521 research outputs found

    Preventing and responding to depression, self-harm, and suicide in older people living in long term care settings: a systematic review

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    Abstract Objective: The well documented demographic shift to an aging population means that more people will in future be in need of long term residential care. Previous research has reported an increased risk of mental health issues and suicidal ideation among older people living in residential care settings. However, there is little information on the actual prevalence of depression, self-harm, and suicidal behavior in this population, how it is measured and how care homes respond to these issues. Method: This systematic review of international literature addressed three research questions relating to; the prevalence of mental health problems in this population; how they are identified and; how care homes try to prevent or respond to mental health issues. Results: Findings showed higher reported rates of depression and suicidal behavior in care home residents compared to matched age groups in the community, variation in the use of standardised measures across studies and, interventions almost exclusively focused on increasing staff knowledge about mental health but with an absence of involvement of older people themselves in these programmes. Conclusion: We discuss the implications of these findings in the context of addressing mental health difficulties experienced by older people in residential care and future research in this area

    John Askin Papers Volume 2: 1796-1820

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    Burton Historical Records, volume 2https://scholar.uwindsor.ca/swoda-windsor-region/1046/thumbnail.jp

    John Askin Papers Volume 1: 1747-1795

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    Burton historical records, volume 1https://scholar.uwindsor.ca/swoda-windsor-region/1045/thumbnail.jp

    Using stated preferences to estimate the impact and cost-effectiveness of new HIV prevention products in South Africa

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    This thesis aims to deepen our understanding of the impact and cost-effectiveness of new HIV prevention products in South Africa. It explores how stated preferences for products vary across groups, and uses these data to estimate their cost-effectiveness in different populations. Also, it seeks to predict how products themselves may change the economics of sex work and lead to risk compensation among female sex workers (FSWs). The validity of predicting behaviours through the use of stated preference methods is explored through a systematic review and meta-analysis. By integrating methods from the fields of health economics and infectious disease modelling, this thesis aims to give better predictions of the potential impact and cost-effectiveness of HIV prevention products. This is a paper-style thesis which incorporates seven papers and a short correspondence publication, linked by short pieces of supporting material. The thesis finds that products offering effective multipurpose protection would be cost-effective among younger female groups and FSWs. However, it predicts that products could change the economics of sex work, potentially leading to risk compensation among FSWs. A dynamic transmission model is used to show how this risk compensation could meaningfully reduce product impact. This thesis demonstrates the value of combining economic and epidemiological modelling methods to explore preventative behaviours in HIV. Further work is needed to assess the external validity of these methods

    Pulmonary nodules and CT screening: the past, present and future

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    Lung cancer screening has come a long way since the early studies with chest X-ray. Advancing technology and progress in the processing of images have enabled low dose CT to be tried and tested, and evidence suggests its use can result in a significant mortality benefit. There are several issues that need refining in order to successfully implement screening in the UK and elsewhere. Some countries have started patchy implementation of screening and there is increased recognition that the appropriate management of pulmonary nodules is crucial to optimise benefits of early detection, while reducing harm caused by inappropriate medical intervention. This review summarises and differentiates the many recent guidelines on pulmonary nodule management, discusses screening activity in other countries and exposes the present barriers to implementation in the UK

    Mapping the spectrum of psychological and behavioural responses to low-dose CT lung cancer screening offered within a Lung Health Check

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    BACKGROUND: Research on the psychological impact of low-dose computed tomography (LDCT) lung cancer screening has typically been narrow in scope and restricted to the trial setting. OBJECTIVE: To explore the range of psychological and behavioural responses to LDCT screening offered as part of a Lung Heath Check (LHC), including lung cancer risk assessment, spirometry testing, a carbon monoxide reading and smoking cessation advice. METHODS: Semi-structured interviews were carried out with 28 current and former smokers (aged 60-75), who had undergone LDCT screening as part of a LHC appointment and mostly received an incidental or indeterminate result (n = 23). Framework analysis was used to map the spectrum of responses participants had across the LHC appointment and screening pathway, to their LDCT results and to surveillance. RESULTS: Interviewees reported a diverse range of both positive and negative psychological responses, beginning at invitation and spanning the entire LHC appointment (including spirometry) and LDCT screening pathway. Similarly, positive behavioural responses extended beyond smoking cessation to include anticipated implications for other cancer prevention and early detection behaviours, such as symptom presentation. Individual differences in responses appeared to be influenced by smoking status and LDCT result, as well as modifiable factors including perceived risk and health status, social support, competing priorities, fatalism and perceived stigma. CONCLUSIONS: The diverse ways in which participants responded to screening, both psychologically and behaviourally, should direct a broader research agenda to ensure all stages of screening delivery and communication are designed to promote well-being, motivate positive behaviour change and maximize patient benefit

    Framing and signalling effects of taxes on sugary drinks: A discrete choice experiment among households in Great Britain

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    This is the final version. Available on open access from Wiley via the DOI in this record. Taxes on sugar-sweetened beverages (SSBs) are in place in many countries to combat obesity with emerging evidence that these are effective in reducing purchases of SSBs. In this study, we tested whether signalling and framing the price increase from an SSB tax explicitly as a health-related, earmarked measure reduces the demand for SSBs more than an equivalent price increase. We measured the demand for non-alcoholic beverages with a discrete choice experiment (DCE) administered online to a randomly selected group of n = 603 households with children in Great Britain (GB) who regularly purchase SSBs. We find a suggestive evidence that a price increase leads to a larger reduction in the probability of choosing SSBs when it is signalled as a tax and framed as a health-related and earmarked policy. Respondents who did not support a tax on SSBs, who were also more likely to choose SSBs in the first place, were on average more responsive to a price increase framed as an earmarked tax than those who supported the tax. The predictive validity of the DCE, to capture preferences for beverages, was confirmed using actual purchase data. The findings imply that a well-signalled and earmarked tax on SSBs could improve its effectiveness at reducing the demand.Economic and Social Research Council (ESRC
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