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Bowes A, Davison L, Dawson A, Pemble C. Outcomes of home design to support healthy cognitive ageing: modified e-Delphi exercise with older people and housing-related professionals. BMC Geriatr 2024; 24:546. [PMID: 38914971 PMCID: PMC11194886 DOI: 10.1186/s12877-024-05085-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/16/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND There is emerging agreement that living in a home designed to support healthy cognitive ageing can enable people to live better with dementia and cognitive change. However, existing literature has used a variety of outcome measures that have infrequently been informed by the perspectives of older people or of professional in design and supply of housing. The DesHCA (Designing Homes for Healthy Cognitive Ageing) study aimed to identify outcomes that were meaningful for these groups and to understand their content and meanings. METHODS A presurvey of older people and housing professionals (n = 62) identified potential outcomes. These were then used in three rounds of a modified e-Delphi exercise with a panel of older people and housing professionals (n = 74) to test meanings and identify areas of agreement and disagreement. Descriptive statistics were used to present findings from previous rounds. RESULTS The survey confirmed a wide range of possible outcomes considered important. Through the e-Delphi rounds, panellists prioritised outcomes relating to living at home that could be influenced by design, and clarified their understanding of the meanings of outcomes. In subsequent rounds, they commented on earlier results. The exercise enabled five key outcome areas to be identified - staying independent, feeling safe, living in an adaptable home, enabling physical activity and enabling enjoyed activities- which were then tested for their content and applicability in panellists' views. CONCLUSION The five key outcome areas appeared meaningful to panellists, whilst also demonstrating nuanced meanings. They indicate useful outcomes for future research, though will require careful definition in each case to become measures. Importantly, they are informed by the views of those most immediately affected by better or poorer home design.
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Affiliation(s)
- Alison Bowes
- Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Lisa Davison
- Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Alison Dawson
- Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
| | - Catherine Pemble
- Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, UK
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Melnychuk E, Sallade TD, Kraus CK. Hospitals as disaster victims: Lessons not learned? J Am Coll Emerg Physicians Open 2022; 3:e12632. [PMID: 35036993 PMCID: PMC8749465 DOI: 10.1002/emp2.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/07/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Hospitals are a key component to disaster response but are susceptible to the effects of disasters as well, including infrastructure damage that disrupts patient care. These events offer an opportunity for evaluation and improvement of preparedness and response efforts when hospitals are affected directly by a disaster. The objective of this structured review was to evaluate the existing literature on hospitals as disaster victims. METHODS A structured and scoping review of peer-reviewed literature, gray literature, and news reports related to hospitals as disaster victims was completed to identify and analyze themes and lessons observed from disasters in which hospitals are victims, to aid in future emergency operations planning and disaster response. RESULTS The literature search and secondary search of referenes identified 366 records in English. A variety of common barriers to successful disaster response include loss of power, water, heating and ventilation, communications, health information technology, staffing, supplies, safety and security, and structural and non-structural damage. CONCLUSIONS There are common weaknesses in disaster preparedness that we can learn from and account for in future planning with the aim of improving resilience in the face of future disasters.
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Affiliation(s)
- Eric Melnychuk
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
- Department of Critical Care MedicineGeisinger Medical CenterDanvillePAUSA
| | - Thomas D. Sallade
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
| | - Chadd K. Kraus
- Department of Emergency MedicineGeisinger Medical CenterDanvillePAUSA
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Khawaja SN, Qadri HA, Yusuf MA. Cancer Hospital Stockpiles: Strategizing for an Efficient and Sufficient Inventory List of Essential Items. JCO Glob Oncol 2021; 7:1490-1499. [PMID: 34665666 PMCID: PMC8791816 DOI: 10.1200/go.21.00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/04/2021] [Accepted: 09/16/2021] [Indexed: 12/04/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has affected health care systems worldwide, resulting in critical shortages of essential items and materials. The available guidelines are of little use for cancer hospitals in low-income and low-middle-income countries. They have been designed for community hospitals serving in a centralized health care network. This study aimed to draft and field test a framework to establish a list of essential supplies that should be stockpiled for subsequent waves of the COVID-19 virus by a tertiary care cancer hospital in a low-middle-income country. MATERIALS AND METHODS A model was formulated using the consumption trends during the peak month of the first wave of COVID-19 infection to compile a list of essential materials and supplies. Furthermore, costing analyses were conducted to determine the financial benefits of stockpiling. RESULTS A proposed list of items to stockpile, including personal protective equipment, radiology supplies, laboratory reagents, medication, and oxygen, was shared with the hospital administration. However, the hospital administration only accepted the proposals for stockpiling personal protective equipment and oxygen. CONCLUSION This paper provides a framework and strategies that cancer hospitals and health care systems can modify and use as per individual, institutional requirements and specifications for stockpiling essential items during the COVID-19 or other similar pandemics.
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Affiliation(s)
- Shehryar Nasir Khawaja
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore and Peshawar, Pakistan
| | - Hussain Ahmed Qadri
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore and Peshawar, Pakistan
| | - Muhammed Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore and Peshawar, Pakistan
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Cunningham M, France EF, Ring N, Uny I, Duncan EAS, Roberts RJ, Jepson RG, Maxwell M, Turley RL, Noyes J. Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BackgroundMeta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.ObjectiveTo develop guidance to improve the completeness and clarity of meta-ethnography reporting.Methods/designThe meta-ethnography reporting guidance (eMERGe) study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed-methods approach. It comprised (1) a methodological systematic review of guidance in the conduct and reporting of meta-ethnography; (2) a review and audit of published meta-ethnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) a consensus workshop and two eDelphi (Version 1, Duncan E, Swinger K, University of Stirling, Stirling, UK) studies to agree guidance content; and (4) the development of the guidance table and explanatory notes.ResultsResults from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct and, in particular, the synthesis phases 4–6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe reporting guidance was produced, comprising 19 items grouped into the seven phases of meta-ethnography.LimitationsThe finalised guidance has not yet been evaluated in practice; therefore, it is not possible at this stage to comment on its utility. However, we look forward to evaluating its uptake and usability in the future.ConclusionsThe eMERGe reporting guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, and to facilitate use of the findings within the guidance to inform the design and delivery of services and interventions in health, social care and other fields. The eMERGe project developed a range of training materials to support use of the guidance, which is freely available atwww.emergeproject.org(accessed 26 March 2018). Meta-ethnography is an evolving qualitative evidence synthesis methodology and future research should refine the guidance to accommodate future methodological developments. We will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance.Study registrationThis study is registered as PROSPERO CRD42015024709 for the stage 1 systematic review.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Maggie Cunningham
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Emma F France
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Nicola Ring
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Isabelle Uny
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Edward AS Duncan
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Rachel J Roberts
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Ruth G Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - Margaret Maxwell
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Ruth L Turley
- Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, UK
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van Rooijen SJ, Jongen ACHM, Wu ZQ, Ji JF, Slooter GD, Roumen RMH, Bouvy ND. Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons. World J Gastroenterol 2017; 23:6172-6180. [PMID: 28970733 PMCID: PMC5597509 DOI: 10.3748/wjg.v23.i33.6172] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/28/2017] [Accepted: 07/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons.
METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication.
RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan’. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation’, and ‘a radiological collection treated with percutaneous drainage’. No consensus was found for all other proposed elements that may be included in a general definition.
CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical’ leaks as CAL, which partly explains the higher reported Dutch CAL rates.
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Affiliation(s)
- Stefanus J van Rooijen
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Audrey CHM Jongen
- Department of Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
| | - Zhou-Qiao Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Ward I of Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Jia-Fu Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Ward I of Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Gerrit D Slooter
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
| | - Rudi MH Roumen
- Department of Surgery, Máxima Medical Center, 5500 MB Veldhoven, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, 6200 MD Maastricht, The Netherlands
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Coster JE, Irving AD, Turner JK, Phung VH, Siriwardena AN. Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study. Health Expect 2017; 21:249-260. [PMID: 28841252 PMCID: PMC5750751 DOI: 10.1111/hex.12610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2017] [Indexed: 11/30/2022] Open
Abstract
Background Current ambulance quality and performance measures, such as response times, do not reflect the wider scope of care that services now provide. Using a three‐stage consensus process, we aimed to identify new ways of measuring ambulance service quality and performance that represent service provider and public perspectives. Design A multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop. Setting and participants Representatives from ambulance services, patient and public involvement (PPI) groups, emergency care clinical academics, commissioners and policymakers. Results Nine measures/principles were highly prioritized by >75% of consensus event participants, including measures relating to pain, patient experience, accuracy of dispatch decisions and patient safety. Twenty experts participated in two Delphi rounds to further refine and prioritize measures; 20 measures in three domains scored ≥8/9, indicating good consensus, including proportion of calls correctly prioritized, time to definitive care and measures related to pain. Eighteen patient/public representatives attended a consensus workshop, and six measures were identified as important. These include time to definitive care, response time, reduction in pain scores, calls correctly prioritized to appropriate levels of response and survival to hospital discharge for treatable emergency conditions. Conclusions Using consensus methods, we identified a shortlist of ambulance outcome and performance measures that are important to ambulance clinicians and service providers, service users, commissioners, and clinical academics, reflecting current pre‐hospital ambulance care and services. The measures can potentially be used to assess pre‐hospital quality or performance over time, with most calculated using routinely available data.
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Affiliation(s)
| | | | | | - Viet-Hai Phung
- Community and Health Research Unit, University Lincoln, Lincoln, UK
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How to Choose? Using the Delphi Method to Develop Consensus Triggers and Indicators for Disaster Response. Disaster Med Public Health Prep 2017; 11:467-472. [PMID: 28153060 DOI: 10.1017/dmp.2016.174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify key decisions along the continuum of care (conventional, contingency, and crisis) and the critical triggers and data elements used to inform those decisions concerning public health and health care response during an emergency. METHODS A classic Delphi method, a consensus-building survey technique, was used with clinicians around Washington State to identify regional triggers and indicators. Additionally, using a modified Delphi method, we combined a workshop and single-round survey with panelists from public health (state and local) and health care coalitions to identify consensus state-level triggers and indicators. RESULTS In the clinical survey, 122 of 223 proposed triggers or indicators (43.7%) reached consensus and were deemed important in regional decision-making during a disaster. In the state-level survey, 110 of 140 proposed triggers or indicators (78.6%) reached consensus and were deemed important in state-level decision-making during a disaster. CONCLUSIONS The identification of consensus triggers and indicators for health care emergency response is crucial in supporting a comprehensive health care situational awareness process. This can inform the creation of standardized questions to ask health care, public health, and other partners to support decision-making during a response. (Disaster Med Public Health Preparedness. 2017;11:467-472).
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Qiu Y, Shen J, Lu H. The Development of Criteria for the Selection of Chinese Peer Educators in HIV Management: A Delphi Study. SCIENTIFICA 2016; 2016:9521313. [PMID: 28003930 PMCID: PMC5143706 DOI: 10.1155/2016/9521313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/06/2016] [Indexed: 06/06/2023]
Abstract
To develop an expert consensus opinion of the criteria for selection of peer educator for HIV/AIDS care program, twenty experts were invited to complete a two-round Delphi consultation. Response rates of the panelists for the first and second rounds were both 100%, and the authority coefficient of the experts was 0.75. Experts achieved consensus on a total of nine items (75%) on completion of the study. The Precedence Chart Method was used to calculate the weight of each indicator, and then a priority list was generated accordingly. This study provides the initial selection criteria for HIV/AIDS peer educators in Shanghai as well as in China.
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Affiliation(s)
- Yan Qiu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
- School of Nursing, Fudan University, Shanghai 200000, China
| | - Jiayin Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
- School of Nursing, Fudan University, Shanghai 200000, China
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France EF, Ring N, Noyes J, Maxwell M, Jepson R, Duncan E, Turley R, Jones D, Uny I. Protocol-developing meta-ethnography reporting guidelines (eMERGe). BMC Med Res Methodol 2015; 15:103. [PMID: 26606922 PMCID: PMC4660777 DOI: 10.1186/s12874-015-0068-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 09/10/2015] [Indexed: 11/25/2022] Open
Abstract
Background Designing and implementing high-quality health care services and interventions requires robustly synthesised evidence. Syntheses of qualitative research studies can provide evidence of patients’ experiences of health conditions; intervention feasibility, appropriateness and acceptability to patients; and advance understanding of health care issues. The unique, interpretive, theory-based meta-ethnography synthesis approach is suited to conveying patients’ views and developing theory to inform service design and delivery. However, meta-ethnography reporting is often poor quality, which discourages trust in, and use of, meta-ethnography findings. Users of evidence syntheses require reports that clearly articulate analytical processes and findings. Tailored research reporting guidelines can raise reporting standards but none exists for meta-ethnography. This study aims to create an evidence-based meta-ethnography reporting guideline articulating the methodological standards and depth of reporting required to improve reporting quality. Methods/design The mixed-methods design of this National Institute of Health Research-funded study (http://www.stir.ac.uk/emerge/) follows good practice in research reporting guideline development comprising: (1) a methodological systematic review (PROSPERO registration: CRD42015024709) to identify recommendations and guidance in conducting/reporting meta-ethnography; (2) a review and audit of published meta-ethnographies to identify good practice principles and develop standards in conduct/reporting; (3) an online workshop and Delphi studies to agree guideline content with 45 international qualitative synthesis experts and 45 other stakeholders including patients; (4) development and wide dissemination of the guideline and its accompanying detailed explanatory document, a report template for National Institute of Health Research commissioned meta-ethnographies, and training materials on guideline use. Discussion Meta-ethnography, devised in the field of education, is now used widely in other disciplines. Methodological advances relevant to meta-ethnography conduct exist. The extent of discipline-specific adaptations of meta-ethnography and the fit of any adaptions with the underpinning philosophy of meta-ethnography require investigation. Well-reported meta-ethnography findings could inform clinical decision-making. A bespoke meta-ethnography reporting guideline is needed to improve reporting quality, but to be effective potential users must know it exists, trust it and use it. Therefore, a rigorous study has been designed to develop and promote a guideline. By raising reporting quality, the guideline will maximise the likelihood that high-quality meta-ethnographies will contribute robust evidence to improve health care and patient outcomes.
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Affiliation(s)
- E F France
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
| | - N Ring
- School of Health Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - J Noyes
- School of Social Sciences, Bangor University, Bangor, Gwynedd, LL57 2DG, UK.
| | - M Maxwell
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling and Glasgow Caledonian University, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
| | - R Jepson
- Scottish Collaboration for Public Health Research and Policy (SCPHRP), University of Edinburgh, 20 West Richmond Street, Edinburgh, EH8 9DX, Scotland, UK.
| | - E Duncan
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
| | - R Turley
- Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, UK.
| | - D Jones
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
| | - I Uny
- Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, Scotland, UK.
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