scholarly journals CATALISE: a multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children

2016 ◽  
Author(s):  
Dorothy V Bishop ◽  
Margaret J Snowling ◽  
Paul A Thompson ◽  
Trisha Greenhalgh ◽  
Keyword(s):  
Evidence Base ◽  
Language Impairments ◽  
Free Text ◽  
Language Therapy ◽  
Delphi Consensus ◽  
Relevant Evidence ◽  
Specialist Services ◽  
Starting Point ◽  
Strongly Agree ◽  
Education Psychology

Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 per cent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

scholarly journals CATALISE: a multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children

2016 ◽  
Author(s):  
Dorothy V Bishop ◽  
Margaret J Snowling ◽  
Paul A Thompson ◽  
Trisha Greenhalgh ◽  
Keyword(s):  
Evidence Base ◽  
Language Impairments ◽  
Free Text ◽  
Language Therapy ◽  
Delphi Consensus ◽  
Relevant Evidence ◽  
Specialist Services ◽  
Starting Point ◽  
Strongly Agree ◽  
Education Psychology

Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting 'agree' or 'strongly agree') was at least 80 per cent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

scholarly journals Improving primary palliative care – a Delphi consensus study on measures for general practice in Germany

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Esma Sümeyya Bilgin ◽  
Rojda Ülgüt ◽  
Nils Schneider ◽  
Stephanie Stiel
Keyword(s):  
Palliative Care ◽  
General Practice ◽  
Delphi Study ◽  
Health Care Research ◽  
Free Text ◽  
Delphi Consensus ◽  
Intervention Package ◽  
Online Questionnaire ◽  
Junior Research ◽  
Strongly Agree

Abstract Background The majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging for GP teams to integrate PPC into their daily routines. Aim A Delphi study with GPs was conducted to achieve consensus on specific measures for improving the integration of PPC into everyday GP practice. Methods The study is part of the junior research project “Primary Palliative Care in General Practice” (ALLPRAX). After having developed, tested and evaluated 26 practical measures for GP practices to improve their PPC, a Delphi consensus study among GPs took place. In 2020, 569 GPs were asked to rate the relevance and feasibility of the measures on a 4-point Likert scale via an anonymous online questionnaire. Consensus was defined as a sum percentage of ‘strongly agree’ and ‘somewhat agree’ responses ≥75% after two rounds. Between these rounds, measures that were not consented in the first round were adapted in light of respondents’ free text comments and suggestions. Results The response rate was 11.3% in round 1 (n = 64) and 53.1% in round 2 (n = 34). From the initial n = 26 measures, n = 20 measures achieved consensus and were included in the final intervention package. The consented measures pertained to four main topics: advance care planning with patients, consulting and informing patients and family caregivers, GP office organisation and continuing education. N = 6 measures did not achieve consensus, predominantly due to time and workload constraints. Conclusion The consented measures provide valuable support to improve the provision of PPC by GPs. They can be used freely and flexibly, according to the needs of individual GP teams, and are thus suitable for implementation nationwide. Trial registration The study was registered in the German Clinical Trials Register (Registration N° DRKS00011821; 4 December 2017; https://apps.who.int/trialsearch/) and the German Register of Health Care Research (Registration N° VfD_ALLPRAX_16_003817; 30 March 2017).

scholarly journals Speech and language therapy for primary progressive aphasia: Referral patterns and barriers to service provision across the UK

Dementia ◽  
2018 ◽  
Vol 19 (5) ◽  
pp. 1349-1363 ◽  
Author(s):  
Anna Volkmer ◽  
Aimee Spector ◽  
Jason D Warren ◽  
Suzanne Beeke
Keyword(s):  
Primary Progressive Aphasia ◽  
Evidence Base ◽  
Research Literature ◽  
Speech And Language ◽  
Language Therapy ◽  
Eligibility Criteria ◽  
Speech And Language Therapy ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Relevant Evidence

Objective To assess the extent of UK speech and language therapy engagement in assessment and management of primary progressive aphasia, determine the factors contributing to any shortfall and explore a gap in the research literature on current speech and language therapy practices with people with primary progressive aphasia. Methods A 37-item, pilot-tested survey was distributed electronically via clinical networks and through the Royal College of Speech and Language Therapists. Survey items included questions on intervention approaches, referral numbers and demographics, referral sources and access to services. Results One hundred and five speech and language therapists completed the survey. Over the previous 24 months, respondents reported seeing a total of 353 people with primary progressive aphasia (an average of 3.27 per speech and language therapist). Neurologists were the most commonly reported referrers to speech and language therapy (22.5%). Seventy-eight percent of respondents reported that people with primary progressive aphasia experienced barriers to accessing speech and language therapy. Key barriers were a lack of referrer awareness of a speech and language therapist’s role, and restrictive eligibility criteria for services. Conclusions This study highlighted inequities in access to speech and language therapy for people with primary progressive aphasia. The medical and speech and language therapy professions need to develop appropriate care pathways for people with primary progressive aphasia. Speech and language therapists have a duty to develop a relevant evidence base for speech and language interventions for people with primary progressive aphasia.

Experience and expression of social isolation by inner-city high-rise residents

2014 ◽  
Vol 17 (3) ◽  
pp. 151-166 ◽  
Author(s):  
Love M. Chile ◽  
Xavier M. Black ◽  
Carol Neill
Keyword(s):  
Older Adults ◽  
Inner City ◽  
Social Isolation ◽  
Age Groups ◽  
Evidence Base ◽  
Structured Interviews ◽  
Content Type ◽  
High Rise ◽  
Starting Point ◽  
Health And Social Care

Purpose – The purpose of this paper is to examine the significance of social isolation and the factors that create social isolation for residents of inner-city high-rise apartment communities. We critically examine how the physical environment and perceptions of safety in apartment buildings and the inner-city implicate the quality of interactions between residents and with their neighbourhood community. Design/methodology/approach – The authors used mixed-methods consisting of survey questionnaires supplemented by semi-structured interviews and focus group discussions using stratified random sampling to access predetermined key strata of inner-city high-rise resident population. Using coefficient of correlation we examine the significance of the association between social isolation, age and ethnicity amongst Auckland's inner-city high-rise residents. Findings – The authors found the experience and expression of social isolation consistent across all age groups, with highest correlation between functional social isolation and “being student”, and older adults (60+ years), length of tenure in current apartment and length of time residents have lived in the inner-city. Research limitations/implications – As a case study, we did not seek in this research to compare the experience and expressions of social isolation in different inner-city contexts, nor of inner-city high-rise residents in New Zealand and other countries, although these will be useful areas to explore in future studies. Practical implications – This study is a useful starting point to build evidence base for professionals working in health and social care services to develop interventions that will help reduce functional social isolation amongst young adults and older adults in inner-city high-rise apartments. This is particularly important as the inner-city population of older adults grow due to international migration, and sub-national shifts from suburbs to the inner-cities in response to governmental policies of urban consolidation. Originality/value – By identifying two forms of social isolation, namely functional and structural social isolation, we have extended previous analysis of social isolation and found that “living alone” or structural social isolation did not necessarily lead to functional social isolation. It also touched on the links between functional social isolation and self-efficacy of older adults, particularly those from immigrant backgrounds.

scholarly journals Termination of wanted pregnancy and suicidal ideation in hyperemesis gravidarum: A mixed methods study

2021 ◽  
pp. 1753495X2110409
Author(s):  
Melanie Nana ◽  
Florence Tydeman ◽  
Georgie Bevan ◽  
Harriet Boulding ◽  
Kimberley Kavanagh ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Hyperemesis Gravidarum ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Termination Of Pregnancy ◽  
Free Text ◽  
Optimal Care ◽  
Specialist Services ◽  
Timely Access ◽  
Improve Patient

Background Difficulty accessing medication and poor patient experience have been implicated as risk factors for termination of pregnancy and suicidal ideation in women with hyperemesis gravidarum. We aimed to gain further insight into these factors in order to further inform and improve patient care. Methods We performed a sub-analysis on quantitative data generated through a UK-wide survey of 5071 participants. A qualitative analysis of free text comments was performed using an inductive thematic approach. Results 41.2% % of women taking prescribed medications had to actively request them. ‘Extremely poor’ or ‘poor’ experiences were described in 39.4% and 30.0% of participants in primary and secondary care respectively. Protective factors for termination of pregnancy and suicidal ideation include holistic support from family, friends and healthcare providers. Conclusion Optimal care in hyperemesis gravidarum should incorporate timely access to pharmacotherapy, assessment of mental health, consideration of referral to specialist services and care being delivered in a compassionate manner.

scholarly journals Children with learning disabilities and related needs placed out of borough: parents' perspective

2006 ◽  
Vol 30 (3) ◽  
pp. 100-102 ◽  
Author(s):  
Amma Shuwa ◽  
Brian Fitzgerald ◽  
Carmen Clemente ◽  
Denny Grant
Keyword(s):  
Learning Disabilities ◽  
Social Services ◽  
Family Stress ◽  
Family Burden ◽  
Clinical Implications ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Parental Experience ◽  
Lack Of Information ◽  
Specialist Services

Aims and MethodTo investigate parental experience of children with learning disability being placed out of borough. The parents of 70 children were interviewed.ResultsParents would prefer in-borough provision but 90% were satisfied with the current school. The main problems experienced in-borough were poor advice, delays, lack of information and family stress. After out-of-borough placement there was a reported increase in the use of speech and language therapy, occupational therapy and sensory facilities and a decrease in the use of paediatric services, social services, and mental health services.Clinical ImplicationsSpecialist services should be helpful and reduce family burden by keeping children in-borough.

Acquired disorders of language and their treatment

2020 ◽  
pp. 279-290
Author(s):  
Alex Leff ◽  
Jenny Crinion
Keyword(s):  
Drug Therapy ◽  
Brain Stimulation ◽  
Main Part ◽  
Evidence Base ◽  
Language Therapy ◽  
Stroke Patients ◽  
Speech And Language Therapy ◽  
Non Invasive ◽  
Aphasia Therapy

This chapter covers the classification of acquired aphasic syndromes. It illustrates some of the speech errors aphasic stroke patients make with videos of a patient describing a picture and attempting to repeat words. The main part of the chapter assesses the evidence base for speech and language therapy (SALT) and answers the following questions: Does SALT work? What is the correct dose and intensity? And is it ever too late for SALT intervention? We then discuss two main adjuvants to SALT: one old—drug therapy; one new—non-invasive brain stimulation. Finally, we examine the role for e-rehabilitation and augmentative aids before asking what the future might hold for aphasia therapy, and wondering if it might already be here.

scholarly journals LO13: Development of a national, standardized simulation case template

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S11-S11 ◽  
Author(s):  
J. Baylis ◽  
C. Heyd ◽  
B. Thoma ◽  
A. Hall ◽  
T. Chaplin ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Nominal Group Technique ◽  
Assessment Tools ◽  
Nominal Group ◽  
Free Text ◽  
Major Barrier ◽  
Canadian Medical School ◽  
Starting Point ◽  
Simulation Based ◽  
Em Simulation

Innovation Concept: A major barrier to the development of a national simulation case repository and multi-site simulation research is the lack of a standardized national case template. This issue was recently identified as a priority research topic for Canadian simulation based education (SBE) research in emergency medicine (EM). We partnered with the EM Simulation Education Researchers Collaborative (EM-SERC) to develop a national simulation template. Methods: The EM Sim Cases template was chosen as a starting point for the consensus process. We generated feedback on the template using a three-phase modified nominal group technique. Members of the EM-SERC mailing list were consulted, which included 20 EM simulation educators from every Canadian medical school except Northern Ontario School of Medicine and Memorial University. When comments conflicted, the sentiment with more comments in favour was incorporated. Curriculum, Tool or Material: In phase one we sought free-text feedback on the EM Sim Cases template via email. We received 65 comments from 11 respondents. An inductive thematic analysis identified four major themes (formatting, objectives, debriefing, and assessment tools). In phase two we sought free-text feedback on the revised template via email. A second thematic analysis on 40 comments from 12 respondents identified three broad themes (formatting, objectives, and debriefing). In phase three we sought feedback on the penultimate template via focus groups with simulation educators and technologists at multiple Canadian universities. This phase generated 98 specific comments which were grouped according to the section of the template being discussed and used to develop the final template (posted on emsimcases.com). Conclusion: We describe a national consensus-building process which resulted in a simulation case template endorsed by simulation educators from across Canada. This template has the potential to: 1. Reduce the replication of effort across sites by facilitating the sharing of simulation cases. 2. Enable national collaboration on the development of both simulation cases and curricula. 3. Facilitate multi centre simulation-based research by removing confounders related to the local adoption of an unfamiliar case template. This could improve the rigour and validity of these studies by reducing inter-site variability. 4. Increase the validity of any simulation scenarios developed for use in national high-stakes assessment.

scholarly journals Extending the RIGHT statement for reporting adapted practice guidelines in healthcare: the RIGHT-Ad@pt Checklist protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031767 ◽  
Author(s):  
Yang Song ◽  
Andrea Darzi ◽  
Monica Ballesteros ◽  
Laura Martínez García ◽  
Pablo Alonso-Coello ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Ethics Committee ◽  
Initial Assessment ◽  
Adaptation Process ◽  
Delphi Consensus ◽  
Relevant Evidence ◽  
Semistructured Interviews ◽  
Multistep Process ◽  
Group 2 ◽  
The Right

IntroductionThe adaptation of guidelines is an increasingly used methodology for the efficient development of contextualised recommendations. Nevertheless, there is no specific reporting guidance. The essential Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement could be useful for reporting adapted guidelines, but it does not address all the important aspects of the adaptation process. The objective of our project is to develop an extension of the RIGHT statement for the reporting of adapted guidelines (RIGHT-Ad@pt Checklist).Methods and analysisTo develop the RIGHT-Ad@pt Checklist, we will use a multistep process that includes: (1) establishment of a Working Group; (2) generation of an initial checklist based on the RIGHT statement; (3) optimisation of the checklist (an initial assessment of adapted guidelines, semistructured interviews, a Delphi consensus survey, an external review by guideline developers and users and a final assessment of adapted guidelines); and (4) approval of the final checklist. At each step of the process, we will calculate absolute frequencies and proportions, use content analysis to summarise and draw conclusions, discuss the results, draft a report and refine the checklist.Ethics and disseminationWe have obtained a waiver of approval from the Clinical Research Ethics Committee at the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain). We will disseminate the RIGHT-Ad@pt Checklist by publishing into a peer-reviewed journal, presenting to relevant stakeholders and translating into different languages. We will continuously seek feedback from stakeholders, surveil new relevant evidence and, if necessary, update the checklist.

scholarly journals Capturing the value of peer support: measuring recovery-oriented services

2019 ◽  
Vol 18 (3) ◽  
pp. 180-187
Author(s):  
Stacey L. Barrenger ◽  
Victoria Stanhope ◽  
Emma Miller
Keyword(s):  
Clinical Outcomes ◽  
Peer Support ◽  
Support Services ◽  
Outcome Measurement ◽  
Evidence Base ◽  
Content Type ◽  
Evaluation Approach ◽  
The People ◽  
Starting Point ◽  
Peer Support Services

Purpose The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap. Design/methodology/approach This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services. Findings Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services. Originality/value This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.

Sign in / Sign up

Export Citation Format

Share Document