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Biomedical subjects

P J Standen

Publications and source records attributed to P J Standen.

At least 19 recordsLinked to original sources
PubMed2006

Systematic evaluation of current control devices used by people with intellectual disabilities in non-immersive virtual environments.

Virtual environments have a role to play in facilitating the acquisition of living skills in people with intellectual disabilities, improving their cognitive skills and providing them with entertainment. However, the currently recommended devices to allow navigation in and interaction with the environments are difficult to use. Using a methodology established in an earlier study, the study aims to systematically document the performance of users with the currently recommended devices in order to (i) inform the design of a usable control device or devices and (ii) act as a baseline against which they can be evaluated. 40 people with severe intellectual disabilities aged 21-67 years used four environments with an equal number of sessions with the different devices being evaluated. Results indicate that when forward movement is provided by the software using the mouse for both navigation and interaction allows better performance both initially and after exposure than using the fire button on the joystick. When the user had to initiate forward movement with the navigation device, the joystick allowed better performance than the arrows on the keyboard. Preventing slippage of the joystick base would make its use much easier and it is suggested that separate devices are retained for navigation and interaction.

Adult↗
PubMed2005

A social semiotic interpretation of suicidal behaviour in young people.

This article presents a study of nurses' and doctors' perceptions of young people who engage in suicidal behaviour. A contemporary view of grounded theory is used to guide the collection and analysis of qualitative data from nurses and doctors working with young people in an accident and emergency department, paediatric medicine and child and adolescent mental health services (adolescent inpatient unit). The analysis of 45 semi-structured interviews generated the category: Processes of communication and associated meanings: Another voice, Complex messages and Seeing and using the social environment. A social semiotic framework is used to explore the way in which nurses and doctors perceive young people who engage in suicidal behaviour. The article concludes by considering the implications for policy and practice.

Adolescent↗
PubMed2004

Smoking prevalence and knowledge of associated risks in adult attenders at day centres for people with learning disabilities.

BACKGROUND: Increased longevity among people with learning disabilities is accompanied by an increase in morbidity. A possible explanation is that living in the community and a move to greater independence may bring higher health risks through obesity and smoking. The study aimed to see if rates of smoking have increased from earlier published rates and to ascertain the awareness of the risks of smoking among people with learning disabilities. METHODS: A total of 435 people attending four social services day centres in a large urban area were assisted to complete a questionnaire. RESULTS: Twenty-seven (6.2%) reported that they currently smoked. Those with mild disabilities were much more likely to smoke than those with more severe disabilities and they also reported smoking more heavily. For those with mild levels of learning disability, a higher than expected proportion living in hospital and staffed housing smoked, a lower proportion living with parents smoked but for those living independently the proportion who smoked was no higher than expected. Smokers were more knowledgeable about the risks than non-smokers even if the level of learning disability was controlled for. Only a third of smokers were concerned about the risks. CONCLUSIONS: The study provides no evidence that rates of smoking are increasing among people with learning disabilities nor that those living independently were more likely to smoke. Knowledge of health risks is poor across the group, but higher among the smokers who were unlikely to express concern about the risks. This may indicate that more support may be needed along with health education in this group.

Adult↗
PubMed2001

Effect of unexpected outcomes and causal attributions on key workers' expectancies of goal attainment.

Goal planning is an integral part of the role of the key worker in services for people with intellectual disability. The present study investigated the effect of the Weiner stability-expectancy principle on unexpected outcomes in goal planning. Four hundred and twenty-two actual goal attainment scales were constructed, with each scale describing the key workers' expected levels of outcome. Two hundred and twenty-six (54%) unexpected outcomes, both successful and unsuccessful, were then rated by key workers to provide a causal explanation for each outcome. These explanations were then grouped according to whether the attributions represented stable or variable causes. Finally, key workers were asked to provide a new expectancy rating to forecast future goal attainment. Two predictions from Weiner's model were confirmed by statistical analysis: (1) that success attributed to stable factors would lead to higher revised forecasts of goal attainment than success attributed to variable factors; and (2) that failure attributed to stable factors would lead to lower revised forecasts of goal attainment than failure attributed to variable factors. The results of the present study confirm that stability attributions do alter key workers' revised forecasts of goal attainment. The results are discussed in terms of the possible consequences for key worker behaviour, such as goal abandonment, differential treatment of service users and the need for a knowledgeable approach to performance appraisal by managers.

Adult↗
PubMed2001

A randomized controlled trial to assess the psychological impact of a family history screening questionnaire in general practice.

BACKGROUND: It has been postulated that systematic enquiry about patients' family histories of inherited illnesses would lead to a population of 'worried well'. OBJECTIVE: The purpose of the present study was to evaluate if the use of a family history screening questionnaire (FHSQ) as part of a general practice health check leads to psychological distress. METHOD: We conducted a randomized controlled trial of a self-administered FHSQ in a single general practice. Individuals who had not had a health check within the previous 2 years were randomized within three age group strata to intervention group (receiving health check and FHSQ) or control group (only receiving health check). A total of 156 patients were offered health checks; 100 accepted and 76 of them were followed through to the 3-month end point. Responses to the six-item Spielberger State-Trait Anxiety Inventory (STAI), Perception of Health questionnaire and Family History Concern questionnaire were compared between intervention and control groups. RESULTS: A two-way analysis of variance on the STAI scores 1 and 2 weeks after the health check with baseline scores as a covariate showed that at both times anxiety was higher in the intervention group than in the controls (F = 6.4; d.f. = 1,73; P = 0.014). Three months later, there was no significant difference between the two groups. The Perception of Health questionnaire only showed a significant result at 1 week, the intervention group having a more pessimistic response to the question eliciting patient's concerns about future health (P = 0.025). CONCLUSION: Short-term psychological distress due to the family history screening questionnaire was identified but did not persist.

Adult↗
PubMed2000

Carers' attributions for challenging behaviour.

OBJECTIVES: The purpose of this study was to apply Weiner's (1986) attributional model of helping to the care of clients presenting with challenging behaviour. A number of predictions were tested: (a) that aggressive, destructive, and self-injurious behaviours would differentially affect carers' ratings of attributional dimensions; (b) that carers' propensity to help would be mediated by positive affect rather than optimism; (c) that optimism would be reduced by a perceived stable cause, such as client's level of dependency. DESIGN AND METHOD: The participants were 50 care staff working in challenging behaviour day services, who were presented with six case studies to rate. A two-factor repeated measures design was employed to examine the effects of challenging behaviour and dependency on carers' ratings of attributional dimensions, affects, optimism and helping. Correlational analysis was employed to examine the relative effects of positive affect, negative affect and optimism on carers' propensity to help. RESULTS: All three predictions were confirmed. The more independent and outer directed the challenging behaviour, the greater the carers' attributions of control and negative affect, and the less the propensity to help. The more self-directed and dependent the client's challenging behaviour, the greater the carers' attribution of stability, positive affect and propensity to help. CONCLUSIONS: The results are discussed in relation to the concept of helping and the experience of carers coping with challenging behaviours.

Adaptation, Psychological↗
PubMed1999

The effect of student nurses' experiences over the Common Foundation Programme on their inferences of suffering.

Poor pain assessment contributes to inadequate postoperative pain relief. Studies in the U.S.A. suggest that nurse education might make students less sensitive to patients' experience of pain. This research examined this process and the factors that influence it in the U.K. Two-hundred and seventeen students completed the Standard Measure of Inferences of Suffering Questionnaire (SMIS) before and after their Common Foundation Programme (CFP). Their inferences of psychological distress increased as studies in the U.S.A. had found but, unlike these studies, no change was found in their inferences of pain. These findings have important implications for both nurse education and the mechanisms to support student nurses in clinical practice.

Adolescent↗
PubMed1998

Effects of seasonal change in rugby league on the incidence of injury.

OBJECTIVES: To assess the effects that the recent seasonal change in rugby league from winter to summer has had on the incidence of injury. METHODS: All injuries that occurred during games and training were recorded throughout four consecutive seasons (three winter, one summer) for the first team squad of a British professional rugby league club. Data included nature of injury, days lost as the result of injury, player position, month, and season. RESULTS: An increasing incidence of injury over the four seasons was observed, with the summer seasons having an incidence almost double that of the first winter season recorded (696.8 per 1000 hours and 363.55 per 1000 hours respectively). The severity of injury was shown to decline over the four seasons. Most injuries were incurred in matches (74.9%) rather than during training (25.1%). CONCLUSIONS: The findings show an increasing incidence of injury in summer rugby but with decreased severity. It is not known if this is the result of playing back to back rugby seasons or is a consequence of a change in playing season and ground conditions.

Adult↗
PubMed1998

Virtual environments special needs and evaluative methods.

This paper presents an overview of the development of the Learning in Virtual Environments programme (LIVE), carried out in special education over the last four years. It is more precisely a project chronology, so that the reader can sense the historical development of the programme rather than giving emphasis to any one particular feature or breakthrough, which are covered in other papers and available through the authors. The project conception in a special school in Nottingham is followed by a description of the development of experiential and communicational virtual learning environments. These are followed, in turn, by the results of our testing programmes which show that experience gained in a virtual environment can transfer to the real world and that their use can encourage self-directed activity in students with severe learning difficulties. Also included is a discussion of the role of virtual learning environments (VLEs) in special education and of its attributes in the context of contemporary educational theory.

Activities of Daily Living↗
PubMed1996

The potentials of virtual environments in the education and training of people with learning disabilities.

The expansion of 'care in the community' has highlighted the need for more effective educational and training media for people with learning disabilities, and this paper suggests that virtual environments (VEs) may help to meet this need. Firstly, key terms (virtual environment, cyberspace and artificial reality) are defined. Secondly, aspects of developmental and cognitive psychological theories and principles of computer-assisted learning are presented that suggest that VEs might be an especially valuable educational media for people with learning disabilities. Thirdly, the existing literature in this field is reviewed. Fourthly, ethical issues associated with the use of VE, both generally and specifically by people with learning disabilities are discussed. Fifth, possible future developments of VEs, both in education and through their convergence with technologies of miniaturization, are suggested. It is concluded that VEs are an effective, affordable, accessible and safe training and educational media for people with learning disabilities, although further research will be required to realise their full potentials.

Computer Systems↗
PubMed1996

Striking the balance: a grounded theory analysis of staff perspectives.

Staff from four units for adults with profound learning disabilities described their relationship with a particular client during individual discussions. Issues arising from discussion were elaborated in subsequent individual and group meetings, evolving into an account of interactional aspects of professional care based on a core typology of relationships (Provider, Meaning-maker, Mutual and Companion). The process of this grounded theory analysis is exemplified. The analysis concludes with four propositions about staff-client relationships, and discussion of their implications for clinical services.

Adult↗
PubMed1996

Personality, smoking and inflammatory bowel disease.

OBJECTIVE: To assess whether psychological factors distinguished patients with Crohn's disease (CD) from those with ulcerative colitis (UC). DESIGN: Survey of prevalent inflammatory bowel disease patients (n = 82) attending a gastroenterology clinic. METHODS: Administration of three self-report rating scales, the Eysenck Personality Questionnaire, the General Health Questionnaire and the Hospital Anxiety and Depression scale. RESULTS: CD patients were significantly more extroverted (P = 0.04) than UC patients, tended to have higher psychoticism scores (P = 0.06) but similar neuroticism scores. Extroversion and psychoticism scores were weakly associated with smoking status. In logistic regression models that adjusted for age, sex and smoking the associations with extroversion and psychoticism scores persisted but were no longer significant at the 5% level. In the final model the psychoticism score was more important than the extroversion score. CONCLUSION: These results suggest that there are substantial personality differences between patients with CD and UC. Although some of the differences in this study were associated with smoking, adjusting for smoking reduced, but did not abolish, the associations with personality scores.

Colitis, Ulcerative↗
PubMed1992

Factors affecting compliance with depot injection treatment in the community.

This study investigated aspects of the community psychiatric care of psychotic patients living in inner city areas, and especially those of Afro-Caribbean ethnicity. Ethnicity was not found to be a major factor affecting compliance with depot injections. More important were variables such as time since first treatment and sex. Defaulters from treatment were more likely to be subsequently admitted to hospital.

Adult↗
PubMed1992

Therapeutic suggestions during general anaesthesia in patients undergoing hysterectomy.

In a double-blind, randomized study, we have examined the influence of positive therapeutic suggestions, presented to anaesthetized patients undergoing total abdominal hysterectomy, on postoperative morbidity and duration of hospital stay. Seventy-five patients were allocated randomly to be exposed to one of three tapes containing positive therapeutic suggestions, a modified history of the Queen's Medical Centre, or no message. We found that neither therapeutic suggestions nor the presence of a voice during anaesthesia improved postoperative outcome or reduced duration of hospital stay after total abdominal hysterectomy.

Adult↗
PubMed1991

Management of first episode psychotic illness in Afro-Caribbean patients.

We studied retrospectively a consecutive series of 40 Afro-Caribbean patients and compared them with 40 non-Caribbean patients matched for age, sex, and diagnosis. There was no overall difference in initial or cumulative doses of neuroleptic medication in the early treatment of psychosis. However, a small subgroup of Afro-Caribbean patients received higher peak dosages. Clearly recorded episodes of behavioural disturbances were more frequent in Afro-Caribbean patients generally. They were more likely to be admitted compulsorily, discharged earlier, and prescribed depot medication.

Acculturation↗
PubMed1991

Friendship among adults who have developmental disabilities.

The difference between people with developmental disabilities who did and did not have peer-group friends was investigated by interviewing 36 adults attending day centers. Those with a friend were significantly more likely to describe themselves positively on all dimensions. Results showed that people without a peer-group friend were similar to lonely people without disabilities on two of the three factors explored. Qualitative analysis of subjects' descriptions of their friends suggested that most of the people interviewed had relatively shallow relationships.

Adult↗
PubMed1989

Seasonal variation of haemoglobin A1 in children with insulin-dependent diabetes mellitus.

The results of three controlled trials performed on children with insulin-dependent diabetes mellitus were examined for evidence of seasonal variation in concentrations of glycosylated haemoglobin (HbA1). All three studies showed lower levels during the summer months. Multiple regression analysis showed that the month of sampling accounted for a significant proportion of the total variance in HbA1 levels (P less than 0.001 in all three studies). We suggest that exercise, dietary changes and the frequency of minor illnesses may all contribute to this fluctuation which has important implications for the design of clinical trials in childhood diabetes.

Adolescent↗