‘All illness is personal to that individual’: a qualitative study of patients’ perspectives on treatment adherence in bronchiectasis

Background: Adherence to treatment is low in bronchiectasis and is associated with poorer health outcomes. Factors affecting adherence decisions have not been explored in patients with bronchiectasis. 

Objective: We aimed to explore patients' perspectives on adherence, factors affecting adherence decision making and to develop a conceptual model explaining this decision-making process in adults with bronchiectasis. 

Methods: Adults with bronchiectasis participated in one-to-one semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed independently by two researchers using thematic analysis. Data from core themes were extracted, categorized into factors affecting adherence decision making and used to develop the conceptual model. 

Results: Participants' beliefs about treatment, the practical aspects of managing treatment, their trust in health-care professionals and acceptance of disease and treatment were important aspects of treatment adherence. The conceptual model demonstrated that adherence decisions were influenced by participants' individual balance of barriers and motivating factors (treatment-related, disease-related, health-care-related, personal and social factors). 

Conclusion: Adherence decision-making in bronchiectasis is complex, but there is the potential to enhance adherence by understanding patients' specific barriers and motivators to adherence and using this to tailor adherence strategies to individual patients and treatments. © 2014 John Wiley & Sons Ltd.

Non-domination, non-alienation and social equality: towards a republican understanding of equality

The republican idea of non-domination stresses the importance of certain social relationships for a person’s freedom, showing that freedom is a social-relational state. While the idea of freedom as non-domination receives a lot of attention in the literature, republican theorists say surprisingly little about equality. Therefore, the aim of this paper is to carve out the contours of a republican conception of equality.. In so doing, I will argue that republican accounts of equality share a significant normative overlap with the idea of social equality. However, closer analysis of Philip Pettit’s account of ‘expressive egalitarianism’ (which Pettit sees as inherently connected to non-domination) and recent theories of social equality shows that republican non-domination – in contrast to what Pettit seems to claim – is not sufficient for securing (republican) social equality. In order to secure social equality for all, republicans would have to go beyond non-domination.

Developing and evaluating the integration of Life and Social Sciences teaching to first-year Nursing and Midwifery students

Title: Evaluating the integrating of life and social sciences teaching to first-year nursing and midwifery students

Objectives: To evaluate an integrated teaching and learning approach to first-year nursing students, combining the life, social sciences and public health with a more integrated and clinical focused approach to teaching delivery

Background: Historically within the School of Nursing and Midwifery the life sciences and social sciences had been taught as separate modules with separate teaching teams. This had reflected in a somewhat dis-integrated approach to student learning and understanding without clear clinical focus on application. With focus upon student learning the teaching teams engaged with a stepped, incremental and progressive movement towards developing and delivering a more integrated structure of learning, combining the life sciences, social sciences and public health teaching and learning within the one extended first-year module. The focus was particularly on integrated understanding and clinical relevance. This paper discusses both the approach to developing the integrated model of teaching and the evaluation of that teaching.

Results: The module, combining life, social science and Public health teaching was positively evaluated by the students. Evaluations are compared and contrasted from to nursing student intakes.

Beyond Criminal Justice: An anthology of abolitionist papers presented to conferences of the European Group for the Study of Deviance and Social Control over the past decade

Beyond Criminal Justice presents a vision of a future without brutal, authoritarian and repressive penal regimes. Many of the papers brought together here have been unavailable for more than two decades. Their republication indicates not only their continuing theoretical importance to abolitionist studies but also how they provide important insights into the nature and legitimacy of criminal processes in the here and now. Contributors highlight the human consequences of the harms of imprisonment, evidencing the hurt, injury and damage of penal incarceration across a number of different countries in Europe. Focusing on penal power and prisoner contestation to such power, the moral and political crises of imprisonment are laid bare. The contributors to Beyond Criminal Justice explore the urgent need for a coherent, rational and morally and politically sophisticated theoretical basis for penal abolitionism. Advocating a utopian imagination and at the same time practical solutions already implemented in countries around Europe - alongside grappling with controversial debates such as abolitionist responses to rape and sexual violence - the book steps outside of common sense assumptions regarding 'crime', punishment and 'criminal justice'. Beyond Criminal Justice will be of interest to students of criminology, zemiology, sociology, penology and critical legal studies as well as anyone interested in rethinking the problem of 'crime' and challenging the logic of the penal rationale.

Re-embedding economic and social constitutionalism:Normative perspectives for the EU

Introduction Tensions between the economic and the social dimensions of European integration are being perceived as increasing, and so is the potential for conflict between national and European levels of policy-making. Both are well illustrated by a highly controversial line of Court of Justice of the European Union (ECJ) cases on industrial relations: Viking and Laval have become symbols for the continuing dominance of the economic over the social dimension of European integration and for an increasing tendency of the EU to diminish national autonomy. As one consequence, demands to protect Member States’ social policy choices from EU law pressures arise. For such demands to be tenable, isolation of national and EU policy-making and of economic and social dimensions of European integration would have to be possible. This is arguably not the case. Economic and social dimensions of integration will thus have to be reconciled across EU and national levels, if the EU and its Member States are to maintain the ability of enhancing social justice against the pulls of economic globalisation.

Environmental and social supply chain management sustainability practices: construct development and measurement

The purpose of this paper is to conceptualise and operationalise the concept of supply chain management sustainability practices. Based on a multi-stage procedure involving a literature review, expert Q-sort and pre-test process, pilot test and survey of 156 supply chain directors and managers in Ireland, we develop a multidimensional conceptualisation and measure of social and environmental supply chain management sustainability practices. The research findings show theoretically sound constructs based on four underlying sustainable supply chain management practices: monitoring, implementing systems, new product and process development and strategy redefinition. A two-factor model is then identified as the most reliable: comprising process-based and market-based practices.

An evaluation of palliative care services for cancer patients in the Southern Health and Social Services Board of Northern Ireland.

An interview study of 55 lay carers of people who died from cancer in the Southern Board of Northern Ireland was undertaken using a combination of closed-format and open-ended questions. The aim of the study was to evaluate palliative care services delivered in the last six months of their lives to cancer patients who died either at home or in hospital. Two-thirds of the deaths (36) occurred in the domestic home, 45 of the deceased were admitted as hospital inpatients, and the great majority were in receipt of community nursing (53) and general practitioner (54) services. Open-ended questions were used to allow respondents to give their views about services in some detail and their views about good and bad aspects of services were sought. While they were generally satisfied with services specific areas of difficulty were identified in each aspect of care addressed by the study. The most favourable assessments were made of community nursing with the greatest number of negative comments being made about inpatient hospital care. Differing interests between some of those who were dying and their lay carers were found in two areas: the receipt of help from nonfamily members and the information that the deceased received about their terminal status.

Validity of a personal and family history of cataract and cataract surgery in genetic studies.

PURPOSE:

To determine the accuracy of a history of cataract and cataract surgery (self-report and for a sibling), and to determine which demographic, cognitive, and medical factors are predictive of an accurate history.

METHODS:

All participants in the Salisbury Eye Evaluation (SEE) project and their locally resident siblings were questioned about a personal and family history of cataract or cataract surgery. Lens grading at the slit lamp, using standardized photographs and a grading system, was performed for both SEE participants (probands) and their siblings. Cognitive testing and a history of systemic comorbidities were also obtained for all probands.

RESULTS:

Sensitivity of a history of cataract provided on behalf of a sibling was 32%, specificity 98%. The performance was better for a history of cataract surgery: sensitivity 90%, specificity 89%. For self-report of cataract, sensitivity was also low at 55%, with specificity at 77%. Self-report of cataract surgery gave a much better performance: sensitivity 94%, specificity 100%. Different cutoffs in the definition of cataract had little impact. Factors predicting a correct history of cataract included high school or greater education in the proband (odds ratio [OR] = 1.13, 95% confidence interval [CI]1.02-1.25) and younger sibling (but not proband) age (OR = 0.94 for each year of age, 95% CI 0.90-0.99). Gender, race and Mini-Mental Status Examination (MMSE) result were not predictive.

CONCLUSIONS:

Whereas accurate self and family histories for cataract surgery may be obtainable, it is difficult to ascertain cataract status accurately from history alone.