• 2400 Day in the life

      Dinsdale, Paul (2005)
      With five years' experience in the research world, Sue Jaycock tells Paul Dinsdale how she now helps others to follow in her footsteps.
    • A feasibility study of a cluster randomised controlled trial to evaluate a falls prevention intervention in care homes for older people

      Robertson, Kate (2014)
      Background: Falls are common and distressing for care home residents and can incur large costs. Implementation of the Guide to Action Care Home (GtACH) tool is a promising approach to prevent falls. Objective: To examine the feasibility of conducting a large scale cluster RCT of the implementation of the GtACH tool. Method: Care homes were randomised to either receive the GtACH intervention or usual care. Baseline and 6 month outcomes assessed trial design. Trial design parameter data included measuring recruitment, attrition and data collection. Feasibility of accelerometer wear as an activity measure was tested in participants. Concurrent process evaluation techniques; including care staff interview and research field notes provided data regarding trial design and intervention feasibility. Results: 22/145 (15%) care homes agreed to take part. Our recruitment target of 6 care homes was met. 52 out of the proposed target of 68 residents (76%) were recruited. 3 homes were randomised to the intervention, 3 to control. 36/115 (31%) home staff were trained to use the GtACH. Two home received protocol compliant training. 10 (19%) participants were lost at follow up, 7 died, 3 moved home. All homes provided falls data with no duplications and little missing descriptive information. Accelerometers were not deemed feasible in 10 residents. The process evaluation revealed high acceptability, safety and intervention adherence with evidence based revisions necessary to optimise trial design and intervention implementation. Conclusion: The GtACH intervention and RCT design is feasible and implementable in care homes. A definitive effectiveness trial is warranted.
    • Aggregator: a machine learning approach to identifying MEDLINE articles that derive from the same underlying clinical trial

      Adams, Clive E. (2015)
      OBJECTIVEIt is important to identify separate publications that report outcomes from the same underlying clinical trial, in order to avoid over-counting these as independent pieces of evidence.METHODSWe created positive and negative training sets (comprised of pairs of articles reporting on the same condition and intervention) that were, or were not, linked to the same clinicaltrials.gov trial registry number. Features were extracted from MEDLINE and PubMed metadata; pairwise similarity scores were modeled using logistic regression.RESULTSArticle pairs from the same trial were identified with high accuracy (F1 score=0.843). We also created a clustering tool, Aggregator, that takes as input a PubMed user query for RCTs on a given topic, and returns article clusters predicted to arise from the same clinical trial.DISCUSSIONAlthough painstaking examination of full-text may be needed to be conclusive, metadata are surprisingly accurate in predicting when two articles derive from the same underlying clinical trial.
    • An analysis of the Research Team-Service User relationship from the Service User perspective: A consideration of 'The Three Rs' (Roles, Relations, and Responsibilities) for healthcare research organisations

      Jordan, Melanie; Morriss, Richard K.; Manning, Nick (2015)
      Background: This article debates interview data from service users who engaged with the work of a Collaboration for Leadership in Applied Health Research and Care (CLAHRC). The evidence base, to date, concerning the nature of CLAHRC work at the frontline (i.e. What is it actually like to do CLAHRC work?) is meagre; thus, this article represents an original contribution to that literature. Further, this article analyses service users' participation in research - as members of the research team - and so contributes to the body of developing literature regarding involvement too.; Objective: This article explores the nature of the Research Team-Service User relationship, plus associated roles, relations and responsibilities of collaborative health research.; Design: Qualitative social science research was undertaken in a health-care research organization utilizing interview method and a medical sociology and organizational sociology theoretical framework for analysis. Data utilized originate from a larger evaluation study that focuses on the CLAHRC as an iterative organization and explores members' experiences.; Results: There can be a disparity between initial expectations and actual experiences of involvement for service users. Therefore, as structured via 'The Three Rs' (Roles, Relations and Responsibilities), aspects of the relationship are evaluated (e.g. motivation, altruism, satisfaction, transparency, scope, feedback, communication, time). Regarding the inclusion of service users in health research teams, a careful consideration of 'The Three Rs' is required to ensure expectations match experiences.; © 2014 John Wiley & Sons Ltd.
    • An evaluation of psychological consultation to social workers

      Dimaro, Lian V.; Kyte, Zoe (2014)
      Although providing psychological consultation to the network around looked after children is a popular intervention within the practice literature, there is little evidence examining its value for social workers. This study utilised mixed methods, integrated through an explanatory sequential design, to explore the extent to which psychological consultation met social workers’ goals and in what way it made a difference. Feedback questionnaires were collated from 48 social workers attending such consultations. Two focus groups were then held with consulting clinicians to gain their perspectives on consultation and the feedback obtained. The survey data demonstrated that social workers wanted a broad range of input and support from consultation, which they reported was largely provided. This reinforced clinicians’ perspectives of consultation as a valuable service. Surprisingly, the survey data implied that consultation had a limited impact in terms of making a difference. This is discussed in relation to the methodology and challenges of gaining feedback. An improved model of evaluation is subsequently proposed.
    • An in-depth observational study of an acute psychiatric ward: Combining the psychodynamic observational method with thematic analysis to develop understanding of ward culture

      Goodwin, Anne M. (2017)
      The question of how to create benign organisational cultures in health care is a topic of particular concern in the UK at the present time. The current study aimed to further understanding of complex health care cultures in the National Health Service (NHS), with a focus on an acute adult in-patient psychiatric ward. The psychoanalytic observational method was used for this purpose. The first author conducted six-hour long observation sessions on the ward at weekly intervals, writing detailed process recordings after each observation to take to a supervision group for discussion. The six presentations of observational material and the responses of the supervision group were audiotaped and transcribed. These data were then analysed thematically. The picture that emerged was of a fragile ward environment in which staff appeared fearful of engagement with patients, there was a sense of confusion regarding roles and decision-making processes, and the nursing team felt burdened by responsibility, isolated and anxious about criticism from outside. Contemporary developments within the social defence paradigm are applied to these findings in the context of the intense pressures currently facing staff in the NHS.
    • Are researchers getting the terms used to denote different types of recreational cannabis right?-a user perspective

      Sami, Musa (2021)
      BACKGROUND: While current cannabis research has advanced our understanding into the effects of its individual components, there is a pressing need to identify simple terminology that is understood in the same way by researchers and users of cannabis. Current categorisation in research focuses on the two main cannabinoids: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD); and two different species of cannabis: indica and sativa. Recreational cannabis has also been categorised by researchers as 'skunk' or 'hash'. Focusing on individuals who use cannabis frequently, this study aimed to identify views on current terms used to denote different types of cannabis and to identify terms validated by participants. These views were extracted from responses of the Cannabis Experiences Questionnaire (CEQ), a widely used instrument in the literature. METHODS: We qualitatively analysed 236 free-text responses from Question 23 of the CEQ survey (using Iterative Categorisation) relating to categorization and consumption methods. Data was used from a previous study (Sami et al., Psychol Med 49:103-12, 2019), which recruited a convenience sample of 1231 participants aged 18 years and above who had previously used cannabis. RESULTS: Regarding type of cannabis used, specific strain names (n = 130), concentrates (n = 37), indica/sativa (n = 22) and THC/CBD terms (n = 22) were mentioned. Other terms used were hybrids (n = 10), origins of specific strains (n = 17), edibles (n = 8), and herbal cannabis (n = 7). Regarding problems with specific terms, participants were skeptical about terms such as skunk and super skunk (n = 78) preferring terms like THC/CBD, indica/sativa, specific marketed strains and references to preparation methods. CONCLUSIONS: The results suggest a disparity between the common terms used by researchers in academia and those used by cannabis consumers. While there are advantages and limitations of using these terms to bridge views of researchers and individuals who use cannabis, this study underscores the importance of formally assessing chemical constituents rather than relying on self-report data and of incorporating cannabis user views on current terms used in research, potentially also incorporating descriptors of preparation and consumption methods.
    • Assessing the quality of meta-analyses in systematic reviews in pharmaceutical research in Iran by 2016: A systematic review

      Shokraneh, Farhad (2020)
      Background: Meta-analyses, like all other studies, may be poorly designed and implemented. This study was designed to determine the quality of meta-analyses in systematic reviews in the field of pharmaceutical research in Iran. Methods: Web of Science Core Collection, EMBASE, Ovid Medline, CINAHL, Scopus, and PubMed were systematically searched on June 4, 2017. The search was limited to the researches in the field of pharmaceutical studies. Based on inclusion criteria, 104 systematic reviews with meta-analysis (SRMA) were selected and assessed using quality assessment tools introduced by Higgins. Results: Participants, experimental interventions, and outcomes were reported in all the articles. Comparator intervention and study design were correctly reported in 103 (99.04%) and 101 (97.12%) articles, respectively. The comprehensive search strategy was available only in 48 articles (46.16%), and there was no evidence of a comprehensive search in 56 articles (53.84%). Risk of bias was investigated in 78 articles (75%). Also, funnel plots were the most commonly used method for reporting the bias in 64 articles (46.42%). Conclusion: In many of the meta-analyses, several items of the tool that represented a high-quality meta-analysis were absent. According to the findings, the comprehensive search and quality assessment were not at an appropriate level. Thus, the importance of reproducibility of information and quality assessment of included studies should be emphasized. © Iran University of Medical Sciences.
    • Assessing the value of a novel "Recovery and Collaborative Care Planning Cafe" initiative for co-designing improvements through a shared learning experience with service users, carers, and practitioners

      Williams, Lyn (2022)
      Objective: This paper ascertains the value of a novel approach to creating a participative social learning space with service users, carers, and practitioners to develop recovery-oriented conversations and the experience of collaborative care planning. Methods: A participatory method “World Café” was utilized with taught masterclasses on recovery principles. Evidenced-based practice was a central feature drawn from service user research. The Model for Improvement: Plan-Do-Study-Act (PDSA) framed the sessions to generate and test ideas. Results: Service user and carer attendance was low at the start, although this increased after testing ideas using PDSA cycles to improve this. Shared learning grew over time, which led to ideas to create improved participation in care planning. Conversations also developed towards becoming more recovery oriented after participants incorporated a framing set of recovery concepts into the sessions. Conclusions: The café design proved it was possible to both create a social learning space and change conversations leading to a greater focus on recovery through using CHIME (a conceptual framework incorporating connectedness, hope, identity, meaning, and empowerment). The café successfully generated improvement ideas and created a participative learning space.
    • Auditing health promotion activities in primary health care teams: An analysis of activity and suggestions for indicators of service delivery

      Phair, Lesley; Banyard, Philip (1999)
      An audit of health promotion activity by primary health care teams in North Nottinghamshire was conducted in 1996/7 which collected quantitative data on the health promotion activity and qualitative data on examples of good practice. This paper reports the quantitative findings of 179 health promotion events. The analysis revealed information about the style, target group and topic of the health promotion events as well as information about the partnerships with outside agencies, and the level of co-operation between health workers. Measures of service delivery are suggested which can help develop targets for a planned and appropriate delivery of health promotion.
    • Automated confidence ranked classification of randomized controlled trial articles: an aid to evidence-based medicine

      Adams, Clive E. (2015)
      OBJECTIVEFor many literature review tasks, including systematic review (SR) and other aspects of evidence-based medicine, it is important to know whether an article describes a randomized controlled trial (RCT). Current manual annotation is not complete or flexible enough for the SR process. In this work, highly accurate machine learning predictive models were built that include confidence predictions of whether an article is an RCT.MATERIALS AND METHODSThe LibSVM classifier was used with forward selection of potential feature sets on a large human-related subset of MEDLINE to create a classification model requiring only the citation, abstract, and MeSH terms for each article.RESULTSThe model achieved an area under the receiver operating characteristic curve of 0.973 and mean squared error of 0.013 on the held out year 2011 data. Accurate confidence estimates were confirmed on a manually reviewed set of test articles. A second model not requiring MeSH terms was also created, and performs almost as well.DISCUSSIONBoth models accurately rank and predict article RCT confidence. Using the model and the manually reviewed samples, it is estimated that about 8000 (3%) additional RCTs can be identified in MEDLINE, and that 5% of articles tagged as RCTs in Medline may not be identified.CONCLUSIONRetagging human-related studies with a continuously valued RCT confidence is potentially more useful for article ranking and review than a simple yes/no prediction. The automated RCT tagging tool should offer significant savings of time and effort during the process of writing SRs, and is a key component of a multistep text mining pipeline that we are building to streamline SR workflow. In addition, the model may be useful for identifying errors in MEDLINE publication types. The RCT confidence predictions described here have been made available to users as a web service with a user query form front end at: http://arrowsmith.psych.uic.edu/cgi-bin/arrowsmith_uic/RCT_Tagger.cgi.
    • Being economical with the evidence

      Haigh, Rex (2012)
      The systematic review undertaken for the Group Analytic Community by Sheffield University is an excellent piece of work 'of its time', but it may not speak to everybody in the field. Some of the reasons for this are the precise methodology of such reviews, concerned with an exclusively rationalist model for selecting and appraising evidence in a framework, which excludes other schools of thought (particularly the social sciences, including critical theory, anthropology and economics). As many of those who work in group analysis have backgrounds in these and allied disciplines, rather than biomedical science, there is a risk of excluding much useful and scholarly collaboration with adjacent disciplines unless we hold an open mind about such methodologies. As group analysts, we are in a strong position to observe and criticize the 'evidence-based hegemony' when it becomes closer to dogma than science. This article is based on a talk given to a Group Analytic Society conference entitled 'Can Group Therapy Survive NICE?' held in London on 29 January 2010. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Best practice framework for Patient and Public Involvement (PPI) in collaborative data analysis of qualitative mental health research: Methodology development and refinement

      Slade, Mike; Bates, Peter; Toney, Rebecca (2018)
      BACKGROUND: Patient and Public Involvement (PPI) in mental health research is increasing, especially in early (pre-funding) stages. PPI is less consistent in later stages, including in analysing qualitative data. The aims of this study were to develop a methodology for involving PPI co-researchers in collaboratively analysing qualitative mental health research data with academic researchers, to pilot and refine this methodology, and to create a best practice framework for collaborative data analysis (CDA) of qualitative mental health research. METHODS: In the context of the RECOLLECT Study of Recovery Colleges, a critical literature review of collaborative data analysis studies was conducted, to identify approaches and recommendations for successful CDA. A CDA methodology was developed and then piloted in RECOLLECT, followed by refinement and development of a best practice framework. RESULTS: From 10 included publications, four CDA approaches were identified: (1) consultation, (2) development, (3) application and (4) development and application of coding framework. Four characteristics of successful CDA were found: CDA process is co-produced; CDA process is realistic regarding time and resources; demands of the CDA process are manageable for PPI co-researchers; and group expectations and dynamics are effectively managed. A four-meeting CDA process was piloted to co-produce a coding framework based on qualitative data collected in RECOLLECT and to create a mental health service user-defined change model relevant to Recovery Colleges. Formal and informal feedback demonstrated active involvement. The CDA process involved an extra 80 person-days of time (40 from PPI co-researchers, 40 from academic researchers). The process was refined into a best practice framework comprising Preparation, CDA and Application phases. CONCLUSIONS: This study has developed a typology of approaches to collaborative analysis of qualitative data in mental health research, identified from available evidence the characteristics of successful involvement, and developed, piloted and refined the first best practice framework for collaborative analysis of qualitative data. This framework has the potential to support meaningful PPI in data analysis in the context of qualitative mental health research studies, a previously neglected yet central part of the research cycle.
    • A bibliometric trend analysis of regenerative medicine research output in Iran: Comparison with the global research output

      Shokraneh, Farhad (2018)
      This report is a bibliometric analysis of the growth rates of publications in the field regenerative medicine in Iran and compares these rates with the rates in other regions of the world. PubMed database was used for extraction of relevant publications using MeSH terms. The data were extracted from 2001-2011 and the address fields of the publications were checked manually in order to allocate the publications to a relevant geographical region. Linear regression was used for fitting a linear model to the publications of a particular region and the slope of the model was used as an indicator of publication growth rate. Statistical comparison of the slopes of different regions showed that Iran enjoys a moderate growth rate in regards to tissue engineering and regenerative medicine publications (including stem cells-related papers) and a low growth rate in regards to general stem cells papers. Iran is a regionally dominant country in the field of tissue engineering but, not in the field of stem cells. Analysis of the annual growth rate showed a steady pattern of growth of tissue engineering papers and a random pattern of growth for general stem cells papers. This is an indication of instability in the general stem cell research and stability in the field of tissue engineering. Due to equal research funding opportunities, this observation is explained by the natural selection of the latter field by Iranian biomedical scientists. This natural selection should be supported and followed by policy makers in order to take advantage of current research interests and capabilities. It is recommended to view and manage stem cells research as a part of regenerative medicine not vice versa
    • Building a new economic evaluation database for the cochrane schizophrenia group: Searching the HEED, NHS EED, CEA registry and economic literature

      Mansi, Kamel; Furtado, Vivek; Adams, Clive E.; Roberts, Samantha (2013)
      The Cochrane Schizophrenia Group formed in 1994 is part of the Cochrane Collaboration and is located at the University of Nottingham. It is also part of the Institute of Mental Health based at Nottingham. The Cochrane Schizophrenia Group is concerned with the evaluation of the prevention, treatment and rehabilitation of people with non-affective, functional, psychotic illnesses. The treatment of those with schizophrenia is a major focus of the Group but it is also concerned with the care of those suffering from unspecified 'chronic/severe' mental illnesses and non-organic, schizophrenialike conditions fall under the Group's umbrella. The CSG work and website focuses on two main areas. The first is the preparation, publication and maintenance of systematic reviews of the effects of interventions for schizophrenia. These reviews are published monthly on The Cochrane Library, and are updated periodically to incorporate new research as it becomes available. The second is the development and maintenance of a specialised register of trials relevant to the scope of the group's work. All reports of Randomised Controlled Trials relevant to the scope of this group, whether randomisation is described or implied, are acquired, coded and included. The Cochrane Schizophrenia Group's Register contains 13593 coded studies (April 2011). The register is maintained on Meerkat 1.6. The Group also maintains a large register of citations (~ 100, 000) and papers (~7767) that have been inspected and found not relevant to the work of this Group. Although, searching covers a vast array of databases, health economic databases are specifically not searched. With a growing interest in systematic reviews of economic evaluations, there was need to see if searching of specialist databases would yield further economic evaluation trials hitherto not found in the CSG Specialised Register. Should it be the case then there would be a need to have a database that included economic evaluations of schizophrenia trials. The health economic evaluation database (HEED), NHS economic evaluation database (NHS EED), the Cost-Effectiveness Analysis (CEA) registry and the economic literature are comprehensive databases of around 9421 cost-effectiveness and utility analyses on a wide variety of schizophrenia antipsychotics. The impact of these databases has led to them being highlighted in the National Library of Medicine's website as an important health economics resource. One of the main goals of these databases will serve as ongoing source of information for those seeking to identify under-studied areas in the cost-effectiveness literature.
    • Characteristics of mental health recovery narratives: Systematic review and narrative synthesis

      Llewellyn-Beardsley, Joy; Rennick-Egglestone, Stefan; Crawford, Paul; Hui, Ada; Manley, David S.; Wright, Nicola; Slade, Mike (2019)
      BACKGROUND: Narratives of recovery from mental health distress have played a central role in the establishment of the recovery paradigm within mental health policy and practice. As use of recovery narratives increases within services, it is critical to understand how they have been characterised, and what may be missing from their characterisation thus far. The aim of this review was to synthesise published typologies in order to develop a conceptual framework characterising mental health recovery narratives. METHOD: A systematic review was conducted of published literature on the characteristics of mental health recovery narratives. Narrative synthesis involved identifying characteristics and organising them into dimensions and types; and subgroup analysis based on study quality, narrator involvement in analysis, diagnosis of psychosis and experience of trauma. The synthesis was informed by consultation with a Lived Experience Advisory Panel and an academic panel. The review protocol was pre-registered (Prospero CRD42018090188). RESULTS: 8951 titles, 366 abstracts and 121 full-text articles published January 2000-July 2018 were screened, of which 45 studies analysing 629 recovery narratives were included. A conceptual framework of mental health recovery narratives was developed, comprising nine dimensions (Genre; Positioning; Emotional Tone; Relationship with Recovery; Trajectory; Use of Turning Points; Narrative Sequence; Protagonists; and Use of Metaphors), each containing between two and six types. Subgroup analysis indicated all dimensions were present across most subgroups, with Turning Points particularly evident in trauma-related studies. CONCLUSIONS: Recovery narratives are diverse and multidimensional. They may be non-linear and reject coherence. To a greater extent than illness narratives, they incorporate social, political and rights aspects. Approaches to supporting development of recovery narratives should expand rather than reduce available choices. Research into the narratives of more diverse populations is needed. The review supports trauma-informed approaches, and highlights the need to understand and support post-traumatic growth for people experiencing mental health issues.