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Previous research suggests that CBT focusing on worry in those with persecutory delusions reduces paranoia, severity of delusions and associated distress. This preliminary case series aimed to see whether it is feasible and acceptable to deliver worry-focused CBT in a group setting to those with psychosis. A secondary aim was to examine possible clinical changes. Two groups totalling 11 participants were run for seven sessions using the Worry Intervention Trial manual. Qualitative and quantitative data about the experience of being in the group was also collected via questionnaires, as was data on number of sessions attended. Measures were delivered pre- and post-group and at 3-month follow-up. These included a worry scale, a measure of delusional belief and associated distress and quality of life measures. Of the 11 participants who started the group, nine completed the group. Qualitative and quantitative feedback indicated that most of the participants found it acceptable and helpful, and that discussing these issues in a group setting was not only tolerable but often beneficial. Reliable Change Index indicated that 6/7 of the group members showed reliable reductions in their levels of worry post-group and 5/7 at follow-up. There were positive changes on other measures, which appeared to be more pronounced at follow-up. Delivering a worry intervention in a group format appears to be acceptable and feasible. Further research with a larger sample and control group is indicated to test the clinical effectiveness of this intervention.
Key learning aims
(1) To understand the role of worry in psychosis.
(2) To learn about the possible feasibility of working on worry in a group setting.
(3) To be aware of potential clinical changes from the group.
(4) To consider acceptability for participants of working on worries in a group setting.
This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care. Our brief analysis demonstrates that general medical/health journals with high impact factors are the dominant routes of publication, but there is variation according to the methodological approach adopted by articles. The number of qualitative health articles submitted to REF 2014 overall was small, and even more so for articles based on mixed methods research, qualitative methodology or reviews/syntheses that included qualitative articles.
In those receiving radiotherapy for pelvic cancers, up to 80% develop gastrointestinal symptoms, with dietary interventions recommended to reduce these symptoms. However, research outlining the current dietary support provided to patients undergoing radiotherapy for pelvic cancer is lacking.
Aim
To identify the gastrointestinal symptoms experienced by those undergoing pelvic radiotherapy and to identify the dietary support provided to these patients.
Methods and materials
A service evaluation was undertaken in one NHS Trust hospital whereby patients undergoing radical pelvic radiotherapy during a 15-week recruitment period were invited to complete an anonymous questionnaire. Participants were recruited using purposive sampling and the data were analysed descriptively using SPSS.
Results
In total, 31 patients responded achieving a response rate of 48%. The most frequent reported gastrointestinal symptoms were gas and flatulence followed by diarrhoea, nausea and abdominal pain. The main dietary changes implemented by the respondents and recommended by health care professionals included reducing fibre intake, reducing certain vegetables, reducing caffeine and increasing water.
Findings
The results illustrate the impact of gastrointestinal side effects on patients’ dietary intake. The results highlight that nutritional guidance need to be standardised, especially for the management of diarrhoea and gas and flatulence as these were the most common occurring side effects. With radiographers most frequently giving nutritional advice they must be provided with guidance to support those undergoing pelvic radiotherapy.
It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness. Consequently, our research aimed to explore OA from the perspective of wellness. We undertook a longitudinal qualitative study to explore ‘wellness and resilience’ in a group of older people who reported chronic joint pain and considered themselves healthy. We interviewed 27 people and followed them up with monthly diary sheets, responding to reports of changes using their chosen contact method. This article focuses on how resilience relates to how people consider themselves to be well. Participants' experience of the adversity of their pain varied, and was influenced by context and meaning. Participants described ‘keeping going’ in body, mind and everyday life. Flexibility and pragmatism were key aspects of keeping going. The findings support a broader version of resilience that incorporates vulnerabilities. In the context of health care we suggest that treating the frail body should not come at the expense of undermining an older person's sense of a resilient self.
The chance find of a discrete pit containing an Early Bronze Age funerary deposit was made at Stanbury, West Yorkshire, during the spring of 2007. A large Collared Urn, which was inverted, contained the cremated remains of a young male, together with a stone battle-axe, a bone belt-hook and pin, a pair of copper alloy earrings, and an accessory vessel. The burial was accompanied by two further Collared Urns, one of which was near complete. The two radiocarbon dates obtained have allowed a fairly tight date range of 1960–1780 cal BC to be proposed. This combination of pyre and grave goods is apparently unique, while a number of the items are exotic to Pennine Yorkshire.
To examine the validity of the additive quality-adjusted lite year model used to evaluate a multiphase health state, data from a pilot study of mammography were used to determine whether the values assigned to a multiphase postmastectomy health state could be estimated from a combination of the independently rated constituent health state values. The results suggest that they cannot.
In his paper “An Essential Unpredictability in Human Behavior,” Michael Scriven offers an argument intended to show that it is impossible in principle to predict what a person (or indeed a suitable robot) will do in a certain possible kind of situation. Moreover, this unpredictability is independent of any indeterminism in physics, of any limitations on the predictor's knowledge of data and laws, and of any limitations on the reliability or amount of calculation the predictor can do. Scriven's argument is a purported proof that if a person in the designated situation is predicted, even by a predictor who does as well as is in principle possible, the prediction will turn out false.
We shall show that Scriven's argument depends on a hidden premise which we have no reason to accept. Without the hidden premise, Scriven cannot demonstrate any failure of prediction which we cannot explain away as due to limitations, in principle remediable, on the amount of calculation available to a given predictor. We conclude that Scriven's argument does not establish an essential unpredictability in human behavior in any interesting sense. Rather it is a reductio establishing the falsehood of Scriven's hidden premise.
SCRIVEN'S ARGUMENT
Let us imagine somebody who is trying to predict the outcome of a free choice by somebody else who is dominantly motivated to avoid being validly predicted. (The dramatis personae are called, respectively, the predictor and the avoider.) Perhaps the avoider has been put in a position where he stands to lose if the predictor knows in advance what he will choose; or perhaps he is just averse to being predicted.