Interviewing children with acquired brain injury (ABI).

Research into the lives of children with acquired brain injury (ABI) often neglects to incorporate children as participants, preferring to obtain the opinions of the adult carer (e.g. McKinlay et al., 2002). There has been a concerted attempt to move away from this position by those working in children’s research with current etiquette highlighting the inclusion of children and the use of a child-friendly methodology (Chappell, 2000). Children with disabilities can represent a challenge to the qualitative researcher due to the combination of maintaining the child’s attention and the demands placed on them by their disability. The focus of this article is to discuss possible impediments to interviewing children with acquired brain injury (ABI) and provide an insight into how the qualitative researcher may address these.

The Routledge Guide to Interviewing: Oral History, Social Enquiry & Investigation

The Routledge Guide to Interviewing sets out a well-tested and practical approach and methodology: what works, difficulties and dangers to avoid and key questions which must be answered before you set out. Background methodological issues and arguments are considered and drawn upon but the focus is on what is ethical, legally acceptable and productive:
-Rationale (why, what for, where, how)
-Ethics and Legalities (informed consent, data protection, risks, embargoes)
-Resources (organisational, technical, intellectual)
-Preparation (selecting and approaching interviewees, background and biographical research, establishing credentials, identifying topics)
-Technique (developing expertise and confidence)
-Audio-visual interviews
-Analysis (modes, methods, difficulties)
-Storage (archiving and long-term preservation)
-Sharing Resources (dissemination and development)

From death row to the mansion of a head of state, small kitchens and front parlours, to legislatures and presbyteries, Anna Bryson and Seán McConville’s wide interviewing experience has been condensed into this book. The material set out here has been acquired by trial, error and reflection over a period of more than four decades. The interviewees have ranged from the delightfully straightforward to the painfully difficult to the near impossible – with a sprinkling of those that were impossible.
Successful interviewing draws on the survival skills of everyday life. This guide will help you to adapt, develop and apply these innate skills. Including a range of useful information such as sample waivers, internet resources, useful hints and checklists, it provides sound and plain-speaking support for the oral historian, social scientist and investigator.

Methodological issues for qualitative research with learning disabled children

This paper discusses key methodological issues for qualitative research with learning disabled children, based on the author's experience of involving learning disabled children in her doctoral study. The study was founded on the social model of disability and a sociological understanding of childhood that recognizes the abilities of disabled children as competent research participants. Issues that arose throughout the research process, from the early stages of gaining access to children, to communication challenges for interviewing learning disabled children, and the analysis and dissemination of data, are discussed. Within this context, this paper explores key methodological issues for researchers with regard to interviewing learning disabled children and actively involving them in qualitative research.

Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice: cluster randomised controlled trial

Objective: To test the effectiveness of a complex intervention designed, within a theoretical framework, to improve outcomes for patients with coronary heart disease. Design: Cluster randomised controlled multicentre trial. Setting: General practices in Northern Ireland and the Republic of Ireland, regions with different healthcare systems. Participants: 903 patients with established coronary heart disease registered with one of 48 practices. Intervention: Tailored care plans for practices (practice based training in prescribing and behaviour change, administrative support, quarterly newsletter), and tailored care plans for patients (motivational interviewing, goal identification, and target setting for lifestyle change) with reviews every four months at the practices. Control practices provided usual care. Main outcome measures: The proportion of patients at 18 month follow-up above target levels for blood pressure and total cholesterol concentration, and those admitted to hospital, and changes in physical and mental health status (SF-12). Results: At baseline the numbers (proportions) of patients above the recommended limits were: systolic blood pressure greater than 140 mm Hg (305/899; 33.9%, 95% confidence interval 30.8% to 33.9%), diastolic blood pressure greater than 90 mm Hg (111/901; 12.3%, 10.2% to 14.5%), and total cholesterol concentration greater than 5 mmol/l (188/860; 20.8%, 19.1% to 24.6%). At the 18 month follow-up there were no significant differences between intervention and control groups in the numbers (proportions) of patients above the recommended limits: systolic blood pressure, intervention 98/360 (27.2%) v control, 133/405 (32.8%), odds ratio 1.51 (95% confidence interval 0.99 to 2.30; P=0.06); diastolic blood pressure, intervention 32/360 (8.9%) v control, 40/405 (9.9%), 1.40 (0.75 to 2.64; P=0.29); and total cholesterol concentration, intervention 52/342 (15.2%) v control, 64/391 (16.4%), 1.13 (0.63 to 2.03; P=0.65). The number of patients admitted to hospital over the 18 month study period significantly decreased in the intervention group compared with the control group: 107/415 (25.8%) v 148/435 (34.0%), 1.56 (1.53 to 2.60; P=0.03). Conclusions: Admissions to hospital were significantly reduced after an intensive 18 month intervention to improve outcomes for patients with coronary heart disease, but no other clinical benefits were shown, possibly because of a ceiling effect related to improved management of the disease. Trial registration: Current Controlled Trials ISRCTN24081411.

Promoting Health Behaviour Change in the Cardiac Patient

The importance of giving patients advice in relation to positive health behaviour change geared towards maximizing physical health must not be overlooked and is an important role of the cardiac nurse in contemporary health care. However, over-reliance on offering advice can often be counter-productive and less likely to achieve effective change. Patients are more likely to make positive health behaviour changes when they self-generate their own solutions to the health issues and problems that they face. In this article, the authors encourage cardiac nurses to embrace a less directive and more facilitative approach to patient health behaviour change in light of the mounting evidence that exists to the effectiveness of motivational interviewing techniques.

Prisons Memory Archive

Between 2006 and 2007, the Prisons Memory Archive (PMA) filmed participants, including former prisoners, prison staff, teachers, chaplains, visitors, solicitors and welfare workers back inside the Maze/Long Kesh Prison and Armagh Gaol. They shared the memory of the time spent in these prisons during the period of political violence from 1970 - 2000 in Northern Ireland, commonly known as the Troubles. Underpinning the overall methodology is co-ownership of the material, which gives participants the right to veto as well as to participate in the processes of editing and exhibiting their stories, so prioritising the value of co-authorship of their stories. The PMA adopted life-story interviewing techniques with the empty sites stimulating participants’ memory while they walked and talked their way around the empty sites. A third feature is inclusivity: the archive holds stories from across the full spectrum of the prison experience. A selection of the material, with accompanying context and links is available online www.prisonsmemoryarchive.com

Further Information:

The protocols of inclusivity, co-ownership and life-story telling make this collection significant as an initiative that engages with contemporary problems of how to negotiate narratives about a conflicted past in a society emerging out of violence. Inclusivity means that prison staff, prisoners, governors, chaplains, tutors and visitors have participated, relating their individual and collective experiences, which sit side by side on the PMA website. Co-ownership addresses the issues of ethics and sensitivity, allowing key constituencies to be involved. Life-story telling, based on oral history methodologies allows participants to be the authors of their own stories, crucial when dealing with sensitive issues from a violent past. The website hosts a selection of excerpts, e.g. the Armagh Stories page shows excerpts from 15 participants, while the Maze and Long Kesh Prison page offers interactive access to 24 participants from that prison. Using an interactive documentary structure, the site offers users opportunities to navigate their own way through the material and encourages them to hear and see the ‘other’, central to attempts at encouraging dialogue in a divided society. Further, public discussions have been held after screening of excerpts with community groups in the following locations - Belfast, Newtownabbey, Derry, Armagh, Enniskillen, London, Cork, Maynooth, Clones, and Monaghan. Extracts have been screened at international academic conferences in Valencia, Australia, Tartu, Estonia, Prague, and York. A dataset of the content, with description and links, is available for REF purposes.

Oxidative-nitrosative stress and systemic vascular function in highlanders with and without exaggerated hypoxemia

ABSTRACT BACKGROUND: Acute exposure to high-altitude stimulates free radical formation in lowlanders yet whether this persists during chronic exposure in healthy well-adapted and maladapted highlanders suffering from chronic mountain sickness (CMS) remains to be established. METHODS: Oxidative-nitrosative stress [ascorbate radical (A•-), electron paramagnetic resonance spectroscopy and nitrite (NO2-), ozone-based chemiluminescence] was assessed in venous blood of 25 male highlanders living at 3,600 m with (n = 13, CMS+) and without (n = 12, CMS-) CMS. Twelve age and activity-matched healthy male lowlanders were examined at sea-level and during acute hypoxia. We also measured flow-mediated dilatation (FMD), arterial stiffness (AIx-75) and carotid intima-media thickness (IMT). RESULTS: Compared to normoxic lowlanders, oxidative-nitrosative stress was moderately increased in CMS- (P < 0.05) as indicated by elevated A•- (3,191 ± 457 vs. 2,640 ± 445 arbitrary units (AU)] and lower NO2- (206 ± 55 vs. 420 ± 128 nmol/L) whereas vascular function remained preserved. This was comparable to that observed during acute hypoxia in lowlanders in whom vascular dysfunction is typically observed. In contrast, this response was markedly exaggerated in CMS+ (A•-: 3,765 ± 429 AU and NO2- : 148 ± 50 nmol/L) compared to both CMS- and lowlanders (P < 0.05). This was associated with systemic vascular dysfunction as indicated by lower (P < 0.05 vs. CMS-) FMD (4.2 ± 0.7 vs. 7.6 ± 1.7 %) and increased AIx-75 (23 ± 8 vs. 12 ± 7 %) and carotid IMT (714 ± 127 vs. 588 ± 94 µM). CONCLUSIONS: Healthy highlanders display a moderate sustained elevation in oxidative-nitrosative stress that unlike the equivalent increase evoked by acute hypoxia in healthy lowlanders, failed to affect vascular function. Its more marked elevation in patients with CMS may contribute to systemic vascular dysfunction.Clinical Trials Gov Registration # NCT011827921Neurovascular Research Laboratory, Faculty of Health, Science and Sport, University of Glamorgan, Wales, UK;2Sondes Moléculaires en Biologie et Stress Oxydant, Institut de Chimie Radicalaire, CNRS UMR 7273, Aix-Marseille University, France;3Department of Cardiology, University Hospital of Bern, Bern, Switzerland;4Institute of Clinical Physiology, CNR, Pisa, Italy;5Instituto Bolivano de Biologia de Altura, La Paz, Bolivia;6Centre for Clinical and Population Sciences, Queen's University Belfast, Belfast, Northern Ireland,7Botnar Center for Clinical Research, Hirslanden Group, Lausanne, Switzerland;8Facultad de Ciencias, Departamento de Biología, Universidad de Tarapacá, Arica, Chile and9Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland*Drs Bailey, Rimoldi, Scherrer and Sartori contributed equally to this workCorrespondence: Damian Miles Bailey, Neurovascular Research Laboratory, Faculty of Health, Science and Sport, University of Glamorgan, UK CF37 4AT email: dbailey1@glam.ac.uk.