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Morrell S, Pittman G, Elliott R, Ziegler E, Borawski S, Mulcaster A, Hebert A, Patel T, Dannawey A. Wound management provided by advanced practice nurses: a scoping review. JBI Evid Synth 2024; 22:790-830. [PMID: 37779423 DOI: 10.11124/jbies-23-00019] [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] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE The objective of the review was to map the similarities and differences in the wound care practices of nurse practitioners, clinical nurse specialists, and advanced practice registered nurses, globally. INTRODUCTION Advanced practice nurses have graduate education and advanced scope of practice. Adding advanced wound care training to their skill set provides an opportunity for advanced practice nurses to provide wound care. INCLUSION CRITERIA This review considered for inclusion studies of advanced practice nurses globally who are registered nurses with graduate-level education and advanced training (certification/education) in wound care in any setting. METHODS The review was conducted using JBI methodology for scoping reviews. The databases searched included MEDLINE, CINAHL, ProQuest Nursing and Allied Health, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, and ProQuest Dissertations and Theses. To reflect changes in the advanced practice nursing scope of practice, searches were limited to articles published from 2011 onward. Articles in languages other than English were translated. Two reviewers independently reviewed titles and abstracts; relevant sources were retrieved in full and screened for eligibility against the inclusion criteria. An additional independent reviewer resolved any disagreements. Data were extracted using a data extraction tool. Extracted data included similarities and differences in wound care practice (type of wound, practice setting, treatments). RESULTS There were 2504 abstracts screened, and 158 articles were screened at full text. Seven articles were included in this review: 3 sources from the United States, 2 from Australia, and 1 each from Canada and The Netherlands. All 7 sources focused on nurse practitioners. Wound care education varied from certification in wound ostomy to a master's education in wounds. The practice setting varied; there were 2 primary care clinics, 2 community clinics, a wound care center; a suburban hospital, and a study that included tertiary, community, and residential care. Treatments varied, but the sources specific to pressure injuries discussed assessments, cleansing, dressings, topical products, and offloading surfaces/equipment. One source examined the impact of hiring nurse practitioners as wound care consultants. Sources that discussed treatments for various wounds described comprehensive assessments, diagnostic investigations, referrals, wound management, and medications prescribed. CONCLUSIONS This review outlined the characteristics of advanced practice nurses providing wound care and their practice settings, types of wounds, and treatments provided. Many articles on advanced practice nurses with advanced wound care expertise lack a description of the graduate-level education and/or the specifics regarding wound care certification. This prevents comparison of advanced practice nurses with each other and with other providers regarding the impact that advanced practice nurses have on the health care system in relation to wound care, including cost, access to services, and patient satisfaction.
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Affiliation(s)
- Sherry Morrell
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Gina Pittman
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
| | - Rachel Elliott
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
| | - Erin Ziegler
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Sylwia Borawski
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
| | - Adam Mulcaster
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- Leddy Library, University of Windsor, Windsor, ON, Canada
| | - Andrew Hebert
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
| | - Twinkle Patel
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
| | - Aya Dannawey
- Faculty of Nursing, University of Windsor, Windsor, ON, Canada
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Marsh LC, Patel SD, Smith AJ, So M, Armstrong H, Elliott R, Watkins E, Moulds M, Dalgleish T, Hitchcock C. From basic science to clinical practice: Can cognitive behavioural therapy tasks be augmented with enhanced episodic specificity? Behav Res Ther 2023; 167:104352. [PMID: 37331240 DOI: 10.1016/j.brat.2023.104352] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/28/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023]
Abstract
Individuals with depression typically remember their past in a generalised manner, at the cost of retrieving specific event memories. This may impair engagement with cognitive behavioural therapy (CBT) tasks that use concrete episodic information to challenge maladaptive beliefs, potentially limiting their therapeutic benefit. Study 1 demonstrated that an episodic specificity induction increased detail and specificity of autobiographical memory in people with major depression, relative to control conditions (N = 88). We therefore examined whether the induction enhanced the efficacy of CBT tasks that depend on episodic memory - cognitive reappraisal (Study 2, N = 30), evidence gathering (Study 2, N = 30), and planning behavioural experiments (Study 3a, N = 30). Across all three tasks, there were no significant differences in emotion- or belief-change between the specificity and control conditions. Although the induction temporarily enhanced specificity in depressed individuals, it did not significantly augment the efficacy of CBT tasks theorised to benefit from the use of specific mnemonic information.
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Affiliation(s)
- Laura C Marsh
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Shivam D Patel
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Alicia J Smith
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Melody So
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Rachel Elliott
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | | | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Caitlin Hitchcock
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Melbourne School of Psychological Science, University of Melbourne, Australia.
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Kinchin I, Walshe V, Normand C, Coast J, Elliott R, Kroll T, Kinghorn P, Thompson A, Viney R, Currow D, O'Mahony JF. Expanding health technology assessment towards broader value: Ireland as a case study. Int J Technol Assess Health Care 2023; 39:e26. [PMID: 37129030 DOI: 10.1017/s0266462323000235] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Healthcare innovations often represent important improvements in population welfare, but at what cost, and to whom? Health technology assessment (HTA) is a multidisciplinary process to inform resource allocation. HTA is conventionally anchored on health maximization as the only relevant output of health services. If we accept the proposition that health technologies can generate value outside the healthcare system, resource allocation decisions could be suboptimal from a societal perspective. Incorporating "broader value" in HTA as derived from social values and patient experience could provide a richer evaluative space for informing resource allocation decisions. This article considers how HTA is practiced and what its current context implies for adopting "broader value" to evaluating health technologies. Methodological challenges are highlighted, as is a future research agenda. Ireland serves as an example of a healthcare system that both has an explicit role for HTA and is evolving under a current program of reform to offer universal, single-tier access to public services. There are various ways in which HTA processes could move beyond health, including considering the processes of care delivery and/or expanding the evaluative space to some broader concept of well-being. Methods to facilitate the latter exist, but their adaptation to HTA is still emerging. We recommend a multi-stakeholder working group to develop and advance an international agenda for HTA that captures welfare/benefit beyond health.
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Affiliation(s)
- Irina Kinchin
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | | | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Joanna Coast
- Bristol Population Health Science Institute, University of Bristol, Bristol, UK
| | - Rachel Elliott
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Philip Kinghorn
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alexander Thompson
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, Australia
| | - David Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - James F O'Mahony
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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Leroi I, Camacho E, Chaghil‐Boissier N, Charalambous AP, Conelly JP, Constantinidou F, David R, Elliott R, Frison E, Hann M, Holden A, Kennelly S, Lawlor B, Longobardi J, Politis A, Kontogianni E, Rao VS, Reeves D, Termote M, Thodi C, Worthington M, Yeung W. A Europe‐wide randomized controlled trial of hearing and vision rehabilitation in dementia: Results from the SENSE‐Cog trial. Alzheimers Dement 2022. [DOI: 10.1002/alz.062722] [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: 12/24/2022]
Affiliation(s)
| | | | - Nathalie Chaghil‐Boissier
- INSERM, EUCLID/F‐CRIN Clinical Trials Platform, Bordeaux Population Health Center, CHU Bordeaux, University of Bordeaux Bordeaux France
| | | | - JP Conelly
- Trinity College Dublin AND St James Hospital Dublin Ireland
| | | | - Renaud David
- CoBTeK “Cognition Behaviour Technology”, Côte d'Azur University Nice France
- Institut Claude Pompidou Nice France
| | | | - Eric Frison
- EUCLID/F‐CRIN Clinical Trials Platform, University of Bordeaux, Inserm Bordeaux France
- University of Bordeaux Bordeaux France
| | - Mark Hann
- University of Manchester Manchester United Kingdom
| | - Alison Holden
- Lancashire & South Cumbria NHS Foundation Trust Preston United Kingdom
| | - Sean Kennelly
- Trinity Centre for Health Sciences, Tallaght Hospital Dublin Ireland
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin Dublin Ireland
| | - Julie Longobardi
- INSERM, EUCLID/F‐CRIN Clinical Trials Platform, Bordeaux Population Health Center, CHU Bordeaux, University of Bordeaux Bordeaux France
| | - Antonis Politis
- Eginition Hospital, National and Kapodistrian University, Athens Medical School Athens Greece
| | - Evangelia Kontogianni
- 1st Department of Psychiatry, School of Medicine, National and Kapodestrian University of Athens Athens Greece
| | | | - David Reeves
- University of Manchester Manchester United Kingdom
| | - Monique Termote
- INSERM, EUCLID/F‐CRIN Clinical Trials Platform Bordeaux France
| | | | - Mark Worthington
- Lancashire & South Cumbria NHS Foundation Trust Preston United Kingdom
| | - Wai Yeung
- University of Manchester Manchester United Kingdom
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Rennick-Egglestone S, Newby C, Robinson C, Yeo C, Ng F, Elliott R, Ali Y, Llewellyn-Beardsley J, Pomberth S, Harrison J, Gavan SP, Cuijpers P, Priebe S, Hall C, Slade M. Differences between online trial participants who have used statutory mental health services and who have not: analysis of baseline data from two pragmatic trials of a digital health intervention (Preprint). J Med Internet Res 2022. [DOI: 10.2196/44687] [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: 03/01/2023] Open
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Rancati T, Gioscio E, Cicchetti A, Rosenstein B, Seibold P, Avuzzi B, Azria D, Choudhury A, De Ruysscher D, Dunning A, Elliott R, Kerns S, Lambrecht M, Sperk E, Symonds P, Talbot C, Vega A, Veldeman L, Valdagni R, Webb A, Chang-Claude J, West C. MO-0557 Estimates of α/β ratios for individual late urinary toxicity endpoints: analysis of a cohort trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rennick-Egglestone S, Elliott R, Newby C, Robinson C, Slade M. Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing non-psychosis mental health problems (NEON-O Trial): updated randomised controlled trial protocol. Trials 2022; 23:90. [PMID: 35093141 PMCID: PMC8800358 DOI: 10.1186/s13063-022-06027-z] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, which refer to events or actions over a period of time, and which include elements of adversity or struggle, and also self-defined or observable strengths, successes, or survival. Recorded recovery narratives are those presented in invariant form, including text, audio, or video. In a previous publication, we presented a protocol for three pragmatic trials of the Narrative Experiences Online (NEON) Intervention, a web application recommending recorded recovery narratives to participants. The aim of the definitive NEON Trial was to understand whether the NEON Intervention benefitted people with experience of psychosis. The aim of the smaller NEON-O and NEON-C trials was to evaluate the feasibility of conducting definitive trials of the NEON Intervention with people (1) experiencing non-psychosis mental health problems and (2) who informally care for others experiencing mental health problems. An open recruitment strategy with a 60-week recruitment period was developed. Recruitment for the NEON Trial and NEON-O Trial targeted mental health service users and people not using mental health services. The NEON Trial recruited to time and target. The NEON-O Trial achieved its target in 10 weeks. Analysis considered by a Programme Steering Committee after the target was achieved demonstrated a definitive result could be obtained if the trial was adapted for recruitment to continue. The UK Health Research Authority approved all needed amendments following ethical review. PURPOSE OF THIS ARTICLE To describe the decision-making process for amending the NEON-O Trial and to describe amendments made to the NEON-O Trial to enable a definitive result. The article describes amendments to the aims, objectives, design, power calculation, recruitment rate, process evaluation design, and informed consent documents. The extended NEON-O Trial adopts analysis principles previously specified for the NEON Trial. The article provides a model for other studies adapting feasibility trials into definitive trials. TRIAL REGISTRATION All trials prospectively registered. NEON Trial: ISRCTN11152837 . Registered on 13th August 2018. NEON-C Trial: ISRCTN76355273 . Registered on 9th January 2020. NEON-O Trial: ISRCTN63197153 . Registered on 9th January 2020. The NEON-O Trial ISRCTN was updated when amendments were approved. Amendment details: NOSA2, 30th October 2020.
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Affiliation(s)
- Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Rachel Elliott
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL UK
| | - Chris Newby
- School of Medicine, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
| | - Clare Robinson
- Centre for Primary Care & Public Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, 58 Turner St, London, E1 2AB UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU UK
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Lyon KA, Elliott R, Ware K, Juhasz G, Brown L. Corrigendum to 'Associations between Facets and Aspects of Big Five Personality and Affective Disorders: Systematic Review and Best Evidence Synthesis' [Journal of Affective Disorders Volume 288 (2021), pages 175-188]. J Affect Disord 2021; 294:115. [PMID: 34280786 DOI: 10.1016/j.jad.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K A Lyon
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG.
| | - R Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG
| | - K Ware
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
| | - G Juhasz
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Lje Brown
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
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Wildman MJ, O’Cathain A, Hind D, Maguire C, Arden MA, Hutchings M, Bradley J, Walters SJ, Whelan P, Ainsworth J, Tappenden P, Buchan I, Elliott R, Nicholl J, Elborn S, Michie S, Mandefield L, Sutton L, Hoo ZH, Drabble SJ, Lumley E, Beever D, Navega Biz A, Scott A, Waterhouse S, Robinson L, Hernández Alava M, Sasso A. An intervention to support adherence to inhaled medication in adults with cystic fibrosis: the ACtiF research programme including RCT. Programme Grants Appl Res 2021. [DOI: 10.3310/pgfar09110] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background
People with cystic fibrosis frequently have low levels of adherence to inhaled medications.
Objectives
The objectives were to develop and evaluate an intervention for adults with cystic fibrosis to improve adherence to their inhaled medication.
Design
We used agile software methods to develop an online platform. We used mixed methods to develop a behaviour change intervention for delivery by an interventionist. These were integrated to become the CFHealthHub intervention. We undertook a feasibility study consisting of a pilot randomised controlled trial and process evaluation in two cystic fibrosis centres. We evaluated the intervention using an open-label, parallel-group randomised controlled trial with usual care as the control. Participants were randomised in a 1 : 1 ratio to intervention or usual care. Usual care consisted of clinic visits every 3 months. We undertook a process evaluation alongside the randomised controlled trial, including a fidelity study, a qualitative interview study and a mediation analysis. We undertook a health economic analysis using both a within-trial and model-based analysis.
Setting
The randomised controlled trial took place in 19 UK cystic fibrosis centres.
Participants
Participants were people aged ≥ 16 years with cystic fibrosis, on the cystic fibrosis registry, not post lung transplant or on the active transplant list, who were able to consent and not using dry-powder inhalers.
Intervention
People with cystic fibrosis used a nebuliser with electronic monitoring capabilities. This transferred data automatically to a digital platform. People with cystic fibrosis and clinicians could monitor adherence using these data, including through a mobile application (app). CFHealthHub displayed graphs of adherence data as well as educational and problem-solving information. A trained interventionist helped people with cystic fibrosis to address their adherence.
Main outcome measures
Randomised controlled trial – adjusted incidence rate ratio of pulmonary exacerbations meeting the modified Fuchs criteria over a 12-month follow-up period (primary outcome); change in percentage adherence; and per cent predicted forced expiratory volume in 1 second (key secondary outcomes). Process evaluation – percentage fidelity to intervention delivery, and participant and interventionist perceptions of the intervention. Economic modelling – incremental cost per quality-adjusted life-year gained.
Results
Randomised controlled trial – 608 participants were randomised to the intervention (n = 305) or usual care (n = 303). To our knowledge, this was the largest randomised controlled trial in cystic fibrosis undertaken in the UK. The adjusted rate of exacerbations per year (primary outcome) was 1.63 in the intervention and 1.77 in the usual-care arm (incidence rate ratio 0.96, 95% confidence interval 0.83 to 1.12; p = 0.638) after adjustment for covariates. The adjusted difference in mean weekly normative adherence was 9.5% (95% confidence interval 8.6% to 10.4%) across 1 year, favouring the intervention. Adjusted mean difference in forced expiratory volume in 1 second (per cent) predicted at 12 months was 1.4% (95% confidence interval –0.2% to 3.0%). No adverse events were related to the intervention. Process evaluation – fidelity of intervention delivery was high, the intervention was acceptable to people with cystic fibrosis, participants engaged with the intervention [287/305 (94%) attended the first intervention visit], expected mechanisms of action were identified and contextual factors varied between randomised controlled trial sites. Qualitative interviews with 22 people with cystic fibrosis and 26 interventionists identified that people with cystic fibrosis welcomed the objective adherence data as proof of actions to self and others, and valued the relationship that they built with the interventionists. Economic modelling – the within-trial analysis suggests that the intervention generated 0.01 additional quality-adjusted life-years at an additional cost of £865.91 per patient, leading to an incremental cost-effectiveness ratio of £71,136 per quality-adjusted life-year gained. This should be interpreted with caution owing to the short time horizon. The health economic model suggests that the intervention is expected to generate 0.17 additional quality-adjusted life-years and cost savings of £1790 over a lifetime (70-year) horizon; hence, the intervention is expected to dominate usual care. Assuming a willingness-to-pay threshold of £20,000 per quality-adjusted life-year gained, the probability that the intervention generates more net benefit than usual care is 0.89. The model results are dependent on assumptions regarding the duration over which costs and effects of the intervention apply, the impact of the intervention on forced expiratory volume in 1 second (per cent) predicted and the relationship between increased adherence and drug-prescribing levels.
Limitations
Number of exacerbations is a sensitive and valid measure of clinical change used in many trials. However, data collection of this outcome in this context was challenging and could have been subject to bias. It was not possible to measure baseline adherence accurately. It was not possible to quantify the impact of the intervention on the number of packs of medicines prescribed.
Conclusions
We developed a feasible and acceptable intervention that was delivered to fidelity in the randomised controlled trial. We observed no statistically significant difference in the primary outcome of exacerbation rates over 12 months. We observed an increase in normative adherence levels in a disease where adherence levels are low. The magnitude of the increase in adherence may not have been large enough to affect exacerbations.
Future work
Given the non-significant difference in the primary outcome, further research is required to explore why an increase in objective normative adherence did not reduce exacerbations and to develop interventions that reduce exacerbations.
Trial registration
Work package 3.1: Current Controlled Trials ISRCTN13076797. Work packages 3.2 and 3.3: Current Controlled Trials ISRCTN55504164.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Martin J Wildman
- Sheffield Adult Cystic Fibrosis Centre, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Alicia O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Daniel Hind
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Chin Maguire
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Madelynne A Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Marlene Hutchings
- Sheffield Adult Cystic Fibrosis Centre, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Judy Bradley
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Stephen J Walters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Pauline Whelan
- Health eResearch Centre, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - John Ainsworth
- Health eResearch Centre, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Paul Tappenden
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Iain Buchan
- Health eResearch Centre, Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Public Health and Policy, Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Rachel Elliott
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jon Nicholl
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Stuart Elborn
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Laura Mandefield
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Laura Sutton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Zhe Hui Hoo
- Sheffield Adult Cystic Fibrosis Centre, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Sarah J Drabble
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Lumley
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Daniel Beever
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Aline Navega Biz
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anne Scott
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Simon Waterhouse
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Louisa Robinson
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | | | - Alessandro Sasso
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Lofters AK, O'Brien MA, Sutradhar R, Pinto AD, Baxter NN, Donnelly P, Elliott R, Glazier RH, Huizinga J, Kyle R, Manca D, Pietrusiak MA, Rabeneck L, Riordan B, Selby P, Sivayoganathan K, Snider C, Sopcak N, Thorpe K, Tinmouth J, Wall B, Zuo F, Grunfeld E, Paszat L. Correction to: Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial. BMC Public Health 2021; 21:1714. [PMID: 34548061 PMCID: PMC8456665 DOI: 10.1186/s12889-021-11700-0] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- A K Lofters
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada. .,Women's College Hospital Research Institute, Toronto, Canada. .,Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Canada. .,Ontario Health (Cancer Care Ontario), Toronto, Canada. .,ICES, Toronto, Canada.
| | - M A O'Brien
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - R Sutradhar
- ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - A D Pinto
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - N N Baxter
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Melbourne School of Global and Population Health, University of Melbourne, Melbourne, Australia
| | - P Donnelly
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,University of St. Andrews, Scotland, UK
| | - R Elliott
- Durham Region Health Department, Whitby, Canada
| | - R H Glazier
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - J Huizinga
- Durham Region Health Department, Whitby, Canada
| | - R Kyle
- Durham Region Health Department, Whitby, Canada
| | - D Manca
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | | | - L Rabeneck
- Ontario Health (Cancer Care Ontario), Toronto, Canada
| | - B Riordan
- Durham Region Health Department, Whitby, Canada
| | - P Selby
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - K Sivayoganathan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.,Durham Region Health Department, Whitby, Canada
| | - C Snider
- Durham Region Health Department, Whitby, Canada
| | - N Sopcak
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - K Thorpe
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Applied Health Research Centre, St. Michael's Hospital, Toronto, Canada
| | - J Tinmouth
- Ontario Health (Cancer Care Ontario), Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - B Wall
- Durham Region Health Department, Whitby, Canada
| | - F Zuo
- Applied Health Research Centre, St. Michael's Hospital, Toronto, Canada
| | - E Grunfeld
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,Women's College Hospital Research Institute, Toronto, Canada.,ICES, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Ontario Institute for Cancer Research, Toronto, Canada
| | - L Paszat
- ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
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11
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Lofters AK, O'Brien MA, Sutradhar R, Pinto AD, Baxter NN, Donnelly P, Elliott R, Glazier RH, Huizinga J, Kyle R, Manca DM, Pietrusiak MA, Rabeneck L, Riordan B, Selby P, Sivayoganathan K, Snider C, Sopcak N, Thorpe K, Tinmouth J, Wall B, Zuo F, Grunfeld E, Paszat L. Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial. BMC Public Health 2021; 21:1496. [PMID: 34344340 PMCID: PMC8329623 DOI: 10.1186/s12889-021-11452-x] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) intervention was designed to integrate the approach to chronic disease prevention and screening in primary care and demonstrated effective in a previous randomized trial. METHODS We tested the effectiveness of the BETTER HEALTH intervention, a public health adaptation of BETTER, at improving participation in chronic disease prevention and screening actions for residents of low-income neighbourhoods in a cluster randomized trial, with ten low-income neighbourhoods in Durham Region Ontario randomized to immediate intervention vs. wait-list. The unit of analysis was the individual, and eligible participants were adults age 40-64 years residing in the neighbourhoods. Public health nurses trained as "prevention practitioners" held one prevention-focused visit with each participant. They provided participants with a tailored prevention prescription and supported them to set health-related goals. The primary outcome was a composite index: the number of evidence-based actions achieved at six months as a proportion of those for which participants were eligible at baseline. RESULTS Of 126 participants (60 in immediate arm; 66 in wait-list arm), 125 were included in analyses (1 participant withdrew consent). In both arms, participants were eligible for a mean of 8.6 actions at baseline. At follow-up, participants in the immediate intervention arm met 64.5% of actions for which they were eligible versus 42.1% in the wait-list arm (rate ratio 1.53 [95% confidence interval 1.22-1.84]). CONCLUSION Public health nurses using the BETTER HEALTH intervention led to a higher proportion of identified evidence-based prevention and screening actions achieved at six months for people living with socioeconomic disadvantage. TRIAL REGISTRATION NCT03052959 , registered February 10, 2017.
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Affiliation(s)
- A K Lofters
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada. .,Women's College Hospital Research Institute, Toronto, Canada. .,Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Canada. .,Ontario Health (Cancer Care Ontario), Toronto, Canada. .,ICES, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. .,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada. .,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.
| | - M A O'Brien
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - R Sutradhar
- ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - A D Pinto
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - N N Baxter
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - R Elliott
- Durham Region Health Department, Whitby, Canada
| | - R H Glazier
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Melbourne School of Global and Population Health, University of Melbourne, Melbourne, Australia
| | - J Huizinga
- Durham Region Health Department, Whitby, Canada
| | - R Kyle
- Durham Region Health Department, Whitby, Canada
| | - D M Manca
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | | | - L Rabeneck
- Ontario Health (Cancer Care Ontario), Toronto, Canada
| | - B Riordan
- Durham Region Health Department, Whitby, Canada
| | - P Selby
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada
| | - K Sivayoganathan
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Durham Region Health Department, Whitby, Canada
| | - C Snider
- Durham Region Health Department, Whitby, Canada
| | - N Sopcak
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - K Thorpe
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Applied Health Research Centre, St. Michael's Hospital, Toronto, Canada
| | - J Tinmouth
- Ontario Health (Cancer Care Ontario), Toronto, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
| | - B Wall
- Durham Region Health Department, Whitby, Canada
| | - F Zuo
- Applied Health Research Centre, St. Michael's Hospital, Toronto, Canada
| | - E Grunfeld
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.,Women's College Hospital Research Institute, Toronto, Canada.,ICES, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Ontario Institute for Cancer Research, Toronto, Canada
| | - L Paszat
- ICES, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Canada
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12
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Bland AR, Zahn R, Elliott R, Taylor JR, Hill J. Patrolling the boundaries of social domains: Neural activations to violations of expectations for romantic and work relationships. Soc Neurosci 2021; 16:513-521. [PMID: 34228605 DOI: 10.1080/17470919.2021.1953134] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
According to the social domains hypothesis, we reduce the information-processing demands of complex social cues by classifying them into a limited number of domains, each with distinct sets of expectations. This requires rapid identification of violations of the boundaries between social domains. We hypothesized that these violations are likely to be associated with neural activation of the salience system. Using fMRI we compared responses of 20 adults to expected and unexpected everyday social scenarios in personal and work interactions. The vignettes exemplified different kinds of scenarios presented in the work setting, i.e., task-focused scenarios which are expected at work and scenarios with a personal focus, which are unexpected at work. The key contrast between task and personal focussed scenarios presented in the work setting was associated with fronto-insular activation. Perceived inappropriateness of the unexpected scenarios, and shorter response time to judgment of inappropriateness were also associated with fronto-insular activation, after controlling for unpleasantness. This study indicates specific neural responses to violations of expectations in different social situations. Our findings suggest that the fronto-insular region is implicated in rapid detection of behaviors that cross the boundaries of social domains, which are hypothesized to be necessary for efficient social information processing.
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Affiliation(s)
- A R Bland
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - R Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - R Elliott
- Neuroscience and Psychiatry Unit, University of Manchester, UK.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK
| | - J R Taylor
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, UK
| | - J Hill
- School of Psychology and Clinical Language Sciences, University of Reading, UK
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13
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Krishna MT, Vedanthan PK, Vedanthan R, El Shabrawy RM, Madhan R, Nguyen HL, Kudagammana T, Williams I, Karmacharya B, Hariharan S, Krishnamurthy K, Sumantri S, Elliott R, Mahesh PA, Marriott JF. Is spurious penicillin allergy a major public health concern only in high-income countries? BMJ Glob Health 2021; 6:bmjgh-2021-005437. [PMID: 34016579 PMCID: PMC8141433 DOI: 10.1136/bmjgh-2021-005437] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Mamidipudi Thirumala Krishna
- Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK .,Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston Campus, Birmingham, UK
| | | | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | | | - Ramesh Madhan
- Department of Phamacy Practice, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Hoa L Nguyen
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Thushara Kudagammana
- Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Central, Sri Lanka
| | - Iestyn Williams
- Health Services Management Centre, University of Birmingham, Birmingham, West Midlands, UK
| | - Biraj Karmacharya
- Departments of Public Health and Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Kathmandu, Nepal
| | - Seetharaman Hariharan
- Department of Clinical Surgical Sciences, The University of the West Indies St Augustine Campus, St Augustine, Tunapuna-Piarco, Trinidad and Tobago
| | | | - Stevent Sumantri
- Department of Internal Medicine, Universitas Pelita Harapan, Tangerang, Banten, Indonesia
| | - Rachel Elliott
- Division of Population Health, Health Services Research and Primary care, The University of Manchester, Manchester, UK
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore, Karnataka, India
| | - John F Marriott
- The School of Pharmacy, University of Birmingham, Birmingham, UK
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14
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Schattenberg JM, Lazarus JV, Newsome PN, Serfaty L, Aghemo A, Augustin S, Tsochatzis E, de Ledinghen V, Bugianesi E, Romero‐Gomez M, Bantel H, Ryder SD, Boursier J, Leroy V, Crespo J, Castera L, Floros L, Atella V, Mestre‐Ferrandiz J, Elliott R, Kautz A, Morgan A, Hartmanis S, Vasudevan S, Pezzullo L, Trylesinski A, Cure S, Higgins V, Ratziu V. Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis in five European countries in 2018: A cost-of-illness analysis. Liver Int 2021; 41:1227-1242. [PMID: 33590598 PMCID: PMC8252761 DOI: 10.1111/liv.14825] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [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: 11/26/2020] [Revised: 01/22/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Non-alcoholic steatohepatitis (NASH) is a chronic disease that can progress to end-stage liver disease (ESLD). A large proportion of early-stage NASH patients remain undiagnosed compared to those with advanced fibrosis, who are more likely to receive disease management interventions. This study estimated the disease burden and economic impact of diagnosed NASH in the adult population of France, Germany, Italy, Spain and the United Kingdom in 2018. METHODS The socioeconomic burden of diagnosed NASH was estimated using cost-of-illness methodology applying a prevalence approach to estimate the number of adults with NASH and the attributable economic and wellbeing costs. Given undiagnosed patients do not incur costs in the study, the probability of diagnosis is central to cost estimation. The analysis was based on a literature review, databases and consultation with clinical experts, economists and patient groups. RESULTS The proportion of adult NASH patients with a diagnosis ranged from 11.9% to 12.7% across countries, which increased to 38.8%-39.1% for advanced fibrosis (F3-F4 compensated cirrhosis). Total economic costs were €8548-19 546M. Of these, health system costs were €619-1292M. Total wellbeing costs were €41 536-90 379M. The majority of the undiagnosed population (87.3%-88.2% of total prevalence) was found to have early-stage NASH, which, left untreated, may progress to more resource consuming ESLD over time. CONCLUSIONS This study found that the majority of economic and wellbeing costs of NASH are experienced in late disease stages. Earlier diagnosis and care of NASH patients could reduce future healthcare costs.
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Affiliation(s)
- Jörn M. Schattenberg
- Metabolic Liver Research Center, I. Department of MedicineUniversity Medical CenterMainzGermany
| | - Jeffrey V. Lazarus
- Barcelona Institute for Global Health (ISGlobal)Hospital Clínic, University of BarcelonaBarcelonaSpain
| | - Philip N. Newsome
- National Institute for Health Research Biomedical Research CentreUniversity Hospitals Birmingham NHS Foundation Trust and the University of BirminghamBirminghamUK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUK
- Liver UnitUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | | | - Alessio Aghemo
- Humanitas University and Humanitas Clinical and Research Center – IRCCSvia Alessandro Manzoni 56, I20089 RozzanoMilanItaly
| | - Salvador Augustin
- Hospital Universitari Vall d'Hebron – Institut de RecercaBarcelonaSpain
| | | | | | | | | | | | - Stephen D. Ryder
- National Institute for Health Research Nottingham Biomedical Research Centre at Nottingham University Hospitals and the University of NottinghamNottinghamUK
| | | | - Vincent Leroy
- Centre Hospitalier Universitaire de GrenobleGrenobleFrance
| | - Javier Crespo
- Hospital Universitario Marqués de ValdecillaSantanderSpain
| | - Laurent Castera
- Department of Hepatology, Hôpital BeaujonUniversité Paris‐7ParisFrance
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15
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Morgan A, Hartmanis S, Tsochatzis E, Newsome PN, Ryder SD, Elliott R, Floros L, Hall R, Higgins V, Stanley G, Cure S, Vasudevan S, Pezzullo L. Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis (NASH) in the United Kingdom (UK) in 2018. Eur J Health Econ 2021; 22:505-518. [PMID: 33751289 PMCID: PMC8166804 DOI: 10.1007/s10198-020-01256-y] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 11/26/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND AND AIMS Non-alcoholic steatohepatitis (NASH) - a progressive subset of non-alcoholic fatty liver disease (NAFLD) - is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. METHODS The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. RESULTS Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. CONCLUSION The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing.
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Affiliation(s)
| | | | - Emmanuel Tsochatzis
- UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK
| | - Philip N Newsome
- National Institute for Health Research Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherpay, University of Birmingham, Birmingham, UK
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Stephen D Ryder
- National Institute for Health Research Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
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16
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Hitchcock C, Smith AJ, Elliott R, O'Leary C, Gormley S, Parker J, Patel SD, Esteves CV, Rodrigues E, Hammond E, Watson P, Werner-Seidler A, Dalgleish T. A randomized, controlled proof-of-concept trial evaluating durable effects of memory flexibility training (MemFlex) on autobiographical memory distortions and on relapse of recurrent major depressive disorder over 12 months. Behav Res Ther 2021; 140:103835. [PMID: 33691266 PMCID: PMC8047774 DOI: 10.1016/j.brat.2021.103835] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/24/2021] [Accepted: 02/21/2021] [Indexed: 12/12/2022]
Abstract
Low-intensity psychological interventions that target cognitive risk factors for depressive relapse may improve access to relapse prevention programs and thereby reduce subsequent risk. This study provides the first evaluation of an autobiographical memory-based intervention for relapse prevention, to establish whether memory-training programs that are efficacious for acute depression may also aid those currently in remission. We also provide the longest follow-up to-date of the effects of autobiographical memory training on autobiographical memory processes themselves. This pre-registered randomized-controlled proof-of-concept trial (N = 74) compared an autobiographical Memory Flexibility (MemFlex) intervention to Psychoeducation about cognitive-behavioral mechanisms which maintain depression. Both interventions were primarily self-guided, and delivered via paper workbooks completed over four weeks. The key cognitive outcome was ability to retrieve and alternate between specific and general autobiographical memories. Co-primary clinical outcomes were time until depressive relapse and depression-free days in the twelve-months following intervention. Results indicated a small-moderate effect size (d = 0.35) in favor of MemFlex for the cognitive outcome. A small Hazard Ratio (1.08) was observed for time until depressive relapse, along with a negligible effect size for depression-free days (d = 0.11). Although MemFlex produced long-term improvement in memory retrieval skills, there was little support for MemFlex as a relapse prevention program for depression.
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Affiliation(s)
- Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK.
| | - Alicia J Smith
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Rachel Elliott
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Cliodhna O'Leary
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Siobhan Gormley
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Jenna Parker
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Shivam D Patel
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Carlos V Esteves
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Evangeline Rodrigues
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Emily Hammond
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; University of Exeter, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
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17
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Gorton HC, Elliott R, Noonan I. Student pharmacists and mental health nurses training together in suicide prevention: an evaluation of interprofessional education. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab016.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Suicide prevention is a Government priority and affects every sector of society.(1) The role of mental health nurses (MHN) in suicide prevention is more obvious than that of pharmacists. However, the requirement for suicide prevention training in community pharmacy staff has been incentivized in England through its inclusion in the Pharmacy Quality Scheme. (2) There is no standardized requirement for suicide prevention training in the MPharm degree so we curated an interprofessional education (IPE) session involving pharmacy and MHN students in order to learn about suicide prevention in a mutually beneficial way.
Aim
We aimed to evaluate the IPE session to understand the attitudes towards suicide and preparedness to help someone thinking about or planning suicide of both sets of students. We aimed to compare any changes in attitude before and after the session both within and between pharmacy students and MHN students.
Methods
We delivered two IPE sessions on suicide, 3.5 hours in length. Students attended one session. This was compulsory for pharmacy students and optional for MHN students. We evaluated the session through a duplicated, anonymous online survey, via the Qualtrics® platform, at the start and end of the session. Students were informed that this was an optional evaluation. They self-assigned a code that we used to link their answers. We invited students to answer a series of questions to assess their attitudes and preparedness to suicide prevention. We summarised these data using descriptive statistics related to individual statements and composite scores. We used Independent-samples median test and Wilcoxon-Signed Rank Tests to compare data distributions between professional groups before the session, between groups after the session and then to understand change within subject groups, using paired data only.
Results
104 students completed the initial survey of which 46% (n=48) were pharmacy students. MHN students reported being more prepared to respond to suicide (median:14, IQR 12–15) than pharmacy students (median: 8, IQR 6–10). Prior to the session, there were no statistically significant differences in responses to the attitude questions between MHN and pharmacy students, barring one question (‘I don’t feel comfortable assessing someone for suicide risk’). A statistically significant increase in preparedness was reported both pharmacy students (p<0.005) and MHN students (p<0.005), following the session (n=76 in paired analysis). MHN students (median: 15, IQR 15–17) continued to report higher levels of preparedness than pharmacy students (median=13, IQR: 10–15).
Conclusion
We present an innovative session in suicide awareness involving two professional groups. MHN self-reported higher levels of preparedness in suicide prevention than pharmacy students both before and after the session but an improvement was seen in both groups. These results indicate that IPE between MHN and pharmacy students could improve preparedness relating to suicide. More work is needed to explore the optimal content of training and longitudinal impact of training involving more students, as well as understanding if self-reported preparedness translates to professional behaviour, all of which are limitations of the current study
References
1. HM Government H. Preventing suicide in England: Third progress report on the cross-government outcomes strategy to save lives. London: HM Government; 2017.
2. NHS Business Service Authority. Drug Tariff; 2020 [cited 07 Oct 2020]. Available at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff
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Affiliation(s)
- H C Gorton
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - R Elliott
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - I Noonan
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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18
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Elliott R, McKinnon A, Dixon C, Boyle A, Murphy F, Dahm T, Travers‐Hill E, Mul C, Archibald S, Smith P, Dalgleish T, Meiser‐Stedman R, Hitchcock C. Prevalence and predictive value of ICD-11 post-traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma. J Child Psychol Psychiatry 2021; 62:270-276. [PMID: 32343370 PMCID: PMC7984249 DOI: 10.1111/jcpp.13240] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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] [Accepted: 02/26/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. METHOD Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. RESULTS At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. CONCLUSIONS Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma.
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Affiliation(s)
- Rachel Elliott
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Anna McKinnon
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Centre for Emotional HealthMacquarie UniversitySydneyNSWAustralia
| | - Clare Dixon
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Adrian Boyle
- Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Fionnuala Murphy
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Theresa Dahm
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Emma Travers‐Hill
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK
| | - Cari‐lène Mul
- Department of PsychologyAnglia Ruskin UniversityCambridgeUK
| | | | - Patrick Smith
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Tim Dalgleish
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Cambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
| | - Richard Meiser‐Stedman
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Department of Clinical PsychologyNorwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Caitlin Hitchcock
- MRC: Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Cambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
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Bland AR, .Roiser JP, Mehta MA, Sahakian BJ, Robbins TW, Elliott R. COVID-19 induced social isolation; implications for understanding social cognition in mental health. Psychol Med 2020; 52:1-2. [PMID: 33028434 PMCID: PMC7591753 DOI: 10.1017/s0033291720004006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/22/2022]
Affiliation(s)
- A. R. Bland
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - J. P .Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - M. A. Mehta
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - B. J. Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - T. W. Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - R. Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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Bland A, Schei T, Roiser J, Mehta M, Zahn R, Seara-Cardoso A, Viding E, Sahakian B, Robbins T, Elliott R. Agency and intentionality-dependent experiences of moral emotions. Personality and Individual Differences 2020. [DOI: 10.1016/j.paid.2020.110125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lyon KA, Juhasz G, Brown LJE, Elliott R. Big Five personality facets explaining variance in anxiety and depressive symptoms in a community sample. J Affect Disord 2020; 274:515-521. [PMID: 32663984 DOI: 10.1016/j.jad.2020.05.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/26/2020] [Accepted: 05/10/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Personality traits are risk and protective factors in affective disorders. However, few studies have investigated the role of narrow personality facets, with existing research yielding contradictory results. Previous research has mostly focused on simple correlations. Several studies have performed separate multiple regressions within each trait, and have used non-standard measures of personality, making it difficult to determine how individual facets make unique contributions. METHOD This study performed secondary analysis of the NewMood data set (collected 2004-2009), comprising 264 participants from Greater Manchester. Participants provided self-reports of all NEO-PI-R personality facets, and semi-structured questionnaires of clinical depression and anxiety. All personality facets were entered into multiple regressions to explain variance in depression and anxiety. RESULTS Variance in both anxiety and depression were explained by a small number of personality facets, namely facet depression (referring to demotivation), facets positive emotion and assertiveness in extroversion, and facet competence in conscientiousness. LIMITATIONS This study relies on cross-sectional data and cannot determine causation. This study uses a mostly female sample, and the results were not stratified by sex due to the small sample. CONCLUSION Previous studies suggest that broad trait neuroticism positively associates with affective disorders; this study adds that the effect of neuroticism is limited to facet depression (related to demotivation). Contrary to previous studies, no facet of agreeableness or openness explained variance in affective disorders, and facet assertiveness positively associated with affective disorder scores. These findings may help to improve treatment matching and explain the mechanisms through which affective disorders develop.
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Affiliation(s)
- K A Lyon
- Division of Neuroscience and Experimental Psychology, University of Manchester, G.803 Stopford Building Oxford Road, M13 9PG, United Kingdom.
| | - G Juhasz
- Division of Neuroscience and Experimental Psychology, University of Manchester, G.803 Stopford Building Oxford Road, M13 9PG, United Kingdom; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - L J E Brown
- Division of Psychology and Mental Health, University of Manchester, M13 9PL, United Kingdom
| | - R Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, G.803 Stopford Building Oxford Road, M13 9PG, United Kingdom
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Rennick-Egglestone S, Elliott R, Smuk M, Robinson C, Bailey S, Smith R, Keppens J, Hussain H, Pollock K, Cuijpers P, Llewellyn-Beardsley J, Ng F, Yeo C, Roe J, Hui A, van der Krieke L, Walcott R, Slade M. Impact of receiving recorded mental health recovery narratives on quality of life in people experiencing psychosis, people experiencing other mental health problems and for informal carers: Narrative Experiences Online (NEON) study protocol for three randomised controlled trials. Trials 2020; 21:661. [PMID: 32690105 PMCID: PMC7370499 DOI: 10.1186/s13063-020-04428-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/17/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental health recovery narratives have been defined as first-person lived experience accounts of recovery from mental health problems which refer to events or actions over a period of time and which include elements of adversity or struggle, and also self-defined strengths, successes or survival. They are readily available in invariant recorded form, including text, audio or video. Previous studies have provided evidence that receiving recorded recovery narratives can provide benefits to recipients. This protocol describes three pragmatic trials that will be conducted by the Narrative Experiences Online (NEON) study using the NEON Intervention, a web application that delivers recorded recovery narratives to its users. The aim of the NEON Trial is to understand whether receiving online recorded recovery narratives through the NEON Intervention benefits people with experience of psychosis. The aim of the NEON-O and NEON-C trials is to evaluate the feasibility of conducting a definitive trial on the use of the NEON Intervention with people experiencing non-psychosis mental health problems and those who care for others experiencing mental health problems respectively. METHODS The NEON Trial will recruit 683 participants with experience of psychosis. The NEON-O Trial will recruit at least 100 participants with experience of non-psychosis mental health problems. The NEON-C Trial will recruit at least 100 participants with experience of caring for others who have experienced mental health problems. In all three trials, participants will be randomly allocated into one of two arms. Intervention arm participants will receive treatment as usual plus immediate access to the NEON Intervention for 1 year. Control arm participants will receive treatment as usual plus access to the NEON Intervention after 1 year. All participants will complete demographics and outcome measures at baseline, 1 week, 12 weeks and 52 weeks. For the NEON Trial, the primary outcome measure is the Manchester Short Assessment of Quality of Life at 52 weeks, and secondary outcome measures are the CORE-10, Herth Hope Index, Mental Health Confidence Scale and Meaning in Life Questionnaire. A cost-effectiveness analysis will be conducted using data collected through the EQ-5D-5 L and the Client Service Receipt Inventory. DISCUSSION NEON Trial analyses will establish both effectiveness and cost-effectiveness of the NEON Intervention for people with experience of psychosis, and hence inform future clinical recommendations for this population. TRIAL REGISTRATION All trials were prospectively registered with ISRCTN. NEON Trial: ISRCTN11152837 . Registered on 13 August 2018. NEON-C Trial: ISRCTN76355273 . Registered on 9 January 2020. NEON-O Trial: ISRCTN63197153 . Registered on 9 January 2020.
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Affiliation(s)
- Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
| | - Rachel Elliott
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Melanie Smuk
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Clare Robinson
- Centre for Primary Care & Public Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, 58 Turner St, London, E1 2AB, UK
| | - Sylvia Bailey
- NEON Lived Experience Advisory Panel, Nottingham, UK
| | - Roger Smith
- NEON Lived Experience Advisory Panel, Nottingham, UK
| | - Jeroen Keppens
- Department of Informatics, King's College London, Bush House, 30 Aldwych, London, WC2B 4BG, UK
| | - Hannah Hussain
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Kristian Pollock
- School of Health Sciences, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - James Roe
- National Institute for Health Research, ARC East Midlands, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK
| | - Ada Hui
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
| | - Lian van der Krieke
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Rianna Walcott
- Department of Digital Humanities, King's College London, Strand, London, WC2R 2LS, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
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Gooding PA, Pratt D, Awenat Y, Drake R, Elliott R, Emsley R, Huggett C, Jones S, Kapur N, Lobban F, Peters S, Haddock G. A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol. BMC Psychiatry 2020; 20:306. [PMID: 32546129 PMCID: PMC7298803 DOI: 10.1186/s12888-020-02697-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/21/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death globally. Suicide deaths are elevated in those experiencing severe mental health problems, including schizophrenia. Psychological talking therapies are a potentially effective means of alleviating suicidal thoughts, plans, and attempts. However, talking therapies need to i) focus on suicidal experiences directly and explicitly, and ii) be based on testable psychological mechanisms. The Cognitive AppRoaches to coMbatting Suicidality (CARMS) project is a Randomised Controlled Trial (RCT) which aims to investigate both the efficacy and the underlying mechanisms of a psychological talking therapy for people who have been recently suicidal and have non-affective psychosis. METHODS The CARMS trial is a two-armed single-blind RCT comparing a psychological talking therapy (Cognitive Behavioural Suicide Prevention for psychosis [CBSPp]) plus Treatment As Usual (TAU) with TAU alone. There are primary and secondary suicidality outcome variables, plus mechanistic, clinical, and health economic outcomes measured over time. The primary outcome is a measure of suicidal ideation at 6 months after baseline. The target sample size is 250, with approximately 125 randomised to each arm of the trial, and an assumption of up to 25% attrition. Hence, the overall recruitment target is up to 333. An intention to treat analysis will be used with primary stratification based on National Health Service (NHS) recruitment site and antidepressant prescription medication. Recruitment will be from NHS mental health services in the North West of England, UK. Participants must be 18 or over; be under the care of mental health services; have mental health problems which meet ICD-10 non-affective psychosis criteria; and have experienced self-reported suicidal thoughts, plans, and/or attempts in the 3 months prior to recruitment. Nested qualitative work will investigate the pathways to suicidality, experiences of the therapy, and identify potential implementation challenges beyond a trial setting as perceived by numerous stake-holders. DISCUSSION This trial has important implications for countering suicidal experiences for people with psychosis. It will provide definitive evidence about the efficacy of the CBSPp therapy; the psychological mechanisms which lead to suicidal experiences; and provide an understanding of what is required to implement the intervention into services should it be efficacious. TRIAL REGISTRATION ClinicalTrials.gov (NCT03114917), 14th April 2017. ISRCTN (reference ISRCTN17776666 https://doi.org/10.1186/ISRCTN17776666); 5th June 2017). Registration was recorded prior to participant recruitment commencing.
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Affiliation(s)
- Patricia A Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK.
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK.
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
| | - Yvonne Awenat
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
| | - Richard Drake
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
| | - Rachel Elliott
- Manchester Centre for Health Economics, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Richard Emsley
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Charlotte Huggett
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
| | - Steven Jones
- Lancashire Care NHS Foundation Trust, Lancashire, UK
- University of Lancaster, Lancaster, UK
| | - Navneet Kapur
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
| | - Fiona Lobban
- Lancashire Care NHS Foundation Trust, Lancashire, UK
- University of Lancaster, Lancaster, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Trust (formerly Manchester Mental Health and Social Care Trust), Manchester, UK
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Barraclough M, Parker B, Mckie S, Pemberton P, Jackson A, Elliott R, Bruce IN. AB0402 DISEASE ACTIVITY AND OBSESSIVE-COMPULSIVE DISORDER IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Obsessive-compulsive disorder (OCD) is more prevalent in systemic autoimmune diseases when compared to healthy controls. This is in part due to inflammatory mechanisms, common across both conditions. Neuroinflammation and specifically problems within the basal ganglia are associated with OCD.Objectives:The primary objective of this analysis was to investigate the effects of disease activity in systemic lupus erythematosus (SLE) on OCD. Other variables investigated included psychiatric aspects, inflammatory biomarkers and structural brain abnormalities.Methods:SLE patients who met ACR or SLICC criteria were recruited. Demographic and clinical data were collected and data measuring disease activity (BILAG and SLEDAI-2K), disease damage (SLICC-DI), depression (MADRS, BDI-II, HADS), anxiety (HADS, STAI), fatigue (FSMC), quality of life (LupusQoL and EQ5D), inflammatory and endothelial activation (EA) biomarkers (IL-6, ESR, TNF-α, MCP-1, hsCRP, BLyS, VCAM-1, VEGF, EMVs) and OCD (OCI-R). MRI FLAIR structural scans were also used to examine signal hyperintensities in the brain. Participants with active disease (SLE-F) also had a 2ndvisit approx. 4 months later. Non-parametric correlations with the OCI-R were undertaken for all SLE participants and for the change over time scores for the SLE-F participants (n=11).Results:39 participants were included in the analysis and were typical for a SLE population. 6 (23%) patients had scores above the threshold for OCD. OCI-R significantly correlated with disease activity, quality of life, fatigue, depression and anxiety measures for all the SLE participants. Change in monocyte chemoattractant protein-1 (MCP-1) correlated with the OCI-R for the within SLE-F group analysis (Table 1). No significant correlations were found with the full SLE group for inflammatory or EA biomarkers or with either group for the structural brain analysis.Table 1.Significant correlations with the OCI-R for: a) all SLE participants; b) the SLE-F group only (visit 1 minus visit 2).Variablersp-valuea)All SLE participants, n=39Disease activity: BILAG global score0.4080.01Quality of life: LupusQoL – Physical-0.4950.001 – Pain-0.535<0.001 – Planning-0.586<0.001 – Intimate-0.3420.03 – Burden-0.5040.001 – Emotion-0.3970.01 – Fatigue-0.4710.002 EQ5D: VAS-0.4180.01 total-0.3590.03Fatigue measures (FSMC): Cognitive0.5210.001 Motor0.4480.004Depression measures: MADRS0.4670.003 HADS – D0.545<0.001Anxiety measure: HADS-A0.3750.02b)SLE-F group (v1-v2), n=11Inflammatory marker: MCP-10.7710.006BILAG The British Isles Lupus Assessment Group index, LupusQoL Lupus quality of life, EQ5D European quality of life, VAS visual analogue scale, FSMC Fatigue scale for motor and cognitive function, MADRS Montgomery Asberg depression rating scale, HADS Hospital anxiety and depression scale, D-depression, A-anxiety score, MCP-1 monocyte chemoattractant protein-1Conclusion:OCD in lupus is strongly related to other psychological co-morbidities, fatigue and quality of life. Our results also support a role for inflammatory pathways in mediating some of these changes and so obsessive-compulsive features should be assessed in SLE patients who flare. A larger study is underway to better understand the mechanisms underlying these associations.Acknowledgments:This study was partially funded by an unrestricted grant from Sanofi Genzyme and supported by the NIHR Manchester Biomedical Research Centre.Disclosure of Interests: :Michelle Barraclough Grant/research support from: This study was partially funded by an unrestricted grant from Sanofi Genzyme., Ben Parker Grant/research support from: GSK and Sanofi Genzyme, Consultant of: GSK, AstraZenaca, UCV, Abbvie, Pfizer, BMS, Celltrion, Shane McKie: None declared, Philip Pemberton: None declared, Alan Jackson: None declared, Rebecca Elliott: None declared, Ian N. Bruce Grant/research support from: Genzyme Sanofi, GSK, and UCB, Consultant of: Eli Lilly, AstraZeneca, UCB, Iltoo, and Merck Serono, Speakers bureau: UCB
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Leroi I, Simkin Z, Hooper E, Wolski L, Abrams H, Armitage CJ, Camacho E, Charalambous AP, Collin F, Constantinidou F, Dawes P, Elliott R, Falkingham S, Frison E, Hann M, Helmer C, Himmelsbach I, Hussain H, Marié S, Montecelo S, Thodi C, Yeung WK. Impact of an intervention to support hearing and vision in dementia: The SENSE-Cog Field Trial. Int J Geriatr Psychiatry 2020; 35:348-357. [PMID: 31713262 PMCID: PMC7079053 DOI: 10.1002/gps.5231] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 05/20/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Hearing, vision, and cognitive impairment commonly co-occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a "sensory intervention" (SI) to support hearing and vision in PwD. Here, we report the findings of an international open-label field trial, and nested case series, to explore the impact of the SI on dementia-related outcomes. METHODS This was a home-based trial conducted in France, England, and Cyprus. Participants were people with mild-to-moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The "basic" SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the "extended" SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia-related, health utility and resource utilisation outcomes were performed. RESULTS Quality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self-efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication. CONCLUSIONS These findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health InstituteTrinity College DublinDublinIreland
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Zoe Simkin
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Emma Hooper
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Lucas Wolski
- Institute of Applied Research, Development and Further EducationCatholic University of Applied Sciences FreiburgFreiburgGermany
| | - Harvey Abrams
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFL
| | | | - Elizabeth Camacho
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | | | - Fideline Collin
- INSERM, EUCLID/F‐CRIN Clinical Trials PlatformUniversity of BordeauxTalenceAquitaineFrance
| | | | - Piers Dawes
- Manchester Centre for Audiology and DeafnessUniversity of ManchesterManchesterUK
| | - Rachel Elliott
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Sue Falkingham
- Department of AudiologyStarkey Hearing TechnologiesStockportUK
| | - Eric Frison
- INSERM, EUCLID/F‐CRIN Clinical Trials PlatformUniversity of BordeauxTalenceAquitaineFrance
| | - Mark Hann
- Centre for BiostatisticsUniversity of ManchesterManchesterUK
| | - Catherine Helmer
- INSERM, Bordeaux Population Health Research Center, Team LEHAUniversity of BordeauxTalenceAquitaineFrance
| | - Ines Himmelsbach
- Institute of Applied Research, Development and Further EducationCatholic University of Applied Sciences FreiburgFreiburgGermany
| | - Hannah Hussain
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Sarah Marié
- Research and DevelopmentEssilor InternationalParisFrance
| | | | - Chryssoula Thodi
- Department of Health SciencesEuropean University CyprusNicosiaCyprus
| | - Wai Kent Yeung
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
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Newsome P, Schattenberg J, Serfaty L, Aghemo A, Augustin S, Tsochatzis E, Canbay A, Ledinghen V, Bugianesi E, Romero-Gomez M, Ryder S, Bantel H, Boursier J, Petta S, Crespo J, Castera L, Leroy V, Le Pen C, Fricke F, Elliott R, Atella V, Mestre-Ferrandiz J, Floros L, Torbica A, Morgan A, Hartmanis S, Trylesinki A, Cure S, Stirzaker E, Vasudevan S, Pezzulo L, Ratziu V. The economic cost and health burden of non-alcoholic steatohepatitis in the EU5 countries. Dig Liver Dis 2020. [DOI: 10.1016/j.dld.2019.12.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Tomkins NW, Elliott R, McGrath JJ, Schatz T. Managing plasma P concentrations in beef heifers with a slow release vitamin D supplementation. Anim Prod Sci 2020. [DOI: 10.1071/an17601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context In extensive northern grazing systems, supplementation of P is recommended to maximise cattle growth rates and reproduction. Improving the absorption of P for the animal by influencing metabolic pathways has the potential to improve both the productivity and profitability of extensive livestock enterprises. Aims This study evaluated the efficacy of rumen bolus containing 25-hydroxyvitamin D (25OHD), commercially available as Hy-D®, and/or monensin on blood P and Ca concentrations in young cattle. Methods A total of 84 heifers, initial liveweight (mean ± s.e.m.) 184 ± 2.0 kg, were allocated to four groups, dosed with one of four slow release bolus: (1) placebo (control), (2) monensin (120 mg/day), (3) Hy-D® (6 mg/day), or (4) monensin with Hy-D®, and managed on a common unimproved native pasture from August 2012 to February 2013. On four occasions postdosing, liveweight, hip height and body condition scores were recorded, and individual faecal and jugular blood samples were collected. Key results Supplementation with monensin had a significant effect (P < 0.05) on average daily gains for the first 25 days. Interactions between 25OHD and monensin and time × monensin were also significant (P < 0.05). After 188 days, heifers receiving monensin or 25OHD + monensin were 5 and 10 kg heavier respectively, compared with their counterparts in the control and 25OHD groups. Plasma P concentrations at 25 days were 6.6 mg/dL, then increased to between 8.5 and 9.0 mg/dL and maintained this level for up to 109 days with a bolus releasing 6.0 mg/day 25OHD. Conclusions The study demonstrated that sustained and elevated plasma concentrations of both 25OHD and P, compared with control animals, can be achieved. The slow release rumen bolus maintained an elevated plasma concentration of 25OHD, and indicated that a target plasma concentration for 25OHD for increasing P absorption in beef cattle is between 200 and 300 ng/mL. Implications Supplementation of a metabolite of vitamin D influences P metabolism in Brahman heifers under grazing conditions. Integration with standard supplementation practices would optimise growth rates and reproductive performance.
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Rancati T, Seibold P, Webb A, Chang-Claude J, Cicchetti A, Azria D, Elliott R, Gutiérrez-Enríquez S, Rosenstein B, de Ruysscher D, Symonds P, Talbot C, Vega A, Valdagni R, Veldeman L, West C. Requite Prostate Cohort: Validating Clinical/Dosimetric/Genetic Risk Factors for Late Urinary Toxicity. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1791] [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: 11/26/2022]
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Sutcliffe J, McLaughlin R, Del Rosso J, Weiss J, Baldwin H, Webster G, Leyden J, Zhao X, Read A, Drlica K, Elliott R, Stuart I. LB1117 Assessing bacterial susceptibility of FMX101 4% topical minocycline foam. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.084] [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: 11/25/2022]
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Hooper E, Simkin Z, Abrams H, Camacho E, Charalambous AP, Collin F, Constantinidou F, Dawes P, Elliott R, Falkingham S, Frison E, Hann M, Helmer C, Himmelsbach I, Hussain H, Marié S, Montecelo S, Reeves D, Regan J, Thodi C, Wolski L, Leroi I. Feasibility of an Intervention to Support Hearing and Vision in Dementia: The SENSE-Cog Field Trial. J Am Geriatr Soc 2019; 67:1472-1477. [PMID: 31034588 DOI: 10.1111/jgs.15936] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES People with dementia (PwD) frequently experience hearing and vision impairment that is underrecognized and undertreated, resulting in reduced quality of life. Managing these impairments may be an important strategy to improve outcomes in PwD. Our objective was to field-trial a multifaceted sensory intervention (SI) to enhance hearing and vision in PwD. DESIGN An international single-arm open-label feasibility, acceptability, and tolerability study. SETTING Home-based setting in the United Kingdom, France, and Cyprus. PARTICIPANTS Adults aged 60 years and older with mild-to-moderate dementia and uncorrected or suboptimally corrected hearing and/or vision impairment, and their study partners (n = 19 dyads). INTERVENTION A sensory intervention (SI), comprising assessment of hearing and vision, fitting of corrective devices (glasses, hearing aids), and home-based support from a sensory support therapist for device adherence and maintenance, communication training, referral to support services, environmental sensory modification, and optimization of social inclusion. MEASUREMENTS Ratings of study procedure feasibility, and intervention acceptability/tolerability, ascertained through questionnaires, participant diaries, therapist logbooks, and semistructured interviews. RESULTS We successfully delivered all intervention components, and these were received and enacted as intended in all those who completed the intervention. No serious adverse events were reported. Acceptability (ie, understanding, motivation, sense of achievement) and tolerability (ie, effort, fatigue) ratings of the intervention were within a priori target ranges. We met recruitment and retention (93.8%) targets in two of the three sites. Participants completed more than 95% of diary entries, representing minimal missing data. Delays in the logistics circuit for the assessment and delivery of hearing aids and glasses were identified, requiring modification. The need for minor modifications to some outcome measures and the inclusion criteria were identified. CONCLUSION This is the first study combining home-based hearing and vision remediation in PwD. The positive feasibility, acceptability, and tolerability findings suggest that a full-scale efficacy trial, with certain modifications, is achievable.
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Affiliation(s)
- Emma Hooper
- Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Zoe Simkin
- Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | | | - Elizabeth Camacho
- Manchester Centre for Health Economics, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Fideline Collin
- INSERM, EUCLID/F-CRIN Clinical Trials Platform, Bordeaux Population Health Center, CHU Bordeaux, F-33000, University of Bordeaux, Bordeaux, France
| | - Fofi Constantinidou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | - Rachel Elliott
- Manchester Centre for Health Economics, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Eric Frison
- INSERM, EUCLID/F-CRIN Clinical Trials Platform, Bordeaux Population Health Center, CHU Bordeaux, F-33000, University of Bordeaux, Bordeaux, France
| | - Mark Hann
- Centre for Biostatistics, University of Manchester, Manchester, United Kingdom
| | - Catherine Helmer
- INSERM, Bordeaux Population Health Research Center, Team LEHA, University of Bordeaux, Bordeaux, France
| | - Ines Himmelsbach
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Hannah Hussain
- Manchester Centre for Health Economics, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Sarah Marié
- Essilor International, Research & Development, Paris, France
| | | | - David Reeves
- Centre for Biostatistics, University of Manchester, Manchester, United Kingdom
| | - Jemma Regan
- University of Manchester, Manchester, United Kingdom
| | - Chryssoula Thodi
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Lucas Wolski
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Iracema Leroi
- Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Greater Manchester Mental Health Foundation Trust, Manchester, United Kingdom
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Elliott R, Snowdon J, Halliday G, Hunt GE, Coleman S. Characteristics of animal hoarding cases referred to the RSPCA in New South Wales, Australia. Aust Vet J 2019; 97:149-156. [DOI: 10.1111/avj.12806] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 03/11/2019] [Accepted: 03/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
- R Elliott
- Sentient, PO Box 223 Oatley New South Wales 2223 Australia
| | - J Snowdon
- Discipline of PsychiatryUniversity of Sydney NSW Australia
- Concord Centre for Mental Health, Sydney Local Health District NSW Australia
| | - G Halliday
- Concord Centre for Mental Health, Sydney Local Health District NSW Australia
| | - GE Hunt
- Discipline of PsychiatryUniversity of Sydney NSW Australia
- Concord Centre for Mental Health, Sydney Local Health District NSW Australia
| | - S Coleman
- Royal Society for Prevention of Cruelty to Animals (NSW) Sydney NSW Australia
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Rancati T, Seibold P, Webb A, Chang-Claude J, Cicchetti A, Azria D, De Ruysscher D, Elliott R, Gutiérrez-Enríquez S, Rosenstein B, Talbot C, Vega A, Veldeman L, Valdagni R, West C. OC-0161 Validation of clinical/dosimetric/genetic risk factor models for late RT-induced rectal bleeding. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30581-x] [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: 11/16/2022]
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Talbot C, Azria D, Burr T, Chang-Claude J, Dunning A, Jacquet MF, Herskind C, De Ruysscher D, Elliott R, Gutiérrez-Enríquez S, Lambin P, Müller A, Rancati T, Rattay T, Rosenstein B, Seibold P, Valdagni R, Vega A, Veldeman L, Veldwijk M, Wenz F, Webb A, West C. OC-0647 Analysis of biomarkers for late radiotherapy toxicity in the REQUITE project. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31067-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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West C, Azria D, Chang-Claude J, De Ruysscher D, Elliott R, Gutiérrez-Enríquez S, Rancati T, Rosenstein B, Seibold P, Talbot C, Vega A, Veldeman L, Webb A. EP-1663 REQUITE multicentre study of patients undergoing radiotherapy for breast, lung or prostate cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32083-3] [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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Douglas E, Hall M, Needham S, McLoughlin C, Bradshaw S, Elliott R. Implementing a cycle ergometry protocol for patients with critical illness: a service evaluation. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Elliott R, Swishchuk A, Zhang IY. A semi-martingale representation for a semi-Markov chain with application to finance. Theor Probability and Math Statist 2018. [DOI: 10.1090/tpms/1033] [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: 11/11/2022]
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O'Brien M, Lofters A, Wall B, Pinto A, Elliott R, Pietrusiak MA, Snider C, Riordan B, Grunfeld E, Makuwaza T, Sivayoganathan K, Manca D, Sopcak N, Donnelly P, Selby P, Kyle R, Baxter N, Rabeneck L, Cornacchi S, Paszat L. Better Health Durham: Community Engagement in a Cluster RCT of a Prevention Practitioner Intervention in Low-Income Neighbourhoods. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.53100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The Building on Existing Tools to Improve Chronic Disease Prevention and Screening (BETTER) intervention has improved uptake of chronic disease prevention and screening activities in primary care. The BETTER intervention consists of 1:1 visits between prevention practitioners (PPs) and patients (40-65 years). It is unknown if an adapted BETTER could be effective in the community with public health nurses as PPs. Aim: The presentation objective is to describe community engagement strategies in a cluster RCT in low income neighborhoods with low cancer screening rates and low uptake of primary care. Methods: Principles of community-based participatory research were used to design the community engagement strategy in Durham region, Ontario. Key elements included close collaboration with public health partners to identify stakeholders and creating a community advisory committee (CAC) and a primary care engagement group to provide advice. Results: We identified 15 community stakeholder groups (∼47 subgroups) including service organizations, faith groups, and charitable organizations representing diverse constituents. Community outreach activities included in-person meetings and information displays at local events. The CAC is comprised of members of the public and representatives from primary care, social services, and community organizations. The CAC and primary care engagement groups have provided advice on trial recruitment strategies and on the design of the PP visit. Conclusion: The partnership between public health, primary care, and the study team has been crucial to connect with community stakeholders. Community engagement is essential in raising awareness about the study and will contribute to successful recruitment. Trial Registration: NCT03052959
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Affiliation(s)
- M.A. O'Brien
- University of Toronto, Family and Community Medicine, Toronto, Canada
| | - A. Lofters
- University of Toronto, Family and Community Medicine, Toronto, Canada
| | - B. Wall
- Durham Region Health Department, Whitby, Canada
| | - A.D. Pinto
- University of Toronto, Family and Community Medicine, Toronto, Canada
- St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
| | - R. Elliott
- Durham Region Health Department, Whitby, Canada
| | | | - C. Snider
- Durham Region Health Department, Whitby, Canada
| | - B. Riordan
- Durham Region Health Department, Whitby, Canada
| | - E. Grunfeld
- University of Toronto, Family and Community Medicine, Toronto, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - T. Makuwaza
- University of Toronto, Family and Community Medicine, Toronto, Canada
| | | | - D. Manca
- University of Alberta, Family Medicine, Edmonton, Canada
| | - N. Sopcak
- University of Alberta, Family Medicine, Edmonton, Canada
| | - P. Donnelly
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
| | - P. Selby
- University of Toronto, Family and Community Medicine, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - R. Kyle
- Durham Region Health Department, Whitby, Canada
| | - N. Baxter
- St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Canada
| | - L. Rabeneck
- University of Toronto, Faculty of Medicine, Toronto, Canada
- University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - S. Cornacchi
- University of Toronto, Family and Community Medicine, Toronto, Canada
| | - L. Paszat
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Canada
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Black M, Hitchcock C, Bevan A, O Leary C, Clarke J, Elliott R, Watson P, LaFortune L, Rae S, Gilbody S, Kuyken W, Johnston D, Newby JM, Dalgleish T. The HARMONIC trial: study protocol for a randomised controlled feasibility trial of Shaping Healthy Minds-a modular transdiagnostic intervention for mood, stressor-related and anxiety disorders in adults. BMJ Open 2018; 8:e024546. [PMID: 30082367 PMCID: PMC6078277 DOI: 10.1136/bmjopen-2018-024546] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/31/2018] [Revised: 06/15/2018] [Accepted: 06/20/2018] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Anxiety, mood and trauma-related disorders are common, affecting up to 20% of adults. Many of these individuals will experience symptoms of more than one disorder as diagnostically defined. However, most psychological treatments focus on individual disorders and are less effective for those who experience comorbid disorders. The Healthy and Resilient Mind Programme: Building Blocks for Mental Wellbeing (HARMONIC) trial introduces a novel transdiagnostic intervention (Shaping Healthy Minds (SHM)), which synthesises several evidence-based treatment techniques to address the gap in effective interventions for people with complex and comorbid difficulties. This early phase trial aims to estimate the efficacy and feasibility of the transdiagnostic intervention in preparation for a later-phase randomised controlled trial, and to explore mechanisms of change. METHODS/ANALYSIS We outline a patient-level two-arm randomised controlled trial (HARMONIC) that compares SHM to treatment-as-usual for individuals aged >18 years (n=50) with comorbid mood, anxiety, obsessive-compulsive or trauma/stressor disorders diagnoses, recruited from outpatient psychological services within the UK National Health Service (NHS). The co-primary outcomes will be 3-month follow-up scores on self-report measures of depressive symptoms, anxiety symptoms, and disability and functional impairment. Secondary outcomes include changes in symptoms linked to individual disorders. We will assess the feasibility and acceptability of SHM, the utility of proposed outcome measures, and refine the treatment manuals in preparation for a later-phase trial. ETHICS AND DISSEMINATION This trial protocol has been approved by the Health Research Authority of the NHS of the UK (East of England, Reference: 16/EE/0095). We anticipate that trial findings will inform future revisions of clinical guidelines for numerous forms of mood, anxiety and stressor-related disorders. Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations, clinical workshops and a trial website. TRIAL REGISTRATION NCT03143634; Pre-results.
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Affiliation(s)
- Melissa Black
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Anna Bevan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Cliodhna O Leary
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - James Clarke
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Rachel Elliott
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Louise LaFortune
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Sarah Rae
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - David Johnston
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
| | - Jill M Newby
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, National Health Service, Fulbourn, UK
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Talbot C, Azria D, Burr T, Chang-Claude J, Dunning A, Herskind C, De Ruysscher D, Elliott R, Gutiérrez-Enríquez S, Lambin P, Müller A, Rancati T, Rosenstein B, Rattay T, Seibold P, Veldeman L, Vega A, Wenz F, Valdagni R, Webb A, West C. SP-0483: The REQUITE project: integrating biomarkers and clinical predictors of radiotherapy side effects. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30793-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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40
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West C, Elliott R, Talbot C, Webb A, Seibold P, Azria D, De Ruysscher D, Symonds R, Veldeman L, Rosenstein B, Lambin P, Burr T, Gutiérrez Enríquez S, Rancati T, Vega A, Chang-Claude J. OC-0154: REQUITE Big Data Resource for Validating Predictive Models and Biomarkers of Radiotherapy Toxicity. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30464-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Affiliation(s)
- R. P. Antunes
- Department of Psychology, University of Évora, Évora, Portugal
| | - C. M. D. Sales
- Faculty of Psychology and Education Sciences at the University of Porto (FPCEUP), Center for Psychologyat the University of Porto (CPUP), Porto, Portugal
| | - R. Elliott
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, Scotland
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Miskowiak KW, Svendsen AMB, Harmer CJ, Elliott R, Macoveanu J, Siebner HR, Kessing LV, Vinberg M. Differences in neural and cognitive response to emotional faces in middle-aged dizygotic twins at familial risk of depression. Psychol Med 2017; 47:2345-2357. [PMID: 28397623 DOI: 10.1017/s0033291717000861] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 02/07/2023]
Abstract
BACKGROUND Negative bias and aberrant neural processing of emotional faces are trait-marks of depression but findings in healthy high-risk groups are conflicting. METHODS Healthy middle-aged dizygotic twins (N = 42) underwent functional magnetic resonance imaging (fMRI): 22 twins had a co-twin history of depression (high-risk) and 20 were without co-twin history of depression (low-risk). During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task and questionnaires assessing mood, personality traits and coping. RESULTS Unexpectedly, high-risk twins showed reduced fear vigilance and lower recognition of fear and happiness relative to low-risk twins. During face processing in the scanner, high-risk twins displayed distinct negative functional coupling between the amygdala and ventral prefrontal cortex and pregenual anterior cingulate. This was accompanied by greater fear-specific fronto-temporal response and reduced fronto-occipital response to all emotional faces relative to baseline. The risk groups showed no differences in mood, subjective state or coping. CONCLUSIONS Less susceptibility to fearful faces and negative cortico-limbic coupling during emotional face processing may reflect neurocognitive compensatory mechanisms in middle-aged dizygotic twins who remain healthy despite their familial risk of depression.
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Affiliation(s)
- K W Miskowiak
- Copenhagen Affective Disorders Research Centre,Copenhagen Psychiatric Centre, Copenhagen University Hospital,Rigshospitalet,Denmark
| | - A M B Svendsen
- Copenhagen Affective Disorders Research Centre,Copenhagen Psychiatric Centre, Copenhagen University Hospital,Rigshospitalet,Denmark
| | - C J Harmer
- Department of Psychiatry,University of Oxford,UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester,UK
| | - J Macoveanu
- Copenhagen Affective Disorders Research Centre,Copenhagen Psychiatric Centre, Copenhagen University Hospital,Rigshospitalet,Denmark
| | - H R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre,Denmark
| | - L V Kessing
- Copenhagen Affective Disorders Research Centre,Copenhagen Psychiatric Centre, Copenhagen University Hospital,Rigshospitalet,Denmark
| | - M Vinberg
- Copenhagen Affective Disorders Research Centre,Copenhagen Psychiatric Centre, Copenhagen University Hospital,Rigshospitalet,Denmark
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Savulich G, Riccelli R, Passamonti L, Correia M, Deakin J, Elliott R, Flechais R, Lingford-Hughes A, McGonigle J, Murphy A, Nutt N, Orban C, Paterson L, Reed L, Smith D, Suckling J, Tait R, Taylor E, Sahakian B, Robbins T, Ersche K. S24-2THE ICCAM PLATFORM: TO INVESTIGATE THE NEUROPHARMACOLOGY OF BRAIN PROCESSES RELEVANT TO ADDICTION. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx075.94] [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: 11/12/2022] Open
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Cross A, George J, Woodward M, Ames D, Brodaty H, Wolfe R, Connors M, Elliott R. POTENTIALLY INAPPROPRIATE MEDICATION AND MORTALITY IN OLDER PEOPLE ATTENDING MEMORY CLINICS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A.J. Cross
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia,
| | - J. George
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia,
| | - M. Woodward
- Medical and Cognitive Research Unit, Austin Health, Heidelberg, Victoria, Australia,
| | - D. Ames
- National Ageing Research Institute, Parkville, Victoria, Australia,
- University of Melbourne Academic Unit for Psychiatry of Old Age, St George’s Hospital, Kew, Victoria, Australia,
| | - H. Brodaty
- Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia,
- Center for Healthy Brain Aging, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia,
| | - R. Wolfe
- Department of Epidemiology and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia,
| | - M. Connors
- Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia,
- Center for Healthy Brain Aging, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia,
| | - R. Elliott
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia,
- Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia
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Workman CI, Lythe KE, McKie S, Moll J, Gethin JA, Deakin JFW, Elliott R, Zahn R. A novel resting-state functional magnetic resonance imaging signature of resilience to recurrent depression. Psychol Med 2017; 47:597-607. [PMID: 27821193 PMCID: PMC5426313 DOI: 10.1017/s0033291716002567] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/22/2016] [Accepted: 09/08/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND A high proportion of patients with remitted major depressive disorder (MDD) will experience recurring episodes, whilst some develop resilience and remain in recovery. The neural basis of resilience to recurrence is elusive. Abnormal resting-state connectivity of the subgenual cingulate cortex (sgACC) was previously found in cross-sectional studies of MDD, suggesting its potential pathophysiological importance. The current study aimed to investigate whether resting-state connectivity to a left sgACC seed region distinguishes resilient patients from those developing recurring episodes. METHOD A total of 47 medication-free remitted MDD patients and 38 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. Over 14 months, 30 patients remained resilient whilst 17 experienced a recurring episode. RESULTS Attenuated interhemispheric left-to-right sgACC connectivity distinguished the resilient from the recurring-episode and control groups and was not correlated with residual depressive symptoms. CONCLUSIONS The current study revealed a neural signature of resilience to recurrence in MDD and thereby elucidates the role of compensatory adaptation in sgACC networks.
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Affiliation(s)
- C. I. Workman
- The University of Manchester & Manchester
Academic Health Sciences Centre, Institute of Brain, Behaviour
and Mental Health, Neuroscience & Psychiatry Unit,
Manchester, UK
- The University of Manchester & Manchester
Academic Health Sciences Centre, School of Psychological
Sciences, Neuroscience and Aphasia Research Unit,
Manchester, UK
| | - K. E. Lythe
- The University of Manchester & Manchester
Academic Health Sciences Centre, School of Psychological
Sciences, Neuroscience and Aphasia Research Unit,
Manchester, UK
| | - S. McKie
- The University of Manchester & Manchester
Academic Health Sciences Centre, Institute of Brain, Behaviour
and Mental Health, Neuroscience & Psychiatry Unit,
Manchester, UK
| | - J. Moll
- Cognitive and Behavioral Neuroscience
Unit, D'Or Institute for Research and Education (IDOR),
Rio de Janeiro, RJ,
Brazil
| | - J. A. Gethin
- The University of Manchester & Manchester
Academic Health Sciences Centre, School of Psychological
Sciences, Neuroscience and Aphasia Research Unit,
Manchester, UK
| | - J. F. W. Deakin
- The University of Manchester & Manchester
Academic Health Sciences Centre, Institute of Brain, Behaviour
and Mental Health, Neuroscience & Psychiatry Unit,
Manchester, UK
| | - R. Elliott
- The University of Manchester & Manchester
Academic Health Sciences Centre, Institute of Brain, Behaviour
and Mental Health, Neuroscience & Psychiatry Unit,
Manchester, UK
| | - R. Zahn
- The University of Manchester & Manchester
Academic Health Sciences Centre, School of Psychological
Sciences, Neuroscience and Aphasia Research Unit,
Manchester, UK
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology, and Neuroscience,
Centre for Affective Disorders, King's College
London, London, UK
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46
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Savulich G, Riccelli R, Passamonti L, Correia M, Deakin JFW, Elliott R, Flechais RSA, Lingford-Hughes AR, McGonigle J, Murphy A, Nutt DJ, Orban C, Paterson LM, Reed LJ, Smith DG, Suckling J, Tait R, Taylor EM, Sahakian BJ, Robbins TW, Ersche KD. Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery. Transl Psychiatry 2017; 7:e1054. [PMID: 28267152 PMCID: PMC5416677 DOI: 10.1038/tp.2017.34] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
Naltrexone is an opioid receptor antagonist used in the management of alcohol dependence. Although the endogenous opioid system has been implicated in emotion regulation, the effects of mu-opioid receptor blockade on brain systems underlying negative emotional processing are not clear in addiction. Individuals meeting criteria for alcohol dependence alone (n=18, alcohol) and in combination with cocaine and/or opioid dependence (n=21, alcohol/drugs) and healthy individuals without a history of alcohol or drug dependence (n=21) were recruited. Participants were alcohol and drug abstinent before entered into this double-blind, placebo-controlled, randomized, crossover study. Functional magnetic resonance imaging was used to investigate brain response while viewing aversive and neutral images relative to baseline on 50 mg of naltrexone and placebo. We found that naltrexone modulated task-related activation in the medial prefrontal cortex and functional connectivity between the anterior cingulate cortex and the hippocampus as a function of childhood adversity (for aversive versus neutral images) in all groups. Furthermore, there was a group-by-treatment-by-condition interaction in the right amygdala, which was mainly driven by a normalization of response for aversive relative to neutral images under naltrexone in the alcohol/drugs group. We conclude that early childhood adversity is one environmental factor that influences pharmacological response to naltrexone. Pharmacotherapy with naltrexone may also have some ameliorative effects on negative emotional processing in combined alcohol and drug dependence, possibly due to alterations in endogenous opioid transmission or the kappa-opioid receptor antagonist actions of naltrexone.
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Affiliation(s)
- G Savulich
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Riccelli
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - L Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - M Correia
- Cognition and Brain Sciences Unit, Medical Research Council, Cambridge, UK
| | - J F W Deakin
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R Elliott
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - R S A Flechais
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | | | - J McGonigle
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - A Murphy
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - D J Nutt
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - C Orban
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L M Paterson
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - L J Reed
- Centre for Neuropsychopharmacology, Imperial College London, London, UK
| | - D G Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - J Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - R Tait
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - E M Taylor
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - B J Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - T W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychology, University of Cambridge, Cambridge, UK
| | - K D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK. E-mail:
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Schlaich M, Rudnicka C, Herat L, Hricova J, Elliott R, Matthews V. Bi-Directional Interaction Between the Sympathetic Nervous System and SGLT-2 Regulation. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.164] [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: 11/29/2022]
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Hamed QS, Elliott R. The Dependence of Secondary Dendrite Arm Spacing on Solidification Conditions—II. Al-7 Si-0.5 Mg Alloys treated with Sr and Sb. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/09534962.1993.11819125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Purpose. To assess whether there is a difference in associated drug costs for the management of chemo therapy-related side effects for patients with advanced colorectal cancer treated with raltitrexed (Tomudex, Zeneca Limited) or 5-FU plus folinic acid (Mayo regimen). Data Sources. The drugs used for the manage ment of side effects were determined using a UK cohort (n = 62) taken from a large phase III ralti trexed clinical study. This study compared the toler ability and efficacy of raltitrexed vs 5-FU plus low- dose folinic acid and reported a significantly lower incidence of WHO grade 3/4 mucositis and leucope nia with raltitrexed. Drug costs were sourced using the British National Formulary, the Monthly Index of Medical Specialities and the Chemist and Druggist. Drug costs for the management of individual chemo therapy-related side-effects were calculated for both treatment groups and the total mean cost was com pared using the Student t test. Costs associated with the use of drugs for the management of clinically similar side effects, for example, nausea and vomiting were also investigated. Results. There was a significant reduction in the mean total drug cost per patient for the management of chemotherapy-related side effects in the raltitrexed group compared to the 5-FU/folinic acid treatment group (£,64.27 vs £139.14; P = .0016). Infection was the most costly individual side effect for both treat ment groups but was lower in the raltitrexed cohort (£25.46 vs £59.93). Drug costs for the management of nausea and vomiting, pain and abdominal pain, and mucositis side effects were also considerably lower in the raltitrexed cohort. Conclusion. The significantly lower drug cost for the management of chemotherapy-related side effects for the raltitrexed patients in the UK cohort suggests that the lower WHO grade 3/4 toxicity observed with raltitrexed in the phase III study would also be associated with a reduction in drug costs for the management of chemotherapy-related side ef fects.
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Affiliation(s)
- Rachel Elliott
- Department of Pharmacy, University of Manchester, Manchester, UK
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50
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Barraclough M, Bruce I, McKie S, Parker B, Elliott R. SAT0281 Compensatory Brain Mechanisms To Maintain Cognitive Function in Systemic Lupus Erythematosus. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2382] [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: 11/03/2022]
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