Swimming for dementia: An exploratory qualitative study: Innovative practice.

Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N = 4), carers or companions (N = 4) and the organisers and facilitators of the group (N = 6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants, (2) the importance of insight and empathy in creating a safe and secure experience, (3) the impact of dementia and (4) how participants valued being part of a group 'all in the same boat'. 'Dementia friendly swimming' appears to be a valuable form of exercise, but it requires considerable preparation and support to make it happen.

Mementos from Boots multisensory boxes - Qualitative evaluation of an intervention for people with dementia: Innovative practice.

This qualitative study explored a multisensory (including olfactory) intervention for people with dementia. Six themed boxes (e.g. Childhood) containing items chosen from the Boots archive designed to encourage conversation were used in weekly group sessions. Session participants were people with dementia and care staff from a local care home, a trained facilitator and archivists from Boots UK. Semi-structured interviews explored participants' experiences of the sessions. Interviews were analysed using thematic analysis. The three major themes Engagement (subthemes: Inclusiveness; Emotional involvement; Factors that supported engagement), What's in the box (subthemes: Contents stimulate memories; Mystery, variety and age of items; Value of olfactory stimuli), and A conversation starter (subtheme: Opportunity for self-expression) reveal the success of the intervention and the value of olfactory stimuli. Multisensory boxes including olfactory stimulation can be an engaging intervention with scope to refine it for people with dementia and their carers in the wider community.

"Here everyone is the same" - A qualitative evaluation of participating in a Boccia (indoor bowling) group: Innovative practice.

This qualitative study explored the impact of a Boccia (modified indoor bowls) group on the lives of people with dementia and their carers. Semi-structured interviews with people with dementia (N = 6), carers (N = 10) and the group organisers (N = 6) analysed using thematic analysis revealed four main themes. 'The struggle of being a carer' was relieved by participating in the group and benefitting from the caring support and social aspects of "This group is a family". "The unique nature of Boccia" helped it to provide physical and mental stimulation as well as being an inclusive and enjoyable group. These aspects contributed to many participants describing the group as a Dementia friendly environment where "Here everyone is the same": treated as equals, without feeling hindered or defined by dementia. Boccia appears an exciting initiative but further research is needed to see if these findings can be replicated with other groups.

Patients with depression who self-refer for transcranial magnetic stimulation treatment: exploratory qualitative study.

Aims and methodAs part of a larger clinical trial concerning the use of transcranial magnetic stimulation (TMS) for treatment-resistant depression, the current study aimed to examine referral emails to describe the clinical characteristics of people who self-refer and explore the reasons for self-referral for TMS treatment. We used content analysis to explore these characteristics and thematic analysis to explore the reasons for self-referral. RESULTS: Of the 98 referrals, 57 (58%) were for women. Depressive disorder was the most commonly cited diagnosis, followed by bipolar affective disorder. Six themes emerged from the thematic analysis: treatment resistance, side-effects of other treatments, desperation for relief, proactively seeking information, long-term illness and illness getting worse.Clinical implicationsTMS has recently been recommended in the UK for routine use in clinical practice. Therefore, the number of people who self-refer for TMS treatment is likely to increase as its availability increases.Declaration of interestNone.

Difficulties experienced by young people with Tourette syndrome in secondary school: a mixed methods description of self, parent and staff perspectives.

BACKGROUND: Tourette syndrome (TS) is a neurodevelopmental disorder characterised by motor and vocal tics. These involuntary movements and vocalizations can have a negative impact in the school environment. The paper presents a mixed methods description of the difficulties experienced by UK students with TS in secondary school, drawing on multiple perspectives. METHODS: Thirty-five young people with TS (11 to 18 years), their parents (n = 35) and key members of school staff (n = 54) took part in semi-structured interviews about TS-related difficulties in secondary school. Theme analysis was used to identify school difficulties reported by the young people, before moving on to analysis of the parents' and staff members' transcripts. The most frequently occurring themes from the young people's accounts were then quantified in order to examine the level of agreement between informants and the association with clinical symptom severity. RESULTS: A range of TS-related difficulties with academic work, and social and emotional well-being in school were reported by young people, parents and staff. Three superordinate themes are described: 1) TS makes school work more difficult, 2) Negative response to TS from staff and fellow students and 3) TS makes it more difficult to manage emotions in school. The three difficulties most frequently reported by the young people were problems concentrating in class, unhelpful responses by school staff to tics and difficulties with other students such as name-calling and mimicking tics. Additional difficulties reported by more than a quarter of young people related to homework, examinations, writing, anxiety and managing anger in school. Having more severe motor tics was associated with reporting difficulties with homework and handwriting, whereas having more severe phonic tics was associated with reporting unhelpful responses from staff. Young people and parents agreed more strongly with each other than they did with staff regarding school difficulties faced by individuals, and staff generally reported fewer TS-related difficulties. CONCLUSIONS: TS can present a barrier to learning in several ways and can also affect interactions with others and emotional experiences in secondary school. Implications for supporting secondary school-aged students with TS are considered.

Are anti-stigma films a useful strategy for reducing weight bias among trainee healthcare professionals? Results of a pilot randomized control trial.

BACKGROUND: Weight bias is an important clinical issue that the educators of tomorrow's healthcare professionals cannot afford to ignore. This study, therefore, aimed to pilot a randomized controlled trial of the effects of educational films designed to reduce weight stigmatization toward obese patients on trainee dietitians' and doctors' attitudes. METHODS: A pre-post experimental design with a 6-week follow-up, which consisted of an intervention group (n = 22) and a control group (n = 21), was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias, and to test whether future, larger-scale studies among trainee healthcare professionals are feasible. RESULTS: Participants at baseline demonstrated weight bias, on both implicit and explicit attitude measures, as well as strong beliefs that obesity is under a person's control. The intervention films significantly improved explicit attitudes and beliefs toward obese people, and participant evaluation was very positive. The intervention did not significantly improve implicit anti-fat bias. CONCLUSION: The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films designed to reduce weight stigma on a larger cohort of trainee healthcare professionals, and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population.

Predicting developmental outcomes in very preterm infants: validity of a neonatal neurobehavioral assessment.

AIM: This study explored inter-rater reliability, discriminative, construct and predictive validity of the Neurobehavioral Assessment of the Preterm Infant (NAPI) in a gestational-age-based cohort. METHODS: The NAPI was conducted at 35 weeks post-menstrual age for 170 infants born <32 weeks. Cognitive and motor development was assessed at 2 years using the Mental Development Index (MDI) and Psychomotor Development Index (PDI) of Bayley Scales of Infant Development-II for 159 infants. RESULTS: Only NAPI motor and irritability scores were significantly different between very (29-3 w) and extremely preterm (<28 w) infants. Results regarding construct validity were variable: there were weak correlations between NAPI motor scores and gestational age (r = -0.23; p = 0.003), days in NICU (r = -0.24; p = 0.001); NAPI alertness scores and days in NICU (r = -0.16; p = 0.037); and NAPI irritability scores and gestational age (r = 0.21; p = 0.006). There were no significant associations with other markers of adverse outcome. Only NAPI irritability scores were correlated with MDI scores (r = -0.16; p = 0.040) but accounted for little additional variance after adjustment for neonatal factors (ΔR(2) = 0.035; p = 0.012). CONCLUSION: We found little evidence of the utility of the NAPI as a measure of short-term neurobehavioural function or for predicting neurodevelopmental outcomes in very preterm infants. It may have greater predictive power when used serially to detect delayed neurobehavioural maturation.

Comparing patients' and clinicians' perceptions of elective single embryo transfer using the attitudes to a twin IVF pregnancy scale (ATIPS).

BACKGROUND: This study evaluated a questionnaire originally developed for use with health professionals to explore and compare patients' and clinicians' perceptions of elective single embryo transfer and twin births. METHODS: IVF clinicians and patients attending an independent Fertility clinic were surveyed using the Attitudes to a twin birth scale (ATIPS) comprising two subscales: attitudes to twins (A-Twin) and attitudes to elective single embryo transfer (A-SET). After refinement total sample scores showed both subscales were reliable with Cronbach's alpha >0.8 and item-total correlations >0.35. RESULTS: Questionnaires were completed by 100 female IVF patients and 17 IVF clinicians. A-Twin subscale scores indicated neither the IVF clinicians nor female IVF patients demonstrated very positive attitudes to a twin birth although the IVF female patients were more in favour (t = 5.29, n = 117, p = <0.001). Responses suggest both groups would benefit from increased information about the risks of a twin birth for the baby. First cycle IVF female patients were significantly more positive about eSET (z = 3.94, n = 100, p = <0.001). Clinicians perceive both their colleagues' and female patients' negativity towards eSET; suggesting a role for education. CONCLUSIONS: This study found the ATIPS to be a reliable measure which could be useful in evaluating interventions to promote single embryo transfer.

Pregnant women's attitudes towards alcohol consumption.

BACKGROUND: There is uncertainty as to whether there is a safe threshold for drinking alcohol during pregnancy. We explored pregnant women's attitudes towards drinking alcohol in pregnancy and their attitudes towards sources of information about drinking in pregnancy following recent changes in UK government guidance. METHODS: A qualitative study involving individual, semi-structured interviews with 20 pregnant women recruited from community organisations in the UK. Interview transcripts were analysed qualitatively using thematic analysis. RESULTS: Most women found information and advice about safe levels of drinking in pregnancy confusing and lacking in evidence and detail. Although most women considered that there were risks involved with drinking in pregnancy and these perceptions influenced their behaviour, only six women reported abstinence. Women reported being influenced by advice from family and friends and their experiences of previous pregnancies. Many had received no individual advice from general practitioners or midwives relating to drinking during pregnancy. CONCLUSION: Pregnant women wished to take responsibility for their own health and make choices based on informed advice. In order to do so, they require clear and consistent advice about safe levels of drinking from policy makers and health professionals. This is an important issue as women might drink socially during their pregnancy.