Recruiting Participants for Randomized Controlled Trials of Music Therapy: A Practical Illustration

Background: Failure to recruit sufficient numbers of participants to randomized controlled trials is a common and serious problem. This problem may be additionally acute in music therapy research.

Objective: To use the experience of conducting a large randomized controlled trial of music therapy for young people with emotional and behavioral difficulties to illustrate the strategies that can be used to optimize recruitment; to report on the success or otherwise of those strategies; and to draw general conclusions about the most effective approaches.

Methods: Review of the methodological literature, and a narrative account and realist analysis of the recruitment process.

Results: The strategies adopted led to the achievement of the recruitment target of 250 subjects, but only with an extension to the recruitment period. In the pre-protocol stage of the research, these strategies included the engagement of non-music therapy clinical investigators, and extensive consultation with clinical stakeholders. In the protocol development and initial recruitment stages, they involved a search of systematic reviews of factors leading to under-recruitment and of interventions to promote recruitment, and the incorporation of their insights into the research protocol and practices. In the latter stages of recruitment, various stakeholders including clinicians, senior managers and participant representatives were consulted in an attempt to uncover the reasons for the low recruitment levels that the research was experiencing.

Conclusions: The primary mechanisms to promote recruitment are education, facilitation, audit and feedback, and time allowed. The primary contextual factors affecting the effectiveness of these mechanisms are professional culture and organizational support.

Holistic Needs Assessment: Rationale and practical implementation

Many people are living with or beyond a cancer diagnosis in the UK. The vision of the National Cancer Survivorship Initiative is that they are supported to live as healthy and as active a life as possible for as long as possible. To realise this vision, a recovery package has been developed, a component of which is holistic needs assessment (HNA) and care planning. This article presents the background and rationale for HNA and offers some practical suggestions for implementation in the current health climate.

Practical guidelines: Lung transplantation in patients with cystic fibrosis

There are no European recommendations on issues specifically related to lung transplantation (LTX) in cystic fibrosis (CF). The main goal of this paper is to provide CF care team members with clinically relevant CF-specific information on all aspects of LTX, highlighting areas of consensus and controversy throughout Europe. Bilateral lung transplantation has been shown to be an important therapeutic option for end-stage CF pulmonary disease. Transplant function and patient survival after transplantation are better than in most other indications for this procedure. Attention though has to be paid to pretransplant morbidity, time for referral, evaluation, indication, and contraindication in children and in adults. This review makes extensive use of specific evidence in the field of lung transplantation in CF patients and addresses all issues of practical importance. The requirements of pre-, peri-, and postoperative management are discussed in detail including bridging to transplant and postoperative complications, immune suppression, chronic allograft dysfunction, infection, and malignancies being the most important. Among the contributors to this guiding information are 19 members of the ECORN-CF project and other experts. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Christiane Herzog Foundation. 

Practical Lattice-Based Digital Signature Schemes

Digital signatures are an important primitive for building secure systems and are used in most real-world security protocols. However, almost all popular signature schemes are either based on the factoring assumption (RSA) or the hardness of the discrete logarithm problem (DSA/ECDSA). In the case of classical cryptanalytic advances or progress on the development of quantum computers, the hardness of these closely related problems might be seriously weakened. A potential alternative approach is the construction of signature schemes based on the hardness of certain lattice problems that are assumed to be intractable by quantum computers. Due to significant research advancements in recent years, lattice-based schemes have now become practical and appear to be a very viable alternative to number-theoretic cryptography. In this article, we focus on recent developments and the current state of the art in lattice-based digital signatures and provide a comprehensive survey discussing signature schemes with respect to practicality. Additionally, we discuss future research areas that are essential for the continued development of lattice-based cryptography.

Practical Spectrum Aggregation for Secondary Networks with Imperfect Sensing

We investigate a collision-sensitive secondary network that intends to opportunistically aggregate and utilize spectrum of a primary network to achieve higher data rates. In opportunistic spectrum access with imperfect sensing of idle primary spectrum, secondary transmission can collide with primary transmission. When the secondary network aggregates more channels in the presence of the imperfect sensing, collisions could occur more often, limiting the performance obtained by spectrum aggregation. In this context, we aim to address a fundamental query, that is, how much spectrum aggregation is worthy with imperfect sensing. For collision occurrence, we focus on two different types of collision: one is imposed by asynchronous transmission; and the other by imperfect spectrum sensing. The collision probability expression has been derived in closed-form with various secondary network parameters: primary traffic load, secondary user transmission parameters, spectrum sensing errors, and the number of aggregated sub-channels. In addition, the impact of spectrum aggregation on data rate is analysed under the constraint of collision probability. Then, we solve an optimal spectrum aggregation problem and propose the dynamic spectrum aggregation approach to increase the data rate subject to practical collision constraints. Our simulation results show clearly that the proposed approach outperforms the benchmark that passively aggregates sub-channels with lack of collision awareness.

Book Review: Working with loss and grief: a theoretical and practical approach

THE UPDATED second edition of this text begins with an overview of theories underpinning loss and grief, followed by a comprehensive outline of the author’s ‘range of response to loss’ (RRL) model, which emerged from her own research and experience. The RRL model provides a framework to explore variability in how people respond to grief, and case studies are used to demonstrate its application in practice. This is followed by an outline of the author’s ‘adult attitude to grief’ scale, which can be used to map a person’s grief and generate a grief profile.

Using Comparative Constitutionalism in Human Rights Discourse:Ireland’s Past and Scotland’s Future

The article considers the use of comparisons in constitutional development, specifically the use of comparative reasoning in the context of debates about human rights in newly emerging independent states, using the examples of Ireland and Scotland.

Imagining the Future: An Existential and Practical Activity

In an attempt to elucidate people’s own imaginings and hopes for the future, I consider the relationship between the following concepts and activities: imagining; the future; hope; the existential human condition; and practical activity. I ask: ‘How do people experience and act on a desire for a different future?’

Multimodal Critical Discourse Analysis (MCDA)

Critical Discourse Analysis (CDA) has probably made the most comprehensive attempt to develop a theory of the inter-connectedness of discourse, power and ideology and is specifically concerned with the role that discourse plays in main-taining and legitimizing inequality in society. While CDA’s general thrust has been towards the analysis of linguistic structures, some critical discourse analysts have begun to focus on multimodal discourses because of the increasingly impor-tant role these play in many social and political contexts. Still, a great deal of CDA analysis has remained largely monomodal. The principal aim of this chapter is therefore to address this situation and demonstrate in what ways CDA can be deployed to analyse the ways that ideological discourses can be communicated, naturalised and legitimated beyond the linguistic level. The chapter also offers a rationale for a multimodal approach based on Halliday’s Systemic Functional Linguistics (SFL), by which it is directly informed