scholarly journals Problem-solving training: assessing the feasibility and acceptability of delivering and evaluating a problem-solving training model for front-line prison staff and prisoners who self-harm

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e026095 ◽  
Author(s):  
Amanda Perry ◽  
Mitchell Glenn Waterman ◽  
Allan House ◽  
Alexandra Wright-Hughes ◽  
Joanne Greenhalgh ◽  
...  
Keyword(s):  
Problem Solving ◽  
Large Scale ◽  
Outcome Data ◽  
Front Line ◽  
Prison Staff ◽  
Intervention Delivery ◽  
Routinely Collected Data ◽  
Self Harm

ObjectivesProblem-solving skills training is adaptable, inexpensive and simple to deliver. However, its application with prisoners who self-harm is unknown. The study assessed the feasibility and acceptability of a problem-solving training (PST) intervention for prison staff and prisoners who self-harm, to inform the design of a large-scale study.Design and settingA mixed-methods design used routinely collected data, individual outcome measures, an economic protocol and qualitative interviews at four prisons in Yorkshire and Humber, UK.Participants(i) Front-line prison staff, (ii) male and female prisoners with an episode of self-harm in the previous 2 weeks.InterventionThe intervention comprised a 1 hour staff training session and a 30 min prisoner session using adapted workbooks and case studies.OutcomesWe assessed the study processes—coverage of training; recruitment and retention rates and adequacy of intervention delivery—and available data (completeness of outcome data, integrity of routinely collected data and access to the National Health Service (NHS) resource information). Prisoner outcomes assessed incidence of self-harm, quality of life and depression at baseline and at follow-up. Qualitative findings are presented elsewhere.ResultsRecruitment was higher than anticipated for staff n=280, but lower for prisoners, n=48. Retention was good with 43/48 (89%) prisoners completing the intervention, at follow-up we collected individual outcome data for 34/48 (71%) of prisoners. Access to routinely collected data was inconsistent. Prisoners were frequent users of NHS healthcare. The additional cost of training and intervention delivery was deemed minimal in comparison to ‘treatment as usual’. Outcome measures of self-harm, quality of life and depression were found to be acceptable.ConclusionsThe intervention proved feasible to adapt. Staff training was delivered but on the whole it was not deemed feasible for staff to deliver the intervention. A large-scale study is warranted, but modifications to the implementation of the intervention are required.

UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees: 1995–2018

2018 ◽  
Vol 43 (1) ◽  
pp. 112-122 ◽  
Author(s):  
Douglas John Matthews ◽  
Mateen Arastu ◽  
Maggie Uden ◽  
John Paul Sullivan ◽  
Kristina Bolsakova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Deep Infection ◽  
Outcome Data ◽  
Superficial Infection ◽  
Kaplan Meier ◽  
The Uk ◽  
Implant System

Background: Amputation of a limb impacts on patients’ self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications. Objectives: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up. Methods: Eighteen transfemoral amputees received unilateral implants between 1997 and 2008. Five were implanted before a formalised protocol, called Osseointegrated Prosthesis for the Rehabilitation of Amputees, was developed. Mean follow-up of the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group is 11.4 years (1.8–18.6 years), while for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group it is 12.3 years (2.9–15.9). Results: The Kaplan–Meier cumulative survivorship is 40% for the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group and 80.21% for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group. Five implants (28%) have been removed, three (17%) for deep infection, one (5.6%) for chronic pain, later proven to be infected and one (5.6%) due to implant fracture secondary to loosening due to infection. Two patients (11%) have peri-implant infections suppressed with oral antibiotics. Eleven cases (61%) of superficial infection were successfully treated with antibiotics. 36-Item short-form health survey and Questionnaire for persons with a Transfemoral Amputation showed significant improvements in quality of life up to 5 years after implantation. Conclusion: This small cohort of patients demonstrates osseointegrated prosthesis allows prolonged usage and improves patients’ quality of life compared to conventional prostheses. Clinical relevance These prostheses may provide a future gold standard for amputees and this study provides the first outcome data over such a time period to be reported from outside of the developers group.

Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder

2013 ◽  
Vol 44 (10) ◽  
pp. 2099-2112 ◽  
Author(s):  
K. L. Gratz ◽  
M. T. Tull ◽  
R. Levy
Keyword(s):  
Emotion Dysregulation ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Post Treatment ◽  
Randomized Controlled ◽  
Self Harm ◽  
Treatment Gains ◽  
Destructive Behaviors

BackgroundDespite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period.MethodFemale out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains).ResultsIntent-to-treat (ITT) analyses (n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures.ConclusionsThe results support the efficacy of this ERGT and the durability of treatment gains.

scholarly journals Quality of Life with Vulvar Carcinoma Treated with Palliative Electrochemotherapy: The ELECHTRA (ELEctroCHemoTherapy vulvaR cAncer) Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1622
Author(s):  
Anna Myriam Perrone ◽  
Martina Ferioli ◽  
Lisa Argnani ◽  
Francesca De Terlizzi ◽  
Cecilia Pirovano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vulvar Cancer ◽  
Pain Scale ◽  
Outcome Data ◽  
Before And After ◽  
Effective Option ◽  
Cancer Project ◽  
Multicenter Prospective Observational Study

The ELECHTRA (ELEctroChemoTherapy vulvaR cAncer) project was conceived to collect data on palliative electrochemotherapy (ECT) in vulvar cancer (VC) assessing patients’ outcomes (response and survival) and impact on quality of life (QoL). After reporting outcome data in 2019, here, we present the results on QoL. A multicenter prospective observational study was conducted on patients with VC refractory or not amenable to standard therapies undergoing palliative ECT as per clinical practice. The following questionnaires were administered before and after ECT (two and four months later, early and late follow-up): visual analog pain scale (VAS), EuroQol 5-Dimension 5-Level (EQ-5D-L5) and Functional Assessment of Cancer Therapy—Vulva cancer (FACT—V). Analyses were conducted on both the whole study population and by subgroups (clinical response after ECT and site, number and size of lesions). Questionnaires from 55 patients were evaluated. Compared to the baseline (6.1 ± 2.1), the VAS was significantly reduced at early (4.3 ± 2.5) and late follow-up (4.6 ± 2.8) (p < 0.0001). The FACT—V score improved significantly at early (9.6 ± 4.0) (p < 0.0001) and late follow-up (8.9 ± 4.1) (p < 0.0054) as compared to the baseline (7.1 ± 3.6). No EQ-5D-5L statistically significant changes were observed. Subgroup analyses showed worse QoL in patients with stable or progressive disease, posterior site and multiple or larger than 3 cm nodules. This is the first study reporting improved QoL in VC patients after palliative ECT. Based on these results, ECT in VC should be considered an effective option based on the favorable outcomes both in terms of response and QoL.

scholarly journals Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

2021 ◽  
Vol 3 ◽  
pp. 12
Author(s):  
Nicholas J. Hulbert-Williams ◽  
Lee Hulbert-Williams ◽  
Ryan James Flynn ◽  
Rosina Pendrous ◽  
Carey MacDonald-Smith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Intervention Programme ◽  
Intervention Delivery

Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient-driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors. Trial registration: ClinicalTrials.gov, NCT03553784 (registered 14 June 2018).

scholarly journals Disaster Preparedness Training Analysis based on Survey

2020 ◽  
Vol 34 (6) ◽  
pp. 135-141
Author(s):  
Sung-kgun Lee ◽  
Gyeong-seok Ko ◽  
Sung-wook Song ◽  
Kyeong-won Kang
Keyword(s):  
Disaster Preparedness ◽  
Local Community ◽  
Fire Service ◽  
Front Line ◽  
Training Analysis ◽  
Medical Institutions ◽  
Effectiveness And Efficiency ◽  
Relative Differences

In this thesis, a questionnaire was conducted with fire service, administrative, and police officials, as well as academic and front-line medical institutions, participating in disaster preparedness drills in a local community. The questionnaire assessed the quality of disaster preparedness training that is still to be implemented in Korea. In addition, the appropriateness of each element of training was assessed with a suitable question, and the opinions of respondents were analyzed. Results indicated that respondents gave a relatively generous evaluation of their own fields or a relatively low evaluation of the group that was most active in training, etc. It was confirmed that differences in perception were determined by relative differences among the groups surveyed. In the future, detailed follow-up studies on items that revealed differences in perceptions should be used to improve the effectiveness and efficiency of disaster preparedness training.

scholarly journals Pelatihan Penyusunan Perangkat Pembelajaran Anak Usia Dini Bagi Guru-Guru Paguyuban POS PAUD di Wilayah Tlogomas

2018 ◽  
Vol 3 (1) ◽  
pp. 239-245
Author(s):  
Yulianti S ◽  
Prihatin Sulistyo
Keyword(s):  
Problem Solving ◽  
Student Development ◽  
Formal Education ◽  
Teacher Competence ◽  
Learning Tools ◽  
Learning Tool ◽  
Planning Stage ◽  
And Training

Based on the results of monitoring of learning at Post PAUD in Tlogomas region in the 20172018 semester, there are several findings in the development of non-formal education institutions among the following; 1). facilities and learning infrastructure that has not been good, 2). The welfare of teachers is still uncertain, 3). administrative demands from partner institutions, and also 4). different curriculum guide of ECD (Formal) with Post PAUD (non Formal), also related teacher competence. This devotion program helps provide partner problem solving that is; mentoring and training of learning tool preparation, the planning stage begins with visits to several PAUD Post. Implementation of each teacher reviewing learning tools, dilanjudkan accompaniment team as well as training the preparation of personal RPPH preparation, then the results are presented in groups to get input repair and end the evaluation with the team of servants. The results of the teacher program can demonstrate the results of the group's work to make the RPPH hope that the follow-up of this activity will be dilanjudkannya in their respective institutions to improve the quality of learning according to student development.

DISSEMINATING A CLINICALLY EFFECTIVE PHYSICAL ACTIVITY PROGRAM TO PRESERVE MOBILITY IN A COMMUNITY SETTING FOR OLDER ADULTS

2016 ◽  
pp. 1-6
Author(s):  
J. LAUSSEN ◽  
C. KOWALESKI ◽  
K. MARTIN ◽  
C. HICKEY ◽  
R.A. FIELDING ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older Adults ◽  
Large Scale ◽  
Well Being ◽  
Moderate Intensity ◽  
Community Based ◽  
Counseling Intervention

Background: As the population of older adults continues to increase, the dissemination of strategies to maintain independence of older persons is of critical public health importance. Recent large-scale clinical trial evidence has definitively shown intervention of moderate-intensity physical activity (PA) reduces major mobility disability in at-risk older adults. However, it remains unknown whether structured PA interventions, with demonstrated efficacy in controlled, clinical environments, can be successfully disseminated into community settings to benefit wider populations of older adults. Objective: To assess the dissemination of an evidence-based PA program for older adults by evaluating program participation and its impact on mobility, strength and quality of life. Setting: An urban senior center. Participants: Fifty older adults (71.2 ± 8 years aged; BMI: 30.1 ± 7 kg/m2). Intervention: Average of 8.0 ± 1.8 months of participation in the Fit-4-Life Program, a community-based PA and nutrition counseling intervention. Measurements: Mobility (Short Physical Performance Battery (SPPB)), self-reported physical activity (CHAMPS questionnaire), leg strength, grip strength, and quality of life (Quality of Well-Being Self-Administered (QWB-SA) scale) were assessed at baseline and follow-up. Results: Mean attendance was 55.8%. Fourteen participants were lost to follow-up. Those who dropped-out engaged in less PA at baseline (78 ± 108 mins/wk) compared to those who completed follow-up (203 ± 177 mins/wk, P=0.01). Participants exhibited sustained increases of PA (65 ± 153 mins/wk, P= 0.08), and there were meaningful improvements in SPPB (0.5 ± 0.2, P< 0.01), knee extensor strength (2.6 ± 4.4 kg, P< 0.01) and QWB-SA (0.04 ± 0.09, P= 0.05). Conclusion: The dissemination of a clinically efficacious PA intervention into a community-based setting can improve mobility, strength and quality of life for older adults. This knowledge may be helpful for the design and implementation of larger-scale PA intervention studies designed to preserve mobility in older adults within community-based settings.

Late Effects of Pelvic Rhabdomyosarcoma and Its Treatment in Female Survivors

2005 ◽  
Vol 23 (28) ◽  
pp. 7143-7151 ◽  
Author(s):  
Sheri L. Spunt ◽  
Teresa A. Sweeney ◽  
Melissa M. Hudson ◽  
Catherine A. Billups ◽  
Matthew J. Krasin ◽  
...  
Keyword(s):  
Late Effects ◽  
Treatment Approach ◽  
Median Number ◽  
Outcome Data ◽  
Late Complications ◽  
Female Survivors ◽  
Grade 3 ◽  
The Impact

Purpose To document the spectrum and severity of late effects in female survivors of pelvic rhabdomyosarcoma. Patients and Methods We reviewed the demographic, diagnostic, treatment, and outcome data of the 26 females treated for pelvic rhabdomyosarcoma at our institution between March 1962 and December 1996 who survived free of disease for 5 or more years. Adverse effects that occurred 5 or more years after diagnosis were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0. Results The most common tumor sites were vagina (n = 7), pelvis/retroperitoneum (n = 6), and bladder (n = 4). All patients received chemotherapy (alkylating agent, n = 23; doxorubicin, n = 16); 22 received radiotherapy (median dose, 46 Gy). Median follow-up of the 23 survivors was 20.3 years. Late effects occurred in 24 patients, 23 of whom had grade 3/4 late effects (median grade 3/4 late effects per patient, three; range, zero to 14). Fourteen patients (54%) required surgery for late complications. The 22 patients who had received radiotherapy had a greater median number of late effects per patient than did the remaining four (9.5 v one; P = .002). The median number of late effects per patient was higher in the 12 patients treated during or after 1984 than in the 14 treated earlier (12.5 v 6.5; P = .041). Conclusion The burden of late effects in girls treated for pelvic rhabdomyosarcoma is significant and does not seem to be diminishing with advances in treatment. Prospective studies are needed to better assess the impact of these late effects on quality of life and functional outcome, and to refine the treatment approach to pelvic rhabdomyosarcoma.

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