Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation

Background: Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems. Methods: Patients with psychosocial problems from 13 general practices in London were referred to a GPCMHW Community Link scheme providing information and support to access voluntary and community resources. Patient satisfaction, mental health and social outcomes, and use of primary care resources, were evaluated. Results: 108 patients consented to take part in the study. At three-month follow-up, 63 (58%) had made contact with a community service identified as suitable for their needs. Most were satisfied with the help provided by the GPCMHW in identifying and supporting access to a suitable service. There was a reduction in the number of patients with a probable mental health problem on the GHQ-12 from 83% to 52% (difference 31% (95% CI, 17% – 44%). Social adjustment improved and frequencies of primary care consultations and of prescription of psychotropic medications were reduced. Conclusion: Graduates with limited training in mental health and no prior knowledge of local community resources can help patients with psychosocial problems access voluntary and community services, and patients value such a scheme. There was some evidence of effectiveness in reducing psychosocial and mental health problems

Chiral dynamics in form factors, spectral-function sum rules, meson-meson scattering and semilocal duality

In this work, we perform the one-loop calculation of the scalar and pseudoscalar form factors in the framework of U(3) chiral perturbation theory with explicit tree level exchanges of resonances. The meson-meson scattering calculation from Ref.[1] is extended as well. The spectral functions of the nonet scalar-scalar (SS) and pseudoscalar-pseudoscalar (PP) correlators are constructed by using the corresponding form factors. After fitting the unknown parameters to the scattering data, we discuss the resonance content of the resulting scattering amplitudes. We also study spectral-function sum rules in the SS-SS, PP-PP and SS-PP sectors as well as semi-local duality from scattering. The former relate the scalar and pseudoscalar spectra between themselves while the latter mainly connects the scalar spectrum with the vector one. Finally we investigate these items as a function of Nc for Nc > 3. All these results pose strong constraints on the scalar dynamics and spectroscopy that are discussed. They are successfully fulfilled by our meson-meson scattering amplitudes and spectral functions.Comment: 45 pages, 17 figures and 4 tables. To match the published version in PRD: a new paragraph is added in the Introduction and two new references are include

Forward dispersion relations and Roy equations in pi-pi scattering

We review results of an analysis of pipi interactions in S, P and D waves for two-pion effective mass from threshold to about 1.4 GeV. In particular we show a recent improvement of this analysis above the K anti-K threshold using more data for phase shifts and including the S0 wave inelasticity from pipi -> K anti-K. In addition, we have improved the fit to the f2(1270) resonance and used a more flexible P wave parametrization above the K anti-K threshold and included an estimation of the D2 wave inelasticity. The better accuracy thus achieved also required a refinement of the Regge analysis above 1.42 GeV. We have checked that the pipi scattering amplitudes obtained in this approach satisfy remarkably well forward dispersion relations and Roy's equations.Comment: 6 pages, invited talk to the IV International Conference on Quarks and Nuclear Physics QNP06, Madrid 5th-10th June 200

Resonances from meson-meson scattering in U(3) CHPT

In this work, the complete one loop calculation of meson-meson scattering amplitudes within U(3)\otimes U(3) chiral perturbation theory with explicit resonance states is carried out for the first time. Partial waves are unitarized from the perturbative calculation employing a non-perturbative approach based on the N/D method. Once experimental data are reproduced in a satisfactory way we then study the resonance properties, such as the pole positions, corresponding residues and their N_C behaviors. The resulting N_C dependence is the first one in the literature that takes into account the fact that the \eta_1 becomes the ninth Goldstone boson in the chiral limit for large N_C. Within this scheme the vector resonances studied, \rho(770), K^*(892) and \phi(1020), follow an N_C trajectory in agreement with their standard \bar{q}q interpretation. The scalars f_0(1370), a_0(1450) and K^*(1430) also have for large N_C a \bar{q}q pole position trajectory and all of them tend to a bare octet of scalar resonances around 1.4 GeV. The f_0(980) tends asymptotically to the bare pole position of a singlet scalar resonance around 1 GeV. The \sigma, \kappa and a_0(980) scalar resonances have a very different N_C behavior. The case of the \sigma resonance is analyzed with special detail.Comment: 50 pages, 15 figures, 1 table. Enlarged version with more detail comparisons with previous results in the literature. To match with accepted version for publicatio

Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation

<p>Abstract</p> <p>Background</p> <p>Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems.</p> <p>Methods</p> <p>Patients with psychosocial problems from 13 general practices in London were referred to a GPCMHW Community Link scheme providing information and support to access voluntary and community resources. Patient satisfaction, mental health and social outcomes, and use of primary care resources, were evaluated.</p> <p>Results</p> <p>108 patients consented to take part in the study. At three-month follow-up, 63 (58%) had made contact with a community service identified as suitable for their needs. Most were satisfied with the help provided by the GPCMHW in identifying and supporting access to a suitable service. There was a reduction in the number of patients with a probable mental health problem on the GHQ-12 from 83% to 52% (difference 31% (95% CI, 17% – 44%). Social adjustment improved and frequencies of primary care consultations and of prescription of psychotropic medications were reduced.</p> <p>Conclusion</p> <p>Graduates with limited training in mental health and no prior knowledge of local community resources can help patients with psychosocial problems access voluntary and community services, and patients value such a scheme. There was some evidence of effectiveness in reducing psychosocial and mental health problems.</p

Connecting communities: A qualitative investigation of the challenges in delivering a national social prescribing service to reduce loneliness

Loneliness is a global public health concern linked to a range of negative health outcomes (Cacioppo & Cacioppo, 2018. The Lancet. 391(10119), 426). Internationally, this has led to the development of a number of interventions, but these are rarely implemented or evaluated on a large scale. This paper is one of the first of its kind to describe elements of an evaluation of a large‐scale national social prescribing scheme to reduce loneliness, deploying individual link workers to signpost people to community activities. Reporting on findings from interviews with staff (n = 25 of which 6 were repeat interviews) and volunteers (n = 9) between October 2017 and December 2018 in localities across the United Kingdom. We reflect on the complexities of the link worker role, the challenges of service delivery and the importance of community infrastructure. There was evidence that highly skilled link workers who had developed positive relationships with providers and service‐users were key to the success of the intervention. As well as providing an effective liaison and signposting function, successful link workers tailored the national programme to local need to proactively address specific gaps in existing service provision. For social prescribing services to be successful and sustainable, commissioners must consider additional funding of community infrastructure

On the precision of chiral-dispersive calculations of ππ\pi\pi scattering

We calculate the combination $2a_0^{(0)}-5a_0^{(2)}$ (the Olsson sum rule) and the scattering lengths and effective ranges $a_1$, $a_2^{(I)}$ and $b_1$, $b_2^{(I)}$ dispersively (with the Froissart--Gribov representation) using, at low energy, the phase shifts for $\pi\pi$ scattering obtained by Colangelo, Gasser and Leutwyler (CGL) from the Roy equations and chiral perturbation theory, plus experiment and Regge behaviour at high energy, or directly, using the CGL parameters for $a$s and $b$s. We find mismatch, both among the CGL phases themselves and with the results obtained from the pion form factor. This reaches the level of several (2 to 5) standard deviations, and is essentially independent of the details of the intermediate energy region ($0.82\leq E\leq 1.42$ GeV) and, in some cases, of the high energy behaviour assumed. We discuss possible reasons for this mismatch, in particular in connection with an alternate set of phase shifts.Comment: Version to appear in Phys. Rev. D. Graphs and sum rule added. Plain TeX fil

CH-01 is a hypoxia-activated prodrug that sensitizes cells to hypoxia/reoxygenation through inhibition of Chk1 and aurora A

The increased resistance of hypoxic cells to all forms of cancer therapy presents a major barrier to the successful treatment of most solid tumors. Inhibition of the essential kinase Checkpoint kinase 1 (Chk1) has been described as a promising cancer therapy for tumors with high levels of hypoxia-induced replication stress. However, as inhibition of Chk1 affects normal replication and induces DNA damage, these agents also have the potential to induce genomic instability and contribute to tumorigenesis. To overcome this problem, we have developed a bioreductive prodrug, which functions as a Chk1/Aurora A inhibitor specifically in hypoxic conditions. To achieve this activity, a key functionality on the Chk1 inhibitor (CH-01) is masked by a bioreductive group, rendering the compound inactive as a Chk1/Aurora A inhibitor. Reduction of the bioreductive group nitro moiety, under hypoxic conditions, reveals an electron-donating substituent that leads to fragmentation of the molecule, affording the active inhibitor. Most importantly, we show a significant loss of viability in cancer cell lines exposed to hypoxia in the presence of CH-01. This novel approach targets the most aggressive and therapy-resistant tumor fraction while protecting normal tissue from therapy-induced genomic instability. © 2013 American Chemical Society

Meson-meson scattering within one loop Chiral Perturbation Theory and its unitarization

We present the complete one-loop calculation of all the two meson scattering amplitudes within the framework of SU(3) Chiral Perturbation Theory, which includes pions, kaons and the eta. In addition, we have unitarized these amplitudes with the coupled channel Inverse Amplitude Method, which ensures simultaneously the good low energy properties of Chiral Perturbation Theory and unitarity. We show how this method provides a remarkable description of meson-meson scattering data up to 1.2 GeV including the scattering lengths and the generation of seven light resonances, which is consistent with previous determination of the chiral parameters. Particular attention is paid to discuss the differences and similarities of this work with previous analysis in the literature.Comment: 20 pages, 5 figures. Comments on sigma, kappa and eta', as well as some references added. Final version to appear in Phys.Rev.

A low-lying scalar meson nonet in a unitarized meson model

A unitarized nonrelativistic meson model which is successful for the description of the heavy and light vector and pseudoscalar mesons yields, in its extension to the scalar mesons but for the same model parameters, a complete nonet below 1 GeV. In the unitarization scheme, real and virtual meson-meson decay channels are coupled to the quark-antiquark confinement channels. The flavor-dependent harmonic-oscillator confining potential itself has bound states epsilon(1.3 GeV), S(1.5 GeV), delta(1.3 GeV), kappa(1.4 GeV), similar to the results of other bound-state qqbar models. However, the full coupled-channel equations show poles at epsilon(0.5 GeV), S(0.99 GeV), delta(0.97 GeV), kappa(0.73 GeV). Not only can these pole positions be calculated in our model, but also cross sections and phase shifts in the meson-scattering channels, which are in reasonable agreement with the available data for pion-pion, eta-pion and Kaon-pion in S-wave scattering.Comment: A slightly revised version of Zeitschrift fuer Physik C30, 615 (1986