1
|
Kennedy H, Trujillo M, Ryan A, Cooley D, Martinez D, McNair B, Hunt C. Identifying Root Causes: Evaluation of a Program to Engage Youth in a Social Justice Approach to Tobacco Control. Health Promot Pract 2023; 24:1151-1162. [PMID: 36050932 DOI: 10.1177/15248399221112456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Movements designed to engage youth in tobacco control have been an important part of tobacco prevention for decades. Today, young people are increasingly diverse, and their primary issues of concern are gun control, racism, mental health, and climate change. To engage today's young people, tobacco control programs need to draw connections between youth's identities, top issues, and tobacco. UpRISE is a social justice youth tobacco control movement that engages diverse youth in identifying the root causes of youth nicotine use. In 2018-2019, 21 youth-serving organizations and schools hosted youth coalitions. Coalitions engaged in a six-session workbook called "Getting to the root cause," and adults were provided training and reflective supervision. Pre/post surveys with youth participants (n = 180) and end-of-year interviews with adult facilitators (n = 22) were used to assess outcomes. The primary outcomes were supportive adult relationships, youth voice in decision-making, anti-tobacco industry attitudes and beliefs, psychological empowerment, critical consciousness, and global belief in a just world. Quantitative measures of supportive adult relationships, youth voice in decision-making, psychological empowerment, and anti-tobacco industry attitudes and beliefs all increased significantly over time (p < .0001, p < .0001, p < .0001, p = .0034, respectively). Critical consciousness and global belief in a just world did not change significantly. During interviews, adults reported learning how: to engage in youth-adult partnerships, the tobacco industry abused its power, to engage in critical reflection about power. Adults also felt empowered. UpRISE may be a promising approach to increase racially diverse youth's engagement in social justice-oriented tobacco control efforts that advance equity.
Collapse
Affiliation(s)
| | | | - Amy Ryan
- Colorado School of Public Health, Aurora, CO, USA
| | | | | | - Bryan McNair
- Colorado School of Public Health, Aurora, CO, USA
| | - Cerise Hunt
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
2
|
Martinez D, Jansen N, Royer G, Kennedy H. Creating a Virtual Network to Support LGBTQIA+ Youth in Rural Settings: Development of Colorado's Queer Youth Network. Health Promot Pract 2022:15248399221142629. [PMID: 36571387 DOI: 10.1177/15248399221142629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more) youth in rural communities have little to no access to gender or sexuality-affirming support, compared with their peers in the metro areas of Colorado. Without access to support and exposure to bullying or discrimination, many rural LGBTQIA+ youth struggle to find belonging. Staff from One Colorado and the Hub for Justice-centered Youth Engagement partnered to develop Colorado's Queer Youth Network (CQYN) to foster a virtual community to support rural LGBTQIA+ youth, enhance belonging and acceptance, and feel empowered to make a change in their community. CQYN is offered virtually, every other week during the academic year, to create a consistent safe space for rural LGBTQIA+ youth and to offer opportunities to grow their unique leadership skills and connect with affirming LGBTQIA+ adults. This article highlights the development of the partnership, design of the virtual network, and challenges in recruiting youth who have been pushed to the margins.
Collapse
Affiliation(s)
| | - Noah Jansen
- Colorado School of Public Health, Aurora, CO, USA
| | | | | |
Collapse
|
3
|
Teixeira S, Kennedy H. Social Work and Youth Participatory Action Research (YPAR): Past, Present, and Future. Soc Work 2022; 67:286-295. [PMID: 35470395 DOI: 10.1093/sw/swac016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/09/2020] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
The social work profession has made tremendous contributions to youth well-being, laying the foundation for social welfare systems and child protection laws. However, deficit-based constructions of youth are deeply engrained in the profession. Social work researchers have called for attention to critical approaches like youth participatory action research (YPAR). YPAR has an action-oriented epistemology and engages youth as coresearchers, providing an opportunity to shift social work research and practice paradigms. Yet, social work scholars lag behind cognate disciplines in adopting YPAR. This article examines challenges that have stymied YPAR in social work. The authors review the historical roots of the profession and its relationship to youth; examine present challenges, including social work's training and career progression; and make suggestions for the future, calling social work to affirm our values by reevaluating the way we do research on youth, the way we train future social workers, and the paradigms driving our practice.
Collapse
|
4
|
Jentz C, Sandbæk A, Andersen A, Kennedy H, Sørensen L. Description of a clinical intervention among patients admitted to the medium secure forensic psychiatric services in Central Denmark Region. Eur Psychiatry 2022. [PMCID: PMC9567130 DOI: 10.1192/j.eurpsy.2022.1543] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Patients with schizophrenia suffer from increased mortality rates equivalent to 15-20 years shorter life expectancy. Up to 60% of this excess mortality can be explained by preventable, somatic conditions like cardiovascular, metabolic, and respiratory comorbidities. As forensic psychiatric (FP) patients often experience the triple stigmatization of mental illness, substance misuse and criminal conviction, the risk of suboptimal diagnosis and treatment may be high. Although benefits from the addition of general practitioner (GP) services to non-FP wards have been shown elsewhere, this cross-sectoral approach has never been attempted in a Danish FP ward.
Objectives
One purpose of this project is to evaluate the associations between self-reported quality of life and objective measures of somatic health.
Methods
A clinical intervention in which a GP consults patients in all medium secure wards in the Central Denmark Region (N=72). The consultation includes a physical examination, medication review, and evaluation of blood samples. Data is collected from: electronic patient files and questionnaires regarding quality of life (SF-12), lifestyle, and attitude towards GP services.
Results
The population will be described in regards to socio-demographic, clinical, and forensic characteristics. Associations will be made between quality of life (SF-12), metabolic syndrome, blood markers, and heart-SCORE risk. Risk profiles for endocrinologic and coronary illness will be examined.
Conclusions
Results may guide future health interventions and will be used as a basis for adjustments to the current project.
Disclosure
No significant relationships.
Collapse
|
5
|
Amin H, Edet I, Basrak N, Crudden G, Kennedy H, Davoren M. Quality of Life, Risk and Recovery in a National Forensic Mental Health Service: A D-FOREST study from DUNDRUM Hospital. Eur Psychiatry 2022. [PMCID: PMC9567632 DOI: 10.1192/j.eurpsy.2022.1545] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Secure forensic mental health services have a dual role, to treat mental disorder and reduce violent recidivism. Quality of life is a method of assessing an individual patients’ perception of their own life and is linked to personal recovery. Placement in secure forensic hospital settings should not be a barrier to achieving meaningful quality of life. The WHO-QuOL measure is a self-rated tool, internationally validated used to measure patients own perception of their quality of life.
Objectives
This aim of this study was to assess self-reported quality of life in a complete National cohort of forensic in-patients, and ascertain the associations between quality of life and measures of violence risk, recovery and functioning.
Methods
This is a cross sectional study, set in Dundrum Hospital, the site of Ireland’s National Forensic Mental Health Service. It therefore includes a complete national cohort of forensic in-patients. The WHO-QuOL was offered to all 95 in-patients in Dundrum Hospital during December 2020 – January 2021, as was PANSS (Positive and Negative Symptoms for Schizophrenia Scale). During the study period the researchers collated the scores from HCR-20 (violence risk), therapeutic programme completion (DUNDRUM-3) and recovery (DUNDRUM-4). Data was gathered as part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST).
Results
Lower scores on dynamic violence risk, better recovery and functioning scores were associated with higher self-rated quality of life.
Conclusions
The quality of life scale was meaningful in a secure forensic hospital setting. Further analysis will test relationships between symptoms, risk and protective factors and global function.
Disclosure
No significant relationships.
Collapse
|
6
|
Gibbons A, Hoare T, Kirrane K, Kennedy H, Davoren M. Sedentary Behaviour in the Secure Forensic Hospital Setting: A Study from Dundrum Hospital Ireland. Eur Psychiatry 2022. [PMCID: PMC9566155 DOI: 10.1192/j.eurpsy.2022.1548] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction
Secure forensic mental health services offer care and treatment to mentally disordered offenders, with high rates of schizophrenia and major mental illness in these groups. Much of the excess morbidity and mortality seen among patients with schizophrenia is due to cardiovascular disease and obesity. Sedentary behaviour is associated with negative symptoms of schizophrenia and obesity. Objectives The aim of this study was to ascertain the level of sedentary behaviour among inpatients in a secure forensic psychiatric hospital, Dundrum, Ireland, using a structured self-report measure of sedentary behaviours, the SIT-Q
tool. Methods A cross sectional study of self-reported sedentary behaviour was completed amongst the secure forensic inpatient population of Dundrum Hospital (N=94). Demographic details, details pertaining to diagnoses, ward level of dependency and length of stay were collated. Results The majority of patients in the sample were male (89%) and the most common diagnosis was schizophrenia (71.7%). Mean age was 44.7 years (SD 11.42). 58.2% met criteria for obesity. We found high rates of self-reported sedentary behaviour across all wards of the service, with significantly high rates of sedentary behaviour being associated with screen time use in the hospital, including both personal screen time and therapeutic sessions based on screen time. Conclusions
Sedentary behaviour among in-patients in secure forensic hospitals is a significant issue. Measuring sedentary behaviour in a systematic manner is possible and identifies a potentially modifiable target to reduce co-morbidity and pre-mature mortality independent of other risk factors in this vulnerable patient group. Disclosure No significant relationships.
Collapse
|
7
|
Murphy F, Mcloughlin A, Butler A, Davoren M, Kennedy H. Frailty in Secure Forensic Mental Health Settings: A Study from Dundrum Hospital, Ireland. Eur Psychiatry 2022. [PMCID: PMC9566090 DOI: 10.1192/j.eurpsy.2022.885] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Frailty is defined as a clinical syndrome that encompasses a combination of decreased physiological reserve and low resistance to stressors. There is an association between mental illness and frailty among elderly cohorts. Frailty is also associated with obesity and smoking. There are high rates of treatment resistant schizophrenia among patients in secure forensic services. Patients with schizophrenia have high rates of morbidity and early mortality.
Objectives
The primary aim of this study was to examine the rates of frailty present in a complete cohort of forensic in-patients.
Methods
An assessment using Fried Frailty criteria was offered to all in-patients (n=95) in Ireland’s National Forensic Service, which included measures of walking speed, grip strength, low physical activity and exhaustion. Demographic details and details pertaining to diagnoses and medications were also gathered.
Results
Of the 95 in-patients, 92 patients agreed to participate. The majority were male (89%). The most common diagnosis was schizophrenia (71.7%). Mean age was 44.7 years (SD 11.42), and 58.2% met criteria for obesity. Of the total group, 47 patients met criteria for ‘pre-frail’ and 10 met criteria for ‘frail’ using Fried criteria.
Conclusions
This is the first study examining frailty in a cohort of patients in secure forensic settings. We found high rates of patients meeting frailty criteria at very young ages. Rates of frailty in this group were comparable to those found amongst elders in community settings. We consider this demonstrates significant medical vulnerability in this patient group.
Disclosure
No significant relationships.
Collapse
|
8
|
Tong K, Har C, Kennedy H, Davoren M. Decision-making capacity regarding healthcare, welfare and finances in a secure forensic setting. Eur Psychiatry 2022. [PMCID: PMC9564983 DOI: 10.1192/j.eurpsy.2022.888] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Impairment in decision-making capacity is a serious consequence of executive dysfunction secondary to serious mental disorders like schizophrenia. Functional mental capacity (FMC) refers to an individual’s ability to make and communicate legally competent decisions autonomously. Studies have shown that FMC is dependent on severity of psychosis and can improve with treatment. Objectives To ascertain the correlation between the scores on a structured judgement tool, namely the Dundrum Capacity Ladders (DCL) with level of acuity of treatment setting and length of stay in a secure forensic hospital. Methods Sixty-two patients were interviewed using the DCL across three domains – healthcare, welfare and finances. Correlation between DCL scores, length of hospital stay and level of acuity of treatment setting was assessed. Results As patients moved from higher to lower dependency wards, mean DCL score increased, indicating a higher level of capacity. Patients in high dependency wards were most impaired while those in the low dependency wards performed significantly better (rs=0.472, p<0.001). The longer the patients stayed in the hospital, up until five years, the higher the mean welfare domain score (rs=0.402, p=0.011) and mean DCL score (rs=0.376, p=0.018). Beyond five years of hospital stay, those who had lower DCL scores and did not improve had longer length of stay. Conclusions Patients’ FMC improve as they progress from high to low level of acuity of treatment setting. However, this is dependent on the length of hospital stay. FMC may be a measure of recovery in the forensic setting. Disclosure No significant relationships.
Collapse
|
9
|
Tong K, Gibbons A, Byrne O, Conlon T, Kennedy H, Davoren M. Zero violence or zero seclusion. Which is more acceptable in our hospitals? Eur Psychiatry 2022. [PMCID: PMC9568153 DOI: 10.1192/j.eurpsy.2022.1539] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction There is an established association between serious mental illness and violence. Secure forensic psychiatric services provide care and treatment to mentally disordered offenders. The majority of patients in forensic services suffer from severe mental illnesses such as schizophrenia, with co-morbid polysubstance abuse and maladaptive personality traits. Psychiatric services are under significant pressure to reduce the use of seclusion and restrictive practices, whilst mandated to provide safe environments for patients and staff. Objectives To determine the number and characteristics of violent incidents in a secure forensic hospital in Ireland. Methods A retrospective review of all incidents in Central Mental Hospital, Ireland between 1st March 2019 and 31st August 2021 was completed. Incidents were categorised into physical assaults and other violent incidents. Demographic measures and measures of violence risk (HCR-20), functioning (GAF), programme completion and recovery (DUNDRUM tool) were collated. Results A total of 321 incidents took place during the period examined, of which 47 (14.6%) involved physical assaults perpetrated by patients. Between March 2020 and August 2021, numbers of assaults increased by 50% and 78% compared to the preceding six-month period respectively. The majority of assaults were committed by a relatively small group of patients. Victims of assaults were more likely to be patients (n=27, 57.4%) and more likely to be males (n=43, 91.9%). Conclusions Physical assaults and other violent incidents happen in forensic and general psychiatric units. Restrictive practices, used in accordance with the law, are necessary at times to prevent serious harm to patients and staff in psychiatric hospitals. Disclosure No significant relationships.
Collapse
|
10
|
O'Hara G, Kennedy H, Naoufal M, Montreuil T. The role of the classroom learning environment in students' mathematics anxiety: A scoping review. Br J Educ Psychol 2022; 92:1458-1486. [PMID: 35538624 DOI: 10.1111/bjep.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Math anxiety is a common experience that interferes with learning and achievement in mathematics. Considering that mathematics learning mostly takes place within the classroom, it is critical to examine how math anxiety develops in this context. AIMS The purpose of the current scoping review was to identify classroom-learning environment factors associated with math anxiety in elementary and high school students. SAMPLE(S) Out of an initial sample of 3011 studies, 28 were eligible for inclusion. METHODS Data on author(s), publication year, and study location; sample demographics; classroom variables; intervention details (if applicable); measures; and key results were extracted from articles. RESULTS Numerous protective and vulnerability factors were identified. CONCLUSIONS Directions for future research and methodological implications were explored.
Collapse
Affiliation(s)
- Gabrielle O'Hara
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Heather Kennedy
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Michael Naoufal
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Tina Montreuil
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.,Research Institute - McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
11
|
Lou NM, Montreuil T, Feldman LS, Fried GM, Lavoie-Tremblay M, Bhanji F, Kennedy H, Kaneva P, Harley JM. Nurses' and Physicians' Distress, Burnout, and Coping Strategies During COVID-19: Stress and Impact on Perceived Performance and Intentions to Quit. J Contin Educ Health Prof 2022; 42:e44-e52. [PMID: 33973927 DOI: 10.1097/ceh.0000000000000365] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Health care providers (HCPs) have experienced more stress and burnout during COVID-19 than before. We compared sources and levels of stress, distress, and approaches to coping between nurses and physicians, and examined whether coping strategies helped mitigate the negative impact of stress and intentions to quit. METHODS Using a cross-sectional study design, burnout was measured with the Maslach Burnout Inventory. Psychological distress was measured using the Depression, Anxiety, and Stress Scale. A self-reported survey was used to evaluate stressors, impact on perceived performance, and intentions to quit. The data were analyzed using t-tests and linear regression models. RESULTS Responses of 119 HCPs were analyzed. Findings suggest that (1) compared to physicians, nurses experienced a higher level of distress and burnout, and used more maladaptive coping strategies. (2) Both nurses and physicians experienced more distress and burnout during COVID-19 than before. (3) Adaptive coping strategies moderated the negative impact of stress on work performance (4) Adaptive coping strategies moderated the negative effect of stress on burnout, which in turn reduced intentions to quit. Stress negatively impacted work performance and burnout only for those with low, but not high, levels of adaptive coping strategies. DISCUSSION The current findings of HCPs' challenges, risks, and protective factors provide valuable information (1) on COVID-19's impact on HCPs, (2) to guide the distribution of institutional supportive efforts and recommend adaptive coping strategies, and (3) to inform medical education, such as resilience training, focusing on adaptive coping approaches.
Collapse
Affiliation(s)
- Nigel Mantou Lou
- Dr. Lou: Postdoctoral Fellow, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Montreuil: Assistant professor, Department of Educational and Counselling Psychology, McGill University, Montreal, CA; Associate Member, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, CA; and Associate Investigator, Research Institute of the McGill University Health Centre, Montreal, CA. Dr. Feldman: Professor and Chair, Department of Surgery, Faculty of Medicine and Health Sciences, and Chair, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Dr. Fried: Professor, Department of Surgery, Faculty of Medicine and Health Sciences, Director, Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, CA. Dr. Lavoie-Tremblay: Associate Professor, Ingram School of Nursing, McGill University, Montreal, CA. Dr. Bhanji: Director of Education, Steinberg Centre for Simulation and Interactive Learning, Professor, Department of Pediatrics, Faculty of Medicine and Health Sciences, and Associate member, Institute for Health Sciences Education, McGill University, Montreal, CA. Ms. Kaneva: Program coordinator, The Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, CA. Ms. Kennedy: Doctoral student, Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, CA. Dr. Harley: Assistant professor, Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, CA, Scientist, Research Institute of the McGill University Health Centre, Montreal, CA; Associate Member, Department of Educational and Counselling Psychology; Director of Research, Steinberg Centre for Simulation and Interactive Learning; and Associate Member, Institute for Health Sciences Education, McGill University, Montreal, CA
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Basrak N, Kennedy H, Davoren M. The characteristics of homicide perpetrators in a medium secure forensic hospital: A study from dundrum hospital. Eur Psychiatry 2021. [PMCID: PMC9475598 DOI: 10.1192/j.eurpsy.2021.1003] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionThe majority of homicides in society are not associated with mental illness, however there is an established association between homicide and schizophrenia. Homicide perpetrated by mentally disordered offenders is a leading reason for admission to secure forensic psychiatric hospitals.ObjectivesTo investigate the clinical characteristics of those with a history of completed homicide in the CMH Dundrum.MethodsThis study was a cross sectional study of a cohort of patients in the Central Mental Hospital who had completed homicide (n=63).ResultsA total of 136 patients were included, 46.3% (n=63) of whom had committed homicide. Mean age of homicide perpetrators at admission was 34.6 years old (median 33.4, s.d. = 9.72). The most common diagnosis was schizophrenia (n=40, 63.5%). 73.0% (n=46) had a history of substance misuse. 36.5% (n=23) had a diagnosis of a personality disorder, including traits only. The most common victim type was a family member (n=32, 50.8%). Patients with a history of homicide had better scores on dynamic risk of violence (F=8.553, p=0.004), programme completion (F=8.258, p=0.005) and recovery (F=3.666, p=0.058) compared to non-homicide offenders, however they also had significantly longer mean length of stay, 12.7 years v 7.5 years (F=9.634,p=0.002).ConclusionsHomicide perpetrators with a mental illness constitute a significant portion of the forensic mental health population and a high number of these offences were against family members. A history of homicide among forensic in-patients is associated with a longer length of stay which has implications for service development into the future.
Collapse
|
13
|
Stenson C, Menne T, Osborne W, Publicover A, Kennedy H, Shaw J, Dewhurst F, Stocker R, Vidrine J. THE PATIENT AND CARER EXPERIENCE OF CHIMERIC ANTIGEN RECEPTOR T‐CELL THERAPY FOR RELAPSED/REFRACTORY B‐CELL LYMPHOMA AT A UK REGIONAL CENTRE. Hematol Oncol 2021. [DOI: 10.1002/hon.93_2881] [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: 11/07/2022]
Affiliation(s)
- C. Stenson
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - T. Menne
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - W. Osborne
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - A. Publicover
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - H. Kennedy
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| | - J. Shaw
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - F. Dewhurst
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - R. Stocker
- Newcastle University Faculty of Medical Sciences Newcastle upon Tyne UK
| | - J. Vidrine
- Freeman Hospital Clinical Haematology Newcastle upon Tyne UK
| |
Collapse
|
14
|
Pegoraro A, Kennedy H, Agha N, Brown N, Berri D. An Analysis of Broadcasting Media Using Social Media Engagement in the WNBA. Front Sports Act Living 2021; 3:658293. [PMID: 34056588 PMCID: PMC8160370 DOI: 10.3389/fspor.2021.658293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022] Open
Abstract
While there has been research into what teams, leagues, and athletes post on social media and the impact of post content on social media engagement, there is limited understanding and empirical research on the impact of broadcasting media on social sport consumption. There are an increasing number of new media through which sport leagues can distribute their content to fans. This research examines the impact of different broadcast platforms on game day engagement with WNBA team Twitter accounts. Using data for the 2016–2018 seasons, results indicate athlete/team quality and performance were positively associated with post engagement, underscoring the importance of the core sport product and potentially indicating that the WNBA is developing a star-driven culture similar to the NBA. In addition, broadcasting on League Pass or local TV (for home teams) and Twitter were associated with lower post engagement suggesting we have more to learn about maximizing online engagement.
Collapse
Affiliation(s)
- Ann Pegoraro
- Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, ON, Canada
| | - Heather Kennedy
- Gordon S. Lang School of Business and Economics, University of Guelph, Guelph, ON, Canada
| | - Nola Agha
- College of Arts and Sciences, University of San Francisco, San Francisco, CA, United States
| | - Nicholas Brown
- College of Arts and Sciences, University of San Francisco, San Francisco, CA, United States
| | - David Berri
- Southern Utah University, Cedar City, UT, United States
| |
Collapse
|
15
|
Lou NM, Montreuil T, Feldman LS, Fried GM, Lavoie-Tremblay M, Bhanji F, Kennedy H, Kaneva P, Drouin S, Harley JM. Evaluations of Healthcare Providers' Perceived Support From Personal, Hospital, and System Resources: Implications for Well-Being and Management in Healthcare in Montreal, Quebec, During COVID-19. Eval Health Prof 2021; 44:319-322. [PMID: 33902348 PMCID: PMC8326888 DOI: 10.1177/01632787211012742] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Increased stressful experiences are pervasive among healthcare providers (HCPs) during the COVID-19 pandemic. Identifying resources that help mitigate stress is critical to maintaining HCPs' well-being. However, to our knowledge, no instrument has systematically examined how different levels of resources help HCPs cope with stress during COVID-19. This cross-sectional study involved 119 HCPs (64 nurses and 55 physicians) and evaluated the perceived availability, utilization, and helpfulness of a list of personal, hospital, and healthcare system resources. Participants also reported on their level of burnout, psychological distress, and intentions to quit. Results revealed that HCPs perceived the most useful personal resource to be family support; the most useful hospital resources were a safe environment, personal protective equipment, and support from colleagues; the most useful system resources were job protection, and clear communication and information about COVID. Moreover, HCPs who perceived having more available hospital resources also reported lower levels of psychological distress symptoms, burnout, and intentions to quit. Finally, although training and counseling services were perceived as useful to reduce stress, training was not perceived as widely available, and counseling services, though reported as being available, were underutilized. This instrument helps identify resources that support HCPs, providing implications for healthcare management.
Collapse
Affiliation(s)
- Nigel Mantou Lou
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Tina Montreuil
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
| | - Liane S Feldman
- Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,The Steinberg-Bernstein Centre for Minimally Invasive Surgery, 5620McGill University, Montreal, Quebec, Canada
| | - Gerald M Fried
- Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada
| | - Mélanie Lavoie-Tremblay
- Department of Pediatrics, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada
| | - Farhan Bhanji
- Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada
| | - Heather Kennedy
- Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Pepa Kaneva
- The Steinberg-Bernstein Centre for Minimally Invasive Surgery, 5620McGill University, Montreal, Quebec, Canada
| | - Susan Drouin
- Ingram School of Nursing, 5620McGill University, Montreal, Quebec, Canada
| | - Jason M Harley
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Surgery, Faculty of Medicine and Health Sciences, 5620McGill University, Montreal, Quebec, Canada.,Steinberg Centre for Simulation and Interactive Learning, 5620McGill University, Montreal, Quebec, Canada.,Institute for Health Sciences Education, Montreal, Quebec, Canada
| |
Collapse
|
16
|
Terkildsen M, Kennedy H, Lieto AD, Jensen B, Uhrskov L. Care & custody: E-sport and patient-professional power-relations in forensic psychiatry. A qualitative study. Eur Psychiatry 2021. [PMCID: PMC9475913 DOI: 10.1192/j.eurpsy.2021.1011] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Recovery orientated care emphasizes equality in relations. Forensic psychiatric professionals need to engage in care-relationships with patients in ways where power is symmetrically distributed among them. However, professionals also need to focus on security at the ward. This promotes patient-professional power-relations that are asymmetrically skewed towards professionals. New practical ways of balancing between the power-relations defined by a care and custody dichotomy in forensic care need to be developed and studied to guide clinical practice. Objectives To study how power-relations are articulated between patient-professional within a social gaming activity (E – sport) in a Danish medium secure forensic psychiatric ward. Methods Three months of observational data, collected via anthropological fieldwork Interviews with 3 professionals and 6 patients Data was analyzed using sociologist Pierre Bourdieu’s notions of field, capital and power Results The E-sport intervention consists of two fields “in-game” and “over-game” In-game concerns the practice of gaming Over-game concerns the interventions organization Power in each field is driven by specific values and access to certain competencies Power in-game was equally open to patients and professionals leading to symmetric power relations Power over-game was open to professionals only leading to asymmetrical power relations Professionals may allow power distribution to patients during gameplay, while still retaining the overall power over the intervention Conclusions It is possible to balance between care-and-custody in forensic psychiatry. This study provides important insights to guide further practice.
Collapse
|
17
|
Sørensen L, Kennedy H, Jensen B, Terkildsen M, Poulsen R, Josefsen M, Lieto AD. Tidier. e-sport; a recovery oriented intervention in forensic psychiatry. Eur Psychiatry 2021. [PMCID: PMC9475813 DOI: 10.1192/j.eurpsy.2021.1016] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Recently video gaming, have attracted considerable attention for its possible beneficial therapeutic effects, the possibility for testing behavior in safe artificial environments and as a tool for professionals and patients to build specific competencies for the everyday life. Also, a substantial amount of research suggests that videogaming might improve the participants social and cognitive skills and emotional regulation. There is little or no evidence that videogaming increases long term aggression or leads to physical aggression. At a medium secure forensic psychiatric in-patient ward, the patients and staff engage in weekly E – Sport sessions (primarily counterstrike) to further the recovery process. Objectives To provide a standardized description of how E-sport is organized and used in the recovery process among forensic psychiatric patients. Methods The Template for Intervention Description and Replication (TIDieR) checklist and guide is widely used to in health research to describe interventions in clinical trials and other health research contexts. By use of TIDieR we describe a newly developed E-sport intervention, in which staff members and patients in a medium secure forensic psychiatric ward engage in weekly E-Sport sessions (primarily counterstrike) to improve patient–staff relationship. Results The E-sport intervention is detailed by use of the 12 TIDieR items and practical experiences and insights will be described. Conclusions This standardized and detailed description of how is used in a recovery-oriented process in forensic psychiatry can be used for future studies that wishes to implement the intervention or for research studies replicating the treatment. Conflict of interest No significant relationships.
Collapse
|
18
|
Harpøth A, Kennedy H, Sørensen L. Modernized architecture may reduce coercion. Eur Psychiatry 2021. [PMCID: PMC9470484 DOI: 10.1192/j.eurpsy.2021.357] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Prevention and treatment of aggression in psychiatric hospitals is achieved through appropriate medical treatment, professional skills, and optimized physical environment and architecture. Coercive measures are used as a last resort. In 2018 Aarhus University Hospital Psychiatry moved from 19th-century asylum buildings to a newly built modern psychiatric hospital. Advances within psychiatric care have rendered the old psychiatric asylum hospitals inadequate for modern treatment of mental disorders. Objectives To examine if relocating from a psychiatric hospital, dating from 19th century to a new, modern psychiatric hospital decreased the use of coercive measures. Methods This is a retrospective longitudinal study, with a follow-up from 2017 to 2019. We use two designs; 1) a pre-post analysis of the use of coercive measures at Aarhus University Hospital Psychiatry before and after the relocation and 2) a case-control analysis of Aarhus University Hospital Psychiatry and the other psychiatric hospitals in the Central Region. Data will be analyzed in STATA using an interrupted time-series analysis or similar method. Additionally case-mix and sensitivity analysis will be performed. Results Preliminary results show a 45% decrease in the total number of coercive measures and a 52% decrease in the use of mechanical restraint. The reduction that may reasonably be attributed to the relocation is still to be determined and will be presented at the congress. Conclusions The study may illuminate how future development and planning of psychiatric facilities might improve psychiatric treatment and increase the understanding of how structural changes might contribute the prevention of the use of coercive measures. Disclosure No significant relationships.
Collapse
|
19
|
Basrak N, Khogali Y, Twomey R, O’Leary C, Prashant D, Elamin ME, Kennedy H, Davoren M. Stratification of a medium secure forensic care pathway according to risk and need: A study from dundrum hospital. Eur Psychiatry 2021. [PMCID: PMC9475777 DOI: 10.1192/j.eurpsy.2021.1002] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Secure forensic mental health services have a dual role, to treat mental illness and reduce violent recidivism. Those admitted to secure forensic services have a significant history of violence and treatment needs in multiple domains including psychiatric illness, violence and other areas such as substance misuse and physical health. Objectives The aim of this study was to ascertain if the units in a medium secure forensic hospital are stratified according to individual risks and needs. We also aimed to clarify if there were differences in the symptom level, risks and needs of those with and without community leave and to clarify the risks and needs of the female patients and ID patients. Methods This is a cross sectional study a cohort of patients (n=138) in a secure forensic hospital. Results There was a total of 138 patients, the majority of whom were male (n=123, 89.1%). The most common diagnosis was schizophrenia (n=99, 71.7%). Placements in the care pathway of the medium secure forensic hospital were associated with level of symptomatology (PANSS positive), dynamic violence risk (F=26.880,P<0.001), DUNDRUM-3 therapeutic programme completion (F=44.067,P<0.001), and DUNDRUM 4 recovery (F=59.629,P<0.001). Patients with community leave had better scores than those without leave on violence risk (F=77.099, P<0.001), therapeutic programme completion (F=116.072, P<0.001) and recovery (F=172.211, P<0.001). Conclusions Stratifying secure forensic psychiatric hospitals according to individual risks and needs provides in-patient care in the least restrictive setting appropriate for individuals, however niche groups such as female forensic patients and ID patients may need special consideration.
Collapse
|
20
|
Basrak N, Mulcrone N, Sharifuddin S, Ghumman Z, Bechan N, Mohamed E, Murray M, Rajendran H, Gunnigle S, Nolan M, Quane T, Terao M, Hoare T, Kirrane K, Kennedy H, Davoren M. COVID-19 in forensic psychiatry settings: The unique vulnerability of patients in secure services. Eur Psychiatry 2021. [PMCID: PMC9471102 DOI: 10.1192/j.eurpsy.2021.1004] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionSecure forensic mental health services treat patient with high rates of treatment resistant psychoses, typically schizophrenia. These groups have high rates of obesity and medical co-morbidities. Population based studies have identified high risk groups in the event of SARS-CoV-2 infection, including those with long term medical conditions.ObjectivesThe aim of this study was to compare the vulnerability to serious adverse outcome in the event of COVID-19 infection in a forensic psychiatric patient population.MethodsAll patients of a complete National Forensic Mental Health Service (n=141) were rated for risk of adverse outcome in the event of SARS-CoV-2 infection, using two structured tools, the COVID-AGE tool and the COVID-Risk tool.ResultsEighty-two patients (58.2%) met criteria for obesity, 32 had type II diabetes and 28 were hypertensive. Mean chronological age was 45.5 years (SD 11.4, median 44.1), while mean COVID-AGE was 59.1 years (SD 19.4, median 58.0), mean difference 13.6 years (SD 15.6) paired t=10.9, df=140, p=0.000. Three patients (2.1%) were chronologically over 70 years compared to 40 (28.4%) with a COVID-AGE over 70 (X2=6.99, df=1, p=0.008, Fishers exact test p=0.027).ConclusionsThese risk assessments may identify the extent of increased risk among a uniquely medically vulnerable patient group. Patients in secure forensic psychiatric services represent a high-risk group for adverse outcomes in the event of SARS-COV-2 infection. Population based cocooning and self-isolating guidance based on chronological age may not be sufficient. There is an urgent need for better physical health research and treatment in this group.
Collapse
|
21
|
Roarty A, Kennedy H, Davoren M. Changes in BMI and blood pressure after implementing a complete smoking ban in a medium secure forensic setting: A study from dundrum hospital dublin. Eur Psychiatry 2021. [PMCID: PMC9471358 DOI: 10.1192/j.eurpsy.2021.1021] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction In February 2020, the Central Mental Hospital Dundrum moved to a complete ban on cigarette smoking. Concerns were raised that this might represent a ‘restrictive practice’ and that patients might gain weight or see changes in their blood pressure if they were not permitted to smoke. Objectives The aim of the study was to ascertain if there were changes in the blood pressure readings or body mass index of a group of patients in a secure forensic hospital after the implementation of a complete campus-wide smoking ban Methods All patients (n=20) working with one medium cluster team were included in the study. Demographic details and data pertaining to legal status, diagnosis and length of stay in the hospital were obtained. BMI, blood pressure and medications were reviewed at the time of introduction of the smoking ban, 1st February 2020 and again 5 months later. Results All those included in the study were male. The median age was 35 years, most common diagnosis was schizophrenia and mean length of stay was 4.23 years. 20% of patients were prescribed anti-hypertensives at the time of introduction of the smoking ban. All of the patients on anti-hypertensives were overweight. At follow up there was no increase in BMI noted in the patient group. Two patients had dose reductions in anti-hypertensives, three had discontinuation of bronchodilators. Conclusions Introducing a campus wide smoking ban in a secure forensic psychiatric hospital is both clinically positive and practically possible. There was no noted increase in incidents in the hospital during this period.
Collapse
|
22
|
Kennedy H, Montreuil TC. The Late Positive Potential as a Reliable Neural Marker of Cognitive Reappraisal in Children and Youth: A Brief Review of the Research Literature. Front Psychol 2021; 11:608522. [PMID: 33679497 PMCID: PMC7925879 DOI: 10.3389/fpsyg.2020.608522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022] Open
Abstract
The mental health of young people is a growing public health concern. With socio-emotional difficulties in youth often resulting in psychiatric disorders later in life and most with mental health conditions rather stabilizing in time, it is essential to support healthy socio-emotional development. With a comprehensive definition of mental health, since emotion regulation (ER) plays a critical role in prevention, it becomes imperative to better understand how children effectively manage their emotions from an early age. Determining effective use of ER skills relies on adequate measurements. Typical methods of data collection in children present consistent shortcomings. This review addresses research findings considering the suitability of the late positive potential measured through electroencephalogram as a neural indicator of ER in children and youth. There is growing evidence, as reported in this review, that indicates that the late positive potential may be a reliable neural indicator of children's cognitive reappraisal abilities more specifically. Results generally suggest that the late positive potential amplitudes are sensitive to directed reappraisal in children. However, given the scant research, questions remain regarding developmental trends, methodology, interindividual variability, reappraisal of various stimuli, and how the late positive potential may relate to more traditional measures of ER. Directions for future research are provided, which are expected to address unanswered research questions and fill literature gaps. Taken together, the findings reviewed indicate that the late positive potential is generally sensitive to directed cognitive reappraisal in children and that there is promise of establishing this neural marker as an indicator of ER.
Collapse
Affiliation(s)
- Heather Kennedy
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
| | - Tina C Montreuil
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Research Institute, Montreal University Health Centre, Montreal, QC, Canada
| |
Collapse
|
23
|
|
24
|
Jain R, Young M, Dogra S, Kennedy H, Nguyen V, Raz E. Surprise Diagnosis of COVID-19 following Neuroimaging Evaluation for Unrelated Reasons during the Pandemic in Hot Spots. AJNR Am J Neuroradiol 2020; 41:1177-1178. [PMID: 32467189 DOI: 10.3174/ajnr.a6608] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/01/2020] [Indexed: 11/07/2022]
Abstract
During the height of the recent outbreak of coronavirus 19 (COVID-19) in New York City, almost all the hospital emergency departments were inundated with patients with COVID-19, who presented with typical fever, cough, and dyspnea. A small number of patients also presented with either unrelated conditions (such as trauma) or other emergencies, and some of which are now known to be associated with COVID-19 (such as stroke). We report such a scenario in 17 patients who were admitted and investigated with CT spine imaging and CT angiography for nonpulmonary reasons (trauma = 13, stroke = 4). Their initial work-up did not suggest COVID-19 as a diagnosis but showed unsuspected/incidental lung findings, which led to further investigations and a diagnosis of COVID-19.
Collapse
Affiliation(s)
- R Jain
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
- Neurosurgery (R.J.), NYU Langone Health, New York, New York
| | - M Young
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
| | - S Dogra
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
| | - H Kennedy
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
| | - V Nguyen
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
| | - E Raz
- From the Departments of Radiology (R.J., M.Y., S.D., H.K., V.N., E.R.)
| |
Collapse
|
25
|
Anyon Y, Roscoe J, Bender K, Kennedy H, Dechants J, Begun S, Gallager C. Reconciling Adaptation and Fidelity: Implications for Scaling Up High Quality Youth Programs. J Prim Prev 2020; 40:35-49. [PMID: 30659405 DOI: 10.1007/s10935-019-00535-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the field of prevention science, some consider fidelity to manualized protocols to be a hallmark of successful implementation. A growing number of scholars agree that high-quality implementation should also include some adaptations to local context, particularly as prevention programs are scaled up, in order to strengthen their relevance and increase participant engagement. From this perspective, fidelity and adaptation can both be seen as necessary, albeit mutually exclusive, dimensions of implementation quality. In this article, we propose that the relationship between these two constructs may be more complex, particularly when adaptations are consistent with the key principles underlying the program model. Our argument draws on examples from the implementation of a manualized youth voice program (YVP) in two different organizations serving six distinct communities. Through a series of retreats, implementers identified examples of modifications made and grouped them into themes. Results suggest that some adaptations were actually indicators of fidelity to the key principles of YVPs: power-sharing, youth ownership, and engagement in social change. We therefore offer suggestions for re-conceptualizing the fidelity-adaptation debate, highlight implications for measurement and assessment, and illustrate that the de facto treatment of adaptation and fidelity as opposing constructs may limit the diffusion or scaling up of these types of youth programs.
Collapse
Affiliation(s)
- Yolanda Anyon
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA.
| | - Joe Roscoe
- School of Social Work, University of California Berkeley, 120 Haviland Hall, Berkeley, CA, 94720, USA
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA
| | - Heather Kennedy
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA
| | - Jonah Dechants
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA
| | - Stephanie Begun
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Christine Gallager
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80208, USA
| |
Collapse
|
26
|
Courtenay M, Burnett E, Castro-Sánchez E, Du Toit B, Figueiredo RM, Gallagher R, Gotterson F, Kennedy H, Manias E, McEwen J, Ness V, Olans R, Padoveze MC. Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardship programmes. J Hosp Infect 2020; 106:176-178. [PMID: 32531230 PMCID: PMC7283056 DOI: 10.1016/j.jhin.2020.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 10/25/2022]
Affiliation(s)
- M Courtenay
- School of Health Sciences, Cardiff University, Cardiff, UK.
| | - E Burnett
- School of Health Sciences, University of Dundee, Scotland, UK
| | - E Castro-Sánchez
- NIHR Health Protection Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK
| | - B Du Toit
- Mediclinic Southern Africa, Stellenbosch, South Africa
| | | | | | - F Gotterson
- The University of Melbourne, National Centre for Antimicrobial Stewardship, Australia
| | | | - E Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Australia
| | | | - V Ness
- Glasgow Caledonian University, Glasgow, UK
| | - R Olans
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - M C Padoveze
- School of Nursing, University of São Paulo, Brazil
| |
Collapse
|
27
|
Kennedy H, Matyasic S, Schofield Clark L, Engle C, Anyon Y, Weber M, Jimenez C, Osiemo Mwirigi M, Nisle S. Early Adolescent Critical Consciousness Development in the Age of Trump. Journal of Adolescent Research 2019. [DOI: 10.1177/0743558419852055] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Political elections have been shown to influence youth civic development. The election of Donald Trump is historic and has elevated precarity for people of color and immigrants, yet we know little about how young people with these identities experienced this potentially catalytic event. Using ethnographic methods, we examined youth and adult discussions that occurred during youth participatory action research in four sites of one after-school program between October 2016 and May 2017, to investigate how the development of critical consciousness occurs among early adolescent youth of color in the context of catalyzing political events. We identified emergent patterns in how young people (a) engaged in critical reflection, (b) weighed political efficacy, and (c) considered engagement in critical action in the wake of Trump’s election. The data revealed that young people’s critical consciousness development ranged from basic to advanced levels. This research highlights the ways that politically catalytic events shape critical consciousness development among early adolescents of color.
Collapse
|
28
|
Kennedy H, DeChants J, Bender K, Anyon Y. More than Data Collectors: A Systematic Review of the Environmental Outcomes of Youth Inquiry Approaches in the United States. Am J Community Psychol 2019; 63:208-226. [PMID: 30843254 DOI: 10.1002/ajcp.12321] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Over the last twenty years, research on the impact of engaging children and adolescents in the generation of new knowledge about their lives, schools, and communities, has grown tremendously. This systematic review summarizes the findings from empirical studies of youth inquiry approaches in the United States, with a focus on their environmental outcomes. Searches of four interdisciplinary databases retrieved a total of 3,724 relevant articles published between 1995 and 2015. Sixty-three distinct studies met the systematic review inclusion criteria, of which, 36 (57.1%) reported that the youth inquiry approach contributed to positive changes among adults, peers, organizations, and/or institutions. These environmental outcomes were qualitatively recorded, inductively categorized, and then organized into Bronfenbrenner's ecological framework. Youth inquiry approaches led to practitioner growth and changes in peer group norms at the micro-system level, program development or improvement and research benefits at the meso-system level, and school, city, and state level policy adoption at the exo-system level. Qualitative methods, especially case studies, were most commonly used to evaluate the impact of youth inquiry approaches on environmental outcomes. Studies of approaches that utilized advocacy to create change, targeted decision-makers as the audience for the youth's work and convened for a longer duration were more likely to report improved environmental outcomes. This systematic review suggests that youth inquiry approaches are a promising strategy for ecological systems change.
Collapse
Affiliation(s)
- Heather Kennedy
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Jonah DeChants
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Yolanda Anyon
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| |
Collapse
|
29
|
Moreau De Bellaing A, Guimier A, Bajolle F, Turner C, Grove M, Dunn K, Katta G, Crozier I, Kidd A, Mayr J, Rotig A, Di Rago J, Delahodde A, Lyonnet S, Doudney K, Kennedy H, Amiel J, Gordon C, Bonnet D. PPA2 gene is involved in neonatal fatal acute dilated cardiomyopathy. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.296] [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]
|
30
|
Kennedy H, Marley M, Torres K, Edelblute A, Novins D. "Be creative and you will reach more people": youth's experiences participating in an arts-based social action group aimed at mental health stigma reduction. Arts Health 2018; 12:23-37. [PMID: 31038428 DOI: 10.1080/17533015.2018.1534249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Starting in 2013, the Mental Health Youth Action Board, made up of 15 teens ages 15-18, was created to advise a large children's hospital on improvements in mental health care and produce social action projects to impact community perceptions of mental health.Methods: This participatory qualitative case study explored the experiences of 14 young people who participated in the Mental Health Youth Action Board between 2013 and 2016.Results: There were two higher order themes: process and outcomes. Process-related themes included how this was a unique leadership experience, the importance of the arts-based approach, and value of the intentionally constructed storytelling process. These processes led to youth growing as advocates for mental health.Conclusions: Arts-based approaches to social action that allow youth to share personal experiences of stigmatized topics can promote healing and support their growth as leaders.
Collapse
Affiliation(s)
- Heather Kennedy
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Maeve Marley
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Kristen Torres
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Anthony Edelblute
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Douglas Novins
- Pediatric Mental Health Institute, Children's Hospital Colorado, Aurora, CO, USA.,School of Medicine, University of Colorado Denver, Aurora, CO, USA
| |
Collapse
|
31
|
Anyon Y, Bender K, Kennedy H, Dechants J. A Systematic Review of Youth Participatory Action Research (YPAR) in the United States: Methodologies, Youth Outcomes, and Future Directions. Health Educ Behav 2018; 45:865-878. [PMID: 29749267 DOI: 10.1177/1090198118769357] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To use a systematic review methodology to describe the state of the youth participatory action research (YPAR) literature and synthesize findings about the youth outcomes reported in these studies. METHODS We screened and coded studies using a process consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Of the 3,724 articles found in the database search, 67 reports of 63 distinct studies were included in the final sample. These reports were coded for reports of YPAR principles and project characteristics, study methods, and reported youth outcomes. RESULTS The YPAR literature comprises predominantly qualitative studies, with only two randomized trials. The most common outcomes associated with participation in YPAR were those related to agency and leadership (75.0%), followed by academic or career (55.8%), social (36.5%), interpersonal (34.6%), and cognitive (23.1%) outcomes. CONCLUSIONS This systematic review provides emerging evidence of the skills and competencies youth may develop through YPAR and offers methodological recommendations for future research that can provide greater evidence of causality.
Collapse
|
32
|
Abstract
A study was undertaken in Northern Ireland (NI) prisons to (i) determine prevalence of bloodborne viruses among inmates, (ii) estimate the extent of self-reported risk behaviours. All three prisons in NI were included in the study. Outcome measures included (i) antibodies to hepatitis C (HCV), hepatitis B (HBV) core antigen, HIV, (ii) self-reported risk behaviour. Five prisoners (0.75%) tested positive for HBV, seven (1.1%) for HCV and none for HIV. Eleven per cent reported ever having injected drugs. Of these, 20% had started injecting while in prison, and 12% shared injecting equipment in prison. Two per cent had completed HBV immunisation. Injecting drugs was associated with HCV (adjusted prevalence ratio=5.2; 95% CI 0.9-16) and HBV infection (adjusted prevalence ratio=4.1; 95% CI 0.7-23). The low prevalence of bloodborne viruses within NI prisons is not consistent with findings of studies in other countries, possibly reflecting the unique sociopolitical situation in NI. In spite of knowledge of the risks of transmission of bloodborne viruses in prison, high-risk practices are occurring. Preventing risk behaviours and transmission of infection in prisons now poses a challenge for health services in the United Kingdom.
Collapse
Affiliation(s)
- K Danis
- European Programme for Intervention Epidemiology Training (EPIET)
| | - L Doherty
- Communicable Disease Surveillance Centre (CDSC-NI), Belfast, Northern Ireland
| | - M McCartney
- Department of Health, Social Services and Public Safety (DHSSPS), Belfast, Northern Ireland
| | - J McCarrol
- Eastern Health and Social Services Board (EHSSB), Belfast, Northern Ireland
| | - H Kennedy
- Eastern Health and Social Services Board (EHSSB), Belfast, Northern Ireland
| |
Collapse
|
33
|
|
34
|
Shuman J, Kennedy H, DeWitt P, Edelblute A, Wamboldt MZ. Group music therapy impacts mood states of adolescents in a psychiatric hospital setting. The Arts in Psychotherapy 2016. [DOI: 10.1016/j.aip.2016.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
35
|
Abstract
Using both qualitative (in-depth, personal interviews) and quantitative (self-report survey indices) techniques, data were collected from 43 women involved in streetwalking prostitution. The purpose of the investigation was to examine exposure to violence and victimization among a particularly vulnerable female population across the life span. A secondary goal was to apply stress theory as an organizing framework for examining personal resources (e.g., social support, locus of control) and coping behavior. Results from both data collection strategies are presented, and implications for intervention are described.
Collapse
Affiliation(s)
| | - Yan Xia
- University of Nebraska-Lincoln
| | | |
Collapse
|
36
|
Waelchli R, Williams J, Cole T, Dattani M, Hindmarsh P, Kennedy H, Martinez A, Khan S, Semple RK, White A, Sebire N, Healy E, Moore G, Kinsler VA. Growth and hormone profiling in children with congenital melanocytic naevi. Br J Dermatol 2015; 173:1471-8. [PMID: 26286459 PMCID: PMC4737097 DOI: 10.1111/bjd.14091] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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] [Accepted: 08/11/2015] [Indexed: 12/15/2022]
Abstract
Background Multiple congenital melanocytic naevi (CMN) is a rare mosaic RASopathy, caused by postzygotic activating mutations in NRAS. Growth and hormonal disturbances are described in germline RASopathies, but growth and hormone status have not previously been investigated in individuals with CMN. Objectives To explore premature thelarche, undescended testes, and a clinically abnormal fat distribution with CMN through prospective endocrinological assessment of a cohort of subjects with CMN, and a retrospective review of longitudinal growth of a larger group of patients with CMN from outpatient clinics (which included all subjects in the endocrinological assessment group). Patients and methods Longitudinal growth in a cohort of 202 patients with single or multiple CMN was compared with the U.K. National Child Measurement Programme 2010. Forty‐seven children had hormonal profiling including measurement of circulating luteinizing hormone, follicle‐stimulating hormone, thyroid stimulating hormone, adrenocorticotrophic hormone, growth hormone, prolactin, pro‐opiomelanocortin, estradiol, testosterone, cortisol, thyroxine, insulin‐like growth factor‐1 and leptin; 10 had oral glucose tolerance testing 25 had dual‐energy X‐ray absorptiometry scans for body composition. Results Body mass index increased markedly with age (coefficient 0·119, SE 0·016 standard deviation scores per year), at twice the rate of the U.K. population, due to increased adiposity. Three per cent of girls had premature thelarche variant and 6% of boys had persistent undescended testes. Both fat and muscle mass were reduced in areas underlying large naevi, resulting in limb asymmetry and abnormal truncal fat distribution. Anterior pituitary hormone profiling revealed subtle and variable abnormalities. Oral glucose tolerance tests revealed moderate–severe insulin insensitivity in five of 10, and impaired glucose tolerance in one. Conclusions Interpersonal variation may reflect the mosaic nature of this disease and patients should be considered individually. Postnatal weight gain is potentially related to the underlying genetic defect; however, environmental reasons cannot be excluded. Naevus‐related reduction of fat and muscle mass suggests local hormonal or metabolic effects on development or growth of adjacent tissues, or mosaic involvement of these tissues at the genetic level. Premature thelarche and undescended testes should be looked for, and investigated, as for any child. What's already known about this topic? CMN are caused by postzygotic mutations in the gene NRAS in the majority of cases, classifying it within the group of mosaic RASopathies. Other germline and mosaic RASopathies are known to have growth and hormonal abnormalities. No studies have been done on growth or endocrinology in children with CMN.
What does this study add? Average body mass index increases markedly with age compared with the normal population; this is due to increased adiposity, and can be associated with insulin insensitivity. Premature thelarche variant and persistent undescended testes are not infrequent findings, but puberty appears to develop normally. Both fat and muscle mass can be reduced in areas underlying large naevi, resulting in asymmetry.
Linked Comment:Millington, Br J Dermatol 2015; 173: 1366–67.
Collapse
Affiliation(s)
- R Waelchli
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - J Williams
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, U.K
| | - T Cole
- MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, U.K
| | - M Dattani
- Department of Genetics and Genomic Medicine, UCL Institute of Child Health, London, U.K.,Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - P Hindmarsh
- Department of Genetics and Genomic Medicine, UCL Institute of Child Health, London, U.K.,Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - H Kennedy
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - A Martinez
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - S Khan
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, U.K
| | - R K Semple
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K
| | - A White
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, U.K
| | - N Sebire
- Department of Paediatric Histopathology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K
| | - E Healy
- Department of Dermatopharmacology, Sir Henry Wellcome Laboratories, University of Southampton, Southampton, U.K
| | - G Moore
- Department of Genetics and Genomic Medicine, UCL Institute of Child Health, London, U.K
| | - V A Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, WC1N 3JH, U.K.,Department of Genetics and Genomic Medicine, UCL Institute of Child Health, London, U.K
| |
Collapse
|
37
|
Brightbill HD, Jackman JK, Suto E, Kennedy H, Jones C, Chalasani S, Lin Z, Tam L, Roose-Girma M, Balazs M, Austin CD, Lee WP, Wu LC. Conditional Deletion of NF-κB-Inducing Kinase (NIK) in Adult Mice Disrupts Mature B Cell Survival and Activation. J Immunol 2015; 195:953-64. [PMID: 26116508 DOI: 10.4049/jimmunol.1401514] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 05/30/2015] [Indexed: 01/19/2023]
Abstract
NF-κB-inducing kinase (NIK) is a primary regulator of the noncanonical NF-κB signaling pathway, which plays a vital role downstream of BAFF, CD40L, lymphotoxin, and other inflammatory mediators. Germline deletion or inactivation of NIK in mice results in the defective development of B cells and secondary lymphoid organs, but the role of NIK in adult animals has not been studied. To address this, we generated mice containing a conditional allele of NIK. Deletion of NIK in adult mice results in decreases in B cell populations in lymph nodes and spleen, similar to what is observed upon blockade of BAFF. Consistent with this, B cells from mice in which NIK is acutely deleted fail to respond to BAFF stimulation in vitro and in vivo. In addition, mice with induced NIK deletion exhibit a significant decrease in germinal center B cells and serum IgA, which is indicative of roles for NIK in additional pathways beyond BAFF signaling. Our conditional NIK-knockout mice may be broadly useful for assessing the postdevelopmental and cell-specific roles of NIK and the noncanonical NF-κB pathway in mice.
Collapse
Affiliation(s)
- Hans D Brightbill
- Department of Immunology, Genentech Inc., South San Francisco, CA 94080;
| | - Janet K Jackman
- Department of Immunology, Genentech Inc., South San Francisco, CA 94080
| | - Eric Suto
- Department of Translational Immunology, Genentech Inc., South San Francisco, CA 94080
| | - Heather Kennedy
- Department of Pathology, Genentech Inc., South San Francisco, CA 94080; and
| | - Charles Jones
- Department of Pathology, Genentech Inc., South San Francisco, CA 94080; and
| | - Sreedevi Chalasani
- Department of Pathology, Genentech Inc., South San Francisco, CA 94080; and
| | - Zhonghua Lin
- Department of Translational Immunology, Genentech Inc., South San Francisco, CA 94080
| | - Lucinda Tam
- Department of Molecular Biology, Genentech Inc., South San Francisco, CA 94080
| | - Meron Roose-Girma
- Department of Molecular Biology, Genentech Inc., South San Francisco, CA 94080
| | - Mercedesz Balazs
- Department of Translational Immunology, Genentech Inc., South San Francisco, CA 94080
| | - Cary D Austin
- Department of Pathology, Genentech Inc., South San Francisco, CA 94080; and
| | - Wyne P Lee
- Department of Translational Immunology, Genentech Inc., South San Francisco, CA 94080
| | - Lawren C Wu
- Department of Immunology, Genentech Inc., South San Francisco, CA 94080;
| |
Collapse
|
38
|
Cohen RI, Kennedy H, Amitrano B, Dillon M, Guigui S, Kanner A. A quality improvement project to decrease emergency department and medical intensive care unit transfer times. J Crit Care 2015; 30:1331-7. [PMID: 26365001 DOI: 10.1016/j.jcrc.2015.07.017] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/19/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To reduce transfer time of critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU). DESIGN A prospective, observational study assessing preimplementation and postimplementation of quality improvement interventions in a tertiary academic medical center. INTERVENTIONS A team of frontline health care professional including ED, MICU, and supporting services using the clinical microsystems approach mapped out existing practice patterns, determined causes for delays, and used the Plan-Do-Study-Act to test changes. Measurements and Main Results The team identified multiple issues that contributed to delays. These included poor coordination between transport services, respiratory therapy, and nursing in transferring patients from the ED as well delays in identification and transfer of stable MICU patients. These interventions reduced transfer time from 4.2 (3.4-5.7) hours to 2.2 (1.4-3.1) hours (median [interquartile range]; P<.001). Hospital length of stay decreased from 9.9±9 to 8.3±7 days (P<.03). CONCLUSION A team made up of frontline health care professionals using a structured quality improvement process and implementing multifaceted, multistage interventions, reduced transfer delays, and length of stay. Added benefits included engagement among members of the 2 microsystems and a more cohesive approach to patient care.
Collapse
Affiliation(s)
- Rubin I Cohen
- Department of Medicine, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| | - Heather Kennedy
- Department of Nursing, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| | - Bernadette Amitrano
- Department of Nursing, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| | - Maryanne Dillon
- Department of Nursing, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| | - Sarah Guigui
- Department of Medicine, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| | - Andrew Kanner
- Department of Nursing, The Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY
| |
Collapse
|
39
|
Kennedy H, Wilson S, Marwick C, Malcolm W, Nathwani D. Reduction in broad-spectrum Gram-negative agents by diverse prescribing of aztreonam within NHS Tayside. J Antimicrob Chemother 2015; 70:2421-3. [PMID: 26012902 DOI: 10.1093/jac/dkv127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Heather Kennedy
- Ninewells Hospital, Ninewells Avenue, Dundee DD1 9SY, Scotland
| | - Sarah Wilson
- Ninewells Hospital, Ninewells Avenue, Dundee DD1 9SY, Scotland
| | - Charis Marwick
- Ninewells Hospital, Ninewells Avenue, Dundee DD1 9SY, Scotland
| | - William Malcolm
- HAI and Infection Control Group, NHS National Services Scotland, 4th Floor, Meridian Court, 5 Cadogan Street, Glasgow G2 6QE, Scotland
| | - Dilip Nathwani
- Ninewells Hospital, Ninewells Avenue, Dundee DD1 9SY, Scotland
| |
Collapse
|
40
|
Goessling JM, Kennedy H, Mendonça MT, Wilson AE. A meta‐analysis of plasma corticosterone and heterophil : lymphocyte ratios – is there conservation of physiological stress responses over time? Funct Ecol 2015. [DOI: 10.1111/1365-2435.12442] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Heather Kennedy
- Department of Biological Sciences Auburn University Auburn Alabama 36849 USA
| | - Mary T. Mendonça
- Department of Biological Sciences Auburn University Auburn Alabama 36849 USA
| | - Alan E. Wilson
- School of Fisheries, Aquaculture, and Aquatic Sciences Auburn University Auburn Alabama 36849 USA
| |
Collapse
|
41
|
Hulse RP, Beazley-Long N, Hua J, Kennedy H, Prager J, Bevan H, Qiu Y, Fernandes ES, Gammons MV, Ballmer-Hofer K, Gittenberger de Groot AC, Churchill AJ, Harper SJ, Brain SD, Bates DO, Donaldson LF. Regulation of alternative VEGF-A mRNA splicing is a therapeutic target for analgesia. Neurobiol Dis 2014; 71:245-59. [PMID: 25151644 PMCID: PMC4194316 DOI: 10.1016/j.nbd.2014.08.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/29/2014] [Accepted: 08/06/2014] [Indexed: 12/02/2022] Open
Abstract
Vascular endothelial growth factor-A (VEGF-A) is best known as a key regulator of the formation of new blood vessels. Neutralization of VEGF-A with anti-VEGF therapy e.g. bevacizumab, can be painful, and this is hypothesized to result from a loss of VEGF-A-mediated neuroprotection. The multiple vegf-a gene products consist of two alternatively spliced families, typified by VEGF-A165a and VEGF-A165b (both contain 165 amino acids), both of which are neuroprotective. Under pathological conditions, such as in inflammation and cancer, the pro-angiogenic VEGF-A165a is upregulated and predominates over the VEGF-A165b isoform. We show here that in rats and mice VEGF-A165a and VEGF-A165b have opposing effects on pain, and that blocking the proximal splicing event – leading to the preferential expression of VEGF-A165b over VEGF165a – prevents pain in vivo. VEGF-A165a sensitizes peripheral nociceptive neurons through actions on VEGFR2 and a TRPV1-dependent mechanism, thus enhancing nociceptive signaling. VEGF-A165b blocks the effect of VEGF-A165a. After nerve injury, the endogenous balance of VEGF-A isoforms switches to greater expression of VEGF-Axxxa compared to VEGF-Axxxb, through an SRPK1-dependent pre-mRNA splicing mechanism. Pharmacological inhibition of SRPK1 after traumatic nerve injury selectively reduced VEGF-Axxxa expression and reversed associated neuropathic pain. Exogenous VEGF-A165b also ameliorated neuropathic pain. We conclude that the relative levels of alternatively spliced VEGF-A isoforms are critical for pain modulation under both normal conditions and in sensory neuropathy. Altering VEGF-Axxxa/VEGF-Axxxb balance by targeting alternative RNA splicing may be a new analgesic strategy. The different vegf-a splice variants, VEGF-A165a and VEGF-A165b have pro- and anti-nociceptive actions respectively. Pro-nociceptive actions of VEGF-A165a are dependent on TRPV1. Alternative pre-mRNA splicing underpins peripheral sensitization by VEGF-A isoforms in normal and neuropathic animals.
Collapse
Affiliation(s)
- R P Hulse
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK; Cancer Biology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham NG2 7UH, UK
| | - N Beazley-Long
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK; School of Life Sciences, The Medical School, University of Nottingham, Queen's Medical Centre, Nottingham NG2 7UH, UK
| | - J Hua
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - H Kennedy
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - J Prager
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - H Bevan
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - Y Qiu
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | | | - M V Gammons
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | | | | | - A J Churchill
- Clinical Sciences, University of Bristol, Bristol BS1 2LX, UK
| | - S J Harper
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK
| | - S D Brain
- King's College London, London SE1 9NH, UK
| | - D O Bates
- Cancer Biology, Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham NG2 7UH, UK.
| | - L F Donaldson
- Physiology and Pharmacology, University of Bristol, Bristol BS8 1TD, UK; School of Life Sciences, The Medical School, University of Nottingham, Queen's Medical Centre, Nottingham NG2 7UH, UK.
| |
Collapse
|
42
|
|
43
|
Anderson AN, Kennedy H, DeWitt P, Anderson E, Wamboldt MZ. Dance/movement therapy impacts mood states of adolescents in a psychiatric hospital. The Arts in Psychotherapy 2014. [DOI: 10.1016/j.aip.2014.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Lincoln P, Manning MJ, Hamilton S, Labreque M, Casey D, Kennedy H, Penny KC, Curley MAQ. A pediatric critical care practice group: use of expertise and evidence-based practice in identifying and establishing "best" practice. Crit Care Nurse 2014; 33:85-7. [PMID: 23547131 DOI: 10.4037/ccn2013740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
45
|
Markov NT, Ercsey-Ravasz MM, Ribeiro Gomes AR, Lamy C, Magrou L, Vezoli J, Misery P, Falchier A, Quilodran R, Gariel MA, Sallet J, Gamanut R, Huissoud C, Clavagnier S, Giroud P, Sappey-Marinier D, Barone P, Dehay C, Toroczkai Z, Knoblauch K, Van Essen DC, Kennedy H. A weighted and directed interareal connectivity matrix for macaque cerebral cortex. ACTA ACUST UNITED AC 2012; 24:17-36. [PMID: 23010748 PMCID: PMC3862262 DOI: 10.1093/cercor/bhs270] [Citation(s) in RCA: 504] [Impact Index Per Article: 42.0] [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] [Indexed: 01/22/2023]
Abstract
Retrograde tracer injections in 29 of the 91 areas of the macaque cerebral cortex revealed 1,615 interareal pathways, a third of which have not previously been reported. A weight index (extrinsic fraction of labeled neurons [FLNe]) was determined for each area-to-area pathway. Newly found projections were weaker on average compared with the known projections; nevertheless, the 2 sets of pathways had extensively overlapping weight distributions. Repeat injections across individuals revealed modest FLNe variability given the range of FLNe values (standard deviation <1 log unit, range 5 log units). The connectivity profile for each area conformed to a lognormal distribution, where a majority of projections are moderate or weak in strength. In the G29 × 29 interareal subgraph, two-thirds of the connections that can exist do exist. Analysis of the smallest set of areas that collects links from all 91 nodes of the G29 × 91 subgraph (dominating set analysis) confirms the dense (66%) structure of the cortical matrix. The G29 × 29 subgraph suggests an unexpectedly high incidence of unidirectional links. The directed and weighted G29 × 91 connectivity matrix for the macaque will be valuable for comparison with connectivity analyses in other species, including humans. It will also inform future modeling studies that explore the regularities of cortical networks.
Collapse
Affiliation(s)
- N T Markov
- Stem cell and Brain Research Institute, INSERM U846, 69500 Bron, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Papadimitriou S, Kennedy H, Norman L, Kennedy DP, Dieckmann GS, Thomas DN. The effect of biological activity, CaCO3mineral dynamics, and CO2degassing in the inorganic carbon cycle in sea ice in late winter-early spring in the Weddell Sea, Antarctica. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jc008058] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
47
|
Syed B, Johnston S, Wong D, Green A, Winterbottom L, Kennedy H, Simpson N, Morgan D, Ellis I, Cheung K. Long-term (37 years) clinical outcome of older women with early operable primary breast cancer managed in a dedicated clinic. Ann Oncol 2012; 23:1465-71. [DOI: 10.1093/annonc/mdr446] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
|
48
|
Chan SSM, Luben R, Bergmann MM, Boeing H, Olsen A, Tjonneland A, Overvad K, Kaaks R, Kennedy H, Khaw KT, Riboli E, Hart AR. Aspirin in the aetiology of Crohn's disease and ulcerative colitis: a European prospective cohort study. Aliment Pharmacol Ther 2011; 34:649-55. [PMID: 21790683 DOI: 10.1111/j.1365-2036.2011.04784.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Aspirin has detrimental effects on the gastrointestinal tract mucosa and may play a role in the aetiology of inflammatory bowel disease. AIM To investigate if the regular use of aspirin is associated with the development of Crohn's disease (CD) and ulcerative colitis (UC) using, for the first time, a prospective cohort study design. METHODS A total of 135,780 men and women in Europe, aged 30-74years, were recruited into the European Prospective Investigation into Cancer and Nutrition study. Participants completed questionnaires at baseline detailing their regular aspirin use and were then followed up to identify those who developed either incident CD or UC. Each case was matched with four controls and odds ratios (OR) were calculated, adjusting for cigarette smoking. Potential interactions between aspirin and smoking were assessed. RESULTS A total of 35 participants developed CD and a further 84 were diagnosed with UC. Regular aspirin intake was positively associated with the risk of developing CD (OR=6.14, 95% CI=1.76-21.35). In those who took aspirin and smoked there was no detectable increased risk of CD (OR=0.30, 95% CI=0.03-3.08). No association was found between regular aspirin use and UC (OR=1.29, 95% CI=0.67-2.46). CONCLUSIONS A strong positive association between regular aspirin use and CD, but not UC, was observed. The data suggest that regular aspirin use should be measured in epidemiological work on CD. If such findings are consistent in other work then aspirin may affect the development of CD in a middle-aged to elderly population.
Collapse
Affiliation(s)
- S S M Chan
- Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Parks RM, Hall L, Tang S, Lakshmanan R, Hurria A, Winterbottom L, Kennedy H, Morgan DAL, Porock D, Cox K, Cheung K. Evaluation of a cancer-specific comprehensive geriatric assessment (CGA) tool in older women with newly diagnosed primary breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
50
|
Syed BM, Al-Khyatt W, Johnston SJ, Wong DWM, Winterbottom L, Kennedy H, Green AR, Morgan DAL, Ellis IO, Cheung KL. Long-term clinical outcome of oestrogen receptor-positive operable primary breast cancer in older women: a large series from a single centre. Br J Cancer 2011; 104:1393-400. [PMID: 21448163 PMCID: PMC3101924 DOI: 10.1038/bjc.2011.105] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/28/2011] [Accepted: 03/02/2011] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION A Cochrane review of seven randomised trials (N=1571) comparing surgery and primary endocrine therapy (PET) (oestrogen receptor (ER) unselected) shows no difference in overall survival (OS). We report outcome of a large series with ER-positive (ER+) early invasive primary breast cancer. METHODS Between 1973 and 2009, 1065 older (≥ 70 years) women (median age 78 years (70-99)) had either surgery (N=449) or PET (N=616) as initial treatment. RESULTS At 49-month median follow-up (longest 230 months), the 5-year breast cancer-specific survival (BCSS) and OS were 90 and 62%, respectively. Majority (74.2%) died from causes other than breast cancer. The rates (per annum) of local/regional recurrence (<1%) (following surgery), contralateral tumour (<1%) and metastases (<3%) were low. For patients on PET, 97.9% achieved clinical benefit (CB) at 6 months, with median time to progression of 49 months (longest 132 months) and significantly longer BCSS when compared with those who progressed (P<0.001). All patients with strongly ER+ (H-score >250) tumours achieved CB and had better BCSS (P<0.01). Patients with tumours having an H-score >250 were found to have equivalent BCSS regardless of treatment (surgery or PET; P=0.175), whereas for those with H-score ≤ 250, surgery produced better outcome (P<0.001). CONCLUSION Older women with ER+ breast cancer appear to have excellent long-term outcome regardless of initial treatment. Majority also die from non-breast cancer causes. Although surgery remains the treatment of choice, patients with ER-rich (H-score >250) tumours tend to do equally well when treated by PET. This should be taken into account when therapies are considered.
Collapse
Affiliation(s)
- B M Syed
- Division of Breast Surgery, University of Nottingham, Nottingham NG5 1PB, UK
| | - W Al-Khyatt
- Division of Breast Surgery, University of Nottingham, Nottingham NG5 1PB, UK
| | - S J Johnston
- Division of Breast Surgery, University of Nottingham, Nottingham NG5 1PB, UK
| | - D W M Wong
- Division of Breast Surgery, University of Nottingham, Nottingham NG5 1PB, UK
| | - L Winterbottom
- Nottingham Breast Institute, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - H Kennedy
- Nottingham Breast Institute, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - A R Green
- Division of Pathology, University of Nottingham, Nottingham NG5 1PB, UK
| | - D A L Morgan
- Department of Oncology, Nottingham University Hospitals, Nottingham NG5 1PB, UK
| | - I O Ellis
- Division of Pathology, University of Nottingham, Nottingham NG5 1PB, UK
| | - K L Cheung
- Division of Breast Surgery, University of Nottingham, Nottingham NG5 1PB, UK
| |
Collapse
|