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Webb R, Ford E, Shakespeare J, Easter A, Alderdice F, Holly J, Coates R, Hogg S, Cheyne H, McMullen S, Gilbody S, Salmon D, Ayers S. Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis. Health Soc Care Deliv Res 2024; 12:1-187. [PMID: 38317290 DOI: 10.3310/kqfe0107] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care. Objectives Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services. Methods Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders. Data sources Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews. Review methods In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway. Results Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women's economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels. Limitations In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low (n = 14) or critically low (n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English. Conclusions The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services. Recommendations for health policy and practice These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it. Future work Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries. Trial registration This trial is registered as PROSPERO: (R1) CRD42019142854; (R2) CRD42020193107. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR 128068) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton & Sussex Medical School, Falmer, UK
| | | | - Abigail Easter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fiona Alderdice
- Oxford Population Health, National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Sally Hogg
- The Parent-Infant Foundation, London, UK
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Simon Gilbody
- Mental Health and Addictions Research Group, University of York, York, UK
| | - Debra Salmon
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
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Skelton E, Webb R, Malamateniou C, Rutherford M, Ayers S. The impact of antenatal imaging on parent experience and prenatal attachment: a systematic review. J Reprod Infant Psychol 2024; 42:22-44. [PMID: 35736666 DOI: 10.1080/02646838.2022.2088710] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 06/04/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Medical imaging in pregnancy (antenatal imaging) is routine. However, the effect of seeing fetal images on the parent-fetal relationship is not well understood, particularly for fathers or partners, or when using advanced imaging technologies. This review aimed to explore how parent experience and prenatal attachment is impacted by antenatal imaging. METHOD Database searches were performed between September 2020 and April 2021 Inclusion criteria were English language primary research studies published since 2000, describing or reporting measures of attachment after antenatal imaging in expectant parents. The Pillar Integration Process was used for integrative synthesis. FINDINGS Twenty-three studies were included. Six pillar themes were developed: 1) the scan experience begins before the scan appointment; 2) the scan as a pregnancy ritual; 3) feeling actively involved in the scan; 4) parents' priorities for knowledge and understanding of the scan change during pregnancy; 5) the importance of the parent-sonographer partnership during scanning; and 6) scans help to create a social identity for the unborn baby. CONCLUSION Antenatal imaging can enhance prenatal attachment. Parents value working collaboratively with sonographers to be actively involved in the experience. Sonographers can help facilitate attachment by delivering parent-centred care tailored to parents' emotional and knowledge needs.
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Affiliation(s)
- Emily Skelton
- Division of Radiography and Midwifery, City University of London, London, UK
| | - Rebecca Webb
- Centre for Maternal and Child Health Research, City University of London, London, UK
| | | | | | - Susan Ayers
- Centre for Maternal and Child Health Research, City University of London, London, UK
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Kodosaki E, Daniels-Morgan A, Hassan N, Webb R, Morris K, Kelly CM. Development and characterisation of mgTHP-1, a novel in vitro model for neural macrophages with microglial characteristics. Neurol Res 2024; 46:1-13. [PMID: 37935114 DOI: 10.1080/01616412.2023.2257422] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/23/2023] [Indexed: 11/09/2023]
Abstract
Neuroinflammation is primarily characterised by activation of the brain's resident macrophages - the microglia. However, other central nervous system (CNS) cells also contribute to this response, including the astrocytes and endothelial cells. In addition, there is infiltration into the CNS of peripherally derived immune cells. Together these cells mediate inflammation by the production of cytokines, chemokines, reactive oxygen species, and secondary messengers, and enacting of the appropriate response to those signals. However, deciphering the specific contributions of each cell type has been challenging. Studying CNS cell biology is often challenging, as the isolation of primary cells is not always feasible, and differentiation towards microglia-like cells is complex. Here, we demonstrate a novel method whereby THP-1 monocytic cells are differentiated into neural macrophage cells with microglia-like cell characteristics. The cells, designated mgTHP-1, show typical morphological and gene expression patterns of resident CNS macrophages and functionally respond to inflammatory stimuli by producing inflammatory cytokines. Furthermore, with the addition of Vicenin-2 (an anti-inflammatory flavonoid) such responses can be reversed. This novel cell model will allow further investigations, and hence insights, into the neuroinflammatory mechanisms associated with CNS diseases.
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Affiliation(s)
- E Kodosaki
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - A Daniels-Morgan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - N Hassan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - R Webb
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - K Morris
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - C M Kelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Andrei AM, Webb R, Enea V. Health anxiety, death anxiety and coronaphobia: Predictors of postpartum depression symptomatology during the COVID-19 pandemic. Midwifery 2023; 124:103747. [PMID: 37276749 PMCID: PMC10229209 DOI: 10.1016/j.midw.2023.103747] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/07/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine levels of postpartum depression symptoms and possible relevant predictors, such as death anxiety, health anxiety, and coronavirus-related anxiety. DESIGN Cross-sectional web-based survey using quantitative methods. SETTING Exclusively online recruiting via social media and unpaid cross-posting conducted during the third wave of the COVID-19 pandemic in Romania. PARTICIPANTS Women were eligible to take part in the study if they were mothers over the age of 18 and had a baby aged between 4 weeks - 12 months of age; 1024 women were included in the final sample. MEASUREMENTS AND FINDINGS Health anxiety, death anxiety, coronavirus-related anxiety, and postpartum depression symptoms were measured using validated instruments. Current depression symptomatology was 67.6%, 26.7% scored above the cut-off for high health anxiety, 1% for coronavirus-related anxiety, and 62.7% for death anxiety. Significant predictors for depressive symptomatology were breastfeeding, history of depression, family income, number of children, health anxiety, death anxiety, and coronavirus anxiety. Further, hierarchical multiple regression analysis indicated that death anxiety, health anxiety, and coronavirus anxiety predicted postpartum depression symptoms over and above socio-demographic factors. KEY CONCLUSIONS Supported by previous studies, our results suggest that postpartum depression symptomatology levels during the COVID-19 pandemic are high and that they are predicted by health and death anxiety, which are also increased during the pandemic. IMPLICATION FOR PRACTICE The findings provide information to identify the risk for depression symptoms in postpartum mothers during acute public health situations.
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Affiliation(s)
- Ana-Maria Andrei
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
| | | | - Violeta Enea
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania.
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Webb R, Uddin N, Constantinou G, Ford E, Easter A, Shakespeare J, Hann A, Roberts N, Alderdice F, Sinesi A, Coates R, Hogg S, Ayers S. Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare. BMJ Open 2023; 13:e066703. [PMID: 37474171 PMCID: PMC10360426 DOI: 10.1136/bmjopen-2022-066703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/22/2023] Open
Abstract
Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. OBJECTIVES To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. DESIGN A meta-review of systematic reviews. REVIEW METHODS Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. RESULTS A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. CONCLUSION The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO REGISTRATION NUMBER CRD42019142854.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City University, London, UK
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, City University, London, UK
| | | | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Abigail Easter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | | | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- Nuffield Department of Population Health, National Perinatal Epidemiology Unit, Oxford, UK
| | - Andrea Sinesi
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), University of Stirling, Stirling, UK
| | - Rose Coates
- Centre for Maternal and Child Health Research, City University, London, UK
| | - Sally Hogg
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University, London, UK
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Webb R, Ford E, Easter A, Shakespeare J, Holly J, Hogg S, Coates R, Ayers S. Conceptual frameworks of barriers and facilitators to perinatal mental healthcare: the MATRIx models. BJPsych Open 2023; 9:e127. [PMID: 37439097 PMCID: PMC10375902 DOI: 10.1192/bjo.2023.510] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Perinatal mental health (PMH) problems are a leading cause of maternal death and increase the risk of poor outcomes for women and their families. It is therefore important to identify the barriers and facilitators to implementing and accessing PMH care. AIMS To develop a conceptual framework of barriers and facilitators to PMH care to inform PMH services. METHOD Relevant literature was systematically identified, categorised and mapped onto the framework. The framework was then validated through evaluating confidence with the evidence base and feedback from stakeholders (women and families, health professionals, commissioners and policy makers). RESULTS Barriers and facilitators to PMH care were identified at seven levels: individual (e.g. beliefs about mental illness), health professional (e.g. confidence addressing perinatal mental illness), interpersonal (e.g. relationship between women and health professionals), organisational (e.g. continuity of carer), commissioner (e.g. referral pathways), political (e.g. women's economic status) and societal (e.g. stigma). The MATRIx conceptual frameworks provide pictorial representations of 66 barriers and 39 facilitators to PMH care. CONCLUSIONS The MATRIx frameworks highlight the complex interplay of individual and system-level factors across different stages of the care pathway that influence women accessing PMH care and effective implementation of PMH services. Recommendations are made for health policy and practice. These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to PMH care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services and quality training for health professionals, with protected time to complete it.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton & Sussex Medical School, UK
| | - Abigail Easter
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK; and Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Jennifer Holly
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Sally Hogg
- Faculty of Education, University of Cambridge, UK
| | - Rose Coates
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, UK
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Frías-Álvareza P, Webb R, Brannelly L, Woodley KR, Skerratt LF, Berger L, Paris DBBP. 31 Chytridiomycosis reduces sperm production in young southern corroboree frogs. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab31] [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: 12/12/2022] Open
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Uddin N, Ayers S, Khine R, Webb R. The perceived impact of birth trauma witnessed by maternity health professionals: A systematic review. Midwifery 2022; 114:103460. [DOI: 10.1016/j.midw.2022.103460] [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] [Received: 08/09/2021] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 11/27/2022]
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Webb R, Ayers S, Shakespeare J. Improving accessing to perinatal mental health care. J Reprod Infant Psychol 2022; 40:435-438. [PMID: 36285387 DOI: 10.1080/02646838.2022.2121993] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health, School of Health Sciences, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health, School of Health Sciences, City, University of London, London, UK
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Kirby P, Villani M, Webb R. Children's Covid-19 writing and drawings and the existential imperative to educate for uncertainty. Child Soc 2022; 37:CHSO12573. [PMID: 35942021 PMCID: PMC9348414 DOI: 10.1111/chso.12573] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 06/15/2023]
Abstract
The Covid-19 pandemic provokes a pedagogic crisis: education is ill-adapted to accommodate multiple uncertainties in students' lives. We examine how pandemic uncertainty is registered in a global collection of writing and drawing from 4 to 17-years-old, during the 2020 lockdowns. The study engages with Biesta's (2021) philosophical work on 'world-centred education', offering empirical examples from the collection that goes beyond the immediacy of everyday lives. We identify educational implications: acknowledging students' present experiences of the world; a slowing of pedagogical tempo; supporting students to navigate desires and fears; a language for expressing uncertainty; and engaging students in ethical and existential difficulty.
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Affiliation(s)
- Perpetua Kirby
- Centre for Innovation and Research in Childhood and YouthUniversity of SussexBrightonUK
| | - Michela Villani
- Haute école du travail social, HES‐SO FribourgUniversity of Applied Sciences and Arts WesternDelémontSwitzerland
| | - Rebecca Webb
- Centre for Innovation and Research in Childhood and YouthUniversity of SussexBrightonUK
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Abstract
PURPOSE To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic. STUDY DESIGN AND METHODS Using a convergent mixed-methods approach, we recruited a convenience sample of women living in the United States who gave birth March 1, 2020 or later from social media Web sites. Participants completed the Postpartum Depression Screening Scale-Short Form and provided written answers to open-ended questions regarding their experiences at home with their new infant. RESULTS Our 262 participants were on average 32.6 years of age, the majority were White (82%), married or partnered (91.9%), and college educated (87.4%). Mean postpartum depression score was 17.7 (SD = 5.9) with 75% scoring ≥14, indicating significant postpartum depressive symptoms. Qualitative content analysis revealed five themes: Isolation and seclusion continue; Fear, anxiety, and stress filled the days; Grieving the loss of normal: It's just so sad; Complicated by postpartum depression: A dark time; and There is a silver lining. Quantitative and qualitative findings provided a holistic view of women's depressive symptoms and experiences at home with their infants during the COVID-19 pandemic. CLINICAL IMPLICATIONS Although policies that reduce risk of COVID-19 exposure and infection for patients and the health care team must continue to be implemented, the adverse effects of depressive symptoms on maternal-infant wellbeing within the context of increased isolation due to the pandemic need to be kept at the forefront. Nurses need to be aware of the consequences of women sheltering in place and social distancing on maternal-infant outcomes, particularly on depression and likelihood of breastfeeding.
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Tilton E, Mitchelson B, Anderson A, Peat B, Jack S, Lund M, Webb R, Wilson N. New Zealand Rheumatic Heart Disease Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.461] [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: 11/15/2022]
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Brown A, Nielsen JDJ, Russo K, Ayers S, Webb R. The Journey towards resilience following a traumatic birth: A grounded theory. Midwifery 2021; 104:103204. [PMID: 34839226 DOI: 10.1016/j.midw.2021.103204] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 10/01/2021] [Accepted: 11/12/2021] [Indexed: 11/25/2022]
Abstract
Statistics have shown that up to 30% of women experience birth as traumatising. However, most women do not go on to develop post-traumatic stress disorder (PTSD), and instead appear to be resilient. Research is still sparse in the field of traumatic birth and resilience, and it is not known how women develop resilience after a traumatic birth. OBJECTIVES The aim of this study was to understand the process of fostering resilience after a traumatic birth. METHOD Semi-structured interviews were conducted with eight female participants aged 30 to 50 years who experienced a traumatic birth. A constructivist grounded theory was used to analyse interviews. RESULTS Two main themes were identified which were developed into an emergent model: 1) the feeling of powerlessness during a traumatic birth; and 2) the journey towards resilience. The powerlessness of a traumatic birth was related to a perceived lack of voice and abandonment by healthcare professionals. The model revealed that women's journey towards resilience was aided by both internal and external resources that included healing self-care and ownership of the role of mother; and drawing upon faith, spirituality and supportive relationships. DISCUSSION The findings suggest resilience is a process whereby women draw upon internal and external resources or both at different points in their journey. The implications of the findings include training healthcare professionals in communication to avoid trauma during labour; and prompting women to identify and utilise both internal and external resources to help them to overcome any trauma.
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Affiliation(s)
- Abigail Brown
- CMHT Hertfordshire NHS Trust and Community Perinatal Team Hertfordshire NHS.
| | - Jessica D Jones Nielsen
- Department of Psychology, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Kate Russo
- Clinical Psychologist, IPA Consultant Psychology & Coaching, Townsville, Australia
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
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Pyae PK, Navarra A, Webb R, Newland-Smith A, Vancheeswaran R, Sehmi J, Barlow A. Three-month cardiac outcomes of survivors of COVID-19 presenting to a district general hospital in West Hertfordshire, UK. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
COVID-19 is novel entity associated with significant morbidity and mortality. Most patients recover completely, however, a proportion describe persistent symptoms consistent with cardiopulmonary disturbance. The long-term cardiac and respiratory outcomes of COVID-19 are not known.
Purpose
The aim of this study was to undertake a comprehensive cardiopulmonary assessment of survivors of COVID-19 with post recovery symptoms. The cardiac findings are presented here.
Methods
Survivors of COVID-19 presenting to a general hospital in West Hertfordshire between 18 March 2020 and 15 May 2020, were reviewed at 3 months using a structured prespecified protocol. Patients with persistent symptoms and those admitted to the intensive care unit (ICU) were invited to attend a clinical assessment comprising an electrocardiogram (ECG), echocardiography, chest x-ray (CXR) and pulmonary function tests. At follow up, patients were categorised according to disease course: 1) monitored via a community based virtual hospital, 2) admitted for supplemental oxygen, 3) requiring non-invasive ventilation and 4) ICU admission.
Results
448 eligible patients were evaluated by telephone. 11 patients admitted to ICU and 147 patients with persistent symptoms were invited for further assessment. At presentation, hospitalised patients were older, had higher levels of obesity and increased rates of hypertension than those managed virtually (p<0.05). Among hospitalised patients, the degree of pulmonary infiltration on CXR was higher, ROX index for intubation lower, eGFR lower, C-reactive protein levels higher and lymphocyte counts lower, compared to those managed virtually (p<0.05). The prevalence of known respiratory conditions was higher among patients admitted to hospital, with a trend towards statistical significance (p=0.051). There were no differences in the prevalence of known cardiac disorders and other co-morbidities amongst both patient groups (table 1).
At follow up, CXR appearances were improved and similar among patients monitored virtually, those admitted for supplemental oxygen, those requiring non-invasive ventilation and those treated on ICU. There were no differences in heart rhythm and ECG parameters in the four patient groups. Left ventricular systolic and diastolic dimensions, Simpson's biplane ejection fraction, left atrial volume and left ventricular filling pressures were similar in all four patient groups. There were no differences in right ventricular dimensions, right ventricular fractional area change, tricuspid annular plane systolic excursion and pulmonary artery systolic pressures among patients irrespective of disease severity (table 2).
Conclusions
At 3 months, we identified no differences in ECG indices and echocardiographic parameters of left and right ventricular function among survivors of COVID-19, independent of disease course. The findings of this study argue against significant cardiac sequalae following COVID-19 infection.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P K Pyae
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - A Navarra
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - R Webb
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - A Newland-Smith
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - R Vancheeswaran
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - J Sehmi
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
| | - A Barlow
- West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom
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Webb R, Ayers S, Bogaerts A, Jeličić L, Pawlicka P, Van Haeken S, Uddin N, Xuereb RB, Kolesnikova N. When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences. BMC Pregnancy Childbirth 2021; 21:475. [PMID: 34215219 PMCID: PMC8252193 DOI: 10.1186/s12884-021-03898-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 02/17/2021] [Accepted: 05/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background Pregnancy and childbirth are significant events in women’s lives and most women have expectations or plans for how they hope their labour and birth will go. It is possible that strong expectations about labour and birth lead to dissatisfaction or other negative outcomes if these expectations are not met, but it is not clear if this is the case. The aim was therefore to synthesise prospective studies in order to understand whether unmet birth expectations are associated with adverse outcomes for women, their partners and their infants. Method Searches were carried out in Academic Search Complete; CINAHL; Medline; PsycINFO, PsychArticles, PubMed, SCOPUS and Web of Science. Forward and backward searches were also completed. Studies were included if they reported prospective empirical research that examined the association between a mismatch in birth expectations/experience and postnatal outcomes in women, their children and/or their partners. Data were synthesised qualitatively using a narrative approach where study characteristics, context and methodological quality were extracted and summarised and then the differences and similarities among studies were used to draw conclusions. Results Eleven quantitative studies were identified for inclusion from nine countries. A mismatch between birth expectations and experiences was associated with reduced birth satisfaction. Three studies found a link between a mismatch and the development of postnatal post-traumatic stress disorder (PTSD). The evidence was inconsistent for postnatal depression, and fear of childbirth. Only one study looked at physical outcomes in the form of health-related quality of life. Conclusions A mismatch between birth expectations and experiences is associated with birth satisfaction and it may increase the risk of developing postnatal PTSD. However, it is not clear whether a mismatch is associated with other postnatal mental health conditions. Further prospective research is needed to examine gaps in knowledge and provide standardised methods of measuring childbirth expectations-experiences mismatch. To ensure women’s expectations are met, and therefore experience a satisfying birth experience, maternity providers should provide sensitive care, which acknowledges women’s needs and preferences, is based on open and clear communication, is delivered as early in pregnancy as possible, and enables women to make their own decisions about care. Trial registration Protocol registration: PROSPERO CRD42020191081. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03898-z.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK.
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | - Annick Bogaerts
- KU Leuven, Department of Development and Regeneration, Research Unit Women and Child, B-3000, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, Devon, PL4 8AA, UK
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Institute for Research and Development "Life Activities Advancement Center", Belgrade, Serbia.,Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Paulina Pawlicka
- Department of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Sarah Van Haeken
- KU Leuven, Department of Development and Regeneration, Research Unit Women and Child, B-3000, Leuven, Belgium.,Research and Expertise, Resilient People, University College Leuven-Limburg, Diepenbeek, Belgium
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | - Rita Borg Xuereb
- Department of Midwifery, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Natalija Kolesnikova
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
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16
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Yassin Alsabbagh A, Higgs N, Moutasim K, Foria V, Webb R. Epstein - Barr virus positive Mucocutaenous ulcer presenting as medication related osteonecrosis of the jaw. Advances in Oral and Maxillofacial Surgery 2021. [DOI: 10.1016/j.adoms.2021.100096] [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: 11/25/2022] Open
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17
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Webb R, Uddin N, Ford E, Easter A, Shakespeare J, Roberts N, Alderdice F, Coates R, Hogg S, Cheyne H, Ayers S. Barriers and facilitators to implementing perinatal mental health care in health and social care settings: a systematic review. Lancet Psychiatry 2021; 8:521-534. [PMID: 33838118 DOI: 10.1016/s2215-0366(20)30467-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023]
Abstract
The improvement of perinatal mental health formed part of WHO's Millennium Development Goals. Research suggests that the implementation of perinatal mental health care is variable. To ensure successful implementation, barriers and facilitators to implementing perinatal mental health services need to be identified. Therefore, we aimed to identify the barriers and facilitators to implementing assessment, care, referral, and treatment for perinatal mental health into health and social care services. In this systematic review, we searched CINAHL, Embase, MEDLINE, and PsycINFO with no language restrictions for primary research articles published between database inception and Dec 11, 2019. Forward and backward searches of included studies were completed by March 31, 2020. Studies were eligible if they made statements about factors that either facilitated or impeded the implementation of perinatal mental health assessment, care, referral, or treatment. Partial (10%) dual screening was done. Data were extracted with EPPI-Reviewer 4 and analysed by use of a thematic synthesis. The protocol is registered on PROSPERO, CRD42019142854. Database searching identified 21 535 citations, of which 46 studies were included. Implementation occurred in a wide range of settings and was affected by individual (eg, an inability to attend treatment), health-care professional (eg, training), interpersonal (eg, trusting relationships), organisational (eg, clear referral pathways), political (eg, funding), and societal factors (eg, stigma and culture). A complex range of barriers and facilitators affect the implementation of perinatal mental health policy and practice. Perinatal mental health services should be flexible and women-centred, and delivered by well trained health-care professionals working within a structure that facilitates continuity of carer. Strategies that can be used to improve implementation include, but are not limited to, co-production of services, implementation team meetings, funding, and coalition building. Future research should focus on implementation barriers and facilitators dependent on illness severity, the health-care setting, and inpatient care.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health, City, University of London, London, UK.
| | - Nazihah Uddin
- Centre for Maternal and Child Health, City, University of London, London, UK
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton & Sussex Medical School, Falmer, UK
| | - Abigail Easter
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Nia Roberts
- Nuffield Department of Population Health, Bodleian Health Care Libraries, Oxford, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Rose Coates
- Centre for Maternal and Child Health, City, University of London, London, UK
| | | | - Helen Cheyne
- NMAHP Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Susan Ayers
- Centre for Maternal and Child Health, City, University of London, London, UK
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18
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Oliveira A, Priviero F, Webb R, Nunes K. HSP70 Contributes to Ca
2+
Handling in Phenylephrine‐induced Vascular Contraction. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.02329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Amanda Oliveira
- Biomedical and Chemical Engineering and SciencesFlorida Institute of TechnologyMelbourneFL
| | - Fernanda Priviero
- PhysiologyAugusta UniversityAugustaGA
- Cell Biology and AnatomyAugusta UniversityAugustaGA
| | - R. Webb
- Cell Biology and AnatomyUniversity of South CarolinaColumbiaSC
| | - Kenia Nunes
- Biomedical and Chemical Engineering and SciencesFlorida Institute of TechnologyMelbourneFL
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19
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Greenwood K, Webb R, Gu J, Fowler D, de Visser R, Bremner S, Abramowicz I, Perry N, Clark S, O'Donnell A, Charlton D, Jarvis R, Garety P, Nandha S, Lennox B, Johns L, Rathod S, Phiri P, French P, Law H, Hodgekins J, Painter M, Treise C, Plaistow J, Irwin F, Thompson R, Mackay T, May CR, Healey A, Hooper R, Peters E. The Early Youth Engagement in first episode psychosis (EYE-2) study: pragmatic cluster randomised controlled trial of implementation, effectiveness and cost-effectiveness of a team-based motivational engagement intervention to improve engagement. Trials 2021; 22:272. [PMID: 33845856 PMCID: PMC8042707 DOI: 10.1186/s13063-021-05105-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/18/2020] [Accepted: 02/06/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Early Intervention in Psychosis (EIP) services improve health outcomes for young people with psychosis in the medium-long term, but 25% of young people disengage in the first 12 months with costs to their mental health, families, society and the NHS. This study will evaluate the effectiveness, cost-effectiveness and implementation of a team-based motivational Early Youth Engagement (EYE-2) intervention. METHOD The study design is a cluster randomised controlled trial (RCT) with economic evaluation, comparing the EYE-2 intervention + standardised EIP service to standardised EIP service alone, with randomisation at the team level. A process evaluation will evaluate the delivery of the intervention qualitatively and quantitatively across contexts. The setting is 20 EIP teams in 5 sites: Manchester, South London, East Anglia, Thames Valley and Hampshire. Participants are young people (14-35 years) with first episode psychosis, and EIP staff. The intervention is the team-based motivational engagement (EYE-2) intervention, delivered alongside standardised EIP services, and supported by additional training, website, booklets and social groups. The comparator is the standardised EIP service. Both interventions are delivered by EIP clinicians. The primary outcome is time to disengagement (time in days from date of allocation to care coordinator to date of last contact following refusal to engage with EIP service, or lack of response to EIP contact for a consecutive 3-month period). Secondary outcomes include mental and physical health, deaths, social and occupational function, recovery, satisfaction and service use at 6, 12, 18 and 24 months. A 12-month within-trial economic evaluation will investigate cost-effectiveness from a societal perspective and from an NHS perspective. DISCUSSION The trial will provide the first test of an engagement intervention in standardised care, with the potential for significant impact on the mental health and wellbeing of young people and their families, and economic benefits for services. The intervention will be highly scalable, supported by the toolkit including manuals, commissioning guide, training and resources, adapted to meet the needs of the diverse EIP population, and based on an in-depth process evaluation. TRIAL REGISTRATION ISRCTN 51629746 prospectively registered 7th May 2019. Date assigned 10th May 2019.
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Affiliation(s)
- Kathryn Greenwood
- R&D, Sussex Partnership NHS Foundation Trust, Hove, UK. .,School of Psychology, University of Sussex, Falmer, UK.
| | - Rebecca Webb
- School of Psychology, University of Sussex, Falmer, UK
| | - Jenny Gu
- School of Psychology, University of Sussex, Falmer, UK
| | - David Fowler
- R&D, Sussex Partnership NHS Foundation Trust, Hove, UK.,School of Psychology, University of Sussex, Falmer, UK.,University of East Anglia, Norwich, UK
| | | | - Stephen Bremner
- Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Iga Abramowicz
- Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Nicky Perry
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Stuart Clark
- Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Dan Charlton
- Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Philippa Garety
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Sunil Nandha
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Belinda Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Johns
- Department of Psychiatry, University of Oxford, Oxford, UK.,Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Paul French
- Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK.,Manchester Metropolitan University, Manchester, UK
| | - Heather Law
- Greater Manchester Mental Health NHS Foundation Trust, Greater Manchester, UK
| | | | | | - Cate Treise
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Francis Irwin
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | | | | | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andy Healey
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Richard Hooper
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Emmanuelle Peters
- King's College London, Institute of Psychiatry Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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20
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Webb R, Smith AM, Ayers S, Wright DB, Thornton A. Development and Validation of a Measure of Birth-Related PTSD for Fathers and Birth Partners: The City Birth Trauma Scale (Partner Version). Front Psychol 2021; 12:596779. [PMID: 33746826 PMCID: PMC7966709 DOI: 10.3389/fpsyg.2021.596779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/08/2021] [Indexed: 12/02/2022] Open
Abstract
Research suggests that some fathers and birth partners can experience post-traumatic stress disorder (PTSD) after witnessing a traumatic birth. Birth-related PTSD may impact on many aspects of fathers’ and birth partners’ life, including relationship breakdown, self-blame and reducing plans for future children. Despite the potential impact on birth partners’ lives there is currently no measure of birth-related PTSD validated for use with birth partners. The current study therefore adapted the City Birth Trauma Scale for use with birth partners. The City Birth Trauma Scale (Partner version) is a 29-item questionnaire developed to measure birth-related PTSD according to DSM-5 criteria: stressor criteria (A), symptoms of re-experiencing (B), avoidance (C), negative cognitions and mood (D), and hyperarousal (E), as well as duration of symptoms (F), significant distress or impairment (G), and exclusion criteria or other causes (H). A sample of 301 fathers/birth partners was recruited online and completed measures of birth-related PTSD, bonding, and demographic details. Results showed the City Birth Trauma Scale (Partner version) had good reliability (α = 0.94) and psychometric and construct validity. The fathers/birth partners version has the same two-factor structure as the original scale: (1) general symptoms and (2) birth-related symptoms, which accounted for 51% of the variance. PTSD symptoms were associated with preterm birth and maternal and infant complications. Overall, the City Birth Trauma Scale (Partner version) provides a promising measure of PTSD following childbirth that can be used in research and clinical practice.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Ann M Smith
- Neonatal Intensive Care Unit, Homerton University Hospital NHS Foundation Trust, London, United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Daniel B Wright
- Department of Educational Psychology and Higher Education, University of Nevada, Las Vegas, NV, United States
| | - Alexandra Thornton
- Perinatal Mental Health Service, West London NHS Trust, St Bernard's Hospital, London, United Kingdom
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21
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Webb R, Whitham A, Tripodis Y, Long WE, Garg A. Does Parental Report of Having a Medical Home Attenuate the Negative Association Between Unmet Basic Needs and Health for Low-Income Children? Glob Pediatr Health 2020; 7:2333794X20985805. [PMID: 33457465 PMCID: PMC7783885 DOI: 10.1177/2333794x20985805] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/23/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background. It is unknown whether the medical home reduces the impact of adverse social determinants on low-income child health. Objective. To examine whether the medical home attenuates the association between unmet basic needs and health for low-income children. Design/Methods. Secondary data analysis of the 2011-12 NSCH restricted to <200% FPL children (n = 26 974). Multivariable logistic regression modeled child health with unmet basic needs to examine the effect modification of the medical home. Results. Low-income children with unmet needs had lower odds of "excellent/very good" health compared to children without unmet needs, regardless of the medical home [aOR = 0.78 (0.61-0.99) vs aOR = 0.77 (0.63-0.94), P = .01), respectively]. The medical home did not modify the negative association between unmet basic needs and "excellent/very good" child health (P = .97). Conclusion. Having a medical home per parental report did not attenuate the negative relationship between unmet basic needs and lowincome child health.
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Affiliation(s)
- Rebecca Webb
- Boston University School of Medicine,
Boston Medical Center, Boston, MA, USA
| | - Anna Whitham
- Boston University School of Medicine,
Boston Medical Center, Boston, MA, USA
| | | | | | - Arvin Garg
- Boston University School of Medicine,
Boston Medical Center, Boston, MA, USA
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22
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Webb R, Bartl G, James B, Skan R, Peters E, Jones AM, Garety P, Kuipers E, Hayward M, Greenwood K. Exploring the Development, Validity, and Utility of the Short-Form Version of the CHoice of Outcome In Cbt for PsychosEs: A Patient-Reported Outcome Measure of Psychological Recovery. Schizophr Bull 2020; 47:653-661. [PMID: 33215190 PMCID: PMC8084424 DOI: 10.1093/schbul/sbaa173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/13/2022]
Abstract
The original CHoice of Outcome In Cbt for psychosEs (CHOICE) measure was designed in collaboration with experts by experience as a patient-reported "Psychological Recovery" outcome measure for cognitive-behavioral therapy for psychosis (CBTp). A short version (CHOICE-SF) was developed to use as a brief outcome measure, with a focus on sensitivity to change, for use in future research and practice. CHOICE-SF was developed and validated using 3 separate samples, comprising 640 service users attending 1 of 2 transdiagnostic clinics for (1) CBTp or (2) therapies for voice hearing or (3) who took part in the treatment as usual arm of a trial. In the initial subsample of 69 participants, items from the original CHOICE measure with medium to large effect sizes for change pre- to post-CBTp were retained to form the CHOICE-SF. Internal consistency, construct validity, and sensitivity to change were confirmed, and the factor structure was examined in 242 participants. Specificity was confirmed by comparison with 44 participants who completed CHOICE at 2 time points but did not receive therapy. Validation of CHOICE-SF was carried out by confirming factor structure and sensitivity to change in a new sample of 354 and a subsample of 51 participants, respectively. The CHOICE-SF comprised 11 items and 1 additional personal goal item. A single-factor structure was confirmed, with high internal consistency, construct validity, and sensitivity to change. The CHOICE-SF is a brief, psychometrically robust measure to assess change following psychological therapies in research and clinical practice for people with psychosis and severe mental illness.
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Affiliation(s)
- Rebecca Webb
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Gergely Bartl
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Bryony James
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Rosie Skan
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,Psychological Interventions Clinic for Outpatients With Psychosis, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
| | - Anna-Marie Jones
- R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Philippa Garety
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Elizabeth Kuipers
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,Psychological Interventions Clinic for Outpatients With Psychosis, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK,National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Mark Hayward
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK,R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Kathryn Greenwood
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK,R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK,To whom correspondence should be addressed; tel: +44 1273 678409, fax: +44 1273 678058, e-mail:
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23
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Pebody R, Djennad A, Ellis J, Andrews N, Marques DFP, Cottrell S, Reynolds AJ, Gunson R, Galiano M, Hoschler K, Lackenby A, Robertson C, O'Doherty M, Sinnathamby M, Panagiotopoulos N, Yonova I, Webb R, Moore C, Donati M, Sartaj M, Shepherd SJ, McMenamin J, de Lusignan S, Zambon M. End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18. ACTA ACUST UNITED AC 2020; 24. [PMID: 31387673 PMCID: PMC6685099 DOI: 10.2807/1560-7917.es.2019.24.31.1800488] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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] [Indexed: 12/03/2022]
Abstract
Background In the United Kingdom (UK), in recent influenza seasons, children are offered a quadrivalent live attenuated influenza vaccine (LAIV4), and eligible adults mainly trivalent inactivated vaccine (TIV). Aim To estimate the UK end-of-season 2017/18 adjusted vaccine effectiveness (aVE) and the seroprevalence in England of antibodies against influenza viruses cultured in eggs or tissue. Methods This observational study employed the test-negative case–control approach to estimate aVE in primary care. The population-based seroprevalence survey used residual age-stratified samples. Results Influenza viruses A(H3N2) (particularly subgroup 3C.2a2) and B (mainly B/Yamagata/16/88-lineage, similar to the quadrivalent vaccine B-virus component but mismatched to TIV) dominated. All-age aVE was 15% (95% confidence interval (CI): −6.3 to 32) against all influenza; −16.4% (95% CI: −59.3 to 14.9) against A(H3N2); 24.7% (95% CI: 1.1 to 42.7) against B and 66.3% (95% CI: 33.4 to 82.9) against A(H1N1)pdm09. For 2–17 year olds, LAIV4 aVE was 26.9% (95% CI: −32.6 to 59.7) against all influenza; −75.5% (95% CI: −289.6 to 21) against A(H3N2); 60.8% (95% CI: 8.2 to 83.3) against B and 90.3% (95% CI: 16.4 to 98.9) against A(H1N1)pdm09. For ≥ 18 year olds, TIV aVE against influenza B was 1.9% (95% CI: −63.6 to 41.2). The 2017 seroprevalence of antibody recognising tissue-grown A(H3N2) virus was significantly lower than that recognising egg-grown virus in all groups except 15–24 year olds. Conclusions Overall aVE was low driven by no effectiveness against A(H3N2) possibly related to vaccine virus egg-adaption and a new A(H3N2) subgroup emergence. The TIV was not effective against influenza B. LAIV4 against influenza B and A(H1N1)pdm09 was effective.
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Affiliation(s)
| | | | | | | | | | | | | | - Rory Gunson
- West of Scotland Specialist Virology Centre, Glasgow, United Kingdom
| | | | | | | | | | - Mark O'Doherty
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | | | | | - Ivelina Yonova
- Royal College of General Practitioners, London, United Kingdom.,University of Surrey, Guildford, United Kingdom
| | | | | | | | - Muhammad Sartaj
- Public Health Agency Northern Ireland, Belfast, United Kingdom
| | | | | | - Simon de Lusignan
- Royal College of General Practitioners, London, United Kingdom.,University of Surrey, Guildford, United Kingdom
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24
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, 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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Jang M, Costa C, Bunch J, Gibson B, Ismail M, Palitsin V, Webb R, Hudson M, Bailey MJ. On the relevance of cocaine detection in a fingerprint. Sci Rep 2020; 10:1974. [PMID: 32029797 PMCID: PMC7005170 DOI: 10.1038/s41598-020-58856-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 12/17/2019] [Indexed: 12/13/2022] Open
Abstract
The finding that drugs and metabolites can be detected from fingerprints is of potential relevance to forensic science and as well as toxicology and clinical testing. However, discriminating between dermal contact and ingestion of drugs has never been verified experimentally. The inability to interpret the result of finding a drug or metabolite in a fingerprint has prevented widespread adoption of fingerprints in drug testing and limits the probative value of detecting drugs in fingermarks. A commonly held belief is that the detection of metabolites of drugs of abuse in fingerprints can be used to confirm a drug has been ingested. However, we show here that cocaine and its primary metabolite, benzoylecgonine, can be detected in fingerprints of non-drug users after contact with cocaine. Additionally, cocaine was found to persist above environmental levels for up to 48 hours after contact. Therefore the detection of cocaine and benzoylecgonine (BZE) in fingermarks can be forensically significant, but do not demonstrate that a person has ingested the substance. In contrast, the data here shows that a drug test from a fingerprint (where hands can be washed prior to donating a sample) CAN distinguish between contact and ingestion of cocaine. If hands were washed prior to giving a fingerprint, BZE was detected only after the administration of cocaine. Therefore BZE can be used to distinguish cocaine contact from cocaine ingestion, provided donors wash their hands prior to sampling. A test based on the detection of BZE in at least one of two donated fingerprint samples has accuracy 95%, sensitivity 90% and specificity of 100% (n = 86).
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Affiliation(s)
- M Jang
- Department of Chemistry, University of Surrey, Guildford, GU2 7XH, UK
| | - C Costa
- Ion Beam Centre, University of Surrey, Guildford, GU2 7XH, UK
| | - J Bunch
- National Physical Laboratory, Teddington, TW11 0LW, UK
| | - B Gibson
- Forensic Science Ireland, Dublin, Republic of Ireland
| | - M Ismail
- Department of Chemistry, University of Surrey, Guildford, GU2 7XH, UK
| | - V Palitsin
- Ion Beam Centre, University of Surrey, Guildford, GU2 7XH, UK
| | - R Webb
- Ion Beam Centre, University of Surrey, Guildford, GU2 7XH, UK
| | - M Hudson
- Intelligent Fingerprinting Limited, Milton Road, Impington, Cambridge, CB24 9NG, UK
| | - M J Bailey
- Department of Chemistry, University of Surrey, Guildford, GU2 7XH, UK.
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Ayers S, Bond R, Webb R, Miller P, Bateson K. Perinatal mental health and risk of child maltreatment: A systematic review and meta-analysis. Child Abuse Negl 2019; 98:104172. [PMID: 31698284 DOI: 10.1016/j.chiabu.2019.104172] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/27/2019] [Accepted: 08/31/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Mental health problems in parents have been identified as a risk factor for child maltreatment. The perinatal period (from conception to 1 year) is a critical period but it is unclear whether perinatal mental health problems are also associated with increased risk. OBJECTIVE To review evidence on perinatal mental health and risk of child maltreatment. METHODS Searches were conducted on six databases and 24 studies reported in 30 papers identified. Studies were conducted in seven countries, mainly the USA (n = 14). Sample sizes ranged from 48-14,893 and most examined mothers (n = 17). Studies were conducted in community (n = 17) or high-risk (n = 7) samples. RESULTS The majority of studies found a relationship between parental perinatal mental health problems and risk of child maltreatment, but inconsistent findings were observed between and within studies. The few studies that examined fathers (n = 6) all found a relationship between fathers' mental health and risk of child maltreatment. Meta-analysis of 17 studies (n = 22,042) showed perinatal mental health problems increased risk of child maltreatment by OR 3.04 (95% CI 2.29-4.03). This relationship was moderated by type of sample, with larger effects for risk of child maltreatment in high-risk samples. The relationship was not moderated by type of mental illness, child maltreatment; methodological or measurement factors. CONCLUSION The association between perinatal mental health and risk of child maltreatment is similar to that observed at other times during childhood. Methodological heterogeneity and inconsistent findings mean conclusions are tentative and need to be considered alongside other individual, family and social/cultural risk factors.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom.
| | - Rod Bond
- School of Psychology, University of Sussex, Falmer, East Sussex, BN1 9RH, United Kingdom
| | - Rebecca Webb
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Pamela Miller
- National Society for the Prevention of Cruelty to Children (NSPCC), Weston House, 42 Curtain Road, London, EC2A 3NH, United Kingdom
| | - Karen Bateson
- National Society for the Prevention of Cruelty to Children (NSPCC), Weston House, 42 Curtain Road, London, EC2A 3NH, United Kingdom
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27
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Ayers S, Crawley R, Webb R, Button S, Thornton A. What are women stressed about after birth? Birth 2019; 46:678-685. [PMID: 31612558 DOI: 10.1111/birt.12455] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Having a baby is associated with a variety of stressors, change, and adjustment. This study aimed to identify what women find stressful during the early postpartum period in contemporary Western society. METHODS Women (n = 148) 6-12 weeks postpartum wrote anonymously about a situation they found stressful as part of the Health after Birth Trial (HABiT) of expressive writing. Transcripts were analyzed for categories of stressors and cross-cutting themes. RESULTS Five categories of stressors were identified. Stressors in pregnancy, labor, and the early postpartum period (49.3%) included physical and emotional difficulties, and insensitive treatment by health professionals. Stressors related to adjusting to life with a baby (35.8%) included difficulties coping with a new baby, parenting, juggling responsibilities, changes to physical health, and loneliness. Stressors related to the baby's health (32.4%) included infant digestive problems, acute health problems, long-term impact, and neonatal intensive care unit experiences. Stressors related to breastfeeding (23.7%) included pressure to breastfeed, feeling like a 'bad mum' for not breastfeeding, or wanting to breastfeed and not being able to. Other stressors related to changing relationships (18.2%): with their partner, children, and other family members. Cross-cutting themes that emerged in different stressor categories were women making negative self-appraisals (eg, a bad mum, failure), feeling guilty, and lack of support from others. DISCUSSION Our findings emphasize the importance of exploring stressors and psychological well-being with women to provide support, help women's adjustment postpartum, and ensure interventions are offered when appropriate.
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Affiliation(s)
- Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | | | - Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Susan Button
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London, UK
| | - Alexandra Thornton
- Centre for Maternal and Child Health Research, City, University of London, London, UK
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de Lusignan S, Correa A, Dos Santos G, Meyer N, Haguinet F, Webb R, McGee C, Byford R, Yonova I, Pathirannehelage S, Ferreira FM, Jones S. Enhanced Safety Surveillance of Influenza Vaccines in General Practice, Winter 2015-16: Feasibility Study. JMIR Public Health Surveill 2019; 5:e12016. [PMID: 31724955 PMCID: PMC6913774 DOI: 10.2196/12016] [Citation(s) in RCA: 5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/23/2018] [Accepted: 03/22/2019] [Indexed: 12/01/2022] Open
Abstract
Background The European Medicines Agency (EMA) requires vaccine manufacturers to conduct enhanced real-time surveillance of seasonal influenza vaccination. The EMA has specified a list of adverse events of interest to be monitored. The EMA sets out 3 different ways to conduct such surveillance: (1) active surveillance, (2) enhanced passive surveillance, or (3) electronic health record data mining (EHR-DM). English general practice (GP) is a suitable setting to implement enhanced passive surveillance and EHR-DM. Objective This study aimed to test the feasibility of conducting enhanced passive surveillance in GP using the yellow card scheme (adverse events of interest reporting cards) to determine if it has any advantages over EHR-DM alone. Methods A total of 9 GPs in England participated, of which 3 tested the feasibility of enhanced passive surveillance and the other 6 EHR-DM alone. The 3 that tested EPS provided patients with yellow (adverse events) cards for patients to report any adverse events. Data were extracted from all 9 GPs’ EHRs between weeks 35 and 49 (08/24/2015 to 12/06/2015), the main period of influenza vaccination. We conducted weekly analysis and end-of-study analyses. Results Our GPs were largely distributed across England with a registered population of 81,040. In the week 49 report, 15,863/81,040 people (19.57% of the registered practice population) were vaccinated. In the EPS practices, staff managed to hand out the cards to 61.25% (4150/6776) of the vaccinees, and of these cards, 1.98% (82/4150) were returned to the GP offices. Adverse events of interests were reported by 113 /7223 people (1.56%) in the enhanced passive surveillance practices, compared with 322/8640 people (3.73%) in the EHR-DM practices. Conclusions Overall, we demonstrated that GPs EHR-DM was an appropriate method of enhanced surveillance. However, the use of yellow cards, in enhanced passive surveillance practices, did not enhance the collection of adverse events of interests as demonstrated in this study. Their return rate was poor, data entry from them was not straightforward, and there were issues with data reconciliation. We concluded that customized cards prespecifying the EMA’s adverse events of interests, combined with EHR-DM, were needed to maximize data collection. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2016-015469
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Affiliation(s)
- Simon de Lusignan
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | - Ana Correa
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | | | | | | | - Rebecca Webb
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | - Christopher McGee
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom.,Royal College of General Practitioners, London, United Kingdom
| | - Rachel Byford
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | - Ivelina Yonova
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom.,Royal College of General Practitioners, London, United Kingdom
| | - Sameera Pathirannehelage
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | - Filipa Matos Ferreira
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom
| | - Simon Jones
- University of Surrey, Department of Clinical and Experimental Medicine, Guildford, United Kingdom.,NYU School of Medicine, Department of Population Health, New York, NY, United States
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Mitchell OR, Plumb JOM, Webb R. Use of a suction tube to prevent nasal pressure sores during nasotracheal intubation. Br J Oral Maxillofac Surg 2019; 57:950-952. [PMID: 31473039 DOI: 10.1016/j.bjoms.2019.07.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - R Webb
- Southampton General Hospital.
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30
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Webb R, Ayers S. Postnatal mental health and mothers’ processing of infant emotion: an eye-tracking study. Anxiety, Stress, & Coping 2019; 32:484-497. [DOI: 10.1080/10615806.2019.1620215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, UK
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31
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Brook J, Aitken L, Webb R, MacLaren J, Salmon D. Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: A systematic review. Int J Nurs Stud 2019; 91:47-59. [DOI: 10.1016/j.ijnurstu.2018.11.003] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 11/24/2022]
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32
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de Lusignan S, Smith N, Livina V, Yonova I, Webb R, Thomas SA. Analysis of Primary Care Computerised Medical Records with Deep Learning. Stud Health Technol Inform 2019; 258:249-250. [PMID: 30942761] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The analysis of primary care data plays an important role in understanding health at an individual and population level. Currently the utilization of computerized medical records is low due to the complexities, heterogeneities and veracity associated with these data. We present a deep learning methodology that clusters 11,000 records in an unsupervised manner identifying non-linear patterns in the data. This provides a useful tool for visualization as well as identify features driving the formation of clusters. Further analysis reveal the features that differentiate sub-groups that can aid clinical decision making. Our results uncover subsets that contain the highest proportion of missing data, specifically Episode type, as well as the sources that provide the most complete data.
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Affiliation(s)
- Simon de Lusignan
- Department of Clinical and Experimental Medicine, University of Surrey, UK
| | | | | | - Ivelina Yonova
- Department of Clinical and Experimental Medicine, University of Surrey, UK
| | - Rebecca Webb
- Royal College of General Practitioners, London, UK
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33
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de Lusignan S, McGee C, Webb R, Joy M, Byford R, Yonova I, Hriskova M, Matos Ferreira F, Elliot AJ, Smith G, Rafi I. Conurbation, Urban, and Rural Living as Determinants of Allergies and Infectious Diseases: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2016-2017. JMIR Public Health Surveill 2018; 4:e11354. [PMID: 30478022 PMCID: PMC6288591 DOI: 10.2196/11354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/24/2018] [Accepted: 09/14/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Living in a conurbation, urban, or rural environment is an important determinant of health. For example, conurbation and rural living is associated with increased respiratory and allergic conditions, whereas a farm or rural upbringing has been shown to be a protective factor against this. OBJECTIVE The objective of the study was to assess differences in general practice presentations of allergic and infectious disease in those exposed to conurbation or urban living compared with rural environments. METHODS The population was a nationally representative sample of 175 English general practices covering a population of over 1.6 million patients registered with sentinel network general practices. General practice presentation rates per 100,000 population were reported for allergic rhinitis, asthma, and infectious conditions grouped into upper and lower respiratory tract infections, urinary tract infection, and acute gastroenteritis by the UK Office for National Statistics urban-rural category. We used multivariate logistic regression adjusting for age, sex, ethnicity, deprivation, comorbidities, and smoking status, reporting odds ratios (ORs) with 95% CIs. RESULTS For allergic rhinitis, the OR was 1.13 (95% CI 1.04-1.23; P=.003) for urban and 1.29 (95% CI 1.19-1.41; P<.001) for conurbation compared with rural dwellers. Conurbation living was associated with a lower OR for both asthma (OR 0.70, 95% CI 0.67-0.73; P<.001) and lower respiratory tract infections (OR 0.94, 95% CI 0.90-0.98; P=.005). Compared with rural dwellers, the OR for upper respiratory tract infection was greater in urban (OR 1.06, 95% CI 1.03-1.08; P<.001) but no different in conurbation dwellers (OR 1.00, 95% CI 0.97-1.03; P=.93). Acute gastroenteritis followed the same pattern: the OR was 1.13 (95% CI 1.01-1.25; P=.03) for urban dwellers and 1.04 (95% CI 0.93-1.17; P=.46) for conurbation dwellers. The OR for urinary tract infection was lower for urban dwellers (OR 0.94, 95% CI 0.89-0.99; P=.02) but higher in conurbation dwellers (OR 1.06, 95% CI 1.00-1.13; P=.04). CONCLUSIONS Those living in conurbations or urban areas were more likely to consult a general practice for allergic rhinitis and upper respiratory tract infection. Both conurbation and rural living were associated with an increased risk of urinary tract infection. Living in rural areas was associated with an increased risk of asthma and lower respiratory tract infections. The data suggest that living environment may affect rates of consultations for certain conditions. Longitudinal analyses of these data would be useful in providing insights into important determinants.
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Affiliation(s)
- Simon de Lusignan
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom.,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Christopher McGee
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom.,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Rebecca Webb
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom
| | - Mark Joy
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom
| | - Rachel Byford
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom
| | - Ivelina Yonova
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom.,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Mariya Hriskova
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom.,Royal College of General Practitioners Research and Surveillance Centre, London, United Kingdom
| | - Filipa Matos Ferreira
- Department of Clinical and Experimental Medicine, University of Surrey, Guildford, United Kingdom
| | - Alex J Elliot
- Real-time Syndromic Surveillance Team, Field Service, National Infection Service, Public Health England, Birmingham, United Kingdom
| | - Gillian Smith
- Real-time Syndromic Surveillance Team, Field Service, National Infection Service, Public Health England, Birmingham, United Kingdom
| | - Imran Rafi
- Royal College of General Practitioners Clinical Innovation and Research Centre, London, United Kingdom
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O'Reilly H, Eltze C, Bennett K, Verhaert K, Webb R, Merrett A, Scott RC, Whitney A, Helen Cross J, de Haan M. Cognitive outcomes following epilepsy in infancy: A longitudinal community-based study. Epilepsia 2018; 59:2240-2248. [DOI: 10.1111/epi.14589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Helen O'Reilly
- Department of Psychology; University College Dublin; Dublin Ireland
- Institute for Women's Health; University College London; London UK
| | - Christin Eltze
- University College London Great Ormond Street Institute of Child Health; London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - Kate Bennett
- Institute for Women's Health; University College London; London UK
| | - Kristien Verhaert
- Rehabilitation Center for Children and Youth Pulderbos; Zandhoven Belgium
| | - Rebecca Webb
- University College London Great Ormond Street Institute of Child Health; London UK
| | - Anna Merrett
- Dorset HealthCare University Foundation NHS Trust; Poole UK
| | - Rod C. Scott
- Department of Neurological Sciences; University of Vermont; Burlington Vermont
| | - Andrea Whitney
- Southampton University Hospital NHS Trust; Southampton UK
| | - J. Helen Cross
- University College London Great Ormond Street Institute of Child Health; London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - Michelle de Haan
- University College London Great Ormond Street Institute of Child Health; London UK
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35
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McDonald AD, Jones BJP, Nygren DR, Adams C, Álvarez V, Azevedo CDR, Benlloch-Rodríguez JM, Borges FIGM, Botas A, Cárcel S, Carrión JV, Cebrián S, Conde CAN, Díaz J, Diesburg M, Escada J, Esteve R, Felkai R, Fernandes LMP, Ferrario P, Ferreira AL, Freitas EDC, Goldschmidt A, Gómez-Cadenas JJ, González-Díaz D, Gutiérrez RM, Guenette R, Hafidi K, Hauptman J, Henriques CAO, Hernandez AI, Hernando Morata JA, Herrero V, Johnston S, Labarga L, Laing A, Lebrun P, Liubarsky I, López-March N, Losada M, Martín-Albo J, Martínez-Lema G, Martínez A, Monrabal F, Monteiro CMB, Mora FJ, Moutinho LM, Muñoz Vidal J, Musti M, Nebot-Guinot M, Novella P, Palmeiro B, Para A, Pérez J, Querol M, Repond J, Renner J, Riordan S, Ripoll L, Rodríguez J, Rogers L, Santos FP, Dos Santos JMF, Simón A, Sofka C, Sorel M, Stiegler T, Toledo JF, Torrent J, Tsamalaidze Z, Veloso JFCA, Webb R, White JT, Yahlali N. Demonstration of Single-Barium-Ion Sensitivity for Neutrinoless Double-Beta Decay Using Single-Molecule Fluorescence Imaging. Phys Rev Lett 2018; 120:132504. [PMID: 29694208 DOI: 10.1103/physrevlett.120.132504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/02/2018] [Indexed: 06/08/2023]
Abstract
A new method to tag the barium daughter in the double-beta decay of ^{136}Xe is reported. Using the technique of single molecule fluorescent imaging (SMFI), individual barium dication (Ba^{++}) resolution at a transparent scanning surface is demonstrated. A single-step photobleach confirms the single ion interpretation. Individual ions are localized with superresolution (∼2 nm), and detected with a statistical significance of 12.9σ over backgrounds. This lays the foundation for a new and potentially background-free neutrinoless double-beta decay technology, based on SMFI coupled to high pressure xenon gas time projection chambers.
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Affiliation(s)
- A D McDonald
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - B J P Jones
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - D R Nygren
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - C Adams
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - V Álvarez
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - C D R Azevedo
- Institute of Nanostructures, Nanomodelling and Nanofabrication (i3N), Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - J M Benlloch-Rodríguez
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - F I G M Borges
- LIP, Department of Physics, University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Botas
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - S Cárcel
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - J V Carrión
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - S Cebrián
- Laboratorio de Física Nuclear y Astropartículas, Universidad de Zaragoza, Calle Pedro Cerbuna, 12, 50009 Zaragoza, Spain
| | - C A N Conde
- LIP, Department of Physics, University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J Díaz
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Diesburg
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Escada
- LIP, Department of Physics, University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Esteve
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - R Felkai
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - L M P Fernandes
- LIBPhys, Physics Department, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - P Ferrario
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - A L Ferreira
- Institute of Nanostructures, Nanomodelling and Nanofabrication (i3N), Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - E D C Freitas
- LIBPhys, Physics Department, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Goldschmidt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720, USA
| | - J J Gómez-Cadenas
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - D González-Díaz
- Instituto Gallego de Física de Altas Energías, Univ. de Santiago de Compostela, Campus sur, Rúa Xosé María Suárez Núñez, s/n, 15782 Santiago de Compostela, Spain
| | - R M Gutiérrez
- Centro de Investigación en Ciencias Básicas y Aplicadas, Universidad Antonio Nariño, Sede Circunvalar, Carretera 3 Este No. 47 A-15, Bogotá, Colombia
| | - R Guenette
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - K Hafidi
- Argonne National Laboratory, Argonne Illinois 60439, USA
| | - J Hauptman
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011-3160, USA
| | - C A O Henriques
- LIBPhys, Physics Department, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A I Hernandez
- Centro de Investigación en Ciencias Básicas y Aplicadas, Universidad Antonio Nariño, Sede Circunvalar, Carretera 3 Este No. 47 A-15, Bogotá, Colombia
| | - J A Hernando Morata
- Instituto Gallego de Física de Altas Energías, Univ. de Santiago de Compostela, Campus sur, Rúa Xosé María Suárez Núñez, s/n, 15782 Santiago de Compostela, Spain
| | - V Herrero
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - S Johnston
- Argonne National Laboratory, Argonne Illinois 60439, USA
| | - L Labarga
- Departamento de Física Teórica, Universidad Autónoma de Madrid, Campus de Cantoblanco, 28049 Madrid, Spain
| | - A Laing
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - P Lebrun
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - I Liubarsky
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - N López-March
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Losada
- Centro de Investigación en Ciencias Básicas y Aplicadas, Universidad Antonio Nariño, Sede Circunvalar, Carretera 3 Este No. 47 A-15, Bogotá, Colombia
| | - J Martín-Albo
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - G Martínez-Lema
- Instituto Gallego de Física de Altas Energías, Univ. de Santiago de Compostela, Campus sur, Rúa Xosé María Suárez Núñez, s/n, 15782 Santiago de Compostela, Spain
| | - A Martínez
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - F Monrabal
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - C M B Monteiro
- LIBPhys, Physics Department, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - F J Mora
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - L M Moutinho
- Institute of Nanostructures, Nanomodelling and Nanofabrication (i3N), Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - J Muñoz Vidal
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Musti
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Nebot-Guinot
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - P Novella
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - B Palmeiro
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - A Para
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Pérez
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Querol
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - J Repond
- Argonne National Laboratory, Argonne Illinois 60439, USA
| | - J Renner
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - S Riordan
- Argonne National Laboratory, Argonne Illinois 60439, USA
| | - L Ripoll
- Escola Politècnica Superior, Universitat de Girona, Av. Montilivi, s/n, 17071 Girona, Spain
| | - J Rodríguez
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - L Rogers
- Department of Physics, University of Texas at Arlington, Arlington, Texas 76019, USA
| | - F P Santos
- LIP, Department of Physics, University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J M F Dos Santos
- LIBPhys, Physics Department, University of Coimbra, Rua Larga, 3004-516 Coimbra, Portugal
| | - A Simón
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - C Sofka
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - M Sorel
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - T Stiegler
- Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843-4242, USA
| | - J F Toledo
- Instituto de Instrumentación para Imagen Molecular (I3M), Centro Mixto CSIC-Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain
| | - J Torrent
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
| | - Z Tsamalaidze
- Joint Institute for Nuclear Research (JINR), Joliot-Curie 6, 141980 Dubna, Russia
| | - J F C A Veloso
- Institute of Nanostructures, Nanomodelling and Nanofabrication (i3N), Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - R Webb
- Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843-4242, USA
| | - J T White
- Department of Physics and Astronomy, Texas A&M University, College Station, Texas 77843-4242, USA
| | - N Yahlali
- Instituto de Física Corpuscular (IFIC), CSIC & Universitat de València, Calle Catedrático José Beltrán, 2, 46980 Paterna, Valencia, Spain
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Webb R, Ayers S, Rosan C. A systematic review of measures of mental health and emotional wellbeing in parents of children aged 0-5. J Affect Disord 2018; 225:608-617. [PMID: 28889046 DOI: 10.1016/j.jad.2017.08.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Received: 05/10/2017] [Revised: 08/15/2017] [Accepted: 08/20/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND A significant proportion of women with young children experience mental health problems and recent research suggests fathers may also be affected. This may have a long term negative impact on the child's development with significant costs to society. Appropriate measures are therefore needed to identify parents and children at risk. METHOD This literature review aimed to identify the most reliable, evidence based global measures of mental health for parents of infants from pregnancy to 5 years postpartum (0-5 years). Literature searches were conducted on online databases and hand searches of reference lists were also carried out. Studies were included in the review if they reported information on measures of global psychological distress or wellbeing from 0 to 5 years postpartum. RESULTS A total of 183 studies were included in the review, 19 of which directly examined the psychometric validity of an outcome measure. These studies reported information on 23 outcome measures, 4 of which had been validated in parents of children from 1 to 5. These were: the General Health Questionnaire (GHQ), the Symptom Checklist (SCL), the Self-Reporting Questionnaire (SRQ) and the Kessler scale (K10/6). Reliability and validity varied across studies. LIMITATIONS Only a small number of studies included fathers and examined psychometric validity across the entire period of early childhood. CONCLUSIONS The GHQ was the most frequently validated but results suggest poor reliability and validity. The SRQ and K10/6 were the most promising measures in terms of psychometric properties and clinical utility.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, EC1V 0HB, United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, EC1V 0HB, United Kingdom.
| | - Camilla Rosan
- Development and Delivery Department, Mental Health Foundation, Colechurch House, 1 London Bridge Walk, London SE1 2SX, United Kingdom
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Brannelly LA, Webb R, Skerratt LF, Berger L. Amphibians with infectious disease increase their reproductive effort: evidence for the terminal investment hypothesis. Open Biol 2017; 6:rsob.150251. [PMID: 27358291 PMCID: PMC4929933 DOI: 10.1098/rsob.150251] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 11/19/2015] [Accepted: 06/01/2016] [Indexed: 12/13/2022] Open
Abstract
Mounting an immune response to fight disease is costly for an organism and can reduce investment in another life-history trait, such as reproduction. The terminal investment hypothesis predicts that an organism will increase reproductive effort when threatened by disease. The reproductive fitness of amphibians infected with the deadly fungal pathogen Batrachochytrium dendrobatidis (Bd) is largely unknown. In this study, we explored gametogenesis in two endangered and susceptible frog species, Pseudophryne corroboree and Litoria verreauxii alpina. Gametogenesis, both oogenesis and spermatogenesis, increased when animals were experimentally infected with Bd. In P. corroboree, infected males have thicker germinal epithelium, and a larger proportion of spermatocytes. In L. v. alpina, infected males had more spermatic cell bundles in total, and a larger proportion of spermatozoa bundles. In female L. v. alpina, ovaries and oviducts were larger in infected animals, and there were more cells present within the ovaries. Terminal investment has consequences for the evolution of disease resistance in declining species. If infected animals are increasing reproductive efforts and producing more offspring before succumbing to disease, it is possible that population-level selection for disease resistance will be minimized.
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Affiliation(s)
- Laura A Brannelly
- One Health Research Group, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Rebecca Webb
- One Health Research Group, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Lee F Skerratt
- One Health Research Group, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Lee Berger
- One Health Research Group, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia
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Abstract
Squamous cell carcinoma is the most common carcinoma in the oral cavity. Resection of these cancers often requires reconstruction. Nasolabial flaps are a robust and reliable local flap that provide a satisfactory outcome. We report two cases where an epidermoid cyst developed within the scar of the nasolabial flap and review the literature.
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Affiliation(s)
- R Mann
- University Hospitals Bristol NHS Foundation Trust , UK
| | - B Srinivasan
- University Hospital Southampton NHS Foundation Trust , UK
| | - R Webb
- University Hospital Southampton NHS Foundation Trust , UK
| | - A Webb
- University Hospital Southampton NHS Foundation Trust , UK
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Ousey K, Webb R. Enhancing skin integrity: an interprofessional approach. J Wound Care 2016; 25:555-6. [PMID: 27608518 DOI: 10.12968/jowc.2016.25.9.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Earlier this year the University of Huddersfield's Institute of Skin Integrity and Infection Prevention in association with the Journal of Wound Care (JWC) held the first International Skin Integrity and Infection Prevention Conference. The 2-day event consisted of a mix of keynotes, symposia and short presentations from key opinion leaders and post graduate research students. Here Professor Karen Ousey and Dr Rachel Webb present the highlights of this event.
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Scheele BC, Hunter DA, Banks SC, Pierson JC, Skerratt LF, Webb R, Driscoll DA. High adult mortality in disease‐challenged frog populations increases vulnerability to drought. J Anim Ecol 2016; 85:1453-1460. [DOI: 10.1111/1365-2656.12569] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/21/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Ben C. Scheele
- Fenner School of Environment and Society College of Medicine Biology and Environment Australian National University Canberra ACT 0200 Australia
- One Health Research Group College of Public Health, Medical and Veterinary Sciences James Cook University 1 James Cook Drive Townsville City QLD 4811 Australia
| | - David A. Hunter
- NSW Office of Environment and Heritage PO Box 544 Albury NSW 2640 Australia
| | - Sam C. Banks
- Fenner School of Environment and Society College of Medicine Biology and Environment Australian National University Canberra ACT 0200 Australia
| | - Jennifer C. Pierson
- Fenner School of Environment and Society College of Medicine Biology and Environment Australian National University Canberra ACT 0200 Australia
| | - Lee F. Skerratt
- One Health Research Group College of Public Health, Medical and Veterinary Sciences James Cook University 1 James Cook Drive Townsville City QLD 4811 Australia
| | - Rebecca Webb
- One Health Research Group College of Public Health, Medical and Veterinary Sciences James Cook University 1 James Cook Drive Townsville City QLD 4811 Australia
| | - Don A. Driscoll
- Centre for Integrative Ecology School of Life and Environmental Sciences Deakin University Burwood Vic 3125 Australia
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Abstract
Objective: To identify and estimate the population impact of primary care service delivery factors that independently predict non-attendance for cervical screening. Setting: Screening records of all eligible women aged 30 years and over and resident in the former Manchester Health Authority area were analysed (n=72,613). Methods: Practice-level and GP-level explanatory variables, along with area-level covariates, were obtained and merged to the study data set. Logistic regression models were used to identify factors associated with having no recorded history of attending NHS cervical screening services. A multivariate model was created to identify independent predictors of non-attendance with comprehensive adjustment for women's age, area-level socio-demographic factors, and other primary care factors. Attributable fraction estimates were used to assess the population impact of the independent predictors. Results: Large practice size (>4,000 patients), single-handed practice, South Asian male GP, part-time GP employment status, older age and birthplace overseas, and area-level measures of deprivation and transience independently predicted non-attendance. Women born overseas and registered at larger practices were especially unlikely to have ever attended. The combined population attributable fraction estimate for the independent predictors reflecting primary care service delivery was almost 40%, and that for all variables in the final model was over 70%. Conclusions: Independent predictors of non-attendance reflecting general practice structure, workload and GP characteristics were identified. Although relative risks were modest, the collective population impact of these factors was considerable, which has implications for the implementation of informed targeting and the development of new screening services by Primary Care Trusts.
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Affiliation(s)
- R Webb
- School of Epidemiology & Health Sciences, University of Manchester, 1st Floor, Stopford Building, Manchester M13 9PL.
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Ruffino JS, Davies NA, Morris K, Ludgate M, Zhang L, Webb R, Thomas AW. Moderate-intensity exercise alters markers of alternative activation in circulating monocytes in females: a putative role for PPARγ. Eur J Appl Physiol 2016; 116:1671-82. [PMID: 27339155 PMCID: PMC4983283 DOI: 10.1007/s00421-016-3414-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/06/2016] [Indexed: 02/07/2023]
Abstract
PURPOSE Monocytes may be primed towards differentiation into classically activated M1 macrophages or alternatively activated M2 macrophages. M1 macrophages greatly contribute to the inflammation which promotes insulin resistance, whereas M2 macrophages resolve inflammation. We have previously shown that exercise increases M2 marker expression in mixed mononuclear cells, possibly via activation of the nuclear transcription factor PPARγ. However, these effects have not been demonstrated specifically within monocytes. Thus, we aimed to investigate whether moderate-intensity exercise elicited similar effects on monocytic M1/M2 marker expression and PPARγ activity to those reported previously in mononuclear cells, so as to further elucidate the mechanisms by which exercise may alter inflammatory status and, accordingly, prevent insulin resistance. METHODS/RESULTS 19 sedentary females completed an 8 week moderate-intensity exercise programme (walking 45 min, thrice weekly). Monocytes were isolated from blood via immunomagnetic separation; monocyte expression of M2 markers (Dectin-1: 2.6 ± 1.9-fold; IL-10: 3.0 ± 2.8-fold) significantly increased, whilst the expression of the M1 marker MCP-1 significantly decreased (0.83 ± 0.2 cf. basal), over the duration of the programme. Serum PPARγ activity levels and PPARγ target-genes (CD36: 1.9 ± 1.5-fold; LXRα: 5.0 ± 4.7-fold) were significantly increased after the 8 week exercise programme. Associated with these effects were significant improvements in systemic insulin sensitivity (McAuley's ISI: Δ0.98 M/mU/L cf. basal). CONCLUSION Exercise participation suppressed M1 markers and induced M2 markers in monocytes, potentially via PPARγ-triggered signalling, and these effects may contribute (perhaps via priming of monocytes for differentiation into M2 tissue-macrophages) to improved systemic insulin sensitivity in exercising participants. These findings provide an alternative mechanism by which exercise may exert its anti-inflammatory effects in order to prevent insulin resistance and type 2 diabetes.
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Affiliation(s)
- J S Ruffino
- Centre for Biomedical Science, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK
| | - N A Davies
- College of Medicine, Swansea University, Swansea, SA2 8PP, UK
| | - K Morris
- Centre for Endocrine & Diabetes Sciences, Cardiff University School of Medicine, Cardiff, CF14 4YU, UK
| | - M Ludgate
- Centre for Endocrine & Diabetes Sciences, Cardiff University School of Medicine, Cardiff, CF14 4YU, UK
| | - L Zhang
- Centre for Endocrine & Diabetes Sciences, Cardiff University School of Medicine, Cardiff, CF14 4YU, UK
| | - R Webb
- Centre for Biomedical Science, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK
| | - A W Thomas
- Centre for Biomedical Science, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK.
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Webb R, Culliford-Semmens N, Mow A, Doughty R, Tilton E, Peat B, Stirling J, Gentles T, Stewart J, Wilson N. PS286 Prevalence of Rheumatic Heart Disease and Other Echocardiographic Abnormalities in Polynesian Young Adults in South Auckland, New Zealand. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Buckley L, Webb R, Lambert C, Nyiri B, Gerig L. SU-F-J-52: A Novel Approach to X-Ray Tube Quality Assurance for CBCT Systems in Order to Better Assess the Patient Imaging Dose in a Large, Multi-Unit Treatment Facility. Med Phys 2016. [DOI: 10.1118/1.4955960] [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: 11/07/2022] Open
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Gregson E, Webb R, Sheldrick EL, Campbell BK, Mann GE, Liddell S, Sinclair KD. Molecular determinants of a competent bovine corpus luteum: first- vs final-wave dominant follicles. Reproduction 2016; 151:563-75. [PMID: 26940100 DOI: 10.1530/rep-15-0415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 03/03/2016] [Indexed: 11/08/2022]
Abstract
Reproductive management in cattle requires the synchrony of follicle development and oestrus before insemination. However, ovulation of follicles that have not undergone normal physiological maturation can lead to suboptimal luteal function. Here, we investigated the expression of a targeted set of 47 genes in (a) a first-wave vs final-wave dominant follicle (DF; the latter destined to ovulate spontaneously) and (b) 6-day-old corpora lutea (CLs) following either spontaneous ovulation or induced ovulation of a first-wave DF to ascertain their functional significance for competent CL development. Both the mass and progesterone-synthesising capacity of a CL formed following induced ovulation of a first-wave DF were impaired. These impaired CLs had reduced expression of steroidogenic enzymes (e.g. STAR and HSD3B1), luteotrophic receptors (LHCGR) and angiogenic regulators (e.g. VEGFA) and increased expression of BMP2 (linked to luteolysis). Relative to final-wave DFs, characteristic features of first-wave DFs included reduced oestradiol concentrations and a reduced oestradiol:progesterone ratio in the face of increased expression of key steroidogenic enzymes (i.e. CYP11A1, HSD3B1 and CYP19A1) in granulosa cells and reduced expression of the HDL receptor SCARB1 in thecal cells. Transcripts for further components of the TGF and IGF systems (e.g. INHA, INHBA, IGF2R and IGFBP2) varied between the first- and final-wave DFs. These results highlight the importance of hormones such as progesterone interacting with local components of both the TGF and IGF systems to affect the maturation of the ovulatory follicle and functional competency of the subsequent CL.
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Affiliation(s)
- E Gregson
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
| | - R Webb
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
| | - E L Sheldrick
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
| | - B K Campbell
- School of Clinical SciencesUniversity of Nottingham, Nottingham, UK
| | - G E Mann
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
| | - S Liddell
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
| | - K D Sinclair
- School of BiosciencesUniversity of Nottingham, Loughborough, UK
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Webb R, Thompson JES, Ruffino JS, Davies NA, Watkeys L, Hooper S, Jones PM, Walters G, Clayton D, Thomas AW, Morris K, Llewellyn DH, Ward M, Wyatt-Williams J, McDonnell BJ. Evaluation of cardiovascular risk-lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes. BMJ Open Sport Exerc Med 2016; 2:e000089. [PMID: 27900165 PMCID: PMC5117059 DOI: 10.1136/bmjsem-2015-000089] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/22/2015] [Accepted: 01/01/2016] [Indexed: 11/28/2022] Open
Abstract
Background To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). Methods Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques. Results In studies 1–3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3. Conclusions Because cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued implementation of community/referral-based exercise programmes.
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Affiliation(s)
- R Webb
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - J E S Thompson
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - J-S Ruffino
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - N A Davies
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - L Watkeys
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - S Hooper
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - P M Jones
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - G Walters
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - D Clayton
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - A W Thomas
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - K Morris
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - D H Llewellyn
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - M Ward
- Blaengad Ltd , Wales , UK
| | - J Wyatt-Williams
- Department of Public Health Wales , Hayden Ellis Building , Cardiff , UK
| | - B J McDonnell
- Department of Biomedical Sciences , Cardiff Metropolitan University , Cardiff , UK
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Webb R, Buratini J, Hernandez-Medrano JH, Gutierrez CG, Campbell BK. Follicle development and selection: past, present and future. Anim Reprod 2016. [DOI: 10.21451/1984-3143-ar883] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Feinberg L, Ryba F, Woods M, Webb R. An unusual case of chronic bilateral TMJ dislocation. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.297] [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: 11/25/2022]
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Stallmann-Jorgensen I, Webb R. Emerging Molecular Targets for Treatment of Erectile Dysfunction: Vascular and Regenerative Therapies on the Horizon. Curr Drug Targets 2015; 16:427-41. [DOI: 10.2174/1389450116666150427160710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 01/16/2015] [Accepted: 03/17/2015] [Indexed: 11/22/2022]
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