SWAT-1: The effectiveness of a 'site visit' intervention on recruitment rates in a multi-centre randomised trial

Background: Recruitment rates in multi-centre randomised trials often fall below target recruitment rates, causing problems for study outcomes. The Studies Within A Trial (SWAT) Programme, established by the All-Ireland Hub for Trials Methodology Research in collaboration with the Medical Research Council Network of Hubs in the United Kingdom and others, is developing methods for evaluating aspects of trial methodology through the conduct of research within research. A recently published design for a SWAT-1 provides a protocol for evaluating the effect of a site visit by the principal investigator on recruitment in multi-centre trials.

Methods: Using the SWAT-1 design, the effect of a site visit, with the sole purpose of discussing trial recruitment, on recruitment rates in a large multicentre trial in the Republic of Ireland was evaluated. A controlled before and after intervention comparison was used, where the date of the site visit provides the time point for the intervention, and for the comparison to control sites. Site A received the intervention. Site B and Site C acted as the controls. Z-scores for proportions were calculated to determine within site recruitment differences. Odds ratios and 95% confidence intervals were calculated to determine between site recruitment differences.

Results: Recruitment rates were increased in Site A post-intervention (17% and 14% percentage point increases at 1 and 3 months, respectively). No differences in recruitment occurred in Site B or in Site C. Comparing between site differences, at 3 months post-intervention, a statistically significant difference was detected in favour of higher recruitment in Site A (34% versus 25%; odds ratio 1.57, 95% confidence interval 1.09 to 2.26).

Conclusions: This is the first reported example of a study in the SWAT programme.. It provides evidence that a site visit, combined with a scheduled meeting, increases recruitment in a clinical trial. Using this example, other researchers might be encouraged to consider conducting a similar study, allowing the findings of future SWAT-1s to be compared and combined, so that higher level evidence on the effect of a site visit by the principal investigator can be obtained.

Plain English: Applying Principles to Home School Written Communication Considering Diverse Families

Schools attempting to engage with the families of all learners, including those with culturally and linguistically diverse backgrounds recognize the importance of effective oral and written communication. The aim of this study is to determine if school generated written communication created by an urban school district serving a culturally and linguistically diverse population in the Northeast of the US adhered to the principles of plain English. This exploratory research examined exemplar pieces of written school generated communication, using different forms of linguistic analysis to determine whether the communication contained elements recognized to facilitate or impede the comprehensibility of each piece of communication. Additionally, a text assessment tool which can help schools to analyze the written text communication they send to families was developed and refined.

Oscar Wilde at Home

Oscar, Constance, Speranza (and Bosie) are “at home” in the exquisitely beautiful Florence Court House this Mayday weekend. House guests will include Jack, Algy, Gwendolen and Cecily from the Importance of Being Earnest, (not to mention the redoubtable Lady Bracknell), Lord and Lady Windermere, the impetuous Lord Darlington, and the precocious Dorian Gray. Visitors will be conducted throughout the house where a range of short scenes from Wilde’s most popular works will be performed live by actors in each of the principal rooms. Is it life or is it art? Come and decide for yourself as we welcome you to the witty, complex and contradictory world of Oscar Wilde. Conceived and directed by David Grant.

Dramatis Personae
Oscar Wilde (and Lord Henry Wotton) – Donal Morgan
Constance Wilde (Lady Wotton, and Cecily Cardew) – Julie Lamberton
Lady Speranza Wilde (Lady Bracknell and Mrs Erlynne) – Antoinette Morelli
Lord Alfred Douglas (and Dorian Gray) – Sydney Bull
Lord Darlington and Basil Hallward – Richard Croxford
Lady Windermere and Gwendolen Fairfax – Stephanie Dale
Jack Worthing – Patrick McBrearty
Algernon Moncrieff and Lord Windermere – Stefan Dunbar
Lane and Parker – Curtis Reed and tbc

Production Team
Costume Design – Enda Kenny
Sound Design – Sydney Bull
Sound Operator – Seth Taylor
Stage Manager – Bronagh McFeely
Company Manager – Eamon Quinn
Director – David Grant

Predictors of place of death for those in receipt of home-based palliative care services in Ontario, Canada

Many cancer patients die in institutional settings despite their preference to die at home. A longitudinal, prospective cohort study was conducted to comprehensively assess the determinants of home death for patients receiving home-based palliative care. Data collected from biweekly telephone interviews with caregivers (n=302) and program databases were entered into a multivariate logistic model. Patients with high nursing costs (odds ratio [OR]: 4.3; confidence interval [CI]: 1.8-10.2) and patients with high personal support worker costs (OR: 2.3; CI: 1.1-4.5) were more likely to die at home than those with low costs. Patients who lived alone were less likely to die at home than those who cohabitated (OR: 0.4; CI: 0.2-0.8), and those with a high propensity for a home-death preference were more likely to die at home than those with a low propensity (OR: 5.8; CI: 1.1-31.3). An understanding of the predictors of place of death may contribute to the development of effective interventions that support home death.

'When I Land in Islamabad I Feel Home and When I Land in Heathrow I Feel Home': Gendered Belonging and Diasporic Identities of South Asian British Citizens in London, in Leicester and in North England

According to Deleuze and Guattari (1987) ‘de-territorialization’ is followed by a moment of re-territorialization. This moment, however, has to be regarded as a continuing educational process that becomes a different spatial site of social practices. It is argued in this chapter that regional, local as well as global identification override national and mono-ethno cultural identities, while shaping particular notions of gendered belonging and creating specific diasporic practices. Based on a sample of interviews with professional and academic South Asian British citizens in London, in Leicester, and in a number of Northern English cities gendered and generational patterns in terms of local diasporic identities are explored. Apart from multiple cultural belonging, foremost, territorial bonds and notions of group loyalty collapse at a point where temporary migration and settlement alternate in individual biographies.

How Mothers Talk About Placement of Their Child With Autism Outside the Home

In this article I use insights offered by the poststructural shift and linguistic turn in social scientific inquiry, specifically discourse analysis, to explore mothers’ talk about the placement of their child with autism outside of the home. By viewing mothers’ talk as data, I bring to light the discourses and interpretive practices that mothers drew on to organize their talk of placement. In doing so, I provide insights into how mothers gave meaning to processes of placement while also expanding on commonsensical discursive notions of “good” mothering, caregiving, and family. Implications of the findings are discussed.