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Search Results: 1 - 10 of 5482 matches for " Linda Davies "
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Patient empowerment: The need to consider it as a measurable patient-reported outcome for chronic conditions
Marion McAllister, Graham Dunn, Katherine Payne, Linda Davies, Chris Todd
BMC Health Services Research , 2012, DOI: 10.1186/1472-6963-12-157
Abstract: Patient empowerment is not a well-defined construct. A range of condition-specific and generic patient empowerment questionnaires have been developed; each captures a different construct e.g. personal control, self-efficacy/self-mastery, and each is informed by a different implicit or explicit theoretical framework. This makes it currently problematic to conduct comparative evaluations of healthcare services on the basis of patient empowerment. A case study (clinical genetics) is used to (1) illustrate that patient empowerment can be a valued healthcare outcome, even if patients do not obtain health status benefits, (2) provide a rationale for conducting work necessary to tighten up the patient empowerment construct (3) provide an exemplar to inform design of interventions to increase patient empowerment in chronic disease. Such initiatives could be evaluated on the basis of measurable changes in patient empowerment, if the construct were properly operationalised as a patient reported outcome measure. To facilitate this, research is needed to develop an appropriate and widely applicable generic theoretical framework of patient empowerment to inform (re)development of a generic measure. This research should include developing consensus between patients, clinicians and policymakers about the content and boundaries of the construct before operationalisation. This article also considers a number of issues for society and for healthcare providers raised by adopting the patient empowerment paradigm.Healthcare policy is driving the need to consider patient empowerment as a measurable patient outcome from healthcare services. Research is needed to (1) tighten up the construct (2) develop consensus about what is important to include (3) (re)develop a generic measure of patient empowerment for use in evaluating healthcare (4) understand if/how people make trade-offs between empowerment and gain in health status.
Neonatal hearing screening: modelling cost and effectiveness of hospital- and community-based screening
Eva Grill, Kai Uus, Franz Hessel, Linda Davies, Rod S Taylor, Juergen Wasem, John Bamford
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-14
Abstract: Design: Clinical effectiveness analysis using a Markov Model. Outcome measure: quality weighted detected child months (QCM).Both hospital and community programmes yielded 794 QCM at the age of 6 months with total costs of £3,690,000 per 100,000 screened children in hospital and £3,340,000 in community. Simulated costs would be lower in hospital in 48% of the trials. Any statistically significant difference between hospital and community in prevalence, test sensitivity, test specificity and costs would result in significant differences in cost-effectiveness between hospital and community.This modelling exercise informs decision makers by a quantitative projection of available data and the explicit and transparent statements about assumptions and the degree of uncertainty. Further evaluation of the cost-effectiveness should focus on the potential differences in test parameters and prevalence in these two settings.Between one and two children per 1000 live births have a moderate or greater bilateral permanent hearing loss [1-3]. Children with congenital hearing impairment benefit from early detection and management of their hearing loss [4,5]. The neurological development of auditory pathways requires acoustic stimulation in the first 18 months of life [6,7]. Communication deficits due to hearing impairment not discovered within the first two years are not easily recovered by later rehabilitation. The consequence may be delayed development of speech and language as well as of other cognitive and social functions. This delay is already measurable in the first 3 years of life [8].These and related considerations led to a comprehensive review of the possible role of newborn hearing screening in the UK [9]. The review recommended the introduction of newborn hearing screening and in 2001 the first phase of a national Newborn Hearing Screening Programme (NHSP) was implemented in England; all areas of the country are expected to be covered by 2005/6.The first implementation p
Creative Expression: Effectiveness of a Weekly Craft Group with Women Who Have Experienced Trauma  [PDF]
Linda Garner
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.52011
Abstract: Creativity interventions have been shown to positively influence psychological and emotional health indicators. Nurses can play an important role in the development and implementation of interventions designed to counter the longer-term emotional and psychological consequences of trauma. The purpose of this study was to explore how participation in a nurse-facilitated weekly craft group may influence anxiety, depression, self-esteem, and self-confidence among women who have emotional and physical experienced trauma. A pre/post visual analog scale was used during a 7-week intervention to measure changes in anxiety, depression, stress, self-esteem and self-confidence among a convenience sample of adult female trauma survivors (n = 33). A paired sample t test was used to evaluate the intervention with significance set at p = 0.05. Participant observation and field notes were used for qualitative data generation. Significant reductions were noted in anxiety, depression, and stress along with significant increases in self-esteem and self-confidence. Cohen’s d statistic indicated a large effect size for anxiety (0.72) and stress (0.69). Moderate effect size was determined for self-confidence (0.36), depression (0.41), and self-esteem (0.52). Emergent qualitative themes included: creative expression improved confidence to sooth the self, safe spaces fostered creativity, a sense of accomplishment was stimulated through creative activities, and creative expression groups provided opportunities for positive affirmation. Offered as a complementary intervention, nurse-facilitated creative expression groups can support continued healing long after traditional support services have been exhausted. It is important for nurses to pursue a greater understanding of the art of nursing and the important contribution of creativity when used as a nursing intervention with trauma survivors.
Residual Effects from Occupational Mercury Exposure Include a Proposed Mercury Tremor Biomarker or “Fingerprint”  [PDF]
Linda Jones
Journal of Environmental Protection (JEP) , 2017, DOI: 10.4236/jep.2017.810068
Abstract: The study investigated residual effects of high levels of occupational mercury exposure, 30 years after a cohort of women worked in public service dentistry. They had all used copper amalgam in a pellet form that required heating and handling, and silver amalgam before the encapsulated form was available. Mercury handling practices changed in the mid-1970 when the workforce was urine tested and mercury poisoning became apparent. The aim was to compare control group and exposed group scores on tasks from a neurobehavioural test battery; plus survey results from a composite health, work history and environmental influences survey. The findings showed that the exposed and control groups were equivalent not only on those variables that one would want to be matched (age, alcohol consumption), but also on many of the cognitive and psychomotor test scores. The present paper focuses on psychomotor skill and tremor patterns. Tremor patterns were seen as generating new evidence of long term effects of the historic mercury insult. Data also suggest that there may be a distinctive mercury “fingerprint”, in samples of sinusoidal waveforms that may have potential as a non-invasive sub-clinical biomarker for adverse effects of mercury exposure, in screening or workplace monitoring.
Pragmatic randomised controlled trial of group psychoeducation versus group support in the maintenance of bipolar disorder
Richard K Morriss, Fiona Lobban, Steven Jones, Lisa Riste, Sarah Peters, Christopher Roberts, Linda Davies, Debbie Mayes
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-114
Abstract: Single blind two centre cluster randomised controlled trial of 21 sessions group psychoeducation versus 21 sessions group peer support in adults with bipolar 1 or 2 disorder, not in current episode but relapsed in the previous two years. Individual randomisation is to either group at each site. The groups are carefully matched for the number and type of therapists, length and frequency of the interventions and overall aim of the groups but differ in content and style of delivery. The primary outcome is time to next bipolar episode with measures of the therapeutic process, barriers and drivers to the effective delivery of the interventions and economic analysis. Follow up is for 96 weeks after randomisation.The trial has features of both an efficacy and an effectiveness trial design. For generalisability in England it is set in routine public mental health practice with a high degree of expert patient involvement.ISRCTN62761948National Institute for Health Research, England.Recurrence rates for mania and depression in bipolar disorder are high; around 50% at one year and 70% at four years [1,2]. Group psychoeducation in addition to maintenance medication is recommended by most recent bipolar disorder practice guidelines for the maintenance management of bipolar disorder [3-6]. In Barcelona, two randomised controlled trials showed that structured curriculum based group psychoeducation for up to 21 sessions increased time to relapse in all types of bipolar episode in patients who were concordant or not concordant with mood stabiliser medication compared to non-didactic group support not following a curriculum [7,8]. The gains were maintained over the next five years with marked reductions in hospitalisation and improvements in function [9]. Subgroup analysis showed improvements with psychoeducation versus control intervention in bipolar 2 disorder [10] and in bipolar disorder with or without personality disorder [11]. In Australia, two randomised controlled trials show
A randomised controlled trial of time limited CBT informed psychological therapy for anxiety in bipolar disorder
Steven H Jones, Elly McGrath, Kay Hampshire, Rebecca Owens, Lisa Riste, Chris Roberts, Linda Davies, Debbie Mayes
BMC Psychiatry , 2013, DOI: 10.1186/1471-244x-13-54
Abstract: This is the first trial of an integrated intervention for anxiety in bipolar disorder. It is of interest to researchers involved in the development of new therapies for bipolar disorder as well as indicating the wider potential for evaluating approaches to the treatment of comorbidity in severe mental illness. Trial Registration Number: ISRCTN84288072
Developing guided self-help for depression using the Medical Research Council complex interventions framework: a description of the modelling phase and results of an exploratory randomised controlled trial
Karina Lovell, Peter Bower, David Richards, Michael Barkham, Bonnie Sibbald, Chris Roberts, Linda Davies, Anne Rogers, Judith Gellatly, Sue Hennessy
BMC Psychiatry , 2008, DOI: 10.1186/1471-244x-8-91
Abstract: A guided self-help intervention was developed following a modelling phase which involved a systematic review, meta synthesis and a consensus process. The intervention was then tested in an exploratory randomised controlled trial by examining (a) fidelity using analysis of taped guided self-help sessions (b) acceptability to patients and professionals through qualitative interviews (c) effectiveness through estimation of the intervention effect size.Fifty eight patients were recruited to the exploratory trial. Seven professionals and nine patients were interviewed, and 22 tapes of sessions analysed for fidelity. Generally, fidelity to the intervention protocol was high, and the professionals delivered the majority of the specific components (with the exception of the use of feedback). Acceptability to both professionals and patients was also high. The effect size of the intervention on outcomes was small, and in line with previous analyses showing the modest effect of guided self-help in primary care. However, the sample size was small and confidence intervals around the effectiveness estimate were wide.The general principles of the modelling phase adopted in this study are designed to draw on a range of evidence, potentially providing an intervention that is evidence-based, patient-centred and acceptable to professionals. However, the pilot outcome data did not suggest that the intervention developed was particularly effective. The advantages and disadvantages of the general methods used in the modelling phase are discussed, and possible reasons for the failure to demonstrate a larger effect in this particular case are outlined.Depression is a significant cause of personal distress, social disability and economic consequences for patients, families and wider society [1]. Cognitive behaviour therapy (CBT) is a crucial treatment for depression [2], but access to CBT is characterised by long waiting lists [3]. The adoption of a 'stepped care' system has been proposed t
A multi-centre, randomised controlled trial of cognitive therapy to prevent harmful compliance with command hallucinations
Max Birchwood, Emmanuelle Peters, Nicholas Tarrier, Graham Dunn, Shon Lewis, Til Wykes, Linda Davies, Helen Lester, Maria Michail
BMC Psychiatry , 2011, DOI: 10.1186/1471-244x-11-155
Abstract: This is a single blind, intention-to-treat, multi-centre, randomized controlled trial comparing Cognitive Therapy for Command Hallucinations + Treatment as Usual with Treatment as Usual alone. Eligible participants have to fulfil the following inclusion criteria: i) ≥16 years; ii) ICD-10 diagnosis of schizophrenia or related disorder; iii) command hallucinations for at least 6 months leading to risk of harm to self or others. Following the completion of baseline assessments, eligible participants will be randomly allocated to either the Cognitive Therapy for Command Hallucinations + Treatment as Usual group or the Treatment as Usual group. Outcome will be assessed at 9 and 18 months post randomization with assessors blind to treatment allocation. The primary outcome is compliance behaviour and secondary outcomes include beliefs about voices' power, distress, psychotic symptoms together with a health economic evaluation. Qualitative interviews with services users will explore the acceptability of Cognitive Therapy for Command Hallucinations.Cognitive behaviour therapy is recommended for people with psychosis; however, its focus and evaluation has primarily revolved around the reduction of psychotic symptoms. In this trial, however, the focus of the cognitive behavioural intervention is on individuals' appraisals, behaviour and affect and not necessarily symptoms; this is also reflected in the outcome measures used. If successful, the results will mark a significant breakthrough in the evidence base for service users and clinicians and will provide a treatment option for this group where none currently exist. The trial will open the way for further breakthrough work with the 'high risk' population of individuals with psychosis, which we would intend to pursue.ISRCTN: ISRCTN62304114Schizophrenia affects 0.8% of the UK population, usually starts in early adult life and leads to persistent disability in most cases [1]. It carries a high risk of suicide (8%) and deliberat
An Amino Acid Substitution (L925V) Associated with Resistance to Pyrethroids in Varroa destructor
Joel González-Cabrera, T. G. Emyr Davies, Linda M. Field, Peter J. Kennedy, Martin S. Williamson
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082941
Abstract: The Varroa mite, Varroa destructor, is an important pest of honeybees and has played a prominent role in the decline in bee colony numbers over recent years. Although pyrethroids such as tau-fluvalinate and flumethrin can be highly effective in removing the mites from hives, their intensive use has led to many reports of resistance. To investigate the mechanism of resistance in UK Varroa samples, the transmembrane domain regions of the V. destructor voltage-gated sodium channel (the main target site for pyrethroids) were PCR amplified and sequenced from pyrethroid treated/untreated mites collected at several locations in Central/Southern England. A novel amino acid substitution, L925V, was identified that maps to a known hot spot for resistance within the domain IIS5 helix of the channel protein; a region that has also been proposed to form part of the pyrethroid binding site. Using a high throughput diagnostic assay capable of detecting the mutation in individual mites, the L925V substitution was found to correlate well with resistance, being present in all mites that had survived tau-fluvalinate treatment but in only 8 % of control, untreated samples. The potential for using this assay to detect and manage resistance in Varroa-infected hives is discussed.
Dissecting Galaxies with Adaptive Optics
Richard Davies,Hauke Engel,Erin Hicks,Natascha Foerster Schreiber,Reinhard Genzel,Linda Tacconi,Frank Eisenhauer,Sebastian Rabien
Physics , 2010, DOI: 10.1117/12.856378
Abstract: We describe several projects addressing the growth of galaxies and massive black holes, for which adaptive optics is mandatory to reach high spatial resolution but is also a challenge due to the lack of guide stars and long integrations. In each case kinematics of the stars and gas, derived from integral field spectroscopy, plays a key role. We explain why deconvolution is not an option, and that instead the PSF is used to convolve a physical model to the required resolution. We discuss the level of detail with which the PSF needs to be known, and the ways available to derive it. We explain how signal-to-noise can limit the resolution achievable and show there are many science cases that require high, but not necessarily diffraction limited, resolution. Finally, we consider what requirements astrometry and photometry place on adaptive optics performance and design.
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