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Utilising Patient and Public Involvement in Stated Preference Research in Health: Learning from the Existing Literature and a Case Study
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: registration 2020-07-17, online 2020-08-04, pub-electronic 2020-08-04, pub-print 2021-07Publication status: PublishedFunder: Programme Grants for Applied Research; doi: http://dx.doi.org/10.13039/501100007602; Grant(s): RP-PG-1211-20011Abstract: Publications reporting discrete choice experiments of healthcare interventions rarely discuss whether patient and public involvement (PPI) activities have been conducted. This paper presents examples from the existing literature and a detailed case study from the National Institute for Health Research-funded PATHWAY programme that comprehensively included PPI activities at multiple stages of preference research. Reflecting on these examples, as well as the wider PPI literature, we describe the different stages at which it is possible to effectively incorporate PPI across preference research, including the design, recruitment and dissemination of projects. Benefits of PPI activities include gaining practical insights from a wider perspective, which can positively impact experiment design as well as survey materials. Further benefits included advice around recruitment and reaching a greater audience with dissemination activities, amongst others. There are challenges associated with PPI activities; examples include time, cost and outlining expectations. Overall, although we acknowledge practical difficulties associated with PPI, this work highlights that it is possible for preference researchers to implement PPI across preference research. Further research systematically comparing methods related to PPI in preference research and their associated impact on the methods and results of studies would strengthen the literature
OVPSYCH2: A randomized controlled trial of psychological support versus standard of care following chemotherapy for ovarian cancer
Get PDFBackground: Fear of disease progression (FOP) is a rational concern for women with Ovarian Cancer (OC) and depression is also common. To date there have been no randomized trials assessing the impact of psychological intervention on depression and FOP in this patient group.
Patients and methods: Patients with primary or recurrent OC who had recently completed chemotherapy were eligible if they scored between 5 and 19 on the PHQ-9 depression and were randomized 1:1 to Intervention (3 standardized CBT-based sessions in the 6 -12 weeks post-chemotherapy) or Control (standard of care). PHQ-9, FOP-Q-SF, EORTC QLQ C30 and OV28 questionnaires were then completed every 3 months for up to 2 years. The primary endpoint was change in PHQ-9 at 3 months. Secondary endpoints were change in other scores at 3 months and all scores at later timepoints.
Results: 182 patients registered; 107 were randomized; 54 to Intervention and 53 to Control; mean age 59 years; 75 (70%) had completed chemotherapy for primary and 32 (30%) for relapsed OC and 67 patients completed both baseline and 3-month questionnaires. Improvement in PHQ-9 was observed for patients in both study arms at three months compared to baseline but there was no significant difference in change between Intervention and Control. A significant improvement on FOP-Q-SF scores was seen in the Intervention arm, whereas for those in the Control arm FOP-Q-SF scores deteriorated at 3 months (intervention effect= -4.4 (-7.57,-1.22), p-value = 0.008).
Conclusions: CBT-based psychological support provided after chemotherapy did not significantly alter the spontaneously improving trajectory of depression scores at three months but caused a significant improvement in FOP. Our findings call for the routine implementation of FOP support for ovarian cancer patients
Evaluation of the Feasibility, Reliability, and Repeatability of Welfare Indicators in Free-Roaming Horses: A Pilot Study.
Get PDFValidated assessment protocols have been developed to quantify welfare states for intensively managed sport, pleasure, and working horses. There are few protocols for extensively managed or free-roaming populations. Here, we trialed welfare indicators to ascertain their feasibility, reliability, and repeatability using free-roaming Carneddau Mountain ponies as an example population. The project involved (1) the identification of animal and resource-based measures of welfare from both the literature and discussion with an expert group; (2) testing the feasibility and repeatability of a modified body condition score and mobility score on 34 free-roaming and conservation grazing Carneddau Mountain ponies; and (3) testing a prototype welfare assessment template
comprising 12 animal-based and 6 resource-based welfare indicators, with a total of 20 questions, on 35 free-roaming Carneddau Mountain ponies to quantify inter-assessor reliability and repeatability. This pilot study revealed that many of the indicators were successfully repeatable and had good levels of inter-assessor reliability. Some of the indicators could not be verified for reliability due to low/absent occurrence. The results indicated that many animal and resource-based indicators commonly used in intensively managed equine settings could be measured in-range with minor modifications. This study is an initial step toward validating a much-needed tool for the welfare assessment of free-roaming and conservation grazing ponies
Age of people with type 2 diabetes and the risk of dying following SARS‐CoV‐2 infection
Get PDFFrom Wiley via Jisc Publications RouterHistory: pub-electronic 2021-07-21, pub-print 2021-08Article version: VoRPublication status: Publishe
Therapeutic alliance in psychological therapy for posttraumatic stress disorder: A systematic review and meta‐analysis
Get PDFFrom Wiley via Jisc Publications RouterHistory: received 2021-02-06, rev-recd 2021-06-21, accepted 2021-06-24, pub-electronic 2021-07-21Article version: VoRPublication status: PublishedAbstract: Background: Therapeutic alliance is a key element of successful therapy. Despite being particularly relevant in people with posttraumatic stress disorder (PTSD), due to fear, mistrust and avoidance, there has not yet been a comprehensive systematic review of therapeutic alliance in this population. This review explored (a) variables which may predict alliance and (b) whether alliance predicts PTSD outcomes. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines, the review identified 34 eligible studies. Studies were subjected to a quality assessment. Predictors of alliance were considered in a narrative synthesis. Twelve studies were entered into a meta‐analysis of the association between therapeutic alliance and PTSD outcomes. Results: There was some evidence for individual variables including attachment, coping styles and psychophysiological variables predicting the alliance. Therapy variables did not predict alliance. The therapeutic alliance was found to significantly predict PTSD outcomes, with an aggregated effect size of r = −.34, across both in‐person and remote therapies. Limitations: Included studies were restricted to peer‐reviewed, English language studies. Quality of included studies was mostly rated weak to moderate, primarily reflecting issues with selection bias in this area of research. Conclusions: This is the first review to demonstrate that therapeutic alliance is a consistent predictor of PTSD outcomes, in both in‐person and remote therapies, and the effect appears at least as strong as in other populations. This is of relevance to clinicians working with traumatized populations. The review identified a need for further research to determine variables predicting alliance in therapy for PTSD
The T cell receptor repertoire of tumor infiltrating T cells is predictive and prognostic for cancer survival
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2020-07-30, accepted 2021-06-09, registration 2021-06-16, pub-electronic 2021-07-02, online 2021-07-02, collection 2021-12Publication status: PublishedFunder: Harry J. Lloyd Charitable Trust; doi: https://doi.org/10.13039/100005976; Grant(s): Career Development AwardFunder: Cancer Research UK (CRUK); doi: https://doi.org/10.13039/501100000289; Grant(s): A27412, A22902Funder: Wellcome Trust (Wellcome); doi: https://doi.org/10.13039/100004440; Grant(s): 100282/Z/12/ZAbstract: Tumor infiltration by T cells is paramount for effective anti-cancer immune responses. We hypothesized that the T cell receptor (TCR) repertoire of tumor infiltrating T lymphocytes could therefore be indicative of the functional state of these cells and determine disease course at different stages in cancer progression. Here we show that the diversity of the TCR of tumor infiltrating T cell at baseline is prognostic in various cancers, whereas the TCR clonality of T cell infiltrating metastatic melanoma pre-treatment is predictive for activity and efficacy of PD1 blockade immunotherapy
Neural Correlates of Central Coherence in Anorexia Nervosa
Get PDFThis is the peer reviewed version of the following article: Leslie, M., Halls, D., Leppanen, J., Sedgewick, F., Lang, K., Fonville, L., ... Tchanturia, K. (2021). The neural correlates of a central coherence task in young women with anorexia nervosa. European Eating Disorders Review, 29(5), 744-755, https://doi.org/10.1002/erv.2852, which has been published in final form at https://doi.org/10.1002/erv.2852. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingObjective: Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples.
Methods: We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan.
Results: There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task.
Conclusions: These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN
Analysis of Continuous Blood Glucose Data in People with Type 1 Diabetes (T1DM) After COVID-19 Vaccination Indicates a Possible Link Between the Immune and the Metabolic Response
Get PDFFrom SAGE Publishing via Jisc Publications RouterHistory: epub 2021-07-29Publication status: Publishe
Study of failure symptoms of a single-tube MR damper using an FEA-CFD approach
Get PDFFrom SAGE Publishing via Jisc Publications RouterHistory: epub 2020-11-03Publication status: PublishedA new magnetorheological (MR) damper has been designed, manufactured, modelled and tested under cyclic loads. A faulty behaviour of the damper was accidentally detected during the experiments. It was deduced that the presence of air bubbles within the MR fluid is the main reason for that failure mode of the damper. The AMT-Smartec+ MR fluid used in the current study, a new MR fluid whose characteristics are not available in the literature, exhibits good magnetic properties. However, the fluid has a very high viscosity in the absence of magnetic field. It is assumed that this high viscosity enables the retention of air bubbles in the damper and causes the faulty behaviour. To prove this assumption, a coupled numerical approach has been developed. The approach incorporates a Finite Element Analysis (FEA) of the magnetic circuit and a Computational Fluid Dynamics (CFD) analysis of the fluid flow. A similar approach was presented in a previous publication in which an ideal behaviour of an MR damper (no effect of air bubbles) was investigated. The model has been modified in the current study to include the effect of air bubbles. The results were found to support the assumptions for the reasons of the failure symptoms of the current MR damper. The results are shown in a comparative way between the former and current studies to show the differences in flow parameters, namely: pressure, velocity and viscosity, in the faultless and faulty modes. The results indicate that the presence of air bubbles in MR dampers reduces the damper force considerably. Therefore, the effect of the high yield stress of MR fluids due to the magnetic field is reduced
Re-thinking public health: Towards a new scientific logic of routine animal health care in European industrial farming
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2020-11-03, accepted 2021-08-19, registration 2021-09-02, pub-electronic 2021-09-20, online 2021-09-20, collection 2021-12Publication status: PublishedAbstract: This study makes the case for a new scientific logic of routine animal health care in industrial farming in Europe. We argue that the social regime underpinning scientific research and development on chronic animal disease management (CADM) in Europe stifles innovation and sustains a productivist model of animal husbandry that facilitates and maintains chronic animal diseases rather than eliminating them. Drawing on documentary analysis and qualitative interviews, the study explores the science of CADM in the broiler, cattle and pig sectors of the European food industry. Our findings show that in these major sectors, research and development on CADM is largely orientated towards a logic of growth, profitability and control rather than a recognition of the interconnection between chronic animal diseases, the food industry, and people (especially consumers) as advocated by the One Health approach. The study contributes to the literature on medical humanities and science and technology studies within One Health and public health in two ways: First, we draw new focus towards chronic animal diseases that are non-transmissible to humans and argue that while these are not zoonoses, they are equally worthy of attention for managing the emergence of new pathogens and diseases. Second, we expand the conceptualisation of One Health to include chronic animal health conditions. Our argument is that public health as an outcome of the One Health approach should be a term of reference that applies to humans and nonhumans alike whether they be farmed animals, practitioners or consumers
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