Psychological management for head and neck cancer patients : United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G)Publisher PDFPeer reviewe

An experimental investigation of an axisymmetric jet in a coflowing airstream

The flow development of an axisymmetric jet exhausting into a moving airstream has been studied. The jet has a Reynolds number of 22,600, and the ratio of the jet velocity to the wind tunnel velocity is 5.1 to 1. The flow field of the axisymmetric jet was examined at locations varying from approximately zero to eight diameters downstream of the orifice. Of primary concern at each downstream location was the mapping of the one point statistical properties of the flow, including mean velocity, turbulent intensity, and intermittency. Autocorrelations and power spectral density curves were determined for both the fluctuating velocity field and the concentration signal at various distances from the jet's center line for different downstream locations. A laser Doppler velocimeter, using a phase locked loop processor, was used to make the desired velocity field measurements which were compared with hot wire anemometer and pressure probe data

The interaction of oxygen atoms with solid surfaces at eV energies Annual status report, 1 Jun. 1968 - 31 May 1969

Interaction of oxygen atoms with solid surfaces at eV energie

The sexual health needs of looked after young people; findings from qualitative interviews led through public health and health psychology.

Background - Looked after young people (LAYP) have poorer sexual health outcomes than their peers. However, research seldom examines the health needs of, or intervenes with, this group. The aim of the current study was to identify LAYP's perceived sexual health needs and explore sources of sexual health information, knowledge levels, concerns and service preferences. Methods - Looked after young people within Fife, Scotland, were recruited through their workers and carers to participate in qualitative semi-structured interviews. Those aged 12–19 years were targeted for recruitment. National Health Services ethics approval was granted. Thematic analysis was conducted using NVivo. Results - Interviews were conducted with 10 LAYP. Key themes included gaps in knowledge, and gaps between knowledge and behaviour. Being ‘looked after’ may have negative consequences on knowledge, sources of support and safer sex. A flexible, one-to-one service, aimed at several lifestyle issues, not solely sexual health, was preferred by respondents. Conclusion - Looked after young people require support to bridge the gap between knowledge and behaviour and several theories relevant to the findings have been identified. Participants desired more support around a range of health issues, which may come from school, workers and carers, as well as health professionals. Further research examining effective interventions with this group is crucial to improve outcomes

Quality of life considerations in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It identifies the current evidence base and role of health-related quality of life assessment for this group of patients.Publisher PDFPeer reviewe

The importance of acknowledgement of emotions in routine patient psychological assessment:The example of the dental setting

This work was funded by the Chief Scientist Office, Scotland under their Clinical Academic Fellowship Scheme (grant number: CAF/07/02).Objective:  To investigate, by means of a conceptual model, the effect of dental staff engaging with their patients who share their level of dental anxiety in a short screening questionnaire. Methods :  Three consecutive studies based in the UK primary dental care services were conducted. Each study adopted a randomised group design to focus on the possible influence on patient state anxiety of the dentist becoming aware of their patients' dental anxiety from the self-reports of the Modified Dental Anxiety Scale (MDAS). Results :  A consistent finding in the first two studies was that the presentation of MDAS score sheet to the dentist was effective in reducing patient state anxiety when leaving the surgery. The third study provided supportive evidence that a more permanent anxiolytic effect of the presentation of the MDAS to the dentist was associated with the dentist responding openly to their patient about the fears expressed. Conclusion:  The active engagement of dental staff in the formal presentation of dental anxiety screening confers a reliable benefit to dentally anxious patients. Clinical implications:   Anxiety assessments in clinical service may give patients significant relief when staff acknowledge and engage patients when presented with their self-reported ratings.PostprintPeer reviewe

Virtual Reality Relaxation to Decrease Dental Anxiety:Immediate Effect Randomized Clinical Trial

Introduction: Dental anxiety is common and causes symptomatic use of oral health services. Objectives: The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. Methods: A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. Results: Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (β = −0.75, P < .001, for MDAS total score; β = −0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (β = −1.08, P < .001) and treatment-related dental anxiety (β = −0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (β = −0.217, P < .026) and women (β = −0.498, P < .001). Conclusion: Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). Knowledge Transfer Statement: Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.Publisher PDFPeer reviewe

Unsteady loads due to propulsive lift configurations. Part B: Pressure and velocity measurements in a three dimensional wall jet

The effects of increasing the velocity ratio, lambda sub j were explored. The quantities measured include the width of the mixing region, the mean velocity field, turbulent intensities and time scales. In addition, wall and static pressure velocity correlations and coherences are presented. The velocity measurements were made using a laser Doppler velocimeter with a phase locked loop processor. The fluctuating pressures were monitored using condenser type microphones

Decision support in addiction: the development of an e-health tool to assess and prevent risk of fatal overdose. The ORION project

Background and Objective. The application of e-health technology to the field of substance use disorders is at a relatively early stage, and methodological quality is still variable. Few have explored the extent of utilization of communication technology in exploring risk perception by patients enrolled in substance abuse services. The Overdose RIsk InfOrmatioN (ORION) project is a European Commission funded programme, aimed to develop and pilot an e-health psycho-educational tool to provide information to drug using individuals about the risks of suffering a drug overdose. Methods. In this article we report on phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) of the ORION project. Results. The development of ORION e-health tool underlined the importance of an evidence-based intervention aimed in obtaining reliable evaluation of risk. The ORION tool supported a decision making process aimed at influencing the substance users' self-efficacy and the degree to which the substance users' understand risk factors. Therefore its innovative power consisted in translating risks combination into a clear estimation for the user who will then appear more likely to be interested in his/her risk perception. Conclusion. Exploratory field testing and validation confirmed the next stage of evaluation, namely, collection of routine patient samples in study clinics. The associations between risk perception of overdose, engagement with the ORION tool and willingness to alter overdose risk factors, in a clinical setting across various EU member states will further confirm the ORION tool's generalisability and effectiveness.PostprintPeer reviewe

Neuropsychological functioning and chronic methadone use:a systematic review and meta-analysis

The authors would like to thank the NHS Fife Research and Development Department for supporting this project.Introduction: There is a presumption that neurocognition is commonly impaired in chronicmethadone exposed individuals (CM) when compared with healthy controls (HP).Additionally, it remains unclear if short term (< 1 year) abstinence (AP) is associated with an altered cognitive profile when compared with CM. Method: A random effect model approach was used on data assembled into the Comprehensive Meta-Analysis programme.Cohen’s d effect sizes and a significance levels of p<0.01 were calculated for each domain. Results: Data from a total cohort of 1063 CM, 412 AP and 879 HP participants, from 23 independent studies indicate global impairments in neurocognitive function in CM relative to HP participants. The smaller body of evidence comparing CM to AP participants is inconclusive. Conclusion: Methodological issues such as small sample sizes, heterogeneity and poor quality limited the interpretation of the results and does not address whether the observed impairments reflect co-morbid functioning, methadone-related sedation and/or other factors. Only higher quality longitudinal studies will permit confident interpretation of the results observed in this meta-analysis.PostprintPeer reviewe