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Moffitt J.,James Cook University | Bostock J.,St Georges Hospital | Cave A.,Care + Wear
Journal of Public Mental Health | Year: 2014

Purpose: Workplace stress is a particular issue in the fire service. Research suggests this is related to excessive demands, relationships with senior managers, changing roles and exposure to traumatic events. The purpose of this paper is to evaluate the impact on managers of three mental health promotion interventions. First, a locally developed course entitled "Looking after Wellbeing at Work" (LWW), second, an internationally developed training course: Mental Health First Aid (MHFA). Third, an hour-long leaflet session (LS). Design/methodology/approach: This study used a random allocation design. In total, 176 fire service line managers were randomly allocated to one of the three training conditions: LWW, MHFA, or a control condition (LS). Participants completed The Attitudes to Mental Illness Scale (Luty et al., 2006) and a locally developed "Mental Health Stigma Questionnaire" pre- and post-intervention. Results were analysed using a MANOVA. Participants were also asked to complete a general evaluation, rating all aspects of the courses from poor to excellent. In total, 30 participants were also chosen at random to conduct telephone interviews about their experience of the course. Results were analysed using thematic analysis. Findings: The LWW and MHFA courses were associated with statistically significant improvements in attitudes to mental illness and knowledge/self-efficacy around mental health, comparing pre- and post-scores, and comparing post-scores of the two training courses with a LS. The general evaluations of the LWW and MHFA courses indicated the mean rating for all aspects of both training conditions was good to excellent. Two themes were identified across the qualitative interviews: participants described they were more able to recognise and respond to mental health problems; and participants described changing attitudes towards mental health. Research limitations/implications: The strengths of this study are the number of participants, random allocation, and multiple facets of evaluation. The quantitative evaluation is limited, as one of the questionnaires has untested psychometric properties. The control condition was limited as it was only offered for one hour, making comparison with two-day training problematic. The qualitative evaluation was useful in gaining descriptive data, however, it may have been possible to conduct a more in-depth analysis with a smaller number of participants. Originality/value: The results from this study indicate that providing training in mental health awareness and promotion was considered helpful, by managers in the Fire Service and had positive outcomes for attitudes and understanding about mental health. While there are limitations, initial results of training in mental health promotion are promising. Such training has the potential to promote the public's mental health and wellbeing, and improve the quality of life for people with mental health problems. © Emerald Group Publishing Limited.

Duckett J.,Care + Wear | Fell P.,Care + Wear | Han K.,Care + Wear | Kimber C.,Care + Wear | Taylor C.,Care + Wear
Emergency Medicine Journal | Year: 2014

Aim: To clinically review the use of basic and advanced airway management techniques within the North East Ambulance Service National Health Service Foundation Trust (NEAS) for cardiac arrests following the introduction of the i-gel. Method: Two retrospective clinical audits were carried out over a monthly period (May 2011 and January 2012) using electronic and paper NEAS patient records. Results: This audit confirmed that a range of basic and/or advanced airway management techniques are being successfully used to manage the airways of cardiac arrest patients. I-gel is emerging as a popular choice for maintaining and securing the airway during prehospital cardiopulmonary resuscitation. Success rates for i-gel insertion are higher (94%, 92%) than endotracheal (ET) tube insertion (90%, 86%). Documentation of the airway management method was poor in 11% of the records. The Quality Improvement Officers addressed this by providing individual feedback. Conclusions: I-gel shows a higher success rate in cardiac arrest patients compared to the ET tube. Staff who chose to use methods other than i-gel indicated this was a confidence issue when using new equipment. The re-audit indicated an upward trend in the popularity of i-gel; insertion is faster with a higher success rate, which allows the crew to progress with the other resuscitation measures more promptly. Airway soiling and aspiration beforehand have been reasons staff resort to ET intubation. It is anticipated by the authors that igel will emerge as the first choice of airway management device in prehospital cardiac arrests.

Dotchin C.,Care + Wear | Dotchin C.,Northumbria University | Colman A.,Care + Wear | Shanshal Y.,Care + Wear
Age and Ageing | Year: 2010

We present a case report of an 86-year-old lady with pubic ramus and sacral insufficiency fractures who developed extravesical bladder rupture following displacement of the pubic ramus fracture, a very unusual complication. © The Author 2010. Published by Oxford University Press on behalf of the British Geriatrics Society.

Bradbury M.,Queen Elizabeth Hospital | Founta C.,Queen Elizabeth Hospital | Taylor W.,Care + Wear | Kucukmetin A.,Queen Elizabeth Hospital | And 2 more authors.
International Journal of Gynecological Cancer | Year: 2015

Objective Both radical hysterectomy with pelvic lymphadenectomy and primary chemoradiotherapy have been shown to be effective in the management of women with stage IB2 cervical cancer. This study aims to review the outcomes related to each treatment modality and the effects of pathological risk factors on overall survival (OS) and disease-free survival. Methods We performed a retrospective study of 92 women with stage IB2 cervical cancer who were treated at the Northern Gynecological Oncology Center (Gateshead, United Kingdom) across a 22-year period between January 1991 and July 2013. Women were divided into those undergoing primary surgery and those undergoing primary radiotherapy/chemoradiotherapy. The main outcome measures were OS and progression-free survival (PFS). Pathological risk factors of survival were assessed using multivariate analysis. Results Sixty-seven women (72.8%) underwent primary surgery, and 25 women (27.2%) had primary radiotherapy/chemoradiotherapy. Thirty-one of 67 women (46.3%) required adjuvant radiotherapy/chemoradiotherapy after surgery because of positive lymph nodes in 77.4% of cases. The median follow-up was 57.5 months (range, 3-137 months). Thirty-two women (34.8%) had disease recurrence: 6 women (16.7%) in the group undergoing surgery alone, 15 women (48.4%) in the group requiring adjuvant treatment after surgery, and 11 women (44%) in the group having primary radiotherapy/chemoradiotherapy. Overall survival and PFS were higher for women undergoing surgery alone (91.7% and 83.3%) compared with women requiring adjuvant treatment after surgery (54.8% and 51.4%) and those having primary radiotherapy/chemoradiotherapy (60% and 56%) (P = 0.0004 and P = 0.005, respectively). Lymph node metastasis was a significant pathological risk factor of OS and PFS in multivariate analysis. Conclusions Most women require adjuvant treatment after surgery because of positive lymph nodes. Because survival outcomes for women requiring dual treatment are similar to those for women undergoing primary chemoradiotherapy, nodal assessment before definitive treatment should guide the management of these women and identify a low-risk group that can be treated with surgery alone. © 2015 by IGCS and ESGO.

Pace S.M.,Care + Wear | Thwaites R.,Cumbria Partnerships NHS Foundation Trust | Freeston M.H.,Northumbria University
Clinical Psychology Review | Year: 2011

The concept of external criticism has been associated with different aspects of Obsessive Compulsive phenomena. The various threads of evidence highlight the potential role of criticism within different areas of the cognitive model of Obsessive Compulsive Disorder (OCD) with often overlapping ideas. However, the fragmented nature of the findings makes it difficult to identify how or why criticism impacts on OCD. This review collates the existing findings and maps these onto the cognitive model of OCD to provide a better understanding of the potential role of criticism. It proposes criticism could play a role in OCD as a vulnerability factor, but also as a perpetuating factor. Furthermore potential research questions have been generated which could help inform future understanding. Future research should consider the complexity of the concept when defining criticism as well as developing methodological designs which could answer questions of causality. © 2011 Elsevier Ltd.

Skinner T.C.,University of Western Australia | Carey M.E.,University of Leicester | Cradock S.,Portsmouth Diabetes Center | Dallosso H.M.,University of Leicester | And 6 more authors.
Diabetic Medicine | Year: 2010

Aims To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Methods Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. Results The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18-22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. Conclusions The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes. © 2010 Diabetes UK.

PubMed | Sunderland Royal Hospital, Care + Wear and Newcastle upon Tyne Hospitals Foundation Trust
Type: Journal Article | Journal: Clinical rheumatology | Year: 2016

Musculoskeletal conditions are common in general practice, but clinicians express poor self confidence in dealing with them. Training in general practice relies on clinical exposure to a range of presentations in order to gain competence. It has been suggested that trainees are exposed to a different case mix from qualified general practices (GPs), due to seeing more minor illness and less chronic disease and that this may be responsible in part for their subsequent lack of confidence. The aims of this study were to analyse the case mix of musculoskeletal conditions encountered by general practice trainees and to compare this to the overall population consulting behaviour. This is a prospective observational study. Thirteen general practices in North East England were recruited. Musculoskeletal disorders encountered by 13 GP trainees (7 junior and 6 senior) were prospectively recorded using a handheld diary. Disorders were classified according to working diagnosis or body region if diagnosis was unclear. Musculoskeletal (MSK) disorders comprised 17 % of consultations, and the distribution of diagnoses of these was in proportion to epidemiological studies of MSK disorders in the UK as they present in primary care. Back pain was the most frequent label with 141 (29 %) consultations with a further 43 (9 %) for neck pain. Inflammatory arthritis accounted for the same number 43 (9 %). Individual joint problems were 115 (24 %) with knee being most common. A specific diagnosis was more likely to be applied when symptoms were more distal and less likely when axial. Trainees are exposed to the same spectrum of MSK disorders as are present in the population as a whole. Case mix does not appear to be a significant factor in low confidence levels in dealing with MSK disorders.

Care + Wear | Date: 2014-11-04

medical wearing apparel with antimicrobial and performance qualities, namely, shirts, pants, vests, jackets, lab coats, bras, tank tops and tights.


Care + Wear | Date: 2014-11-04

medical wearing apparel.

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