Digital Commons Network^™

Mental Imagery To Reduce Alcohol-Related Harm In Patients With Alcohol Use Disorder And Alcohol-Related Liver Damage, Ashwin Dhanda, Jackie Andrade, Hannah Allende, Victoria Allgar, Matthew Bailey, Lynne Callaghan, Laura Cocking, Elizabeth Goodwin, Annie Hawton, Christopher Hayward, Ben Hudson, Wendy Ingram, Alison Jeffery, Angela King, Victoria Lavers, Joe Lomax, C Anne Mccune, Crispin Musicha, Richard Parker, Christopher Rollinson, Jonny Wilks, E Siobhan Creanor

Peninsula Medical School

OBJECTIVE: The healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are lacking. We tested whether people with ARLD and AUD admitted to hospital could be recruited to and retained in a trial of Functional Imagery Training (FIT), a psychological therapy that uses mental imagery to reduce alcohol craving. We conducted a multicentre randomised pilot trial of treatment as usual (TAU) versus FIT+TAU in people admitted to hospital with ARLD and AUD.

DESIGN: Participants were randomised to TAU (a single session …

Increased Peptide Yy Blood Concentrations, Not Decreased Acyl-Ghrelin, Are Associated With Reduced Hunger And Food Intake In Healthy Older Women: Preliminary Evidence., Mary Hickson, Charlotte Moss, Waljit S. Dhillo, Jeanne Bottin, Gary Frost

School of Health Professions

With ageing there is frequently a loss of appetite, termed anorexia of ageing, which can result in under-nutrition. We do not know how appetite control alters with ageing. The objective of this study was to investigate whether differences in the release of, and response to, gastrointestinal appetite hormones is altered in young compared to old healthy volunteers. We hypothesised that an increase in PYY and GLP-1 or a decrease ghrelin may result in a decreased appetite. A comparative experimental design, using a cross-sectional sample of ages from a healthy population, matched for sex and BMI was used. The study compared …

Enhanced Visual Statistical Learning In Adults With Autism., Matthew E. Roser, Richard N. Aslin, Rebecca Mckenzie, Daniel Zahra, József Fiser

School of Psychology

OBJECTIVE: Individuals with autism spectrum disorder (ASD) are often characterized as having social engagement and language deficiencies, but a sparing of visuospatial processing and short-term memory (STM), with some evidence of supranormal levels of performance in these domains. The present study expanded on this evidence by investigating the observational learning of visuospatial concepts from patterns of covariation across multiple exemplars. METHOD: Child and adult participants with ASD, and age-matched control participants, viewed multishape arrays composed from a random combination of pairs of shapes that were each positioned in a fixed spatial arrangement. RESULTS: After this passive exposure phase, a posttest …

Effects Of A Clinician Referral And Exercise Program For Men Who Have Completed Active Treatment For Prostate Cancer: A Multicenter Cluster Randomized Controlled Trial (Engage)., Patricia M. Livingston, Melinda J. Craike, Jo Salmon, Kerry S. Courneya, Cadeyrn J. Gaskin, Steve F. Fraser, Mohammadreza Mohebbi, Suzanne Broadbent, Mari Botti, Bridie Kent, Engage Uro-Oncology Clinicians' Group

School of Nursing and Midwifery

BACKGROUND: The purpose of this study was to determine the efficacy of a clinician referral and exercise program in improving exercise levels and quality of life for men with prostate cancer. METHODS: This was a multicenter cluster randomized controlled trial in Melbourne, Australia comprising 15 clinicians: 8 clinicians were randomized to refer eligible participants (n = 54) to a 12-week exercise program comprising 2 supervised gym sessions and 1 home-based session per week, and 7 clinicians were randomized to follow usual care (n = 93). The primary outcome was self-reported physical activity; the secondary outcomes were quality of life, anxiety, …

Modelling The Impact Of Improving Screening And Treatment Of Chronic Hepatitis C Virus Infection On Future Hepatocellular Carcinoma Rates And Liver-Related Mortality., Matthew E. Cramp, William M. Rosenberg, Steven D. Ryder, Sarah Blach, Julie Parkes

Peninsula Medical School

BACKGROUND: The societal, clinical and economic burden imposed by the complications of chronic hepatitis C virus (HCV) infection - including cirrhosis and hepatocellular carcinoma (HCC) - is expected to increase over the coming decades. However, new therapies may improve sustained virological response (SVR) rates and shorten treatment duration. This study aimed to estimate the future burden of HCV-related disease in England if current management strategies remain the same and the impact of increasing diagnosis and treatment of HCV as new therapies become available. METHODS: A previously published model was adapted for England using published literature and government reports, and validated …

Barriers And Facilitators That Influence The Delivery Of Prevention Guidance In Health Service Dental Practice: A Questionnaire Study Of Practising Dentists In Southwest England., Rv Witton, Dr Moles

Peninsula Dental School

UNLABELLED: Objective: OBJECTIVE: To investigate the barriers and facilitators influencing the delivery of prevention in accordance with a national guideline (Delivering Better Oral Health, Department of Health England) in health service dental practice.

Elucidating The Structural Properties That Influence The Persistence Of Pcbs In Humans Using The National Health And Nutrition Examination Survey (Nhanes) Dataset., David Megson, Gwen O'Sullivan, Sean Comber, Paul J. Worsfold, Maeve C. Lohan, Melanie R. Edwards, Walter J. Shields, Courtney D. Sandau, Donald G. Patterson

School of Geography, Earth and Environmental Sciences

In human exposure studies involving Polychlorinated Biphenyls (PCBs), it is useful to establish when an individual was potentially exposed. Age dating PCB exposure is complex but assessments can be made because different PCB congeners have different residence times in the human body. The less chlorinated congeners generally tend to have shorter residence times because they are biotransformed and eliminated faster than more chlorinated congeners. Therefore, the presence of high proportions of less chlorinated congeners is often indicative of recent exposure. The 2003-04 National Health and Nutrition Examination Survey (NHANES) dataset contains results for the concentration of 37 PCBs in a …

Guided Self-Help Concreteness Training As An Intervention For Major Depression In Primary Care: A Phase Ii Randomized Controlled Trial., E. R. Watkins, R. S. Taylor, R. Byng, C. Baeyens, R. Read, K. Pearson, L. Watson

Peninsula Medical School

BACKGROUND: The development of widely accessible, effective psychological interventions for depression is a priority. This randomized trial provides the first controlled data on an innovative cognitive bias modification (CBM) training guided self-help intervention for depression. METHOD: One hundred and twenty-one consecutively recruited participants meeting criteria for current major depression were randomly allocated to treatment as usual (TAU) or to TAU plus concreteness training (CNT) guided self-help or to TAU plus relaxation training (RT) guided self-help. CNT involved repeated practice at mental exercises designed to switch patients from an unhelpful abstract thinking habit to a helpful concrete thinking habit, thereby targeting …

Collaborative Learning About E-Health For Mental Health Professionals And Service Users In A Structured Anonymous Online Short Course: Pilot Study., Emily J. Ashurst, Ray B. Jones, Graham R. Williamson, Tobit Emmens, Jon Perry

School of Nursing and Midwifery

BACKGROUND: Professionals are interested in using e-health but implementation of new methods is slow. Barriers to implementation include the need for training and limited awareness or experience. Research may not always convince mental health professionals (MHPs). Adding the 'voice' of mental health service users (MHSUs) in collaborative learning may help. Involving MHSUs in face-face education can be difficult. We had previously been unable to engage MHPs in online discussion with MHSUs. Here we assessed the feasibility of short online courses involving MHSUs and MHPs. METHODS: We ran three e-health courses, comprising live interactive webcast, week's access to a discussion forum, …

Use Of A Clay Modeling Task To Reduce Chocolate Craving., Jackie Andrade, Sally Pears, Jon May, David J. Kavanagh

School of Psychology

Elaborated Intrusion theory (EI theory; Kavanagh, Andrade, & May, 2005) posits two main cognitive components in craving: associative processes that lead to intrusive thoughts about the craved substance or activity, and elaborative processes supporting mental imagery of the substance or activity. We used a novel visuospatial task to test the hypothesis that visual imagery plays a key role in craving. Experiment 1 showed that spending 10 min constructing shapes from modeling clay (plasticine) reduced participants' craving for chocolate compared with spending 10 min 'letting your mind wander'. Increasing the load on verbal working memory using a mental arithmetic task (counting …

Phase 1 Pilot Study Of E-Mail Support For People With Long Term Conditions Using The Internet., Bryony Sheaves, Ray B. Jones, Graham R. Williamson, Rohan Chauhan

School of Nursing and Midwifery

BACKGROUND: Use of the Internet for people with Long Term Conditions (LTCs) can have a positive effect on knowledge, social support, behavioural and clinical outcomes, yet there is concern that a 'digital divide' prevents some patients from benefitting. While some patients do not have access to the Internet, others that do may still lack expertise or the confidence to make full use of it. The aim of this pilot study was to develop an intervention and test methods for a definitive randomised controlled trial (RCT) of anonymous personal online email support for patients in this latter group. METHODS: Recruitment success …

Patient-Orientated Longitudinal Study Of Multiple Sclerosis In South West England (The South West Impact Of Multiple Sclerosis Project, Swims) 1: Protocol And Baseline Characteristics Of Cohort., John P. Zajicek, Wendy M. Ingram, Jane Vickery, Siobhan Creanor, Dave E. Wright, Jeremy C. Hobart

Peninsula Medical School

BACKGROUND: There is a need for greater understanding of the impact of multiple sclerosis (MS) from the perspective of individuals with the condition. The South West Impact of MS Project (SWIMS) has been designed to improve understanding of disease impact using a patient-centred approach. The purpose is to (1) develop improved measurement instruments for clinical trials, (2) evaluate longitudinal performance of a variety of patient-reported outcome measures, (3) develop prognostic predictors for use in individualising drug treatment for patients, particularly early on in the disease course. METHODS: This is a patient-centred, prospective, longitudinal study of multiple sclerosis and clinically isolated …

Neuronal Network Pharmacodynamics Of Gabaergic Modulation In The Human Cortex Determined Using Pharmaco-Magnetoencephalography., Stephen D. Hall, Gareth R. Barnes, Paul L. Furlong, Stefano Seri, Arjan Hillebrand

School of Psychology

Neuronal network oscillations are a unifying phenomenon in neuroscience research, with comparable measurements across scales and species. Cortical oscillations are of central importance in the characterization of neuronal network function in health and disease and are influential in effective drug development. Whilst animal in vitro and in vivo electrophysiology is able to characterize pharmacologically induced modulations in neuronal activity, present human counterparts have spatial and temporal limitations. Consequently, the potential applications for a human equivalent are extensive. Here, we demonstrate a novel implementation of contemporary neuroimaging methods called pharmaco-magnetoencephalography. This approach determines the spatial profile of neuronal network oscillatory power …

Regulation Of The Fibrosis And Angiogenesis Promoter Sparc/Osteonectin In Human Adipose Tissue By Weight Change, Leptin, Insulin, And Glucose., Katrina Kos, Steve Wong, Bee Tan, Anders Gummesson, Margareta Jernas, Niclas Franck, David Kerrigan, Fredrik H. Nystrom, Lena M.S. Carlsson, Harpal S. Randeva, Jonathan H. Pinkney, John P.H. Wilding

Peninsula Medical School

OBJECTIVE: Matricellular Secreted Protein, Acidic and Rich in Cysteine (SPARC), originally discovered in bone as osteonectin, is a mediator of collagen deposition and promotes fibrosis. Adipose tissue collagen has recently been found to be linked with metabolic dysregulation. Therefore, we tested the hypothesis that SPARC in human adipose tissue is influenced by glucose metabolism and adipokines. RESEARCH DESIGN AND METHODS: Serum and adipose tissue biopsies were obtained from morbidly obese nondiabetic subjects undergoing bariatric surgery and lean control subjects for analysis of metabolic markers, SPARC, and various cytokines (RT-PCR). Additionally, 24 obese subjects underwent a very-low-calorie diet of 1,883 kJ …

Provision Of 24 Hour Acute Neurology Care By Neurologists: Manpower Requirements In The Uk., C. Carroll, J. Zajicek

Peninsula Medical School

OBJECTIVES: The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. METHODS: All admissions to the neurology department were analysed prospectively for a three month period (March to May 2002). RESULTS: There were 629 admissions (equating to 2500 per year); data …