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Chow P, Thomas D, Agazaryan N, Cao M, Low D, Yang Y, Lamb J. SU-F-J-125: Effects of Couch Position Variability On Dosimetric Accuracy with An MRI-Guided Co-60 Radiation Therapy Machine. Med Phys 2016. [DOI: 10.1118/1.4956033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dowrick C, Bower P, Chew-Graham C, Lovell K, Edwards S, Lamb J, Bristow K, Gabbay M, Burroughs H, Beatty S, Waheed W, Hann M, Gask L. Evaluating a complex model designed to increase access to high quality primary mental health care for under-served groups: a multi-method study. BMC Health Serv Res 2016; 16:58. [PMID: 26883118 PMCID: PMC4756439 DOI: 10.1186/s12913-016-1298-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 02/09/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Many people with mental distress are disadvantaged because care is not available or does not address their needs. In order to increase access to high quality primary mental health care for under-served groups, we created a model of care with three discrete elements: community engagement, primary care training and tailored wellbeing interventions. We have previously demonstrated the individual impact of each element of the model. Here we assess the effectiveness of the combined model in increasing access to and improving the quality of primary mental health care. We test the assumptions that access to the wellbeing interventions is increased by the presence of community engagement and primary care training; and that quality of primary mental health care is increased by the presence of community engagement and the wellbeing interventions. METHODS We implemented the model in four under-served localities in North-West England, focusing on older people and minority ethnic populations. Using a quasi-experimental design with no-intervention comparators, we gathered a combination of quantitative and qualitative information. Quantitative information, including referral and recruitment rates for the wellbeing interventions, and practice referrals to mental health services, was analysed descriptively. Qualitative information derived from interview and focus group responses to topic guides from more than 110 participants. Framework analysis was used to generate findings from the qualitative data. RESULTS Access to the wellbeing interventions was associated with the presence of the community engagement and the primary care training elements. Referrals to the wellbeing interventions were associated with community engagement, while recruitment was associated with primary care training. Qualitative data suggested that the mechanisms underlying these associations were increased awareness and sense of agency. The quality of primary mental health care was enhanced by information gained from our community mapping activities, and by the offer of access to the wellbeing interventions. There were variable benefits from health practitioner participation in community consultative groups. We also found that participation in the wellbeing interventions led to increased community engagement. CONCLUSIONS We explored the interactions between elements of a multilevel intervention and identified important associations and underlying mechanisms. Further research is needed to test the generalisability of the model. TRIAL REGISTRATION Current Controlled Trials, reference ISRCTN68572159 . Registered 25 February 2013.
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Robinson JI, Taylor JC, Foy E, Vyse T, Cooper R, Chinoy H, Lamb J, Barton A, Martin J, Sawalha AH, Wilson AG, Barrett JH, Morgan AW. A6.17 FCGR2Aassociation with susceptibility to autoimmune and inflammatory diseases. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunningham RK, Lamb J. A Cocoa Shade and Manurial Experiment at the West African Cocoa Research Institute, Ghana I. First Year. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/00221589.1959.11513939] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lamb J, Agazaryan N, Cao M, Low D, Thomas D, Yang Y. SU-E-J-198: Out-Of-Field Dose and Surface Dose Measurements of MRI-Guided Cobalt-60 Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4924284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Thomas D, O'Connell D, Lamb J, Cao M, Yang Y, Agazaryan N, Lee P, Low D. SU-F-303-17: Real Time Dose Calculation of MRI Guided Co-60 Radiotherapy Treatments On Free Breathing Patients, Using a Motion Model and Fast Monte Carlo Dose Calculation. Med Phys 2015. [DOI: 10.1118/1.4925244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lamb J, Kamrava M, Agazaryan N, Cao M, Low D, Thomas D, Yang Y. SU-E-J-206: Adaptive Radiotherapy for Gynecological Malignancies with MRIGuided Cobolt-60 Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4924292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yang Y, Low D, Cao M, Sheng K, Lamb J, Thomas D, Kamrava M, Hu P. TH-CD-204-06: Diffusion MRI for Treatment Response Assessment of MRI-Guided Tri-Cobalt 60 Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4926253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jani S, Low D, Lamb J. SU-E-T-261: Development of An Automated System to Detect Patient Identification and Positioning Errors Prior to Radiotherapy Treatment. Med Phys 2015. [DOI: 10.1118/1.4924623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lamb J. MO-FG-210-03: Intraoperative Ultrasonography-Guided Positioning of Plaque Brachytherapy in the Treatment of Choroidal Melanoma. Med Phys 2015. [DOI: 10.1118/1.4925441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dou T, Thomas D, O'Connell D, Lamb J, Low D. TH-CD-303-04: A Method for Assessing Ground-Truth Accuracy of a Motion Model Based 4DCT Technique. Med Phys 2015. [DOI: 10.1118/1.4926239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Varghese M, Lamb J, Rambani R, Venkateswaran B. The use of shoulder scoring systems and outcome measures in the UK. Ann R Coll Surg Engl 2015; 96:590-2. [PMID: 25350180 DOI: 10.1308/003588414x14055925058157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In future, outcomes following shoulder surgery may be subject to public survey. Many outcome measures exist but we do not know whether there is a consensus between shoulder surgeons in the UK. The aim of this study was to survey the preferred outcome measures used by National Health Service (NHS) shoulder surgeons operating in the UK. METHODS A total of 350 shoulder surgeons working in NHS hospitals were asked to complete a short written questionnaire regarding their use of scoring systems and outcome measures. Questionnaires were sent and responses were received by post. RESULTS Overall, 217 responses were received (62%). Of the respondents, 171 (79%) use an outcome measure in their shoulder practice while 46 (21%) do not. There were 118 surgeons (69%) who use more than one outcome measure. The Oxford shoulder score was most commonly used by 150 surgeons (69%), followed by the Constant score with 106 (49%), the Oxford shoulder instability score with 82 (38%), and the Disabilities of the Arm, Shoulder and Hand score with 54 (25%). The less commonly used outcome measures were the SF-36® and SF-12® health questionnaires with 19 (9%), the University of California at Los Angeles activity score with 8 (4%), the American Shoulder and Elbow Surgeons shoulder assessment form with 8 (4%) and the EQ-5D™ with 10 (3%). Conclusions Validated outcome measures should be adopted by all practising surgeons in all specialties. This will allow better assessment of treatments in addition to assessment of surgical performance in a transparent way.
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Lamb J, Dowrick C, Burroughs H, Beatty S, Edwards S, Bristow K, Clarke P, Hammond J, Waheed W, Gabbay M, Gask L. Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups. Health Expect 2014; 18:2865-79. [PMID: 25263536 DOI: 10.1111/hex.12272] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Despite the availability of effective evidence-based treatments for depression and anxiety, many 'harder-to-reach' social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement. OBJECTIVES To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model. DESIGN Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered. SETTING & PARTICIPANTS A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom. KEY FINDINGS Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to 'do it now', allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement. CONCLUSIONS CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology.
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Kishan A, King C, Jani S, Steinberg M, Lamb J. Pelvic Nodal Dosing With Registration to the Prostate: Implications for High-Risk Prostate Cancer Patients Receiving SBRT. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gyurdzhyan S, Lamb J, Kaprealian T, Selch M, Cao M, Tenn S, Agazaryan N. Dosimetric Impact of Positioning Errors for Spinal Radiosurgery Patients: A Planning Tool Proposition. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lovell K, Lamb J, Gask L, Bower P, Waheed W, Chew-Graham C, Lamb J, Aseem S, Beatty S, Burroughs H, Clarke P, Dowrick A, Edwards S, Gabbay M, Lloyd-Williams M, Dowrick C. Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care. BMC Psychiatry 2014; 14:217. [PMID: 25085447 PMCID: PMC4149271 DOI: 10.1186/s12888-014-0217-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 07/18/2014] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Psychological therapy is effective for symptoms of mental distress, but many groups with high levels of mental distress face significant barriers in terms of access to care, as current interventions may not be sensitive to their needs or their understanding of mental health. There is a need to develop forms of psychological therapy that are acceptable to these groups, feasible to deliver in routine settings, and clinically and cost effective. METHODS We developed a culturally sensitive wellbeing intervention with individual, group and sign-posting elements, and tested its feasibility and acceptability for patients from ethnic minorities and older people in an exploratory randomised trial. RESULTS We recruited 57 patients (57% of our target) from 4 disadvantaged localities in the NW of England. The results of the exploratory trial suggest that the group receiving the wellbeing interventions improved compared to the group receiving usual care. For elders, the largest effects were on CORE-OM and PHQ-9. For ethnic minority patients, the largest effect was on PHQ-9. Qualitative data suggested that patients found the intervention acceptable, both in terms of content and delivery. CONCLUSIONS This exploratory trial provides some evidence of the efficacy and acceptability of a wellbeing intervention for older and ethnic minority groups experiencing anxiety and depression, although challenges in recruitment and engagement remain. Evidence from our exploratory study of wellbeing interventions should inform new substantive trial designs. TRIAL REGISTRATION Current controlled trials ISRCTN68572159.
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Lamb J, Valdes G, Lee C, Tee S, Lee P, Robinson C, Iwamoto K, Low D. TU-F-17A-08: The Relative Accuracy of 4D Dose Accumulation for Lung Radiotherapy Using Rigid Dose Projection Versus Dose Recalculation On Every Breathing Phase. Med Phys 2014. [DOI: 10.1118/1.4889335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Thomas D, Tan J, Neylon J, Dou T, Jani S, Lamb J, Low D. TH-C-18A-11: Investigating the Minimum Scan Parameters Required to Generate Free-Breathing Fast-Helical CT Scans Without Motion-Artifacts. Med Phys 2014. [DOI: 10.1118/1.4889635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dou T, Thomas D, Lamb J, Low D. SU-D-17A-05: A Method to Determine the Accuracy of a Proposed Breathing Motion Model-Based 4DCT Technique. Med Phys 2014. [DOI: 10.1118/1.4887898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jani M, Massey J, Wedderburn L, Vencovský J, Danko K, Lundberg I, Selva-O'Callaghan A, Radstake T, Platt H, Warren R, Griffiths C, Padyukov L, Lee A, Gregersen P, Ollier W, Cooper R, Chinoy H, Lamb J. OP0235 Genetic Risk Factors in Idiopathic Inflammatory Myopathies Are Shared with Other Autoimmune Disorders in European Populations. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dou T, Thomas D, Lamb J, Low D. SU-E-J-25: Analysis of Commercial 4DCT Flaws and the Potential Benefits of a New Technique for Irregular Breathing Patients. Med Phys 2014. [DOI: 10.1118/1.4888076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cao M, Tenn S, Lee C, Yang Y, Lamb J, Agazaryan N, Lee P, Low D. SU-E-T-481: Dosimetric Comparison of Acuros XB and Anisotropic Analytic Algorithm with Commercial Monte Carlo Based Dose Calculation Algorithm for Stereotactic Body Radiation Therapy of Lung Cancer. Med Phys 2014. [DOI: 10.1118/1.4888814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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O' Connell D, Chow P, Agazaryan N, Jani S, Low D, Lamb J. SU-F-BRD-11: Prediction of Dosimetric Endpoints From Patient Geometry Using Neural Nets. Med Phys 2014. [DOI: 10.1118/1.4889065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Agazaryan N, Gyurdzhyan S, Lamb J, Chow P, Tenn S, Cao M, Lee C, Kaprealian T, Selch M, Low D. SU-E-J-242: Post-Treatment Planning Tool for Estimating Dose Distribution Delivered to Spinal Radiosurgery Patients Based On Measured Intra-Fraction Positional Data. Med Phys 2014. [DOI: 10.1118/1.4888295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jani S, O' Connell D, Chow P, Agazaryan N, Low D, Lamb J. SU-C-BRD-04: Automatic Detection of Patient Identification and Patient Positioning Errors Using 3D Setup Images. Med Phys 2014. [DOI: 10.1118/1.4889717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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