Recent Submissions

  • Effects of mental fatigue on static upright stance and functional balance in older adults

    Fletcher, Lucy J.; Osler, Callum J.; University of Derby (Elsevier, 2021-11-16)
    Cognitive influences on balance control may contribute to greater instability and falls in older adults. In support of this, old age exacerbates the effects of a concurrent cognitive task on balance. Mental fatigue is a psychobiological state experienced following prolonged demanding cognitive activity. However, its effects on static upright stance and functional balance in older adults is unclear. It is also unclear how the effects of mental fatigue and a concurrent task interact. Balance was assessed in ten younger and ten older participants before and immediately after 25 min of the incongruent Stroop colour-word test (mental fatigue) and leisurely reading (control), presented in a randomized counterbalanced order on separate days. Static and functional balance was assessed using the centre of pressure path length when standing still and the ‘Timed Up & Go’ test, respectively. These balance assessments were completed with and without a concurrent backward counting task (i.e. dual-task and single-task, respectively). Under subjectively-confirmed conditions of mental fatigue, sway path length when standing still was 32% greater than the control condition in older adults but unchanged in younger adults. This age-dependant effect of mental fatigue on static balance was similar in single-task and dual-task trials. Mental fatigue did not significantly affect functional balance performance in either age group. These findings are the first to show mental fatigue to impair static balance control in older adults. Therefore, whether due to everyday activities or a symptom of disease, mental fatigue may contribute to poor balance in older adults.
  • Effects of Caffeine Ingestion on Human Standing Balance: A Systematic Review of Placebo-Controlled Trials.

    Briggs, Isobel; Chidley, Joel; Chidley, Corinna; Osler, Callum; University of Derby (MDPI, 2021-10-08)
    Caffeine ingestion may influence balance control via numerous mechanisms. Although previously investigated using various study designs and methods, here we aimed to create the first evidence-based consensus regarding the effects of caffeine on the control of upright stance via systematic review (PROSPERO registration CRD42021226939). Embase, PubMed/MEDLINE, SPORTDiscus and Web of Science databases were searched on 27 January 2021 to identify placebo-controlled trials investigating caffeine-induced changes in human standing balance. Reference lists of eligible studies were also searched. Overall, nine studies involving a total of 290 participants were included. All studies were moderate to strong in quality according to the QualSyst tool. Balance-related outcome measures were collected across a range of different participant ages, stances and sensory conditions. The results show that younger participants' balance was generally unaffected by caffeine ingestion. However, a significant balance impairment was observed following caffeine ingestion in all studies involving older participants (average age >65 years). Our results therefore suggest an age-dependent effect of caffeine ingestion on human standing. Further research into this effect is warranted as only one study has directly compared younger and older adults. Nonetheless, an important implication of our findings is that caffeine ingestion may increase fall risk in older adults. Furthermore, based on our findings, caffeine ingestion should be considered as a potential confounding factor when assessing human standing balance, particularly in older adults.
  • It pays to quit: a review of evidence about how financial incentives may improve smoking cessation during pregnancy

    Wyke, Eleanor; Elander, James; University of Derby (British Psychological Society, 2022-03-03)
    Helping women to stop smoking during pregnancy is a major priority for health professionals and evidence suggests that financial incentives can be effective. With the aim of maximising the benefits and minimising unintended negative consequences, this paper gives a brief review of evidence about using financial incentives for smoking cessation during pregnancy, with a special emphasis on how financial incentives work. The review showed that financial incentives can increase pregnant women’s capability, opportunity and motivation to stop smoking. The evidence supports five specific recommendations about how financial incentives should be used in future to reduce smoking during pregnancy, including measures to increase public acceptability. These recommendations can contribute to updating published UK policy for smoking cessation during pregnancy, including the National Institute for Health and Care Excellence (NICE) guideline on stopping smoking in pregnancy and after childbirth (PH26).
  • A systematic review of compassion-based interventions for individuals struggling with body weight shame

    Carter, Alicia; Gilbert, Paul; Kirby, James, N.; University of Queensland; university of Derby (Taylor & Francis Online, 2021-10-25)
    This systematic review investigated compassion-based interventions and the extent to which they can assist with addressing body weight shame. The systematic review was pre-registered and conducted according to PRISMA guidelines. Seven electronic databases (PsycNET, Pubmed, Web of science, CINAHL, Scopus, ProQuest, Social Science Database) were searched. The methodological quality of studies was also assessed. Main outcomes were body weight shame, and compassion. Secondary outcomes assessed were mental health, eating attitudes and behaviours, physical exercise and Body Mass Index and weight. 25 studies (23 papers) met inclusion criteria and results indicated promise for compassion-based interventions for body weight shame, compassion, and health related behaviour. Mixed results were found for BMI and weight. The studies varied considerably in terms of populations targeted, the duration of interventions, and intervention delivery.Conclusion: Overall, compassion-based interventions were found to reduce body weight shame and improve levels of compassion. However, the impact of compassion-based interventions on BMI and weight is less promising. Recommendations for future research are provided.
  • Using lessons from a comparative study of chemistry & bioscience pre-lab activities to design effective pre-lab interventions : a case study

    Rayment, S. J; Evans, J; Moss, K; Coffey, M; Kirk, S. H; Sivasubramaniam, S. D; Nottingham Trent University; University of Derby (Routledge - Taylor and Francis, 2022-01-04)
    Laboratory classes form an important aspect of bioscience education. However, this environment is challenging for students due to cognitive load and lack of confidence. Familiarising students with aspects of their laboratory classes prior to the session can improve this. This study compares the pre-laboratory scaffolding that bioscience and chemistry students experience across UK HE institutions. Typically, bioscience modules used fewer types of activities than chemistry although reading the protocol was the most common activity for both disciplines. Within bioscience, pre-laboratory activities differed by level: first year undergraduates were more likely to be asked to read the protocol, watch videos or do calculation practice in their modules whereas final year undergraduates were more likely to experience experimental design or contextualised activities. Alongside this, this paper discusses an institutional case study of the development and evaluation of technical laboratory videos as pre-laboratory scaffolding for first year students. These were found to benefit both student focus and enhance confidence: implying that using the videos impacted on cognitive load and hence learning. Exploring barriers to the uptake of these resources identified a lack of awareness of them as a major factor, suggesting that greater integration of such resources would enhance engagement and impact.
  • 'e’-thinking teaching and assessment to uphold academic integrity: lessons learned from emergency distance learning

    Reza Khan, Zeenath; Sivasubramaniam, Shivadas; Anand, Pranit; Ajrina, Hysaj; University of Wollongong in Dubai, Dubai, UAE; University of Derby; Queensland University of Technology, Australia (BMC - Springer, 2021-08-24)
    Covid-19 pandemic had an impact on many day-to-day activities but one of the biggest collateral impacts was felt by the education sector. The nature and the complexity of higher education is such that no matter how prepared we are as faculty, how planned our teaching and assessments, faculty are all too aware of the adjustments that have to be made to course plans, assessments designed, content delivery strategies and so on once classes begin. Faculties find themselves changing, modifying and deviating from original plans to ensure accessibility and inclusiveness, this may be due to a variety of reasons such as student abilities, behaviour, disturbances and even outside factors that may be political, environmental, social etc. Majority of the time, faculty are prepared for the change that needs to be incorporated and are quick to adjust. However, no one expected the disruption to education that was caused by COVID19 pandemic. The world came to a standstill while schools and universities scrambled to push learning to the digital space. It was important to try to ensure continuity of learning for students, but the issue of integrity came to the forefront by summertime. Faculties were suddenly expected to restructure their lessons, delivery, teaching and assessing digitally, at the same time ensuring and upholding integrity of the concepts taught and assessed. This has neither been easy or straightforward because the situation was unprecedented with little or no prior documentation or guidelines to help. Recognising this gap, this paper is an attempt at providing exploratory findings from authors’ experiences in their respective institutions over the ensuing months. The paper attempts to record the changes made by the faculty and colleagues to lessons and assessments with particular focus on how technology has been used to help restructure classes, deliver lessons and assess students which have aided in minimizing the likelihood of students cheating. The paper further narrates the reflective changes that were made in response to experience, student/external examiners feedback etc.
  • Three good things in nature: a nature-based positive psychological intervention to improve mood and well-being for depression and anxiety

    Keenan, Rosaline; Lumber, Ryan; Richardson, Miles; Sheffield, David; HSE Community Healthcare Organisation One, Cavan, Ireland; De Montfort University , Leicester; University of Derby (Emerald, 2021-10-08)
    Visiting and connecting with nature through psychological interventions improves well-being within the general population. However, few such interventions have been conducted in clinically relevant populations. This paper aims to address this gap by investigating the effectiveness of a nature-based psychological intervention within a clinically relevant sample. An experimental design using a noticing Three Good Things in Nature (TGTiN) task during a nature based or urban (control) walk was conducted with nature connectedness, well-being, positive and negative affect measured at baseline, post and six-week follow-up. Individuals living with depression and/or anxiety (n = 50; 39 having a diagnosis) were randomly allocated to 30 min walking in nature or urban environments for five consecutive days. An ANCOVA, with age as co-variate, showed a significant effect of time by condition on all variables: nature connectedness ηp2 = 0.34; positive affect ηp2 = 0.42; negative affect ηp2 = 0.66; well-being ηp2 = 0.29. Post-hoc tests indicated a significant increase in nature connectedness and positive affect in the nature versus an urban walk at post and follow-up. Negative affect decreased in the nature walk at post intervention, while well-being was significantly greater in the nature walk at follow-up. The TGTiN intervention effectively improves positive affect, and well-being in clinically relevant populations, although replication with a larger sample is warranted.
  • The influence of experimental confederate peers on children's food intake: A systematic review and meta-analysis

    Sharps, Maxine; Coulthard, Helen; Salvy, S.J.; Ryan, Sean; Fallon, Vicky; De Montfort University; Cedars-Sinai Medical Center, Los Angeles, California, USA; University of Derby; University of Liverpool (Elsevier, 2021-12-15)
    Confederates influence eating behaviour. Systematic reviews and meta-analyses have been conducted on this topic, however, the majority have examined adults, or a combination of adults and children, therefore, an up-to-date meta-analysis is needed to examine the impact of confederate peers on children's food intake. We systematically reviewed and meta-analysed the influence of confederate peers on children's food intake in research using present and remote-confederates. Six publications summarising findings from seven studies were included in this review. One publication was excluded from the meta-analysis because it was not possible to extract the required data. The meta-analysis showed that children were influenced by confederate peers; eating more when exposed to a high-intake compared to a no or low-intake confederate. Larger effects were observed when children were exposed to a remote-than a present-confederate, and for studies using healthy snacks compared to high fat high sugar (HFHS) snacks. No difference in effect size was observed when children were exposed to a high-vs. low-intake confederate compared to a high-vs. no-intake confederate. In the narrative synthesis, confederate intake influenced children's eating behaviour 24-h later, and possible moderators and a potential mechanism underlying the influence of confederates were identified. Caution is needed when interpreting the results, as the sub-groups were not compared statistically due to high heterogeneity, and a small number of studies were included in this review. Furthermore, all studies using the present-confederate design examined HFHS snack intake, therefore, it is unclear whether observed differences in effect sizes between present- and remote-confederates may be due to confederate or food type. Research is needed to further examine the influence of confederate peers on children's food intake and to examine mechanisms and moderators.
  • Cultivating the Compassionate Self: an Exploration of the Mechanisms of Change in Compassionate Mind Training

    Matos, Marcela; Duarte, Cristiana; Duarte, Joana; Pinto-Gouveia, José; Petrocchi, Nicola; GIlbert, Paul; University of Coimbra, Portugal; York St John University; Lund University; John Cabot University; et al. (Springer Science and Business Media LLC, 2021-10-21)
    The current study aimed to examine the mechanisms of change that mediate the impact of a compassionate mind training (CMT) intervention, in particular, whether changes in compassion, fears of compassion and heart rate variability (HRV) would mediate the effects of a brief CMT intervention on psychological vulnerability factors, mental health indicators and positive affect. Using a longitudinal design, general population participants were randomly assigned to one of the two conditions: compassionate mind training (n = 56) and wait list control (n = 37). Participants in the CMT condition attended a psychoeducation session and practiced a set of core CMT exercises for 2 weeks. Self-report measures of compassion, fears of compassion, self-criticism, shame, depression, stress and positive affect were completed, and HRV was assessed at pre- and post-intervention. Mediation analyses revealed that increases in compassion for self and from others and reductions in fears of compassion for self, for others and from others mediated the effects of CMT on self-criticism and shame. In depression and stress, compassion for the self and from others and fears of compassion for the self emerged as significant mediators. Compassion for the self and from others and fears of compassion for self and from others significantly mediated the effect of CMT in safe affect. Compassion for the self, fears of compassion for self and for others and HRV mediated changes in relaxed affect. Cultivating a compassionate mind/self-identity through the core components of CMT may stimulate vagal regulatory activity and positively impact one’s ability to experience and be open to compassion, and thus promote emotion regulation, well-being and mental health.
  • The Science of Compassion

    GIlbert, Paul; university of Derby (Routledge, 2021-11-30)
    This chapter explores the nature and science of compassion, how it can texture political discourse, but also the challenges it is up against. Most scientists recognise that nothing makes much sense in biology, or the nature of the mind, without an evolutionary analysis. Evolutionary analysis operates through two fundamental processes in the universe, which are splitting apart, separating, diversifying, and even competing versus coming together, integrating, coordinating, and building complexity. In the television series Westworld, pleasure androids are programmed with algorithms and scripts to live out certain kinds of life narratives such that the human participants visiting the 'theme park' can interact and do what they want to them. As primates, humans are capable of two quite different types of life strategy and motivational orientation to the world.
  • Bio-vehicles of cytotoxic drugs for delivery to tumor specific targets for cancer precision therapy

    Al-mansoori, Layla; Elsinga, Philip; Goda, Sayed K.; Qatar University, Doha, Qatar; University Medical Center Groningen, the Netherlands; Cairo University, Egypt; University of Derby (Elsevier BV, 2021-10-01)
    Abnormal structural and molecular changes in malignant tissues were thoroughly investigated and utilized to target tumor cells, hence rescuing normal healthy tissues and lowering the unwanted side effects as non-specific cytotoxicity. Various ligands for cancer cell specific markers have been uncovered and inspected for directional delivery of the anti-cancer drug to the tumor site, in addition to diagnostic applications. Over the past few decades research related to the ligand targeted therapy (LTT) increased tremendously aiming to treat various pathologies, mainly cancers with well exclusive markers. Malignant tumors are known to induce elevated levels of a variety of proteins and peptides known as cancer “markers” as certain antigens (e.g., Prostate specific membrane antigen “PSMA”, carcinoembryonic antigen “CEA”), receptors (folate receptor, somatostatin receptor), integrins (Integrin αvβ3) and cluster of differentiation molecules (CD13). The choice of an appropriate marker to be targeted and the design of effective ligand-drug conjugate all has to be carefully selected to generate the required therapeutic effect. Moreover, since some tumors express aberrantly high levels of more than one marker, some approaches investigated targeting cancer cells with more than one ligand (dual or multi targeting). We aim in this review to report an update on the cancer-specific receptors and the vehicles to deliver cytotoxic drugs, including recent advancements on nano delivery systems and their implementation in targeted cancer therapy. We will discuss the advantages and limitations facing this approach and possible solutions to mitigate these obstacles. To achieve the said aim a literature search in electronic data bases (PubMed and others) using keywords “Cancer specific receptors, cancer specific antibody, tumor specific peptide carriers, cancer overexpressed proteins, gold nanotechnology and gold nanoparticles in cancer treatment” was carried out.
  • Production of Long-Acting CNGRC–CPG2 Fusion Proteins: New Derivatives to Overcome Drug Immunogenicity of Ligand-Directed Enzyme Prodrug Therapy for Targeted Cancer Treatment

    Al-mansoori, Layla; Al Qahtani, Alanod D.; Elsinga, Philip; Goda, Sayed K.; Qatar University, Doha, Qatar; Anti-Doping Lab-Qatar (ADLQ), Doha, Qatar; University of Groningen, the Netherlands; Cairo University, Giza, Egypt; University of Derby (SAGE Publications, 2021-11-20)
    Aminopeptidase N (APN) is an enzyme highly expressed in metastatic cancers and could be used in targeted cancer therapy. Our previous work showed the successful construction of CNGRC–carboxypeptidase G2 (CPG2) and CNGRC–CPG2–CNGRC fusion proteins. Our conjugates and prodrugs were effective in targeting high APN-expressing cancer cells. In the present study, we aim to produce long-acting fusion proteins to overcome 2 of the main drawbacks of antibody-directed enzyme prodrug therapy. N-terminal and N-, C-terminal fusion CPG2, CNGRC–CPG2, and CNGRC–CPG2–CNGRC, respectively, were PEGylated using polyethylene glycol (PEG) maleimide (40K). We examined the effect of PEGylation on the therapeutic efficacy of the new products. The resulting PEGylated fusion proteins were tested for their stability, ex vivo immunotoxicity, binding capacity to their target on high HT1080, and low A549 APN-expressing cells. The catalytic activity of the resulting PEGylated fusion CPG2 proteins was investigated. Pro-drug “ZD2767P” cytotoxic effect in association with PEG CPG2–CNGRC fusion proteins on cancer cells was studied. Our work demonstrated that the properties of the PEGylated single-fused proteins were significantly improved over that of un-PEGylated fused CPG2, and its kinetic activity and APN-binding affinity were not negatively affected by the PEGylation. Significantly, The PEGylated single-fused CPG2 had lower immunogenicity than the un-PEGylated CPG2. Our results, however, were different in the case of the PEGylated double-fused CPG2. Although its stability in human serum under physiological conditions was not significantly affected, the kinetic activity and its binding affinity to their cellular marker (APN) were substantially reduced. When the study was performed with high and low APN-expressing cancer cell lines, using the prodrug ZD2767p, the PEGylated fusion CPG2 demonstrated cancer cell killing effects. We have successfully produced PEGylated-CNGRC–CPG2, which is bioactive and with lower immunogenicity in ligand-directed enzyme prodrug therapy for cancer treatment.
  • Discourse analysis and emotions

    Childs, Carrie; University of Derby (De Gruyter, 2022)
    This chapter is concerned with discourse-centred approaches for examining emotion in conversation. Specifically, the chapter focuses on Conversation Analysis and Discursive Psychology. These approaches share a focus on the study of language as a topic in its own right- as a means of constructing, rather than representing, reality. With regard to emotion, the focus is on examining emotional displays and the ways in which these are invoked, managed and treated in conversation. The primary issue is the interactional work that is done and how notions of emotion are topicalized and managed in specific settings. The chapter has two major subsections. In the first I introduce Conversation Analysis and Discursive Psychology as research tools. I provide a description of each and outline their core methodological features. In the second I provide specific examples that illustrate the application of Conversation Analysis and Discursive Psychology to the study of emotion. The aim is to elucidate these approaches as ways of exploring emotion in naturally occurring interaction, highlighting the ways in which approaches based on analysis of authentic interaction can contribute to an understanding of emotion in conversation.
  • Self-disgust as a potential mechanism underlying the association between body image disturbance and suicidal thoughts and behaviours

    Akram, Umair; Allen, Sarah; Stevenson, Jodie C.; Lazarus, Lambros; Ypsilanti, Antonia; Ackroyd, Millicent; Chester, Jessica; Longden, Jessica; Peters, Chloe; Irvine, Kamila R.; et al. (Elsevier BV, 2022-10-26)
    This study examined whether self-disgust added incremental variance to and mediated the multivariate association between measures of body image disturbance and suicidal thoughts and behaviours. We hypothesized that self-disgust would be associated with suicidal ideation above the effects of body image disturbance, and that self-disgust would mediate the relationship between body image disturbance and suicidal ideation. A total of N=728 participants completed The Body Image Disturbance Questionnaire, The Self-Disgust Scale, and the Suicidal Behaviours Questionnaire-Revised. Suicidality was significantly related to increased levels of self-disgust and body image disturbance, whereas self-disgust was associated with greater body image disturbance. Linear regression analysis showed that self-disgust was associated with suicidal thoughts and behaviours, over and above the effects of body image disturbance. Multiple mediation modelling further showed that self-disgust mediated the relationship between body image disturbance and suicidal thoughts and behaviours. Our findings highlight the role of self-disgust in the context of body image disturbance and support the notion that body image disturbance is associated with aversive self-conscious emotions. Interventions aiming to reduce the risk of suicidality in people with body image disturbance may address self-disgust and negative self-conscious emotions.
  • Continuing professional development and mentoring

    Bryson, David; University of Derby (Taylor & Francis, 2021-11-24)
    This professional development paper aims to give you some pointers that will help you get the most from your mentorship experience as a mentor or a mentee. We look at how mentoring can support your professional development. A simple definition is that a mentor may share with a mentee (or protege) information about his or her own career path, as well as provide guidance, motivation, emotional support, and role modelling. A mentor may help with exploring careers, setting goals, developing contacts, and identifying resources.
  • 25 Years on: progress in computer-based learning,

    Bryson, David; University of Derby (Taylor & Francis, 2021-11-24)
    1996 saw several papers addressing and informing readers about developments in computer-based learning and their effective use in teaching also the impact of technological developments on services and personnel.
  • An Interpretative Phenomenological Analysis exploring the experiences of mothers who relate to the term ‘Gender Disappointment’

    Young, Nina; Hallam, Jenny; Jackson, Jessica; Barnes, Christopher; Montague, Jane; University of Nottingham; University of Derby (MAG, 2021-11-19)
    In a western context little is known about what it means to associate with the term gender disappointment - feelings of despair around not having a child of the desired sex. Explore the lived experiences of British women who identify with the term gender disappointment. Six mothers of only sons who desired a daughter participated in a semi-structured interview via an online platform. An Interpretative Phenomenological Analysis (IPA) identified themes which relate to (i) pity, societal expectations of unfulfillment and concerns relating to future mother son relationship (ii) feelings of guilt and shame and (iii) barriers to seeking help and benefits of talking. More awareness relating to gender disappointment and the negative impact it has upon maternal wellbeing is needed. Mothers who identify with gender disappointment would benefit from support from health visitors to enable them to access the help they need.
  • Patient-reported factors associated with degree of pain medication dependence and presence of severe dependence among spinal outpatients

    Elander, James; Kapadi, Romaana; Bateman, Antony H; University of Derby; Royal Derby Spinal Centre, Royal Derby Hospital (Future Medicine Ltd, 2021-11-03)
    To identify risk factors for pain medication dependence. Chronic spinal pain outpatients (n=106) completed the Leeds Dependence. Questionnaire (LDQ) and measures of potential risk factors. Participants with high (n=3) and low (n=3) dependence were interviewed. Mean LDQ score was 11.52 (SD 7.35) and 15/106 participants (14.2%) were severely dependent (LDQ ≥20). In linear regression, pain intensity (β=0.313, p<0.001), being disabled by pain (β=0.355, p<0.001), borrowing pain medication (β=0.209, p=0.006), and emergency phone calls or clinic visits (β=0.169, p=0.029) were associated with degree of dependence across the range of LDQ scores. In logistic regression, pain intensity (p=0.001) and borrowing pain medication (p=0.004) increased the odds of severe dependence. Interviewees described how their pain influenced their pain medication use and one described pain medication addiction. Interventions to reduce pain intensity and pain-related disability may reduce pain medication dependence.
  • Using patient feedback to adapt intervention materials based on acceptance and commitment therapy for people receiving renal dialysis

    Elander, James; Kapadi, Romaana; Coyne, Emma; Taal, Maarten W.; Selby, Nicholas M.; Stalker, Carol; Mitchell, Kathryn; University of Derby (Springer Science and Business Media LLC, 2021-11-15)
    Theory-based intervention materials must be carefully adapted to meet the needs of users with specific physical conditions. Acceptance and Commitment Therapy (ACT) has been adapted successfully for cancer, chronic pain, diabetes, irritable bowel syndrome, multiple sclerosis, and a range of other conditions, but not so far for people receiving renal haemodialysis. This paper presents findings from a study to adapt ACT-based intervention materials specifically for renal dialysis. Draft written materials consisting of four stories depicting fictitious individuals who used ACT-related techniques to help overcome different challenges and difficulties related to dialysis were adapted using a systematic patient consultation process. The participants were 18 people aged 19 to 80 years, with chronic kidney disease and receiving renal dialysis. Individual, semi-structured interviews were conducted to elicit participants’ views about how the content of the draft materials should be adapted to make them more realistic and relevant for people receiving renal dialysis and about how the materials should be presented and delivered to people receiving renal dialysis. The interview transcripts were analysed using a qualitative adaptation of the Delphi method in which themes are used as a framework for translating feedback into proposals for modifications. The analysis of patient feedback supported the use of patient stories but suggested they should be presented by video and narrated by real dialysis patients. They also indicated specific adaptations to make the stories more credible and realistic. Participant feedback was translated into proposals for change that were considered along with clinical, ethical and theoretical factors. The outcome was a design for a video-based intervention that separated the stories about individuals from the explanations of the specific ACT techniques and provided greater structure, with material organised into smaller chunks. This intervention is adapted specifically for people receiving renal dialysis while retaining the distinctive theoretical principles of ACT. The study shows the value of consulting patients in the development of intervention materials and illustrates a process for integrating patient feedback with theoretical, clinical and practical considerations in intervention design.

View more