Jennifer Murray

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

BackgroundAllied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice.MethodsA systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings.Results960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice.ConclusionsWhilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome measurement may only be deliverable if appropriate action is taken at individual therapist, team, and organisational levels of an organisation.

Preliminary evidence that glucose ingestion facilitates prospective memory performance

Previous research has found that the ingestion of glucose boosts task performance in the memory domain (including tasks tapping episodic, semantic, and working memory). The present pilot study tested the hypothesis that glucose ingestion would enhance performance on a test of prospective memory. In a between-subjects design, 56 adults ranging from 17 to 80 years of age performed a computerized prospective memory task and an attention (filler) task after 25 g of glucose or a sweetness-matched placebo. Blood glucose measurements were also taken to assess the impact of individual differences on glucose regulation. After the drink containing glucose, cognitive facilitation was observed on the prospective memory task after excluding subjects with impaired fasting glucose level. Specifically, subjects receiving glucose were 19% more accurate than subjects receiving a placebo, a trend that was marginally nonsignificant, F₁,₄₁ = 3.4, P = .07, but that had a medium effect size, d = 0.58. Subjects receiving glucose were also significantly faster on the prospective memory task, F₁,₃₅ = 4.8, P < .05, d = 0.6. In addition, elevated baseline blood glucose (indicative of poor glucose regulation) was associated with slower prospective memory responding, F₁,₃₅ = 4.4, P < .05, d = 0.57. These data add to the growing body of evidence suggesting that both memory and executive functioning can benefit from the increased provision of glucose to the brain.

Influencing expert judgment: Attributions of crime causality

Purpose: The present research aimed to investigate the effects of attribution on expert clinical judgment in comparison to semi-experts and lay-people. Two research questions were addressed. Firstly, would experts be less subject to attributional manipulations, in terms of their perceived ratings of dangerousness, than would semi-experts or lay-people? Second, would experts be less subject to attributional manipulations, in terms of their assessments of offender responsibility, than would semi-experts or lay-people? nMethod: A 3x3x2 mixed groups design was implemented. Participants read nine crime scenarios that had been internally or externally manipulated. For each scenario, participants were asked to rate offender dangerousness, offender responsibility and the seriousness of the crime and to suggest a suitable sentence length. Targeted recruitment was employed, yielding 12 experts, 21 semi-experts and 22 lay-people. n nResults: Offenders were considered to be more responsible for their actions and more dangerous to others in the internal manipulations than in the external ones across all crime types and by all levels of expertise. Findings indicate that semi-experts are less subject to the influence of attributional manipulations than both experts and lay-people. Marked similarities in the pattern of expert and lay-person judgments can be observed from the present analyses nConclusions: The current findings lend support to previous research in the area in that similarities between expert and lay-person judgment were observed. However, through expanding and clarifying the levels of expertise investigated, the current findings highlight the need for greater research into the distinct ‘semi-expert’ group.

The effects of a recalled injustice on the experience of experimentally induced pain and anxiety in relation to just-world beliefs

A growing field of investigation into social justice cognitions and pain suggests perceived injustice has a negative impact on pain, but little is known about individual variation in the impact of a perceived injustice. One published study found that individuals with a strong rather than a weak just‐world belief reported greater pain from the cold pressor task after experiencing a perceived injustice, but an overt measure of perceived unfairness is needed to investigate this relationship.

Risk Factors for Suicide and Suicidal Behavior Relevant to Emergency Health Care Settings: A Systematic Review of Post-2007 Reviews

Suicide is a global public health problem, and with recent economic and societal changes, there may be emerging risk factors unrecognized by health care professionals. The aim of this systematic review was to update existing suicide risk factor literature applicable to emergency health care settings. A total of 35 articles identified from PsycINFO, CINAHL, and Medline met the inclusion criteria. Results supported the significance of existing suicide risk factors and identified emerging risk factors. The review provides a high-quality update of risk factor literature that could be applied to emergency health care settings; however, further research is needed to confirm emerging risk factors.

Male youth perceptions of violent extremism: towards a test of rational choice theory

Understanding how people perceive the pros and cons of risky behaviors such as terrorism or violent extremism represents a first step in developing research testing rational choice theory aiming to explain and predict peoples intentions to engage in, or support, these behaviors. Accordingly, the present study provides a qualitative, exploratory analysis of a sample of 57 male youths perceptions of the benefits and drawbacks of: (a) accessing a violent extremist website, (b) joining a violent extremist group, and (c) leaving such a group. Youth perceived significantly more drawbacks than benefits of joining a violent extremist group (p = .001, d = .46) and accessing a violent extremist website (p = .001, d = .46). The perceived benefits of engagement referred to gaining knowledge/awareness, being part of a group/similar people, and fighting the enemy/for a cause. The drawbacks referred to being exposed to negative material and emotions, having violent/criminal beliefs and behaviors, and getting in trouble with the law. The perceived benefits of disengagement referred to no longer committing illegal acts, and regaining independence/not being manipulated. The drawbacks referred to exposing oneself to harm and reprisal. These findings provide an insight into how male youth think about (dis)engagement in violent extremism, and can inform future quantitative research designed to explain and predict (dis)engagement in violent extremism. Eventually, such research may inform the development of evidence-based prevention and intervention strategies.

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

BackgroundVisualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma.xa0We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.ResultsOur final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.ConclusionsWe have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

Are consistent juror decisions related to fast and frugal decision making? Investigating the relationship between juror consistency, decision speed and cue utilisation.

The aim of this study was to establish whether more consistent/accurate juror decision making is related to faster decision-making processes which use fewer cues – that is, fast and frugal heuristic processes. A correlational design was implemented with the co-variables: consistency of verdict decisions (participant decisions compared to the actual court verdicts), decision speed, and cue utilisation (the number of cues used to make a final verdict decision). Sixty participants read information about six murder trials which were based on real cases and whose outcome verdicts were deemed to be correct by the Scottish legal institution. Three of the cases had been handed down ‘not guilty’ verdicts, and three had been handed down ‘guilty’ verdicts. Participants read opening statements and were then presented with a block of prosecution evidence, followed by a block of defence evidence. They were then asked to make a final verdict. All three co-variables were significantly related. Cue utilisation and speed were positively correlated, as would be expected. Consistency was negatively and significantly related to both speed and cue utilisation. Partial correlations highlighted that cue utilisation was the only variable to have a significant relationship with consistency, and that the relationship between speed and consistency was a by-product of how frugal the juror was. Findings support the concept of frugal decisional processes being optimal within a juror context. The more frugal a decision is, the more likely jurors are to be to be accurate/consistent.

Can a Theory-Informed Interactive Animation Increase Intentions to Engage in Physical Activity in Young People with Asthma?

A theoretically-informed interactive animation was developed, using themes drawn from psychology, sociology, applied health research, and narrative theory, which aimed to encourage young people with asthma to engage in physical activity. The animation was evaluated using qualitative and quantitative methods. A web-based Interactive Modelling Experiment was used to evaluate whether the animation was effective in three key areas: knowledge about asthma, inhaler use, and intention to increase physical activity. One-to-one interviews and focus groups were used to evaluate the acceptability of the animation and whether the theoretical basis was effective. Preliminary qualitative findings indicate good acceptability and perceived effectiveness. The quantitative findings are less clear, with a change in simulated activity and inhaler use being found, but with no clear association between these changes and the animation itself. Future work will be carried out to established whether these levels of acceptability and perceived effectiveness are actually translated into behaviour change.

Investigating the Influence of Causal Attributions on Both the Worksheet and Checklist Versions of the HCR-20.

Attribution theories suggest that when assessing an individuals actions, judgments are made about the cause of these behaviours and often these judgments focus on internal or external causal explanations. The current research investigated the effects of internal and external attribution on the scoring of the HCR-20 and the possibility of differences in scoring between two ways of using the HCR-20 (using the HCR-20 as a worksheet versus checklist). No differences were present in the scoring between the checklist versus worksheet. Attribution effects were present within the Historical Scale, Clinical Scale, and overall scoring of the HCR-20. Ratings were higher within the internal attribution condition than the external one, indicating that judgments made using the HCR-20 are subject to attribution effects in a similar manner as unaided violence risk assessments.