1,520 research outputs found
Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling
This article is made available through the Brunel Open Access Publishing Fund. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Introduction: Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis.
Methods: Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case.National Institute for Health Research
Health Technology Assessment (NIHR HTA) Programm
Proof of a conjecture of Polya on the zeros of successive derivatives of real entire functions
We prove Polya's conjecture of 1943: For a real entire function of order
greater than 2, with finitely many non-real zeros, the number of non-real zeros
of the n-th derivative tends to infinity with n. We use the saddle point method
and potential theory, combined with the theory of analytic functions with
positive imaginary part in the upper half-plane.Comment: 26 page
Permutable entire functions satisfying algebraic differential equations
It is shown that if two transcendental entire functions permute, and if one
of them satisfies an algebraic differential equation, then so does the other
one.Comment: 5 page
Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations
Background
Writing therapy to improve physical or mental health can take many forms. The most researched model of therapeutic writing (TW) is unfacilitated, individual expressive writing (written emotional disclosure). Facilitated writing activities are less widely researched.
Data sources
Databases including: MEDLINE, EMBASE, PsychINFO, Linguistics and Language Behavior Abstracts, AMED, and CINHAL were searched from inception to March 2013.
Review methods
Four TW practitioners provided expert advice. Study procedures were conducted by one reviewer and checked by a second. Randomised controlled trials (RCTs) and non-randomised comparative studies were included. Quality was appraised using the Cochrane risk of bias tool. Unfacilitated and facilitated TW studies were analysed separately under ICD-10 chapter headings. Meta-analyses were performed where possible using Revman 5.2. Costs were estimated from an NHS perspective and three cost-consequence case studies were prepared. Realist synthesis followed RAMESES guidelines.
Objectives
To review the clinical and cost-effectiveness of TW for people with long-term health conditions (LTCs) compared to no writing, or other controls, reporting any relevant clinical outcomes.
To conduct a realist synthesis to understand how TW might work, and for whom.
Results
From 14,658 unique citations, 284 full text papers were reviewed and 64 studies (58 RCTs) were included in the final effectiveness reviews. Five studies examined facilitated TW, these were extremely heterogeneous with unclear or high risk of bias, but suggested that facilitated TW interventions may be beneficial in individual LTCs.
Unfacilitated expressive writing was examined in 59 studies of variable, or unreported, quality. Overall there was very little or no evidence of any benefit reported in the following conditions (number of studies): HIV (six); breast cancer (eight); gynaecological and genitourinary cancers (five); mental health (five); asthma (four); psoriasis (three); chronic pain (four).
In inflammatory arthropathies (six) there was a reduction in disease severity (n= 191, standardised mean difference (SMD) - 0.61 [95% confidence intervals (95% CI) -0.96, -0.26]) in the short term on meta-analysis of four studies. For all other LTCs there was either no, or sparse, data with no, or inconsistent, evidence of benefit.
Meta-analyses conducted across all the LTCs provided no evidence that unfacilitated EW had any effect on depression at short term (n= 1,563, SMD -0.06, 95% CI -0.29 to 0.17, substantial heterogeneity), or long term (n= 778, SMD-0.04 95% CI -0.18 to 0.10, little heterogeneity) follow up, or on anxiety, physiological or biomarker-based outcomes.
One study reported costs, none reported cost-effectiveness, twelve reported resource use; meta-analysis suggested reduced medication use but no impact on health centre visits. Estimated costs of intervention were low, but there was insufficient evidence to judge cost-effectiveness.
Realist review findings suggested that facilitated TW is a complex intervention and group interaction contributes to the perception of benefit. It was unclear from the available data who might benefit most from facilitated TW.
Limitations
Difficulties with developing realist review programme theory meant that mechanisms operating during TW remain obscure.
Conclusions
Overall there is little evidence to support the effectiveness or cost-effectiveness of unfacilitated expressive writing interventions in people with LTCs. Further research focussed on facilitated TW in people with LTCs could be informative.The National Institute for Health Research Health Technology Assessment programme
Seasonal Toxicity Observed with Amphipods (Eohaustorius estuarius) at Paleta Creek, San Diego Bay, USA
To assess potential impacts on receiving systems, associated with storm water contaminants, laboratory 10âd amphipod (Eohaustorius estuarius) survival toxicity tests were performed using intact sediment cores collected from Paleta Creek (San Diego Bay, CA, USA) on 5 occasions between 2015 and 2017. The approach included depositionâassociated sediment particles collected from sediment traps placed at each of 4 locations during the 2015 to 2016 wet seasons. The bioassays demonstrated wet season toxicity, especially closest to the creek mouth, and greater mortality associated with particles deposited in the wet season compared with dry season samples. Grain size analysis of sediment trap material indicated coarser sediment at the mouth of the creek and finer sediment in the outer depositional areas. Contaminant concentrations of metals (Cd, Cu, Hg, Ni, Pb, and Zn) and organic compounds (polycyclic aromatic hydrocarbons [PAHs], polychlorinated biphenyls [PCBs], and pesticides) were quantified to assess possible causes of toxicity. Contaminant concentrations were determined in the top 5âcm of sediment and porewater (using passive samplers). Whereas metals, PAHs, and PCBs were rarely detected at sufficient concentrations to elicit a response, pyrethroid pesticides were highly correlated with amphipod toxicity. Summing individual pyrethroid constituents using a toxic unit approach suggested that toxicity to E. estuarius could be associated with pyrethroids. This unique test design allowed delineation of spatial and temporal differences in toxicity, suggesting that storm water discharge from Paleta Creek may be the source of seasonal toxicity. Environ Toxicol Chem 2019;39:229â239. © 2019 SETACPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152638/1/etc4619_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152638/2/etc4619.pd
Spanish medical studentsâ attitudes and views towards Mental Health and Psychiatry: a multicentric cross-sectional study.
Objective The aim of this study is to investigate the attitudes
towards mental illness and psychiatry among fifth year
Spanish medical students.
Methods The study included 171 students from three medical
schools located in different areas of Spain: CĂĄdiz; UCA (n=
113), Madrid; San Pablo-CEU (n=22), and Barcelona; UAB
(n=36). They responded, prior to their undergraduate medical
course in psychiatry, to the AMI questionnaire to measure the
attitudes towards mental illness and to Balonâs adapted questionnaire
to investigate their view towards psychiatry.
Results The students (93.4 %) had a positive attitude towards
mental illness (AMI). Attitudes towards psychiatry were fairly
positive with a few negative views, specifically regarding the
role of psychiatrists (items 11 and 13) and the prestige of the
specialty (item 16). There were some statistically significant
differences between the three medical schools in the perception
of psychiatry as a medical discipline. A better attitude
towards mental illness was associated with a better view of the
overall merits of psychiatry.
Conclusions Findings suggest that Spanish medical students
do not have a negative attitude towards mental illness and they
have a good perception of psychiatry, although there are still
some misconceptions about this specialty. These studentâs
attitudes could favor an appropriate management of patients
suffering from mental illness
An Anglo-Saxon execution cemetery at Walkington Wold, Yorkshire
This paper presents a re-evaluation of a cemetery excavated over
30 years ago at Walkington Wold in east Yorkshire. The cemetery is
characterized by careless burial on diverse alignments, and by the fact that
most of the skeletons did not have associated crania. The cemetery has been
variously described as being the result of an early post-Roman massacre, as
providing evidence for a âCelticâ head cult or as an Anglo-Saxon execution
cemetery. In order to resolve the matter, radiocarbon dates were acquired and
a re-examination of the skeletal remains was undertaken. It was confirmed that
the cemetery was an Anglo-Saxon execution cemetery, the only known example
from northern England, and the site is set into its wider context in the paper
On the nature of the FBS blue stellar objects and the completeness of the Bright Quasar Survey. II
In Paper I (Mickaelian et al. 1999), we compared the surface density of QSOs
in the Bright Quasar Survey (BQS) and in the First Byurakan Survey (FBS) and
concluded that the completeness of the BQS is of the order of 70% rather than
30-50% as suggested by several authors. A number of new observations recently
became available, allowing a re-evaluation of this completeness. We now obtain
a surface density of QSOs brighter than B = 16.16 in a subarea of the FBS
covering ~2250 deg^2, equal to 0.012 deg^-2 (26 QSOs), implying a completeness
of 53+/-10%.Comment: LaTeX 2e, 11 pages, 3 tables and 3 figures (included in text). To
appear in Astrophysics. Uses a modified aaspp4.sty (my_aaspp4.sty), included
in packag
Modeled microbial dynamics explain the apparent temperature sensitivity of wetland methane emissions
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