Adapting Cognitive Behavioural Therapy Interventions for Anxiety or Depression to Meet the Needs of People with Long-term Physical Health Conditions: A Mixed-Methods Study

Objective(s). An increasing demand exists for psychological interventions to increase recovery from depression and anxiety in people with long-term physical health conditions (LTCs). Guided self-help (GSH) may meet this need, however, there is limited evidence of GSH’s appropriateness for people with LTCs. Design. A mixed-methods study using qualitative interviews with people with stroke and Chronic Obstructive Pulmonary Disease (COPD), and a quantitative survey of professionals who support guided self-help, explored opinions about whether self-help is appropriate, and whether suggested adaptations varied across LTCs. Results. Opinions varied about the appropriateness of standard self-help and adaptations required. Illness beliefs may help explain differences between the two LTCs and individual interviewees. The majority of professionals surveyed felt competent supporting people with LTCs, and reported having access to appropriate self-help material. Conclusions. Recommendations for improving the appropriateness of contents of guided self-help for people with LTCs are provided. Supporting professionals need relevant knowledge and skills to integrate information about the LTC into the intervention, and offer flexible, personalised delivery to support participation

An exploration of how young people and parents use online support in the context of living with cystic fibrosis

Background: There is increasing recognition of the Internet's potential role in providing information and support for people living with long-term conditions. However, how young people and parents use online forms of self-care support in the context of living with childhood chronic illness has been under-researched. Objective: To explore how online peer support is used by young people and parents to support self-care in relation to cystic fibrosis (CF). Setting and participants: Online forum for young people and parents based on a CF charity website. A total of 279 individuals participated in the forum during the study. Design: An online ethnographical approach, involving observing, downloading and analysing discussion group postings. All postings made over a random 4-month period were included (151 discussion threads). Results: The online setting enabled a physically disconnected group to connect and create a safe space to collectively share experiences and receive support to manage and live with cystic fibrosis. Participants exchanged experientially derived advice and views on how to manage treatments, emotions, relationships, identity and support from services. While parents sought information and support on managing specific therapies/services and ways of maintaining their child's health, the information and support young people desired appeared to be more directed at how to 'fit' CF into their everyday lives. Discussion and conclusions: Online support groups appear to supplement professional support in relation to self-management. They enable young people and parents to share experiences, feelings and strategies for living with long-term conditions with peers and develop the expertise to empower them in interactions with health-care professionals

Numerical examinations of energy absorption in simplified spondylodesis models

A simplified model for spondylodesis, ie fixation of vertebrae by osteosynthesis, is developed for virtual magnetic resonance imaging (MRI) examinations to numerically calculate energy absorption. This paper presents results of calculated energy absorption in body tissue surrounding titanium rod implants. In general each wire or rod behaves like an antenna in electromagnetic fields. The specific absorption rate (SAR) profile describes dependence of implant size. SAR hotspots appear near the rod edges. Depending of the size of implant fixation SAR is 62%(small fixation) up to 90.95%(large fixation) higher than without implants. In addition, local SAR profile displays local dependency on tissue: SAR is lower between the vertebrae

Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging

Metallic implants in magnetic resonance imaging (MRI) are a potential safety risk since the energy absorption may increase temperature of the surrounding tissue. The temperature rise is highly dependent on implant size. Numerical examinations can be used to calculate the energy absorption in terms of the specific absorption rate (SAR) induced by MRI on orthopaedic implants. This research presents the impact of titanium osteosynthesis spine implants, called spondylodesis, deduced by numerical examinations of energy absorption in simplified spondylodesis models placed in 1.5 T and 3.0 T MRI body coils. The implants are modelled along with a spine model consisting of vertebrae and disci intervertebrales thus extending previous investigations [1], [2]. Increased SAR values are observed at the ends of long implants, while at the center SAR is significantly lower. Sufficiently short implants show increased SAR along the complete length of the implant. A careful data analysis reveals that the particular anatomy, i.e. vertebrae and disci intervertebrales, has a significant effect on SAR. On top of SAR profile due to the implant length, considerable SAR variations at small scale are observed, e.g. SAR values at vertebra are higher than at disc positions

Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging

Metallic implants in magnetic resonance imaging (MRI) are a potential safety risk since the energy absorption may increase temperature of the surrounding tissue. The temperature rise is highly dependent on implant size. Numerical examinations can be used to calculate the energy absorption in terms of the specific absorption rate (SAR) induced by MRI on orthopaedic implants. This research presents the impact of titanium osteosynthesis spine implants, called spondylodesis, deduced by numerical examinations of energy absorption in simplified spondylodesis models placed in 1.5 T and 3.0 T MRI body coils. The implants are modelled along with a spine model consisting of vertebrae and disci intervertebrales thus extending previous investigations [1], [2]. Increased SAR values are observed at the ends of long implants, while at the center SAR is significantly lower. Sufficiently short implants show increased SAR along the complete length of the implant. A careful data analysis reveals that the particular anatomy, i.e. vertebrae and disci intervertebrales, has a significant effect on SAR. On top of SAR profile due to the implant length, considerable SAR variations at small scale are observed, e.g. SAR values at vertebra are higher than at disc positions

Numerical examinations of simplified spondylodesis models concerning energy absorption in magnetic resonance imaging

Metallic implants in magnetic resonance imaging (MRI) are a potential safety risk since the energy absorption may increase temperature of the surrounding tissue. The temperature rise is highly dependent on implant size. Numerical examinations can be used to calculate the energy absorption in terms of the specific absorption rate (SAR) induced by MRI on orthopaedic implants. This research presents the impact of titanium osteosynthesis spine implants, called spondylodesis, deduced by numerical examinations of energy absorption in simplified spondylodesis models placed in 1.5 T and 3.0 T MRI body coils. The implants are modelled along with a spine model consisting of vertebrae and disci intervertebrales thus extending previous investigations [1], [2]. Increased SAR values are observed at the ends of long implants, while at the center SAR is significantly lower. Sufficiently short implants show increased SAR along the complete length of the implant. A careful data analysis reveals that the particular anatomy, i.e. vertebrae and disci intervertebrales, has a significant effect on SAR. On top of SAR profile due to the implant length, considerable SAR variations at small scale are observed, e.g. SAR values at vertebra are higher than at disc positions