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Lloyd-Evans B, Fullarton K, Lamb D, Johnston E, Onyett S, Osborn D, Ambler G, Marston L, Hunter R, Mason O, Henderson C, Goater N, Sullivan SA, Kelly K, Gray R, Nolan F, Pilling S, Bond G, Johnson S. The CORE Service Improvement Programme for mental health crisis resolution teams: study protocol for a cluster-randomised controlled trial. Trials 2016; 17:158. [PMID: 27004517 PMCID: PMC4804533 DOI: 10.1186/s13063-016-1283-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As an alternative to hospital admission, crisis resolution teams (CRTs) provide intensive home treatment to people experiencing mental health crises. Trial evidence supports the effectiveness of the CRT model, but research suggests that the anticipated reductions in inpatient admissions and increased user satisfaction with acute care have been less than hoped for following the scaling up of CRTs nationally in England, as mandated by the National Health Service (NHS) Plan in 2000. The organisation and service delivery of the CRTs vary substantially. This may reflect the lack of a fully specified CRT model and the resources to enhance team model fidelity and to improve service quality. We will evaluate the impact of a CRT service improvement programme over a 1-year period on the service users' experiences of care, service use, staff well-being, and team model fidelity. METHODS/DESIGN Twenty-five CRTs from eight NHS Trusts across England will be recruited to this cluster-randomised trial: 15 CRTs will be randomised to receive the service improvement programme over a 1-year period, and ten CRTs will not receive the programme. Data will be collected from 15 service users and all clinical staff from each participating CRT at baseline and at the end of the intervention. Service use data will be collected from the services' electronic records systems for two 6-month periods: the period preceding and the period during months 7-12 of the intervention. The study's primary outcome is service user satisfaction with CRT care, measured using a client satisfaction questionnaire. Secondary outcomes include the following: perceived continuity of care, hospital admission rates and bed use, rates of readmission to acute care following CRT support, staff morale, job satisfaction, and general health. The adherence of the services to a model of best practice will be assessed at baseline and follow-up. Outcomes will be compared between the intervention and control teams, adjusting for baseline differences and participant characteristics using linear random effects modelling. Qualitative investigations with participating CRT managers and staff and programme facilitators will explore the experiences of the service improvement programme. DISCUSSION Our trial will show whether a theoretically underpinned and clearly defined package of resources are effective in supporting service improvement and improving outcomes for mental health crisis resolution teams. TRIAL REGISTRATION Current Controlled Trials ISRCTN47185233.
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Lamb D, Berthnal EM. Editorial. J ROY ARMY MED CORPS 2015; 161 Suppl 1:i1. [PMID: 26621805 DOI: 10.1136/jramc-2015-000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lamb D, Cogan N. Coping with work-related stressors and building resilience in mental health workers: A comparative focus group study using interpretative phenomenological analysis. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2015. [DOI: 10.1111/joop.12136] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Ridgeway A, Gomez L, Ramasamy R, Lipshultz L, Lamb D. Infertile men with non-obstructive azoospermia exhibit defects in the DNA mismatch repair pathway. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bernthal EMM, Lamb D. From the Trenches to Trenchard lines: a comparison of military nursing in 1914 to 2014. J ROY ARMY MED CORPS 2014; 160 Suppl 1:i59-62. [PMID: 24845907 DOI: 10.1136/jramc-2014-000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Piper N, Lamb D. The patient experience: measuring the quality of care in the Defence Medical Services. J ROY ARMY MED CORPS 2014; 160:155-60. [PMID: 24413476 DOI: 10.1136/jramc-2013-000221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Healthcare provided by the Defence Medical Services (DMS) is acknowledged to be of a high standard but patients' experiences of it has not been measured and collated in a consistent and meaningful way, which has limited strategic quality improvement initiatives. Responsibility for implementing and delivering a programme of healthcare governance and assurance for the DMS rests with the Inspector General (IG). An important aspect of this role is to nurture a culture of continuous improvement in the DMS and under this leadership the IG team has prioritised a number of projects to address this. The project to improve patient experience data capture was prioritised in the work schedule as it incorporated initiatives that would lead to improved quality in DMS healthcare, information exploitation and ultimately patient safety. This is the first in a series of articles that will document this important work and describe the methodological considerations associated with the initial questionnaire design, collaboration with NHS partners, the pilot study and progress towards the introduction of the definitive DMS tool later this year.
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Lamb D, Lobo R. Session 25: ASRM exchange session - Genetic and metabolic consequences for fertility in men and women. Hum Reprod 2013. [DOI: 10.1093/humrep/det153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Akli KU, Orban C, Schumacher D, Storm M, Fatenejad M, Lamb D, Freeman RR. Coupling of high-intensity laser light to fast electrons in cone-guided fast ignition. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2012; 86:065402. [PMID: 23367996 DOI: 10.1103/physreve.86.065402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Indexed: 06/01/2023]
Abstract
Cu wires attached to Al cones are used to investigate the energy coupling efficiency of laser light to fast electrons through a cone into a dense plasma. We present experimental and simulation results demonstrating the effect on the energy coupling of effectively placing the cone in a surrounding high density plasma as well as the effect of a large preformed plasma inside the cone. Thick cone walls, simulating plasma surrounding the cone in fast ignition, reduce the energy coupling by a factor of up to 4. An increase in prepulse inside the cone by a factor of 50 further reduces coupling by a factor of 3. Simulations with the pic code lsp that include the laser plasma interaction and the preformed plasma from the flash code show that electron refluxing in thin cone-wall targets enhances coupling to the wire. The implications for full-scale cone-guided fast ignition are discussed.
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Ebert M, Haworth A, Kearvell R, Hooton B, Baker-James S, Spry N, Joseph D, Bydder S, Lamb D, Duchesne G, Murray J, Denham J. 1143 poster OBTAINING A HIGH QUALITY DATASET FOR DOSE/OUTCOMES ANALYSIS – THE AUSTRALASIAN RADAR PROSTATE RADIOTHERAPY TRIAL. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71265-8] [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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Denham J, Steigler A, Lamb D, Joseph D, Turner S, Matthews J, Atkinson C, North J, Christie D, Spry N, Keen-Hun T, Wynne C, D'Este C. 496 oral IMPORTANT MORTALITY REDUCTIONS BY SHORT TERM ANDROGEN DEPRIVATION AND RADIOTHERAPY FOR LOCALLY ADVANCED PROSTATE CANCER: 10 YEAR TRIAL DATA FROM TROG 96.01. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70618-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van der Griend R, Lamb D, Challis D, Chinnock M, Blomfield P. A mucinous mimic: identification of a distracting artefact. Cytopathology 2010; 22:133-4. [PMID: 20860733 DOI: 10.1111/j.1365-2303.2010.00809.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cantlay AM, Lamb D, Gillooly M, Norrman J, Morrison D, Smith CA, Harrison DJ. Association between the CYP1A1 gene polymorphism and susceptibility to emphysema and lung cancer. Mol Pathol 2010; 48:M210-4. [PMID: 16696009 PMCID: PMC407965 DOI: 10.1136/mp.48.4.m210] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim-To investigate cytochrome P4501A1 (CYP1A1) polymorphism and susceptibility to emphysema and lung cancer.Methods-A novel polymerase chain reaction (PCR) for genotyping the CYP1A1 polymorphism, corresponding to putative low or high enzyme activity, was developed to genotype lung cancer resection samples which had been assessed macroscopically for the presence of centriacinar and panacinar emphysema. Samples were collected and genotyped from a group of patients with chronic obstructive airways disease. A control group of anonymous blood donations was genotyped to determine the basal levels of the polymorphism in the Scottish population.Results-The high activity allele of the CYP1A1 gene is associated with susceptibility to centriacinar emphysema and lung cancer but not panacinar emphysema. CYP1A1 polymorphism is not linked to lung cancer in the absence of emphysema, nor to chronic obstructive airways disease which is the clinical manifestation of emphysema, particularly of the panacinar type.Conclusions-Susceptibility to emphysema and lung cancer is associated with polymorphism of the P4501A1 gene. A trend towards damage of centriacinar pattern has been detected, which supports the theory that centriacinar emphysema results from local, direct damage to the respiratory bronchioles from exposure to cigarette smoke.
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Flenley D, MacNee W, Gould G, Redpath A, Best J, McLean A, Lamb D. Quantitative Computerised Tomography Scan Can Diagnose, Quantitate and Locate Pulmonary Emphysema Non-Invasively in Humans. Respiration 2009. [DOI: 10.1159/000195081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Arnèodo A, Benzi R, Berg J, Biferale L, Bodenschatz E, Busse A, Calzavarini E, Castaing B, Cencini M, Chevillard L, Fisher RT, Grauer R, Homann H, Lamb D, Lanotte AS, Lévèque E, Lüthi B, Mann J, Mordant N, Müller WC, Ott S, Ouellette NT, Pinton JF, Pope SB, Roux SG, Toschi F, Xu H, Yeung PK. Universal intermittent properties of particle trajectories in highly turbulent flows. PHYSICAL REVIEW LETTERS 2008; 100:254504. [PMID: 18643666 DOI: 10.1103/physrevlett.100.254504] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Indexed: 05/26/2023]
Abstract
We present a collection of eight data sets from state-of-the-art experiments and numerical simulations on turbulent velocity statistics along particle trajectories obtained in different flows with Reynolds numbers in the range R{lambda}in[120:740]. Lagrangian structure functions from all data sets are found to collapse onto each other on a wide range of time lags, pointing towards the existence of a universal behavior, within present statistical convergence, and calling for a unified theoretical description. Parisi-Frisch multifractal theory, suitably extended to the dissipative scales and to the Lagrangian domain, is found to capture the intermittency of velocity statistics over the whole three decades of temporal scales investigated here.
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Lamb D. Restoring Natural Capital: Science, Business, and Practice James Aronson, Suzanne J. Milton and James N. Blignaut, editors. 2007. Washington, DC: Island Press. Cloth, $90.00. ISBN: 978-1-59726-076-3. Paper, $45.00. IS BN: 978-1-59726-077-0. 384 pages. ECOL RESTOR 2008. [DOI: 10.3368/er.26.2.161] [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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Denham J, Joseph D, Lamb D, Tai K, Turner S, Matthews J, Greer P, Bill D, Gleeson P, Steigler A. 4003 ORAL Reasons for initial PSA (iPSA) and biochemical failure (BF) being poor predictors of prostate cancer (PC) mortality. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71071-6] [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] Open
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Lamb D, Sundararajan L, Ledson M, Walshaw M. 326 Referrals to a new adult CF psychology service. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60299-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carey FA, Fabbroni G, Lamb D. Expression of proliferating cell nuclear antigen in lung cancer: a systematic study and correlation with DNA ploidy. Histopathology 2007; 20:499-503. [PMID: 1351473 DOI: 10.1111/j.1365-2559.1992.tb01034.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Heterogeneity of expression of the proliferating cell nuclear antigen (PCNA) was assessed immunohistochemically in 156 tissue samples from 33 surgically resected pulmonary carcinomas using the monoclonal antibody 19A2. The DNA content of each of these samples was measured by flow cytometry. Mean PCNA expression was higher in squamous carcinomas than in adenocarcinomas but there was marked intra-tumour variation in PCNA index in almost all cases. Intra-tumour heterogeneity of DNA content was noted in 11 cases. The PCNA index of these cases (34.1) was higher than that of DNA homogeneous cases (19.4). The wide variation in PCNA expression between different samples within a tumour would indicate that systematic sampling and counting will be necessary in future immunohistochemical studies of cell proliferation in tumour material.
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Lamb D, Denham J, Joseph D, Tai K, Turner S, Matthews J, Woodhead D, Kumar M, Greer P, Steigler A. 2226. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.632] [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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Kshirsagar A, Murthy L, Chelu L, Lamb D, Ross L, Niederberger C. Predicting Outcomes for Intracytoplasmic Sperm Injection. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kademani D, Lewis J, Lamb D, Keller E, Koka S, Harmsen S. Loco-regional predictors for failure of early stage (T1&T2) nomo intraoral squamous cell carcinoma. Int J Oral Maxillofac Surg 2005. [DOI: 10.1016/s0901-5027(05)81228-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghayour-Mobarhan M, Lamb D, Livingstone C, Ferns G. M.522 Antibody titres to heat shock protein 60, 65 and 70 are elevated in dyslipidaemic patients with established CHD. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90520-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Scott WD, Lamb D. Two solid compounds which decompose into a common vapor. Anhydrous reactions of ammonia and sulfur dioxide. J Am Chem Soc 2002. [DOI: 10.1021/ja00716a019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Read TR, Bellairs SM, Mulligan DR, Lamb D. Smoke and heat effects on soil seed bank germination for the re-establishment of a native forest community in New South Wales. AUSTRAL ECOL 2001. [DOI: 10.1046/j.1442-9993.2000.01031.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alexander R, Lamb D, White D, Wentzel T, Politis S, Rijnsburger J, van Ruyven D, Kelly N, Garland SM. 'RETCIF': a rapid, sensitive method for detection of viruses, applicable for large numbers of clinical samples. J Virol Methods 2001; 97:77-85. [PMID: 11483219 DOI: 10.1016/s0166-0934(01)00344-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rapid detection of viruses in clinical samples is important for continuing appropriate antiviral treatment and discontinuing unnecessary antibacterial treatment, as well as for excluding viral pathogens. Yet detection of viral agents may require numerous susceptible cell lines. Even with the shell vial culture method, it is cumbersome for handling large volumes of specimens. A procedure has been developed, which is time and cost-saving and uses specific cell lines in a 96-well microtitre plate and monoclonal antibodies (RETCIF-rapid enhanced tissue culture immunofluorescence). Each clinical sample was inoculated into 12 different wells with five different cell lines. Enhancement was achieved by sonication, centrifugation and hormonal supplementation to the medium used. Cytomegalovirus (CMV), herpes simplex virus (HSV) and respiratory viruses were detected by monoclonal antibodies on day 2, whilst varicella zoster virus (VZV) and enteroviruses were detected on days 5 and 7, respectively. During July-December 1998, 3298 patient specimens were compared by RETCIF and a modified shell vial method. Either or both methods isolated 779 viruses (24% positivity rate), whilst both methods detected 621. Of the 779 viruses, 87% (679) were isolated by the shell vial method in an average time of 4.9 days. For RETCIF the respective rate was 92.5% (721), in an average time of 3.0 days. The RETCIF method is a time-saving procedure, with higher isolation rates than the shell vial method.
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