https://bura.brunel.ac.uk/handle/2438/32859 Thu, 22 Oct 2026 23:55:26 GMT 2026-10-22T23:55:26Z https://bura.brunel.ac.uk/handle/2438/33938 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# . Fri, 07 Aug 2026 00:00:00 GMT https://bura.brunel.ac.uk/handle/2438/33938 2026-08-07T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33937 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 . Thu, 14 May 2026 00:00:00 GMT https://bura.brunel.ac.uk/handle/2438/33937 2026-05-14T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33904 Title: Border Externalisation: Pullback and Pushback Practices Authors: Kapogianni, Vicky; Mutsvara, Shepherd; Xanthopoulou, Ermioni Abstract: This policy brief builds upon the RLI Declaration on Externalisation and Asylum, and it outlines the legal implications of pushbacks and pullbacks in the context of externalisation. Pushbacks and pullbacks raise serious legal and ethical concerns and often bypass established legal and humanitarian safeguards. Key challenges include unclear jurisdiction responsibility, minimal transparency, and weak enforcement, all of which contribute to systemic and persistent violations. Urgent reforms are needed to strengthen accountability mechanisms, enhance transparency, and ensure the protection of fundamental rights–essential for aligning with legal commitments under human rights and refugee law. Description: Acknowledgements: The policy brief has been produced in collaboration with the NOVA University of Lisbon Refugee and Migration Clinic, coordinated by Veronica Corcodel with the following students contributing: Nora Marlene Neubauer and Fernanda Bittencourt Leal. Other policy briefs in the Externalisation Series: #1 - What is Externalisation (https://rli.sas.ac.uk/sites/default/files/RLI%20Policy%20Brief-%20What%20is%20Externalisation_%20%28Updated%2011.08.25%29.pdf). Tue, 04 Feb 2025 00:00:00 GMT https://bura.brunel.ac.uk/handle/2438/33904 2025-02-04T00:00:00Z https://bura.brunel.ac.uk/handle/2438/33663 Title: Can we pay it out? Civilians and the compensation of cumulative war trauma in the aftermath of the international climate change litigation Authors: Solomon, Solon Abstract: The legal appraisal of civilian mental harm amounting to trauma is something that has been discussed by international scholars when it comes to warfare and its aftermath, but no discussion has taken place on how such civilian war trauma can be compensated for. The question becomes even starker in cases of cumulative war trauma, where the trauma incurred appears as an externality of warfare and as a natural repercussion stemming from the latter. Along these lines and drawing from climate change litigation that has taken place before international courts and tribunals over the last few years, this article details how arguments derived from that litigation scheme can present prospects as well as limitations with regard to how cumulative war trauma, caused by States as well as by non-State actors, can be subject to compensation. Description: Footnotes: The advice, opinions and statements contained in this article are those of the author/s and do not necessarily reflect the views of the ICRC. The ICRC does not necessarily represent or endorse the accuracy or reliability of any advice, opinion, statement or other information provided in this article. Mon, 13 Jul 2026 00:00:00 GMT https://bura.brunel.ac.uk/handle/2438/33663 2026-07-13T00:00:00Z