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Langenecker SA, Westlund Schreiner M, Bessette KL, Roberts H, Thomas L, Dillahunt A, Pocius SL, Feldman DA, Jago D, Farstead B, Pazdera M, Kaufman E, Galloway JA, Kerig PK, Bakian A, Welsh RC, Jacobs RH, Crowell SE, Watkins ER. Rumination-Focused Cognitive Behavioral Therapy Reduces Rumination and Targeted Cross-network Connectivity in Youth With a History of Depression: Replication in a Preregistered Randomized Clinical Trial. Biol Psychiatry Glob Open Sci 2024; 4:1-10. [PMID: 38021251 PMCID: PMC10654545 DOI: 10.1016/j.bpsgos.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Rumination-focused cognitive behavioral therapy (RF-CBT) is designed to reduce depressive rumination or the habitual tendency to dwell on experiences in a repetitive, negative, passive, and global manner. RF-CBT uses functional analysis, experiential exercises, and repeated practice to identify and change the ruminative habit. This preregistered randomized clinical trial (NCT03859297, R61) is a preregistered replication of initial work. We hypothesized a concurrent reduction of both self-reported rumination and cross-network connectivity between the left posterior cingulate cortex and right inferior frontal and inferior temporal gyri. Methods Seventy-six youths with a history of depression and elevated rumination were randomized to 10 to 14 sessions of RF-CBT (n = 39; 34 completers) or treatment as usual (n = 37; 28 completers). Intent-to-treat analyses assessed pre-post change in rumination response scale and in functional connectivity assessed using two 5 minute, 12 second runs of resting-state functional magnetic resonance imaging. Results We replicated previous findings: a significant reduction in rumination response scale and a reduction in left posterior cingulate cortex to right inferior frontal gyrus/inferior temporal gyrus connectivity in participants who received RF-CBT compared with those who received treatment as usual. Reductions were large (z change = 0.84; 0.73, respectively [ps < .05]). Conclusions This adolescent clinical trial further demonstrates that depressive rumination is a brain-based mechanism that is modifiable via RF-CBT. Here, we replicated that RF-CBT reduces cross-network connectivity, a possible mechanism by which rumination becomes less frequent, intense, and automatic. This National Institute of Mental Health-funded fast-fail study continues to the R33 phase during which treatment-specific effects of RF-CBT will be compared with relaxation therapy.
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Affiliation(s)
- Scott A. Langenecker
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, Ohio
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, Illinois
| | | | - Katie L. Bessette
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, Illinois
- Center for Cognitive Neuroscience, University of California Los Angeles, Los Angeles, California
| | - Henrietta Roberts
- Department of Experimental and Applied Clinical Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Exeter, United Kingdom
| | - Leah Thomas
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Alina Dillahunt
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Stephanie L. Pocius
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Daniel A. Feldman
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Dave Jago
- Department of Experimental and Applied Clinical Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Exeter, United Kingdom
| | - Brian Farstead
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Myah Pazdera
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Erin Kaufman
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Jennica A. Galloway
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Patricia K. Kerig
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Amanda Bakian
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Robert C. Welsh
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
- Center for Cognitive Neuroscience, University of California Los Angeles, Los Angeles, California
| | - Rachel H. Jacobs
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sheila E. Crowell
- Departments of Psychiatry and Psychology, University of Utah, Salt Lake City, Utah
| | - Edward R. Watkins
- Department of Experimental and Applied Clinical Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Exeter, United Kingdom
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Tchelebi L, Korah B, Goodman KA, Hoffe S, Stricker C, Pinto DM, Deperalta D, Hong TS, Hacker-Prietz A, Narang A, Aguilera TA, Roberts H, Raldow A, Tempero M, Murphy JD, Malik NK, Herman J. Pancreas Cancer Learning Health Network Established to Share Best Practice Across 14 Centers and Improve Patient Outcomes. Int J Radiat Oncol Biol Phys 2023; 117:e343-e344. [PMID: 37785197 DOI: 10.1016/j.ijrobp.2023.06.2408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Pancreas cancer (PC) survival is among the lowest of all malignancies. Clinical trials have failed to significantly improve outcomes. Individual and institutional biases in care result in significant variation in practice, further hindering progress. Learning health networks (LHNs) prospectively collect real world data across centers and test improvements that can rapidly be expanded across centers if deemed successful. Herein, we report preliminary progress from the Pancreas Cancer Canopy Cancer Collective (PC-CCC), the first oncology LHN, established to improve duration and quality of survival in PC. MATERIALS/METHODS In 2019, we established the PC-CCC with six care centers who engaged in a collaborative design process to create a set of improvement aims, change ideas, and outcome measures. Center team members receive training and coaching in collaborative quality improvement methods, applied to local improvement efforts. Eight more centers joined in 2021, and a shared Canopy outcomes database was built and implemented to inform center-specific and network-wide improvement efforts and allow the LHN to undertake research using real-world data. Current improvement efforts are focused on proactively screening new PC patients for: (1) Clinical trials, (2) pancreas enzymes, (3) palliative care needs, and (4) goals of care conversations. RESULTS Currently, 14 care centers are active participants in the PC-CCC LHN. Data on a total of 2,002 PC patients are available to date. At presentation to the care center, most patients are female (51%) and have biopsy proven PC (83.9%). Average age is 68 years, and presenting disease status is metastatic (14.5%), resectable (11.4%), locally advanced (10.9%), borderline resectable (8.1%), or not yet staged (40%). For those who received radiation, 75.8% received stereotactic body radiation therapy. Among patients whose chemotherapy regimen was documented, most received 5-fluorouracilbased treatment (52%). Descriptive follow up data (including treatment and outcomes) are being actively updated, to be reported at time of presentation. CONCLUSION Creation of a cancer LHN for PC is feasible and has set the stage for improving patient and provider outcomes through iterative community-building, continuous improvement, and sharing of data and multidisciplinary best practices. Additionally, the data obtained from the CCC database can rapidly inform the network how variation in clinical practice across centers can influence outcomes.
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Affiliation(s)
- L Tchelebi
- Department of Radiation Medicine, Northwell Health Cancer Institute, New Hyde Park, NY
| | - B Korah
- 1440 Foundation Canopy Cancer Collective, Scotts Valley, CA
| | - K A Goodman
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - S Hoffe
- H. Lee Moffitt Cancer Center and Research Institute, Department of Radiation Oncology, Tampa, FL
| | - C Stricker
- 1440 Foundation Canopy Cancer Collective, Scotts Valley, CA
| | | | | | - T S Hong
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - A Hacker-Prietz
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Narang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - T A Aguilera
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - H Roberts
- Dana Farber Cancer Institute, Boston, MA
| | - A Raldow
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - M Tempero
- University of California San Francisco, San Francisco, CA
| | - J D Murphy
- Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA
| | - N K Malik
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - J Herman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY
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Westlund Schreiner M, Roberts H, Dillahunt AK, Farstead B, Feldman D, Thomas L, Jacobs RH, Bessette KL, Welsh RC, Watkins ER, Langenecker SA, Crowell SE. Negative association between non-suicidal self-injury in adolescents and default mode network activation during the distraction blocks of a rumination task. Suicide Life Threat Behav 2023; 53:510-521. [PMID: 36942887 PMCID: PMC10441767 DOI: 10.1111/sltb.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/17/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Rumination, or repetitive and habitual negative thinking, is associated with psychopathology and related behaviors in adolescents, including non-suicidal self-injury (NSSI). Despite the link between self-reported rumination and NSSI, there is limited understanding of how rumination is represented at the neurobiological level among youth with NSSI. METHOD We collected neuroimaging and rumination data from 39 adolescents with current or past NSSI and remitted major depression. Participants completed a rumination induction fMRI task, consisting of both rumination and distraction blocks. We examined brain activation associated with total lifetime NSSI in the context of the rumination versus distraction contrast. RESULTS Lifetime NSSI was associated with a greater discrepancy in activation during rumination relative to distraction conditions in clusters including the precuneus, posterior cingulate, superior, and middle frontal gyrus, and cerebellum. CONCLUSION Difficulties associated with rumination in adolescents with NSSI may be related to requiring greater cognitive effort to distract from ruminative content in addition to increased attention in the context of ruminative content. Increasing knowledge of neurobiological circuits and nodes associated with rumination and their relationship with NSSI may enable us to better tailor interventions that can facilitate lasting well-being and neurobiological change.
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Affiliation(s)
- Mindy Westlund Schreiner
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Alina K Dillahunt
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Brian Farstead
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Daniel Feldman
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Leah Thomas
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Rachel H Jacobs
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Katie L Bessette
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Robert C Welsh
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | | | - Scott A Langenecker
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Sheila E Crowell
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
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Thomas LR, Bessette KL, Westlund Schreiner M, Dillahunt AK, Frandsen SB, Pocius SL, Schubert BL, Farstead BW, Roberts H, Watkins ER, Kerig PK, Crowell SE, Langenecker SA. Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task. Child Psychiatry Hum Dev 2023:10.1007/s10578-022-01484-8. [PMID: 36637686 PMCID: PMC9839218 DOI: 10.1007/s10578-022-01484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 11/16/2022] [Accepted: 12/08/2022] [Indexed: 01/14/2023]
Abstract
Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (BChilhood Maltreatment = 27.52, 95% CIs [5.63, 49.41], BFamily Cohesion = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.
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Affiliation(s)
- Leah R Thomas
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA.
- Department of Psychology, University of Utah, 84112, Salt Lake City, UT, USA.
| | - Katie L Bessette
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
- Department of Psychology, University of Illinois at Chicago, 60607, Chicago, IL, USA
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 90024, Los Angeles, CA, USA
| | - Melinda Westlund Schreiner
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Alina K Dillahunt
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Summer B Frandsen
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Stephanie L Pocius
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Briana Lee Schubert
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | - Brian W Farstead
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
| | | | | | - Patricia K Kerig
- Department of Psychology, University of Utah, 84112, Salt Lake City, UT, USA
| | - Sheila E Crowell
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
- Department of Psychology, University of Utah, 84112, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah, 84112, Salt Lake City, UT, USA
| | - Scott A Langenecker
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, 501 Chipeta Way, 84108, Salt Lake City, UT, USA
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Roberts H, Ford TJ, Karl A, Reynolds S, Limond J, Adlam ALR. Mood Disorders in Young People With Acquired Brain Injury: An Integrated Model. Front Hum Neurosci 2022; 16:835897. [PMID: 35754774 PMCID: PMC9218558 DOI: 10.3389/fnhum.2022.835897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose/Objective Young people with paediatric acquired brain injury (pABI) are twice as likely to develop a mood disorder as their peers, frequently have significant unmet socio-emotional needs, and are at over double the risk of going on to use adult mental health services. Recent years have seen significant advances in the development of interventions for young people with mood disorders. However, evidence-based approaches to mood disorders in pABI are lacking and surprisingly little work has evaluated clinical and neuro-developmental models of mood disorders in this population. Method We review the literature regarding key mechanisms hypothesised to account for the increased vulnerability to mood disorders in pABI: First, we summarise the direct neurocognitive consequences of pABI, considering the key areas of the brain implicated in vulnerability to mood disorders within a neurodevelopmental framework. Second, we outline five key factors that contribute to the heightened prevalence of mood disorders in young people following ABI. Finally, we synthesise these, integrating neuro-cognitive, developmental and systemic factors to guide clinical formulation. Results and Implications We present a framework that synthesises the key mechanisms identified in our review, namely the direct effects of pABI, neurocognitive and neuroendocrine factors implicated in mood and anxiety disorders, maladaptive neuroplasticity and trauma, structural and systemic factors, and psychological adjustment and developmental context. This framework is the first attempt to provide integrated guidance on the multiple factors that contribute to elevated life-long risk of mood disorders following pABI.
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Affiliation(s)
| | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Anke Karl
- Psychology, University of Exeter, Exeter, United Kingdom
| | - Shirley Reynolds
- Department of Psychology, University of Reading, Reading, United Kingdom
| | - Jenny Limond
- Psychology, University of Exeter, Exeter, United Kingdom
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Hosny A, Bitterman D, Guthier C, Roberts H, Perni S, Saraf A, Qian J, Peng L, Pashtan I, Kann B, Kozono D, Catalano P, Aerts H, Mak R. Clinical Validation of Deep Learning Algorithms for Lung Cancer Radiotherapy Targeting. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wood S, McCluskey L, Ellwood-Thompson R, Files C, Medway C, White R, Roberts H, Morgan S. 364P Implementation of a comprehensive streamlined next generation sequencing (NGS) test for glioma including detection of the 1p/19q codeletion. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Roberts H, Mostazir M, Moberly NJ, Watkins ER, Adlam AL. Working memory updating training reduces state repetitive negative thinking: Proof-of-concept for a novel cognitive control training. Behav Res Ther 2021; 142:103871. [PMID: 34004447 PMCID: PMC8214071 DOI: 10.1016/j.brat.2021.103871] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
Repetitive negative thinking (RNT) is a proximal risk factor implicated in the onset and maintenance of common mental health problems such as depression and anxiety. Adolescence may be a key developmental window in which to target RNT and prevent the emergence of such disorders. Impairments in updating the contents of working memory are hypothesised to causally contribute to RNT, and some theorists have suggested these difficulties may be specific to the manipulation of negative information. The present study compared the effects of computerised adaptive working memory updating training (in which the task becomes more difficult as performance improves) to a non-adaptive control task in reducing levels of RNT. 124 healthy young people were randomised to 20 sessions of (i) working memory updating training using neutral stimuli, (ii) working memory updating training using negative stimuli, or (iii) non-adaptive working memory updating training. Adaptive working memory updating training using neutral, but not negative, stimuli resulted in significant improvements to working memory updating for negative material, as assessed using an unpractised task, and significant reductions in susceptibility to state RNT. These findings demonstrate proof-of-concept that working memory updating training has the potential to reduce susceptibility to episodes of state RNT.
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Roberts H, Jacobs RH, Bessette KL, Crowell SE, Westlund-Schreiner M, Thomas L, Easter RE, Pocius SL, Dillahunt A, Frandsen S, Schubert B, Farstead B, Kerig P, Welsh RC, Jago D, Langenecker SA, Watkins ER. Mechanisms of rumination change in adolescent depression (RuMeChange): study protocol for a randomised controlled trial of rumination-focused cognitive behavioural therapy to reduce ruminative habit and risk of depressive relapse in high-ruminating adolescents. BMC Psychiatry 2021; 21:206. [PMID: 33892684 PMCID: PMC8062943 DOI: 10.1186/s12888-021-03193-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Adolescent-onset depression often results in a chronic and recurrent course, and is associated with worse outcomes relative to adult-onset depression. Targeting habitual depressive rumination, a specific known risk factor for relapse, may improve clinical outcomes for adolescents who have experienced a depressive episode. Randomized controlled trials (RCTs) thus far have demonstrated that rumination-focused cognitive behavioral therapy (RFCBT) reduces depressive symptoms and relapse rates in patients with residual depression and adolescents and young adults with elevated rumination. This was also observed in a pilot RCT of adolescents at risk for depressive relapse. Rumination can be measured at the self-report, behavioral, and neural levels- using patterns of connectivity between the Default Mode Network (DMN) and Cognitive Control Network (CCN). Disrupted connectivity is a putative important mechanism for understanding reduced rumination via RFCBT. A feasibility trial in adolescents found that reductions in connectivity between DMN and CCN regions following RFCBT were correlated with change in rumination and depressive symptoms. METHOD This is a phase III two-arm, two-stage, RCT of depression prevention. The trial tests whether RFCBT reduces identified risk factors for depressive relapse (rumination, patterns of neural connectivity, and depressive symptoms) in adolescents with partially or fully remitted depression and elevated rumination. In the first stage, RFCBT is compared to treatment as usual within the community. In the second stage, the comparator condition is relaxation therapy. Primary outcomes will be (a) reductions in depressive rumination, assessed using the Rumination Response Scale, and (b) reductions in resting state functional magnetic resonance imaging connectivity of DMN (posterior cingulate cortex) to CCN (inferior frontal gyrus), at 16 weeks post-randomization. Secondary outcomes include change in symptoms of depression following treatment, recurrence of depression over 12 months post-intervention period, and whether engagement with therapy homework (as a dose measure) is related to changes in the primary outcomes. DISCUSSION RFCBT will be evaluated as a putative preventive therapy to reduce the risk of depressive relapse in adolescents, and influence the identified self-report, behavioral, and neural mechanisms of change. Understanding mechanisms that underlie change in rumination is necessary to improve and further disseminate preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03859297 , registered 01 March 2019.
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Affiliation(s)
- Henrietta Roberts
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK
| | | | - Katie L Bessette
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, 84108, USA
| | | | - Leah Thomas
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Rebecca E Easter
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Stephanie L Pocius
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Alina Dillahunt
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Summer Frandsen
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Briana Schubert
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Brian Farstead
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Patricia Kerig
- Department of Psychology, University of Utah, Salt Lake City, UT, 84108, USA
| | - Robert C Welsh
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - David Jago
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK
| | - Scott A Langenecker
- Department of Psychiatry, University of Utah, Salt Lake City, UT, 84108, USA
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK.
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Abeynayake I, Marinucci L, Klingler M, Roberts H. Impact of OFF periods on aspects of employment for people with Parkinson's disease. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hauser R, Klingler M, Abeynayake I, Roberts H. UPDRS motor-score improvement after CVT-301 treatment is associated with improved scores in Parkinson's Disease Questionnaire (PDQ-39) activities of daily living. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abeynayake I, Klingler M, Roberts H. The financial burden of Parkinson's disease is greater for caregivers of people experiencing OFF periods. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boklund A, Dhollander S, Chesnoiu Vasile T, Abrahantes JC, Bøtner A, Gogin A, Gonzalez Villeta LC, Gortázar C, More SJ, Papanikolaou A, Roberts H, Stegeman A, Ståhl K, Thulke HH, Viltrop A, Van der Stede Y, Mortensen S. Risk factors for African swine fever incursion in Romanian domestic farms during 2019. Sci Rep 2020; 10:10215. [PMID: 32576841 PMCID: PMC7311386 DOI: 10.1038/s41598-020-66381-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/18/2020] [Indexed: 01/06/2023] Open
Abstract
African swine fever (ASF) entered Georgia in 2007 and the EU in 2014. In the EU, the virus primarily spread in wild boar (Sus scrofa) in the period from 2014-2018. However, from the summer 2018, numerous domestic pig farms in Romania were affected by ASF. In contrast to the existing knowledge on ASF transmission routes, the understanding of risk factors and the importance of different transmission routes is still limited. In the period from May to September 2019, 655 Romanian pig farms were included in a matched case-control study investigating possible risk factors for ASF incursion in commercial and backyard pig farms. The results showed that close proximity to outbreaks in domestic farms was a risk factor in commercial as well as backyard farms. Furthermore, in backyard farms, herd size, wild boar abundance around the farm, number of domestic outbreaks within 2 km around farms, short distance to wild boar cases and visits of professionals working on farms were statistically significant risk factors. Additionally, growing crops around the farm, which could potentially attract wild boar, and feeding forage from ASF affected areas to the pigs were risk factors for ASF incursion in backyard farms.
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Affiliation(s)
- A Boklund
- University of Copenhagen, Faculty of Health and Medical Sciences, Section for Animal Welfare and Disease Control, Grønnegårdsvej 8, 1870, Frederiksberg C, Denmark.
| | - S Dhollander
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - T Chesnoiu Vasile
- The National Sanitary Veterinary and Food Safety Authority, Bucharest, Piata Free Press no. 1 Body D1, District 1, Post Code 013 701, Bucharest, Romania
| | - J C Abrahantes
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - A Bøtner
- University of Copenhagen, Faculty of Health and Medical Sciences, Section for Veterinary Clinical Microbiology, Stigbøjlen 4, 1870, Frederiksberg C, Denmark
- Statens Serum Institut, Department of Virus and Microbiological Special Diagnostics, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - A Gogin
- Federal Research Center for Virology and Microbiology, 601125, Volginsky, Russia
| | | | - C Gortázar
- SaBio research group at IREC (Universidad de Castilla-La Mancha & CSIC), Ronda de Toledo 12, 13003, Ciudad Real, Spain
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland
| | - A Papanikolaou
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - H Roberts
- Department for Environment Food and Rural Affairs (DEFRA), Exotic Disease Control team, Area 2D, Nobel House, 17 Smith Square, London, SW1P 3JR, England
| | - A Stegeman
- Utrecht University, Faculty of Veterinary Medicine, Yalelaan 7, Utrecht, The Netherlands
| | - K Ståhl
- National Veterinary Institute, 751 89, Uppsala, Sweden
| | - H H Thulke
- Helmholtz Centre for Environmental Research GmbH - UFZ, Department of Ecological Modelling, PG EcoEpi, Permoserstr. 15, Leipzig, Germany
| | - A Viltrop
- Estonian University of Life Sciences, Institute of Veterinary Medicine and Animal Sciences, Kreutzwaldi 62, Tartu, 51006, Estonia
| | - Y Van der Stede
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - S Mortensen
- Danish Veterinary and Food Administration, Stationsparken 31-33, 2600, Glostrup, Denmark
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Rajkumar C, Wilks M, Islam J, Ali K, Raftery J, Davies K, Timeyin J, Cheek E, Cohen J, Wright J, Natarajan U, Nicholl C, Dewhurst G, Fonseka M, Slovick D, Maskell P, Mukherjee S, Ali K, Nari R, Qureshi A, Gertner D, Khan Z, Shinh N, Bodmer C, Martin-Marero C, Poullis A, Pollok R, Ala A, Chauhan A, Patel M, Roberts H, Conroy S, McGowan D, Pathansali R, Yau C, Vasileiadis E, Guleri A, Orr D, Aldulami D. Do probiotics prevent antibiotic-associated diarrhoea? Results of a multicentre randomized placebo-controlled trial. J Hosp Infect 2020; 105:280-288. [DOI: 10.1016/j.jhin.2020.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/27/2020] [Indexed: 02/07/2023]
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Mallya J, DuVall N, Brewster J, Roberts H. Endodontic Access Effect on Full Contour Zirconia and Lithium Disilicate Failure Resistance. Oper Dent 2020; 45:276-285. [DOI: 10.2341/18-231-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
To evaluate the effect of endodontic access on the failure load resistance of both adhesively and conventionally luted, full-contour monolithic yttria-stabilized zirconium dioxide (Y-TZP) and adhesively luted lithium disilicate (LD) crowns cemented on prepared teeth.
Methods and Materials:
Seventy-two human maxillary molars were prepared per respective guidelines for all-ceramic crowns with one group (n=24) restored with LD and the other (n=48) receiving Y-TZP crowns. Preparations were scanned using computer-aided design/computer-aided milling (CAD/CAM) technology, and milled crowns were sintered following manufacturer recommendations. All LD crowns and half (n=24) of the Y-TZP crowns were adhesively cemented, while the remaining Y-TZP specimens were luted using a conventional glass ionomer cement (GIC). One LD group, one Y-TZP adhesive group, and one GIC-luted group (all n=12) then received endodontic access preparations by a board-certified endodontist: the pulp chambers were restored with a dual-cure, two-step, self-etch adhesive and a dual-cure resin composite core material. The access preparations were restored using a nano-hybrid resin composite after appropriate ceramic margin surface preparation. After 24 hours, all specimens were loaded axially until failure; mean failure loads were analyzed using Mann-Whitney U test (α=0.05)
Results:
Endodontic access did not significantly reduce the failure load of adhesively luted LD or Y-TZP crowns, but Y-TZP crowns with GIC cementation demonstrated significantly less failure load.
Conclusions:
These initial findings suggest that endodontic access preparation may not significantly affect failure load resistance of adhesively luted Y-TZP and LD crowns. Definitive recommendations cannot be proposed until fatigue testing and coronal seal evaluations have been accomplished.
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Affiliation(s)
- J Mallya
- John Mallya, DMD, MS, 47th Medical Group, Laughlin AFB, TX, USA
| | - N DuVall
- Nicholas DuVall, DDS, MS, 96th Dental Squadron, Eglin AFB, FL USA
| | - J Brewster
- John Brewster, DDS, MS, USAF Postgraduate Dental School, Keesler AFB, MS, USA
| | - H Roberts
- Howard Roberts, DMD, MS, Division of Restorative Dentistry, University of Kentucky College of Dentistry, Lexington, KY, USA
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Roberts H, Moberly NJ, Cull T, Gow H, Honeysett M, Dunn BD. Short-term affective consequences of specificity of rumination about unresolved personal goals. J Behav Ther Exp Psychiatry 2020; 66:101519. [PMID: 31614265 DOI: 10.1016/j.jbtep.2019.101519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 08/23/2019] [Accepted: 09/29/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Rumination is a form of repetitive thinking that has been associated with both helpful and unhelpful consequences for mood and self-regulation. It has been suggested that the specificity of ruminative thought content may be one factor that determines whether state rumination about personal goals is adaptive. The present study tested the hypothesis that state rumination about unresolved personal goals is associated with unhelpful affective consequences only when rumination is low in specificity. METHODS We measured the extent and specificity of uninstructed rumination following the cueing of resolved and unresolved personal goals using a 30-min go/no-go task with thought probes. Changes in state positive and negative affect from before to after cueing goals, and before to after rumination during the go/no-go task were assessed. RESULTS Cueing unresolved goals resulted in a significant increase in negative affect, and subsequent affective recovery during the go/no-go task. Cueing unresolved goals resulted in more goal-focused rumination than cueing resolved goals. When ruminative thoughts were low in specificity, rumination mediated the association between goal discrepancies and negative affect: greater rumination about unresolved goals significantly impaired affective recovery and perpetuated negative affect. LIMITATIONS The findings await replication in clinical populations, where rumination is more commonly associated with unhelpful outcomes. CONCLUSIONS Greater levels of goal-focused rumination were associated with unhelpful affective consequences only when rumination was low in specificity. Specificity of thought content may be an important determinant of whether goal-focused rumination has helpful or unhelpful effects.
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Affiliation(s)
- Henrietta Roberts
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK.
| | - Nicholas J Moberly
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK
| | - Tamsin Cull
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK
| | - Hannah Gow
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK
| | - Meghan Honeysett
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK
| | - Barnaby D Dunn
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, EX4 4QG, UK
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Abstract
BACKGROUND Reduced food intake is prevalent in people in residential and hospital care settings. Little is known about the use of finger foods (i.e. foods eaten without cutlery) with respect to increasing feeding independence and food intake. The Social Care Institute for Excellence (Malnutrition Task Force: State of the Nation, 2017) recommends the use of finger foods to enable mealtime independence and to prevent loss of dignity and embarrassment when eating in front of others. The aim of this review is to identify and evaluate the existing literature regarding the use and effectiveness of finger foods among adults in health and social care settings. METHODS An integrative review methodology was used. A systematic search of electronic databases for published empirical research was undertaken in October 2018. Following screening of titles and abstracts, the full texts of publications, which investigated outcomes associated with the provision of finger foods in adult care settings, were retrieved and assessed for inclusion. Two independent investigators conducted data extraction and quality assessment using Critical Appraisal Skills Programme checklists. Thematic analysis was used to summarise the findings. RESULTS Six studies met the inclusion criteria. Four themes were identified: Finger food menu implementation; Importance of a team approach; Effect on nutrition; and Influence on wellbeing. Study designs were poorly reported, with small sample sizes. CONCLUSIONS There is some evidence that the provision of finger foods may positively affect patient outcomes in long-term care settings. There is a paucity of research evaluating the use of a finger food menu in acute care settings, including economic evaluation. Future high quality trials are required.
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Affiliation(s)
- M Heelan
- School of Health Sciences, University of Southampton, Southampton, UK
| | - J Prieto
- School of Health Sciences, University of Southampton, Southampton, UK
| | - H Roberts
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - N Gallant
- School of Health Sciences, University of Southampton, Southampton, UK
| | - C Barnes
- Research and Improvement Team, St Marys Community Health Campus, Portsmouth, UK
| | - S Green
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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18
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Roberts H, Wood S, McNeil E, White R, Morgan S. Validation and implementation of a bespoke pan-cancer NGS panel for FFPE solid tumour analysis within an NHS setting. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Kirschner H, Kuyken W, Wright K, Roberts H, Brejcha C, Karl A. Soothing Your Heart and Feeling Connected: A New Experimental Paradigm to Study the Benefits of Self-Compassion. Clin Psychol Sci 2019; 7:545-565. [PMID: 32655984 PMCID: PMC7324152 DOI: 10.1177/2167702618812438] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 09/06/2018] [Indexed: 12/04/2022]
Abstract
Self-compassion and its cultivation in psychological interventions are associated with improved mental health and well-being. However, the underlying processes for this are not well understood. We randomly assigned 135 participants to study the effect of two short-term self-compassion exercises on self-reported-state mood and psychophysiological responses compared to three control conditions of negative (rumination), neutral, and positive (excitement) valence. Increased self-reported-state self-compassion, affiliative affect, and decreased self-criticism were found after both self-compassion exercises and the positive-excitement condition. However, a psychophysiological response pattern of reduced arousal (reduced heart rate and skin conductance) and increased parasympathetic activation (increased heart rate variability) were unique to the self-compassion conditions. This pattern is associated with effective emotion regulation in times of adversity. As predicted, rumination triggered the opposite pattern across self-report and physiological responses. Furthermore, we found partial evidence that physiological arousal reduction and parasympathetic activation precede the experience of feeling safe and connected.
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Affiliation(s)
- Hans Kirschner
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter.,Institute of Psychology, Otto-von-Guericke University
| | - Willem Kuyken
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter.,Department of Psychiatry, University of Oxford
| | - Kim Wright
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Henrietta Roberts
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Claire Brejcha
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Anke Karl
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
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Affiliation(s)
- Paul Phipps
- APHA, Woodham Lane, New Haw, Surrey, KT15 4NB
| | | | | | - H Roberts
- Defra, Nobel House, 17 Smith Square, London SW1P 3JR
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21
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Abstract
The EUFORA fellowship programme ‘Livestock Health and Food Chain Risk Assessment’ was proposed by the Animal and Plant Health Agency (APHA), a British governmental institution responsible for safeguarding animal and plant health in the UK. The working programme, which was organised into four different modules, covered a wide range of aspects related to risk assessment including identification of emerging risks, risk prioritisation methods, scanning surveillance, food production exposure assessment and import risk assessment of animal and human infectious diseases. Over the course of the year, the Fellow had the opportunity to work for international projects with experts in these disciplines. This allowed for significant opportunities to ‘learn‐by‐doing’ the methods and the techniques that are employed to assess animal health and food safety risks. Moreover, he consolidated his knowledge by attending several training courses and academic lessons, submitting scientific papers to peer‐reviewed journals and conferences, giving presentations and using modelling software.
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22
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Pinto-Sinai G, Brewster J, Roberts H. Linear Coefficient of Thermal Expansion Evaluation of Glass Ionomer and Resin-Modified Glass Ionomer Restorative Materials. Oper Dent 2018; 43:E266-E272. [PMID: 29953342 DOI: 10.2341/17-381-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this evaluation was to evaluate the linear coefficient of thermal expansion (LCTE) of 12 conventional glass ionomer (GIC) and four resin-modified glass ionomer (RMGI) restorative materials. METHODS GIC and RMGI specimens (2 mm × 5 mm × 5 mm) were fabricated (n=12) following manufacturer instructions and were placed in 0.2M phosphate-buffered saline and stored at 37°C and 98% humidity for one week. Specimens had LCTE determined with a thermomechanical analysis (TMA) unit using a 15°C-50°C heating cycle as well as a 50°C-15°C cooling cycle at a 5°C/min rate, using a 3-mm ball-point probe under 0.02 N probe pressure with all specimens kept saturated with PBS using a specially designed quartz container. Each specimen was tested three times, with the mean representing the specimen LCTE. Mean results between specimen heating and cooling were compared with paired Wilcoxon sign rank test, while results between materials were compared with Kruskal-Wallis/Dunn's ( α=0.05). RESULTS GIC LCTE ranged from approximately 5°C to 20°C ppm °K-1, while the RMGI LCTE ranged from approximately 25°C to 47°C ppm °K-1. With some exception, the LCTE during cooling displayed a greater trend. SIGNIFICANCE Under moisture conditions similar to the oral cavity, GIC materials overall had LCTE values closer to that reported for tooth structure. RMGI materials displayed higher values, which was thought to be related to the amount of resin in the matrix. A generally greater LCTE trend with cooling for all materials was noted, but the small magnitude of the difference is presently thought to be of minor clinical significance.
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Abstract
PURPOSE The purpose of this study was to evaluate the effect of endocrown pulp chamber extension on mandibular molar fracture resistance. METHODS AND MATERIALS A total of 36 recently extracted mandibular third molars of approximate equal size were sectioned at the facial lingual height of contour followed by endodontic access into the pulp chamber. The specimens were then randomly divided into three groups (n=12) and pulpal and root canal contents removed. Pulp chamber floors were established at 2, 3, and 4 mm from the occlusal table using a three-step etch-and-rinse adhesive and a flowable resin composite. The prepared specimens were then embedded in auto-polymerizing denture base resin with surface area available for adhesive bonding determined using a digital recording microscope. Specimens were restored using a standardized template with a chairside computer-aided design/computer-aided manufacturing unit with the endocrown milled from a lithium disilicate glass-ceramic material. Restoration parameters of occlusal table anatomy and thickness were standardized with the only parameter difference being the pulp chamber extension depth. The endocrown restorations were luted with a self-adhesive resin luting agent and tested to failure after 24 hours on a universal testing machine, with force applied to the facial cusps at a 45° angle to the long axis of the tooth. The failure load was converted into stress for each specimen using the available surface area for bonding. Mean failure load and stress among the three groups was first subjected to the Shapiro-Wilk and Bartlett tests and then analyzed with an analysis of variance with the Tukey post hoc test at a 95% confidence level (p=0.05). RESULTS The 2- and 4-mm chamber extension groups demonstrated the highest fracture resistance stress, with the 3-mm group similar to the 2-mm group. The 3- and 4-mm chamber extension group specimens demonstrated nearly universal catastrophic tooth fracture, whereas half the 2-mm chamber extension group displayed nonrestorable root fractures. CONCLUSIONS Under the conditions of this study, mandibular molars restored with the endocrown technique with 2- and 4-mm pulp chamber extensions displayed greater tooth fracture resistance force as well as stress. All groups demonstrated a high number of catastrophic fractures, but these results may not be clinically significant because the fracture force results are higher than normal reported values of masticatory function.
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24
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Batt J, Milward M, Chapple I, Grant M, Roberts H, Addison O, Addison O. TiO 2 nanoparticles can selectively bind CXCL8 impacting on neutrophil chemotaxis. Eur Cell Mater 2018; 35:13-24. [PMID: 29350745 DOI: 10.22203/ecm.v035a02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The interaction between TiO2 nanoparticles (NPs) and inflammatory cytokines, including CXCL8, a clinically relevant pro-inflammatory chemokine was investigated. TiO2 is present in tissues adjacent to failing implanted Ti (titanium) devices. TiO2 NPs were shown to bind to CXCL8 in vitro, causing perturbation of quantification of CXCL8 by ELISA, in both simple and complex protein panels, in a dose-dependent manner. Binding between TiO2 NPs and CXCL8 was demonstrated by protein gel electrophoresis. TiO2 NPs were also shown to inactivate the chemoattractant property of CXCL8 in a dose-dependent manner, suggesting that the binding between TiO2 NPs and CXCL8 is likely to be clinically relevant. The results of this study disputed the applicability of detection of CXCL8 by ELISA in systems where TiO2 NPs were present. Clinically, the disruption of chemotaxis of neutrophils in response to CXCL8 in the presence of TiO2 might mean a hampered immune response to inflammation in tissues containing TiO2 NPs.
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Affiliation(s)
| | | | | | | | | | - O Addison
- School of Dentistry, University of Alberta, Edmonton, T6G 1C9,
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25
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Parker SG, McCue P, Phelps K, McCleod A, Arora S, Nockels K, Kennedy S, Roberts H, Conroy S. What is Comprehensive Geriatric Assessment (CGA)? An umbrella review. Age Ageing 2018; 47:149-155. [PMID: 29206906 DOI: 10.1093/ageing/afx166] [Citation(s) in RCA: 244] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Indexed: 12/24/2022] Open
Abstract
Background Comprehensive Geriatric Assessment (CGA) is now the accepted gold standard for caring for frail older people in hospital. However, there is uncertainty about identifying and targeting suitable recipients and which patients benefit the most. Objectives our objectives were to describe the key elements, principal measures of outcome and the characteristics of the main beneficiaries of inpatient CGA. Methods we used the Joanna Briggs Institute umbrella review method. We searched for systematic reviews and meta-analyses describing CGA services for hospital inpatients in the Cochrane Database of Systematic Reviews, Database of Reviews of Effectiveness (DARE), MEDLINE and EMBASE and a range of other sources. Results we screened 1,010 titles and evaluated 419 abstracts for eligibility, 143 full articles for relevance and included 24 in a final quality and relevance check. Thirteen reviews, reported in 15 papers, were selected for review. The most widely used definition of CGA was: 'a multidimensional, multidisciplinary process which identifies medical, social and functional needs, and the development of an integrated/co-ordinated care plan to meet those needs'. Key clinical outcomes included mortality, activities of daily living and dependency. The main beneficiaries were people ≥55 years in receipt of acute care. Frailty in CGA recipients and patient related outcomes were not usually reported. Conclusions we confirm a widely used definition of CGA. Key outcomes are death, disability and institutionalisation. The main beneficiaries in hospital are older people with acute illness. The presence of frailty has not been widely examined as a determinant of CGA outcome.
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Affiliation(s)
- S G Parker
- Newcastle University, Institute for Health and Society, Newcastle upon Tyne, Tyne and Wear, UK
| | - P McCue
- Newcastle University, Institute for Health and Society, Newcastle upon Tyne, Tyne and Wear, UK
| | - K Phelps
- Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK
| | - A McCleod
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S Arora
- Nuffield Trust, 59 New Cavendish Street, London W1G 7LP, UK
| | - K Nockels
- University of Leicester Library, Leicester, UK
| | - S Kennedy
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield S1 4DA, UK
| | - H Roberts
- University of Southampton, Academic Geriatric Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - S Conroy
- Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK
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26
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Guenzinger R, Lange R, Rieß F, Hanke T, Bischoff N, Obadia JF, Sahar G, Bitran D, Roberts H, Bolling S. Six-month Performance of a Three-Dimensional Annuloplasty Ring for Repair of Functional Tricuspid Regurgitation. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Guenzinger
- Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany
| | - R. Lange
- Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany
| | - F. Rieß
- Department of Cardiac Surgery, Albertinen-Krankenhaus, Hamburg, Germany
| | - T. Hanke
- Department of Cardiac Surgery, Asklepios Klinikum Harburg, Hamburg, Germany
| | - N. Bischoff
- Department of Cardiac Surgery, Centre Hospitalier de Mulhouse - Hopital Emile Mulller, Mulhouse, France
| | - J.-F. Obadia
- Department of Cardiac Surgery, Hopitaux de Lyon - Hopital Louis Pradel, Bron, France
| | - G. Sahar
- Department of Cardiothoracic Surgery, Soroka Medical Center, Be'er Scheva, Beersheba, Israel
| | - D. Bitran
- Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
| | - H. Roberts
- Department of Cardiovascular Surgery, Florida Heart and Vascular Care, Aventura Hospital and Medical Center, Aventura, United States
| | - S. Bolling
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, United States
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Subramaniam S, Cerone M, McBride D, Rehal P, Rettino A, Bell J, Roberts H, Macdonald M, Butler R, MacMahon S, Thompson L, Middleton C, Sharpe R, Walker I, Johnson P. Use of NGS for stratification of patients with advanced NSCLC within the NHS using FFPE-extracted DNA from diagnostic biopsies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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McCue P, McLeod A, Phelps K, Nockels K, Conroy S, Roberts H, Kennedy S, Parker S. HOSPITAL-WIDE COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) FOR OLDER PEOPLE: EMERGING MODELS OF CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P. McCue
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom,
| | - A. McLeod
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom,
| | - K. Phelps
- Leicester University, Leicester, UK, United Kingdom,
| | - K. Nockels
- Leicester University, Leicester, UK, United Kingdom,
| | - S. Conroy
- Leicester University, Leicester, UK, United Kingdom,
| | - H. Roberts
- Southampton University, Southampton, United Kingdom,
| | - S. Kennedy
- Sheffield University, Sheffield, United Kingdom
| | - S.G. Parker
- Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom,
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McCue P, Parker S, Roberts H, Kennedy S, Conroy S. HOSPITAL-WIDE COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) FOR OLDER PEOPLE: A SURVEY OF UK HOSPITALS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P. McCue
- Newcastle University, Newcastle upon Tyne, United Kingdom,
| | - S.G. Parker
- Newcastle University, Newcastle upon Tyne, United Kingdom,
| | - H. Roberts
- Southampton University, Southampton, United Kingdom,
| | - S. Kennedy
- Sheffield University, Sheffield, United Kingdom,
| | - S. Conroy
- Leicester University, Leicester, United Kingdom
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French K, Ivanenko A, Kek L, Roberts H. 0937 ACCESS TO PEDIATRIC SLEEP LABORATORY SERVICES IN THE SUBURBAN CHICAGO AREA SINCE IMPLEMENTATION OF THE AFFORDABLE CARE ACT (ACA). Sleep 2017. [DOI: 10.1093/sleepj/zsx050.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Liabo K, McKenna C, Ingold A, Roberts H. Leaving foster or residential care: a participatory study of care leavers' experiences of health and social care transitions. Child Care Health Dev 2017; 43:182-191. [PMID: 27896832 DOI: 10.1111/cch.12426] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 09/05/2016] [Accepted: 10/10/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Young people in residential or foster care experience multiple transitions around their 18th birthday without the long term and consistent support from their family of origin that most of their peers can expect. We report a mixed methods qualitative study of transitions across health and social care services for children leaving care, providing narratives of what young people described as positive, and what they and professionals think might be improved. METHODS Data were collected in participatory meetings and individual interviews between young people and researchers (n = 24) and individual interviews with practitioners (n = 11). In addition to discussion and interview techniques, we used pictorial and other participatory methods. Interviews were coded by three members of the team and differences resolved with a fourth. Our analysis draws on thematic and framework approaches. RESULTS Health was rarely at the top of any young person's agenda, although gaps in health care and exceptional care were both described. Housing, financial support and education took priority. Young people and professionals alike emphasized the importance of workers prepared to go the extra mile; of young people being able to contact professionals; and professionals being able to contact one another. CONCLUSIONS Policy and practice aspirations for care leavers recommend gradual change but transfer rather than transition continues to be described by care leavers. Our data support the need for transition as a long-term process, with children and young people having early opportunities to prepare for citizenship.
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Affiliation(s)
- K Liabo
- University of Exeter Medical School, Exeter, UK
| | - C McKenna
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - H Roberts
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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More S, Bicout D, Bøtner A, Butterworth A, Calistri P, Depner K, Edwards S, Garin-Bastuji B, Good M, Gortázar Schmidt C, Michel V, Miranda MA, Saxmose Nielsen S, Raj M, Sihvonen L, Spoolder H, Thulke HH, Velarde A, Willeberg P, Winckler C, Adlhoch C, Baldinelli F, Breed A, Brouwer A, Guillemain M, Harder T, Monne I, Roberts H, Cortinas Abrahantes J, Mosbach-Schulz O, Verdonck F, Morgado J, Stegeman A. Urgent request on avian influenza. EFSA J 2017; 15:e04687. [PMID: 32625275 PMCID: PMC7009852 DOI: 10.2903/j.efsa.2016.4687] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Highly pathogenic avian influenza (HPAI) H5N8 is currently causing an epizootic in Europe, infecting many poultry holdings as well as captive and wild bird species in more than 10 countries. Given the clear clinical manifestation, passive surveillance is considered the most effective means of detecting infected wild and domestic birds. Testing samples from new species and non‐previously reported areas is key to determine the geographic spread of HPAIV H5N8 2016 in wild birds. Testing limited numbers of dead wild birds in previously reported areas is useful when it is relevant to know whether the virus is still present in the area or not, e.g. before restrictive measures in poultry are to be lifted. To prevent introduction of HPAIV from wild birds into poultry, strict biosecurity implemented and maintained by the poultry farmers is the most important measure. Providing holding‐specific biosecurity guidance is strongly recommended as it is expected to have a high impact on the achieved biosecurity level of the holding. This is preferably done during peace time to increase preparedness for future outbreaks. The location and size of control and in particular monitoring areas for poultry associated with positive wild bird findings are best based on knowledge of the wider habitat and flight distance of the affected wild bird species. It is recommended to increase awareness among poultry farmers in these established areas in order to enhance passive surveillance and to implement enhanced biosecurity measures including poultry confinement. There is no scientific evidence suggesting a different effectiveness of the protection measures on the introduction into poultry holdings and subsequent spread of HPAIV when applied to H5N8, H5N1 or other notifiable HPAI viruses. This publication is linked to the following EFSA Supporting Publications article: http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2016.EN-1142/full
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Williams A, Nelmes D, Roberts H, Butler R. 31: A new NHS diagnostic service to detect EGFR ctDNA mutations in non-small cell lung cancer patients. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30081-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECTIVE To evaluate the significance of reduced axial wall height on retention of adhesively luted, all-ceramic, lithium disilicate premolar computer-aided design/computer-aided manufacturing (CAD/CAM) crowns based on preparations with a near ideal total occlusal convergence of 10°. METHODS Forty-eight recently extracted premolars were randomly divided into four groups (n=12). Each group received all-ceramic CAD/CAM crown preparations featuring axial wall heights of 0, 1, 2, and 3 mm, respectively, all with a 10° total occlusal convergence. Scanned preparations were fitted with lithium disilicate all-ceramic crowns that were luted with a self-etching resin cement. Specimens were tested to failure at a 45° angle to the tooth long axis with failure load converted to megapascals (MPa) based on the measured bonding surface area. Mean data were analyzed using analysis of variance/Tukey's post hoc test (α=0.05). RESULTS Lithium disilicate crowns adhesively luted on preparations with 0 axial wall height demonstrated significantly less failure resistance compared with the crowns luted on preparations with axial wall heights of 1 to 3 mm. There was no failure stress difference between preparations with 1 to 3 mm axial wall height. CONCLUSIONS Under conditions of this study, adhesively luted lithium disilicate bicuspid crowns with a total occlusal convergence of 10° demonstrated similar failure resistance independent of axial wall height of 1 to 3 mm. This study provides some evidence that adhesion combined with an ideal total occlusal convergence may compensate for reduced axial wall height.
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Abstract
Patients with heart failure have multiple readmissions to hospital, a poor prognosis and varying quality of life. This paper explores how patients with heart failure and their family carers cope with daily life. 36 patients and 20 family caregivers were interviewed in five centres in the UK. Analysis showed that living with heart failure can be frightening, restrictive and distressing for both patients and their family carers. Patients found most difficulty coping with functional limitation and adapting to living with heart failure, but also reported particular problems due to side effects of medications, co-morbidities and a lack of psychosocial support and rehabilitation services. Those with less socio-economic resources found it harder to cope. Patients from minority ethnic groups held different beliefs about the illness and its treatment, and some had profound problems communicating with health and social care professionals that made managing the disease even more difficult. Caring for a person with heart failure often has a considerable impact on the psychological and physical health of family caregivers. Psychosocial support and rehabilitation services provided at diagnosis and after an acute episode would enable families to better manage living with this syndrome.
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Affiliation(s)
- J F Pattenden
- British Heart Foundation Care and Education Research Group, Department of Health Sciences, Seebohm Rowntree Building Area 4, University of York, York YO10 5DD, England, United Kingdom.
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Schaap L, Fox B, Henwood T, Bruyère O, Reginster JY, Beaudart C, Buckinx F, Roberts H, Cooper C, Cherubini A, dell’Aquilla G, Maggio M, Volpato S. Grip strength measurement: Towards a standardized approach in sarcopenia research and practice. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Anderson SG, Narayanan RP, Malipatil NS, Roberts H, Dunn G, Heald AH. Socioeconomic deprivation independently predicts painful diabetic neuropathy in type 2 diabetes. Exp Clin Endocrinol Diabetes 2015; 123:423-7. [PMID: 26069072 DOI: 10.1055/s-0035-1549966] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Painful peripheral neuropathy in people with type 2 diabetes is a disabling complication. We explored associations of this condition with socioeconomic deprivation. RESEARCH DESIGN AND METHODS The Townsend index of socioeconomic deprivation was examined in the pseudonymised GP records of 15388 (44.1% female) individuals with type 2 diabetes in the Cheshire county of England, and related to prevalence of drug treated painful diabetic neuropathy. We also analysed prescription trends with respect to pharmacotherapy for neuropathy pain relief. RESULTS Treatment for neuropathic pain was initiated in 3 266 (21.2%) of patients. Those on treatment were older [68.2 (95% CI 67.8-68.7) vs. 66.6 (66.4-66.8) years] than those not on treatment. There was no difference in HbA1c (7%, 55 mmol/mol).There were significant differences between the groups for the Townsend deprivation index, with a greater proportion (30.6% vs. 22.8% of patients with treated neuropathic pain) having a score of ≥1 (Χ(2)=83.9, p<0.0001).Multivariate logistic regression analyses indicated that each unit increment in the Townsend index was associated with an 6% increased odds of requiring neuropathic pain treatment [odds ratio (95%CI) 1.06 (1.05-1.08), p<0.0001] independent of 5 year age band, BMI, gender, systolic BP, eGFR, HbA1C and total cholesterol. CONCLUSIONS In this study using pseudonymised clinical records, a higher level of socioeconomic deprivation seemingly may predispose to severe neuropathic pain in diabetes requiring pharmacological intervention. Targeted allocation of healthcare resources to this group may offer clinical benefits.
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Affiliation(s)
- S G Anderson
- Cardiovascular Sciences Research Group, The University of Manchester, Manchester, United Kingdom
| | - R P Narayanan
- Department of Obesity and Endocrinology, University of Liverpool
| | - N S Malipatil
- Vascular Research Group, The University of Manchester
| | - H Roberts
- Department of Medicine, Leighton Hospital, Crewe
| | - G Dunn
- Department of Podiatry, East Cheshire NHS Trust, Macclesfield
| | - A H Heald
- Department of Medicine, Leighton Hospital, Crewe
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Ashburn A, Robison J, Wiles R, Hulbert S, Fitton C, Kunkel D, Roberts L, Pickering R, Roberts H. Dancing with Parkinson's disease: a qualitative exploration of the views and experience of participants in a feasibility study. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fitton C, Kunkel D, Hulbert S, Robison J, Roberts L, Pickering R, Wiles R, Roberts H, Ashburn A. Dancing with Parkinson's disease: feasibility randomised controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Patients who do not attend ('DNA') health appointments have been identified as a service problem incurring significant costs to the NHS. In order to explore the causes, effects and costs of child DNAs, we carried out a scoping study to map the literature and identify gaps in the research. Given the breadth of issues underpinning DNAs, a scoping study, including research studies, audits, policy documents and conference abstracts, was the most useful way to map the field. To foster public and patient participation, we sought advice from parents participating in the National Children's Bureau's Family Research Advisory Group. From a pool of 1997 items, we found few UK studies with non-attendance of 0-10 year olds as a primary focus, though many more incidentally reported DNA rates. Overall, four topics predominated: the conceptualization of DNAs; the correlates of non-attendance; initiatives to reduce non-attendance; and the relationship between non-attendance and safeguarding. The Family Research Advisory Group identified broadly similar issues, but with a stronger emphasis on communication and practical matters. While there may be circumstances where failing to attend appointments makes little or no difference to a child (or even benefits them) it is likely that there are children whose health or well-being are compromised as a result of failing to attend appointments. Both 'over' and 'under'-attendance can be a source of anxiety to health professionals. Areas where further work is needed include robust evaluation of the effectiveness, cost-effectiveness and maintenance of measures to reduce DNAs and a better understanding of the relationship of safeguarding to non-attendance.
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Affiliation(s)
- L Arai
- School of Health and Social Care, Teesside University, Middlesbrough, Tees Valley, UK
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Baylis D, Syddall H, Jameson K, Cooper C, Roberts H, Sayer AA. 77 * PHYSICAL FUNCTIONING AND ALL-CAUSE MORTALITY IN FRAIL COMMUNITY DWELLING OLDER WOMEN. Age Ageing 2014. [DOI: 10.1093/ageing/afu038.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Baulch C, Stack E, Roberts H. 128 * A SIMPLE PROTOCOL FOR OBSERVING BACKWARD STEPPING AMONG PEOPLE WITH PARKINSON'S: AN ACTION FREQUENTLY ASSOCIATED WITH FALLS. Age Ageing 2014. [DOI: 10.1093/ageing/afu047.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Baylis D, Syddall H, Jameson K, Cooper C, Roberts H, Sayer AA. 76 * CACHEXIA IN HOSPITALISED OLDER WOMEN: A GERIATRIC GIANT? Age Ageing 2014. [DOI: 10.1093/ageing/afu038.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hepburn D, Roberts H, Zouwail S. Impact of reduced frequency of phosphate testing on detected phosphate levels and phosphate prescription in critical care. Crit Care 2014. [PMCID: PMC4069453 DOI: 10.1186/cc13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Roberts H, Watkins ER, Wills AJ. Cueing an unresolved personal goal causes persistent ruminative self-focus: an experimental evaluation of control theories of rumination. J Behav Ther Exp Psychiatry 2013; 44:449-55. [PMID: 23810947 DOI: 10.1016/j.jbtep.2013.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 04/02/2013] [Accepted: 05/24/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Control theory predicts that the detection of goal discrepancies initiates ruminative self-focus (Martin & Tesser, 1996). Despite the breadth of applications and interest in control theory, there is a lack of experimental evidence evaluating this prediction. The present study provided the first experimental test of this prediction. METHODS We examined uninstructed state rumination in response to the cueing of resolved and unresolved goals in a non-clinical population using a novel measure of online rumination. RESULTS Consistent with control theory, cueing an unresolved goal resulted in significantly greater recurrent intrusive ruminative thoughts than cueing a resolved goal. Individual differences in trait rumination moderated the impact of the goal cueing task on the extent of state rumination: individuals who had a stronger tendency to habitually ruminate were more susceptible to the effects of cueing goal discrepancies. LIMITATIONS The findings await replication in a clinically depressed sample where there is greater variability and higher levels of trait rumination. CONCLUSIONS These results indicate that control theories of goal pursuit provide a valuable framework for understanding the circumstances that trigger state rumination. Additionally, our measure of uninstructed online state rumination was found to be a valid and sensitive index of the extent and temporal course of state rumination, indicating its value for further investigating the proximal causes of state rumination.
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Affiliation(s)
- Henrietta Roberts
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QG, UK.
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Kosmider R, Paterson A, Voas A, Roberts H. Echinococcus multilocularis introduction and establishment in wildlife via imported beavers. Vet Rec 2013; 172:606. [PMID: 23636702 DOI: 10.1136/vr.101572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- R Kosmider
- Epidemiology, Surveillance and Risk Group, Weybridge Animal Health and Veterinary Laboratories Agency, Woodham Lane, Addlestone, Surrey KT15 3NB, UK.
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Roberts H, Bayman N, Swindell R, Blackhall F, Taylor P, Burt P, Chittalia A, Coote J, Harris M, Lee L, Pemberton L, Sheikh H, Faivre-Finn C. 48 Radical management of inoperable stage III non-small cell lung cancer (NSCLC) in the Greater Manchester and Cheshire Cancer Network (GMCCN) – an analysis of patient eligibility and justification for treatment. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Affiliation(s)
- H Roberts
- Veterinary and Science Policy Advice Team, Animal Health and Veterinary Laboratories Agency, Defra, 17 Smith Square, London SW1P 3JR
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