BURA Community: Known as College of Business, Arts and Social Sciences until 2024/25

Codeveloping a Set of Quality of Care Indicators for People Living With Multiple Long-Term Conditions in Primary Care: Protocol for a Modified RAND/UCLA Study

2026-10-05T02:00:25Z

Title: Codeveloping a Set of Quality of Care Indicators for People Living With Multiple Long-Term Conditions in Primary Care: Protocol for a Modified RAND/UCLA Study Authors: Tavares, Sara; Beaney, Thomas; Reisberg, Arad; Henley, Ania; Edwards, Angela; Belsey, David; Downey, Laura Abstract: Background: Quality indicators in primary care remain predominantly disease-specific and professionally defined, with limited incorporation of what matters most to people living with multiple long-term conditions (MLTCs) and their caregivers. Existing frameworks and quality standards provide important conceptual direction, but few produce a pragmatic set of ready-to-use indicators. Objective: This study aims to codevelop a disease-agnostic set of quality of care indicators with people living with MLTCs, caregivers, and health care professionals, including preliminary operational specifications to support future feasibility testing and service improvement in general practices within the National Health Service in England. Methods: This protocol describes a 3-round modified RAND/UCLA Appropriateness Method (RAM) study. The first round will evaluate the importance of candidate indicators through an online questionnaire to an expert panel of patients, caregivers, and health care professionals. Indicators without agreement or requiring revision will proceed to a structured consensus meeting (round 2) with subsequent rerating rounds (round 3) for feasibility and measurability. Results: As of July 2026, 10 patient and caregiver participants and 12 health care professionals have consented to join an expert panel. The expected RAM study completion, including data analysis and reporting, is early 2027. Fifty-four candidate quality indicators have been generated through triangulation of findings between a scoping review of published quality indicators in MLTCs and a qualitative study with 21 patients and caregivers with lived experience of MLTCs. Ongoing patient and public involvement and engagement with four community partners have further informed the study design, interpretation of multistage findings, and refinement of candidate indicators. The indicators have been mapped to a structure-process-outcome quality framework and will be taken forward into a modified 3-staged RAM study. Conclusions: This study will generate a co-designed and implementation-oriented set of primary care quality indicators for MLTCs. The final indicator set is intended to support future measurement, quality improvement, and later field testing in real-world primary care systems. International Registered Report Identifier (IRRID): DERR1-10.2196/99217 JMIR Res Protoc 2026;15:e99217 Description: Data Availability: The datasets generated and/or analyzed during the current study are not publicly available due to confidentiality but are available from the corresponding author on reasonable request.; Supplementary materials are available online (above the references) at: https://www.researchprotocols.org/2026/1/e99217# .

The content and processes of patient-derived quality of care indicators for people living with multiple long-term conditions (MLTC): A scoping review

2026-10-04T02:00:25Z

Title: The content and processes of patient-derived quality of care indicators for people living with multiple long-term conditions (MLTC): A scoping review Authors: Tavares, Sara; Beaney, Thomas; Reisberg, Arad; Henley, Ania; Belsey, David; Edwards, Angela; Downey, Laura E Abstract: Background: The growing prevalence of multiple long-term conditions (MLTC) poses a public health challenge. Existing quality of care (QoC) indicators are poorly suited to the needs of MLTC populations with limited clarity on how quality should be measured. This scoping review aimed to map QoC indicators for MLTC in primary care developed with patient and caregiver input, and to characterise the methods and extent of that involvement. Methods: Scoping review following the six-stage framework by Arksey and O’Malley refined by Levac et al. Searches were conducted on six databases. Studies were included if adults with two or more chronic conditions were involved. Data were charted on indicator content (name, quality domain, data sources, measurement characteristics) and development processes (methodological approaches and stakeholders involved). Where indicators were not specified, qualitative findings were synthesised to identify QoC domains and mapped to the Donabedian model and Institute of Medicine quality domains. Community partners with lived experience of MLTC were involved. Results: Twenty-five studies were included, 78 QoC indicators were identified and a further 33 quality domains were synthesised through thematic analysis. Quality was predominately measured through patient-experience surveys rather than indicators. Studies articulated quality through care processes such as care coordination, shared decision-making and holistic assessments. Outcomes focused on functional capacity, social participation and quality of life. Conclusion: Despite robust evidence on what matters to people living with MLTC, few patient-derived QoC indicators have been developed into measurable indicators. Further work is needed to co-produce indicators suitable to existing primary care settings. Description: Data availability statement: All relevant data are within the paper and its supporting Information files.; Supplementary Material is available at: https://journals.sagepub.com/doi/10.1177/26335565261451686#supplementary-materials .

A Sociological Approach to the Rights and Dignity of Nature: Towards a Shared Rights Framework

2026-10-04T02:00:30Z

Title: A Sociological Approach to the Rights and Dignity of Nature: Towards a Shared Rights Framework Authors: Malik, Sarita; Peck, Mika Abstract: This article offers a sociological analysis of the global Rights of Nature movement, positioning dignity, repair, and socio-ecological justice at its heart. While Rights of Nature has gained traction across environmental law, Indigenous politics, and ecological science, Sociology has largely overlooked its implications, despite the deeply social origins and unequal consequences of ecological harm. To address this, the article integrates Cultural Sociology with decolonial scholarship and Indigenous relational philosophies, situating Lauren Berlant’s concepts of slow death and cruel optimism alongside the Andean philosophy of Buen Vivir . It reframes ecological degradation as an ongoing violation of dignity affecting both human communities and ecosystems. Recognising nature as a rights-bearing subject challenges foundational assumptions about the human-nature binary in rights discourse, presenting an opportunity to broaden sociological research, society–environment knowledge, and socio-political activism. The article makes three core contributions: first, it establishes the Rights of Nature as a necessary object of sociological analysis, showing that existing anthropocentric frameworks are insufficient for understanding contemporary ecological crisis; second, it demonstrates that sociological concepts, particularly those concerning representation, inequality, coloniality, and governance, provide essential tools for analysing and strengthening Rights of Nature frameworks; and third, it develops an original socio-(eco)logical rights framework grounded in dignity and reparations, including a socio-ecological forensics toolkit that enables the diagnosis of harm and the articulation of reparative pathways across human and more-than-human worlds. Together, these contributions reposition Sociology as central to understanding and advancing socio-ecological justice in the context of the global ecological crisis. Description: Data availability statement: This study did not generate or analyse any datasets, as it is based entirely on conceptual and theoretical reasoning.

‘The Best-regarded Virgins of Our Clime’: Unseen Black Women, Race, and the Construction of White Femininity in The Merchant of Venice

2026-10-04T02:00:29Z

Title: ‘The Best-regarded Virgins of Our Clime’: Unseen Black Women, Race, and the Construction of White Femininity in The Merchant of Venice Authors: Sheeha, Iman Abstract: Using the tools of premodern critical race studies and whiteness studies, this article brings to critical visibility the Black women Shakespeare's Merchant of Venice evokes in passing, only to leave them on the margins of the text. Unseen and unheard, those women's alleged preferences in romantic partners are reported second-hand by the Prince of Morocco. It has become something of a critical and theatrical tradition to interpret this moment as revealing his alleged lustfulness, thus indulging in a sensational (and Orientalist) reading of him and them. I challenge this reading, proposing, instead, that the Prince's evocation of his countrywomen should be inserted within the play's (and early modern England's) larger investment in the construction of white femininity and the attendant fashioning of an emerging national white identity. The Moroccan virgins, I argue, are one strategy the Prince adopts to signal his proximity to patriarchal whiteness by announcing to his audience both on- and offstage his subscription to the gendered, white values which elevate white women at the expense of Black women. A white man's fantasy of a Black man, the Prince of Morocco deploys Black women as a tool to elevate white femininity and to announce his assimilability into Portia's white world.