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Moffitt J.,James Cook University | Bostock J.,Psychological Services | 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. Source

Bradbury M.,Northern Gynecological Oncology Center | Founta C.,Northern Gynecological Oncology Center | Taylor W.,Care + Wear | Kucukmetin A.,Northern Gynecological Oncology Center | 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. Source

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. Source

Yeo J.,Gateshead Health NHS Foundation Trust | Yeo J.,Care + Wear | Steven A.,Northumbria University | Pearson P.,Northumbria University | Price C.,Northumbria Healthcare NHS Foundation Trust
Advances in Health Sciences Education | Year: 2010

Education has moved from teacher to student-centred practices. Increasing emphasis is placed on 'life-long' learning in the context of a rapidly changing knowledge base. Self-evaluation is seen as one strategy to facilitate student-centred continuous professional development. The literature, however, suggests that learners' ability to self-assess is mixed, and little is known regarding how students perform self-assessment. This study focussed on senior nurses undertaking a scenario-based clinical skills course. Learners were asked to self-evaluate several times during the course. This research explored the influences on using the self-evaluation exercise. The study drew upon grounded theory methodology and was influenced by constructionist and postmodernist theories. Three methods of data collection were used: semi-structured interviews, observation of supervision sessions and recording of the numerical self-evaluation ratings. Multiple interviews with students (n = 14) and the educational supervisor (n = 1) were conducted. Thematic analysis and data collection were conducted iteratively. The study found that feeling confident and stating that confidence were not necessarily the same. Feeling confident was complex, influenced by changing perceptions of clinical skills and credibility. Changing frames of reference were used to judge feelings of confidence. Stating confidence appeared to be socially negotiated, influenced by social acceptability considerations such as modesty and the need to show progress over time. The discourses of empowerment and surveillance were influential and self-evaluation is discussed using Foucault's theory of governmentality, illustrating how learners can be both empowered and controlled through self-evaluation. Further consideration of the socially constructed nature of self-evaluations would benefit both educational practice and future research. © 2009 Springer Science+Business Media B.V. Source

Lobaz S.,Northern General Hospital | Clymer M.,Northern General Hospital | Sammut M.,Care + Wear
Clinical Medicine Insights: Therapeutics | Year: 2014

Since its first human use in 2005, the γ-cyclodextrin sugammadex (Org 25969) has had the potential to become the reversal agent of choice, for rocuronium- or vecuronium-induced neuromuscular blockade. Sugammadex binds to the aminosteroid neuromuscular blocker, encapsulating it and extracting it from the neuromuscular junction, effectively ceasing activity and allowing neuromuscular transmission to recover rapidly. Phases I-III and subsequent trials have found sugammadex to be safe and effective in a wide range of doses and for the reversal of a range of depth of muscle relaxation in healthy volunteers and a variety of disease states. Sugammadex use may allow refinement of anesthetic practice and improvement in surgical conditions, through the maintenance of deep neuromuscular blockade right to the end of surgery, with subsequent rapid reversal. Debate remains about the use of sugammadex in the treatment of rocuronium anaphylaxis and airway emergencies. The high price of sugammadex currently prohibits its routine use, but if the price falls, after expiry of its patent, it may become cost-effective as a readily available agent in certain specific clinical situations. Serious adverse reac- tions have occurred in less than 1% of patients and are most commonly because of hypersensitivity. No deaths have been reported, but caution is advised in neonates, pediatrics, and pregnancy where data are lacking. © the authors. Source

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