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Yirmiya K, Constantinou M, Simes E, Bateman A, Wason J, Yakeley J, McMurran M, Crawford M, Frater A, Moran P, Barrett B, Cameron A, Hoare Z, Allison E, Pilling S, Butler S, Fonagy P. The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders. Psychol Med 2024:1-12. [PMID: 38563288 DOI: 10.1017/s003329172400062x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. METHODS A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. RESULTS Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. CONCLUSIONS These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.
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Affiliation(s)
- Karen Yirmiya
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Matthew Constantinou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mike Crawford
- Division of Psychiatry, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - Zoe Hoare
- NWORTH Clinical Trials Unit, School of Health Sciences, Bangor University, Bangor, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
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Fonagy P, Yakeley J, Gardner T, Simes E, McMurran M, Moran P, Crawford M, Frater A, Barrett B, Cameron A, Wason J, Pilling S, Butler S, Bateman A. Mentalization for Offending Adult Males (MOAM): study protocol for a randomized controlled trial to evaluate mentalization-based treatment for antisocial personality disorder in male offenders on community probation. Trials 2020; 21:1001. [PMID: 33287865 PMCID: PMC7720544 DOI: 10.1186/s13063-020-04896-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background Antisocial personality disorder (ASPD), although associated with very significant health and social burden, is an under-researched mental disorder for which clinically effective and cost-effective treatment methods are urgently needed. No intervention has been established for prevention or as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment that has shown some promising preliminary results for reducing personality disorder symptomatology by specifically targeting the ability to recognize and understand the mental states of oneself and others, an ability that is compromised in people with ASPD. This paper describes the protocol of a multi-site RCT designed to test the effectiveness and cost-effectiveness of MBT for reducing aggression and alleviating the wider symptoms of ASPD in male offenders subject to probation supervision who fulfil diagnostic criteria for ASPD. Methods Three hundred and two participants recruited from a pool of offenders subject to statutory supervision by the National Probation Service at 13 sites across the UK will be randomized on a 1:1 basis to 12 months of probation plus MBT or standard probation as usual, with follow-up to 24 months post-randomization. The primary outcome is frequency of aggressive antisocial behaviour as assessed by the Overt Aggression Scale – Modified. Secondary outcomes include violence, offending rates, alcohol use, drug use, mental health status, quality of life, and total service use costs. Data will be gathered from police and criminal justice databases, NHS record linkage, and interviews and self-report measures administered to participants. Primary analysis will be on an intent-to-treat basis; per-protocol analysis will be undertaken as secondary analysis. The primary outcome will be analysed using hierarchical mixed-effects linear regression. Secondary outcomes will be analysed using mixed-effects linear regression, mixed-effects logistic regression, and mixed-effects Poisson models for secondary outcomes depending on whether the outcome is continuous, binary, or count data. A cost-effectiveness and cost-utility analysis will be undertaken. Discussion This definitive, national, multi-site trial is of sufficient size to evaluate MBT to inform policymakers, service commissioners, clinicians, and service users about its potential to treat offenders with ASPD and the likely impact on the population at risk. Trial registration ISRCTN 32309003. Registered on 8 April 2016.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. .,Anna Freud National Centre for Children and Families, London, UK.
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Tessa Gardner
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mike Crawford
- Centre for Mental Health, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Psychology Department, University of Prince Edward Island, Charlottetown, Canada
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
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Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, Frater A. An audit of tuberculosis health services in prisons and immigration removal centres. J Public Health (Oxf) 2017; 39:387-394. [PMID: 27247121 DOI: 10.1093/pubmed/fdw033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Tuberculosis (TB) is the second leading cause of death worldwide due to a single infectious agent. Rates of active TB in places of prescribed detention (PPD), which include Prisons, Young Offender Institutions and Immigration Removal Centres, are high compared with the general population. PPD therefore present an opportunity to develop targeted health programmes for TB control. This audit aims to assess current service provisions and identify barriers to achieving best practice standards in PPD across London. Methods Twelve healthcare teams within PPD commissioned by NHS England (London Region) were included in the audit. Services were evaluated against the National Institute for Health and Care Excellence standards for TB best practice. Results None of the health providers with a digital X-ray machine were conducting active case finding in new prisoners and no health providers routinely conduct Latent TB infection testing and preventative treatment. Barriers to implementing standards include the lack of staff skills and staff skills mix, structural and technical barriers, and demands of custodial and health services. Conclusions This audit restates the importance of national public health TB strategies to consider healthcare provisions across PPD.
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Affiliation(s)
- Anita Mehay
- School of Law, Royal Holloway University of London, Egham Hill, Egham, Surrey, TW20 0EX, UK
| | - Thara Raj
- Public Health England (London Region), 4th Floor, Southside, 105, Victoria Street, London, SW1E 6QT, UK
| | - Lynn Altass
- NHS England and Public Health England, PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Autilia Newton
- Wellington House, 135-155 Waterloo Road, London SE1 8UG, UK
| | - Eamonn O'Moore
- Public Health England, Premier House, 60 Caversham Road, Reading RG1 7EB, UK
| | - Cathie Railton
- Public Health England, Block 2, FERA, Sand Hutton, York YO41 1LZ, UK
| | - Hong Tan
- NHS England (London Region) 4th Floor, Southside, 105, Victoria Street, London, SW1E 6QT, UK
| | - Al Story
- University College Hospital, 235 Euston Road, London NW1 2BU, UK
| | - Alison Frater
- School of Law, Royal Holloway University of London, Egham Hill, Egham, Surrey, TW20 0EX, UK
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4
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Affiliation(s)
- Alison Frater
- Centre for Criminology and Sociology, Royal Holloway, University of London, London, UK
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5
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Roderick P, S Sundaram S, Dimitrov BD, Dewhirst S, Tucker LJ, Leydon G, Sheron N, Frater A, Harindra V. Assessing feasibility and acceptability of a brief intervention for risky alcohol consumption in sexual health clinic attendees: a randomised controlled trial. ACTA ACUST UNITED AC 2015; 42:143-51. [PMID: 26259896 DOI: 10.1136/jfprhc-2014-100912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 07/01/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the feasibility and acceptability of screening attendees at a sexual health clinic (SHC) for alcohol misuse, and delivering a brief intervention (BI). To explore the effect of this BI on drinking and sexual behaviour. METHODS A consecutive sample of consenting SHC attendees aged ≥16 years were screened using Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Men scoring ≥5 and women scoring ≥4 were invited to complete the full AUDIT, alcohol diary and baseline questionnaire. INTERVENTIONS Participants were randomised to receive BI by a trained sexual health professional or a standard alcohol leaflet (usual care, UC). All were followed up for changes in alcohol and sexual behaviour at 6 weeks and 6 months. A fidelity check and staff focus group were undertaken. RESULTS Of 664 participants screened, 215 (32%) were eligible for randomisation and 207 were included in the final analysis: 103 (BI) and 104 (UC). Follow-up rates were 54% and 47% at 6 weeks and 6 months, respectively. Both groups reduced alcohol consumption though the degree of change did not differ between them. There was some evidence of positive changes in sexual health risk in both groups. BI was delivered as intended, adding 5 minutes to the consultation, and staff feedback was positive. CONCLUSIONS Alcohol misuse was common in SHC attendees. Systematic assessment and BI for alcohol misuse was feasible and acceptable to staff and patients. Identification and provision of standard information alone appeared to influence drinking and sexual behaviour. TRIAL REGISTRATION NUMBER ISRCTN19452424.
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Affiliation(s)
- Paul Roderick
- Academic Unit of Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Borislav D Dimitrov
- Academic Unit of Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Susan Dewhirst
- Academic Unit of Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Geraldine Leydon
- Academic Unit of Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nick Sheron
- Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Alison Frater
- South Central Strategic Health Authority, Reading, UK
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Dimitrov BD, Sundaram S, Roderick P, Frater A, Leydon G, Sheron N, Dewhirst S, Tucker L, Maskell J, Chatwin J, Harindra V. PP43 Feasibility and Acceptability of a Brief Intervention to Reduce Alcohol Consumption in Sexual Health Clinic Attendees. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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7
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Nnoaham KE, Frater A, Roderick P, Moon G, Halloran S. Do geodemographic typologies explain variations in uptake in colorectal cancer screening? An assessment using routine screening data in the south of England. J Public Health (Oxf) 2010; 32:572-81. [PMID: 20410067 DOI: 10.1093/pubmed/fdq025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Uptake of colorectal cancer (CRC) screening in UK is less than 60%. Geodemographic typologies are useful in describing patterns of individual preventive health behaviour but little is known of their value in assessing uptake of CRC screening, or how this compares to traditional measures of area deprivation. METHODS We used data on CRC screening uptake in the South Central, South-East Coast and South-West England National Health Service regions in multilevel logistic regression to describe the effects of individual composition and contextual factors (area deprivation and geodemographic segments) on non-response to screening invitation. The relative impact of geodemographic segmentation and the index of multiple deprivation (IMD) 2007 was compared. The potential population impact of a targeted increase in uptake in specific geodemographic segments was examined. RESULTS About 88 891 eligible adults were invited to be screened from 2006 to 2008. Uptake rate was 57.3% (CI: 57.0-57.7) and was lower amongst younger persons, men, residents of more deprived areas and people in specific geodemographic segments. Age and gender were significant determinants of uptake and contextual factors explained an additional 3% of the variation. Geodemographic segmentation reduced this residual contextual variation in uptake more than the IMD 2007 (72% vs. 53% reduction). The three geodemographic types that best predicted non-response were characterized by both ethnic mix and a higher than average proportion of single pensioner households renting council properties. Achieving average uptake in the 2.3% of the study population in these geodemographic segments would only increase the total population uptake rate by 0.5% (57.3-57.8%). CONCLUSION Variation in the CRC screening uptake in Southern England is principally explained by characteristics of individuals but contextual factors also have a small but significant effect. This effect is captured in greater detail by geodemographic segmentation than by IMD 2007. This information could be used to inform the design of interventions aiming to improve uptake.
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Affiliation(s)
- Kelechi E Nnoaham
- South Central Strategic Health Authority, Newbury, Berkshire RG14 2PZ, UK.
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8
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Abstract
The risk factors are known, but public policy is lagging behind
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9
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Frater A. B107: Prevention Issues for Women's Health in the New Millennium. Public Health 2004. [DOI: 10.1016/j.puhe.2003.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Frater A. Gender and health care in the UK. Public Health 2004. [DOI: 10.1016/j.puhe.2003.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Frater A, Gill M. Clinical networks. Sum of the parts. Health Serv J 2002; 112:24-5. [PMID: 12412328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A simulation exercise intended to ease the development of clinical networks found that primary care trusts were eager to co-operate with one other. Acute trusts emerged as the most confident 'players'; they were perceived as a 'provider cabal' by PCTs. Participants felt the legacy of the internal market might have impeded joint-working across trusts. The regulator role of strategic health authorities was crucial.
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Cuzick J, Sasieni P, Davies P, Adams J, Normand C, Frater A, van Ballegooijen M, van den Akker-van Marle E. A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions. Br J Cancer 2000; 83:561-5. [PMID: 10944591 PMCID: PMC2363499 DOI: 10.1054/bjoc.2000.1375] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A systematic review of the available evidence on the role of HPV testing in cervical screening has been published by the Health Technology Assessment Committee of the UK Department of Health. The review summarized relevant data on testing methods, natural history, and prevalence of the virus in different disease groups. Cost-effectiveness modelling was undertaken. Ten major conclusions were reached and are reported here. The key conclusions were that HPV testing was more sensitive than cytology, but that there were concerns about specificity, especially in young women. The increased sensitivity led to a recommendation that HPV testing be introduced on a pilot basis for women with borderline and mild smears. HPV testing has great potential as a primary screening test, but large trials are needed to properly evaluate this application and to determine if its introduction can reduce invasive cancer rates. There is an urgent need to undertake a large trial of HPV testing in conjunction with other new technologies (liquid-based cytology and computer-assisted cytology reading) to determine the best way to integrate them into ongoing screening programmes. A range of issues including the age to start and stop screening, the appropriate screening interval, the role of self-sampling for HPV testing and the choice of primary test (HPV and/or cytology) require further evaluation.
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Affiliation(s)
- J Cuzick
- Department of Mathematics, Statistics and Epidemiology, Imperial Cancer Research Fund, London, UK
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13
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Cuzick J, Sasieni P, Davies P, Adams J, Normand C, Frater A, van Ballegooijen M, van den Akker E. A systematic review of the role of human papillomavirus testing within a cervical screening programme. Health Technol Assess 2000; 3:i-iv, 1-196. [PMID: 10530393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Affiliation(s)
- J Cuzick
- Department of Mathematics, Statistics and Epidemiology, Imperial Cancer Research Fund, London, UK
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14
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Frater A. Quality of care in developing countries: relevance and reality. Qual Health Care 1997; 6:179-80. [PMID: 10177030 PMCID: PMC1055488 DOI: 10.1136/qshc.6.4.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
The patient-administered Health Assessment Questionnaire (HAQ) is widely used in rheumatology studies. Another health quality assessment technique commonly used for other non-rheumatological conditions is the 'Short Form 36' (SF36). This has questions designed to assess eight aspects of health ranging from physical limitations to general perceptions of vitality and mental well-being. This study presents information on the health status of 137 patients with rheumatoid arthritis (RA) assessed by both the SF36 and HAQ. Summary statistics are given for the elements of the SF36 according to age, gender, disease measures of RA and the presence of co-morbidity. There were significant associations between the physical functioning score of the SF36 and the HAQ score. with other measures of disease activity and severity, and with co-morbidity, although there was considerable inter-patient variability. These findings suggest that future applications of health status questionnaires are possible.
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Affiliation(s)
- J Talamo
- Department of Rheumatology, City Hospital, St Albans, Herts
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16
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Frater A. Priority Setting: The Health Care Debate. Qual Health Care 1996. [DOI: 10.1136/qshc.5.4.260-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Frater A, Turner L, Jones G. Locality information. Kind Herts and coronaries. Health Serv J 1996; 106:32-4. [PMID: 10158258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- A Frater
- Hertfordshire Health Authorities, UK
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19
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Frater A. A Review of Economic Policy Analysis. A Rights Based Approach. Qual Health Care 1995. [DOI: 10.1136/qshc.4.1.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Affiliation(s)
- J Shanks
- South East London Health Authority
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22
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23
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Frater A. Healthy outcomes. Health Service Journal conference, London, November 1992. Qual Health Care 1993. [DOI: 10.1136/qshc.2.1.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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24
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Chapple J, Frater A, Thames N. Audit guidelines in public health medicine. Qual Health Care 1992. [DOI: 10.1136/qshc.1.2.144-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Frater A. Auditing medical audit. Association for Management Education for Clinicians (AMEC) conference, Birmingham, March 1992. Qual Health Care 1992. [DOI: 10.1136/qshc.1.2.145-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Eccles S, Barber N, Frater A, Wilson P. A better pill to swallow. Health Serv J 1992; 102:22-3. [PMID: 10118087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- S Eccles
- North West Thames Regional Health Authority
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Frater A, Moss F. Computing. When no tech is best. Health Serv J 1991; 101:36. [PMID: 10112562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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30
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Frater A, Buchan H. Physician, heal thy software. Br J Hosp Med (Lond) 1991; 45:47-8. [PMID: 2009441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This article begins with the view that computers are not essential for medical audit. There is a lot of pressure from manufacturers and enthusiasts to purchase computers as a prerequisite to undertaking medical audit. The authors challenge this view and provide a useful checklist of questions to ask before deciding to buy a computer and discuss how to choose the right system for your needs, once the decision has been made.
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Affiliation(s)
- A Frater
- North West Thames Regional Health Authority, London
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31
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Frater A, Spiby J. Groundwork for audit. Health Serv J 1990; 100:1682-4. [PMID: 10108244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- A Frater
- North West Thames Regional Health Authority
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32
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