What do we know about the experience of age related macular degeneration? A systematic review and meta-synthesis of qualitative research

Age Related Macular Degeneration (AMD) is the leading cause of registerable blindness with a high medical and societal cost burden. Much of the research examining experiences of living with AMD has been conducted independently with small sample sizes and has failed to impact on practice. Meta-synthesis of qualitative research can improve the understanding of the experience of living with AMD by drawing together findings of qualitative studies. This article presents a systematic review and meta-synthesis of qualitative studies investigating the experience of AMD (literature searched up to April 2012; published studies identified range from 1996 to 2009). The review highlights themes relating to: functional limitations, adaptation and independence; feelings about the future with vision impairment; interaction with the health service; social engagement; disclosure; and the emotional impacts of living with AMD. Attention to the experience of living with AMD can help us to better understand the needs of patients. This meta-synthesis aimed to bring together the findings of qualitative research studies and highlights important areas for consideration when caring for patients with AMD. Our findings suggest that a holistic approach to service provision and support for AMD is needed which takes into account individuals' needs and experiences when coping with and adjusting to living with AMD. This support should aim to reduce stigma, increase social engagement, and develop the psychological resources of patients with AMD.

Shifting accountability:a longitudinal qualitative study of diabetes causation accounts

We undertook a longitudinal qualitative study involving of 20 patients from Scotland who had type 2 diabetes. We looked at their perceptions and understandings of why they had developed diabetes and how, and why, their causation accounts had changed or remained stable over time. Respondents, all of whom were white, were interviewed four times over a 4-year period (at baseline, 6, 12 and 48 months). Their causation accounts often shifted, sometimes subtly, sometimes radically, over the 4 years. The experiential dimensions of living with, observing, and managing their disease over time were central to understanding the continuities and changes we observed. We also highlight how, through a process of removing, adding and/or de-emphasising explanatory factors, causation accounts could be used as “resources” to justify or enable present treatment choices. We use our work to support critiques of social cognition theories, with their emphasis upon beliefs being antecedent to behaviours. We also provide reflections upon the implications of our findings for qualitative research designs and sampling strategies.

Avoiding measurement dogma:a response to Rossiter

Purpose – This paper aims to respond to John Rossiter's call for a “Marketing measurement revolution” in the current issue of EJM, as well as providing broader comment on Rossiter's C-OAR-SE framework, and measurement practice in marketing in general. Design/methodology/approach – The paper is purely theoretical, based on interpretation of measurement theory. Findings – The authors find that much of Rossiter's diagnosis of the problems facing measurement practice in marketing and social science is highly relevant. However, the authors find themselves opposed to the revolution advocated by Rossiter. Research limitations/implications – The paper presents a comment based on interpretation of measurement theory and observation of practices in marketing and social science. As such, the interpretation is itself open to disagreement. Practical implications – There are implications for those outside academia who wish to use measures derived from academic work as well as to derive their own measures of key marketing and other social variables. Originality/value – This paper is one of the few to explicitly respond to the C-OAR-SE framework proposed by Rossiter, and presents a number of points critical to good measurement theory and practice, which appear to remain underdeveloped in marketing and social science.

Breaking down barriers:teenage girls’ perceptions of engineering as a study and career choice

Background: Stereotypically perceived to be an ‘all male’ occupation, engineering has for many years failed to attract high numbers of young women [1,2]. The reasons for this are varied, but tend to focus on misconceptions of the profession as being more suitable for men. In seeking to investigate this issue a participatory research approach was adopted [3] in which two 17 year-old female high school students interviewed twenty high school girls. Questions focused on the girls’ perceptions of engineering as a study and career choice. The findings were recorded and analysed using qualitative techniques. The study identified three distinctive ‘influences’ as being pivotal to girls’ perceptions of engineering; pedagogical; social; and, familial. Pedagogical Influences: Pedagogical influences tended to focus on science and maths. In discussing science, the majority of the girls identified biology and chemistry as more ‘realistic’ whilst physics was perceived to more suitable for boys. The personality of the teacher, and how a particular subject is taught, proved to be important influences shaping opinions. Social Influences: Societal influences were reflected in the girls’ career choice with the majority considering medical or social science related careers. Although all of the girls believed engineering to be ‘male dominated’, none believed that a woman should not be engineer. Familial Influences: Parental influence was identified as key to career and study choice; only two of the girls had discussed engineering with their parents of which only one was being actively encouraged to pursue a career in engineering. Discussion: The study found that one of the most significant barriers to engineering is a lack of awareness. Engineering did not register in the girls’ lives, it was not taught in school, and only one had met a female engineer. Building on the study findings, the discussion considers how engineering could be made more attractive to young women. Whilst misconceptions about what an engineer is need to be addressed, other more fundamental pedagogical barriers, such as the need to make physics more attractive to girls and the need to develop the curriculum so as to meet the learning needs of 21st Century students are discussed. By drawing attention to the issues around gender and the barriers to engineering, this paper contributes to current debates in this area – in doing so it provides food for thought about policy and practice in engineering and engineering education.

Reflection and reflexivity in reviewing and evaluating CDIO:an empirical approach to evaluation

Facilitated by an Engineer and a Social Scientist, both of whom have expertise in Engineering Education Research and Evaluation (EERE), this interactive workshop is divided into three main sections, each one focusing on a different area of evaluation. It will build on research conducted at Aston University School of Engineering and Applied Science to explore and critique the value of introducing CDIO across the first year undergraduate curriculum. Participants will be invited to consider the pedagogical and engineering related challenges of evaluating the academic and practical value of CDIO as a strategy for learning and teaching in the discipline. An empirical approach to evaluation developed by the researchers to provide empirically grounded evidence of the pedagogical and vocational value of CDIO will form the theoretical and conceptual basis of the workshop. This approach is distinctive in that it encapsulates both engineering and social science methods of evaluation. It is also contemporaneous in nature, with the researchers acting as a ‘fly on the wall’ capturing data as the programme unfolds. Through facilitated discussion and participation, the workshop will provide colleagues with the opportunity to develop a cross-disciplinary, empirically grounded research proposal specifically for the purposes of critically evaluating CDIO. It is anticipated that during the workshop, colleagues will work together in small groups. Suitable pedagogical approaches and tools will be suggested and a purposefully developed Engineering Education Research Guide, written by the workshop facilitators, will be given to all participants to inform and support the Workshop approach.

The silence of the archives:postcolonialism and the practice of historical reconstruction from archival evidence

History as a discipline has been accused of being a-theoretical. For business historians working at business schools, however, the issue of methodology looms larger, as it is hard to make contributions to social science debates without explicating one’s disciplinary methodology. This paper seeks to outline an important aspect of historical methodology, which is data collection from archives. In this area, postcolonialism has made significant methodological contributions not just for non-Western history, as it has emphasized the importance of considering how archives were created, and how one can legitimately use them despite their limitations.

Supply management:is it a discipline?

Purpose – To examine management literature for guidance on what constitutes a discipline. To examine supply management publications to determine whether the field constitutes a discipline or an emerging discipline. To contribute a structured evaluation to the body of supply management theory/discipline development knowledge. Design/methodology/approach – Literature review of what constitutes a discipline and an initial assessment of whether supply management is a discipline. Development of research questions used to design tests, using combinations of qualitative pattern matching, journal quality rankings, and social science citations index impact factor. Application of the tests, to evaluate field coherence, quality and the existence of a discipline-debate, to determine whether supply management is an emerging discipline. Findings – An initial literature review finds supply management not to be a discipline, as the field lacks quality of theoretical development and discussion, and coherence. Tests for increasing evidence of coherence, quality and impact yield positive results, indicating that supply management is progressing in its theoretical development. The test findings combined with the existence of the start of a discipline-debate indicate that supply management should be judged to be an emerging discipline. Originality/value – Drawing from the management literature, the paper provides a unique structured evaluation of the field of supply management, finding it not to be a discipline, but showing evidence of being an emerging discipline.

What are tests for? The implications of stuttering steps along the patient pathway

This article explores the implications of how US family physicians make decisions about ordering diagnostic tests for their patients. Data is based on a study of 256 physicians interviewed after viewing a video vignette of a presenting patient. The qualitative analysis of 778 statements relating to trustworthiness of evidence for their decision making, the use of any kind of technology and diagnostic testing suggests a range of internal and external constraints on physician decision making. Test-ordering for family physicians in the United States is significantly influenced by both hidden cognitive processes related to the physician's calculation of patient resources and a health insurance system that requires certain types of evidence in order to permit further tests or particular interventions. The consequence of the need for physicians to meet multiple forms of proof that may not always relate to relevant treatment delays a diagnosis and treatment plan agreed not only by the physician and patient but also the insurance company. This results in a patient journey that is made up of stuttering steps to a confirmed diagnosis and treatment undermining patient-centred practice, compromising patient care, constraining physician autonomy and creating additional expense. © 2014 Elsevier Ltd.

Quality of life instruments in studies of menorrhagia: a systematic review

BACKGROUND: The use of quality of life (QoL) instruments in menorrhagia research is increasing but there is concern that not enough emphasis is placed on patient-focus in these measurements, i.e. on issues which are of importance to patients and reflect their experiences and concerns (clinical face validity). The objective was to assess the quality of QoL instruments in studies of menorrhagia. STUDY DESIGN: A systematic review of published research. Papers were identified through MEDLINE (1966-April 2000), EMBASE (1980-April 2000), Science Citation Index (1981-April 2000), Social Science Citation Index (1981-April 2000), CINAHL (1982-1999) and PsychLIT (1966-1999), and by manual searching of bibliographies of known primary and review articles. Studies were selected if they assessed women with menorrhagia for life quality, either developing QoL instruments or applying them as an outcome measure. Selected studies were assessed for quality of their QoL instruments, using a 17 items checklist including 10 items for clinical face validity (issues of relevance to patients' expectations and concerns) and 7 items for measurement properties (such as reliability, responsiveness, etc.). RESULTS: A total of 19 articles, 8 on instrument development and 11 on application, were included in the review. The generic Short Form 36 Health Survey Questionnaire (SF36) was used in 12/19 (63%) studies. Only two studies developed new specific QoL instruments for menorrhagia but they complied with 7/17 (41%) and 10/17 (59%) of the quality criteria. Quality assessment showed that only 7/19 (37%) studies complied with more than half the criteria for face validity whereas 17/19 (90%) studies complied with more than half of the criteria for measurement properties (P = 0.0001). CONCLUSION: Among existing QoL instruments, there is good compliance with the quality criteria for measurement properties but not with those for clinical face validity. There is a need to develop methodologically sound disease specific QoL instruments in menorrhagia focussing both on face validity and measurement properties.

Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries have a less well developed mental model of depression for black compared with white patients. © 2014 The Authors.

Negotiating access and establishing expertise

This book is concerned with the day-to-day realities of doing social science research. It is based upon the reflections and experiences of a wide range of established social researchers, the majority of whom undertake research in the field of health care. By drawing upon their anecdotal accounts of setting up research projects, negotiating access, collecting and analysing data, and disseminating findings, the book highlights a multitude of practical and ethical complexities involved in the conduct of empirically based research. It delineates the emotional, social and cultural factors involved at all stages of the research process, and sets this delineation in the context of wider debates about the relationship between research methods and research ethics.

Lessening sensitivity:student experiences of teaching and learning sensitive issues

Despite growing interest in learning and teaching as emotional activities, there is still very little research on experiences of sensitive issues. Using qualitative data from students from a range of social science disciplines, this study investigates student's experiences. The paper highlights how, although they found it difficult and distressing at times, the students all valued being able to explore sensitive issues during their studies. The paper argues that it is though repeated exposure to sensitive issues within the classroom that the students became more comfortable with the issues. This process of lessening sensitivity is an important part of the emotional journey through higher education. It will argue that good student experiences need not always be positive emotions and that sensitive issues should be seen as an important part of transformational education.

A Taxonomy of Big Data for Optimal Predictive Machine Learning and Data Mining

Big data comes in various ways, types, shapes, forms and sizes. Indeed, almost all areas of science, technology, medicine, public health, economics, business, linguistics and social science are bombarded by ever increasing flows of data begging to be analyzed efficiently and effectively. In this paper, we propose a rough idea of a possible taxonomy of big data, along with some of the most commonly used tools for handling each particular category of bigness. The dimensionality p of the input space and the sample size n are usually the main ingredients in the characterization of data bigness. The specific statistical machine learning technique used to handle a particular big data set will depend on which category it falls in within the bigness taxonomy. Large p small n data sets for instance require a different set of tools from the large n small p variety. Among other tools, we discuss Preprocessing, Standardization, Imputation, Projection, Regularization, Penalization, Compression, Reduction, Selection, Kernelization, Hybridization, Parallelization, Aggregation, Randomization, Replication, Sequentialization. Indeed, it is important to emphasize right away that the so-called no free lunch theorem applies here, in the sense that there is no universally superior method that outperforms all other methods on all categories of bigness. It is also important to stress the fact that simplicity in the sense of Ockham’s razor non-plurality principle of parsimony tends to reign supreme when it comes to massive data. We conclude with a comparison of the predictive performance of some of the most commonly used methods on a few data sets.

Guest editors' introduction : diversity and inclusion in different work settings:emerging patterns, challenges, and research agenda

The purpose of this article is to analyze and highlight the developments in the current scholarship on managing diversity and inclusion (D&I) and provide insights for future research. While doing so, the article advances our understanding of “what matters” in this field, through the integration of different literature concerning the dimensions of D&I. It also provides a neo-institutionalist framework, which locates different themes in the D&I scholarship to assist in further development of the field. It argues for a consideration of inquiry in D&I from a neo-institutionalist perspective to encourage interdisciplinarity and align with broader social science research in human resource management (HRM) and development, highlighting the complexity involved in the theorizing of D&I management in organizations. Specifically, we argue for the need to engage with a variety of stakeholders concerned with the management of D&I, to enable cross-fertilization of theories and mixing methods for future research designs. The article also introduces the manuscripts included in this special issue and build on them as well to develop the future research agenda. © 2015 Wiley Periodicals, Inc.

Manoeuvring towards research decline:the RAE and the decline of Britain's international research standing

Purpose: This research paper aims to examine the global trends in publishing in the leading marketing journals between 1964 and 2008, focusing on how public policy intervention in the assessment and funding of academic research has influenced Britain's relative productivity in the world's leading marketing journals. Design/methodology/approach: The method was an audit of contributions to the leading journals based on the authors' affiliation, country of origin and country in which they obtained their doctoral training. Findings: The results show that the proportion of leading marketing publications by authors affiliated to British universities have held steady at about 2 per cent, while the productivity of several other countries has accelerated past Britain. However, to retain that share, Britain has increasingly depended upon importing people whose PhD is not British. This contrasts with some other European countries that are now more productive than Britain, but mainly recruit locals with local PhDs. The pattern of decline in the UK is related to the impact of Britain's research assessment exercise and the continuation of relatively weak social science research training. Research limitations/implications: The analysis is limited by only looking at one academic discipline and only the top few academic journals in the field. Practical implications: The findings have implications at several levels. At a national policy level it questions the value of the research assessment exercises that appear to have presided over a decline in research productivity. For institutions, it questions the value in investing in developing local talent when success has come to those who buy talent internationally. Perhaps, the major implication arises from Britain's academic productivity declining while neighbouring countries have grown in international excellence. Originality/value: At a time when the continuation of expensive university research assessments is being questioned the research findings add value to the current debate in showing how that very process has accompanied academic decline. © Emerald Group Publishing Limited.