42 research outputs found
Assessing the specificity of the relationship between brain alpha oscillations and tonic pain
No full textRecent research proposed that the slowing of individual alpha frequency (IAF) could be an objective marker of pain. However, it is unclear whether this research can fully address the requirements of specificity and sensitivity of IAF to the pain experience. Here, we sought to develop a robust methodology for assessing the specificity of the relationship between alpha oscillations and acute tonic pain in healthy individuals. We recorded electroencephalography (EEG) of 36 volunteers during consecutive 5-minute sessions of painful hot water immersion, innocuous warm water immersion and aversive, non-painful auditory stimulus, matched by unpleasantness to the painful condition. Participants rated stimulus unpleasantness throughout each condition. We isolated two regions of the scalp displaying peak alpha activity across participants: centro-parietal (CP) and parieto-occipital (PO) ROI. In line with previous research our findings revealed decreased IAF during hot compared with warm stimulation, however the effect was not specific for pain as we found no difference between hot and sound in the CP ROI (compared to baseline). In contrast, the PO ROI reported the same pattern of differences, but their direction was opposite to the CP in that this ROI revealed faster frequency during hot condition than controls. Finally, we show that IAF in both ROIs did not mediate the relationship between the experimental manipulation and the affective experience. Altogether, these findings emphasize the importance of a robust methodological and analytical design to disclose the functional role of alpha oscillations during affective processing. Likewise, they suggest the absence of a causal role of IAF in the generation of acute pain experience in healthy individuals
Changing from face-to-face to virtual meetings during the COVID-19 pandemic: exploring the impact on cancer multidisciplinary team (MDT) meetings
No full textMultidisciplinary teams (MDT) are groups of professionals from one or more clinical discipline who together make decisions regarding recommended treatment of individual patients. In the UK, the National Cancer Plan (2000) requires every cancer patient’s care to be reviewed by an MDT. The aim is to facilitate specialist input and reduce variation in access to, and decisions about, cancer care. However, since the introduction of these guidelines, MDTs have faced increasing demands, in terms of the number and complexity of cases they review. Further guidelines have since been released to help improve and streamline MDT working. More recently, the COVID-19 pandemic has presented MDTs with the challenge of running MDT meetings virtually rather than face-to-face. This has potential advantages and disadvantages. In this study, we aim to explore how the change from face-to-face to virtual MDT meetings during the COVID-19 pandemic may have impacted the effectiveness of decision-making in cancer MDT meetings. And use the findings to co-produce resource packs to improve future cancer MDT working
Emotional disclosure to enhance wellbeing: Developing an intervention for people with terminal illness receiving hospice care at the time of the COVID-19 pandemic
No full textBackground: People living with terminal illness experience emotional distress. Hospice care aims to alleviate that distress, but provision of psychological support is limited by staff capacity. Psychological interventions with minimal need for input from specialist staff could be a valuable resource for hospices. Emotional disclosure (ED)-based interventions hold potential to meet this need. However, evidence to support their use in hospices is limited, due in part to lack of intervention tailoring.
Aim: The primary aim was to develop and evaluate (for feasibility and acceptability) an ED-based intervention tailored for adults with terminal illness receiving hospice care. The onset of the COVID-19 pandemic midway through this PhD highlighted the potential for an adapted version of the intervention to reduce distress for the general population. This thesis therefore also addresses the secondary aim of developing and evaluating an ED-based intervention for the general population during the pandemic.
Methods: Findings from a scoping review of ED-based interventions for people with terminal illness and a survey of psychological services in UK hospices were used to inform development of a prototype of both interventions. A pilot randomised controlled trial evaluated the intervention for the general population during the pandemic. Findings from this influenced adaptation of the intervention tailored for adults with terminal illness, which was then evaluated by conducting a feasibility study and process evaluation in six hospices. Each intervention development phase was supported by stakeholder consultation.
Results: Two ED-based interventions were developed: Let It Out for people living with terminal illness; and Let It Out – COVID 19 for the general population during the pandemic. Both were feasible and acceptable, but required adaptations to minimise risk of recipients experiencing excessive, unsupported distress.
Conclusions: Future research should evaluate the safety and efficacy of Let It Out for people with terminal illness receiving hospice care
Changing from face-to-face to virtual meetings during the COVID-19 pandemic: exploring the impact on cancer multidisciplinary team (MDT) meetings
No full textMultidisciplinary teams (MDT) are groups of professionals from one or more clinical discipline who together make decisions regarding recommended treatment of individual patients. In the UK, the National Cancer Plan (2000) requires every cancer patient’s care to be reviewed by an MDT. The aim is to facilitate specialist input and reduce variation in access to, and decisions about, cancer care. However, since the introduction of these guidelines, MDTs have faced increasing demands, in terms of the number and complexity of cases they review. Further guidelines have since been released to help improve and streamline MDT working. More recently, the COVID-19 pandemic has presented MDTs with the challenge of running MDT meetings virtually rather than face-to-face. This has potential advantages and disadvantages. In this study, we aim to explore how the change from face-to-face to virtual MDT meetings during the COVID-19 pandemic may have impacted the effectiveness of decision-making in cancer MDT meetings. And use the findings to co-produce resource packs to improve future cancer MDT working
Changing from face-to-face to virtual meetings during the COVID-19 pandemic: exploring the impact on cancer multidisciplinary team (MDT) meetings
No full textMultidisciplinary teams (MDT) are groups of professionals from one or more clinical discipline who together make decisions regarding recommended treatment of individual patients. In the UK, the National Cancer Plan (2000) requires every cancer patient’s care to be reviewed by an MDT. The aim is to facilitate specialist input and reduce variation in access to, and decisions about, cancer care. However, since the introduction of these guidelines, MDTs have faced increasing demands, in terms of the number and complexity of cases they review. Further guidelines have since been released to help improve and streamline MDT working. More recently, the COVID-19 pandemic has presented MDTs with the challenge of running MDT meetings virtually rather than face-to-face. This has potential advantages and disadvantages. In this study, we aim to explore how the change from face-to-face to virtual MDT meetings during the COVID-19 pandemic may have impacted the effectiveness of decision-making in cancer MDT meetings. And use the findings to co-produce resource packs to improve future cancer MDT working
Understanding the impact of distance and disadvantage on lung cancer care and outcomes: a study protocol
No full textAbstract Background Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person’s location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients’ and informal carers’ participation in and experience of the lung cancer care pathway. Methods A qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals’ capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement. Discussion The study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway. Protocol registration The study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023; https://osf.io/njq48 )
Let It Out (LIO) study: protocol for a mixed-methods study to optimise the design and assess the feasibility of an online emotional disclosure-based intervention in UK hospices
No full textIntroduction The current COVID-19 pandemic has forced hospices to look for more ways to support people remotely, including psychological support. Emotional disclosure-based interventions hold potential as a way of providing support remotely. However, evidence of their efficacy in people with terminal illness is mixed. Reviews have highlighted this may be due to interventions not being tailored to the unique needs of this population. In response to this, we are developing Let It Out (LIO), an online, self-guided emotional disclosure-based intervention tailored for people living with terminal illness.Aims The primary objective of the study is to optimise the design of the LIO intervention. Secondary objectives include assessing its acceptability and feasibility; exploring potential impact on well-being; identifying potential adverse effects; and informing choice of outcome measures for potential future evaluation.Methods and analysis A single arm, mixed-methods, multisite, longitudinal study. Up to 40 people living with a terminal illness under the care of hospices in England and Scotland will receive the online LIO intervention. LIO consists of 3, self-guided expression sessions over 2 weeks. The primary outcome measures are (1) a structured feedback form completed by participants after the final expression session; and (2) semi-structured interviews and focus groups with ≤15 patient participants, ≤30 hospice staff and ≤15 informal carers. These quantitative and qualitative data will be triangulated via process evaluation to inform optimisation of the intervention design. Secondary outcome measures include validated measures of physical and psychological health collected at baseline and after the final expression session (immediately, 1, 4 and 8 weeks after); and data on recruitment, retention and fidelity.Ethics and dissemination The study is approved by the University College London Research Ethics Committee (reference: 15281/002). The findings will be shared through peer-reviewed scientific journals and conferences, and traditional, online and social media platforms
P-237 A survey of psychological support services in UK hospices: who, what, where and how?
No full textAssessing the specificity of the relationship between brain alpha oscillations and tonic pain
No full textwe sought to develop a robust methodology for assessing the specificity of the relationship between alpha oscillations and acute tonic pain in healthy individuals
Virtual Cancer Multidisciplinary team meetings: A systematic scoping review
No full textMore recently the COVID-19 pandemic has presented multidisciplinary teams (MDT) with a new challenge; forcing MDT meetings to take place virtually rather than face-to-face. This has potential advantages and disadvantages. For example, virtual MDTs have been noted to eliminate geographical barriers as well as promote clinical communication and decision-making in diagnosis. However, there remains concern over virtual MDTs introducing novel forms of distraction as well as the difficulties associated with connectivity and technology.
We aim to explore what a virtual or hybrid cancer MDT constitutes, determine what research evaluates the effectiveness of virtual or hybrid MDT meetings, and discover any measures used for evaluation
