English Pilot Research Articles

TEACHER TRAINERS’ BELIEFS ABOUT THE PLURICENTRICITY OF ENGLISH AND GERMAN Pilot results from two Hungarian universities

The present study investigates the beliefs of teacher trainers at Hungarian universities about the pluricentricity of English and German as foreign languages. The results of the pilot phase are based on the analysis of two semi-structured interviews with one lecturer each from two Hungarian universities from 2023. The analysis also includes a comparison of the results with 37 previous interviews conducted between 2020 and 2022 with 21 English and German teachers and 16 language learners in Hungary. The interviews were analysed using the Taguette software, in a qualitative content analysis framework, by setting up a coding frame with 13 codes. The main research question was how the university instructors’ beliefs about pluricentricity relate to those of the language teachers and language learners. The results show that there are far more similarities than differences, and that university instructors appear to be more open to pluricentricity than their colleagues in public education, but more conservative than language learners. The pilot nature of the study means that, in addition to presenting the preliminary results, I have also drawn methodological conclusions which will be very important for the continuation of the study, i.e. for the addition of further university instructors to the sample.

Pilot Study to Evaluate Patients’ Understanding of Key Terms and Aspects of Antimicrobial Use in a Rural Province in South Africa Findings and Implications

Abstract Introduction: Antimicrobial resistance (AMR) is a global concern, necessitating the understanding of utilisation patterns and their rationale. Pilot studies have been conducted in a rural province in South Africa to determine the extent of self-purchasing of antibiotics by patients from independent and chain pharmacies. It is imperative to understand the extent of knowledge and concerns of patients regarding the key aspects of antibiotic use and AMR, and potential language barriers, when pharmacists and their assistants are discussing the key aspects with patients. Consequently, the aim was to pre-test a patient questionnaire translated in three native languages building on the findings from the English language pilot. Materials and Methods: The English patient questionnaire (Parts 1 and 2) was translated to Sepedi, Tshivenda and Xitsonga. In total 30 patients were interviewed (5/language for Part 1 and Part 2 respectively) when leaving 10 chain and independent pharmacies. This was followed by interviews with patients to evaluate their understanding of questions and key concepts. Results: Eleven of 15 patients interviewed for Part 1 received antibiotics, including 8 without a prescription. Only independent pharmacies (8/10) dispensed antibiotics without prescriptions. Interviews revealed concerns about antibiotic knowledge and AMR and that certain terms including ‘antibiotic’ and ‘AMR’ posed challenges with patient understanding of the purpose of antibiotics. For instance, one patient self-purchased antibiotics for ‘cleansing’ of sexually transmitted infections. The questionnaires in the native languages were subsequently revised so that explanations for terms, including ‘antibiotic’ and ‘AMR’ will be provided in the main study. Conclusion: Similar to the previous pilot studies, self-purchasing of antibiotics was observed among independent pharmacies, although at varying rates, with similar indications. Continued health literacy education for pharmacists and patients, especially with native language communication, are needed to address current challenges and will be explored in the main study.

Nonsuicidal self-injury and intersubjective recognition: ‘You can’t argue with wounds’

This article explores the relevance of intersubjective recognition and the ‘recognition theoretical turn’ to our understanding of nonsuicidal self-injury. While previous research has demonstrated that self-injury possesses an important social dimension alongside its intrapsychic characteristics, a major challenge for any social approach to self-injury has been to find a way to describe and analyse this dimension without reductively implying that self-injury is a form of ‘attention-seeking’, where this describes a pejorative accusation of social manipulation. One possible solution to this challenge lies in the concept of intersubjective recognition and the idea that what some have interpreted as ‘attention-seeking’ behaviour is perhaps better understood as recognition-seeking. As such, we draw on data from a 2016–2017 English pilot study to examine three basic questions: (1) does self-injury constitute, at least in some cases and amongst its many other observed intrapsychic and social functions, a form of recognition-seeking? (2) if so, how does self-injury work as a claim to recognition? and (3), how do we solve the apparent contradiction of using a stigmatic mark as a means of claiming a normative status? Our study suggests that one of self-injury’s intersubjective imperatives is the need to be listened to and taken seriously, to have one’s feelings and experiences confirmed by others as being legitimate and valid. As such, intersubjective recognition does appear to form a distinct part of the overdetermined complex of meanings and effects associated with self-injury and may be an important factor in a number of cases.

The Effectiveness of Integrating Psychotherapy Into Overweight/Obesity Interventions on Youth’s Weight Status and Depressive Symptoms: A Narrative Review

Introduction: Childhood obesity and youth depression are serious ongoing global crises of the 21st century. Many researchers have often attributed this to the well-established association between them. Consequently, psychotherapies are increasingly being integrated into interventions to improve weight status and depression outcomes for individuals with overweight and/or obesity (OW/OB). However, the effectiveness of these interventions has not yet been reviewed for youth with OW/OB. Such youth tend to be at a higher risk of developing comorbid depressive symptoms, which can likely persist into adulthood. Therefore, this narrative review explored the effectiveness of psychotherapy integrations within OW/OB interventions on youth’s weight statuses and their depressive symptoms contemporaneously. Methods: Medline, Embase, PsycInfo, PubMed, and Scopus were accessed. English peer-reviewed empirical articles, reviews, meta-analyses, clinical trials, and pilot studies from the last ten years and those that investigated the effectiveness of OW/OB interventions integrated with psychotherapy among youth (5-18 years) were included. Keywords related to diet, psychotherapy, OW/OB, youth, and depression were used. Non-peer-reviewed sources, reviews lacking sufficient transparency in their methodology, editorials, letters, study protocols, commentaries, preprints, and dissertations were excluded. Results: Four studies, including two pilot studies, were included. Overall, we found high heterogeneity in their intervention components and conditions, study designs, participants, and results. Among youth, all studies found no significant improvements in weight status as per the authors’ set significance thresholds. Mixed results were obtained for the effect on youth’s depressive symptoms. Discussion: There is an alarming lack of recent literature investigating the impact of integrated evidence-based psychotherapies within OW/OB interventions on youth’s weight statuses and depressive symptoms. It is important to investigate their effectiveness in equipping youth with OW/OB with skills to make sustained lifestyle changes and cope with weight discrimination and depressive symptoms. We attributed the weak success of these interventions to the lack of cultural adaptations and standardization of study types, intervention structures, components, and conditions. Conclusion: It is important for researchers to continue investigating the success of such interventions on youth with OW/OB’s physical and mental outcomes simultaneously. This will further inform the interdisciplinary approach needed to deliver appropriate care to these youth.

Extension of cervical screening intervals with primary human papillomavirus testing: observational study of English screening pilot data

ObjectivesTo provide updated evidence about the risk of cervical intraepithelial neoplasia grade 3 or higher (CIN3+) and cervical cancer after a negative human papillomavirus (HPV) test in primary cervical screening,...

Cytology interpretation after a change to HPV testing in primary cervical screening: Observational study from the English pilot.

BACKGROUNDOvercalling of abnormalities has been a concern for using cytology triage after positive high‐risk human papillomavirus (HPV) tests in cervical screening.METHODSThe authors studied the detection of cytological and histological abnormalities at age 24 to 64 years, using data from the English HPV pilot. The pilot compared routine implementation of primary cervical screening based on cytology (N = 931,539), where HPV test results were not available before cytology reporting, with that based on HPV testing (N = 403,269), where cytology was only required after positive HPV tests.RESULTSRevealed HPV positivity was associated with a higher direct referral to colposcopy after any abnormality (adjusted odds ratio [ORadj], 1.16; 95% confidence interval [CI], 1.14‐1.18). Laboratories with higher direct referral referred fewer persistently HPV‐positive women after early recall. The detection of high‐grade cervical intraepithelial neoplasia (CIN2+) after direct referral increased with an ORadj of 1.17 (95% CI, 1.13‐1.20) for informed versus uninformed cytology. Generally, the positive predictive value (PPV) of colposcopy for CIN2+ remained comparable under both conditions of interpreting cytology. In women 50 to 64 years old with high‐grade dyskaryosis, however, the PPV increased from 71% to 83% after revealing HPV positivity (ORadj, 2.05; 95% CI, 1.43‐2.93).CONCLUSIONSQuality‐controlled cervical screening programs can avoid inappropriate overgrading of HPV‐positive cytology.;

Age-specific outcomes from the first round of HPV screening in unvaccinated women: Observational study from the English cervical screening pilot.

To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening. Observational study with screening in 2013-2016, followed by two early recalls and/or colposcopy until the end of 2019. Six NHS laboratory sites. A total of 1341584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC). Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality. We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group. Among unvaccinated women screened with HR-HPV testing at age 24-29years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50-64years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24-29years and 55% at 50-64years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC. These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination. Data from the English pilot study provide a comprehensive overview of abnormalities detected through HPV screening.

Detection of pregnancy risk: A Literature Review

In the millennial era unhealthy eating patterns and lifestyles associated with excess weight gain (obesity), diabetes mellitus, cholesterol and pregnancy complications, concomitant diseases such as heart disease, cholesterol, mothers exposed to alcohol, cigarettes or narcotics must be know. This study aimed to know the effectiveness of media books for pregnancy detection. The keywords used were detection of pregnancy risk, symptoms and signs of pregnancy. This literature review used articles from Google Scholar, Science Direct, Pubmed, DOAJ published from 2010 to 2020. The inclusion criteria are full text articles, using English language, survey research, workshop, and pilot study to health promotion. The exclusion criteria are articles was non English language, incomplete articles, case study. Containing symptoms and danger signs is effective for risk detection in early pregnancy

Attendance at early recall and colposcopy in routine cervical screening with human papillomavirus testing.

Attendance at early recall and colposcopy is crucial to attaining the benefits of primary high-risk human papillomavirus (HR-HPV)-based screening. Within the English HPV pilot, we analysed deprivation- and age-related patterns of attendance at colposcopy and 12- and 24-month early recall of HR-HPV positive women screened in 2013 to 2015 (N = 36 466). We fitted logistic regression models for adjusted odds ratios (OR). Despite high overall attendance, area deprivation had a small but significant impact at both early recalls, for example, attendance at 24 months was 86.3% and 83.0% in less vs more deprived areas, respectively (ORadj : 0.76; 95% CI: 0.67-0.87). Older women (≥30 years) were more likely to attend early recall than younger women (<30 years), for example, attendance at 24 months was 86.1% vs 82.3%, respectively (ORadj : 1.32, 95% CI: 1.16-1.51). Most women attended colposcopy following a baseline referral, with 96.9% attendance among more deprived and 97.8% among less deprived areas (ORadj : 0.70; 95% CI: 0.55-0.88). Differences in colposcopy attendance by deprivation level at 12 and 24 months were of approximately the same magnitude. In conclusion, attendance at early recall and colposcopy was reassuringly high. Although there were statistically significant differences by deprivation and age group, these were small in absolute terms.

Lessons from integrated care pilots in England

PurposeThe purpose of this paper is to provide a summary of some of the lessons about implementing different types of integrated care.Design/methodology/approachThe author used evidence from the author’s own evaluations and the findings of other researchers to identify some important lessons for policy makers and practitioners.FindingsThe author identifies eight high-level lessons which may be of interest to policy makers and practitioners working in the field.Research limitations/implicationsThe lessons outlined in the paper provide only a starting point for those designing interventions or evaluation.Practical implicationsThe changes required to implement integrated care are complex and are embedded in a complex context. Change of this type is difficult and generally takes longer to deliver than expected. The evaluation of these models often requires longer than is often available and needs to focus on the impact on the whole system rather than narrow measures, e.g. hospital utilisation.Originality/valueThis is a viewpoint paper synthesising evidence from the English pilot programmes in integrated care.

16/18 genotyping in triage of persistent human papillomavirus infections with negative cytology in the English cervical screening pilot

BackgroundIn the English pilot of primary cervical screening with high-risk human papillomavirus (HR-HPV), we exploited natural viral clearance over 24 months to minimise unnecessary referral of HR-HPV+ women with negative cytology. Three laboratories were permitted to use 16/18 genotyping to select women for referral at 12-month recall. We estimated the clinical impact of this early genotyping referral.MethodsThe observed numbers of women referred to colposcopy and with detected high-grade cervical intraepithelial neoplasia (CIN2+), and of women who did not attend early recall in the three laboratories were compared with those estimated to represent a situation without an early genotyping referral. The 95% confidence intervals (CI) for the differences between the protocols were calculated by using a parametric bootstrap.ResultsAmongst 127,238 screened women, 16,097 (13%) had HR-HPV infections. The genotyping protocol required 5.9% (95% CI: 4.4–7.7) additional colposcopies and led to a detection of 1.2% additional CIN2+ (95% CI: 0.6–2.0), while 2.3% (95% CI: 2.1–2.5) fewer HR-HPV+/cytology− women did not attend the early recall compared with the non-genotyping protocol.ConclusionsIn a screening programme with high quality of triage cytology and high adherence to early recall,16/18 genotyping of persistent HPV infections does not substantially increase CIN2+ detection.

Optimising future cervical screening strategies

The switch from primary cytology to primary high risk papillomavirus (HR-HPV) testing for cervical screening is now being implemented in a number of countries. The advantages of this are to increase screening sensitivity which will save lives, and at the same time to extend screening intervals. The challenge with HR-HPV testing is its relatively poor specificity which means identifying a large number of women who are HR-HPV positive with negative cytology. One way of tackling this is to use early recall, in order to select referral to colposcopy to those women who do not clear the virus over a period of 1-2 years, as done in the recently published English Pilot Study. Another challenge in optimising screening is to recognise that wide coverage with prophylactic vaccination will require fewer screens over the lifetime of vaccinated women to maintain cost-effectiveness. HR-HPV testing allows self sampling which could both encourage more women to be screened and be more convenient for those who do wish to be screened. Cervical cancer prevention which combines vaccination and screening now offers a future in which cervical cancer could become a rarity, but efficient strategies need to be implemented.

Cultural adaptation of a pediatric functional assessment for rehabilitation outcomes research

BackgroundSignificant racial and ethnic health care disparities experienced by Hispanic children with special health care needs (CSHCN) create barriers to enacting culturally competent rehabilitation services. One way to minimize the impact of disparities in rehabilitation is to equip practitioners with culturally relevant functional assessments to accurately determine service needs. Current approaches to culturally adapting assessments have three major limitations: use of inconsistent translation processes; current processes assess for some, but not all, elements of cultural equivalence; and limited evidence to guide decision making about whether to undertake cultural adaptation with and without language translation. The aims of this observational study are (a) to examine similarities and differences of culturally adapting a pediatric functional assessment with and without language translation, and (b) to examine the feasibility of cultural adaptation processes.MethodsThe Young Children’s Participation and Environment Measure (YC-PEM), a pediatric functional assessment, underwent cultural adaptation (i.e., language translation and cognitive testing) to establish Spanish and English pilot versions for use by caregivers of young CSHCN of Mexican descent. Following language translation to develop a Spanish YC-PEM pilot version, 7 caregivers (4 Spanish-speaking; 3 English-speaking) completed cognitive testing to inform decisions regarding content revisions to English and Spanish YC-PEM versions. Participant responses were content coded to established cultural equivalencies. Coded data were summed to draw comparisons on the number of revisions needed to achieve cultural equivalence between the two versions. Feasibility was assessed according to process data and data quality.ResultsResults suggest more revisions are required to achieve cultural equivalence for the translated (Spanish) version of the YC-PEM. However, issues around how the participation outcome is conceptualized were identified in both versions. Feasibility results indicate that language translation processes require high resource investment, but may increase translation quality. However, use of questionnaires versus interview methods for cognitive testing may have limited data saturation.ConclusionsResults lend preliminary support to the need for and feasibility of cultural adaptation with and without language translation. Results inform decisions surrounding cultural adaptations with and without language translation and thereby enhance cultural competence and quality assessment of healthcare need within pediatric rehabilitation.

Speaking Transnationally: Early Modern European Linguistic Exchanges with Islamic Southeast Asia

This article considers European cross-cultural exchanges with Islamic Southeast Asia from the perspective of language. Earlier assumptions of the superiority of European languages over non-European ones are unwarranted. In the early modern period English was a peripheral language, and the English and other Europeans used various languages to communicate in trading relations with the East. In Southeast Asia (the “East Indies”), Malay was a significant early modern lingua franca. This study examines the circumstances under which the Dutch explorer Frederick de Houtman came to write a handbook on Malay, later translated into Latin, English, and other languages, when he joined a 1598–99 Dutch East Indies voyage to Aceh. Imprisoned by the sultan, he also wrote an account of his experience. The textual materials produced by this encounter include, aside from Houtman's own Dutch account, an account by the expedition's English pilot and an Acehnese chronicle, Hikayat Aceh, mentioning the European visitors. Using these varied materials—in English, Dutch, and Malay—this study analyzes Houtman's role as translator and interpreter to rethink early modern transnational communication.

Implementing a national flexible sigmoidoscopy screening program: results of the English early pilot.

Following the results of a major UK study showing that once-only flexible sigmoidoscopy (FSIG) screening significantly reduced colorectal cancer (CRC) incidence and mortality, an FSIG screening program in England was announced in late 2010. Three "early pilot" sites were selected in 2011 in Derby, South of Tyne, and Tees to assess the practicalities of the delivery of FSIG screening. Eligible people aged 55 from selected practices in the three early pilot areas received postal invitations to participate. The South of Tyne and Derby sites employed interactive models of screening invitation, while Tees used a simple invitation. Data were collected to assess uptake, process, and outcome. A self-completion participant satisfaction questionnaire was sent to all participants 1 month after attendance. A total of 4023 55-year-olds were invited to participate. Uptake was 29 %, with 1151 people screened over a 3-month period. Screening uptake differed by method of invitation: a simple approach was significantly more successful than an interactive one (32 % vs. 27 %, P = 0.0015). Uptake decreased significantly with increasing deprivation. Adenomas were found in 111 (9.8 %) of those screened and cancer in two. The procedure was rated "very" or "fairly" acceptable by 97 % of participants. Over 90 % of respondents said they would participate in future cancer screening and a similar proportion would recommend doing so to others. Delivery of an FSIG screening program to prevent CRC is feasible and should be implemented using a simple invitation system. The national Bowel Scope program subsequently commenced at pilot sites in May 2013, with full implementation planned by 2016.

Corpora Processing and Computational Scaffolding for a Web-based English Learning Environment

This paper describes the development of an innovative web-based environment for English language learning with advanced data-driven and statistical approaches. The project uses various corpora, including a Chinese-English parallel corpus (Sinorama) and various natural language processing (NLP) tools to construct effective English learning tasks for college learners with adaptive computational scaffolding. It integrates the expertise of a group of researchers in four areas: (a) advances in NLP technologies and applications, (b) construction of a self-access reading environment, (c) exploration of English language learning through written exercises and translations, and (d) use of bilingual corpora for culture-based English learning. In this paper, the conceptualization of the system and its various reference tools (e.g., a bilingual concordancer) for English learning and pilot testing on various modules (e.g., a reading module, Text Grader, and Collocation Practice) are reported.

Child Sex Offender Public Disclosure Scheme: The views of applicants using the English pilot disclosure scheme

A limited Child Sexual Offender Disclosure Scheme was launched in England and Wales in 2009–10. Drawing upon data from an evaluation of the pilot scheme, this paper explores the views of applicants seeking a disclosure. In particular, the paper considers issues around the low take-up, perceptions of satisfaction and more broadly the role of the scheme in providing reassurance to the public about child sexual offenders in the community. Interestingly, while perceptions of satisfaction with the scheme were high, anxieties about child sexual offenders were not necessarily alleviated by the scheme, and in many instances were heightened.

The Development and Validation of a Questionnaire to Audit Advance Care Planning

Background: Advance Care Planning (ACP) is established as a standard of care in many settings. However, no validated tool exists to measure participants’ perspectives on ACP. The purpose of this study was to develop and validate a questionnaire to assess ACP from the perspectives of patients and their family members, and to pilot the use of this questionnaire in both English and French. Methods: To develop the ACP-specific questionnaire, items were generated from focus groups with health care professionals and face-to-face interviews withhospitalized patients and their families. The items from this novel questionnaire were combined with other validated evaluation instruments and then piloted in English-speaking hospitalized patients who had advanced, life-limiting illnesses and a version for their family members. Revisions were made based on that experience and feedback from content experts and this questionnaire was then piloted in another sample of French-speaking respondents. Results: The novel questionnaire was divided into 2 parts, the first part focusing on ACP activities before admission to hospital (6 questions) and the second part relating to ‘goals of care’ discussions that occur during hospitalization (8 questions). For the English pilot study, the average duration of the entire interview (including consent, baseline demographics and other questionnaires) was 53.1 mins (range 35-80 mins) for patients and 60.8 mins (range 33-125 mins) for family members. English-speaking patients rated the burden of participating in the interview as a mean of 2.8 (Standard Deviation [SD] 1.9, 1=no burden, 10=extreme burden) and family members as 1.9 (SD 1.9). For the French pilot study, the results were similar. Conclusions: This is the first ACP questionnaire to be developed that has face and content validity. Despite a relatively lengthy interview process, the ACP audit process seems feasible and is not associated with undue burden.

Performance measures in three rounds of the English bowel cancer screening pilot

ObjectivesTo compare performance measures across all three rounds of the English bowel cancer screening faecal occult blood test pilot and their relation to social deprivation and ethnicity.MethodsIn each round in...

A pilot whole‐school intervention to improve school ethos and reduce substance use

PurposeEvidence from the USA/Australia suggests whole‐school interventions designed to increase social inclusion/engagement can reduce substance use. Completeness of implementation varies but contextual determinants have not been fully explored. Informed by previous interventions, the paper aims to examine these topics in an English pilot of the Healthy School Ethos intervention.Design/methodology/approachThis intervention, like previous interventions, balanced standardization of inputs/process (external facilitator, manual, needs‐survey and staff‐training delivered over one year to enable schools to convene action‐teams) with local flexibility regarding actions to improve social inclusion. Evaluation was via a pilot trial comprising: baseline/follow‐up surveys with year‐7 students in two intervention/comparison schools; semi‐structured interviews with staff, students and facilitators; and observations.FindingsThe intervention was delivered as intended with components implemented as in the USA/Australian studies. The external facilitator enabled schools to convene an action‐team involving staff/students. Inputs were feasible and acceptable and enabled similar actions in both schools. Locally determined actions (e.g. peer‐mediators) were generally more feasible/acceptable than pre‐set actions (e.g. modified pastoral care). Implementation was facilitated where it built on aspects of schools' baseline ethos (e.g. a focus on engaging all students, formalized student participation in decisions) and where senior staff led actions. Student awareness of the intervention was high.Originality/valueKey factors affecting feasibility were: flexibility to allow local innovation, but structure to ensure consistency; intervention aims resonating with at least some aspects of school baseline ethos; and involvement of staff with the capacity to deliver. The intervention should be refined and its health/educational outcomes evaluated.