Andrew F Long

University of Leeds · School of Healthcare

Background Pain and dementia are common in older people, and impaired cognitive abilities make it difficult for them to communicate their pain. Pain, if poorly managed, impairs health and well-being. Accurate pain assessment in this vulnerable group is challenging for hospital staff, but essential for appropriate management. Robust methods for iden...

Promoting mental health and emotional wellbeing (EWB) in children and young people (YP) is vitally important for their psycho-social development. Critical review of the literature reveals a dearth of research that has explored the perspective of the child, adolescent or adult in this concept, with much research being intervention focused and promot...

There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the e...

Background: Despite the increasing popularity of acupuncture, there remains uncertainty as to its effectiveness and how it brings about change. Particular questions are posed over whether acupuncture research has sufficient model validity and reflects acupuncture as practised. Exploring traditional acupuncture (TA) in practice should help to expos...

Healthcare services across Europe face increasing pressure on service provision within a context of tight resource constraints, population ageing, an ever-increasing burden of chronic illness and multiple co-morbidities. However, a very low, average of 3% of resources is spent on prevention. With the publication of Health 2020, a resurgence of publ...

This article reports on two major quality-of-life perception changes for patients who had undergone plastic surgery following dramatic weight loss. The exploratory, qualitative study was undertaken with 20 patients from one teaching hospital. In-depth interviews were conducted, and a thematic analysis of the data was undertaken. The results provide...

Introduction Complementary therapy (CT) use amongst cancer patients is common and increasing. Further understanding of why cancer patients choose to have CTs and their expected benefits is needed. Methods The aim was to compare cancer patients’ expectations/attitudes regarding CTs pre- and post-CT. Multiple case study method (after Yin) was employ...

Women diagnosed with breast cancer experience symptom clusters in addition to existential issues from a life-threatening diagnosis during chemotherapy. A complementary therapy, such as traditional acupuncture (TA) with its whole-person orientation, may help to modify these effects, alongside inducing other patient benefits. Exploring the needs and...

Women diagnosed with breast cancer experience symptom clusters in addition to existential issues from a life-threatening diagnosis during chemotherapy. A complementary therapy, such as traditional acupuncture (TA) with its whole-person orientation, may help to modify these effects, alongside inducing other patient benefits. Exploring the needs and...

An article by Alex Leff and David Howard in the November issue of Nature Reviews Neurology (Stroke: Has speech and language therapy been shown not to work? Nat. Rev. Neurol. 8, 600–601

It is encouraging to see the Royal College of Speech and Language Therapists supporting randomised controlled trials (RCTs).1 2 Meteyard worries that RCTs will not cope with the complexity inherent after stroke.3 However, many RCTs have demonstrated the effectiveness of a range of complex interventions for heterogeneous populations (for example, st...

To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact). Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment. Twelve UK hospital and community stroke services. 170 adults (mean age 70 years) randomis...

Objective: To explore the experiences of young women with developmental dysplasia of the hip explicating the impact of peri-acetabular osteotomy surgery and recovery in the short and longer term. Design: Postings of five, selected women on an online active message board aimed at women with developmental dysplasia of the hip were analysed. Intere...

To determine the clinical effectiveness, cost-effectiveness and service users' views of enhanced early communication therapy by speech and language (SL) therapists compared with attention control (AC). Successful feasibility study followed by a randomised trial with economic evaluation, and nested qualitative study using 32 individual interviews. T...

Rationale Routine collection of outcome measures is advocated to improve quality of care. However, there has been scant investigation of how measurement tools are used in clinical practice and what impact they may have. This paper compares two neuro-rehabilitation teams, one which routinely used standardized measurement tools and the other which di...

Unlabelled: Within the United Kingdom, the statutory supervision of midwives has a central role in both the provision of safe, high-quality maternity services and in the regulation of midwifery practice. Despite its long history, little is currently known about how midwives and their supervisors perceive and experience the statutory supervisory pr...

To explore the experiences of young women adjusting to living with developmental dysplasia of the hip (DDH) and deciding on treatment choices. Exploratory study of a set of online postings from one message board aimed at women with DDH. Postings of five, purposively selected users were explored from first posting to the time of their peri-acetabula...

Herbal products obtained over the counter are commonly used in Europe, North America and Australia. Although there is concern about a lack of information provided to consumers to allow the safe use of these products, there has been no published research to confirm these fears. In this study, we evaluated written information provided with commonly u...

  Behavioural change interventions for persons with chronic illness draw on a variety of theoretical approaches including motivational interviewing and shared decision making. Health literacy provides an additional, potentially powerful explanatory framework to guide research and practice.   To examine the changes in the depth and detail of diabete...

Background: Assessment of communication for people with communication problems following stroke should be socially valid; it should encompass activities relevant to the speaker's environment and the opinion of people within that environment. Potentially relevant opinions include those of the person with the communication problem and their close car...

Acupuncture can be described as a complex intervention. In reports of clinical trials the mechanism of acupuncture (that is, the process by which change is effected) is often left unstated or not known. This is problematic in assisting understanding of how acupuncture might work and in drawing together evidence on the potential benefits of acupunct...

Health care increasingly incorporates telephone counselling, but the dynamics of interactions supporting its delivery are not well understood. This paper explores how advice was packaged and received by participants with type 2 diabetes within the context of a Pro-Active Call-Centre Treatment Support (PACCTS) system delivered to provide diabetes se...

To explore the way in which standardized measurement tools are used in day-to-day clinical practice. Non-participant observation and semi-structured interviews. Hospital-based adult neurorehabilition unit. The multidisciplinary team delivering rehabilitation in the unit. The multidisciplinary team used the measurement tools internally to establish...

To explore the way that patient-centred care is realised within a tele-carer behavioural change intervention. In-depth, semi-structured interviews undertaken at years 1 and 3 with a purposively selected sample from the intervention group within a 3-year randomised controlled trial (RCT) of a telephone-based education and support for persons with ty...

To uncover complementary therapists' motivation to work in cancer/supportive and palliative care. The study employed a multiple case-study design, involving three cancer/supportive and palliative care settings in the North West of England. A questionnaire survey (n=51) was undertaken, followed by semi-structured interviews with a subgroup of the sa...

To identify the significant events and persons prompting search for non-biomedical/complementary and alternative (CAM) ways to cope with the impact of Ménière's syndrome, the CAM therapies used and perceived benefits. A narrative-based approach, with participants recruited from web sites and newsletters of two Ménière's Societies (in the UK and in...

This paper examines the importance of systematic reviews to decision-makers in the UK National Health Service (NHS), outlines Effective Health Care which is a specific initiative to provide systematic reviews in an accessible form, describes the findings of a recent review of the effectiveness of treatment of depression in primary care, and highlig...

To develop and apply a client-centred typology for classifying negative responses to a CAM therapy. Prospective, 6 months cohort, pragmatic study of the effects and experience of shiatsu within three countries (Austria, Spain and the UK). Data collected via postal questionnaires, including on client-perceived negative responses. Classification of n...

To explore professional experience and training of complementary therapists working within cancer care. A Questionnaire survey of complementary therapists practising in three cancer care settings in North West England. Respondents (n=51; n=47 female; mean age 50 years, range 23-78 years) had varied career backgrounds; 24 were healthcare professiona...

Ménière's syndrome is a long-term, progressive disease that damages the balance and hearing parts of the inner ear. To address the paucity of information on which evidence-based treatment decisions should be made, a systematic review of acupuncture for Ménière's syndrome was undertaken. The method used was a systematic review of English and Chinese...

The potential contribution of complementary and alternative medicine (CAM) modalities to promote and support critical health literacy has not received substantial attention within either the health promotion or the CAM literature. This paper explores the potential of one CAM modality, shiatsu, in promoting well-being and critical health literacy. D...

To validate a measure of the carer's perspective of a stroke survivor's communication in everyday life. Cross-sectional, interview-based, psychometric study. A community sample from the northwest of England, UK.Subjects: Fifty-eight carers and 58 stroke survivors with communication problems (aphasia and/or dysarthria) following a stroke within the...

To develop and validate a clinically feasible measure of communication effectiveness for people with any type of communication problem following stroke. Cross-sectional, interview-based, psychometric study, building on the development phase for construction of the Communication Outcome after Stroke (COAST) scale. A community sample from the northwe...

Interest is increasing in the application of standardised outcome measures in clinical practice. Measures designed for use in research may not be sufficiently precise to be used in monitoring individual patients. However, little is known about how clinicians and in particular, multidisciplinary teams, score patients using these measures. This paper...

The objective of this study was to explore client perceptions of the short-term and longer-term effects of shiatsu. The study design was a prospective, 6-month observational, pragmatic study. There were 85 shiatsu practitioners in three countries involved in the study: Austria, Spain, and the United Kingdom. There were 948 clients receiving shiatsu...

Background: In assessing communication outcome in people following stroke, the emphasis has moved from impairment to its consequent effects on functional activity and participation in society. Alongside this has come an increasing focus on conversation. Conversation is a socially vital tool but its evaluation by speech and language therapists is no...

People with multiple sclerosis (MS) are commonly actively involved in self-care, with many accessing complementary and alternative medicine (CAM) to help in symptom management. To provide increased insight into benefits from CAM use and service user ideas over research priorities, a two-part study, involving a questionnaire and interactive workshop...

This paper explores how multidisciplinary teams (MDTs) balance encoded knowledge, in the form of standardised outcome measurement, with tacit knowledge, in the form of intuitive judgement, clinical experience and expertise, in the process of clinical decision making. The paper is based on findings from a qualitative case study of a multidisciplinar...

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a...

Purpose: This paper reports a synopsis of a recent systematic review of the literature regarding the effectiveness of workplace physical activity interventions, commissioned by the National Institute for Health and Clinical Excellence (NICE), UK (Dugdill et al., 2007). Methods: A search for English-language papers published between 1996-2007 was...

This report presents the findings from the postal questionnaire survey of practitioners who participated in the three country, longitudinal, cohort study of the effects and experience of shiatsu (Long 2007). The purpose of the survey was to provide a context in which to situate the findings from the client-reported experiences and effects of shiats...

Evaluation is an essential part of service development and quality management and this is especially pertinent when introducing new initiatives. In 2001 a new countywide assessment and rehabilitation Intermediate Care service, consisting of three care management Rehabilitation Link Teams (RLT), was implemented for older people. To monitor the imple...

Background and objective An economic analysis of telemedicine support to improve glycemic control in patients with type 2 diabetes mellitus, illustrating the use of an analytic framework that efficiently combines telemedicine program findings with published estimates of treatment cost effectiveness. Method The Pro-Active Call Centre Treatment Suppo...

A retrospective survey was undertaken at the University of Salford Teaching Acupuncture Clinic. A postal questionnaire, exploring patient satisfaction and experience with the treatment and clinic, was sent to all persons who had attended the clinic between September 2001 and 2002. Eighty-four (76%) of the 110 patients returned the questionnaire. Ne...

Achieving strict control of diabetes is challenging for many patients and most need regularly to depend on ongoing support from health care professionals. One approach that might successfully provide this in a cost-effective and acceptable way is the delivery of advice and support over the telephone (tele-care). To date the process and effects of t...

Economic evaluation, linking the costs and consequences of an intervention to indicate the potential benefits of alternative interventions, is becoming established as one of the core tools for decision making in health care. As knowledge of the safety and effectiveness of complementary and alternative medicine (CAM) interventions increases, economi...

To determine whether Pro-Active Call Center Treatment Support (PACCTS), using trained nonmedical telephonists supported by specially designed software and a diabetes nurse, can effectively improve glycemic control in type 2 diabetes. A randomized controlled implementation trial of 1-year duration was conducted in Salford, U.K. The trial comprised 5...

To examine patients' views of the acceptability of and satisfaction with telephone care center support provided to improve blood glucose control in type 2 diabetes. The Pro-Active Call-Center Treatment Support (PACCTS) Trial randomized patients from 47 general practices in a deprived urban area in northwest England to usual care or to proactive cal...

This paper applies a theory-driven approach to explore why the use of patient-reported outcome (PRO) measures in clinical practice, in particular, health-related quality of life (HRQoL) instruments, has little or no apparent influence on clinical decision making. A theory-driven approach involves combining knowledge of whether and how an interventi...

The amount of data generated in qualitative research can be difficult to manage. In this paper Tracey Williamson and Andrew Long discuss how the use of data displays can improve data management and also how the process can help to make the routes from raw data to research findings in qualitative research more transparent. Data displays can take sev...

Social care policy and practice draw on multiple sources of knowledge. In order to help practitioners and policymakers identify and act on the basis of high quality evidence, ways of assessing the quality of this knowledge are needed. Part of the answer may lie in the use of a set of generic standards. To test the potentiality of this approach, one...

Developments in primary and intermediate care services have enhanced interest in the notion of care management, the processes that it encompasses and the challenges that it poses to practitioners who are more used to working in a uni- or multidisciplinary manner. This article explores the way that a set of practitioners, new to care management, cop...

• This article identifies that the introduction of the support worker role in the critical care team facilitates flexibility when organizing and managing patient care • Qualified nurses' time can be used more effectively, enhancing the quality of the patient care delivered • Aspects of the qualified nurses' workload in critical care can be shared a...

Nurses have always looked to support their activities through the presence of unregistered co-workers. In the later part of the 20th century this workforce has evolved from a predominance of students to increasing use of variously prepared second level nurses, nursing assistants and Health Care Support Workers. The study evaluated the development o...

Critical appraisal of research studies forms a central role within the application and uptake of evidence‐based approaches within health and social care. While there are established checklists for evaluating quantitative research, this is not the case for qualitative research. This article outlines the process of developing an evaluative tool for q...

This study aimed to develop further a diary originally devised to measure the impact of multiple sclerosis (MS) as part of a cost utility study of beta interferon, and to evaluate its reliability, validity, and responsiveness in an outpatient sample of people with MS. The original diary was further developed using qualitative and quantitative metho...

Classification is a useful tool for understanding, organising and accessing knowledge. It can form a valuable part of the infrastructure of evidence based policy and practice by clarifying the full range of knowledge that might be relevant to a practitioner or policy maker's information need. This paper explores two possible classifications for soc...

Effective rehabilitation depends on multiple inputs from a variety of skilled multi-professional team members. This paper explores perceptions of the nurse's role within the multi-professional rehabilitation team and challenges for effective team working. It draws on findings from a 2-year qualitative study exploring the role of the nurse within re...

To provide insight into client and practitioner perceptions of the effects of shiatsu, in the short and longer term, and positive and negative in nature. A two-country, exploratory study was undertaken in the United Kingdom and Germany. In-depth interviews were undertaken with a purposive sample of 14 shiatsu practitioners and 15 clients. Client in...

Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. Thi...

As the focus of UK health care moves towards the achievement of health gain, information on health outcomes is required by health care commissioners and providers in order to bring about improved patient outcomes. The information required includes health care activity and population data, and textual and bibliographic information to identify publis...

Quality outcome measures are the cornerstone of clinical research. A review of outcome measures used in foot and ankle surgery research reveals that the issues of validity, reliability and responsiveness of outcome measures have not been addressed. Most reports in the literature have attempted to evaluate patient perceptions of outcome following fo...

The issues of what outcomes to measure and how this is central to the development of a sound knowledge base for evidence-based practice are examined. Within complementary and alternative medicine (CAM) there is a crucial debate over what is meant by an "effect" of a set of CAM treatment sessions. The goal of this paper is promote debate and reflect...

Complementary medicine has a different philosophy from conventional medicine, presenting challenges to research methodology. Rigorous evaluation of complementary medicine could provide much needed evidence of its effectiveness. Good design of randomised controlled trials will avoid invalid results and misrepresentation of the holistic essence of...

The increasing importance of rehabilitation in the health sector and the nurses' critical role therein make it essential that nurses have the right skills and knowledge to work effectively in rehabilitation settings. Drawing from a wider qualitative investigation of the role of the nurse within the multi-professional rehabilitation team, gaps in th...

The role of the nurse within the multi-professional rehabilitation team Aim of the study/paper. To identify the contribution of the nurse within the multi-professional rehabilitation team. Background. The requirement for nurses to work effectively within the multi-professional rehabilitation team is increasingly important with the higher incidence...

Effective team working is essential to the delivery of consistent and goal-directed rehabilitation. Within the rehabilitation team, the nurse has a key role to play. This paper reports on a study which gained insight into the nursing contribution to rehabilitation.

Critical appraisal of research studies forms a central role within the application and uptake of evidence-based approaches within health and social care. While there are established checklists for evaluating quantitative research, this is not the case for qualitative research. This article outlines the process of developing an evaluative tool for q...

The research sought to examine the overlap in coverage between several health-related databases, thus enabling the identification of the most important sources for searching for information on the rehabilitation of people with severe mental illness. The literature was searched within a systematic review. Several health-related databases were retrie...

Recently, policy makers, managers and users of health services have focused their attention on questions about service outcomes and effectiveness. However, the stakeholders in health care-communities, patients, clinicians, insurers, purchasers, managers and policy-makers - may, for various reasons, desire different outcomes to be realised over diff...

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a...

The concepts of evidence-based practice and clinical effectiveness are reliant on up to date, accurate, high quality, and relevant information. Although this information can be obtained from a range of sources, computerised databases such as MEDLINE offer a fast, effective means of bringing up to date information to clinicians, as well as health se...

The aim of this study was to assess the involvement of general dental practitioners in Yorkshire in clinical audit activity and in postgraduate dental education and to compare the results with those of a previous survey undertaken in 1989. There is a need to find ways of encouraging all general dental practitioners to become actively involved in co...

Discusses measuring outcomes in the context of disease management and provides a single framework in the form of a key question checklist. Identifies key stakeholders. Outlines levels of outcome monitoring, measurement and date type and source. The development of an evaluative culture is essential to successful outcome measurements.

With the development of an internal market for health care, ‘purchasing for outcomes’ has become an important if somewhat rhetorical catchphrase. While there is emerging understanding about how it can be pursued, doubts are being expressed over an outcomes rather than a process emphasis. This debate has been confused by a failure to differentiate t...

Literature relating to the management of prolapsed lumbar intervertebral discs was reviewed in order to assess the effectiveness of current medical care. Five aspects of care were addressed: the effectiveness of alternative forms of conservative treatment the length of time necessary for a satisfactory trial of conservative management the usefulnes...

Reports on the first phase of an evaluation of the UK Clearing House on Health Outcomes (UKCHHO) undertaken by a sample survey of purchasers and providers on its mailing list and users of its enquiry service. Explores user satisfaction with the services and publications of the project, uses made of the information provided and perceptions of the fu...