Midwives' role in screening for antenatal depression and postnatal depression

This is an educational paper which aims to inform midwives of tools available to help them make appropriate provisional diagnosis of perinatal depression. A second aim of the paper is to increase midwives' awareness of the relatively newer diagnosis of antenatal depression (AND). Of additional clinical importance, midwives need to recognise that postnatal depression (PND) may be a continuation of AND. To date, screening for AND has received relatively little attention compared with PND, with the evidence-base supporting that the impact can be as severe. It is important for midwives to know that screening for AND can be undertaken using valid and reliable psychometric self-report depression screening questionnaires which have known validity characteristics and threshold cut-off scores. There are several of these tools available to help midwives make the decision about whether or not to refer the women to the mental health team. Current practice in the UK involves the midwife asking an initial short two-item ‘Whooley Question’ screen which, if indicates depression, can be followed up by the women completing a self-report depression screening questionnaire. To highlight their availability, a selection of valid and reliable psychometric self-report depression screening questionnaires are discussed herein, with it being important for midwives to develop a toolkit that can be given to women at clinics, in pamphlets, online or embedded into mobile applications.

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Differential research impact in cancer practice guidelines’ evidence base: lessons from ESMO, NICE and SIGN

ESMO Open ◽

10.1136/esmoopen-2017-000258 ◽

2018 ◽

Vol 3 (1) ◽

pp. e000258 ◽

Cited By ~ 8

Author(s):

Elena Pallari ◽

Anthony W Fox ◽

Grant Lewison

Keyword(s):

Practice Guidelines ◽

Western Europe ◽

Statistical Tests ◽

Geographic Location ◽

Basic Research ◽

Research Impact ◽

Evidence Base ◽

Effective Decision Making ◽

The Uk ◽

The Impact

BackgroundThis is an appraisal of the impact of cited research evidence underpinning the development of cancer clinical practice guidelines (CPGs) by the professional bodies of the European Society for Medical Oncology (ESMO), the National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).MethodsA total of 101 CPGs were identified from ESMO, NICE and SIGN websites across 13 cancer sites. Their 9486 cited references were downloaded from the Web of Science Clarivate Group database, analysed on Excel (2016) using Visual Basic Application macros and imported onto SPSS (V.24.0) for statistical tests.ResultsESMO CPGs mostly cited research from Western Europe, while the NICE and SIGN ones from the UK, Canada, Australia and Scandinavian countries. The ESMO CPGs cited more recent and basic research (eg, drugs treatment), in comparison with NICE and SIGN CPGs where older and more clinical research (eg, surgery) papers were referenced. This chronological difference in the evidence base is also in line with that ESMO has a shorter gap between the publication of the research and its citation on the CPGs. It was demonstrated that ESMO CPGs report more chemotherapy research, while the NICE and SIGN CPGs report more surgery, with the results being statistically significant.ConclusionsWe showed that ESMO, NICE and SIGN differ in their evidence base of CPGs. Healthcare professionals should be aware of this heterogeneity in effective decision-making of tailored treatments to patients, irrespective of geographic location across Europe.

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Psychological distress and resilience in a sample of Adolescents and Young Adults with cancer during the COVID-19 pandemic

10.1101/2021.03.29.21254529 ◽

2021 ◽

Author(s):

Clare Jacobson ◽

Rebecca Mulholland ◽

Nicola Miller ◽

Laura Baker ◽

Daniel Glazer ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Cancer Treatment ◽

Online Survey ◽

Protective Factor ◽

Care Delivery ◽

Self Report ◽

Patient Health ◽

The Uk ◽

The Impact

AbstractBACKGROUNDAdolescents and young people (AYA) with cancer are at greater risk of psychological distress which can impact treatment. COVID-19 has resulted in changes to cancer care delivery and AYA have been disproportionately affected by economic and educational effects of COVID-19, potentially impacting on mental health. Understanding the impact of COVID-19 on AYA with cancer is important to inform care.METHODSOnline survey of 16-24 year olds receiving cancer treatment at 8 cancer centres in the UK in December 2020. We measured: self-perceived increased anxiety since COVID-19, impact of COVID-19 on treatment, life and relationships and used the 8-item Patient Health Questionnaire(PHQ-8), 7-item Generalised Anxiety Disorder Scale(GAD) and the 2-item Connor-Davidson Resilience Scale(CD-RISC).RESULTS112 AYA participated (17.8% of total eligible). 62.8% were female, 67.3% were 21-24 years. 83% were white. 59.8% had previously experienced mental health difficulties. 67.9% received cancer treatment during the pandemic and 33.9% were diagnosed during the pandemic. 78.6% reported COVID-19 having a significant impact on their life, 55.4% on their key relationship and 39.3% on their treatment. 79% reported experiencing some degree of increased anxiety since COVID-19.43.4% had moderate-severe PHQ-8 scores and 37.1% for GADS-7. Self-report of impact on life was associated with greater anxiety during COVID-19 and moderate-severe PHQ-8 score (OR 3.64, 95% CI 2.52 to 19.40, p <0.01; OR 5.23, 95%CI 1.65 to 16.56, p < 0.01). Impact on relationships was associated with greater anxiety and moderate-severe GADS-7and PHQ-8 score (OR 2.89, 95% CI 1.11 to 7.54, p = 0,03; OR 3.54, 95% CI 2.32 to 15.17, p<0.01; OR 2.42, 95% CI 1.11 to 5.25, p =0.03). Greater CD-RISC score was associated with lower risk of anxiety and mod-severe GADS-7and PHQ-8 scores (OR 0.58, 95%CI 0.41 to 0.81, p <0.01; OR 0.55 95% CI 0.4 to 0.72, p <0.01; OR 0.52, 95% CI 0.38 to 0.69, p <0.01)CONCLUSIONSWe found high levels of psychological distress in AYA with cancer, which is important knowledge for clinical teams working with this age group. Perceived impact of COVID-19 on relationships and life was predictive of poorer mental health, with resilience a potential protective factor.

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The impact of cycle proficiency training on cycle-related behaviours and accidents in adolescence: findings from ALSPAC, a UK longitudinal cohort

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.137 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Alison Teyhan ◽

Rosie Cornish ◽

Andy Boyd ◽

Mary Sissons Joshi ◽

John Macleod

Keyword(s):

Hospital Admissions ◽

Self Report ◽

School Level ◽

Individual Level ◽

Parents And Children ◽

Cycle Training ◽

The Uk ◽

Serious Injuries ◽

Minor Cycle ◽

The Impact

ABSTRACT ObjectivesIn the UK, some children undertake National Cycle Proficiency Scheme [NCPS]/Bikeability training in primary school. It aims to promote cycling and safe cycling behaviours but there has been little scientific evaluation of its effectiveness. We aimed to examine the impact of cycle training on cycle-related behaviours and accidents in adolescence using self-report and hospital episode statistics (HES) data. ApproachThe sample (n=5415) were participants in the Avon Longitudinal Study of Parents and Children who reported whether or not they had received NCPS training. Self-reported outcomes at 14 and 16 years included: cycling to school, ownership of cycle helmet, use of cycle helmet and high-visibility clothing on last cycle, and involvement in a cycle accident. Hospital admittance due to a cycle accident from 11-16 years was also included for a subsample (n=2222) who have been linked to HES. The association between cycle training and each of the outcomes was analysed using multilevel logistic regression (individual level 1, school level 2 [pseudo-ID of school attended obtained from linkage to National Pupil Database]), adjusted for a range of potential confounders. ResultsApproximately 40% had received NCPS training. At 14 and 16 years, trained children were more likely to cycle to school (at 16 years: adjusted OR 1.56, 95% CI 1.20-2.02) and to own a helmet (16 years: 2.03, 1.72-2.41) than those who had not attended a course. They were also more likely to have worn a helmet on their last cycle at age 14 (1.26, 1.07-1.49), and to have worn high-visibility clothing at age 16 (1.70, 1.22-2.39). Training was not associated with self-reported involvement in a cycle accident, and only six participants with HES data had been admitted to hospital due to a cycle accident. Irrespective of training, results indicate very low use of high-visibility clothing (5%), very few girls cycling to school (<2%), and less than half of helmet owners wearing one on their last cycle. Ownership and use of helmets was particularly low in children from lower socio-economic position families. ConclusionCycle training for children can have benefits that persist into adolescence. However, the low use of cycle helmets and high-visibility clothing indicate the further potential for interventions to encourage safe cycling behaviours in young people. Our hospital admissions outcome only captures individuals who sustained serious injuries; more minor cycle injuries would have been treated in A&E but a lack of detail in admission codes precludes analysis of such data.

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Mindfulness for Psychosis Groups; Within-Session Effects on Stress and Symptom-Related Distress in Routine Community Care

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465818000723 ◽

2019 ◽

Vol 47 (4) ◽

pp. 421-430 ◽

Cited By ~ 1

Author(s):

Pamela Jacobsen ◽

Matthew Richardson ◽

Emma Harding ◽

Paul Chadwick

Keyword(s):

Mindfulness Meditation ◽

Community Setting ◽

Evidence Base ◽

Self Report ◽

Psychotic Symptoms ◽

Psychotic Experience ◽

Positive Effects ◽

General Stress ◽

Before And After ◽

The Impact

Background: There is an emerging evidence base that mindfulness for psychosis is a safe and effective intervention. However, empirical data on the within-session effects of mindfulness meditation was hitherto lacking. Aims: The aim of the study was to assess the impact of taking part in a mindfulness for psychosis group, using a within-session self-report measure of general stress, and symptom-related distress. Method: Users of a secondary mental health service (n = 34), who experienced enduring psychotic symptoms, took part in an 8-week mindfulness for psychosis group in a community setting. Mindfulness meditations were limited to 10 minutes and included explicit reference to psychotic experience arising during the practice. Participants self-rated general stress, and symptom-related distress, before and after each group session using a visual analogue scale. Results: Average ratings of general stress and symptom-related distress decreased from pre- to post-session for all eight sessions, although not all differences were statistically significant. There was no increase in general stress, or symptom-related distress across any session. Conclusions: There was evidence of positive effects and no evidence of any harmful effects arising from people with psychotic symptoms taking part in a mindfulness for psychosis session.

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Revised standards of proficiencies for midwives: an opportunity to influence childhood health?

British Journal of Midwifery ◽

10.12968/bjom.2020.28.3.150 ◽

2020 ◽

Vol 28 (3) ◽

pp. 150-154

Author(s):

Samantha Meegan

Keyword(s):

Public Health ◽

Child Development ◽

Evidence Base ◽

Early Child Development ◽

Childhood Health ◽

Early Child ◽

The Public ◽

The Future ◽

The Uk ◽

The Impact

The first 1 000 days of life are critical during early child development, yet the significance of this time and the impact on childhood health have only recently been recognised within the UK. In early 2020, the Nursing and Midwifery Council (NMC) released revised standards of proficiency for midwives. These draw on the evidence-base generated by recent research developments within public health, providing the first update of midwifery standards for a decade. This article critically explores the main aspects within the NMC's future midwife proficiencies that relate to the public health component of the midwifery role, and will examine how these factors can equip midwives of the future to support women, their babies and families within the fundamental early days of life.

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Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

Geriatrics ◽

10.3390/geriatrics5010004 ◽

2020 ◽

Vol 5 (1) ◽

pp. 4

Author(s):

Carol A. Fairfield ◽

David G. Smithard

Keyword(s):

Acute Phase ◽

Best Practice ◽

Evidence Base ◽

Post Stroke ◽

Effortful Swallow ◽

The Us ◽

Screening Assessment ◽

The Uk ◽

Management Of Dysphagia ◽

The Impact

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

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Lessons from a publicly funded tier 2 healthy weight programme in Cornwall, UK

Journal of Public Health ◽

10.1093/pubmed/fdz037 ◽

2019 ◽

Author(s):

A J Williams ◽

T Barter ◽

R A Sharpe

Keyword(s):

Statistical Tests ◽

Evidence Base ◽

Lessons Learned ◽

Healthy Weight ◽

Anthropometric Measures ◽

Prevention Services ◽

Treatment And Prevention ◽

Weight Management Programme ◽

The Uk ◽

The Impact

Abstract Background The UK has one of the highest prevalence rates of obesity worldwide. Public health departments have a duty to provide some obesity treatment and prevention services. With evidence of effective programmes lacking, we investigate lessons learned from a healthy weight programme in Cornwall, UK. Methods Data from the 12-week multi-component adult healthy weight management programme were obtained for 2012–2016. Descriptive statistics and statistical tests were used to describe participants’ demographics, health status and anthropometric measures to explore the enrolment and retention of the programme as well as the impact. Results A total of 1872 adults were referred into the programme. Overall, 646 completed the programme and, 48.8% achieved the programme’s aim of a >3% reduction in weight. Those who completed and met the programme aim tended to have had healthier outcomes at baseline. Conclusions For those who engage with the programme the impact can be meaningful. However, <1% of the population of Cornwall with overweight or obesity enroled in the programme, and those who benefitted most might have been in least need. Providing services that meet the needs of the population is challenging when a variety of services is needed, and the evidence base is poor.

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Fifty years of the UK Misuse of Drugs Act 1971: the legislative contexts

Drugs and Alcohol Today ◽

10.1108/dat-08-2021-0038 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Blaine Stothard

Keyword(s):

Design Methodology ◽

Evidence Base ◽

People Who Use Drugs ◽

Content Type ◽

Before And After ◽

History Of ◽

The Government ◽

The Uk ◽

The Impact ◽

Practical Implications

Purpose The purpose of this paper is to illustrate the history of relevant legislation before and after the 1971 Misuse of Drugs Act (MDA). Design/methodology/approach A chronological narrative of laws and reports with concluding discussion. Findings That UK legislators have not made use of the evidence base available to them and have favoured enforcement rather than treatment approaches. That current UK practice has exacerbated not contain the use of and harms caused by illegal drugs. Research limitations/implications The paper does not cover all relevant documents, especially those from non-governmental sources. Practical implications The practical implications centre on the failure of consecutive governments to reflect on and review the impact of current legislation, especially on people who use drugs. Social implications That the situations of people who use drugs are currently ignored by the government and those proven responses which save lives and reduce harm are rejected. Originality/value The paper attempts to show the historical contexts of control and dangerousness of which the MDA is one instrument.

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Innovative Use of Administrative Data in Legal Research and Practice

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1504 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Matthew A Jay ◽

Natalie Byrom ◽

Matthew A Jay ◽

Suzie Forell

Keyword(s):

Administrative Data ◽

Social Issues ◽

Evidence Base ◽

Access To Justice ◽

Data Generation ◽

Great Opportunity ◽

Challenges And Opportunities ◽

Using Data ◽

The Uk ◽

The Impact

IntroductionThere is widespread recognition of the need to use administrative data from justice, crime, prisons and legal services to improve the evidence base on determinants and outcomes of involvement with justice systems and to improve services. There is great opportunity to use data from justice to improve health and other outcomes for clients and service users but this is a relatively unexplored area and these datasets have been neglected partly due to access concerns. This 90 minute symposium presents research and learning from data initiatives in justice settings and will explore challenges from the perspectives of researchers and the legal profession. Objectives and ApproachTalks will cover: Development of legal epidemiology and use of administrative data in this nascent field (Matthew A Jay). Examples from the presenter’s family justice research using linked data will also be presented. The UK Ministry of Justice’s (MoJ’s) Data First programme (Prof Betsy Stanko). Data First aims to unlock the potential of data already created by MoJ, by linking datasets from the justice system and beyond, and enabling accredited researchers to access the data ethically and responsibly. UK court reform and data collection: using data to monitor equality and access to justice in the move to on-line dispute resolution (Dr Natalie Byrom). Health Justice Partnerships (HJPs) in Australia (Prof Suzie Forell). HJPs bring legal help into health settings to address social issues affecting the health of patients. This will be a discussion of HJPs as an opportunity to explore the impact of legal assistance on health and the challenges and opportunities of relevant data generation. Conclusion / ImplicationsBetter use of data in justice spheres will be a difficult process requiring cross-disciplinary collaboration. But it is one that promises to bring the study and practice of law into the 21 st Century.

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The impact of the changes to United Kingdom psychiatry training recruitment in 2021

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-08-2021-0091 ◽

2022 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Alexander Challinor ◽

Jonathon Whyler

Keyword(s):

Empirical Evidence ◽

Evidence Base ◽

Psychiatry Training ◽

Selection Methods ◽

Recruitment Process ◽

Content Type ◽

Recruitment Methods ◽

Advantages And Disadvantages ◽

The Uk ◽

The Impact

Purpose The purpose of this paper is to review and critically evaluate UK psychiatry national recruitment process for 2021, which was re-structured following the COVID-19 pandemic. Additionally, this paper aims to review the empirical evidence of the selection methodologies in psychiatry recruitment. Design/methodology/approach The UK national psychiatry recruitment process is discussed, with a focus on the changes made to recruitment in 2021. The advantages and disadvantages of different selection methodologies are explored, with an emphasis on evaluating the validity, acceptability and reliability of different recruitment selection methodologies. The potential impact of the changes to psychiatry recruitment are explored. Findings The decision of the National Recruitment Office to remove certain selection methods for recruitment in 2021 may have limited their ability to choose the best candidate for the training place and be fair to the applicant. Overall, there is a lack of research into the validity of the selection methods used in psychiatry recruitment. A framework for outcome criteria relevant to psychiatry recruitment should be developed, which would allow research into selection methods and guide the NRO to examine the evidence base effectively. Originality/value This paper examined the recruitment methods used to choose doctors for psychiatry training in the UK, demonstrating that the empirical evidence base for psychiatry recruitment is limited. This paper can contribute to our understanding of selection methodologies used in psychiatry recruitment and highlights the value of different recruitment approaches for choosing the best psychiatrists of the future.

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