[Show abstract][Hide abstract] ABSTRACT: To determine the optimal databases to search for studies of faith-sensitive interventions for treating depression.
We examined 23 health, social science, religious, and grey literature databases searched for an evidence synthesis. Databases were prioritized by yield of (1) search results, (2) potentially relevant references identified during screening, (3) included references contained in the synthesis, and (4) included references that were available in the database. We assessed the impact of databases beyond MEDLINE, EMBASE, and PsycINFO by their ability to supply studies identifying new themes and issues. We identified pragmatic workload factors that influence database selection.
PsycINFO was the best performing database within all priority lists. ArabPsyNet, CINAHL, Dissertations and Theses, EMBASE, Global Health, Health Management Information Consortium, MEDLINE, PsycINFO, and Sociological Abstracts were essential for our searches to retrieve the included references. Citation tracking activities and the personal library of one of the research teams made significant contributions of unique, relevant references. Religion studies databases (Am Theo Lib Assoc, FRANCIS) did not provide unique, relevant references.
Literature searches for reviews and evidence syntheses of religion and health studies should include social science, grey literature, non-Western databases, personal libraries, and citation tracking activities.
[Show abstract][Hide abstract] ABSTRACT: Preventable sight loss is one of the Public Health Outcome Indicators in England. Despite availability of NHS-funded eye examinations, many people do not take up their entitlement. This paper explores older adults understanding of eye health and the purpose of eye examinations and the reasons why they do or do not attend for eye examinations. The aim is to provide evidence to inform policy on increasing uptake of eye examinations among older people who have increased risk of preventable sight loss.
10 focus-group meetings were held with people living in deprived areas of Leeds, recruited via community groups and neighbourhood networks. Focus groups were transcribed and a thematic analysis approach was used.
The majority of participants were aged over 60, wore spectacles, and had regular eye examinations. Most were eligible for a NHS-funded eye examination. There was poor knowledge about eye disease and the purpose of different elements of the eye examination. Participants felt very vulnerable about getting the tests 'wrong' and looking foolish. Wearing of spectacles was associated with appearing old and frail. Many did not trust the veracity of optometrists, and perceived opticians to be expensive places, where it was difficult to control spending. Many had experienced 'hard sell' and opaque pricing. Most, but not all, were happy with the optometric services received. Participants indicated a preference for utilising a local optometrist located alongside other familiar health care services.
Not-for-profit services co-located with other public services are needed to address concerns about cost of spectacles, lack of trust in optometrists, and poor access to eye examinations in local settings. It will also be important to raise public understanding about the purpose of eye examinations in terms of other causes of preventable sight loss and not just refractive error and need for spectacles.
Ophthalmic and Physiological Optics 01/2014; 34(1):38-45.
[Show abstract][Hide abstract] ABSTRACT: The rise in child obesity poses a serious public health challenge. It has been argued that efforts may be best targeted towards prevention, but there is a relative dearth of initiatives targeting infants. Earlier evaluation of the impact of HENRY (Health Exercise Nutrition for the Really Young) has shown an improvement in the way practitioners work with families and a positive impact upon their work setting and personal life.
This study of the impact on families found that parents participating in HENRY groups report a healthier family lifestyle, which was sustained at follow-up. Participants reported increased parental self-efficacy around lifestyle change and parenting generally. They also reported increased consumption of fruit and vegetables; positive changes in mealtime behaviours and reduced screen time.
One-quarter of children in England are overweight/obese at school entry. We investigated the impact of a programme designed to provide parents of infants and preschool children with the skills required for a healthier family lifestyle.
A cohort of families was followed across the 8-week HENRY (Health Exercise Nutrition for the Really Young) parent course at nine locations in England. Seventy-seven parents enrolled on the course, of which 71 agreed to complete questionnaires addressing eating behaviours, dietary intake and parental self-efficacy. Pre- and post-course data was available from 60 (84.5%) parents (8-week follow-up data from 58 parents) and was analysed using repeated measures analyses.
Significant changes were observed, with most sustained at follow-up. Parents reported increased self-efficacy and ability to encourage good behaviour (P < 0.001). Increased consumption of fruits and vegetables was reported in both children and adults, together with reduced consumption of sweets, cakes and fizzy drinks in adults (all P < 0.01). There were also positive changes in eating behaviours (e.g. frequency of family mealtimes and eating while watching television or in response to negative emotion [P < 0.01] ) and reduced screen time in adults (P < 0.001).
The results build upon earlier evaluation, indicating that the HENRY intervention has a beneficial impact upon the families of infants and preschool children. Furthermore, the findings suggest that positive changes inspired by the programme can be maintained beyond its completion. Such changes may serve to protect against later obesity.
[Show abstract][Hide abstract] ABSTRACT: The views of people with inherited retinal disease are important to help develop health policy and plan services. This study aimed to record levels of understanding of and attitudes to genetic testing for inherited retinal disease, and views on the availability of testing.
Telephone questionnaires comprising quantitative and qualitative items were completed with adults with inherited retinal disease. Participants were recruited via postal invitation (response rate 48%), approach at clinic or newsletters of relevant charitable organisations.
Questionnaires were completed with 200 participants. Responses indicated that participants' perceived understanding of genetic testing for inherited retinal disease was variable. The majority (90%) considered testing to be good/very good and would be likely to undergo genetic testing (90%) if offered. Most supported the provision of diagnostic (97%) and predictive (92%) testing, but support was less strong for testing as part of reproductive planning. Most (87%) agreed with the statement that testing should be offered only after the individual has received genetic counselling from a professional. Subgroup analyses revealed differences associated with participant age, gender, education level and ethnicity (p<0.02). Participants reported a range of perceived benefits (eg, family planning, access to treatment) and risks (eg, impact upon family relationships, emotional consequences).
Adults with inherited retinal disease strongly support the provision of publicly funded genetic testing. Support was stronger for diagnostic and predictive testing than for testing as part of reproductive planning.
[Show abstract][Hide abstract] ABSTRACT: This article reports the development of natural history and active treatment benchmarks for psychological treatments of chronic pain. The benchmarks were derived from randomized controlled trials reported in a published meta-analysis (Eccleston C, et al. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Review, 2009). In two preliminary studies we surveyed small samples of active clinicians working in UK pain management programs. Study1 assessed the fit between routine clinical treatment and the selected randomized controlled trials. In Study 2 Delphi methodology was used to determine a set of outcome domains to be used in the development of benchmarks. In Study 3 we extracted data from a set of randomized controlled trials where both pre-treatment and post-treatment data were reported. Measures were allocated to one of 5 outcome domains (cognitive coping and appraisal, pain experience, pain behaviour, emotional functioning and physical functioning). Pre-treatment to post-treatment effect sizes (Cohen's d) were computed and where necessary aggregated within trial so that each trial contributed a single estimate to outcome domain. Effect size (ES) benchmarks were computed for all trials and those trials with an explicit cognitive behavior therapy protocol. In no case did the ES estimates for the untreated control deviate from 0. The average ES across outcome domains for the treatment arms was approximately 0.35. These benchmarks may be used to assess the effectiveness of routine clinical treatments for chronic pain. The application of these data and the limitations of the study are discussed.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Enteral tube feeding (ETF) has been evaluated in paediatric and mixed child and adult populations with cystic fibrosis, demonstrating positive outcomes from 6months to 2years post insertion. No studies have examined the longer term nutritional and clinical outcomes in an exclusively adult population with cystic fibrosis or compared the outcomes for those who meet standard criteria and opt to undertake or decline ETF. METHODS: Twenty three out of 380 patients attending the Leeds Regional Adult CF unit fulfilled the standard criteria for commencing ETF (CF Trust, 2002) between 2004 and 2008. Weight, BMI, FEV1, FVC, CFRD, and number of intravenous antibiotic treatment days were collected at 1year pre baseline, at baseline, and at 1, 2, and 3years post baseline for all these patients whether they accepted or declined ETF. RESULTS: Seventeen of the 23 patients agreed to accept a programme of ETF, two of whom died within the first year of ETF. In the remaining patients (n=15), weight increased by 19.5% from baseline (p<0.001), BMI increased to within the normal range and lung function stabilised. There was no reduction in the requirement for intravenous antibiotic treatment. The six patients who declined ETF had a decline in lung function and no weight gain. CONCLUSION: Supplemental enteral tube feeding improves clinical outcomes when administered over 3years, resulting in significant weight gain, a normal BMI and stabilisation of lung function. It does not reduce intravenous antibiotic treatment days. In contrast those patients eligible for, but who declined ETF, showed a deterioration in lung function and a failure to gain weight and to achieve normal BMI status.
Journal of cystic fibrosis: official journal of the European Cystic Fibrosis Society 06/2013;
[Show abstract][Hide abstract] ABSTRACT: Objectives. This study aimed to explore how guidance contributes to the outcome of self-help for disordered eating. Method. A sample of guides and clients with a range of disordered eating was interviewed on completion of a randomized control trial and analysed using thematic framework analysis. Results. Four themes emerged; the necessity of having a guide as a facilitator, features of the therapeutic relationship in clients with positive outcomes, features of the therapeutic relationship in clients with poor outcomes, and client suitability. Conclusions. These findings have implications for the delivery of guided self-help interventions for disordered eating. They suggest the value of assessing clients' readiness to change, working with clients with less severe and complex conditions, and the importance of guide qualities and skills. PRACTITIONER POINTS: • Guidance is a necessary adjunct to self-help approaches for the effective treatment of a range of disordered eating and can be delivered by trained non-eating disorder specialists. • Guided self-help appears most appropriate for less severe, binge-related eating disorders, including eating disorders not otherwise specified (EDNOS), further work is needed for use with anorexic-type presentations. • While it is important to establish and maintain a strong, open, and collaborative therapeutic relationship, client 'readiness' appears fundamental in the relationship and consequent treatment outcome.
Psychology and psychotherapy. 03/2013; 86(1):86-104.
[Show abstract][Hide abstract] ABSTRACT: AIM: The aim of this study is to explore the dimensionality of the CASP-19-a quality-of-life measure for early old age-and to assess the stability of the item locations over time and changes in person measures. METHODS: The Rasch partial credit model was applied to the CASP-19 data obtained from Waves 1 and 3 (N = 9,407 and N = 7,732) of the English Longitudinal Study of Ageing to assess item fit, dimensionality and differential item functioning (DIF). RESULTS: Five items demonstrated category disordering for the last two response categories of the CASP-19 (which were collapsed), and 4 items demonstrated item misfit and were removed from the analysis. Cronbach's alpha indicated good internal consistency for both waves (0.87 for Wave 1 and 0.88 for Wave 3). There was no evidence of multidimensionality, and no significant DIF was observed for gender. When the two datasets were combined, no statistically significant differences were observed between the two sets of item locations. A statistically significant difference was found for the mean person measure [t(5,524) = 17.88, p < 0.001)], suggesting quality of life improves as people age. CONCLUSION: A 15-item unidimensional factor structure was observed for the CASP-19, which was stable over time.
[Show abstract][Hide abstract] ABSTRACT: Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.
The Lancet 02/2013;
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