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"GRIFFITHS, ALISON"
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Psychometric properties of gross motor assessment tools for children: a systematic review
ObjectiveGross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2–12 years.MethodA systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools.ResultsSeven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5–0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test–retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80–0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83–0.96) and TGMD-2 (ICC=0.81–0.92). TGMD-2 has the highest inter-rater (ICC=0.88–0.93) and intrarater reliability (ICC=0.92–0.99).ConclusionsThe majority of gross motor assessments for children have good-excellent validity. Test–retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.
Journal Article
“For the Amusement of the Shutins”: The Vicissitudes of Film Viewing in Prison
This essay explores how watching movies in prisons both affirms and compromises the spectatorial contract of commercial filmgoing, picking apart the various kinds of interferences that defined and modified the experience of motion pictures in the nontheatrical setting of the early twentieth-century prison. Prison spectatorship is examined in relation to issues of policing and safety in prison screenings where all manner of distractions came between the inmate-spectator and the screen, including flammable nitrate catching fire in improvised projection booths, hostile or absorbed guards, fights breaking out between inmates, and the presence of dignitaries or celebrities. Using accounts of prison spectatorship from prominent archives and the popular press, this essay constructs prison moviegoing as an enigmatic and discursively complex phenomenon—an important if little understood example of the cinematic apparatus.
Journal Article
The effect of interactive digital interventions on physical activity in people with inflammatory arthritis: a systematic review
The aim of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) evaluating the effectiveness of interactive digital interventions (IDIs) for physical activity (PA) and health related quality of life (HRQoL) in people with Inflammatory Arthritis [rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) axial Spondyloarthritis (AS) and psoriatic arthritis (PsA)]. Seven electronic databases identified published and unpublished studies. Two reviewers conducted independent data extraction and quality assessment using the Cochrane risk of bias tool (RoB). The primary outcome was change in objective PA after the intervention; secondary outcomes included self-reported PA and HRQoL after the intervention and objective or self-reported PA at least 1 year later. Five manuscripts, reporting four RCTs (three high and one low RoB) representing 492 (459 RA, 33 JIA) participants were included. No trials studying PsA or AS met the inclusion criteria. Interventions ranged from 6 to 52 weeks and included 3–18 Behaviour Change Techniques. Due to heterogeneity of outcomes, a narrative synthesis was conducted. No trials reported any significant between group differences in objective PA at end of intervention. Only one low RoB trial found a significant between group difference in self-reported vigorous [MD Δ 0.9 days (95% CI 0.3, 1.5); p = 0.004], but not moderate, PA in people with RA but not JIA. There were no between group differences in any other secondary outcomes. There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS.
Journal Article
Results of a prospective, mixed methods study to assess feasibility, acceptability and effectiveness of TRIumPH (Treatment and Recovery In PsycHosis): an integrated care pathway for psychosis, compared to usual treatment
ObjectivesTo evaluate whether a newly developed care pathway, Treatment and Recovery In PsycHosis (TRIumPH), is feasible, acceptable and effective in meeting National Institute of Health and Care Excellence (NICE) quality standards in a timely manner.MethodsThis is a pragmatic, non-randomised, prospective, mixed methods study comparing an implementation (TRIumPH) and comparator site (not implementing TRIumPH) across three cohorts to assess feasibility, acceptability and effectiveness of the integrated pathway.SettingEarly intervention in psychosis (EIP) services at two National Health Service organisations in South of England.ParticipantsAll patients accepted into EIP services between 1 June 2014 and 31 May 2017 were each followed up for 1 year within their respective cohorts.MethodologyQuantitative data consisted of routinely collected clinical data retrieved from patient records to assess whether the implementation of TRIumPH achieved better concordance to NICE standards. These included time to access services, physical health assessments, clinical outcomes based timeliness of delivery and acute data. The controlled trial has evaluated the effect of TRIumPH (Intervention) with Care As Usual (Comparator). Qualitative measures consisted of questionnaires, interviews and focus groups to assess acceptability and satisfaction. Outcome measures were compared within the baseline, year 1 and year 2 cohorts and between the two sites. Quantitative data were statistically analysed by comparing means and proportions.ResultsTime to assessment improved in the implementation site and remained within the target in comparator site. Meeting of quality standards increased substantially in the implementation site but was more variable and reached lower levels in the comparator site especially for physical health standards. Cognitive therapy for psychosis, family intervention and carer and employment support were all offered to a greater extent in the implementation site and uptake increased over the period.ConclusionsPathway implementation generally led to greater improvements in achievement of access and quality standards compared with comparator site.Trial registration numberUK Clinical Research Network Portfolio (19187)
Journal Article
A comparison of Mamdani and Sugeno fuzzy based packet scheduler for MANET with a realistic wireless propagation model
The mobile nature of the nodes in a wireless mobile ad-hoc network (MANET) and the error prone link connectivity between nodes pose many challenges. These include frequent route changes, high packet loss, etc. Such problems increase the end-to-end delay and decrease the throughput. This paper proposes two adaptive priority packet scheduling algorithms for MANET based on Mamdani and Sugeno fuzzy inference system. The fuzzy systems consist of three input variables: data rate, signal-to-noise ratio (SNR) and queue size. The fuzzy decision system has been optimised to improve its efficiency. Both fuzzy systems were verified using the Matlab fuzzy toolbox and the performance of both algorithms were evaluated using the riverbed modeler (formally known as OPNET modeler). The results were compared to an existing fuzzy scheduler under various network loads, for constant-bit-rate (CBR) and variable-bit-rate (VBR) traffic. The measuring metrics which form the basis for performance evaluation are end-to-end delay, throughput and packet delivery ratio. The proposed Mamdani and Sugeno scheduler perform better than the existing scheduler for CBR traffic. The end-to-end delay for Mamdani and Sugeno scheduler was reduced by an average of 52% and 54%, respectively. The performance of the throughput and packet delivery ratio for CBR traffic are very similar to the existing scheduler because of the characteristic of the traffic. The network was also at full capacity. The proposed schedulers also showed a better performance for VBR traffic. The end-to-end delay was reduced by an average of 38% and 52%, respectively. Both the throughput and packet delivery ratio (PDR) increased by an average of 53% and 47%, respectively. The Mamdani scheduler is more computationally complex than the Sugeno scheduler, even though they both showed similar network performance. Thus, the Sugeno scheduler is more suitable for real-time applications.
Journal Article
Cinema in Extremis: Mount Everest and the Poetics of Monumentality
Two British attempts to climb Mount Everest cosponsored by the Royal Geographical Society and the Alpine Club in the 1920s, equipped with motion-picture cameras, telescopic lenses, and filters, promised to elevate Britain's reputation within international mountaineering circles, as well as claim victory for machine and humanity in extreme altitude. This essay examines how ideas of monumentality circulate textually and discursively in the two extant films, Climbing Mount Everest (1922) and The Epic of Everest (1924), homing in on how Everest's scale denuded cinema of some of its essential capabilities while paradoxically capturing saturated moments of monumentality through specific cinematic techniques. Though commercial success eluded the filmic records of the failed climbing attempts, the films' negotiation of the complex dialectics of British national identity and Tibetan life brings the poetics of monumentality into conversation with issues of culture, memory, indigenous agency, and history.
Journal Article
Development and Verification of Simulation Model Based on Real MANET Experiments for Transport Layer Protocols (UDP and TCP)
There is a lack of appropriate guidelines for realistic user traces, mobility models, routing protocols, considerations of real-life challenges, etc. for general-purpose mobile ad hoc networks (MANET). In this paper, four laptops are used in an open field environment in four scenarios to evaluate the performances of Internet control message protocol (ICMP) based ping and transmission control protocol (TCP) based streaming video applications using optimised link state routing (OLSR) implementation in an IEEE 802.11g wireless network. Corresponding simulations are developed in Network Simulator ns-2 by setting simulation parameters according to the real experiments. Difficulties faced to regenerate real-life scenarios have been discussed and the gaps between reality and simulation are identified. A setup guideline to produce realistic simulation results has been established.
Journal Article
58 Front door palliative care: development of a macmillan specialist palliative care practitioner role in the emergency department of a tertiary hospital in the UK
In recent years attendances to the emergency department (ED), and consequently patient waiting times have skyrocketed. This combined with increasingly stretched community services has led to growing numbers of patients presenting at end of life (EOL) and dying in ED. ED staff describe huge dissatisfaction in their ability to provide good end of life care to patients in the department. A big factor in this is the lack of ability to rapidly discharge a patient from ED to die in a more appropriate setting. In May 2023 a Macmillan funded Specialist Palliative Care Practitioner role (band 7 specialist nurse) was created with the aim of improving the experience of patients at EOL, increase the early identification of patients in the dying phase, change departmental culture, provide education and reduce the number of deaths within the department. The practitioner worked closely with the regional Ambulance Trust, the hospital Frailty Team and Medical Assessment Unit and was based full time Monday – Friday in the ED. The role was patient both patient facing and strategic, with the aim of developing processes to reduce time spent in ED for EOL patients and improve discharge processes.Early data has shown a hugely positive impact from the role. In the first 21 weeks 99 patients were reviewed; of these 76 had Treatment Escalation Plan (TEP) documents updated, 6 died in ED with support from the post holder, 24 were admitted to hospital and 64 potential acute potential admissions were avoided and instead successfully discharge to their own home, nursing home or hospice directly from ED. The joint role of having a specialist palliative practitioner embedded in ED has been hugely successful so far and the Hospital Trust is now looking to expand the role further to provide a 7 day service to support pre-conveyance decision making.
Journal Article