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Howie C, Shevlin M, Shannon C, Davidson G, Bunting L, Grant A, McBride O, McCartan C, Murphy J, Nolan E, Schubotz D, Mulholland C. The structure of the Prodromal Questionnaire-16 (PQ-16) in a non-help-seeking youth population: Exploratory and confirmatory factor analyses study. Schizophr Res 2023; 261:281-286. [PMID: 37871410 DOI: 10.1016/j.schres.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/25/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
AIMS The present study aimed to examine the structure of the Prodromal Questionnaire-16 (PQ-16) in a non-help-seeking youth population through exploratory and confirmatory factor analysis. Previous studies have not examined the structure of this self-report measure in this age group outside a clinical setting. METHODS Participants (n = 1165) aged 11-19 years were recruited to an epidemiological study of young people in Northern Ireland, and completed the PQ-16 alongside other measures. The dataset was split randomly in two for separate factor analyses. A polychoric correlation matrix was created and exploratory factor analysis was used to identify the optimal number of factors. In addition, based on previous studies, six models were tested through confirmatory factor analysis to determine best fit. A one-factor, 3 two-factor, a three-factor and a four-factor model were all tested. RESULTS The exploratory factor analysis indicated a two-factor structure of the PQ-16 in this population, which we have labelled 'general unusual experiences' and 'hallucinations'. Confirmatory analysis indicated that the two-factor model identified through the exploratory analysis was the best fit for the data. DISCUSSION The present study suggests that the structure of the PQ-16 may vary across age groups in non-clinical settings, and adds further support to the validity of the PQ-16 is a cost-effective, easy to administer self-report measure that is suitable for use in non-help-seeking populations as a screening tool for prodromal symptoms.
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Affiliation(s)
- Clare Howie
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland.
| | - Mark Shevlin
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Ciarán Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Gavin Davidson
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Bunting
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Anne Grant
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Orla McBride
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Claire McCartan
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland; Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Jamie Murphy
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Emma Nolan
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Dirk Schubotz
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Ciaran Mulholland
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland; Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
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Karageorgou M, Hughes DM, Myint AS, Pritchard DM, Bonnett LJ. Clinical prediction models assessing response to radiotherapy for rectal cancer: protocol for a systematic review. Diagn Progn Res 2022; 6:19. [PMID: 36199114 PMCID: PMC9535989 DOI: 10.1186/s41512-022-00132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Rectal cancer has a high prevalence. The standard of care for management of localised disease involves major surgery and/or chemoradiotherapy, but these modalities are sometimes associated with mortality and morbidity. The notion of 'watch and wait' has therefore emerged and offers an organ-sparing approach to patients after administering a less invasive initial treatment, such as X-ray brachytherapy (Papillon technique). It is thus important to evaluate how likely patients are to respond to such therapies, to develop patient-tailored treatment pathways. We propose a systematic review to identify published clinical prediction models of the response of rectal cancer to treatment that includes radiotherapy and here present our protocol. METHODS Included studies will develop multivariable clinical prediction models which assess response to treatment and overall survival of adult patients who have been diagnosed with any stage of rectal cancer and have received radiotherapy treatment with curative intent. Cohort studies and randomised controlled trials will be included. The primary outcome will be the occurrence of salvage surgery at 1 year after treatment. Secondary outcomes include salavage surgery at at any reported time point, the predictive accuracy of models, the quality of the developed models and the feasibility of using the model in clinical practice. Ovid MEDLINE, PubMed, Cochrane Library, EMBASE and CINAHL will be searched from inception to 24 February 2022. Keywords and phrases related to rectal cancer, radiotherapy and prediction models will be used. Studies will be selected once the deduplication, title, abstract and full-text screening process have been completed by two independent reviewers. The PRISMA-P checklist will be followed. A third reviewer will resolve any disagreement. The data extraction form will be pilot-tested using a representative 5% sample of the studies reviewed. The CHARMS checklist will be implemented. Risk of bias in each study will be assessed using the PROBAST tool. A narrative synthesis will be performed and if sufficient data are identified, meta-analysis will be undertaken as described in Debray et al. DISCUSSION: This systematic review will identify factors that predict response to the treatment protocol. Any gaps for potential development of new clinical prediction models will be highlighted. TRIAL REGISTRATION CRD42022277704.
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Affiliation(s)
- Margarita Karageorgou
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - David M Hughes
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GF, UK
| | - Arthur Sun Myint
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Papillon Suite, Clatterbridge Cancer Centre, Liverpool, UK
| | - D Mark Pritchard
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Laura J Bonnett
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, Brownlow Street, Liverpool, L69 3GF, UK.
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Ma WF, Yeh TP, Ho YF, Chang SM, Lin YP. The exploration of a screen model for detecting undergraduates at higher risk for developing psychosis: A cross-sectional study in a medical university. Perspect Psychiatr Care 2022; 58:1372-1380. [PMID: 34462933 DOI: 10.1111/ppc.12939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 07/28/2021] [Accepted: 08/18/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine a screen model for detecting undergraduates with higher risk for developing psychosis (HRDP). DESIGN AND METHODS A cross-sectional design with convenience sampling was used. The screen model included exploration stage by self-report scales and confirmation stage by face-to-face interviews. FINDINGS A total of 273 students were detected from 4744 surveys during 4 years. Of them, 120 students with HRDP were identified and 7 had been diagnosed as schizophrenia or bipolar disorders at 12-month follow-up. PRACTICE IMPLICATIONS This screen model can be used in early detection for undergraduates with HRDP from large general samples.
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Affiliation(s)
- Wei-Fen Ma
- College of Health Care, School of Nursing, China Medical University, Taichung, Taiwan.,College of Health Care, Ph.D Program for Health Science and Industry, China Medical University, Taichung, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, Taichung, Taiwan
| | - Tzu-Pei Yeh
- College of Health Care, School of Nursing, China Medical University, Taichung, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, Taichung, Taiwan
| | - Ya-Fang Ho
- College of Health Care, School of Nursing, China Medical University, Taichung, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, Taichung, Taiwan
| | - Shan-Mei Chang
- College of Health Care, School of Nursing, China Medical University, Taichung, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, Taichung, Taiwan
| | - Yun-Ping Lin
- College of Health Care, School of Nursing, China Medical University, Taichung, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, Taichung, Taiwan
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Shields GE, Buck D, Varese F, Yung AR, Thompson A, Husain N, Broome MR, Upthegrove R, Byrne R, Davies LM. A review of economic evaluations of health care for people at risk of psychosis and for first-episode psychosis. BMC Psychiatry 2022; 22:126. [PMID: 35177010 PMCID: PMC8851734 DOI: 10.1186/s12888-022-03769-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Preventing psychotic disorders and effective treatment in first-episode psychosis are key priorities for the National Institute for Health and Care Excellence. This review assessed the evidence base for the cost-effectiveness of health and social care interventions for people at risk of psychosis and for first-episode psychosis. METHODS Electronic searches were conducted using the PsycINFO, MEDLINE and Embase databases to identify relevant published full economic evaluations published before August 2020. Full-text English-language studies reporting a full economic evaluation of a health or social care intervention aiming to reduce or prevent symptoms in people at risk of psychosis or experiencing first-episode psychosis were included. Screening, data extraction, and critical appraisal were performed using pre-specified criteria and forms based on the NHS Economic Evaluation Database (EED) handbook and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist for economic evaluations. The protocol was registered on the PROSPERO database (CRD42018108226). Results were summarised qualitatively. RESULTS Searching identified 1,628 citations (1,326 following the removal of duplications). After two stages of screening 14 studies met the inclusion criteria and were included in the review. Interventions were varied and included multidisciplinary care, antipsychotic medication, psychological therapy, and assertive outreach. Evidence was limited in the at-risk group with only four identified studies, though all interventions were found to be cost-effective with a high probability (> 80%). A more substantial evidence base was identified for first-episode psychosis (11 studies), with a focus on early intervention (7/11 studies) which again had positive conclusions though with greater uncertainty. CONCLUSIONS Study findings generally concluded interventions were cost-effective. The evidence for the population who are at-risk of psychosis was limited, and though there were more studies for the population with first-episode psychosis, limitations of the evidence base (including generalisability and heterogeneity across the methods used) affect the certainty of conclusions.
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Affiliation(s)
- Gemma E. Shields
- grid.5379.80000000121662407Manchester Centre for Health Economics, Division of Population Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Deborah Buck
- grid.5379.80000000121662407Manchester Centre for Health Economics, Division of Population Health, School of Health Sciences, University of Manchester, Manchester, UK ,grid.83440.3b0000000121901201Institute of Education, University College London, London, UK
| | - Filippo Varese
- grid.5379.80000000121662407Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK ,grid.507603.70000 0004 0430 6955Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Alison R. Yung
- grid.5379.80000000121662407Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK ,grid.507603.70000 0004 0430 6955Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, University of Melbourne, Melbourne, Australia ,grid.1021.20000 0001 0526 7079Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Andrew Thompson
- grid.1008.90000 0001 2179 088XOrygen, The Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia ,grid.7372.10000 0000 8809 1613Division of Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Nusrat Husain
- grid.5379.80000000121662407Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Matthew R. Broome
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK ,grid.498025.20000 0004 0376 6175Birmingham Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Rachel Upthegrove
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK ,grid.498025.20000 0004 0376 6175Birmingham Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Rory Byrne
- grid.507603.70000 0004 0430 6955Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Linda M. Davies
- grid.5379.80000000121662407Manchester Centre for Health Economics, Division of Population Health, School of Health Sciences, University of Manchester, Manchester, UK
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Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041959. [PMID: 33670454 PMCID: PMC7922885 DOI: 10.3390/ijerph18041959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
Background: Increasing health awareness in health promotion is considered as one of the less stigmatized interventions for improving help-seeking behaviors and total well-being. This study aimed to explore the short-term and long-term effectiveness of the health-awareness-strengthening lifestyle (HASL) program on Taiwanese young adults with at-risk mental state. Methods: A pre- and post-test randomized trial was conducted on 92 young adults with at-risk mental state. The HASL program was provided to the experimental group as intervention, and it was only provided to the control group passively by request after the post-test for ethical reasons. The program was conducted once every six weeks, 60–90 min per session, for a total of three times. Mental health risk, anxiety level, health promotion lifestyles, quality of life, physiological index, and physical exercises were assessed one week before and after the program for both groups and followed up to 6 and 12 months for experimental group only. Results: Compared to the control group, those in the experimental group showed significant improvements regarding anxiety level, health promotion lifestyles, and quality of life one week after participating in the program. Furthermore, the experimental group also showed an additional long-term positive effect on mental risk, physical exercises, and physical health after the follow-ups. Conclusions: The outcomes highlighted the interventions of the HASL program leading to more positive health effects on young adults with at-risk mental state. The implementation of similar clinical service is recommended for young adults with at-risk mental state.
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