235 research outputs found
Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies
Objectives:
This study aimed to describe the recovery journeys of people with a history of recurrent depression who took part in a psychosocial programme designed to teach skills to prevent depressive relapse (mindfulness-based cognitive therapy (MBCT)), alongside maintenance antidepressant medication (ADM).
Design:
A qualitative study embedded within a multicentre, single blind, randomised controlled trial (the PREVENT trial).
Setting:
Primary care urban and rural settings in the UK. Participants 42 people who participated in the MBCT arm of the parent trial were purposively sampled to represent a range of recovery journeys.
Interventions:
MBCT involves eight weekly group sessions, with four refresher sessions offered in the year following the end of the programme. It was adapted to offer bespoke support around ADM tapering and discontinuation.
Methods:
Written feedback and structured in-depth interviews were collected in the 2 years after participants undertook MBCT. Data were analysed using thematic analysis and case studies constructed to illustrate the findings.
Results:
People with recurrent depression have unique recovery journeys that shape and are shaped by their pharmacological and psychological treatment choices. Their journeys typically include several over-arching themes: (1) beliefs about the causes of depression, both biological and psychosocial; (2) personal agency, including expectations about their role in recovery and treatment; (3) acceptance, both of depression itself and the recovery journey; (4) quality of life; (5) experiences and perspectives on ADM and ADM tapering-discontinuation; and (6) the role of general practitioners, both positive and negative.
Conclusions:
People with recurrent depression describe unique, complex recovery journeys shaped by their experiences of depression, treatment and interactions with health professionals. Understanding how several themes coalesce for each individual can both support their recovery and treatment choices as well as health professionals in providing more accessible, collaborative, individualised and empowering care.
:Trial registration number: Clinical trial number ISRCTN26666654; post results.</p
The end of the beginning? Taking forward local democratic renewal in the post-referendum North East.
This article draws upon the author’s commissioned research on the nature of regional governance following the 2004 Referendum in the North East on elected regional assemblies. The article aimed to both capture these views and to assess how the ‘No vote in the referendum has impacted on subsequent developments in sub-national governance. The article provides both an empirical overview of recent developments and engages with the wider conceptual debates on democratic renewal. The arguments covered in this output are aimed at both academic and practitioner audiences, and have been also disseminated at regional and national conferences
Language and social/emotional problems identified at a universal developmental assessment at 30 months
Non peer reviewedPublisher PD
Supporting children’s social and emotional well-being in the early years: an exploration of practitioners’ perceptions
Children’s social and emotional well-being can be supported through their experiences of early years education to promote positive life-long outcomes. This study explored the views of 10 early years practitioners in relation to supporting children’s social and emotional well-being. Data was gathered using semi-structured interviews and analysed using thematic analysis. Themes were explored in relation to practitioners’ understanding of ‘social and emotional well-being’ as well as their views on training opportunities in this area. The findings identified how early years practitioners conceptualize social and emotional well-being and highlighted the complexities and intricacies of the parent-practitioner relationship in the early years. The emotional well-being of staff was also pertinent to early years practitioners’ views. It is proposed that future research and practice focuses on opportunities for reflective discussions for early years staff and on the development of relationships
How can the skills of Early Years leaders support other leaders in a primary school setting?
This study investigated the leadership skills Early Years leaders demonstrated through their daily practice of teaching, assessing and teamwork within their setting. It explored how revealing the potential of Early Years leaders could have a positive impact on the leadership practice of other leaders in the same setting to improve pupil outcomes. A qualitative approach using interviews with Early Years leaders in 20 primary settings from the East Midlands and Bedfordshire areas was undertaken by two academics from two different UK based universities. Ethical guidelines ensuring anonymity and trustworthiness were followed. Using verbatim comments, data were analysed in themes against contemporary Early Years literature. Findings showed the skills of Early Years leaders could support pedagogy and practice but some of these skills were not utilized beyond this age phase. Our conclusion suggested that Early Years leaders had a range of leadership skills which were deemed specialist as they were unique to the success of the age phase, but needed to be exposed beyond Early Years for wider success and impact
Brain science and early years policy: Hopeful ethos or ‘cruel optimism’?
Ideas that the quality of parental nurturing and attachment in the first years of a child’s life is formative, hard-wiring their brains for success or failure, are reflected in policy reports from across the political spectrum and in targeted services delivering early intervention. In this article we draw on our research into ‘Brain science and early intervention’, using reviews of key policy literature and interviews with influential advocates of early intervention and with early years practitioners, to critically assess the ramifications and implications of these claims. Rather than upholding the ‘hopeful ethos’ proffered by advocates of the progressive nature of brain science and early intervention, we show that brain claims are justifying gendered, raced and social inequalities, positioning poor mothers as architects of their children’s deprivation
High-throughput assay for determining enantiomeric excess of chiral diols, amino alcohols, and amines and for direct asymmetric reaction screening
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Student Engagement Guidelines: Learning from innovative practices introduced in response to COVID-19
This guidance document was produced as part of the Student Experience and Student Expectations in a post-pandemic teaching and learning environment Collaborative Enhancement Project. The team collected data from ten participating universities through a student survey and focus groups. As a result of the survey, they gathered important quantitative data on students’ perspectives on engagement. For example, participating students ranked the importance of 31 engagement criteria from ‘not at all’ to ‘extremely’ important, indicating their priorities for what they view as student engagement
The clinical presentation of culture-positive and culture-negative, qPCR-attributable shigellosis in the Global Enteric Multicenter Study and derivation of a Shigella severity score: implications for pediatric Shigella vaccine trials
BACKGROUND: Shigella is a leading cause of childhood diarrhea and target for vaccine development. Microbiologic and clinical case definitions are needed for pediatric field vaccine efficacy trials. METHODS: We compared characteristics of moderate to severe diarrhea (MSD) cases in the Global Enteric Multicenter Study (GEMS) between children with culture positive Shigella to those with culture-negative, qPCR-attributable Shigella (defined by an ipaH gene cycle threshold <27.9). Among Shigella MSD cases, we determined risk factors for death and derived a clinical severity score. RESULTS: Compared to culture-positive Shigella MSD cases (n=745), culture-negative/qPCR-attributable Shigella cases (n=852) were more likely to be under 12 months, stunted, have a longer duration of diarrhea, and less likely to have high stool frequency or a fever. There was no difference in dehydration, hospitalization, or severe classification from a modified Vesikari score. Twenty-two (1.8%) Shigella MSD cases died within the 14-days after presentation to health facilities, and 59.1% of these deaths were in culture-negative cases. Age < 12 months, diarrhea duration prior to presentation, vomiting, stunting, wasting, and hospitalization were associated with mortality. A model-derived score assigned points for dehydration, hospital admission, and longer diarrhea duration but was not significantly better at predicting 14-day mortality than a modified Vesikari score. CONCLUSIONS: A composite severity score consistent with severe disease or dysentery may be a pragmatic clinical endpoint for severe shigellosis in vaccine trials. Reliance on culture for microbiologic confirmation may miss a substantial number of Shigella cases but is currently required to measure serotype specific immunity
Born in Bradford's Better Start: an experimental birth cohort study to evaluate the impact of early life interventions.
BACKGROUND: Early interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford's Better Start (BiBBS) that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB) has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0-3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford. METHOD: The BiBBS study aims to recruit 5000 babies, their mothers and their mothers' partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education) data throughout the children's lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs) approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple) interventions on health and social outcomes during the critical early years will be measured. DISCUSSION: The focus of the BiBBS cohort is on intervention impact rather than observation. As far as we are aware BiBBS is the world's first such experimental birth cohort study. While some risk factors for adverse health and social outcomes are increasingly well described, the solutions to tackling them remain elusive. The novel design of BiBBS can contribute much needed evidence to inform policy makers and practitioners about effective approaches to improve health and well-being for future generations
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