918 research outputs found
sj-docx-1-bjp-10.1177_20494637221095447 – Supplemental material for Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service
No full textSupplemental material, sj-docx-1-bjp-10.1177_20494637221095447 for Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service by Riya Ghose, Fiona Cowden, Abirami Veluchamy, Blair H Smith and Lesley A Colvin in British Journal of Pain</p
sj-docx-2-bjp-10.1177_20494637221095447 – Supplemental material for Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service
No full textSupplemental material, sj-docx-2-bjp-10.1177_20494637221095447 for Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service by Riya Ghose, Fiona Cowden, Abirami Veluchamy, Blair H Smith and Lesley A Colvin in British Journal of Pain</p
Postpartum Depression: Healing through Archetypes and the Expressive Arts Therapies
Get PDFThis thesis is a literature review investigating treating postpartum depression through the expressive arts therapies and feminine archetypes. The expressive arts therapies explored for treatment are dance, music, art, and drama. Meditation, mindfulness, and writing are also included. The importance of expressive arts therapies in treating postpartum depression is of interest now because of the increasing number of mothers who experience postpartum depression who are looking for alternatives to treatment beyond, or complementing, traditional talk therapy and medication. A search for literature on treating postpartum depression with expressive arts therapies and archetypes was conducted on-line using the Lesley University database. This research provides resources for women who are seeking to overcome postpartum depression in increasingly creative ways. The author will be presenting recommendations for incorporating this creativity in the lives of mothers. Recommendations for incorporating expressive arts therapy interventions for treating postpartum depression will include examples of integrating feminine archetypes for healing
sj-pdf-1-bjp-10.1177_20494637221092907 – Supplemental material for The core minimum dataset for measuring pain outcomes in pain services across Scotland. Developing and testing a brief multi-dimensional questionnaire
No full textSupplemental material, sj-pdf-1-bjp-10.1177_20494637221092907 for The core minimum dataset for measuring pain outcomes in pain services across Scotland. Developing and testing a brief multi-dimensional questionnaire by Magdalena S Laskawska, Harry L Hébert, Cara Richardson, Katherine Berlouis, Paul Cameron, Lesley A Colvin and Blair H Smith in British Journal of Pain</p
Dance/Movement Therapy as a Potential Supplementary Treatment for Vasovagal Syncope: A Literature Review
Get PDFDance movement therapy has been utilized as an evidenced-based modality in treating numerous medical diagnoses. Despite its established efficacy in diverse medical contexts, little research exists on its application for vasovagal syncope, a condition often intertwined with mental health challenges. Although vasovagal syncope is situated in the body and frequently comorbid with mental health struggles that impact physiological symptoms, treatment options remain solely in the medical model. This literature review seeks to address this lack of research and adequate treatment options by highlighting the body/mind connection and advocating for dance/movement therapy as a potential supplementary treatment for vasovagal syncope. The author used personal experience with this diagnosis as well as Lesley @ll search and Google Scholar to gather research. The research explored is summarized through a description of the diagnosis, the physical and psychological impact, current treatment options, the use of dance/movement therapy with other medical and psychological diagnoses, and polyvagal-informed dance/movement therapy. The therapeutic qualities that emerged from the literature as important to treatment are therapeutic presence, embodied awareness, interoception, resilience, coping, empowerment, self-efficacy, and identity. It was concluded that dance movement therapy has the unique potential to support the body and mind of those struggling with vasovagal syncope supplementary to medical care. However, further research is needed to test this hypothesis
Person-centred advocacy: Some ethical issues
No full textIn the second of two articles on advocacy for people with dementia Mike Fox with Lesley Wilson considers some of the ethical issues arising from advocacy work within a residential home that was due to close
Assessing the impact of a national clinical guideline for the management of chronic pain on opioid prescribing rates:a controlled interrupted time series analysis
Get PDFBackground : Opioids can be effective analgesics, but long-term use may be associated with harms. In 2013, the first national, comprehensive, evidence-based pain management guideline was published, from the Scottish Intercollegiate Guideline Network (SIGN 136: Management of Chronic Pain) with key recommendations on analgesic prescribing. This study aimed to examine the potential impact on national opioid prescribing rates in Scotland.Methods: Trends in national and regional community opioid prescribing data for Scotland were analysed from quarter one (Q1) 2005 to Q2 2020. Interrupted time series regression examined the association of SIGN 136 publication with prescribing rates for opioid-containing drugs. Gabapentinoid prescribing was used as a comparison drug.Results: After a positive prescribing trend pre-publication, the timing of SIGN 136 publication was associated with a negative change in trend of opioid prescribing rates (-2.82 items per 1,000 population per quarter [PTPPQ]; P<0.01). By Q2 2020, the relative reduction in opioid prescribing rate was -20.67% (95% CI: -23.67, -17.77). This persisted after correcting for gabapentinoid prescribing and was mainly driven by reduction in weak opioids, whereas strong opioid prescribing rates continued to rise. Gabapentinoid prescribing showed a significant rise in level (8.00 items per 1,000 population; P=0.01) and trend (0.27 items PTPPQ; P=0.01) following SIGN 136 publication.Conclusions: Publication of SIGN 136 was associated with a reduction in opioid prescribing rates. This suggests that changes in clinical policy through evidence-based national clinical guidelines may affect community opioid prescribing, though this may be partially replaced by gabapentinoids, and other factors may also contribute
Investigating chemotherapy induced peripheral neuropathy (CIPN) and its treatment, using functional Magnetic Resonance Imaging (fMRI)
Get PDFBackground
Chemotherapy Induced Peripheral Neuropathy (CIPN) is a debilitating
neuropathy caused by commonly used chemotherapeutics. Clinically, the
problem of CIPN is compounded by difficulties with diagnosis and limited
treatment options. The pathophysiology of CIPN remains elusive, with current
mechanistic postulates focused mainly on the peripheral nervous system.
However, animal and human models of non-CIPN neuropathic conditions have
shown the brain to be central to the development and maintenance of painful
neuropathy. Moreover, evidence suggests that aberrant activity in key regions of
the brain and brainstem could denote individual vulnerability for chronic pain
states. The impact of the brain on CIPN development is unknown. Assessment of
drug efficacy using brain imaging can provide sensitive readouts and is
increasingly used in clinical trials.
Aims
Firstly, to prospectively explore the structure and function of the brain in cancer
patients prior to chemotherapy administration, using functional magnetic
resonance imaging (fMRI), in order to determine whether baseline differences
exist between patients who progress to CIPN as compared to those who do not.
Secondly, to develop a pilot study using fMRI to investigate a topical treatment
for CIPN, in order to assess the feasibility of setting up a study with this kind of
design.
Methods
To address the first aim of this thesis a prospective cohort study (the CIPN fMRI
Study) was developed. Cancer patients scheduled to receive neurotoxic
chemotherapy treatment including oxaliplatin, carboplatin, carbotaxol, or
cisplatin, were recruited from three NHS trusts in Scotland, to undergo a high
resolution (3 tesla) functional MRI scan, at a single time point prior to
commencement of chemotherapy. During the scan structural, resting state and
functional data were collected. Functional data involved the presentation of
punctate stimuli (using a 256mN von Frey filament), above the patients’ right
medial malleolus. While receiving the punctate stimuli, patients viewed images
that had neutral or positive emotional content or a baseline coloured image with
no content. Sample size was based on previously successful pain fMRI studies
and pragmatic estimates. Acute CIPN was defined clinically by common toxicity
criteria as necessitating a chemotherapy dose reduction or cessation. Data were
analysed using FMRIB’s Software Library (FSL) version 5, 2015. Standard data
pre-processing (brain extraction, registration, B0 unwarping, motion correction,
and denosiing with FIX) was carried out. Structural analysis was conducted using
FIRST. Resting state analysis utilised FSL’s MELODIC tool, and a non-parametric
group comparison was made following a dual regression approach. FEAT was
used for both first and second level functional analyses. Group comparisons were
made using a mixed effects analysis (z threshold 2·3 and 2, regions considered
significant at p<0·05, cluster corrected). The group was split by sex to explore
known sex differences in pain processing. To address the second aim of this
thesis, a pilot fMRI randomised controlled trial (MINT3 Study) was designed.
Approvals from ethics and research and development were sought and obtained.
Data collection forms were developed. An fMRI experiment was proposed and a
single pilot scan was conducted and analysed.
Results
30 patients were recruited for the CIPN fMRI study (mean age 60·4 years, [95%
Confidence Interval: 57.4-63.4, 17 women). Two patients had lung cancer, nine
had gynecological malignancies and 18 had colorectal cancer. 17 patients
developed acute CIPN. Structural analysis showed that patients who developed
CIPN had a smaller volume of the Nucleus Accumbens (NAc). Resting state
analysis did not show clear differences between those who developed CIPN and
those who did not. Finally, functional analysis showed that patients who did not
develop CIPN had greater activation in the superior frontal gyrus when viewing
positive emotional images as compared to those who did progress to CIPN.
Region of interest analysis showed that female patients who developed CIPN had
greater activity in their mesencephalic pontine reticular formation (MPRF). Male
patients who progressed to CIPN had decreased activity in their thalamus.
Feasability of the MINT3 study set up and fMRI paradigm was assessed.
Interpretation
Differences in brain structure and function are evident between patients who
developed CIPN and those who did not. Crucially, the regions identified, in
particular the NAc, have been postulated to denote a vulnerability for
progression to pain states. Although the findings need further confirmation they
suggest a paradigm shift in terms of CIPN as a clinical problem. Specifically, it
appears that certain individuals can be considered as having increased risk of
CIPN development prior to chemotherapy administration. This risk relates to the
baseline structure, and function of their brains. Finally, the set up of the MINT3
fMRI study showed that this kind of study design is acceptable in terms of ethical
and R&D approvals and a single healthy volunteer pilot
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