• Adolescent problem gambling requires community-level health promotion approaches

      Sapthiang, S.; Shonin, E.; Griffiths, M.D.; Van Gordon, William; University of Derby (Taylor and Francis, 2019-04-04)
    • Attachment-based compassion therapy for ameliorating fibromyalgia: mediating role of mindfulness and self-compassion

      Montero-Marin, Jesus; Van Gordon, William; Shonin, Edo; Navarro-Gil, Mayte; Gasión, Virginia; López-Del-Hoyo, Yolanda; Luciano, Juan V.; Garcia-Campayo, Javier; University of Oxford; University of Derby; et al. (Springer Science and Business Media LLC, 2020-01-10)
      The aim of this study was to evaluate the efficacy of Attachment-Based Compassion Therapy (ABCT)—a standardised programme that includes practices to improve compassionate awareness with the aim of addressing maladaptive attachment—for improving mindfulness and self-compassion in fibromyalgia (FM) patients, and to determine whether gains in mindfulness and self-compassion mediate improvements in FM functional status together with comorbid anxiety and depression. The study comprised a randomised controlled trial of individuals undergoing ABCT, with a Relaxation condition as an active control group. Baseline, post-test, and 3-month follow-up assessments were included. Participants (n = 42) were FM patients randomly assigned to ABCT or relaxation. Outcomes were functional status (FIQ), anxiety (HADS-A), depression (HADS-D), mindfulness (FFMQ), and self-compassion (SCS). Differences between groups were estimated using mixed-effects regression models, and mediation analyses were conducted using path analyses. Compared with the Relaxation condition, the ABCT group was more effective for improving mindfulness and self-compassion, as it observed through changes in the FFMQ and SCS subscales. Effect sizes were in the moderately large to large range (Cohen’s d between 0.60–2.20). Reductions in FM functional status were not mediated by either mindfulness or self-compassion. However, the self-compassion facet of common humanity was a mediator for reductions in both anxiety (B = − 2.04; bootstrapped 95% CI = − 4.44, − 0.04) and depression (B = − 2.12; bootstrapped 95% CI = − 4.40, − 0.45). The improvement of common humanity via ABCT might be an active component for the reduction of comorbid anxiety and depression in FM patients.
    • Evaluation of the clinical and cost effectiveness of intermediate care clinics for diabetes (ICCD): A multicentre cluster randomised controlled trial

      Wilson, Andrew; O’Hare, Joseph Paul; Hardy, Ainslea; Raymond, Neil; Szczepura, Ala; Crossman, Ric; Baines, Darrin; Khunti, Kamlesh; Kumar, Sudhesh; Saravanan, Ponnusamy; et al. (PLOS, 2014-04-15)
      Background Configuring high quality care for the rapidly increasing number of people with type 2 diabetes (T2D) is a major challenge worldwide for both providers and commissioners. In the UK, about two thirds of people with T2D are managed entirely in primary care, with wide variation in management strategies and achievement of targets. Pay for performance, introduced in 2004, initially resulted in improvements but disparities exist in ethnic minorities and the improvements are levelling off. Community based, intermediate care clinics for diabetes (ICCDs) were considered one solution and are functioning across the UK. However, there is no randomised trial evidence for the effectiveness of such clinics. Trial Design, Methods and Findings This is a cluster-randomised trial, involving 3 primary care trusts, with 49 general practices randomised to usual care (n = 25) or intervention (ICCDs; n = 24). All eligible adult patients with T2D were invited; 1997 were recruited and 1280 followed-up after 18-months intervention. Primary outcome: achievement of all three of the NICE targets [(HbA1c≤7.0%/53 mmol/mol; Blood Pressure <140/80 mmHg; cholesterol <154 mg/dl (4 mmol/l)]. Primary outcome was achieved in 14.3% in the intervention arm vs. 9.3% in the control arm (p = 0.059 after adjustment for covariates). The odds ratio (95% CI) for achieving primary outcome in the intervention group was 1.56 (0.98, 2.49). Primary care and community clinic costs were significantly higher in the intervention group, but there were no significant differences in hospital costs or overall healthcare costs. An incremental cost-effectiveness ratio (ICER) of +£7,778 per QALY gained, indicated ICCD was marginally more expensive at producing health gain. Conclusions Intermediate care clinics can contribute to improving target achievement in patients with diabetes. Further work is needed to investigate the optimal scale and organisational structure of ICCD services and whether, over time, their role may change as skill levels in primary care increase. Trial Registration ClinicalTrials.gov NCT00945204; National Research Register (NRR) M0014178167.
    • 'Everything's from the inside out with PCOS': Exploring women's experiences of living with polycystic ovary syndrome and co-morbidities through Skype interviews

      Williams, Sophie; Sheffield, David; Knibb, Rebecca C.; University of Derby (Sage Publications, 2015-08-31)
      Polycystic ovary syndrome is an endocrine disorder affecting 1 in 10 women. Women with polycystic ovary syndrome can experience co-morbidities, including depressive symptoms. This research explores the experience of living with polycystic ovary syndrome and co-morbidities. Totally, 10 participants with polycystic ovary syndrome took part in Skype™ interviews and analysed using thematic analysis. Four themes emerged from the data: change (to life plans and changing nature of condition); support (healthcare professionals, education and relationships); co-morbidities (living with other conditions and depression, self-harm and suicidal ideation) and identity (feminine identity and us and them). The findings highlight the need for screening of women with polycystic ovary syndrome for depressive disorders.
    • Mindfulness for addressing key public health concerns in young people: Preventative applications and safety concerns.

      Sapthiang, S.; Shonin, E.; Griffiths, M.D.; Van Gordon, William; University of Derby; University of Essex; Nottingham Trent University (Schools Health Education Unit, 2019-04-15)
    • Review of the evidence for adolescent and young person specific, community-based health services for NHS managers

      Ryan, Gemma Sinead; University of Derby; Leicestershire Partnership NHS Trust (Emerald, 2015-11)
      Purpose – The purpose of this paper is to provide an overview of the evidence surrounding the design and delivery of adolescent-specific health services for young people aged 14-25. This aims to make recommendations for National Health Service (NHS) senior management teams on the available literature relating to service design for children’s and young people's services within the UK. Design/methodology/approach – This paper presents a mini-review carried out in Spring 2013 using EMBASE, BNI, PSYCHinfo, MEDLINE and Google Scholar to systematically search available published and unpublished research papers. Systematic reviews, meta-analyses and evaluations of service models were included within this review. Adapted “GRADE” criteria were used to appraise the evidence. Findings – Of 70 papers found, 22 met the inclusion criteria. There were five main service designs found within the literature: hospital-based; school-linked or school-based; community based; combination and integrative; and other methods which did not fit into the four other categories. Research limitations/implications – This review is limited to the literature available within the inclusion criteria and search strategy used. It intends to inform management decisions in combination with other parameters and available evidence. Originality/value – There is range of research and evidence syntheses relating to adolescent services, but none of these have been conducted with a focus on the UK NHS and the information needs of managers re-designing services in the current climate within England.
    • A snapshot of the lives of women with polycystic ovary syndrome: A photovoice investigation.

      Williams, Sophie; Sheffield, David; Knibb, Rebecca C.; University of Derby (Sage Publications, 2014-09-09)
      Polycystic ovary syndrome affects 6  percent of women. Symptoms include hirsutism, acne, and infertility. This research explores the impact of polycystic ovary syndrome on women’s lives using photovoice. Nine participants photographed objects related to their quality of life and made diary entries explaining each photograph. Three themes emerged from thematic analysis of the diaries: control (of symptoms and polycystic ovary syndrome controlling their lives), perception (of self, others, and their situation), and support (from relationships, health care systems, and education). These findings illuminate positive aspects of living with polycystic ovary syndrome and the role pets and social networking sites play in providing support for women with polycystic ovary syndrome.