disabled users.

The research contributes additional findings relating to the usability of BCI systems. The value of the work is to highlight the practical issues involved in translating such systems to participants where the acquired brain injury can impact on the ability of the participant to use the BCI system.

Patients without spleens are at risk of septicaemia which is largely preventable by vaccination and prophylactic antibiotics as detailed in several recent guidelines. This study sought to identify all people, in one health district, with a previous splenectomy and treat them according to the guidelines on post‐splenectomy care. Patients without a spleen were identified by a variety of methods and targeted mailing, manipulation of the local press, opinion leaders, postgraduate meetings, peer pressure, disease‐ and patient‐specific reminders, feedback and patient empowerment were all used as dissemination and implementation strategies. The number of patients iden‐tified rose from 15 to 68. All were offered the opportunity to discuss their care, 80% took this opportunity and had pneumococcal vaccine, 77% were started on long‐term antibiotics, 75% discussed Hib and meningococcal vaccines and these were given to 54%. In summary the strategies used dramatically increased the numbers of patients identified and the improved care offered.

Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to describe a qualitative feasibility assessment of a primary care-based complex intervention to promote screening and brief intervention for PAU, which also aims to examine acceptability and potential effectiveness.

Semi-structured interviews were conducted with 14 patients and eight general practitioners (GPs) who had been purposively sampled from practices that had participated in the feasibility study. The interviews were transcribed verbatim and analysed thematically.

Six key themes were identified. While all GPs found the intervention informative and feasible, most considered it challenging to incorporate into practice. Barriers included time constraints, and overlooking and underestimating PAU among this cohort of patients. However, the intervention was considered potentially deliverable and acceptable in practice. Patients reported that (in the absence of the intervention) their use of alcohol was rarely discussed with their GP, and were reticent to initiate conversations on their alcohol use for fear of having their methadone dose reduced.

Although a complex intervention to enhance alcohol screening and brief intervention among primary care patients attending for OAT is likely to be feasible and acceptable, time constraints and patients’ reticence to discuss alcohol as well as GPs underestimating patients’ alcohol problems is a barrier to consistent, regular and accurate screening by GPs. Future research by way of a definitive efficacy trial informed by the findings of this study and the Psychosocial INTerventions for Alcohol quantitative data is a priority.

To the best of the knowledge, this is the first qualitative study to examine the capability of primary care to address PAU among patients receiving OAT.

Respite care is one of the services most frequently requested by family carers, but places are often not taken up because of carers' concerns about the quality of the respite experience. This paper describes the formation of a new respite unit at St Ita's Hospital in Western Ireland and staff's efforts to create a respite experience that more closely reflects the older person's home environment. The initial focus was on providing more choice in terms of the food served and the times of meals. The challenges of introducing even small changes to the delivery of care are considered, and the need for a more widespread and sustained approach to culture change is promoted.

The purpose of this research is to examine the factors that influence the design of performance measurement systems (PMSs) in nonprofit organizations (NPOs) and public administration and explore inter-relationships among these factors.

Findings resulted through the identification of design factors from the paper portfolio of a previous systematic literature review on this topic and the construction of a factor co-occurrence network for the identified factors. 

The methodology helped to determine the relationships among factors and show how these factors influence PMSs in NPOs and public administration. It also helped to demonstrate how PMSs in these organizations are different from PMSs in traditional companies because of the impact of the factors on the complexity and dynamics of NPOs and public administration. The findings and discussion contribute to the performance measurement literature on NPOs and public administration by presenting a set of design factors related to purpose, stakeholders and management.

This paper presents practical implications for managers regarding the PMS design process and shows how some design factors can be particularly related to these organizations

The design factors are particular to the organizational dynamic and should be considered by managers involved with the design (or redesign) process of performance measurement systems.

The purpose of this paper is to discuss methodological issues connected to being a member of a stigmatised group invited to take part in a research study.

This paper draws on experiences of interviewing young parents and their families about teenage parenthood. The paper reflects on how the feelings of young parents about being under surveillance all the time, by official agencies and in their communities, could lead to resistance to “official” visitors, role confusion relating to access, and a great deal of image management, all of which potentially influenced the interviews.

Participants may feel that they should consent to an interview because of their position as a member of a group accustomed to being under surveillance, but they can take the opportunity to use the interview to demonstrate their competence, in this case as mothers. Interviewing members of a stigmatised group such as teenage parents empowers them to challenge negative stereotypes normally encountered in discourses of teenage parenting, thus subverting a sense of feeling bound to take part in an interview and turning the encounter around to assert a positive identity.

The “positionality” of the researcher as an influence on the research process has been widely examined, the positionality of the participants less so. This paper highlights how members of a stigmatised and potentially vulnerable group position themselves, and by so doing, can use the interview as part of the process of asserting a valued identity.

Following a high‐profile publicity campaign across South Tyneside aimed at professionals and patients, 52.4 per cent of all patients admitted with suspected myocardial infarction during a six‐month period received 300mg of aspirin. Twelve months later GPs’ performance had improved from 25 per cent to 52.9 per cent of patients directly admitted by GPs being prescribed aspirin when first seen. Following a definite myocardial infarction 78.4 per cent of patients were discharged taking 75mg of aspirin, with no valid reason for omission in 6.6 per cent of patients. Six months after discharge 71.8 per cent of patients were still taking aspirin. Twelve months later 90 per cent of discharged patients were taking aspirin. GP PACT data showed a marked increase in prescribing 75mg aspirin during the period. The use of a publicity campaign to disseminate the message to both professionals and patients has resulted in a beneficial increase in aspirin prescribing for myocardial infarction across the district.