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Valabhji J, Holman N, Collins N, Young RJ, Chadwick P, Robinson A, Nayar R, Rajbhandari S, Coppini DV, Kong MF, Ashwell S, Nayak A, Mehta S, Manu C, Edmonds M, Gooday C, Dhatariya K. Can the introduction of a 12-lead ECG help reduce mortality in those presenting with foot ulceration to multidisciplinary diabetic foot clinics? An observational evaluation of a real-world implementation pilot in England. Diabetologia 2024:10.1007/s00125-024-06134-3. [PMID: 38584181 DOI: 10.1007/s00125-024-06134-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/20/2024] [Indexed: 04/09/2024]
Abstract
AIMS/HYPOTHESIS The risk of dying within 2 years of presentation with diabetic foot ulceration is over six times the risk of amputation, with CVD the major contributor. Using an observational evaluation of a real-world implementation pilot, we aimed to assess whether for those presenting with diabetic foot ulceration in England, introducing a 12-lead ECG into routine care followed by appropriate clinical action was associated with reduced mortality. METHODS Between July 2014 and December 2017, ten multidisciplinary diabetic foot services in England participated in a pilot project introducing 12-lead ECGs for new attendees with foot ulceration. Inception coincided with launch of the National Diabetes Footcare Audit (NDFA), whereby all diabetic footcare services in England were invited to enter data on new attendees with foot ulceration. Poisson regression models assessed the mortality RR at 2 and 5 years following first assessment of those receiving care in a participating pilot unit vs those receiving care in any other unit in England, adjusting for age, sex, ethnicity, deprivation, type and duration of diabetes, ulcer severity, and morbidity in the year prior to first assessment. RESULTS Of the 3110 people recorded in the NDFA at a participating unit during the pilot, 33% (1015) were recorded as having received an ECG. A further 25,195 people recorded in the NDFA had attended another English footcare service. Unadjusted mortality in the pilot units was 16.3% (165) at 2 years and 37.4% (380) at 5 years for those who received an ECG, and 20.5% (430) and 45.2% (950), respectively, for those who did not receive an ECG. For people included in the NDFA at other units, unadjusted mortality was 20.1% (5075) and 42.6% (10,745), respectively. In the fully adjusted model, mortality was not significantly lower for those attending participating units at 2 (RR 0.93 [95% CI 0.85, 1.01]) or 5 years (RR 0.95 [95% CI 0.90, 1.01]). At participating units, mortality in those who received an ECG vs those who did not was lower at 5 years (RR 0.86 [95% CI 0.76, 0.97]), but not at 2 years (RR 0.87 [95% CI 0.72, 1.04]). Comparing just those that received an ECG with attendees at all other centres in England, mortality was lower at 5 years (RR 0.87 [95% CI 0.78, 0.96]), but not at 2 years (RR 0.86 [95% CI 0.74, 1.01]). CONCLUSIONS/INTERPRETATION The evaluation confirms the high mortality seen in those presenting with diabetic foot ulceration. Overall mortality at the participating units was not significantly reduced at 2 or 5 years, with confidence intervals just crossing parity. Implementation of the 12-lead ECG into the routine care pathway proved challenging for clinical teams-overall a third of attendees had one, although some units delivered the intervention to over 60% of attendees-and the evaluation was therefore underpowered. Nonetheless, the signals of potential mortality benefit among those who had an ECG suggest that units in a position to operationalise implementation may wish to consider this. DATA AVAILABILITY Data from the National Diabetes Audit can be requested through the National Health Service Digital Data Access Request Service process at: https://digital.nhs.uk/services/data-access-request-service-dars/dars-products-and-services/data-set-catalogue/national-diabetes-audit-nda.
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Affiliation(s)
- Jonathan Valabhji
- NHS England, Wellington House, London, UK.
- Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
| | - Naomi Holman
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | | | - Rahul Nayar
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | | | | | | | - Simon Ashwell
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Ananth Nayak
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Sanjeev Mehta
- Ealing Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Chris Manu
- Diabetic Foot Clinic, Kings College Hospital NHS Foundation Trust, London, UK
| | - Michael Edmonds
- Diabetic Foot Clinic, Kings College Hospital NHS Foundation Trust, London, UK
| | - Catherine Gooday
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Ketan Dhatariya
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
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Dissemond J, Chadwick P, Weir D, Alves P, Isoherranen K, Lázaro Martínez JL, Swanson T, Gledhill A, Malone M. M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update. INT J LOW EXTR WOUND 2024:15347346241245159. [PMID: 38571403 DOI: 10.1177/15347346241245159] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Essen, Germany
| | | | - Dot Weir
- Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Saratoga Springs, NY, USA
| | - Paulo Alves
- Universidade Católica Portuguesa, Institute of Health Sciences - Wounds Research Lab, Lisboa, Portugal
| | - Kirsi Isoherranen
- Department of Dermatology and Allergology, University of Helsinki and Inflammation center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | - Terry Swanson
- Wound Education Research Consultancy, Warrnambool, Victoria, Australia
| | - Andrea Gledhill
- Department of Podiatric Surgery, Trauma and Orthopaedics, Great Western Hospital NHSFT, Swindon, UK
| | - Matthew Malone
- Research and Development, Molnlycke Healthcare AB, Gothenburg, Sweden
- Infectious Diseases Microbiology, School of Medicine, Western Sydney University, Sydney, Australia
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Özker E, Krakowiecki A, Cassino R, Pezzuto C, Chadwick P, Romanelli M. Unique combination of hyaluronic acid and amino acids in the management of patients with a wide range of moderate-to-severe chronic wounds: Evidence from international clinical practice. Int Wound J 2024; 21 Suppl 1:9-24. [PMID: 38393140 PMCID: PMC10886432 DOI: 10.1111/iwj.14630] [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] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/25/2024] Open
Abstract
The availability of new products and strategies to manage wounds has taken a quantum leap in recent years. Healthcare professionals now have an extensive range of products to choose from, but while positive this also raises dilemmas in real-world clinical practice to decide on the most appropriate treatment for a given patient. Clinical trials confirm the effectiveness of the unique combination of hyaluronic acid and amino acids (Vulnamin®) in a range of wounds, but are these results replicated in real-world clinical practice? International experts presented their clinical experience with the use of the combination in difficult-to-treat wounds. The objective was to reach a consensus on how and when to use the unique combination products to provide a cost-effective, convenient option, in all healthcare settings that improves QoL for patients and their carers.
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Affiliation(s)
- Emre Özker
- Altınbaş University Faculty of Medicine, Head of Cardiovascular SurgeryAcıbadem Health Group Wound ClinicsIstanbulTurkey
| | | | - Roberto Cassino
- “Residenze Heliopolis” Korian Nursing HomeMilanItaly
- Lecturer at the Master of VulnologyUniversity of TurinTurinItaly
| | - Carla Pezzuto
- Department of Plastic SurgeryBurn Unit and Skin BankTurinItaly
| | - Paul Chadwick
- Tissue ViabilityBirmingham City University School of Health SciencesBirminghamUK
| | - Marco Romanelli
- Division of Dermatology, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
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Gordan LN, Ray D, Ijioma SC, Dranitsaris G, Warner A, Heritage T, Fink M, Wenk D, Chadwick P, Khrystolubova N, Peles S. Impact of a Best Practices Program in Patients with Relapsed/Refractory Multiple Myeloma Receiving Selinexor. Curr Oncol 2024; 31:501-510. [PMID: 38248119 PMCID: PMC10814155 DOI: 10.3390/curroncol31010034] [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] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/31/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
Best practice (BP) in cancer care consists of a multifaceted approach comprising individualized treatment plans, evidence-based medicine, the optimal use of supportive care and patient education. We investigated the impact of a BP program in patients with relapsed/refractory multiple myeloma (RRMM) receiving selinexor. Features of the BP program that were specific to selinexor were initiating selinexor at doses ≤80 mg once weekly and the upfront use of standardized antiemetics. Study endpoints included time to treatment failure (TTF), duration of therapy, dose limiting toxicities and overall survival. Comparative analysis on TTF and duration of therapy was conducted using a log-rank test and multivariate Cox proportional hazard regression. Over the ensuing 12-month post-BP period, 41 patients received selinexor-based therapy compared to 68 patients who received selinexor-based therapy pre-BP implementation. Patients treated in the post-BP period had reductions in TTF (hazard ratio [HR] = 0.50; 95% CI: 0.27 to 0.92). Patients in the pre-BP period were four times more likely to stop therapy than those in the post-period (odds ratio [OR] = 4.0, 95% CI: 1.75 to 9.3). The findings suggest a BP program tailored to selinexor could increase the time to treatment failure, increase treatment duration and lower the incidence of drug limiting toxicities.
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Affiliation(s)
- Lucio N. Gordan
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - David Ray
- Karyopharm Therapeutics Inc., Newton, MA 02459, USA
| | | | - George Dranitsaris
- Department of Public Health, Syracuse University, Syracuse, NY 13244, USA
| | - Amanda Warner
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Trevor Heritage
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Matthew Fink
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - David Wenk
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | - Paul Chadwick
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
| | | | - Shachar Peles
- Florida Cancer Specialists and Research Institute, Tampa, FL 33609, USA
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Barrado-Martín Y, Frost R, Catchpole J, Rookes T, Gibson S, Avgerinou C, Gardner B, Gould R, Chadwick P, Jowett C, Hopkins J, Kumar R, Elaswarapu R, Marston L, Kharicha K, Drennan VM, Walters K. Goal setting as part of a holistic intervention to promote independence in older people with mild frailty: a process evaluation alongside a randomised controlled trial. Lancet 2023; 402 Suppl 1:S1. [PMID: 37997048 DOI: 10.1016/s0140-6736(23)02069-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/16/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Frailty is a condition resulting from a decline in physiological reserves caused by an accumulation of several deficits, which progressively impairs the ability to recover from health adverse events. Following a promising feasibility study, the HomeHealth trial assessed a holistic tailored intervention for older adults with mild frailty to promote independence in their own homes, compared with usual care. We aimed to understand how goal setting worked among older people with mild frailty. METHODS This study was a process evaluation alongside the HomeHealth randomised trial in older adults with mild frailty. The intervention was delivered at participants' homes, either in person or by telephone or videoconferencing. We carried out semi-structured interviews with older participants who had received the intervention (between three and six appointments), on average 233 days (range 68-465) after their last appointment, purposively sampled according to age, gender, number of sessions attended, adverse events, ethnicity, Index of Multiple Deprivation, Montreal Cognitive Assessment (MoCA) and Barthel scores, research site, and HomeHealth worker. We also conducted interviews with HomeHealth workers who delivered the intervention (n=7). Interviews explored the experience and process of goal setting, benefits and challenges, perceived progress, and behaviour change maintenance after the service had finished. Ethics approval was obtained, and all participants gave informed consent. Interviews were thematically analysed. HomeHealth workers kept formal records of goals set and assessed progress towards goals (0-2 rating scale) during six monthly-sessions, which were descriptively summarised. FINDINGS 56 interviews were completed between July 15, 2022, and May 18, 2023. Study participants (n=49) had a mean age of 80 years (range 66-94), including 32 (65%) women and 17 (35%) men. Participants self-identified as White (n=42), Asian (n=3), Black (n=2), Mixed (n=1), and other ethnic (n=1) backgrounds. Findings suggested goal setting could be both a challenge and a motivator for older participants with mild frailty. Goal setting worked well when the older person could identify a clear need and set realistic goals linked to functioning, which led to a positive sense of achievement. Challenges occurred when older people were already accessing multiple resources and health services, or where the terminology of "goals" was off-putting due to work or school connotations. Average progress towards goals was 1·15/2. Most participants set goals around improving mobility (or a combination of mobility and another goal type such as socialising), and there was evidence of participants sustaining these behaviour changes after the intervention. INTERPRETATION Older people with mild frailty can engage well with goal setting to promote independence. The lapse between receiving the intervention and being interviewed limited recall for some participants. However, the acceptability and adherence to the intervention for older people with mild frailty, and their moderate progress towards goals, should encourage further tailored and person-centred practices to promote their independence. FUNDING National Institute for Health Research (NIHR) Health Technology Assessment.
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Affiliation(s)
- Yolanda Barrado-Martín
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK.
| | - Rachael Frost
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Jessica Catchpole
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Tasmin Rookes
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sarah Gibson
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Christina Avgerinou
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | | | - Rebecca Gould
- Division of Psychiatry, University College London, London, UK
| | - Paul Chadwick
- Division of Psychology & Language Sciences, University College London, London, UK
| | - Claire Jowett
- Patient and Public Involvement Contributor, London, UK
| | - Jane Hopkins
- Patient and Public Involvement Contributor, London, UK
| | - Rashmi Kumar
- Patient and Public Involvement Contributor, London, UK
| | | | - Louise Marston
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Kalpa Kharicha
- NIHR Health & Social Care Workforce Research Unit, The Policy Institute, King's College London, London, UK
| | - Vari M Drennan
- Centre for Health and Social Care Research, Kingston University, London, UK
| | - Kate Walters
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
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O’Brien-Venus B, Jenkins T, Chadwick P. Self-dehumanisation in voice hearers: the end of a continuum. Front Psychiatry 2023; 14:1173380. [PMID: 37854440 PMCID: PMC10579558 DOI: 10.3389/fpsyt.2023.1173380] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
Background Meta-dehumanisation and self-dehumanisation have been identified as potentially relevant phenomena for developing a deeper understanding of distress related to voice-hearing, particularly those experiencing voices as part of psychosis. Chadwick has previously argued that those with psychosis, including those who hear distressing voices, typically feel "dehumanised and set apart by their experiences of psychosis and trauma." The present study explores the subjective experience of self-dehumanisation in people who experience distressing voices, which was selected as a useful starting point to inform future research focused on understanding dehumanisation in people with psychosis. Methods Qualitative data was obtained through twenty semi-structured interviews with self-identifying voice hearers and analysed using reflexive thematic analysis. This followed the recursive six phase procedure of Braun and Clarke, and this was conducted from a critical realist, contextualist position. Results Reflexive thematic analysis of participant's experiences produced a core theme, Dehumanisation as the End of Experiential Continua, and six subthemes: Extent of Distressing Sensory Fragmentation; Sense of Belonging with Other Humans; Integrity of Self as a Private, Coherent Entity; Sense of Worth as a Human Being; Strength of Personal Agency; and Trust in Own Credibility and Reliability. Two further themes, The Push and Pull of Dehumanising Forces and Reclaiming Life through Humanising Forces, were identified. Findings were presented to a panel of five experts by experience, all with lived experience of psychosis and service-use; all five strongly endorsed the themes as fitting with and expressing their own experiences of self-dehumanisation. Conclusion Reflexive thematic analysis of voice hearers' accounts identified self-dehumanisation as the endpoint where six experiential continua coalesce. Experiential movement along these continua was affected by a range of interpersonal, intrapersonal, and societal forces over time, including dehumanising attitudes of others and voice malevolence and omnipotence. Future research might examine if and how psychological therapies aimed at those experiencing distressing voices, such as people experiencing psychosis may address feelings of self-dehumanisation.
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Affiliation(s)
| | | | - Paul Chadwick
- Department of Psychology, University of Bath, Bath, United Kingdom
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Rippon M, Rogers AA, Ousey K, Chadwick P. Experimental and clinical evidence for DACC-coated dressings: an update. J Wound Care 2023; 32:S13-S22. [PMID: 37591666 DOI: 10.12968/jowc.2023.32.sup8a.s13] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To update the evidence in relation to the use of dialkylcarbamoyl chloride (DACC)-coated wound dressings in the prevention, treatment and management of wounds. METHOD PubMed and PubMed Central databases were searched to identify articles published since 2020 describing the experimental and clinical evidence for DACC-coated dressings, and their antimicrobial effect, as well as their impact on the prevention and treatment of infected wounds. The identified articles were then narratively reviewed. RESULTS The search yielded 113 articles (plus references from ad hoc sources), of which nine met the inclusion criteria. Of the nine included studies, five related to clinical aspects and four were laboratory studies. CONCLUSION A number of new studies have provided further evidence for the mode of action of the antimicrobial effect of DACC-coated dressings and its wide spectrum effect (including World Health Organization-prioritised microorganisms). Additional clinical studies have provided evidence of new applications, such as in treating wounds in paediatric patients, and extended the evidence relating to their use in treating surgical site infections. Evidence also shows that DACC-coated wound dressings can aid in the binding of biofilms, and how this technology can align and support antimicrobial stewardship in the prevention of antimicrobial resistance.
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Affiliation(s)
- Mark Rippon
- Visiting Clinical Research Associate, Huddersfield University, Huddersfield, UK
- Medical Marketing Consultant, Daneriver Consultancy Ltd., Holmes Chapel, UK
| | - Alan A Rogers
- Independent Wound Care Consultant, Flintshire, North Wales, UK
| | - Karen Ousey
- Professor of Skin Integrity, Director for the Institute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, UK
- Adjunct Professor, School of Nursing, Faculty of Health, Queensland University of Technology, Australia
- Visiting Professor, Royal College of Surgeons of Ireland, Dublin, Ireland
- Chair, International Wound Infection Institute, UK
- President Elect, International Skin Tear Advisory Panel
| | - Paul Chadwick
- Visiting Professor, Birmingham City University, Birmingham, UK
- Clinical Director and Acting Chief Executive, Royal College of Podiatry, UK
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Frykberg R, Andersen C, Chadwick P, Haser P, Janssen S, Lee A, Niezgoda J, Serena T, Stang D, Agarwal A, Cole W, Dissemond J, Kirby J, Lantis J, Lavery L, Martinez JL, Wild T. Use of Topical Oxygen Therapy in Wound Healing. J Wound Care 2023; 32:S1-S32. [PMID: 37607744 DOI: 10.12968/jowc.2023.32.sup8b.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Affiliation(s)
- Robert Frykberg
- Adjunct Professor, Midwestern University, Glendale, Arizona, US
| | - Charles Andersen
- Chief of the Vascular/Endovascular Surgery Service and Medical Director of the Wound Care Clinic, Madigan Army Medical Center, US
| | - Paul Chadwick
- Visiting Professor Birmingham City University, Honorary Consultant Podiatrist Manchester and Director Curativo WoundCare Consultancy
| | - Paul Haser
- Chief of Vascular Surgery, ONE Brooklyn Health System, New York, US
| | - Sandra Janssen
- Nurse Specialist, Wound Care, Elkerliek Hospital Helmond/Deurne, Netherlands
| | - Aliza Lee
- Clinical Research Investigator and Director of Podiatric Medical Education, VA Hospital in Salem, Virginia, US
| | - Jeff Niezgoda
- CMO Kent Imaging, President/CMO WebCME.net, American Professional Wound Care Association, RxOS Medical and Auxillium Heath, US
| | | | - Duncan Stang
- (Glasg), Podiatrist, Lanarkshire NHS Scotland; Diabetes Foot Coordinator for Scotland and Executive Committee Member, Foot in Diabetes UK, UK
| | - Animesh Agarwal
- Professor, Division of Orthopaedic Traumatology, University of Texas Health Science Center, San Antonio, Texas, US
| | - Windy Cole
- Director of Wound Care Research, Kent State University College of Podiatric Medicine; Global Medical Affairs Director, NATROX Wound Care, UK
| | - Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University of Essen, Germany
| | - John Kirby
- Acute and Critical Care Surgeon, Washington University in St Louis, Missouri, US
| | - John Lantis
- Chief and Professor of Surgery, Mount Sinai West Hospital and the Icahn School of Medicine, New York, US
| | - Lawrence Lavery
- Professor, Department of Plastic Surgery, University of Texas Southwestern Medical Center; Medical Director, Diabetic Limb Salvage Program, Parkland Memorial Hospital, Texas, US
| | - Jose Lazaro Martinez
- Professor of Podiatric Surgery, Podiatry College; Clinical Director and Head of Diabetic Foot Unit, Podiatric Clinic, Complutense University of Madrid, Spain
| | - Thomas Wild
- Clinic of Plastic, Hand and Aesthetic Surgery, Burn Center, BG Clinic Bergmannstrost, Halle (Saale, Germany); Medical University Halle, Outpatient and Operating Center, Martin-Luther University, Halle (Saale), Germany; University of Applied Science Anhalt, Institute of Applied Bioscience and Process Management, Head of Academic Wound Consultant Education Course, Koethen, Germany
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Hübsch C, Clarenbach C, Chadwick P, Peterer M, Beckmann S, Naef R, Schmid-Mohler G. Acceptability, Appropriateness and Feasibility of a Nurse-Led Integrated Care Intervention for Patients with Severe Exacerbation of COPD from the Healthcare Professional's Perspective - A Mixed Method Study. Int J Chron Obstruct Pulmon Dis 2023; 18:1487-1497. [PMID: 37489242 PMCID: PMC10363352 DOI: 10.2147/copd.s404712] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/30/2023] [Indexed: 07/26/2023] Open
Abstract
Purpose To improve inpatient care and self-management in patients with severe acute exacerbations of COPD, we implemented a nurse-led behavioral intervention. This study aimed to assess implementation outcomes from the perspective of the healthcare professionals (HCP) who delivered it. Methods Using an explanatory sequential mixed method approach, we conducted an online questionnaire and two small group interviews. We applied descriptive statistics for quantitative data, a framework analysis for qualitative data, and a mixed methods matrix to integrate the results. Results A total of 19 of 27 invited participants answered the online questionnaire; 9 of 19 participated in the group interviews. The intervention's overall acceptability, appropriateness, and feasibility was rated high to very high (median 5/5; 4/5 and 4/5). Enablers to implementation included general recognition of the need for specialized care, sufficient knowledge of the intervention by HCP, and strong interprofessional collaboration. Main barriers included the lack of resident physician's resources and difficulties in adaptability. Conclusion While the acceptance of the intervention was very high, the perceived appropriateness and feasibility were affected by its complexity. The availability of a knowledgeable interprofessional core team is a strategy that supports the implementation of complex interventions.
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Affiliation(s)
- Christine Hübsch
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Clarenbach
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Matthias Peterer
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Sonja Beckmann
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Gabriela Schmid-Mohler
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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10
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Ellett L, Wildschut T, Chadwick P. Schizophrenia and Increased Distrust-Based Competitiveness in Interpersonal Interactions: A Serial Process Model. Schizophr Bull 2023; 49:1088-1094. [PMID: 36912015 PMCID: PMC10318864 DOI: 10.1093/schbul/sbad021] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND AND HYPOTHESIS Game theory paradigms, such as the Prisoner's Dilemma Game (PDG), have been used to study nonclinical paranoia, though research using clinical populations has been scarce. We test our novel theoretical model that schizophrenia leads to competitiveness in interpersonal interactions, and that this link is serially mediated by trait paranoia, state paranoia, and distrust. STUDY DESIGN In this quasi-experimental study, individuals with schizophrenia spectrum diagnoses with current persecutory delusions (n = 46) and a nonclinical control group (n = 43) played the PDG, and completed measures of trait paranoia, state paranoia, and distrust. STUDY RESULTS Individuals with schizophrenia competed more in the PDG than the control group. Supporting our theoretical model, all direct effects were significant: schizophrenia was associated with higher trait paranoia (H1); trait paranoia predicted state paranoia in the PDG (H2); state paranoia in the PDG predicted distrust of the opponent in the PDG (H3); and distrust predicted competition in the PDG (H4). The hypothesized indirect effect of schizophrenia on competition in the PDG via trait paranoia, state paranoia, and distrust was supported in a serial mediation model (H5). CONCLUSIONS The findings make clear theoretical and methodological contributions. We provide the first evidence for a theoretical process model by which schizophrenia leads to competitiveness in interpersonal interactions via trait paranoia, state paranoia, and distrust. Game theory paradigms, and the PDG in particular, are important for advancing theory and research on paranoia as it occurs in both clinical and nonclinical populations.
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Affiliation(s)
- Lyn Ellett
- School of Psychology, University of Southampton, Southampton, UK
| | - Tim Wildschut
- School of Psychology, University of Southampton, Southampton, UK
| | - Paul Chadwick
- Department of Psychology, University of Bath, Bath, UK
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11
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Johnson BJ, Downing KL, Chadwick P, Gubbels JS. Editorial: Behavior change approaches to improve children and families' dietary intake and 24h movement behaviors. Front Public Health 2023; 11:1211601. [PMID: 37361166 PMCID: PMC10289156 DOI: 10.3389/fpubh.2023.1211601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/12/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
| | - Katherine L. Downing
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Jessica S. Gubbels
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
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12
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Bem R, Chadwick P, Cvjetko I, Koliba M, Kokeny Z, Lipinski P, Mrozikiewicz-Rakowska B, Rozsos I, Wegrzynowski A. A new algorithm for the management of diabetic foot ulcer: recommendations from Central and Eastern Europe. J Wound Care 2023; 32:264-272. [PMID: 37094925 DOI: 10.12968/jowc.2023.32.5.264] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
There is wide regional variation in clinical practice and access to treatment for patients with diabetic foot ulcer (DFU) from countries in Central and Eastern Europe (CEE). A treatment algorithm that reflects current treatment practices while providing a common framework may facilitate best practice in DFU management and improve outcomes across the CEE region. Following a series of regional advisory board meetings with experts from Poland, the Czech Republic, Hungary and Croatia, we present consensus recommendations for the management of DFU and outline the key features of a unified algorithm for dissemination and use as a quick tool in clinical practice in CEE. The algorithm should be accessible to specialists as well as non-specialist clinicians and should incorporate: patient screening; checkpoints for assessment and referral; triggers of treatment change; and strategies for infection control, wound bed preparation and offloading. Among adjunctive treatments in DFU, there is a clear role for topical oxygen therapy, which can be used concomitantly with most existing treatment regimens in hard-to-heal wounds following standard of care. Countries from CEE face a number of challenges in the management of DFU. It is hoped that such an algorithm will help standardise the approach to DFU management and overcome some of these challenges. Ultimately, a regionwide treatment algorithm in CEE has the potential to improve clinical outcomes and save limbs.
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Affiliation(s)
- Robert Bem
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | | | | | - Zoltan Kokeny
- Outpatient Office of Jahn Ferenc Hospital, Budapest, Hungary
| | | | - Beata Mrozikiewicz-Rakowska
- Endocrinology Department, Medical Centre of Postgraduate Education, Ul. Marymoncka 99/103, 01-813 Warszawa, Poland
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13
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Meyer C, Goffe L, Antonopoulou V, Graham F, Tang MY, Lecouturier J, Grimani A, Chadwick P, Sniehotta FF. Using the precaution adoption process model to understand decision-making about the COVID-19 booster vaccine in England. Vaccine 2023; 41:2466-2475. [PMID: 36933983 PMCID: PMC9935297 DOI: 10.1016/j.vaccine.2023.02.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 12/21/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND COVID-19 continues to pose a threat to public health. Booster vaccine programmes are critical to maintain population-level immunity. Stage theory models of health behaviour can help our understanding of vaccine decision-making in the context of perceived threats of COVID-19. PURPOSE To use the Precaution Adoption Process Model (PAPM) to understand decision-making about the COVID-19 booster vaccine (CBV) in England. METHODS An online, cross-sectional survey informed by the PAPM, the extended Theory of Planned Behaviour and Health Belief Model administered to people over the age of 50 residing in England, UK in October 2021. A multivariate, multinomial logistic regression model was used to examine associations with the different stages of CBV decision-making. RESULTS Of the total 2,004 participants: 135 (6.7%) were unengaged with the CBV programme; 262 (13.1%) were undecided as to whether to have a CBV; 31 (1.5%) had decided not to have a CBV; 1,415 (70.6%) had decided to have a CBV; and 161 (8.0%) had already had their CBV. Being unengaged was positively associated with beliefs in their immune system to protect against COVID-19, being employed, and low household income; and negatively associated with CBV knowledge, a positive COVID-19 vaccine experience, subjective norms, anticipated regret of not having a CBV, and higher academic qualifications. Being undecided was positively associated with beliefs in their immune system and having previously received the Oxford/AstraZeneca (as opposed to Pfizer/BioNTech) vaccine; and negatively associated with CBV knowledge, positive attitudes regarding CBV, a positive COVID-19 vaccine experience, anticipated regret of not having a CBV, white British ethnicity, and living in East Midlands (vs London). CONCLUSIONS Public health interventions promoting CBV may improve uptake through tailored messaging directed towards the specific decision stage relating to having a COVID-19 booster.
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Affiliation(s)
- Carly Meyer
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK.
| | - Louis Goffe
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Vivi Antonopoulou
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK
| | - Fiona Graham
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Mei Yee Tang
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Aikaterini Grimani
- NIHR Policy Research Unit in Behavioural Science - Behavioural Science Group, Warwick Business School, University of Warwick, UK
| | - Paul Chadwick
- NIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Germany
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14
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Osborne EL, Ainsworth B, Chadwick P, Atkinson MJ. The role of emotion regulation in the relationship between mindfulness and risk factors for disordered eating: A longitudinal mediation analysis. Int J Eat Disord 2023; 56:458-463. [PMID: 36367130 PMCID: PMC10099542 DOI: 10.1002/eat.23849] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evidence suggests mindfulness may reduce risk factors for disordered eating. However, mechanisms of change in this relationship are unclear. This longitudinal study tested whether emotion regulation mediates the prospective associations between mindfulness and two proximal risk factors for disordered eating: weight and shape concerns, and negative affect. METHOD This study is a secondary analysis of data collected within an eating disorder prevention trial. Adolescent girls (N = 374, Mage = 15.70, SD = 0.77) completed self-report measures of mindfulness, emotion regulation, weight and shape concerns, and negative affect at baseline, 2 months following baseline, and 7 months following baseline. Path analyses were computed to test hypothesized indirect effects using confidence intervals based on 5000 bootstrap samples. RESULTS Higher baseline mindfulness predicted lower weight and shape concerns and negative affect at 7 months via a mediator of better emotion regulation at 2 months. This effect remained while controlling for earlier measurements of the mediator and outcome in the model of negative affect but not weight and shape concerns. DISCUSSION Emotion regulation may be an important mechanism explaining how mindfulness influences negative affect. Efforts should be made to intervene on mindfulness and emotion regulation in prevention and early intervention programmes for eating disorders and other psychiatric conditions. PUBLIC SIGNIFICANCE Research has shown that mindfulness can help to reduce some of the risk of developing an eating disorder. This study explored whether mindfulness reduces some of this risk by helping people to better manage their emotions. Understanding this process can help us to develop better mindfulness-based strategies to support people who are at risk of developing an eating disorder.
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Affiliation(s)
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Paul Chadwick
- Department of Psychology, University of Bath, Bath, UK
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15
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Chu MT, Marks E, Smith CL, Chadwick P. Self-caught methodologies for measuring mind wandering with meta-awareness: A systematic review. Conscious Cogn 2023; 108:103463. [PMID: 36640586 DOI: 10.1016/j.concog.2022.103463] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/24/2022] [Accepted: 12/25/2022] [Indexed: 01/14/2023]
Abstract
Mind wandering, also known as task-unrelated thought, refers to the drift of attention from a focal task or train of thought. Because self-caught measures of mind wandering require participants to spontaneously indicate when they notice their attention drift, self-caught methodologies provide a way to measure mind wandering with meta-awareness. Given the proposed role of meta-awareness in mental health and psychological interventions, an overview of existing self-caught methodologies would help clinicians and researchers make informed decisions when choosing or adapting a mind wandering or meta-awareness measure. This systematic review included 39 studies after 790 studies were assessed for eligibility. All studies operationalised mind wandering as instances of attention drift from a primary task. Three types of primary task were identified: (1) tasks adapted from computerised continuous performance tests (CPT) of sustained attention, (2) tasks involving focusing on the breath or a stream of aural beats, akin to in-vivo mindfulness meditation, (3) tasks involving an everyday life activity such as reading. Although data on mind wandering without meta-awareness (e.g., measured with probe-caught measures) was also obtained in many studies, such data was not always used in conjunction with self-caught mind wandering data to determine level of mind wandering meta-awareness. Few studies reported both reliability and validity of the measures used. This review shows that considerable methodological heterogeneity exists in the literature. Methodological variants of self-caught mind wandering methodologies are documented and examined, and suggestions for future research and clinical work are suggested.
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Affiliation(s)
- Maria T Chu
- Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Elizabeth Marks
- Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | | | - Paul Chadwick
- Department of Psychology, University of Bath, Bath BA2 7AY, UK.
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16
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Ellett L, Kingston J, Tarant E, Kouimtsidis C, Vivarelli L, Chadwick P. Self-Structure in Persecutory Delusions. Behav Ther 2023; 54:132-140. [PMID: 36608970 DOI: 10.1016/j.beth.2022.07.011] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 01/14/2023]
Abstract
There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.
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Affiliation(s)
| | | | - Eryna Tarant
- Surrey and Borders Partnership NHS Foundation Trust
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17
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Haycocks S, Cameron R, Edge M, Budd J, Chadwick P. Implementation of a novel mHealth application for the management of people with diabetes and recently healed foot ulceration: A feasibility study. Digit Health 2022; 8:20552076221142103. [PMID: 36506489 PMCID: PMC9732796 DOI: 10.1177/20552076221142103] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background Diabetic foot ulcers (DFUs) cause significant morbidity and mortality. Faster referral to specialist clinics is associated with a reduced risk of severe DFUs. The INTELLIN® diabetes management platform is a novel mHealth application for the management of recently healed DFUs and other complications, promoting engagement and expediting self-referral. Methods To determine the acceptability, suitability, and usability of the INTELLIN® platform, time until reulceration, site, ischemia, neuropathy, bacterial infection, and depth (SINBAD) score and incidence of self-referral for recurrence were assessed in patients from the Salford Royal NHS Foundation Trust. Patients and clinic staff also assessed platform usability. A Markov cost-utility model was used for the health economics and outcomes research analysis. Results 197 patients were assessed for eligibility and 15 entered the full analysis set (FAS). Through Week 52, 8/15 patients experienced recurrence, with a mean SINBAD score of 2.1 and mean duration of 2.6 days. Mean time to recurrence was 273.0 days (95% confidence interval 74.0, 484.0). No patients self-referred. Initial qualitative data showed high platform usability. The INTELLIN® platform only required a relative reduction in recurrence of 5% versus standard of care (SoC) for an incremental cost effectiveness ratio of £20,000 per quality-adjusted life-year, suggesting potential for significant cost savings upon wider adoption. The barriers to enrollment encountered demonstrate the impact of socioeconomics on mHealth. Conclusions These results suggest that the INTELLIN® platform is required to provide only a small reduction in recurrence compared to SoC to be a cost-effective strategy for prevention of recurrent DFUs.
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Affiliation(s)
- Samantha Haycocks
- Salford Care Organisation, Northern Care Alliance NHS Foundation
Trust, Salford, UK
| | | | | | - Jayne Budd
- Gendius Ltd, Cheshire, UK,Jayne Budd, Gendius Ltd, The Glasshouse,
Alderley Park, Cheshire SK10 4ZE, UK.
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18
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Winnebeck E, Fissler M, Gärtner M, Chadwick P, Barnhofer T. Corrigendum to “Brief training in mindfulness meditation reduces symptoms in patients with a chronic or recurrent lifetime history of depression: A randomized controlled study” [Behaviour Research and Therapy 99 (2017) 124–130]. Behav Res Ther 2022; 159:104225. [DOI: 10.1016/j.brat.2022.104225] [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: 11/24/2022]
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19
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Antonopoulou V, Goffe L, Meyer CJ, Grimani A, Graham F, Lecouturier J, Tang MY, Chadwick P, Sniehotta FF. A comparison of seasonal influenza and novel Covid-19 vaccine intentions: A cross-sectional survey of vaccine hesitant adults in England during the 2020 pandemic. Hum Vaccin Immunother 2022; 18:2085461. [PMID: 35816683 PMCID: PMC9621000 DOI: 10.1080/21645515.2022.2085461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 12/26/2022] Open
Abstract
We compared intention to receive the seasonal influenza vaccine with a prospective coronavirus (COVID-19) vaccine among undecided or COVID-19 vaccine hesitant individuals to better understand the underlying differences and similarities in factors associated with vaccine intention. We delivered a cross-sectional online survey in October-November 2020. We included psychological constructs and sociodemographic variables informed by theory. We conducted pairwise comparisons and multiple linear regression models to explore associations between vaccine intention and psychological constructs. We recruited 1,660 participants, where 47.6% responded that they would likely receive the influenza vaccine, 31.0% that they would probably not accept the vaccination and 21.4% were unsure. In relation to the prospective COVID-19 vaccine, 39.0% responded that they would likely receive the vaccination, 23.7% that they would probably not accept the vaccination and 37.3% were unsure. Unique factors positively associated with COVID-19 vaccine intention were: perceived knowledge sufficiency about vaccine safety, beliefs about vaccine safety, and living in an area of low deprivation. The only unique factor positively associated with influenza intention was past influenza behavior. The strongest common predictors positively associated with intention were: favorable vaccine attitudes, the anticipated regret they may feel following infection if they were not to receive a vaccine, and the expectation from family or friends to accept the vaccine. Despite overall similarities in those factors associated with vaccination intention, we identified unique influences on intention. This additional insight will help support the planning and tailoring of future immunizations programmes for the respective viruses.
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Affiliation(s)
- Vivi Antonopoulou
- NIHR Policy Research Unit in Behavioural Science, Centre for Behaviour Change, Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Louis Goffe
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Carly J Meyer
- NIHR Policy Research Unit in Behavioural Science, Centre for Behaviour Change, Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Aikaterini Grimani
- NIHR Policy Research Unit in Behavioural Science – Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, UK
| | - Fiona Graham
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mei Yee Tang
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Paul Chadwick
- NIHR Policy Research Unit in Behavioural Science, Centre for Behaviour Change, Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Germany
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20
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Hale J, Jofeh C, Chadwick P. Decarbonising existing homes in Wales: a participatory behavioural systems mapping approach. UCL Open Environ 2022; 4:e047. [PMID: 37228458 PMCID: PMC10208331 DOI: 10.14324/111.444/ucloe.000047] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 09/01/2022] [Indexed: 05/27/2023]
Abstract
To reduce carbon emissions, urgent change is needed to high-carbon human behaviours including home energy use. Previous policy failures point to insufficient integration of systemic and behavioural approaches which are too often seen as alternative and incompatible approaches to bring about change. A novel behavioural systems mapping approach was used to inform national policy recommendations for energy-saving retrofit of homes in Wales. Three participatory workshops were held with the independent Welsh residential decarbonisation advisory group ('the Advisory Group') to: (1) map relationships between actors, behaviours and influences on behaviour within the home retrofit system; (2) provide training in the Behaviour Change Wheel (BCW) framework and (3) use these to develop policy recommendations for interventions. Recommendations were analysed using the capability, opportunity and motivation (COM-B) model of behaviour to assess whether they addressed these factors. Two behavioural systems maps (BSMs) were produced, representing privately rented and owner-occupied housing tenures. The main causal pathways and feedback loops in each map are described. Necessary interventions to achieve national-scale retrofit included: government-led investment, campaigns and awareness-building, financial-sector funding mechanisms, enforcement of regulations and creating more streamlined and trusted supply chain services. Of 27 final policy recommendations, six addressed capability, 24 opportunity and 12 motivation. Participatory behavioural systems mapping can be used in conjunction with behaviour change frameworks to develop policy recommendations that address the behavioural determinants of complex environmental problems in a systemic way. Research is underway to refine and extend the approach through application to other sustainability challenges and methods of constructing systems maps.
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Affiliation(s)
- Joanna Hale
- Centre for Behaviour Change, University College London, London, UK
| | - Christopher Jofeh
- Welsh Government’s Independent Advisory Group on Residential Decarbonisation
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
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21
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Schmid-Mohler G, Hübsch C, Steurer-Stey C, Greco N, Schuurmans MM, Beckmann S, Chadwick P, Clarenbach C. Supporting Behavior Change After AECOPD - Development of a Hospital-Initiated Intervention Using the Behavior Change Wheel. Int J Chron Obstruct Pulmon Dis 2022; 17:1651-1669. [PMID: 35923357 PMCID: PMC9339665 DOI: 10.2147/copd.s358426] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
After hospitalization due to acute COPD exacerbations, patient-manageable behaviors influence rehospitalization frequency. This study's aim was to develop a hospital-ward-initiated Behaviour-Change-Wheel (BCW)-based intervention targeting patients' key health behaviors, with the aim to increase quality of life and reduce rehospitalization frequency. Intervention development was performed by University Hospital Zurich working groups and followed the three BCW stages for each of the three key literature-identified problems: insufficient exacerbation management, lack of physical activity and ongoing smoking. In stage one, by analyzing published evidence - including but not limited to patients' perspective - and health professionals' perspectives regarding these problems, we identified six target behaviors. In stage two, we identified six corresponding intervention functions. As our policy category, we chose developing guidelines and service provision. For stage three, we defined eighteen basic intervention packages using 46 Behaviour Change Techniques in our basic intervention. The delivery modes will be face-to-face and telephone contact. In the inpatient setting, this behavioral intervention will be delivered by a multi-professional team. For at least 3 months following discharge, an advanced nursing practice team will continue and coordinate the necessary care package via telephone. The intervention is embedded in a broader self-management intervention complemented by integrated care components. The BCW is a promising foundation upon which to develop our COPD intervention. In future, the interaction between the therapeutic care team-patient relationships and the delivery of the behavioral intervention will also be evaluated.
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Affiliation(s)
- Gabriela Schmid-Mohler
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christine Hübsch
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Claudia Steurer-Stey
- Epidemiology, Biostatistics and Prevention Institute, University Zurich, Zurich, Switzerland
- mediX Group Practice Zurich, Zurich, Switzerland
| | - Nico Greco
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Sonja Beckmann
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Paul Chadwick
- Centre for Behavior Change, University College London, London, UK
| | - Christian Clarenbach
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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22
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Ellett L, Foxall A, Wildschut T, Chadwick P. Dispositional Forgiveness Buffers Paranoia Following Interpersonal Transgression. J Pers 2022; 91:556-565. [PMID: 35837856 DOI: 10.1111/jopy.12755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/20/2022] [Accepted: 06/30/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To test a novel proposition that dispositional forgiveness has the unrecognised benefit of buffering feelings of paranoia following negative interpersonal experiences and interpersonal transgressions. METHODS In Study 1 (N = 128), we used an experimental paradigm, the Prisoner's Dilemma Game (PDG), to test the premise that an interpersonal transgression increases state paranoia. Study 2 (N = 180) used a longitudinal design to test the central proposition that dispositional forgiveness buffers state paranoia following naturally occurring difficult (vs pleasant) interpersonal events. Study 3 (N = 102) used a novel experimental paradigm to determine the causal effect of manipulating forgiveness on paranoia. RESULTS In Study 1, interpersonal transgressions in the PDG increased paranoia. In Study 2, paranoia was higher following difficult (rather than pleasant) events, and higher levels of dispositional forgiveness moderated the negative effect of difficult events on paranoia. In Study 3, there was a causal effect of forgiveness on (reduced) paranoia. CONCLUSIONS This is the first evidence that (1) interpersonal transgressions increase paranoia, (2) high dispositional forgiveness moderates the deleterious effect of interpersonal transgression on paranoia, and (3) dispositional forgiveness is causally related to less paranoia.
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Begum S, Povey R, Ellis N, Gidlow C, Chadwick P. Influences of decisions to attend a national diabetes prevention programme from people living in a socioeconomically deprived area. Diabet Med 2022; 39:e14804. [PMID: 35122316 PMCID: PMC9315040 DOI: 10.1111/dme.14804] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
Abstract
AIMS To explore key influences of decisions in participants from a socioeconomically deprived area to attend the Healthier You: NHS Diabetes Prevention Programme (NHSDPP). The NHSDPP is a lifestyle behaviour change programme for adults with prediabetes living in England. METHODS Semi-structured interviews were conducted with 35 participants who had attended the initial assessment, but not yet started the NHSDPP; 23 were classified as "attenders," 12 as "non-attenders" after they were interviewed based on whether they had attended the first NHSDPP session or not. Transcribed interviews were analysed using inductive thematic analysis. RESULTS Seven themes were derived from the data. The results demonstrate how understanding type 2 diabetes, making lifestyle changes, comparing themselves with others, having support and certain self-perceptions can all affect individuals' motivation to attend a diabetes prevention programme. Accessibility and practicalities also influenced both motivation and attendance. CONCLUSIONS This study identified a range of different influences on decisions to attend a diabetes prevention programme, which programme organisers and healthcare professionals should consider to maximise attendance. Initial communication from general practitioners (GPs) and initial assessments are key points where people's beliefs and understanding could be explored.
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Affiliation(s)
- Sonia Begum
- School of Health, Science and WellbeingStaffordshire UniversityStoke‐on‐TrentUK
| | - Rachel Povey
- School of Health, Science and WellbeingStaffordshire UniversityStoke‐on‐TrentUK
| | - Naomi Ellis
- School of Health, Science and WellbeingStaffordshire UniversityStoke‐on‐TrentUK
| | - Christopher Gidlow
- School of Health, Science and WellbeingStaffordshire UniversityStoke‐on‐TrentUK
| | - Paul Chadwick
- Centre for Behaviour ChangeUniversity College LondonLondonUK
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Perkins N, Smith P, Chadwick P. Young Children’s Conceptualisations of Kindness: A Thematic Analysis. Front Psychol 2022; 13:909613. [PMID: 35783797 PMCID: PMC9249386 DOI: 10.3389/fpsyg.2022.909613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
Although there is much interest in the development of prosocial behaviour in young children, and many interventions that attempt to cultivate kindness in children, there is a paucity of research exploring children’s lived experiences of kindness and including their voices. In this study, children’s understanding of kindness is approached through qualitative interviews using puppets. Interviews were conducted with 33 children aged 5-6 years in 3 schools in the United Kingdom. Through thematic analysis, 4 themes were developed: (a) doing things for others, (b) relating with others, (c) rules and values, and (d) kindness affects us. These themes are examined in light of current thinking on prosocial and sociomoral development, and several key insights are highlighted, including types of prosocial behaviour, social connection, kindness-by-omission and defending, in-group bias, universal kindness versus personal safety, self-image, and a desire to improve the condition of society. These findings have implications for future research on prosocial development and for the design of kindness-based interventions, as well as providing an ecologically valid method of inquiry for use with young children.
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Ellett L, Dannahy L, Chadwick P. Engagement, clinical outcomes and therapeutic process in online mindfulness for psychosis groups delivered in routine care. Psychol Psychother 2022; 95:467-476. [PMID: 35049131 PMCID: PMC9303574 DOI: 10.1111/papt.12382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/24/2021] [Accepted: 01/04/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES There is growing evidence for the benefit of mindfulness-based interventions (MBI) for people with psychosis. However, research is yet to evaluate the clinical benefit of delivering MBI groups online. We examine engagement, clinical outcomes, participant experience and therapeutic process of delivering therapy groups online in routine clinical practice. METHODS The study used an uncontrolled pre-post design to examine engagement, therapeutic benefits (depression, anxiety, beliefs about voices) and group process in a 12-session online mindfulness group for individuals with a schizophrenia spectrum diagnosis with current distressing voices. Qualitative data on participant experience of online group therapy were analysed using Thematic Analysis. RESULTS 17/21 participants (81%) completed one of three consecutively run therapy groups. For completers there were significant reductions pre-post in depression, anxiety, beliefs about voices and voice-related negative affect, with medium to large effect sizes. There were individuals showing reliable and clinically significant improvements in each clinical outcome, and none showing reliable or clinically significant deterioriation. Participants' rankings of the importance of different group therapeutic factors were very similar to those observed in face-to-face mindfulness for psychosis groups. Qualitative analysis of participant feedback identified three themes: 'experience of online delivery', 'therapeutic benefits' and 'feeling connected to people in the group'. CONCLUSIONS Findings in relation to therapy engagement, clinical benefits, participant experience and group process offer encouragement that online delivery of mindfulness for psychosis groups may be a useful addition to mental health services for people with distressing voices.
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Baumeister D, Peters E, Pruessner J, Howes O, Chadwick P. The effects of voice content on stress reactivity: A simulation paradigm of auditory verbal hallucinations. Schizophr Res 2022; 243:225-231. [PMID: 31377050 PMCID: PMC9205337 DOI: 10.1016/j.schres.2019.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/27/2019] [Accepted: 07/11/2019] [Indexed: 12/02/2022]
Abstract
OBJECTIVES Psychosis is associated with increased subjective and altered endocrine and autonomic nervous system stress-reactivity. Psychosis patients often experience auditory verbal hallucinations, with negative voice content being particularly associated with distress. The present study developed a voice-simulation paradigm and investigated the effect of simulated voices with neutral and negative content on psychophysiological stress-reactivity, and the effect of mindful voice-appraisals on stress-reactivity. METHOD Eighty-four healthy participants completed the Montreal Imaging Stress Task with simultaneous presentation of one of three randomly allocated auditory stimuli conditions: negative voices, neutral voices or non-voice ambient sounds. Subjective stress-levels and mindful voice-appraisals were assessed using questionnaire measures, and cortisol and α-amylase levels were measured using saliva samples. RESULTS ANOVA revealed a significant effect of condition on subjective stress-levels (p = .002), but not cortisol (p = .63) or α-amylase (p = .73). Post-hoc analyses showed that negative voices increased subjective stress-levels relative to neutral voices (p = .002) and ambient sounds (p = .01), which did not differ from each other (p = .41). Mindful voice-appraisals were associated with less distress across conditions (p = .003), although negative voices were also associated with less mindful appraisals (p < .001). CONCLUSIONS Negative voice content, rather than voices or auditory stimuli per se, is linked to greater subjective but not physiological stress-reactivity. Mindful appraisals may partially moderate this effect. These findings highlight the importance of voice content for the impact of voice-hearing, and highlight the potential value of mindfulness training to treat voice distress in psychosis.
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Affiliation(s)
- David Baumeister
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK; Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany.
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK
| | - Jens Pruessner
- Department of Psychology, University of Constance, Constance, Germany
| | - Oliver Howes
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, Kent, UK,Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychosis Studies, London, UK
| | - Paul Chadwick
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK,Department of Psychology, University of Bath, Bath, UK
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27
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Hunter KE, Johnson BJ, Askie L, Golley RK, Baur LA, Marschner IC, Taylor RW, Wolfenden L, Wood CT, Mihrshahi S, Hayes AJ, Rissel C, Robledo KP, O'Connor DA, Espinoza D, Staub LP, Chadwick P, Taki S, Barba A, Libesman S, Aberoumand M, Smith WA, Sue-See M, Hesketh KD, Thomson JL, Bryant M, Paul IM, Verbestel V, Stough CO, Wen LM, Larsen JK, O'Reilly SL, Wasser HM, Savage JS, Ong KK, Salvy SJ, Messito MJ, Gross RS, Karssen LT, Rasmussen FE, Campbell K, Linares AM, Øverby NC, Palacios C, Joshipura KJ, González Acero C, Lakshman R, Thompson AL, Maffeis C, Oken E, Ghaderi A, Campos Rivera M, Pérez-Expósito AB, Banna JC, de la Haye K, Goran M, Røed M, Anzman-Frasca S, Taylor BJ, Seidler AL. Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity. BMJ Open 2022; 12:e048166. [PMID: 35058256 PMCID: PMC8783820 DOI: 10.1136/bmjopen-2020-048166] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/18/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups. METHODS AND ANALYSIS Systematic searches of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2021 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index z-score at age 24±6 months using WHO Growth Standards, and effect differences will be explored among prespecified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events. ETHICS AND DISSEMINATION Approved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations and media releases. PROSPERO REGISTRATION NUMBER CRD42020177408.
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Affiliation(s)
- Kylie E Hunter
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lisa Askie
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Ian C Marschner
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Charles T Wood
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alison J Hayes
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristy P Robledo
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Denise A O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lukas P Staub
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul Chadwick
- Centre For Behaviour Change, University College London, London, UK
| | - Sarah Taki
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Angie Barba
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Mason Aberoumand
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Wendy A Smith
- Canterbury Community Health Centre, Sydney Local Health District, Campsie, New South Wales, Australia
- Consumer Representative, Sydney, New South Wales, Australia
| | | | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | | | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, University of York, York, UK
| | - Ian M Paul
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Li Ming Wen
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, The Netherlands
| | - Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer S Savage
- Department of Nutritional Sciences & Center for Childhood Obesity Research, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ken K Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, California, USA
| | - Mary Jo Messito
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Rachel S Gross
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Levie T Karssen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, The Netherlands
| | - Finn E Rasmussen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Ana Maria Linares
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Kaumudi J Joshipura
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Carolina González Acero
- Social Protection and Health Division, Inter-American Development Bank, Santo Domingo, Distrito Nacional, Dominican Republic
| | | | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | | | - Ana B Pérez-Expósito
- Social Protection and Health Division, Inter-American Development Bank, Washington, District of Columbia, USA
| | - Jinan C Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii, Honolulu, Hawaii, USA
| | - Kayla de la Haye
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael Goran
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Margrethe Røed
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Barry J Taylor
- Better Start National Science Challenge, University of Otago, Dunedin, New Zealand
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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Johnson BJ, Hunter KE, Golley RK, Chadwick P, Barba A, Aberoumand M, Libesman S, Askie L, Taylor RW, Robledo KP, Mihrshahi S, O'Connor DA, Hayes AJ, Wolfenden L, Wood CT, Baur LA, Rissel C, Staub LP, Taki S, Smith W, Sue-See M, Marschner IC, Espinoza D, Thomson JL, Larsen JK, Verbestel V, Odar Stough C, Salvy SJ, O'Reilly SL, Karssen LT, Rasmussen FE, Messito MJ, Gross RS, Bryant M, Paul IM, Wen LM, Hesketh KD, González Acero C, Campbell K, Øverby NC, Linares AM, Wasser HM, Joshipura KJ, Palacios C, Maffeis C, Thompson AL, Ghaderi A, Lakshman R, Banna JC, Oken E, Campos Rivera M, Pérez-Expósito AB, Taylor BJ, Savage JS, Røed M, Goran M, de la Haye K, Anzman-Frasca S, Seidler AL. Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol. BMJ Open 2022; 12:e048165. [PMID: 35058255 PMCID: PMC8783827 DOI: 10.1136/bmjopen-2020-048165] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 10/28/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER CRD42020177408.
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Affiliation(s)
- Brittany J Johnson
- Caring Fututures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca K Golley
- Caring Fututures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Angie Barba
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Mason Aberoumand
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Askie
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kristy P Robledo
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Denise A O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - Alison J Hayes
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Charles T Wood
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Louise A Baur
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lukas P Staub
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Taki
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Wendy Smith
- Canterbury Community Health Centre, Campsie, New South Wales, Australia
- Consumer Representative, Sydney, New South Wales, Australia
| | | | - Ian C Marschner
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - David Espinoza
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Junilla K Larsen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, California, USA
| | - Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Levie T Karssen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Finn E Rasmussen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Mary Jo Messito
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Rachel S Gross
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, University of York, Heslington, UK
| | - Ian M Paul
- College of Medicine, Penn State, Hershey, Pennsylvania, USA
| | - Li Ming Wen
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Carolina González Acero
- Office of Strategic Planning and Development Effectiveness, Inter- American Development Bank, Santo Domingo, Dominican Republic
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Ana M Linares
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Universita degli Studi di Verona, Verona, Italy
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, UK
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rajalakshmi Lakshman
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jinan C Banna
- Human Nutrition, Food and Animal Sciences, University of Hawaii System, Honolulu, Hawaii, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
| | | | - Ana B Pérez-Expósito
- Office of Strategic Planning and Development Effectiveness, Inter- American Development Bank, Washington DC, District of Columbia, USA
| | - Barry J Taylor
- Better Start National Science Challenge, University of Otago, Dunedin, New Zealand
| | - Jennifer S Savage
- Department of Nutritional Sciences and Center for Childhood Obesity Research, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Margrethe Røed
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Michael Goran
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Kayla de la Haye
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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Poulikakos D, Chinnadurai R, Mcgee Y, Gray S, Clough T, Clarke N, Murphy T, Wickens O, Mitchell C, Darby D, Paul J, Chadwick P, Sethi S, Sinha S, Kalra PA, Donne R. A Quality Improvement Project to Minimize COVID-19 Infections in Patients Receiving Haemodialysis and the Role of Routine Surveillance Using Nose and Throat Swabs for SARS-CoV-2 rRT-PCR and Serum Antibody Testing. Nephron Clin Pract 2021; 146:335-342. [PMID: 34937042 PMCID: PMC8805076 DOI: 10.1159/000520654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/22/2021] [Indexed: 11/19/2022] Open
Abstract
Background Patients receiving in-centre haemodialysis (ICHD) are highly vulnerable to COVID-19. Objective We created a quality improvement (QI) project aimed to eliminate outbreaks of COVID-19 in haemodialysis units and evaluated the utility of surveillance rRT-PCR test and SARS-CoV-2 serum antibodies for prompt identification of patients infected with COVID-19. Methods A multifaceted QI programme including a bundle of infection prevention control (IPC) measures was implemented across 5 ICHD units following the first wave of the pandemic in June 2020. Primary outcomes evaluated before and after QI implementation were incidence of outbreaks and severe COVID-19 illness defined as COVID-19-related death or hospitalization. Secondary outcomes included the proportion of patients identified in the pre-symptomatic/asymptomatic phase on surveillance rRT-PCR screening and the incidence and longevity of SARS-CoV-2 antibody response. Results Following the implementation of the QI project, there were no further outbreaks. Pre- and post-implementation comparison showed a significant reduction in COVID-19-related mortality and hospitalization (26 vs. 13 events, respectively, p < 0.001). Surveillance rRT-PCR screening identified 39 asymptomatic or pre-symptomatic cases out of a total of 59 rRT-PCR-positive patients (39/59, 66%). SARS-CoV-2 antibody levels were detected in 72/74 (97%) rRT-PCR-positive patients. Amongst rRT-PCR-positive patients diagnosed before August 2020, 96% had detectable antibodies until January 2021 (days from the rRT-PCR test to last antibody testing, 245–280). Conclusions Systematic implementation of a bundle of IPC measures using QI methodology and surveillance rRT-PCR eliminated outbreaks in HD facilities. Most HD patients mount and sustain antibody response to COVID-19 for over 8 months.
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Affiliation(s)
- Dimitrios Poulikakos
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Rajkumar Chinnadurai
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- *Rajkumar Chinnadurai,
| | - Yvonne Mcgee
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Simon Gray
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Toni Clough
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Nicola Clarke
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Tracey Murphy
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Olivia Wickens
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Carol Mitchell
- Infection Control Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Denise Darby
- Chemical Pathology Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Joel Paul
- Virology Department, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Paul Chadwick
- Microbiology Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
| | - Su Sethi
- Public Health England, North West Region Specialised Commissioning Team, NHS, London, United Kingdom
| | - Smeeta Sinha
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Philip A. Kalra
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Rosie Donne
- Renal Department, Salford Royal NHS Foundation Trust, The Northern Care Alliance NHS Group, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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Abstract
There is increasing interest in potential harmful effects of mindfulness-based interventions. In relation to psychosis, inconsistency and shortcomings in how harm is monitored and reported are holding back our understanding. We offer eight recommendations to help build a firmer evidence base on potential harm in mindfulness for psychosis.
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Affiliation(s)
- Lyn Ellett
- Department of Psychology, Royal Holloway, University of London, UK
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31
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Mediavilla R, Muñoz-Sanjose A, Rodriguez-Vega B, Lahera G, Palao A, Bayon C, Vidal-Villegas MP, Chadwick P, Bravo-Ortiz MF. People with psychosis improve affective social cognition and self-care after a mindfulness-based social cognition training program (SocialMIND). Psychiatr Rehabil J 2021; 44:391-395. [PMID: 33570983 DOI: 10.1037/prj0000466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study explores whether social cognition and social functioning improve after a mindfulness-based social cognition training (SocialMIND). METHODS Thirty-eight outpatients with psychosis completed an assessment with social cognition (Eyes Test, Ambiguous Intentions and Hostility Questionnaire [AIHQ], and Hinting Task) and social functioning tasks (Personal and Social Performance [PSP] scale) before and after eight SocialMIND weekly sessions. Mean differences between timepoints were standardized and 95% confidence intervals were obtained with a paired samples t-test. RESULTS The scores of the Eyes Test (95% CI [.43, 3.32], d = .48), the Hostility Bias subscale (AIHQ) (95% CI [-.29, -.01], d = .44), and the self-care difficulties subscale (PSP) (95% CI [-.77, -.09], d = .45) improved after the intervention. CONCLUSIONS and Implications for practice: The results of SocialMIND-8 are very promising in terms of developing comprehensive rehabilitation programs. Further trials must address its effectiveness against a control group during longer follow-up periods. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Roberto Mediavilla
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | - Ainoa Muñoz-Sanjose
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | | | | | - Angela Palao
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | - Carmen Bayon
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
| | | | | | - Maria-Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Neuroscience Research Area
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32
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Atkin L, Bullock L, Chadwick P, Elwell R, Gardner S, Goodwin T, Hopkins A, O'Connor C, Sneddon M, Wiles K, Williams K. Making Legs Matter: A Case for System Change and Transformation in Lower-Limb Management. J Wound Care 2021; 30:S1-S25. [PMID: 34756097 DOI: 10.12968/jowc.2021.30.sup11.s1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This consensus document is endorsed by The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS).
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Affiliation(s)
- Leanne Atkin
- Legs Matter Chair; Vascular Nurse Consultant, Mid Yorks NHS Trust/University of Huddersfield, UK
| | - Lynn Bullock
- PA to Ellie Lindsay, The Lindsay Leg Club Foundation, UK
| | - Paul Chadwick
- National Clinical Director, The College of Podiatry, UK
| | - Rebecca Elwell
- Macmillan Lymphoedema ANP and Team Leader, Lymphoedema Clinic, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, UK
| | | | | | | | | | - Margaret Sneddon
- Honorary Senior Research Fellow, University of Glasgow; Chair, British Lymphology Society, UK
| | | | - Kate Williams
- Tissue Viability Nurse, Leeds Community Health NHS Trust, UK
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33
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Bem R, Chadwick P, Cvjetko I, Koliba M, Kokeny Z, Lipinski P, Mrozikiewicz-Rakowska B, Rozsos I, Wegrzynowski A, Arts E, Elezaby H, Hestner A, Timmons J, Wright E, Ampofo C. Eastern European Diabetic Foot Ulcer Advisory Board Meeting. J Wound Care 2021; 30:810-821. [PMID: 34644139 DOI: 10.12968/jowc.2021.30.10.810] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Hisham Elezaby
- Medical Affairs and Market Access Lead, Eastern Europe, Middle East Africa and Latin America
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Chater AM, Shorter GW, Swanson V, Kamal A, Epton T, Arden MA, Hart J, Byrne-Davis LMT, Drury J, Whittaker E, Lewis LJM, McBride E, Chadwick P, O’Connor DB, Armitage CJ. Template for Rapid Iterative Consensus of Experts (TRICE). Int J Environ Res Public Health 2021; 18:10255. [PMID: 34639553 PMCID: PMC8508030 DOI: 10.3390/ijerph181910255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, "mixed messaging" of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. METHOD TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. RESULTS Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4-156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. CONCLUSION TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford MK41 9EA, UK
- Centre for Behavioural Medicine, University College London, BMA House, Tavistock Square, London WC1H 9JP, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Northern Ireland BT7 1NN, UK;
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling FK9 4LA, UK;
- NHS Education for Scotland, 2 Central Quay, 89, Hydepark Street, Glasgow G3 8BW, UK
| | - Atiya Kamal
- School of Social Sciences, Department of Psychology, Birmingham City University, Birmingham B4 7BD, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield S10 2BQ, UK;
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - Lucie M. T. Byrne-Davis
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - John Drury
- School of Psychology, University of Sussex, Falmer BN1 9QN, UK;
| | - Ellie Whittaker
- North Yorkshire County Council, County Hall, Northallerton, North Yorkshire DL7 8DD, UK;
| | - Lesley J. M. Lewis
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK;
| | - Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK;
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds LS2 9JT, UK;
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
- Manchester University NHS Foundation Trust and NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester M13 9PL, UK
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35
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Soni A, Beeken RJ, McGowan L, Lawson V, Chadwick P, Croker H. 'Shape-Up', a Modified Cognitive-Behavioural Community Programme for Weight Management: Real-World Evaluation as an Approach for Delivering Public Health Goals. Nutrients 2021; 13:2807. [PMID: 34444967 PMCID: PMC8402118 DOI: 10.3390/nu13082807] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 11/17/2022] Open
Abstract
Obesity is widespread, with serious health consequences; addressing it requires considerable effort at a public health level, incorporating prevention and management along with policies to support implementation. Behavioural weight-management programmes are widely used by public health bodies to address overweight and obesity. Shape-Up is an evidence-based programme combining a structured behavioural intervention (targeting nutrition and physical activity behaviours) within a peer-learning framework. This study was a service-evaluation of Shape-Up, as delivered in Rotherham by a local leisure provider, and included a secondary analysis of data collected in the community by service providers. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to explore programme effectiveness, implementation, and whom it reached. A total of 141 participants were included. Compared to local demographics, participants were older, at 48.9 (SD 14.47) years, with a lower employment rate (41% employed) and greater proportion female (67% female). Mean BMI was 38.0 (SD 7.54) kg/m2. Mean weight-change between baseline and endpoint (12 weeks, 10 group sessions) was -4.4 (SD 3.38) kg, and degree of weight change was associated with session attendance (F (9, 131) = 6.356, p < 0.0005). There were positive effects on participants' weight, health-related behaviours, and quality of life. The intervention content (including the focus of nutritional recommendations) and structure were adapted during implementation to better suit national guidelines and local population needs. RE-AIM was found to be a useful framework for evaluating and adapting an existing evidence-based weight management programme in line with local population needs. This could be a more cost-effective approach, compared to developing new programmes, for delivering public health goals relating to obesity, nutrition, and physical activity.
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Affiliation(s)
- Amber Soni
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK;
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Laura McGowan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast BT9 7BL, UK;
- Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Belfast BT9 5DL, UK
| | - Victoria Lawson
- Talking Therapies Southwark, Maudsley Hospital, London SE5 8AZ, UK;
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London WC1E 6BT, UK;
| | - Helen Croker
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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36
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Atkin L, Chadwick P. Improving care for 'Cinderella' patients with non-diabetic lower limb wounds. ACTA ACUST UNITED AC 2021; 30:S6. [PMID: 34379477 DOI: 10.12968/bjon.2021.30.15.s6] [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: 11/11/2022]
Affiliation(s)
- Leanne Atkin
- Lecturer Practitioner, School of Human and Health Sciences, University of Huddersfield and Vascular Nurse Consultant, Mid Yorkshire NHS Trust
| | - Paul Chadwick
- National Clinical Director, The Royal College of Podiatry, London
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Baumeister D, Ward T, Garety P, Jackson M, Morgan C, Charalambides M, Chadwick P, Howes O, Peters E. Need for care, adversity exposure and perceived stress in clinical and healthy voice-hearers. Psychol Med 2021; 51:1944-1950. [PMID: 32686627 PMCID: PMC8381238 DOI: 10.1017/s0033291720002433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Psychosis, and in particular auditory verbal hallucinations (AVHs), are associated with adversity exposure. However, AVHs also occur in populations with no need for care or distress. AIMS This study investigated whether adversity exposure would differentiate clinical and healthy voice-hearers within the context of a 'three-hit' model of vulnerability and stress exposure. METHODS Samples of 57 clinical and 45 healthy voice-hearers were compared on the three 'hits': familial risk; adversity exposure in childhood and in adolescence/adulthood. RESULTS Clinical voice-hearers showed greater familial risk than healthy voice-hearers, with more family members with a history of psychosis, but not with other mental disorders. The two groups did not differ in their exposure to adversity in childhood [sexual and non-sexual, victimisation; discrimination and socio-economic status (SES)]. Contrary to expectations, clinical voice-hearers did not differ from healthy voice-hearers in their exposure to victimisation (sexual/non-sexual) and discrimination in adolescence/adulthood, but reported more cannabis and substance misuse, and lower SES. CONCLUSIONS The current study found no evidence that clinical and healthy voice-hearers differ in lifetime victimisation exposure, suggesting victimisation may be linked to the emergence of AVHs generally, rather than need-for-care. Familial risk, substance misuse and lower SES may be additional risk factors involved in the emergence of need-for-care and distress.
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Affiliation(s)
- David Baumeister
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Ward
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Mike Jackson
- Bangor University, School of Psychology, Bangor, North Wales, UK
- Betsi Cadwaladr University Health Board, Bangor, North Wales, UK
| | - Craig Morgan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Health Service & Population Research, London, UK
| | - Monica Charalambides
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Chadwick
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Oliver Howes
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
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38
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Baumeister D, Ward T, Garety P, Jackson M, Morgan C, Charalambides M, Chadwick P, Howes O, Peters E. Need for care, adversity exposure and perceived stress in clinical and healthy voice-hearers - Corrigendum. Psychol Med 2021; 51:1959. [PMID: 33814030 PMCID: PMC8381234 DOI: 10.1017/s0033291721000696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- David Baumeister
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Ward
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Mike Jackson
- Bangor University, School of Psychology, Bangor, North Wales, UK
- Betsi Cadwaladr University Health Board, Bangor, North Wales, UK
| | - Craig Morgan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Health Service & Population Research, London, UK
| | - Monica Charalambides
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Chadwick
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Oliver Howes
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
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Veličković VM, Chadwick P, Rippon MG, Ilić I, McGlone ER, Gebreslassie M, Csernus M, Streit I, Bordeanu A, Kaspar D, Linder J, Smola H. Cost-effectiveness of superabsorbent wound dressing versus standard of care in patients with moderate-to-highly exuding leg ulcers. J Wound Care 2021; 29:235-246. [PMID: 32281509 DOI: 10.12968/jowc.2020.29.4.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the cost-effectiveness/utility of a superabsorbent wound dressing (Zetuvit Plus Silicone) versus the current standard of care (SoC) dressings, from the NHS perspective in England, in patients with moderate-to-high exudating leg ulcers. METHOD A model-based economic evaluation was conducted to analyse the cost-effectiveness/utility of a new intervention. We used a microsimulation state-transition model with a time horizon of six months and a cycle length of one week. The model uses a combination of incidence base and risk prediction approach to inform transition probabilities. All clinical efficiency, health-related quality of life (HRQoL), cost and resource use inputs were informed by conducting a systematic review of UK specific literature. RESULTS Treatment with the superabsorbent dressing leads to a total expected cost per patient for a six month period of £2887, associated with 15.933 expected quality adjusted life weeks and 10.9% healing rate. When treated with SoC, the total expected cost per patient for a six month period is £3109, 15.852 expected quality adjusted life weeks and 8% healing rate. Therefore, the superabsorbent dressing leads to an increase in quality-adjusted life weeks, an increase in healing rate by 2.9% and a cost-saving of £222 per single average patient over six months. Results of several scenario analyses, one-way deterministic sensitivity analysis, and probabilistic sensitivity analysis confirmed the robustness of base-case results. The probabilistic analysis confirmed that, in any combination of variable values, the superabsorbent dressing leads to cost saving results. CONCLUSION According to the model prediction, the superabsorbent dressing leads to an increase in health benefits and a decrease in associated costs of treatment.
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Affiliation(s)
- Vladica M Veličković
- Hartmann Group, Heidenheim, Germany.,Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT, Hall i.T., Austria
| | | | - Mark G Rippon
- Huddersfield University, Queensgate, Huddersfield, UK
| | - Ivana Ilić
- Faculty of Medicine, University of Niš, Serbia
| | | | - Mihretab Gebreslassie
- Department of Public Health and Caring Sciences, Social Medicine/CHAP, Uppsala University, Sweden
| | - Mariann Csernus
- Nursing Department, Semmelweis University Faculty of Health Sciences, Budapest, Hungary
| | | | | | | | | | - Hans Smola
- Hartmann Group, Heidenheim, Germany.,Department of Dermatology, University of Cologne, Cologne, Germany
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Coates E, Amiel S, Baird W, Benaissa M, Brennan A, Campbell MJ, Chadwick P, Chater T, Choudhary P, Cooke D, Cooper C, Cross E, De Zoysa N, Eissa M, Elliott J, Gianfrancesco C, Good T, Hopkins D, Hui Z, Lawton J, Lorencatto F, Michie S, Pollard DJ, Rankin D, Schutter J, Scott E, Speight J, Stanton-Fay S, Taylor C, Thompson G, Totton N, Yardley L, Zaitcev A, Heller S. Protocol for a cluster randomised controlled trial of the DAFNE plus (Dose Adjustment For Normal Eating) intervention compared with 5x1 DAFNE: a lifelong approach to promote effective self-management in adults with type 1 diabetes. BMJ Open 2021; 11:e040438. [PMID: 33462097 PMCID: PMC7813353 DOI: 10.1136/bmjopen-2020-040438] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/23/2020] [Accepted: 12/15/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The successful treatment of type 1 diabetes (T1D) requires those affected to employ insulin therapy to maintain their blood glucose levels as close to normal to avoid complications in the long-term. The Dose Adjustment For Normal Eating (DAFNE) intervention is a group education course designed to help adults with T1D develop and sustain the complex self-management skills needed to adjust insulin in everyday life. It leads to improved glucose levels in the short term (manifest by falls in glycated haemoglobin, HbA1c), reduced rates of hypoglycaemia and sustained improvements in quality of life but overall glucose levels remain well above national targets. The DAFNEplus intervention is a development of DAFNE designed to incorporate behavioural change techniques, technology and longer-term structured support from healthcare professionals (HCPs). METHODS AND ANALYSIS A pragmatic cluster randomised controlled trial in adults with T1D, delivered in diabetes centres in National Health Service secondary care hospitals in the UK. Centres will be randomised on a 1:1 basis to standard DAFNE or DAFNEplus. Primary clinical outcome is the change in HbA1c and the primary endpoint is HbA1c at 12 months, in those entering the trial with HbA1c >7.5% (58 mmol/mol), and HbA1c at 6 months is the secondary endpoint. Sample size is 662 participants (approximately 47 per centre); 92% power to detect a 0.5% difference in the primary outcome of HbA1c between treatment groups. The trial also measures rates of hypoglycaemia, psychological outcomes, an economic evaluation and process evaluation. ETHICS AND DISSEMINATION Ethics approval was granted by South West-Exeter Research Ethics Committee (REC ref: 18/SW/0100) on 14 May 2018. The results of the trial will be published in a National Institute for Health Research monograph and relevant high-impact journals. TRIAL REGISTRATION NUMBER ISRCTN42908016.
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Affiliation(s)
- Elizabeth Coates
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Stephanie Amiel
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Wendy Baird
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Mohammed Benaissa
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | | | | | - Tim Chater
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Pratik Choudhary
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Debbie Cooke
- Department of Diabetes, King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Cindy Cooper
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Elizabeth Cross
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | | | - Mohammad Eissa
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Jackie Elliott
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
| | - Carla Gianfrancesco
- Diabetes Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tim Good
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - David Hopkins
- General and Emergency Medicine, King's College London, London, UK
| | - Zheng Hui
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Julia Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | - Daniel John Pollard
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - David Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Elaine Scott
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
| | | | - Carolin Taylor
- Diabetes Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Nikki Totton
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Aleksandr Zaitcev
- Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Simon Heller
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
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Walburn J, Sainsbury K, Foster L, Weinman J, Morgan M, Norton S, Canfield M, Chadwick P, Sarkany B, Araújo-Soares V. Why? What? How? Using an Intervention Mapping approach to develop a personalised intervention to improve adherence to photoprotection in patients with Xeroderma Pigmentosum. Health Psychol Behav Med 2020; 8:475-500. [PMID: 34040882 PMCID: PMC8114411 DOI: 10.1080/21642850.2020.1819287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Indexed: 11/28/2022] Open
Abstract
Background: Intervention Mapping (IM) is a systematic approach for developing theory-based interventions across a variety of contexts and settings. This paper describes the development of a complex intervention designed to reduce the dose of ultraviolet radiation (UVR) reaching the face of adults with Xeroderma Pigmentosum (XP), by improving photoprotection. XP is a genetic condition that without extreme UVR photoprotection, leads to high risk of developing skin cancer. Methods: The IM protocol of 6 steps was applied, involving comprehensive mixed-methods formative research. Key stakeholders (XP clinical staff and Patient and Public Involvement Panel), were instrumental at every step. Behaviour change methods were informed by the IM taxonomy, therapeutic approaches (e.g. ACT, CBT) and coded according to the taxonomy of behaviour change techniques (version 1). Results: We designed a personalised modular intervention to target psychosocial determinants of photoprotective activities that influence the amount of UVR reaching the face. Content was developed to target determinants of motivation to protect and factors preventing the enactment of behaviours. Participants received personalised content addressing determinants/barriers most relevant to them, as well as core ‘behaviour-change’ material, considered important for all (e.g. SMART goals). Core and personalised content was delivered via 7 one-to-one sessions with a trained facilitator using a manual and purpose designed materials: Magazine; text messages; sunscreen application video; goal-setting tools (e.g. UVR dial and face protection guide); activity sheets. Novel features included use of ACT-based values to enhance intrinsic motivation, targeting of emotional barriers to photoprotection, addressing appearance concerns and facilitating habit formation. Conclusion: IM was an effective approach for complex intervention design. The structure (e.g. use of matrices) tethered the intervention tightly to theory and evidence-based approaches. The significant amount of time required needs to be considered and may hinder translation of IM into clinical and non-academic settings.
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Affiliation(s)
- Jessica Walburn
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Kirby Sainsbury
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lesley Foster
- National Xeroderma Pigmentosum Service, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - John Weinman
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Myfanwy Morgan
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Sam Norton
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Martha Canfield
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Bob Sarkany
- National Xeroderma Pigmentosum Service, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Chadwick P, Ambrose L, Barrow R, Fox M. A commentary on podiatry during the Covid-19 pandemic : Podiatry during the Covid-19 pandemic. J Foot Ankle Res 2020; 13:63. [PMID: 33059721 PMCID: PMC7561248 DOI: 10.1186/s13047-020-00425-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The arrival of the novel coronavirus (SARS-CoV-2) has impacted the many aspects of modern life, especially, in the immediate term, the delivery of healthcare. CONTEXT This commentary examines the profession of podiatry and how it has adapted and responded to the emerging crisis. It focusses on but is not exclusive to the position in the United Kingdom (UK) and the edicts and direction from the UK Government. PODIATRY ROLES DURING THE PANDEMIC It describes the role of podiatry in the pandemic and highlights the deployment of podiatry resources to fight the pandemic beyond traditional podiatric practice. It also looks at the shift from conventional consultation to digital solutions for managing patients in an effort to achieve the goals of maintenance of foot health whilst reducing the spread of the virus. The commentary summarises the emerging data related to a possible foot related presentation of the coronavirus. CONCLUSION The podiatry profession proved its flexibility and adaptability during the pandemic, to adjust rapidly to ensure that patients were able to access treatment to reduce risk of infection, ulceration and amputation. Dermatological presentations on the feet have been associated with Covid-19 in adolescents as is often the case in viral infections. CPD webinars to support clinicians and manage and prevent the spread of Covid-19 have been widely disseminated along with algorithms to ensure that patients that need treatment are being treated appropriately. Podiatrists have embraced remote technology to ensure that patients are correctly and safely triaged and, signposted and given appropriate self-care advice. MSK podiatrists have the ability to play an intrinsic role within the post discharge rehabilitation pathway.
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Affiliation(s)
| | | | | | - Martin Fox
- Manchester Local Care Organisation, Manchester, UK
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Ellett L, Tarant E, Kouimtsidis C, Kingston J, Vivarelli L, Mendis J, Chadwick P. Group mindfulness-based therapy for persecutory delusions: A pilot randomised controlled trial. Schizophr Res 2020; 222:534-536. [PMID: 32402604 DOI: 10.1016/j.schres.2020.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/30/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Lyn Ellett
- Department of Psychology, Royal Holloway, University of London, United Kingdom of Great Britain and Northern Ireland
| | - Eryna Tarant
- Surrey and Borders Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Christos Kouimtsidis
- Surrey and Borders Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Jessica Kingston
- Department of Psychology, Royal Holloway, University of London, United Kingdom of Great Britain and Northern Ireland
| | - Laura Vivarelli
- Surrey and Borders Partnership NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Jeewaka Mendis
- University of Surrey, United Kingdom of Great Britain and Northern Ireland
| | - Paul Chadwick
- Department of Psychology, University of Bath, United Kingdom of Great Britain and Northern Ireland.
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Rhodes A, Smith AD, Chadwick P, Croker H, Llewellyn CH. Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2020; 8:e18255. [PMID: 32673251 PMCID: PMC7382015 DOI: 10.2196/18255] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/30/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. OBJECTIVE This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. METHODS A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. RESULTS In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (-0.28 kg; 95% CI -1.43 to 0.87) or per-protocol data (-0.65 kg; 95% CI -1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. CONCLUSIONS In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.
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Affiliation(s)
| | | | | | - Helen Croker
- University College London, London, United Kingdom
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Jacobsen P, Peters E, Robinson EJ, Chadwick P. Mindfulness-based crisis interventions (MBCI) for psychosis within acute inpatient psychiatric settings; a feasibility randomised controlled trial. BMC Psychiatry 2020; 20:193. [PMID: 32349698 PMCID: PMC7191699 DOI: 10.1186/s12888-020-02608-x] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/19/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Inpatient psychiatric care is a scarce and expensive resource in the National Health Service (NHS), with chronic bed shortages being partly driven by high re-admission rates. Brief inpatient talking therapies for psychosis could help reduce re-admission rates. The primary aim was to assess feasibility and acceptability of a novel, brief, mindfulness-based intervention for inpatients with psychosis. The secondary aim was to collect pilot outcome data on readmission rate, at 6 and 12 months (m) post discharge, and self-report symptom measures at 6 m. METHODS The amBITION study (BrIef Talking therapIes ON wards) was a parallel group, feasibility randomised controlled trial (RCT). In addition to treatment as usual (TAU), eligible inpatients with psychotic symptoms were randomly allocated to receive either (Mindfulness-Based Crisis Intervention; MBCI) or a control intervention (Social Activity Therapy; SAT), for 1-5 sessions. RESULTS Fifty participants were recruited (26 MBCI; 24 SAT); all received at least 1 therapy session (mean = 3). Follow-up rates were 98% at 6 m and 96% at 12 m for service use data extracted from clinical notes, and 86% for self-report measures. At 6 m follow-up, re-admission rates were similar across groups (MBCI = 6, SAT = 5; odds ratio = 1.20, 95% CI: 0.312-4.61). At 12 m follow-up, re-admissions were lower in the MBCI group (MBCI = 7, SAT = 11; odds ratio = 0.46, 95% CI: 0.14-1.51). Three participants experienced adverse events; none was related to trial participation. CONCLUSIONS Delivering a brief mindfulness-based inpatient intervention for psychosis is feasible and acceptable, and may reduce risk of short-term readmission. These promising findings warrant progression to a larger clinical effectiveness trial. TRIAL REGISTRATION ISRCTN37625384.
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Affiliation(s)
- Pamela Jacobsen
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, SE5 8AF UK
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Emmanuelle Peters
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX UK
| | - Emily J. Robinson
- Department of Biostatistics & Health Informatics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, SE5 8AF UK
- Present address: School of Population Health and Environmental Sciences, King’s College London, London, SE1 1UL UK
| | - Paul Chadwick
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), De Crespigny Park, London, SE5 8AF UK
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
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Brown S, Nixon J, Ransom M, Gilberts R, Dewhirst N, McGinnis E, Longo R, Game F, Bojke C, Chadwick P, Chandrasekar A, Chetter I, Collier H, Fernandez C, Homer-Vanniasinkam S, Jude E, Leigh R, Lomas R, Vowden P, Wason J, Sharples L, Russell D. Multiple Interventions for Diabetic Foot Ulcer Treatment Trial (MIDFUT): study protocol for a randomised controlled trial. BMJ Open 2020; 10:e035947. [PMID: 32312727 PMCID: PMC7245399 DOI: 10.1136/bmjopen-2019-035947] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Diabetes affects more than 425 million people worldwide with a lifetime risk of diabetic foot ulcer (DFU) of up to 25%. Management includes wound debridement, wound dressings, offloading, treatment of infection and ischaemia, optimising glycaemic control; use of advanced adjuvant therapies is limited by high cost and lack of robust evidence. METHODS AND ANALYSIS A multicentre, seamless phase II/III, open, parallel group, multi-arm multi-stage randomised controlled trial in patients with a hard-to-heal DFU, with blinded outcome assessment. A maximum of 447 participants will be randomised (245 participants in phase II and 202 participants in phase III). The phase II primary objective will determine the efficacy of treatment strategies including hydrosurgical debridement ± decellularised dermal allograft, or the combination with negative pressure wound therapy, as an adjunct to treatment as usual (TAU), compared with TAU alone, with patients randomised in a 1:1:1:2 allocation. The outcome is achieving at least 50% reduction in index ulcer area at 4 weeks post randomisation.The phase III primary objective will determine whether one treatment strategy, continued from phase II, reduces time to healing of the index ulcer compared with TAU alone, with participants randomised in a 1:1 allocation. Secondary objectives will compare healing status of the index ulcer, infection rate, reulceration, quality of life, cost-effectiveness and incidence of adverse events over 52 weeks post randomisation. Phase II and phase III primary endpoint analysis will be conducted using a mixed-effects logistic regression model and Cox proportional hazards regression, respectively. A within-trial economic evaluation will be undertaken; the primary economic analysis will be a cost-utility analysis presenting ICERs for each treatment strategy in rank order of effectiveness, with effects expressed as quality-adjusted life years.The trial has predefined progression criteria for the selection of one treatment strategy into phase III based on efficacy, safety and costs at 4 weeks. ETHICS AND DISSEMINATION Ethics approval has been granted by the National Research Ethics Service (NRES) Committee Yorkshire and The Humber - Bradford Leeds Research Ethics Committee; approved 26 April 2017; (REC reference: 17/YH/0055). There is planned publication of a monograph in National Institute for Health Research journals and main trial results and associated papers in high-impact peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN64926597; registered on 6 June 2017.
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Affiliation(s)
- Sarah Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Jane Nixon
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Myka Ransom
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Rachael Gilberts
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Nikki Dewhirst
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Elizabeth McGinnis
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Roberta Longo
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Frances Game
- Derby Teaching Hospitals NHS Fundation Trust, Derby, UK
| | - Chris Bojke
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | | | - Howard Collier
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Catherine Fernandez
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | | | | | | | - Peter Vowden
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - James Wason
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Linda Sharples
- Department of Medical Statistics, London Schoool of Hygience and Tropical Medicine, London, UK
| | - David Russell
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Harding K, Chadwick P, Jeffery S, Gray D, Lindsay E, Younis I, Sharpe A, Cutting K, Butcher M. Major concerns regarding the generic product specification for wound care. J Wound Care 2020; 28:497. [PMID: 31393804 DOI: 10.12968/jowc.2019.28.8.497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Keith Harding
- Professor of Wound Healing Research, Clinical Innovation Cardiff (ClIC), College of Biomedical and Life Sciences, Cardiff University School of Medicine
| | - Paul Chadwick
- Visiting Professor and Podiatrist, Wound Healing Practice, Development Unit, Birmingham City University, Birmingham
| | - Sla Jeffery
- Consultant Burns and Plastic Surgeon, Professor of Wound Study BCU, Visiting Professor Cardiff University
| | - David Gray
- Wound Healing Practice, Development Unit, Birmingham City University, Birmingham
| | | | - Ibby Younis
- Professor of Plastic Surgery, Consultant Plastic Surgeon, Royal Free Hospitals & University College London
| | - Andew Sharpe
- Podiatrist and Lecturer, University of Huddersfield
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Atkin L, Barrett S, Chadwick P, Callaghan R, Rippon MG, Rogers AA, Simm S. Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series. J Wound Care 2020; 29:174-182. [DOI: 10.12968/jowc.2020.29.3.174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: The primary objective of this study was to evaluate the fluid management capabilities of a superabsorbent wound dressing (Zetuvit Plus Silicone), with secondary objectives related to parameters that support whether the dressing enables undisturbed healing. Method: This study was an open labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. Results: A total of 50 patients were included in the study. Results related to the primary objective demonstrated that the superabsorbent wound dressing was able to absorb all levels of exudate across the range (low to high). At each assessment time point these results show that in 98% of assessments the superabsorbent dressing was rated as ‘very good’ (91%) or ‘good’ (7%) at exudate management. Secondary objectives relating to wound bed preparation, healing and management of pain were also positive. Additionally, at the end of each patient treatment, the dressing's fluid management capabilities were rated overall as ‘excellent’ (100% of cases). There was little pain associated with the wound or at dressing change throughout the study and its flexibility/conformability allowed for comfort and patient satisfaction aligned with increased quality of life. Additionally, inclusion of a silicone adhesive layer allowed painless and atraumatic removal of the dressing, increasing patient comfort, both during wear and at dressing removal, and supported the description of enabling undisturbed wound healing. Conclusion: The superabsorbent wound dressing achieved the primary objective relating to wound exudate management in all the assessments undertaken in this study. In addition, the silicone interface allowed for undisturbed healing as evidenced by little or no adherence of the dressing to underlying tissue, preventing damage to periwound skin. Overall, the superabsorbent wound dressing with the addition of the silicone interface could offer advantages over other superabsorbent polymer dressings (that might adhere to the wound surface) or silicone wound dressings (that might not have the absorbent properties of this type of dressing).
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Affiliation(s)
| | - Simon Barrett
- Tissue Viability Nurse Specialist; Humber NHS Foundation Trust, The Grange Hessle, 11 Hull Road, Hessle, HU13 9LZ
| | | | | | - Mark G Rippon
- Visiting Clinical Research Fellow; Huddersfield University
| | - Alan A Rogers
- Medical Communications Consultant; Flintshire, North Wales
| | - Sue Simm
- Clinical Consultant; Luna Consultants
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Cattini P, Chadwick P, Thirkell G, McManamon C, Kretzer D, Davies F, Stewart E. Escherichia coli blood stream infection in cancer patients: a multicentre, multidisciplinary collaborative audit to identify risk factors in order to target preventative strategies for improvement of patient care and outcomes. Access Microbiol 2020. [DOI: 10.1099/acmi.fis2019.po0116] [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: 11/18/2022] Open
Affiliation(s)
| | - Paul Chadwick
- Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Gary Thirkell
- Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Frances Davies
- Imperial College Healthcare Trust, London, United Kingdom
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Chadwick P, Peel A, Thirkell G, Pichon B. Use of whole genome sequencing to resolve a surgical ward cluster of meticillin-resistant Staphylococcus aureus. Infect Dis Health 2019. [DOI: 10.1016/j.idh.2019.09.032] [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: 11/30/2022]
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