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1. Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes.

Author

Cotton, S, McHugh, M, Dewar, R, Haas, J, and Templeton, K

Subjects
Care homes, Hospital discharge, Introduction, SARS-CoV-2, Humans, SARS-CoV-2, COVID-19, Patient Discharge, Hospitalization, Hospitals
Abstract

BACKGROUND: The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. AIM: To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. METHODS: A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. FINDINGS: In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. CONCLUSION: The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine.

Published
2023

3. Real-World Treatment Patterns and Outcomes Among Patients with Episodic Migraine in China: Results from the Adelphi Migraine Disease Specific Programme&trade

Author

Zhao H, Xiao Z, Zhang L, Ford J, Zhong S, Ye W, Li J, Tockhorn-Heidenreich A, Cotton S, and Chen C

Subjects
episodic migraine, clinical practice, patient-reported outcomes, real-world, disease burden, Medicine (General), R5-920
Abstract

Hongru Zhao,1 Zheman Xiao,2 Lei Zhang,3 Janet Ford,4 Shiying Zhong,3 Wenyu Ye,4 Jinnan Li,3 Antje Tockhorn-Heidenreich,4 Sarah Cotton,5 Chunfu Chen6,7 1The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Eli Lilly China, Shanghai, People’s Republic of China; 4Eli Lilly and Company, Indianapolis, IN, USA; 5Adelphi Real World, Bollington, UK; 6Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan, Jinan, People’s Republic of China; 7Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of ChinaCorrespondence: Chunfu Chen, Department of Neurology, Shandong Provincial Hospital, &num; 324 Jingwuweiqi, Road, Shandong, 250021, People’s Republic of China, Tel +86 13853153248, Email chencf301@163.comObjective: This study assessed treatment patterns, disease burden, outcomes, and unmet needs among patients with episodic migraine (EM) in China using Adelphi Migraine Disease Specific Programme™ (DSP) real-world data.Background: Migraine is a prevalent and debilitating neurological disorder which presents a major public health burden globally. Research on characteristics, disease burden, and treatment patterns in EM patients in China is limited.Methods: Data were drawn from an existing data set Adelphi Migraine DSP, a point-in-time survey conducted in China (January-June 2014). Internists/neurologists completed patient record forms for the next 9 patients who consulted them in clinical practice; these same patients completed the ‘patient self-completion questionnaires’. Descriptive analyses were used to assess key variables: patient demographics, treatment patterns (current acute and preventive medication [AM/PM]), effectiveness, issues with existing treatment, Migraine Disability Assessment (MIDAS) scores, and Work Productivity and Activity Impairment scores.Results: Total of 125 internists/neurologists provided data on 1113 patients with EM (headache days/month < 15). Mean (standard deviation [SD]) age was 43.8 (13.1) years; mean (SD) number of migraine days/month was 3.2 (1.7). AM was prescribed in 86.1% of patients (non-steroid anti-inflammatory drugs [NSAIDs]: 62.7%; triptans: 7.7%), PM in 38.5%, and both in 24.9% of patients. Approximately 55% of patients experienced ≥ 1 issue with their current AM or PM. Migraine-related symptoms (including nausea, photophobia, and phonophobia) were fully controlled in < 50% of patients receiving NSAIDs (21.7– 38.4%) or triptans (32.4– 43.5%). Insufficient response to current AM (migraine headache fully resolved within 2 hours in ≤ 3/5 attacks) was reported by 42.5% of patients. Mild-to-severe disability was reported by 36.8% of patients with a mean (SD) MIDAS score of 5.8 (7.3). Overall, 58.0% of work time was impaired (including time missed and impairment while working).Conclusion: This analysis suggests, despite existing treatment options, disease burden and unmet medical needs remain substantial in Chinese patients with EM.Keywords: episodic migraine, clinical practice, patient-reported outcomes, real-world, disease burden

Published
2023

4. Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Author

Robson, Samuel C., Connor, Thomas R., Loman, Nicholas J., Golubchik, Tanya, Martinez Nunez, Rocio T., Bonsall, David, Rambaut, Andrew, Snell, Luke B., Livett, Rich, Ludden, Catherine, Corden, Sally, Nastouli, Eleni, Nebbia, Gaia, Johnston, Ian, Prieto, Jacqui A., Saeed, Kordo, Jackson, David K., Houlihan, Catherine, Frampton, Dan, Hamilton, William L., Witney, Adam A., Bucca, Giselda, Pope, Cassie F., Moore, Catherine, Thomson, Emma C., Cutino-Moguel, Teresa, Harrison, Ewan M., Smith, Colin P., Rogan, Fiona, Beckwith, Shaun M., Murray, Abigail, Singleton, Dawn, Eastick, Kirstine, Sheridan, Liz A., Randell, Paul, Jackson, Leigh M., Ariani, Cristina V., Gonçalves, Sónia, Fairley, Derek J., Loose, Matthew W., Watkins, Joanne, Moses, Samuel, Nicholls, Sam, Bull, Matthew, Amato, Roberto, Smith, Darren L., Aanensen, David M., Barrett, Jeffrey C., Kele, Beatrix, Aggarwal, Dinesh, Shepherd, James G., Curran, Martin D., Parmar, Surendra, Parker, Matthew D., Williams, Catryn, Glaysher, Sharon, Underwood, Anthony P., Bashton, Matthew, Pacchiarini, Nicole, Loveson, Katie F., Byott, Matthew, Carabelli, Alessandro M., Templeton, Kate E., Peacock, Sharon J., de Silva, Thushan I., Wang, Dennis, Langford, Cordelia F., Sillitoe, John, Gunson, Rory N., Cottrell, Simon, O’Grady, Justin, Kwiatkowski, Dominic, Lillie, Patrick J., Cortes, Nicholas, Moore, Nathan, Thomas, Claire, Burns, Phillipa J., Mahungu, Tabitha W., Liggett, Steven, Beckett, Angela H., Holden, Matthew TG., Levett, Lisa J., Osman, Husam, Hassan-Ibrahim, Mohammed O., Simpson, David A., Chand, Meera, Gupta, Ravi K., Darby, Alistair C., Paterson, Steve, Pybus, Oliver G., Volz, Erik M., de Angelis, Daniela, Robertson, David L., Page, Andrew J., Martincorena, Inigo, Aigrain, Louise, Bassett, Andrew R., Wong, Nick, Taha, Yusri, Erkiert, Michelle J., Spencer Chapman, Michael H., Dewar, Rebecca, McHugh, Martin P., Mookerjee, Siddharth, Aplin, Stephen, Harvey, Matthew, Sass, Thea, Umpleby, Helen, Wheeler, Helen, McKenna, James P., Warne, Ben, Taylor, Joshua F., Chaudhry, Yasmin, Izuagbe, Rhys, Jahun, Aminu S., Young, Gregory R., McMurray, Claire, McCann, Clare M., Nelson, Andrew, Elliott, Scott, Lowe, Hannah, Price, Anna, Crown, Matthew R., Rey, Sara, Roy, Sunando, Temperton, Ben, Shaaban, Sharif, Hesketh, Andrew R., Laing, Kenneth G., Monahan, Irene M., Heaney, Judith, Pelosi, Emanuela, Silviera, Siona, Wilson-Davies, Eleri, Fryer, Helen, Adams, Helen, du Plessis, Louis, Johnson, Rob, Harvey, William T., Hughes, Joseph, Orton, Richard J., Spurgin, Lewis G., Bourgeois, Yann, Ruis, Chris, O'Toole, Áine, Gourtovaia, Marina, Sanderson, Theo, Fraser, Christophe, Edgeworth, Jonathan, Breuer, Judith, Michell, Stephen L., Todd, John A., John, Michaela, Buck, David, Gajee, Kavitha, Kay, Gemma L., Heyburn, David, Charalampous, Themoula, Alcolea-Medina, Adela, Kitchman, Katie, McNal, Alan, Pritch, David T., Dervisevic, Samir, Muir, Peter, Robinson, Esther, Vipond, Barry B., Ramadan, Newara A., Jeanes, Christopher, Weldon, Danni, Catalan, Jana, Jones, Neil, da Silva Filipe, Ana, Williams, Chris, Fuchs, Marc, Miskelly, Julia, Jeffries, Aaron R., Oliver, Karen, Park, Naomi R., Ash, Amy, Koshy, Cherian, Barrow, Magdalena, Buchan, Sarah L., Mantzouratou, Anna, Clark, Gemma, Holmes, Christopher W., Campbell, Sharon, Davis, Thomas, Tan, Ngee Keong, Brown, Julianne R., Harris, Kathryn A., Kidd, Stephen P., Grant, Paul R., Xu-McCrae, Li, Cox, Alison, Madona, Pinglawathee, Pond, Marcus, Randell, Paul A., Withell, Karen T., Williams, Cheryl, Graham, Clive, Denton-Smith, Rebecca, Swindells, Emma, Turnbull, Robyn, Sloan, Tim J., Bosworth, Andrew, Hutchings, Stephanie, Pymont, Hannah M., Casey, Anna, Ratcliffe, Liz, Jones, Christopher R., Knight, Bridget A., Haque, Tanzina, Hart, Jennifer, Irish-Tavares, Dianne, Witele, Eric, Mower, Craig, Watson DipHE, Louisa K., Collins, Jennifer, Eltringham, Gary, Crudgington, Dorian, Macklin, Ben, Iturriza-Gomara, Miren, Lucaci, Anita O., McClure, Patrick C., Carlile, Matthew, Holmes, Nadine, Moore, Christopher, Storey, Nathaniel, Rooke, Stefan, Yebra, Gonzalo, Craine, Noel, Perry, Malorie, Alikhan, Nabil-Fareed, Bridgett, Stephen, Cook, Kate F., Fearn, Christopher, Goudarzi, Salman, Lyons, Ronan A., Williams, Thomas, Haldenby, Sam T., Durham, Jillian, Leonard, Steven, Davies, Robert M., Batra, Rahul, Blane, Beth, Spyer, Moira J., Smith, Perminder, Yavus, Mehmet, Williams, Rachel J., Mahanama, Adhyana IK., Samaraweera, Buddhini, Girgis, Sophia T., Hansford, Samantha E., Green, Angie, Beaver, Charlotte, Bellis, Katherine L., Dorman, Matthew J., Kay, Sally, Prestwood, Liam, Rajatileka, Shavanthi, Quick, Joshua, Poplawski, Radoslaw, Reynolds, Nicola, Mack, Andrew, Morriss, Arthur, Whalley, Thomas, Patel, Bindi, Georgana, Iliana, Hosmillo, Myra, Pinckert, Malte L., Stockton, Joanne, Henderson, John H., Hollis, Amy, Stanley, William, Yew, Wen C., Myers, Richard, Thornton, Alicia, Adams, Alexander, Annett, Tara, Asad, Hibo, Birchley, Alec, Coombes, Jason, Evans, Johnathan M., Fina, Laia, Gatica-Wilcox, Bree, Gilbert, Lauren, Graham, Lee, Hey, Jessica, Hilvers, Ember, Jones, Sophie, Jones, Hannah, Kumziene-Summerhayes, Sara, McKerr, Caoimhe, Powell, Jessica, Pugh, Georgia, Taylor, Sarah, Trotter, Alexander J., Williams, Charlotte A., Kermack, Leanne M., Foulkes, Benjamin H., Gallis, Marta, Hornsby, Hailey R., Louka, Stavroula F., Pohare, Manoj, Wolverson, Paige, Zhang, Peijun, MacIntyre-Cockett, George, Trebes, Amy, Moll, Robin J., Ferguson, Lynne, Goldstein, Emily J., Maclean, Alasdair, Tomb, Rachael, Starinskij, Igor, Thomson, Laura, Southgate, Joel, Kraemer, Moritz UG., Raghwani, Jayna, Zarebski, Alex E., Boyd, Olivia, Geidelberg, Lily, Illingworth, Chris J., Jackson, Chris, Pascall, David, Vattipally, Sreenu, Freeman, Timothy M., Hsu, Sharon N., Lindsey, Benjamin B., James, Keith, Lewis, Kevin, Tonkin-Hill, Gerry, Tovar-Corona, Jaime M., Cox, MacGregor, Abudahab, Khalil, Menegazzo, Mirko, Taylor, Ben EW., Yeats, Corin A., Mukaddas, Afrida, Wright, Derek W., de Oliveira Martins, Leonardo, Colquhoun, Rachel, Hill, Verity, Jackson, Ben, McCrone, J.T., Medd, Nathan, Scher, Emily, Keatley, Jon-Paul, Curran, Tanya, Morgan, Sian, Maxwell, Patrick, Smith, Ken, Eldirdiri, Sahar, Kenyon, Anita, Holmes, Alison H., Price, James R., Wyatt, Tim, Mather, Alison E., Skvortsov, Timofey, Hartley, John A., Guest, Martyn, Kitchen, Christine, Merrick, Ian, Munn, Robert, Bertolusso, Beatrice, Lynch, Jessica, Vernet, Gabrielle, Kirk, Stuart, Wastnedge, Elizabeth, Stanley, Rachael, Idle, Giles, Bradley, Declan T., Killough, Nicholas F., Poyner, Jennifer, Mori, Matilde, Jones, Owen, Wright, Victoria, Brooks, Ellena, Churcher, Carol M., Delgado Callico, Laia, Fragakis, Mireille, Galai, Katerina, Jermy, Andrew, Judges, Sarah, Markov, Anna, McManus, Georgina M., Smith, Kim S., Thomas-McEwen, Peter MD., Westwick, Elaine, Attwood, Stephen W., Bolt, Frances, Davies, Alisha, De Lacy, Elen, Downing, Fatima, Edwards, Sue, Meadows, Lizzie, Jeremiah, Sarah, Smith, Nikki, Foulser, Luke, Patel, Amita, Berry, Louise, Boswell, Tim, Fleming, Vicki M., Howson-Wells, Hannah C., Joseph, Amelia, Khakh, Manjinder, Lister, Michelle M., Bird, Paul W., Fallon, Karlie, Helmer, Thomas, McMurray, Claire L., Odedra, Mina, Shaw, Jessica, Tang, Julian W., Willford, Nicholas J., Blakey, Victoria, Raviprakash, Veena, Sheriff, Nicola, Williams, Lesley-Anne, Feltwell, Theresa, Bedford, Luke, Cargill, James S., Hughes, Warwick, Moore, Jonathan, Stonehouse, Susanne, Atkinson, Laura, Lee, Jack CD., Shah, Divya, Ohemeng-Kumi, Natasha, Ramble, John, Sehmi, Jasveen, Williams, Rebecca, Chatterton, Wendy, Pusok, Monika, Everson, William, Castigador, Anibolina, Macnaughton, Emily, El Bouzidi, Kate, Lampejo, Temi, Sudhanva, Malur, Breen, Cassie, Sluga, Graciela, Ahmad, Shazaad SY., George, Ryan P., Machin, Nicholas W., Binns, Debbie, James, Victoria, Blacow, Rachel, Coupland, Lindsay, Smith, Louise, Barton, Edward, Padgett, Debra, Scott, Garren, Cross, Aidan, Mirfenderesky, Mariyam, Greenaway, Jane, Cole, Kevin, Clarke, Phillip, Duckworth, Nichola, Walsh, Sarah, Bicknell, Kelly, Impey, Robert, Wyllie, Sarah, Hopes, Richard, Bishop, Chloe, Chalker, Vicki, Harrison, Ian, Gifford, Laura, Molnar, Zoltan, Auckland, Cressida, Evans, Cariad, Johnson, Kate, Partridge, David G., Raza, Mohammad, Baker, Paul, Bonner, Stephen, Essex, Sarah, Murray, Leanne J., Lawton, Andrew I., Burton-Fanning, Shirelle, Payne, Brendan AI., Waugh, Sheila, Gomes, Andrea N., Kimuli, Maimuna, Murray, Darren R., Ashfield, Paula, Dobie, Donald, Ashford, Fiona, Best, Angus, Crawford, Liam, Cumley, Nicola, Mayhew, Megan, Megram, Oliver, Mirza, Jeremy, Moles-Garcia, Emma, Percival, Benita, Driscoll, Megan, Ensell, Leah, Lowe, Helen L., Maftei, Laurentiu, Mondani, Matteo, Chaloner, Nicola J., Cogger, Benjamin J., Easton, Lisa J., Huckson, Hannah, Lewis, Jonathan, Lowdon, Sarah, Malone, Cassandra S., Munemo, Florence, Mutingwende, Manasa, Nicodemi, Roberto, Podplomyk FD, Olga, Somassa, Thomas, Beggs, Andrew, Richter, Alex, Cormie, Claire, Dias, Joana, Forrest, Sally, Higginson, Ellen E., Maes, Mailis, Young, Jamie, Davidson, Rose K., Jackson, Kathryn A., Keeley, Alexander J., Ball, Jonathan, Byaruhanga, Timothy, Chappell, Joseph G., Dey, Jayasree, Hill, Jack D., Park, Emily J., Fanaie, Arezou, Hilson, Rachel A., Yaze, Geraldine, Lo, Stephanie, Afifi, Safiah, Beer, Robert, Maksimovic, Joshua, McCluggage, Kathryn, Spellman, Karla, Bresner, Catherine, Fuller, William, Marchbank, Angela, Workma, Trudy, Shelest, Ekaterina, Debebe, Johnny, Sang, Fei, Francois, Sarah, Gutierrez, Bernardo, Vasylyeva, Tetyana I., Flaviani, Flavia, Ragonnet-Cronin, Manon, Smollett, Katherine L., Broos, Alice, Mair, Daniel, Nichols, Jenna, Nomikou, Kyriaki, Tong, Lily, Tsatsani, Ioulia, O'Brien, Sarah, Rushton, Steven, Sanderson, Roy, Perkins, Jon, Cotton, Seb, Gallagher, Abbie, Allara, Elias, Pearson, Clare, Bibby, David, Dabrer, Gavin, Ellaby, Nicholas, Gallagher, Eileen, Hubb, Jonathan, Lackenby, Angie, Lee, David, Manesis, Nikos, Mbisa, Tamyo, Platt, Steven, Twohig, Katherine A., Morgan, Mari, Aydin, Alp, Baker, David J., Foster-Nyarko, Ebenezer, Prosolek, Sophie J., Rudder, Steven, Baxter, Chris, Carvalho, Sílvia F., Lavin, Deborah, Mariappan, Arun, Radulescu, Clara, Singh, Aditi, Tang, Miao, Morcrette, Helen, Bayzid, Nadua, Cotic, Marius, Balcazar, Carlos E., Gallagher, Michael D., Maloney, Daniel, Stanton, Thomas D., Williamson, Kathleen A., Manley, Robin, Michelsen, Michelle L., Sambles, Christine M., Studholme, David J., Warwick-Dugdale, Joanna, Eccles, Richard, Gemmell, Matthew, Gregory, Richard, Hughes, Margaret, Nelson, Charlotte, Rainbow, Lucille, Vamos, Edith E., Webster, Hermione J., Whitehead, Mark, Wierzbicki, Claudia, Angyal, Adrienn, Green, Luke R., Whiteley, Max, Betteridge, Emma, Bronner, Iraad F., Farr, Ben W., Goodwin, Scott, Lensing, Stefanie V., McCarthy, Shane A., Quail, Michael A., Rajan, Diana, Redshaw, Nicholas M., Scott, Carol, Shirley, Lesley, Thurston, Scott AJ., Rowe, Will, Gaskin, Amy, Le-Viet, Thanh, Bonfield, James, Liddle, Jennifier, Whitwham, Andrew, Cotton, S., McHugh, M.P., Dewar, R., Haas, J.G., and Templeton, K.

Published
2023
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6. Wireless Body Area Communications

Author

D’Errico, R., primary, Yazdandoost, K. Yekeh, additional, Rosini, R., additional, Sayrafian, K., additional, Kumpuniemi, T., additional, Cotton, S., additional, and Mackowiak, M., additional

Published
2022
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8. PUrE RCT 1: Clinical and cost-effectiveness of flexible ureterorenoscopy and extracorporeal shockwave lithotripsy for lower pole stones ≤10 mm

Author

Wiseman, O., primary, Smith, R.D., additional, Starr, K., additional, Aucott, L., additional, Hernández, R., additional, Thomas, R.E., additional, Maclennan, S., additional, Clark, T., additional, Maclennan, G., additional, Mcrae, D., additional, Bell, V., additional, Cotton, S., additional, Gall, Z., additional, Turney, B., additional, and Mcclinton, S., additional

Published
2024
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9. PUrE RCT 2: Clinical and cost-effectiveness of FURS and percutaneous nephrolithotomy for lower pole stones 10-25mm

Author

Smith, R.D., primary, Wiseman, O., additional, Starr, K., additional, Aucott, L., additional, Hernández, R., additional, Thomas, R.E., additional, Maclennan, S., additional, Clark, T., additional, Maclennan, G., additional, Mcrae, D., additional, Bell, V., additional, Cotton, S., additional, Gall, Z., additional, Turney, B., additional, and Mcclinton, S., additional

Published
2024
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10. Climate change concerns impact on young Australians' psychological distress and outlook for the future

Author

Teo, SM, Gao, CX, Brennan, N, Fava, N, Simmons, MB, Baker, D, Zbukvic, I, Rickwood, DJ, Brown, E, Smith, CL, Watson, AE, Browne, V, Cotton, S, Mcgorry, P, Killackey, E, Freeburn, T, Filia, KM, Teo, SM, Gao, CX, Brennan, N, Fava, N, Simmons, MB, Baker, D, Zbukvic, I, Rickwood, DJ, Brown, E, Smith, CL, Watson, AE, Browne, V, Cotton, S, Mcgorry, P, Killackey, E, Freeburn, T, and Filia, KM

Published
2024

12. Impact of forest fragmentation and associated edge effects on the population density of four nocturnal lemur species in North West Madagascar.

Author

Hending, D., Randrianarison, H., Andriamavosoloarisoa, N. N. M., Ranohatra‐Hending, C., McCabe, G., Cotton, S., and Holderied, M.

Subjects
COMPETITION (Biology), FRAGMENTED landscapes, FOREST degradation, TROPICAL forests, POPULATION density, EDGE effects (Ecology)
Abstract

The clearing and fragmentation of tropical forests is the single biggest threat to primate populations who depend on this habitat for survival. In contrast to primates that live in continuous, undisturbed forests, primate communities of fragmented forests need to adapt to decreased food availability and increased inter‐ and intraspecific competition typical of these degraded and anthropogenically disturbed habitats. Some primate species are highly sensitive to habitat fragmentation, whilst other species can adapt and even thrive in fragmented and degraded forests. Here, we assessed how forest fragmentation and associated edge effects impact the population density of four species of nocturnal lemur in the Sahamalaza‐Iles Radama National Park, North West Madagascar. We conducted 118 transect walks over a 3‐year period covering a total distance of 107 km to collect encounter rate (N/km) and population density (N/Ha) data for each species, which we then compared between the edge and core areas of a continuous forest and a fragmented forest. Our results were highly species‐specific, with the population densities of two species (Lepilemur sahamalaza and Microcebus sambiranensis) increasing in edge and fragmented habitat, whilst we observed the opposite for Cheirogaleus medius. Mirza zaza density appeared consistent between the continuous and fragmented forest and in both edge and core areas. We also found evidence of species‐specific population density relationships with fragment size, core area and fragment shape; however, further work is needed to support these findings. This study demonstrates that some nocturnal lemurs can adapt to degraded habitats and thrive within fragmented forests, whilst other species are less capable of doing so. [ABSTRACT FROM AUTHOR]

Published
2024
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13. EP06.02-01 Prevalence of PD-L1 Expression in Non-Small Cell Lung Cancer: a Real-World Australian Perspective

Author

Prabhakaran, S., primary, Russell, P.A., additional, Farrall, A.L., additional, Asadi, K., additional, Barrett, W., additional, Cooper, C., additional, Cooper, W., additional, Duhig, E.E., additional, Egan, M., additional, Fox, S., additional, Godbolt, D., additional, Gupta, S., additional, Cotton, S., additional, Leslie, C., additional, Leong, T., additional, Moffat, D., additional, Qiu, M., additional, Sivasubramaniam, V., additional, Snell, C., additional, Skerman, J., additional, Walsh, M., additional, Whale, K., additional, and Klebe, S., additional

Published
2023
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15. Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Author

Cotton, S., primary, McHugh, M.P., additional, Dewar, R., additional, Haas, J.G., additional, Templeton, K., additional, Robson, Samuel C., additional, Connor, Thomas R., additional, Loman, Nicholas J., additional, Golubchik, Tanya, additional, Martinez Nunez, Rocio T., additional, Bonsall, David, additional, Rambaut, Andrew, additional, Snell, Luke B., additional, Livett, Rich, additional, Ludden, Catherine, additional, Corden, Sally, additional, Nastouli, Eleni, additional, Nebbia, Gaia, additional, Johnston, Ian, additional, Prieto, Jacqui A., additional, Saeed, Kordo, additional, Jackson, David K., additional, Houlihan, Catherine, additional, Frampton, Dan, additional, Hamilton, William L., additional, Witney, Adam A., additional, Bucca, Giselda, additional, Pope, Cassie F., additional, Moore, Catherine, additional, Thomson, Emma C., additional, Cutino-Moguel, Teresa, additional, Harrison, Ewan M., additional, Smith, Colin P., additional, Rogan, Fiona, additional, Beckwith, Shaun M., additional, Murray, Abigail, additional, Singleton, Dawn, additional, Eastick, Kirstine, additional, Sheridan, Liz A., additional, Randell, Paul, additional, Jackson, Leigh M., additional, Ariani, Cristina V., additional, Gonçalves, Sónia, additional, Fairley, Derek J., additional, Loose, Matthew W., additional, Watkins, Joanne, additional, Moses, Samuel, additional, Nicholls, Sam, additional, Bull, Matthew, additional, Amato, Roberto, additional, Smith, Darren L., additional, Aanensen, David M., additional, Barrett, Jeffrey C., additional, Kele, Beatrix, additional, Aggarwal, Dinesh, additional, Shepherd, James G., additional, Curran, Martin D., additional, Parmar, Surendra, additional, Parker, Matthew D., additional, Williams, Catryn, additional, Glaysher, Sharon, additional, Underwood, Anthony P., additional, Bashton, Matthew, additional, Pacchiarini, Nicole, additional, Loveson, Katie F., additional, Byott, Matthew, additional, Carabelli, Alessandro M., additional, Templeton, Kate E., additional, Peacock, Sharon J., additional, de Silva, Thushan I., additional, Wang, Dennis, additional, Langford, Cordelia F., additional, Sillitoe, John, additional, Gunson, Rory N., additional, Cottrell, Simon, additional, O’Grady, Justin, additional, Kwiatkowski, Dominic, additional, Lillie, Patrick J., additional, Cortes, Nicholas, additional, Moore, Nathan, additional, Thomas, Claire, additional, Burns, Phillipa J., additional, Mahungu, Tabitha W., additional, Liggett, Steven, additional, Beckett, Angela H., additional, Holden, Matthew TG., additional, Levett, Lisa J., additional, Osman, Husam, additional, Hassan-Ibrahim, Mohammed O., additional, Simpson, David A., additional, Chand, Meera, additional, Gupta, Ravi K., additional, Darby, Alistair C., additional, Paterson, Steve, additional, Pybus, Oliver G., additional, Volz, Erik M., additional, de Angelis, Daniela, additional, Robertson, David L., additional, Page, Andrew J., additional, Martincorena, Inigo, additional, Aigrain, Louise, additional, Bassett, Andrew R., additional, Wong, Nick, additional, Taha, Yusri, additional, Erkiert, Michelle J., additional, Spencer Chapman, Michael H., additional, Dewar, Rebecca, additional, McHugh, Martin P., additional, Mookerjee, Siddharth, additional, Aplin, Stephen, additional, Harvey, Matthew, additional, Sass, Thea, additional, Umpleby, Helen, additional, Wheeler, Helen, additional, McKenna, James P., additional, Warne, Ben, additional, Taylor, Joshua F., additional, Chaudhry, Yasmin, additional, Izuagbe, Rhys, additional, Jahun, Aminu S., additional, Young, Gregory R., additional, McMurray, Claire, additional, McCann, Clare M., additional, Nelson, Andrew, additional, Elliott, Scott, additional, Lowe, Hannah, additional, Price, Anna, additional, Crown, Matthew R., additional, Rey, Sara, additional, Roy, Sunando, additional, Temperton, Ben, additional, Shaaban, Sharif, additional, Hesketh, Andrew R., additional, Laing, Kenneth G., additional, Monahan, Irene M., additional, Heaney, Judith, additional, Pelosi, Emanuela, additional, Silviera, Siona, additional, Wilson-Davies, Eleri, additional, Fryer, Helen, additional, Adams, Helen, additional, du Plessis, Louis, additional, Johnson, Rob, additional, Harvey, William T., additional, Hughes, Joseph, additional, Orton, Richard J., additional, Spurgin, Lewis G., additional, Bourgeois, Yann, additional, Ruis, Chris, additional, O'Toole, Áine, additional, Gourtovaia, Marina, additional, Sanderson, Theo, additional, Fraser, Christophe, additional, Edgeworth, Jonathan, additional, Breuer, Judith, additional, Michell, Stephen L., additional, Todd, John A., additional, John, Michaela, additional, Buck, David, additional, Gajee, Kavitha, additional, Kay, Gemma L., additional, Heyburn, David, additional, Charalampous, Themoula, additional, Alcolea-Medina, Adela, additional, Kitchman, Katie, additional, McNal, Alan, additional, Pritch, David T., additional, Dervisevic, Samir, additional, Muir, Peter, additional, Robinson, Esther, additional, Vipond, Barry B., additional, Ramadan, Newara A., additional, Jeanes, Christopher, additional, Weldon, Danni, additional, Catalan, Jana, additional, Jones, Neil, additional, da Silva Filipe, Ana, additional, Williams, Chris, additional, Fuchs, Marc, additional, Miskelly, Julia, additional, Jeffries, Aaron R., additional, Oliver, Karen, additional, Park, Naomi R., additional, Ash, Amy, additional, Koshy, Cherian, additional, Barrow, Magdalena, additional, Buchan, Sarah L., additional, Mantzouratou, Anna, additional, Clark, Gemma, additional, Holmes, Christopher W., additional, Campbell, Sharon, additional, Davis, Thomas, additional, Tan, Ngee Keong, additional, Brown, Julianne R., additional, Harris, Kathryn A., additional, Kidd, Stephen P., additional, Grant, Paul R., additional, Xu-McCrae, Li, additional, Cox, Alison, additional, Madona, Pinglawathee, additional, Pond, Marcus, additional, Randell, Paul A., additional, Withell, Karen T., additional, Williams, Cheryl, additional, Graham, Clive, additional, Denton-Smith, Rebecca, additional, Swindells, Emma, additional, Turnbull, Robyn, additional, Sloan, Tim J., additional, Bosworth, Andrew, additional, Hutchings, Stephanie, additional, Pymont, Hannah M., additional, Casey, Anna, additional, Ratcliffe, Liz, additional, Jones, Christopher R., additional, Knight, Bridget A., additional, Haque, Tanzina, additional, Hart, Jennifer, additional, Irish-Tavares, Dianne, additional, Witele, Eric, additional, Mower, Craig, additional, Watson DipHE, Louisa K., additional, Collins, Jennifer, additional, Eltringham, Gary, additional, Crudgington, Dorian, additional, Macklin, Ben, additional, Iturriza-Gomara, Miren, additional, Lucaci, Anita O., additional, McClure, Patrick C., additional, Carlile, Matthew, additional, Holmes, Nadine, additional, Moore, Christopher, additional, Storey, Nathaniel, additional, Rooke, Stefan, additional, Yebra, Gonzalo, additional, Craine, Noel, additional, Perry, Malorie, additional, Alikhan, Nabil-Fareed, additional, Bridgett, Stephen, additional, Cook, Kate F., additional, Fearn, Christopher, additional, Goudarzi, Salman, additional, Lyons, Ronan A., additional, Williams, Thomas, additional, Haldenby, Sam T., additional, Durham, Jillian, additional, Leonard, Steven, additional, Davies, Robert M., additional, Batra, Rahul, additional, Blane, Beth, additional, Spyer, Moira J., additional, Smith, Perminder, additional, Yavus, Mehmet, additional, Williams, Rachel J., additional, Mahanama, Adhyana IK., additional, Samaraweera, Buddhini, additional, Girgis, Sophia T., additional, Hansford, Samantha E., additional, Green, Angie, additional, Beaver, Charlotte, additional, Bellis, Katherine L., additional, Dorman, Matthew J., additional, Kay, Sally, additional, Prestwood, Liam, additional, Rajatileka, Shavanthi, additional, Quick, Joshua, additional, Poplawski, Radoslaw, additional, Reynolds, Nicola, additional, Mack, Andrew, additional, Morriss, Arthur, additional, Whalley, Thomas, additional, Patel, Bindi, additional, Georgana, Iliana, additional, Hosmillo, Myra, additional, Pinckert, Malte L., additional, Stockton, Joanne, additional, Henderson, John H., additional, Hollis, Amy, additional, Stanley, William, additional, Yew, Wen C., additional, Myers, Richard, additional, Thornton, Alicia, additional, Adams, Alexander, additional, Annett, Tara, additional, Asad, Hibo, additional, Birchley, Alec, additional, Coombes, Jason, additional, Evans, Johnathan M., additional, Fina, Laia, additional, Gatica-Wilcox, Bree, additional, Gilbert, Lauren, additional, Graham, Lee, additional, Hey, Jessica, additional, Hilvers, Ember, additional, Jones, Sophie, additional, Jones, Hannah, additional, Kumziene-Summerhayes, Sara, additional, McKerr, Caoimhe, additional, Powell, Jessica, additional, Pugh, Georgia, additional, Taylor, Sarah, additional, Trotter, Alexander J., additional, Williams, Charlotte A., additional, Kermack, Leanne M., additional, Foulkes, Benjamin H., additional, Gallis, Marta, additional, Hornsby, Hailey R., additional, Louka, Stavroula F., additional, Pohare, Manoj, additional, Wolverson, Paige, additional, Zhang, Peijun, additional, MacIntyre-Cockett, George, additional, Trebes, Amy, additional, Moll, Robin J., additional, Ferguson, Lynne, additional, Goldstein, Emily J., additional, Maclean, Alasdair, additional, Tomb, Rachael, additional, Starinskij, Igor, additional, Thomson, Laura, additional, Southgate, Joel, additional, Kraemer, Moritz UG., additional, Raghwani, Jayna, additional, Zarebski, Alex E., additional, Boyd, Olivia, additional, Geidelberg, Lily, additional, Illingworth, Chris J., additional, Jackson, Chris, additional, Pascall, David, additional, Vattipally, Sreenu, additional, Freeman, Timothy M., additional, Hsu, Sharon N., additional, Lindsey, Benjamin B., additional, James, Keith, additional, Lewis, Kevin, additional, Tonkin-Hill, Gerry, additional, Tovar-Corona, Jaime M., additional, Cox, MacGregor, additional, Abudahab, Khalil, additional, Menegazzo, Mirko, additional, Taylor, Ben EW., additional, Yeats, Corin A., additional, Mukaddas, Afrida, additional, Wright, Derek W., additional, de Oliveira Martins, Leonardo, additional, Colquhoun, Rachel, additional, Hill, Verity, additional, Jackson, Ben, additional, McCrone, J.T., additional, Medd, Nathan, additional, Scher, Emily, additional, Keatley, Jon-Paul, additional, Curran, Tanya, additional, Morgan, Sian, additional, Maxwell, Patrick, additional, Smith, Ken, additional, Eldirdiri, Sahar, additional, Kenyon, Anita, additional, Holmes, Alison H., additional, Price, James R., additional, Wyatt, Tim, additional, Mather, Alison E., additional, Skvortsov, Timofey, additional, Hartley, John A., additional, Guest, Martyn, additional, Kitchen, Christine, additional, Merrick, Ian, additional, Munn, Robert, additional, Bertolusso, Beatrice, additional, Lynch, Jessica, additional, Vernet, Gabrielle, additional, Kirk, Stuart, additional, Wastnedge, Elizabeth, additional, Stanley, Rachael, additional, Idle, Giles, additional, Bradley, Declan T., additional, Killough, Nicholas F., additional, Poyner, Jennifer, additional, Mori, Matilde, additional, Jones, Owen, additional, Wright, Victoria, additional, Brooks, Ellena, additional, Churcher, Carol M., additional, Delgado Callico, Laia, additional, Fragakis, Mireille, additional, Galai, Katerina, additional, Jermy, Andrew, additional, Judges, Sarah, additional, Markov, Anna, additional, McManus, Georgina M., additional, Smith, Kim S., additional, Thomas-McEwen, Peter MD., additional, Westwick, Elaine, additional, Attwood, Stephen W., additional, Bolt, Frances, additional, Davies, Alisha, additional, De Lacy, Elen, additional, Downing, Fatima, additional, Edwards, Sue, additional, Meadows, Lizzie, additional, Jeremiah, Sarah, additional, Smith, Nikki, additional, Foulser, Luke, additional, Patel, Amita, additional, Berry, Louise, additional, Boswell, Tim, additional, Fleming, Vicki M., additional, Howson-Wells, Hannah C., additional, Joseph, Amelia, additional, Khakh, Manjinder, additional, Lister, Michelle M., additional, Bird, Paul W., additional, Fallon, Karlie, additional, Helmer, Thomas, additional, McMurray, Claire L., additional, Odedra, Mina, additional, Shaw, Jessica, additional, Tang, Julian W., additional, Willford, Nicholas J., additional, Blakey, Victoria, additional, Raviprakash, Veena, additional, Sheriff, Nicola, additional, Williams, Lesley-Anne, additional, Feltwell, Theresa, additional, Bedford, Luke, additional, Cargill, James S., additional, Hughes, Warwick, additional, Moore, Jonathan, additional, Stonehouse, Susanne, additional, Atkinson, Laura, additional, Lee, Jack CD., additional, Shah, Divya, additional, Ohemeng-Kumi, Natasha, additional, Ramble, John, additional, Sehmi, Jasveen, additional, Williams, Rebecca, additional, Chatterton, Wendy, additional, Pusok, Monika, additional, Everson, William, additional, Castigador, Anibolina, additional, Macnaughton, Emily, additional, El Bouzidi, Kate, additional, Lampejo, Temi, additional, Sudhanva, Malur, additional, Breen, Cassie, additional, Sluga, Graciela, additional, Ahmad, Shazaad SY., additional, George, Ryan P., additional, Machin, Nicholas W., additional, Binns, Debbie, additional, James, Victoria, additional, Blacow, Rachel, additional, Coupland, Lindsay, additional, Smith, Louise, additional, Barton, Edward, additional, Padgett, Debra, additional, Scott, Garren, additional, Cross, Aidan, additional, Mirfenderesky, Mariyam, additional, Greenaway, Jane, additional, Cole, Kevin, additional, Clarke, Phillip, additional, Duckworth, Nichola, additional, Walsh, Sarah, additional, Bicknell, Kelly, additional, Impey, Robert, additional, Wyllie, Sarah, additional, Hopes, Richard, additional, Bishop, Chloe, additional, Chalker, Vicki, additional, Harrison, Ian, additional, Gifford, Laura, additional, Molnar, Zoltan, additional, Auckland, Cressida, additional, Evans, Cariad, additional, Johnson, Kate, additional, Partridge, David G., additional, Raza, Mohammad, additional, Baker, Paul, additional, Bonner, Stephen, additional, Essex, Sarah, additional, Murray, Leanne J., additional, Lawton, Andrew I., additional, Burton-Fanning, Shirelle, additional, Payne, Brendan AI., additional, Waugh, Sheila, additional, Gomes, Andrea N., additional, Kimuli, Maimuna, additional, Murray, Darren R., additional, Ashfield, Paula, additional, Dobie, Donald, additional, Ashford, Fiona, additional, Best, Angus, additional, Crawford, Liam, additional, Cumley, Nicola, additional, Mayhew, Megan, additional, Megram, Oliver, additional, Mirza, Jeremy, additional, Moles-Garcia, Emma, additional, Percival, Benita, additional, Driscoll, Megan, additional, Ensell, Leah, additional, Lowe, Helen L., additional, Maftei, Laurentiu, additional, Mondani, Matteo, additional, Chaloner, Nicola J., additional, Cogger, Benjamin J., additional, Easton, Lisa J., additional, Huckson, Hannah, additional, Lewis, Jonathan, additional, Lowdon, Sarah, additional, Malone, Cassandra S., additional, Munemo, Florence, additional, Mutingwende, Manasa, additional, Nicodemi, Roberto, additional, Podplomyk FD, Olga, additional, Somassa, Thomas, additional, Beggs, Andrew, additional, Richter, Alex, additional, Cormie, Claire, additional, Dias, Joana, additional, Forrest, Sally, additional, Higginson, Ellen E., additional, Maes, Mailis, additional, Young, Jamie, additional, Davidson, Rose K., additional, Jackson, Kathryn A., additional, Keeley, Alexander J., additional, Ball, Jonathan, additional, Byaruhanga, Timothy, additional, Chappell, Joseph G., additional, Dey, Jayasree, additional, Hill, Jack D., additional, Park, Emily J., additional, Fanaie, Arezou, additional, Hilson, Rachel A., additional, Yaze, Geraldine, additional, Lo, Stephanie, additional, Afifi, Safiah, additional, Beer, Robert, additional, Maksimovic, Joshua, additional, McCluggage, Kathryn, additional, Spellman, Karla, additional, Bresner, Catherine, additional, Fuller, William, additional, Marchbank, Angela, additional, Workma, Trudy, additional, Shelest, Ekaterina, additional, Debebe, Johnny, additional, Sang, Fei, additional, Francois, Sarah, additional, Gutierrez, Bernardo, additional, Vasylyeva, Tetyana I., additional, Flaviani, Flavia, additional, Ragonnet-Cronin, Manon, additional, Smollett, Katherine L., additional, Broos, Alice, additional, Mair, Daniel, additional, Nichols, Jenna, additional, Nomikou, Kyriaki, additional, Tong, Lily, additional, Tsatsani, Ioulia, additional, O'Brien, Sarah, additional, Rushton, Steven, additional, Sanderson, Roy, additional, Perkins, Jon, additional, Cotton, Seb, additional, Gallagher, Abbie, additional, Allara, Elias, additional, Pearson, Clare, additional, Bibby, David, additional, Dabrer, Gavin, additional, Ellaby, Nicholas, additional, Gallagher, Eileen, additional, Hubb, Jonathan, additional, Lackenby, Angie, additional, Lee, David, additional, Manesis, Nikos, additional, Mbisa, Tamyo, additional, Platt, Steven, additional, Twohig, Katherine A., additional, Morgan, Mari, additional, Aydin, Alp, additional, Baker, David J., additional, Foster-Nyarko, Ebenezer, additional, Prosolek, Sophie J., additional, Rudder, Steven, additional, Baxter, Chris, additional, Carvalho, Sílvia F., additional, Lavin, Deborah, additional, Mariappan, Arun, additional, Radulescu, Clara, additional, Singh, Aditi, additional, Tang, Miao, additional, Morcrette, Helen, additional, Bayzid, Nadua, additional, Cotic, Marius, additional, Balcazar, Carlos E., additional, Gallagher, Michael D., additional, Maloney, Daniel, additional, Stanton, Thomas D., additional, Williamson, Kathleen A., additional, Manley, Robin, additional, Michelsen, Michelle L., additional, Sambles, Christine M., additional, Studholme, David J., additional, Warwick-Dugdale, Joanna, additional, Eccles, Richard, additional, Gemmell, Matthew, additional, Gregory, Richard, additional, Hughes, Margaret, additional, Nelson, Charlotte, additional, Rainbow, Lucille, additional, Vamos, Edith E., additional, Webster, Hermione J., additional, Whitehead, Mark, additional, Wierzbicki, Claudia, additional, Angyal, Adrienn, additional, Green, Luke R., additional, Whiteley, Max, additional, Betteridge, Emma, additional, Bronner, Iraad F., additional, Farr, Ben W., additional, Goodwin, Scott, additional, Lensing, Stefanie V., additional, McCarthy, Shane A., additional, Quail, Michael A., additional, Rajan, Diana, additional, Redshaw, Nicholas M., additional, Scott, Carol, additional, Shirley, Lesley, additional, Thurston, Scott AJ., additional, Rowe, Will, additional, Gaskin, Amy, additional, Le-Viet, Thanh, additional, Bonfield, James, additional, Liddle, Jennifier, additional, and Whitwham, Andrew, additional

Published
2023
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16. Moderated Online Social Therapy for Carers of Early Psychosis Clients in Real-World Settings: Cluster Randomized Controlled Trial

Author

Gleeson, J, Lin, A, Koval, P, Hopkins, L, Denborough, P, Lederman, R, Herrman, H, Bendall, S, Eleftheriadis, D, Cotton, S, Perry, Y, Kaess, M, Alvarez-Jimenez, M, Gleeson, J, Lin, A, Koval, P, Hopkins, L, Denborough, P, Lederman, R, Herrman, H, Bendall, S, Eleftheriadis, D, Cotton, S, Perry, Y, Kaess, M, and Alvarez-Jimenez, M

Abstract

BACKGROUND: Family carers of youth recovering from early psychosis experience significant stress; however, access to effective family interventions is poor. Digital interventions provide a promising solution. OBJECTIVE: Our objective was to evaluate across multiple Australian early psychosis services the effectiveness of a novel, web-based early psychosis intervention for carers. METHODS: In this cluster randomized controlled trial conducted across multiple Australian early psychosis services, our digital moderated online social therapy for carers (Altitudes) plus enhanced family treatment as usual (TAU) was compared with TAU alone on the primary outcome of perceived stress and secondary outcomes including mental health symptoms and family variables at the 6-month follow-up. RESULTS: Eighty-six caregivers were randomized and data were available for 74 young people in their care. Our primary hypothesis that carers randomized to Altitudes+TAU would report greater improvements in perceived stress at follow-up compared with carers randomized to TAU alone was not supported, with the TAU alone group showing more improvement. For secondary outcomes, the TAU alone group showed improved mindfulness over time. Regardless of group assignment, we observed improvements in satisfaction with life, quality of life, emotional overinvolvement, and burden of care. In contrast, hair cortisol concentration increased. Post hoc analyses revealed more contact with early psychosis services in the intervention group compared to TAU alone and that improvements in perceived stress and social support were associated with use of the intervention in the Altitudes+TAU group. In this study, 80% (12/15) reported a positive experience with Altitudes and 93% (14/15) would recommend it to others. CONCLUSIONS: Our trial did not show a treatment effect for Altitudes in perceived stress. However, our post hoc analysis indicated that the amount of use of Altitudes related to improvements in stress and soci

Published
2023

17. Does Post-traumatic Stress Disorder Impact Treatment Outcomes within a Randomised Controlled Trial of Mitochondrial Agents for Bipolar Depression?

Author

Russell, SE, Wrobel, AL, Ashton, MM, Turner, A, Mohebbi, M, Berk, M, Cotton, S, Dodd, S, Ng, CH, Malhi, GS, Dean, OM, Russell, SE, Wrobel, AL, Ashton, MM, Turner, A, Mohebbi, M, Berk, M, Cotton, S, Dodd, S, Ng, CH, Malhi, GS, and Dean, OM

Abstract

OBJECTIVE: Bipolar disorder often co-occurs with post-traumatic stress disorder, yet few studies have investigated the impact of post-traumatic stress disorder in bipolar disorder on treatment outcomes. The aim of this sub-analysis was to explore symptoms and functioning outcomes between those with bipolar disorder alone and those with comorbid bipolar disorder and post-traumatic stress disorder. METHODS: Participants (n = 148) with bipolar depression were randomised to: (i) N-acetylcysteine alone; (ii) a combination of nutraceuticals; (iii) or placebo (in addition to treatment as usual) for 16 weeks (＋4 weeks discontinuation). Differences between bipolar disorder and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning at five timepoints, as well as on the rate of change from baseline to week 16 and baseline to week 20, were examined. RESULTS: There were no baseline differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder apart from the bipolar disorder alone group being significantly more likely to be married (p = 0.01). There were also no significant differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning. CONCLUSION: There were no differences in clinical outcomes over time within the context of an adjunctive randomised controlled trial between those with bipolar disorder alone compared to those with comorbid bipolar disorder and post-traumatic stress disorder. However, differences in psychosocial factors may provide targets for areas of specific support for people with comorbid bipolar disorder and post-traumatic stress disorder.

Published
2023

18. Regional, circuit and network heterogeneity of brain abnormalities in psychiatric disorders

Author

Segal, A, Parkes, L, Aquino, K, Kia, SM, Wolfers, T, Franke, B, Hoogman, M, Beckmann, CF, Westlye, LT, Andreassen, OA, Zalesky, A, Harrison, BJ, Davey, CG, Soriano-Mas, C, Cardoner, N, Tiego, J, Yucel, M, Braganza, L, Suo, C, Berk, M, Cotton, S, Bellgrove, MA, Marquand, AF, Fornito, A, Segal, A, Parkes, L, Aquino, K, Kia, SM, Wolfers, T, Franke, B, Hoogman, M, Beckmann, CF, Westlye, LT, Andreassen, OA, Zalesky, A, Harrison, BJ, Davey, CG, Soriano-Mas, C, Cardoner, N, Tiego, J, Yucel, M, Braganza, L, Suo, C, Berk, M, Cotton, S, Bellgrove, MA, Marquand, AF, and Fornito, A

Abstract

The substantial individual heterogeneity that characterizes people with mental illness is often ignored by classical case-control research, which relies on group mean comparisons. Here we present a comprehensive, multiscale characterization of the heterogeneity of gray matter volume (GMV) differences in 1,294 cases diagnosed with one of six conditions (attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, depression, obsessive-compulsive disorder and schizophrenia) and 1,465 matched controls. Normative models indicated that person-specific deviations from population expectations for regional GMV were highly heterogeneous, affecting the same area in <7% of people with the same diagnosis. However, these deviations were embedded within common functional circuits and networks in up to 56% of cases. The salience-ventral attention system was implicated transdiagnostically, with other systems selectively involved in depression, bipolar disorder, schizophrenia and attention-deficit/hyperactivity disorder. Phenotypic differences between cases assigned the same diagnosis may thus arise from the heterogeneous localization of specific regional deviations, whereas phenotypic similarities may be attributable to the dysfunction of common functional circuits and networks.

Published
2023

19. A systematic review and meta-analysis of global and social functioning among people at risk of bipolar disorder

Author

Watson, M, Filia, K, Stevens, A, Cotton, S, Nelson, B, Ratheesh, A, Watson, M, Filia, K, Stevens, A, Cotton, S, Nelson, B, and Ratheesh, A

Abstract

BACKGROUND: Functional status could predict development of bipolar disorder (BD) or have clinical significance. The relationship between BD risk and functioning is poorly understood. We undertook a systematic review examining the global and social functioning of those at risk for BD. METHODS: We examined observational studies comparing a risk sample with healthy controls or full-threshold BD participants, using measures of global or social functioning. Risk status included family history of BD, meeting risk criteria, or having prodromal symptomatology, or premorbid functioning of persons with BD. Medline, PsycINFO, and Embase were searched. The Newcastle-Ottawa Scale for Cross-Sectional Studies was used to assess quality. Meta-analyses were performed where possible. RESULTS: 7215 studies were screened and 40 studies were included (8474 participants). Risk samples had poorer functioning than controls, and superior functioning to participants with BD. Meta-analysis indicated poorer global functioning among persons with familial risk compared to healthy controls (mean global functional difference: 5.92; 95 % confidence interval: 7.90, 3.95; mean premorbid functioning difference: 2.31; 95 % confidence interval: 0.70, 3.92). Studies with higher proportions of female participants had slightly poorer global functioning. High heterogeneity was attributable functional measures and potentially functionally differential subgroups within the risk samples. LIMITATIONS: Broader measures of functioning, such as neurocognition and behavioural measures, were excluded. Measures of global functioning are limited by conflating functioning and symptoms. CONCLUSIONS: Functioning in the BD risk populations is intermediate to that of healthy controls and persons with BD, indicating their value in definitions of BD risk, in itself a likely heterogeneous state.

Published
2023

20. Psychological distress in siblings of people with mental illness: A systematic review and meta-analysis

Author

Jayasinghe, A, Wrobel, A, Filia, K, Byrne, LK, Melvin, G, Berk, L, Berk, M, Cotton, S, Jayasinghe, A, Wrobel, A, Filia, K, Byrne, LK, Melvin, G, Berk, L, Berk, M, and Cotton, S

Abstract

OBJECTIVE: The objective of this study was to characterise the prevalence and/or severity of psychological distress (namely, depression and anxiety symptoms) in siblings of people with mental illness (MI) and to examine correlates of distress in siblings of people with MI. METHOD: Studies comparing distress in individuals with and without a sibling with MI were eligible. Studies reporting on correlates of distress in siblings were also eligible. A search of MEDLINE Complete, PsycINFO and Embase was conducted up until 17 March 2022. RESULTS: Fifteen studies comprising 2304 siblings and 2263 comparison individuals were included. Meta-analyses indicated individuals with a sibling with MI experience significantly greater depressive symptoms (Hedges's g = 0.53, 95% CI = [0.32, 0.73], siblings n = 1962, comparison individuals n = 2248) and anxiety symptoms (Hedges's g = 0.40, 95% CI = [0.19, 0.61], siblings n = 653, comparison individuals n = 533) than those without. The sibling relationship, siblings' locus of control, interpersonal functioning and their appraisal of the impacts of MI were identified as important and potentially modifiable correlates. CONCLUSION: Individuals with a sibling with MI experience greater depressive and anxiety symptoms than those without and would likely benefit from support. Future studies are required to elucidate the mechanisms underlying distress in siblings.

Published
2023

21. Regional, circuit and network heterogeneity of brain abnormalities in psychiatric disorders.

Author

Segal, A., Parkes, L., Aquino, K., Kia, S.M., Wolfers, T., Franke, B., Hoogman, M., Beckmann, C.F., Westlye, L.T., Andreassen, O.A., Zalesky, A., Harrison, B.J., Davey, C.G., Soriano-Mas, C., Cardoner, N., Tiego, J., Yücel, M., Braganza, L., Suo, C., Berk, M., Cotton, S., Bellgrove, M.A., Marquand, A.F., Fornito, A., Segal, A., Parkes, L., Aquino, K., Kia, S.M., Wolfers, T., Franke, B., Hoogman, M., Beckmann, C.F., Westlye, L.T., Andreassen, O.A., Zalesky, A., Harrison, B.J., Davey, C.G., Soriano-Mas, C., Cardoner, N., Tiego, J., Yücel, M., Braganza, L., Suo, C., Berk, M., Cotton, S., Bellgrove, M.A., Marquand, A.F., and Fornito, A.

Abstract

01 september 2023, Contains fulltext : 296133.pdf (Publisher’s version ) (Open Access), The substantial individual heterogeneity that characterizes people with mental illness is often ignored by classical case-control research, which relies on group mean comparisons. Here we present a comprehensive, multiscale characterization of the heterogeneity of gray matter volume (GMV) differences in 1,294 cases diagnosed with one of six conditions (attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, depression, obsessive-compulsive disorder and schizophrenia) and 1,465 matched controls. Normative models indicated that person-specific deviations from population expectations for regional GMV were highly heterogeneous, affecting the same area in <7% of people with the same diagnosis. However, these deviations were embedded within common functional circuits and networks in up to 56% of cases. The salience-ventral attention system was implicated transdiagnostically, with other systems selectively involved in depression, bipolar disorder, schizophrenia and attention-deficit/hyperactivity disorder. Phenotypic differences between cases assigned the same diagnosis may thus arise from the heterogeneous localization of specific regional deviations, whereas phenotypic similarities may be attributable to the dysfunction of common functional circuits and networks.

Published
2023

25. SARS-CoV-2 lineage dynamics in England from September to November 2021: high diversity of Delta sub-lineages and increased transmissibility of AY.4.2

Author

Eales, O, Page, AJ, de Oliveira Martins, L, Wang, H, Bodinier, B, Haw, D, Jonnerby, J, Atchison, C, Robson, SC, Connor, TR, Loman, NJ, Golubchik, T, Nunez, RTM, Bonsall, D, Rambaut, A, Snell, LB, Livett, R, Ludden, C, Corden, S, Nastouli, E, Nebbia, G, Johnston, I, Lythgoe, K, Torok, ME, Goodfellow, IG, Prieto, JA, Saeed, K, Jackson, DK, Houlihan, C, Frampton, D, Hamilton, WL, Witney, AA, Bucca, G, Pope, CF, Moore, C, Thomson, EC, Harrison, EM, Smith, CP, Rogan, F, Beckwith, SM, Murray, A, Singleton, D, Eastick, K, Sheridan, LA, Randell, P, Jackson, LM, Ariani, CV, Gonçalves, S, Fairley, DJ, Loose, MW, Watkins, J, Moses, S, Nicholls, S, Bull, M, Amato, R, Smith, DL, Aanensen, DM, Barrett, JC, Aggarwal, D, Shepherd, JG, Curran, MD, Parmar, S, Parker, MD, Williams, C, Glaysher, S, Underwood, AP, Bashton, M, Pacchiarini, N, Loveson, KF, Byott, M, Carabelli, AM, Templeton, KE, de Silva, TI, Wang, D, Langford, CF, Sillitoe, J, Gunson, RN, Cottrell, S, O’Grady, J, Kwiatkowski, D, Lillie, PJ, Cortes, N, Moore, N, Thomas, C, Burns, PJ, Mahungu, TW, Liggett, S, Beckett, AH, Holden, MTG, Levett, LJ, Osman, H, Hassan-Ibrahim, MO, Simpson, DA, Chand, M, Gupta, RK, Darby, AC, Paterson, S, Pybus, OG, Volz, EM, de Angelis, D, Robertson, DL, Martincorena, I, Aigrain, L, Bassett, AR, Wong, N, Taha, Y, Erkiert, MJ, Chapman, MHS, Dewar, R, McHugh, MP, Mookerjee, S, Aplin, S, Harvey, M, Sass, T, Umpleby, H, Wheeler, H, McKenna, JP, Warne, B, Taylor, JF, Chaudhry, Y, Izuagbe, R, Jahun, AS, Young, GR, McMurray, C, McCann, CM, Nelson, A, Elliott, S, Lowe, H, Price, A, Crown, MR, Rey, S, Roy, S, Temperton, B, Shaaban, S, Hesketh, AR, Laing, KG, Monahan, IM, Heaney, J, Pelosi, E, Silviera, S, Wilson-Davies, E, Fryer, H, Adams, H, du Plessis, L, Johnson, R, Harvey, WT, Hughes, J, Orton, RJ, Spurgin, LG, Bourgeois, Y, Ruis, C, O’Toole, Á, Gourtovaia, M, Sanderson, T, Fraser, C, Edgeworth, J, Breuer, J, Michell, SL, Todd, JA, John, M, Buck, D, Gajee, K, Kay, GL, Peacock, SJ, Heyburn, D, Kitchman, K, McNally, A, Pritchard, DT, Dervisevic, S, Muir, P, Robinson, E, Vipond, BB, Ramadan, NA, Jeanes, C, Weldon, D, Catalan, J, Jones, N, da Silva Filipe, A, Fuchs, M, Miskelly, J, Jeffries, AR, Oliver, K, Park, NR, Ash, A, Koshy, C, Barrow, M, Buchan, SL, Mantzouratou, A, Clark, G, Holmes, CW, Campbell, S, Davis, T, Tan, NK, Brown, JR, Harris, KA, Kidd, SP, Grant, PR, Xu-McCrae, L, Cox, A, Madona, P, Pond, M, Randell, PA, Withell, KT, Graham, C, Denton-Smith, R, Swindells, E, Turnbull, R, Sloan, TJ, Bosworth, A, Hutchings, S, Pymont, HM, Casey, A, Ratcliffe, L, Jones, CR, Knight, BA, Haque, T, Hart, J, Irish-Tavares, D, Witele, E, Mower, C, Watson, LK, Collins, J, Eltringham, G, Crudgington, D, Macklin, B, Iturriza-Gomara, M, Lucaci, AO, McClure, PC, Carlile, M, Holmes, N, Storey, N, Rooke, S, Yebra, G, Craine, N, Perry, M, Alikhan, N - F, Bridgett, S, Cook, KF, Fearn, C, Goudarzi, S, Lyons, RA, Williams, T, Haldenby, ST, Durham, J, Leonard, S, Davies, RM, Batra, R, Blane, B, Spyer, MJ, Smith, P, Yavus, M, Williams, RJ, Mahanama, AIK, Samaraweera, B, Girgis, ST, Hansford, SE, Green, A, Beaver, C, Bellis, KL, Dorman, MJ, Kay, S, Prestwood, L, Rajatileka, S, Quick, J, Poplawski, R, Reynolds, N, Mack, A, Morriss, A, Whalley, T, Patel, B, Georgana, I, Hosmillo, M, Pinckert, ML, Stockton, J, Henderson, JH, Hollis, A, Stanley, W, Yew, WC, Myers, R, Thornton, A, Adams, A, Annett, T, Asad, H, Birchley, A, Coombes, J, Evans, JM, Fina, L, Gatica-Wilcox, B, Gilbert, L, Graham, L, Hey, J, Hilvers, E, Jones, S, Jones, H, Kumziene-Summerhayes, S, McKerr, C, Powell, J, Pugh, G, Taylor, S, Trotter, AJ, Williams, CA, Kermack, LM, Foulkes, BH, Gallis, M, Hornsby, HR, Louka, SF, Pohare, M, Wolverson, P, Zhang, P, MacIntyre-Cockett, G, Trebes, A, Moll, RJ, Ferguson, L, Goldstein, EJ, Maclean, A, Tomb, R, Starinskij, I, Thomson, L, Southgate, J, Kraemer, MUG, Raghwani, J, Zarebski, AE, Boyd, O, Geidelberg, L, Illingworth, CJ, Jackson, C, Pascall, D, Vattipally, S, Freeman, TM, Hsu, SN, Lindsey, BB, James, K, Lewis, K, Tonkin-Hill, G, Tovar-Corona, JM, Cox, MG, Abudahab, K, Menegazzo, M, MEng, BEWT, Yeats, CA, Mukaddas, A, Wright, DW, Colquhoun, R, Hill, V, Jackson, B, McCrone, JT, Medd, N, Scher, E, Keatley, J - P, Curran, T, Morgan, S, Maxwell, P, Smith, K, Eldirdiri, S, Kenyon, A, Holmes, AH, Price, JR, Wyatt, T, Mather, AE, Skvortsov, T, Hartley, JA, Guest, M, Kitchen, C, Merrick, I, Munn, R, Bertolusso, B, Lynch, J, Vernet, G, Kirk, S, Wastnedge, E, Stanley, R, Idle, G, Bradley, DT, Poyner, J, Mori, M, Jones, O, Wright, V, Brooks, E, Churcher, CM, Fragakis, M, Galai, K, Jermy, A, Judges, S, McManus, GM, Smith, KS, Westwick, E, Attwood, SW, Bolt, F, Davies, A, De Lacy, E, Downing, F, Edwards, S, Meadows, L, Jeremiah, S, Smith, N, Foulser, L, Charalampous, T, Patel, A, Berry, L, Boswell, T, Fleming, VM, Howson-Wells, HC, Joseph, A, Khakh, M, Lister, MM, Bird, PW, Fallon, K, Helmer, T, McMurray, CL, Odedra, M, Shaw, J, Tang, JW, Willford, NJ, Blakey, V, Raviprakash, V, Sheriff, N, Williams, L - A, Feltwell, T, Bedford, L, Cargill, JS, Hughes, W, Moore, J, Stonehouse, S, Atkinson, L, Lee, JCD, Shah, D, Alcolea-Medina, A, Ohemeng-Kumi, N, Ramble, J, Sehmi, J, Williams, R, Chatterton, W, Pusok, M, Everson, W, Castigador, A, Macnaughton, E, Bouzidi, KE, Lampejo, T, Sudhanva, M, Breen, C, Sluga, G, Ahmad, SSY, George, RP, Machin, NW, Binns, D, James, V, Blacow, R, Coupland, L, Smith, L, Barton, E, Padgett, D, Scott, G, Cross, A, Mirfenderesky, M, Greenaway, J, Cole, K, Clarke, P, Duckworth, N, Walsh, S, Bicknell, K, Impey, R, Wyllie, S, Hopes, R, Bishop, C, Chalker, V, Harrison, I, Gifford, L, Molnar, Z, Auckland, C, Evans, C, Johnson, K, Partridge, DG, Raza, M, Baker, P, Bonner, S, Essex, S, Murray, LJ, Lawton, AI, Burton-Fanning, S, Payne, BAI, Waugh, S, Gomes, AN, Kimuli, M, Murray, DR, Ashfield, P, Dobie, D, Ashford, F, Best, A, Crawford, L, Cumley, N, Mayhew, M, Megram, O, Mirza, J, Moles-Garcia, E, Percival, B, Driscoll, M, Ensell, L, Lowe, HL, Maftei, L, Mondani, M, Chaloner, NJ, Cogger, BJ, Easton, LJ, Huckson, H, Lewis, J, Lowdon, S, Malone, CS, Munemo, F, Mutingwende, M, Nicodemi, R, Podplomyk, O, Somassa, T, Beggs, A, Richter, A, Cormie, C, Dias, J, Forrest, S, Higginson, EE, Maes, M, Young, J, Davidson, RK, Jackson, KA, Turtle, L, Keeley, AJ, Ball, J, Byaruhanga, T, Chappell, JG, Dey, J, Hill, JD, Park, EJ, Fanaie, A, Hilson, RA, Yaze, G, Lo, S, Afifi, S, Beer, R, Maksimovic, J, McCluggage, K, Spellman, K, Bresner, C, Fuller, W, Marchbank, A, Workman, T, Shelest, E, Debebe, J, Sang, F, Zamudio, ME, Francois, S, Gutierrez, B, Vasylyeva, TI, Flaviani, F, Ragonnet-Cronin, M, Smollett, KL, Broos, A, Mair, D, Nichols, J, Nomikou, K, Tong, L, Tsatsani, I, O’Brien, PS, Rushton, S, Sanderson, R, Perkins, J, Cotton, S, Gallagher, A, Allara, E, Pearson, C, Bibby, D, Dabrera, G, Ellaby, N, Gallagher, E, Hubb, J, Lackenby, A, Lee, D, Manesis, N, Mbisa, T, Platt, S, Twohig, KA, Morgan, M, Aydin, A, Baker, DJ, Foster-Nyarko, E, Prosolek, SJ, Rudder, S, Baxter, C, Carvalho, SF, Lavin, D, Mariappan, A, Radulescu, C, Singh, A, Tang, M, Morcrette, H, Bayzid, N, Cotic, M, Balcazar, CE, Gallagher, MD, Maloney, D, Stanton, TD, Williamson, KA, Manley, R, Michelsen, ML, Sambles, CM, Studholme, DJ, Warwick-Dugdale, J, Eccles, R, Gemmell, M, Gregory, R, Hughes, M, Nelson, C, Rainbow, L, Vamos, EE, Webster, HJ, Whitehead, M, Wierzbicki, C, Angyal, A, Green, LR, Whiteley, M, Betteridge, E, Bronner, IF, Farr, BW, Goodwin, S, Lensing, SV, McCarthy, SA, Quail, MA, Rajan, D, Redshaw, NM, Scott, C, Shirley, L, Thurston, SAJ, Rowe, W, Gaskin, A, Le-Viet, T, Bonfield, J, Liddle, J, Whitwham, A, Ashby, D, Barclay, W, Taylor, G, Cooke, G, Ward, H, Darzi, A, Riley, S, Chadeau-Hyam, M, Donnelly, CA, Elliott, P, The COVID-19 Genomics UK (COG-UK) Consortium, Department of Health, Imperial College Healthcare NHS Trust- BRC Funding, Medical Research Council (MRC), Cancer Research UK, Commission of the European Communities, Wellcome Trust, National Institute for Health Research, and Imperial College Healthcare NHS Trust: Research Capability Funding (RCF)

Subjects
Delta variant, Science & Technology, SARS-CoV-2, COVID-19, 1103 Clinical Sciences, C500, Microbiology, Genetic diversity, B900, Infectious Diseases, England, COVID-19 Genomics UK (COG-UK) Consortium, 1108 Medical Microbiology, Mutation, Humans, Transmission advantage, Life Sciences & Biomedicine, Phylogeny, 0605 Microbiology
Abstract

Background Since the emergence of SARS-CoV-2, evolutionary pressure has driven large increases in the transmissibility of the virus. However, with increasing levels of immunity through vaccination and natural infection the evolutionary pressure will switch towards immune escape. Genomic surveillance in regions of high immunity is crucial in detecting emerging variants that can more successfully navigate the immune landscape. Methods We present phylogenetic relationships and lineage dynamics within England (a country with high levels of immunity), as inferred from a random community sample of individuals who provided a self-administered throat and nose swab for rt-PCR testing as part of the REal-time Assessment of Community Transmission-1 (REACT-1) study. During round 14 (9 September–27 September 2021) and 15 (19 October–5 November 2021) lineages were determined for 1322 positive individuals, with 27.1% of those which reported their symptom status reporting no symptoms in the previous month. Results We identified 44 unique lineages, all of which were Delta or Delta sub-lineages, and found a reduction in their mutation rate over the study period. The proportion of the Delta sub-lineage AY.4.2 was increasing, with a reproduction number 15% (95% CI 8–23%) greater than the most prevalent lineage, AY.4. Further, AY.4.2 was less associated with the most predictive COVID-19 symptoms (p = 0.029) and had a reduced mutation rate (p = 0.050). Both AY.4.2 and AY.4 were found to be geographically clustered in September but this was no longer the case by late October/early November, with only the lineage AY.6 exhibiting clustering towards the South of England. Conclusions As SARS-CoV-2 moves towards endemicity and new variants emerge, genomic data obtained from random community samples can augment routine surveillance data without the potential biases introduced due to higher sampling rates of symptomatic individuals.

Published
2022

26. Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse: the EMPOWER feasibility cluster RCT

Author

Gumley, AI, Bradstreet, S, Ainsworth, J, Allan, S, Alvarez-Jimenez, M, Birchwood, M, Briggs, A, Bucci, S, Cotton, S, Engel, L, French, P, Lederman, R, Lewis, S, Machin, M, Maclennan, G, McLeod, H, McMeekin, N, Mihalopoulos, C, Morton, E, Norrie, J, Reilly, F, Schwannauer, M, Singh, SP, Sundram, S, Thompson, A, Williams, C, Yung, A, Aucott, L, Farhall, J, Gleeson, J, Gumley, AI, Bradstreet, S, Ainsworth, J, Allan, S, Alvarez-Jimenez, M, Birchwood, M, Briggs, A, Bucci, S, Cotton, S, Engel, L, French, P, Lederman, R, Lewis, S, Machin, M, Maclennan, G, McLeod, H, McMeekin, N, Mihalopoulos, C, Morton, E, Norrie, J, Reilly, F, Schwannauer, M, Singh, SP, Sundram, S, Thompson, A, Williams, C, Yung, A, Aucott, L, Farhall, J, and Gleeson, J

Abstract

Background: Relapse is a major determinant of outcome for people with a diagnosis of schizophrenia. Early warning signs frequently precede relapse. A recent Cochrane Review found low-quality evidence to suggest a positive effect of early warning signs interventions on hospitalisation and relapse. Objective: How feasible is a study to investigate the clinical effectiveness and cost-effectiveness of a digital intervention to recognise and promptly manage early warning signs of relapse in schizophrenia with the aim of preventing relapse? Design: A multicentre, two-arm, parallel-group cluster randomised controlled trial involving eight community mental health services, with 12-month follow-up. Settings: Glasgow, UK, and Melbourne, Australia. Participants: Service users were aged > 16 years and had a schizophrenia spectrum disorder with evidence of a relapse within the previous 2 years. Carers were eligible for inclusion if they were nominated by an eligible service user. Interventions: The Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement, and Recovery (EMPOWER) intervention was designed to enable participants to monitor changes in their well-being daily using a mobile phone, blended with peer support. Clinical triage of changes in well-being that were suggestive of early signs of relapse was enabled through an algorithm that triggered a check-in prompt that informed a relapse prevention pathway, if warranted. Main outcome measures: The main outcomes were feasibility of the trial and feasibility, acceptability and usability of the intervention, as well as safety and performance. Candidate co-primary outcomes were relapse and fear of relapse. Results: We recruited 86 service users, of whom 73 were randomised (42 to EMPOWER and 31 to treatment as usual). Primary outcome data were collected for 84% of participants at 12 months. Feasibility data for people using the smartphone application (app) suggested that the app was easy to use an

Published
2022

28. A protocol for the first episode psychosis outcome study (FEPOS): ≥15 year follow-up after treatment at the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia

Author

Cotton, S, Filia, K, Watson, A, Mackinnon, AJ, Hides, L, Gleeson, JFM, Berk, M, Conus, P, Lambert, M, Schimmelmann, B, Herrman, H, Rayner, V, Ratheesh, A, McGorry, PD, Cotton, S, Filia, K, Watson, A, Mackinnon, AJ, Hides, L, Gleeson, JFM, Berk, M, Conus, P, Lambert, M, Schimmelmann, B, Herrman, H, Rayner, V, Ratheesh, A, and McGorry, PD

Abstract

BACKGROUND: Specialist early intervention (SEI) service models are designed to treat symptoms, promote social and vocational recovery, prevent relapse, and resource and up-skill patients and their families. The benefits of SEI over the first few years have been demonstrated. While early recovery can be expected to translate to better long-term outcomes by analogy with other illnesses, there is limited evidence to support this from follow-up studies. The current study involves the long-term follow-up of a sub-set of first episode psychosis (FEP) patients, with a range of diagnoses, who were first treated at Orygen's Early Psychosis Prevention and Intervention Centre (EPPIC) between 1998 and 2000. The aim of this paper is to present the methodology for this follow-up study. METHODS: Between January 1998 and December 2000, 786 patients between the ages of 15-29 years were treated at EPPIC, located in Melbourne, Australia. Our cohort consists of 661 people (82 were transferred/discharged and 43 were not diagnosed with a psychotic disorder at time of discharge). The 18-month treatment characteristics of this cohort have been extensively examined in the First Episode Psychosis Outcome Study (FEPOS). The ≥15 year outcomes of this cohort are being examined in this study, known as FEPOS15. RESULTS: Participant follow-up is ongoing. In order to extend and assess broader outcomes of the cohort, data linkage with health-related databases will be conducted. CONCLUSION: This study will provide a comprehensive evaluation of the long-term trajectory of psychotic disorders after treatment for FEP in a SEI service.

Published
2022

29. Severe and complex youth depression: Clinical and historical features of young people attending a tertiary mood disorders clinic

Author

Rice, SM, McKechnie, B, Cotton, S, Brooker, A, Pilkington, V, Youzchalveen, B, Schmaal, L, Davey, CG, Rice, SM, McKechnie, B, Cotton, S, Brooker, A, Pilkington, V, Youzchalveen, B, Schmaal, L, and Davey, CG

Abstract

AIM: The concept of severe and complex youth depression has evolved from clinical experience. Here we conducted a file audit study to evaluate supporting data for the construct. METHODS: A retrospective file audit was undertaken with 84 consecutively discharged patients over 6-months from Orygen's Youth Mood Clinic (YMC; 50% female). RESULTS: Over a third (36.9%) were disengaged from vocation and education, with exposure to traumatic events common (84.5%). Almost all patients (91.7%) reported past 2-week suicidal ideation at clinic entry. Hospital emergency departments were the most frequent referral source (31.0%). Most (72.6%) had received previous mental health treatment. Multimorbidity was frequently observed. The presence of a substance use disorder, or ≥ 3 comorbidities were both associated with a greater likelihood of prior suicide attempt. CONCLUSIONS: These data highlight the clinical needs associated with severe and complex depression. Findings have implications for youth experiencing mood disorders attending tertiary and community mental health settings.

Published
2022

30. Trial Forge Guidance 3: randomised trials and how to recruit and retain individuals from ethnic minority groups-practical guidance to support better practice

Author

Dawson, S, Banister, K, Biggs, K, Cotton, S, Devane, D, Gardner, H, Gillies, K, Gopalakrishnan, G, Isaacs, T, Khunti, K, Nichol, A, Parker, A, Russell, AM, Shepherd, V, Shiely, F, Shorter, G, Starling, B, Williams, H, Willis, A, Witham, MD, Treweek, S, Dawson, S, Banister, K, Biggs, K, Cotton, S, Devane, D, Gardner, H, Gillies, K, Gopalakrishnan, G, Isaacs, T, Khunti, K, Nichol, A, Parker, A, Russell, AM, Shepherd, V, Shiely, F, Shorter, G, Starling, B, Williams, H, Willis, A, Witham, MD, and Treweek, S

Abstract

Randomised trials, especially those intended to directly inform clinical practice and policy, should be designed to reflect all those who could benefit from the intervention under test should it prove effective. This does not always happen. The UK National Institute for Health and Care Research (NIHR) INCLUDE project identified many groups in the UK that are under-served by trials, including ethnic minorities.This guidance document presents four key recommendations for designing and running trials that include the ethnic groups needed by the trial. These are (1) ensure eligibility criteria and recruitment pathway do not limit participation in ways you do not intend, (2) ensure your trial materials are developed with inclusion in mind, (3) ensure staff are culturally competent and (4) build trusting partnerships with community organisations that work with ethnic minority groups. Each recommendation comes with best practice advice, public contributor testimonials, examples of the inclusion problem tackled by the recommendation, or strategies to mitigate the problem, as well as a collection of resources to support implementation of the recommendations.We encourage trial teams to follow the recommendations and, where possible, evaluate the strategies they use to implement them. Finally, while our primary audience is those designing, running and reporting trials, we hope funders, grant reviewers and approvals agencies may also find our guidance useful.

Published
2022

31. Trial Forge Guidance 3: randomised trials and how to recruit and retain individuals from ethnic minority groups-practical guidance to support better practice (vol 23, 672, 2022)

Author

Dawson, S, Banister, K, Biggs, K, Cotton, S, Devane, D, Gardner, H, Gillies, K, Gopalakrishnan, G, Isaacs, T, Khunti, K, Nichol, A, Parker, A, Russell, AM, Shepherd, V, Shiely, F, Shorter, G, Starling, B, Williams, H, Willis, A, Witham, MD, Treweek, S, Dawson, S, Banister, K, Biggs, K, Cotton, S, Devane, D, Gardner, H, Gillies, K, Gopalakrishnan, G, Isaacs, T, Khunti, K, Nichol, A, Parker, A, Russell, AM, Shepherd, V, Shiely, F, Shorter, G, Starling, B, Williams, H, Willis, A, Witham, MD, and Treweek, S

Published
2022

32. Genomic reconstruction of the SARS-CoV-2 epidemic in England

Author

Vöhringer, HS, Sanderson, T, Sinnott, M, De Maio, N, Nguyen, T, Goater, R, Schwach, F, Harrison, I, Hellewell, J, Ariani, CV, Gonçalves, S, Jackson, DK, Johnston, I, Jung, AW, Saint, C, Sillitoe, J, Suciu, M, Goldman, N, Panovska-Griffiths, J, Abnizova, I, Aigrain, L, Alderton, A, Ali, M, Allen, L, Amato, R, Anderson, R, Ariani, C, Austin-Guest, S, Bala, S, Barrett, J, Bassett, A, Battleday, K, Beal, J, Beale, M, Beaver, C, Bellany, S, Bellerby, T, Bellis, K, Berger, D, Berriman, M, Betteridge, E, Bevan, P, Binley, S, Bishop, J, Blackburn, K, Bonfield, J, Boughton, N, Bowker, S, Brendler-Spaeth, T, Bronner, I, Brooklyn, T, Buddenborg, SK, Bush, R, Caetano, C, Cagan, A, Carter, N, Cartwright, J, Monteiro, TC, Chapman, L, Chillingworth, T-J, Clapham, P, Clark, R, Clarke, A, Clarke, C, Cole, D, Cook, E, Coppola, M, Cornell, L, Cornwell, C, Corton, C, Crackett, A, Cranage, A, Craven, H, Craw, S, Crawford, M, Cutts, T, Dabrowska, M, Davies, M, Davies, R, Dawson, J, Day, C, Densem, A, Dibling, T, Dockree, C, Dodd, D, Dogga, S, Dorman, M, Dougan, G, Dougherty, M, Dove, A, Drummond, L, Drury, E, Dudek, M, Durham, J, Durrant, L, Easthope, E, Eckert, S, Ellis, P, Farr, B, Fenton, M, Ferrero, M, Flack, N, Fordham, H, Forsythe, G, Foulser, L, Francis, M, Fraser, A, Freeman, A, Galvin, A, Garcia-Casado, M, Gedny, A, Girgis, S, Glover, J, Goncalves, S, Goodwin, S, Gould, O, Gourtovaia, M, Gray, A, Gray, E, Griffiths, C, Gu, Y, Guerin, F, Hamilton, W, Hanks, H, Harrison, E, Harrott, A, Harry, E, Harvison, J, Heath, P, Hernandez-Koutoucheva, A, Hobbs, R, Holland, D, Holmes, S, Hornett, G, Hough, N, Huckle, L, Hughes-Hallet, L, Hunter, A, Inglis, S, Iqbal, S, Jackson, A, Jackson, D, James, K, Jamrozy, D, Verdejo, CJ, Jones, M, Kallepally, K, Kane, L, Kay, K, Kay, S, Keatley, J, Keith, A, King, A, Kitchin, L, Kleanthous, M, Klimekova, M, Korlevic, P, Krasheninnkova, K, Lane, G, Langford, C, Laverack, A, Law, K, Lawniczak, M, Lensing, S, Leonard, S, Letchford, L, Lewis, K, Lewis-Wade, A, Liddle, J, Lin, Q, Lindsay, S, Linsdell, S, Livett, R, Lo, S, Long, R, Lovell, J, Ludden, C, Mack, J, Maddison, M, Makunin, A, Mamun, I, Mansfield, J, Marriott, N, Martin, M, Mayho, M, McCarthy, S, McClintock, J, McGuigan, S, McHugh, S, McMinn, L, Meadows, C, Mobley, E, Moll, R, Morra, M, Morrow, L, Murie, K, Nash, S, Nathwani, C, Naydenova, P, Neaverson, A, Nelson, R, Nerou, E, Nicholson, J, Nimz, T, Noell, GG, O’Meara, S, Ohan, V, Oliver, K, Olney, C, Ormond, D, Oszlanczi, A, Palmer, S, Pang, YF, Pardubska, B, Park, N, Parmar, A, Patel, G, Patel, M, Payne, M, Peacock, S, Petersen, A, Plowman, D, Preston, T, Prestwood, L, Puethe, C, Quail, M, Rajan, D, Rajatileka, S, Rance, R, Rawlings, S, Redshaw, N, Reynolds, J, Reynolds, M, Rice, S, Richardson, M, Roberts, C, Robinson, K, Robinson, M, Robinson, D, Rogers, H, Rojo, EM, Roopra, D, Rose, M, Rudd, L, Sadri, R, Salmon, N, Saul, D, Scott, C, Seekings, P, Shirley, L, Simms, A, Sivadasan, S, Siwek, B, Sizer, D, Skeldon, K, Skelton, J, Slater-Tunstill, J, Sloper, L, Smerdon, N, Smith, C, Smith, J, Smith, K, Smith, M, Smith, S, Smith, T, Sneade, L, Soria, CD, Sousa, C, Souster, E, Sparkes, A, Spencer-Chapman, M, Squares, J, Stanley, R, Steed, C, Stickland, T, Still, I, Stratton, MR, Strickland, M, Swann, A, Swiatkowska, A, Sycamore, N, Swift, E, Symons, E, Szluha, S, Taluy, E, Tao, N, Taylor, K, Taylor, S, Thompson, S, Thompson, M, Thomson, M, Thomson, N, Thurston, S, Tonkin-Hill, G, Toombs, D, Topping, B, Tovar-Corona, J, Ungureanu, D, Uphill, J, Urbanova, J, Van Vuuren, PJ, Vancollie, V, Voak, P, Walker, D, Walker, M, Waller, M, Ward, G, Weatherhogg, C, Webb, N, Weldon, D, Wells, A, Wells, E, Westwood, L, Whipp, T, Whiteley, T, Whitton, G, Whitwham, A, Widaa, S, Williams, M, Wilson, M, Wright, S, Robson, SC, Connor, TR, Loman, NJ, Golubchik, T, Martinez Nunez, RT, Bonsall, D, Rambaut, A, Snell, LB, Corden, S, Nastouli, E, Nebbia, G, Lythgoe, K, Torok, ME, Goodfellow, IG, Prieto, JA, Saeed, K, Houlihan, C, Frampton, D, Hamilton, WL, Witney, AA, Bucca, G, Pope, CF, Moore, C, Thomson, EC, Harrison, EM, Smith, CP, Rogan, F, Beckwith, SM, Murray, A, Singleton, D, Eastick, K, Sheridan, LA, Randell, P, Jackson, LM, Fairley, DJ, Loose, MW, Watkins, J, Moses, S, Nicholls, S, Bull, M, Smith, DL, Aanensen, DM, Aggarwal, D, Shepherd, JG, Curran, MD, Parmar, S, Parker, MD, Williams, C, Glaysher, S, Underwood, AP, Bashton, M, Pacchiarini, N, Loveson, KF, Byott, M, Carabelli, AM, Templeton, KE, de Silva, TI, Wang, D, Langford, CF, Gunson, RN, Cottrell, S, O’Grady, J, Kwiatkowski, D, Lillie, PJ, Cortes, N, Moore, N, Thomas, C, Burns, PJ, Mahungu, TW, Liggett, S, Beckett, AH, Holden, MTG, Levett, LJ, Osman, H, Hassan-Ibrahim, MO, Simpson, DA, Chand, M, Gupta, RK, Darby, AC, Paterson, S, Pybus, OG, Volz, EM, de Angelis, D, Robertson, DL, Page, AJ, Bassett, AR, Wong, N, Taha, Y, Erkiert, MJ, Spencer Chapman, MH, Dewar, R, McHugh, MP, Mookerjee, S, Aplin, S, Harvey, M, Sass, T, Umpleby, H, Wheeler, H, McKenna, JP, Warne, B, Taylor, JF, Chaudhry, Y, Izuagbe, R, Jahun, AS, Young, GR, McMurray, C, McCann, CM, Nelson, A, Elliott, S, Lowe, H, Price, A, Crown, MR, Rey, S, Roy, S, Temperton, B, Shaaban, S, Hesketh, AR, Laing, KG, Monahan, IM, Heaney, J, Pelosi, E, Silviera, S, Wilson-Davies, E, Fryer, H, Adams, H, du Plessis, L, Johnson, R, Harvey, WT, Hughes, J, Orton, RJ, Spurgin, LG, Bourgeois, Y, Ruis, C, O’Toole, Á, Fraser, C, Edgeworth, J, Breuer, J, Michell, SL, Todd, JA, John, M, Buck, D, Gajee, K, Kay, GL, Peacock, SJ, Heyburn, D, Kitchman, K, McNally, A, Pritchard, DT, Dervisevic, S, Muir, P, Robinson, E, Vipond, BB, Ramadan, NA, Jeanes, C, Catalan, J, Jones, N, da Silva Filipe, A, Fuchs, M, Miskelly, J, Jeffries, AR, Park, NR, Ash, A, Koshy, C, Barrow, M, Buchan, SL, Mantzouratou, A, Clark, G, Holmes, CW, Campbell, S, Davis, T, Tan, NK, Brown, JR, Harris, KA, Kidd, SP, Grant, PR, Xu-McCrae, L, Cox, A, Madona, P, Pond, M, Randell, PA, Withell, KT, Graham, C, Denton-Smith, R, Swindells, E, Turnbull, R, Sloan, TJ, Bosworth, A, Hutchings, S, Pymont, HM, Casey, A, Ratcliffe, L, Jones, CR, Knight, BA, Haque, T, Hart, J, Irish-Tavares, D, Witele, E, Mower, C, Watson, LK, Collins, J, Eltringham, G, Crudgington, D, Macklin, B, Iturriza-Gomara, M, Lucaci, AO, McClure, PC, Carlile, M, Holmes, N, Storey, N, Rooke, S, Yebra, G, Craine, N, Perry, M, Alikhan, N-F, Bridgett, S, Cook, KF, Fearn, C, Goudarzi, S, Lyons, RA, Williams, T, Haldenby, ST, Davies, RM, Batra, R, Blane, B, Spyer, MJ, Smith, P, Yavus, M, Williams, RJ, Mahanama, AIK, Samaraweera, B, Girgis, ST, Hansford, SE, Green, A, Bellis, KL, Dorman, MJ, Quick, J, Poplawski, R, Reynolds, N, Mack, A, Morriss, A, Whalley, T, Patel, B, Georgana, I, Hosmillo, M, Pinckert, ML, Stockton, J, Henderson, JH, Hollis, A, Stanley, W, Yew, WC, Myers, R, Thornton, A, Adams, A, Annett, T, Asad, H, Birchley, A, Coombes, J, Evans, JM, Fina, L, Gatica-Wilcox, B, Gilbert, L, Graham, L, Hey, J, Hilvers, E, Jones, S, Jones, H, Kumziene-Summerhayes, S, McKerr, C, Powell, J, Pugh, G, Trotter, AJ, Williams, CA, Kermack, LM, Foulkes, BH, Gallis, M, Hornsby, HR, Louka, SF, Pohare, M, Wolverson, P, Zhang, P, MacIntyre-Cockett, G, Trebes, A, Moll, RJ, Ferguson, L, Goldstein, EJ, Maclean, A, Tomb, R, Starinskij, I, Thomson, L, Southgate, J, Kraemer, MUG, Raghwani, J, Zarebski, AE, Boyd, O, Geidelberg, L, Illingworth, CJ, Jackson, C, Pascall, D, Vattipally, S, Freeman, TM, Hsu, SN, Lindsey, BB, Tovar-Corona, JM, Cox, M, Abudahab, K, Menegazzo, M, Taylor, BEW, Yeats, CA, Mukaddas, A, Wright, DW, de Oliveira Martins, L, Colquhoun, R, Hill, V, Jackson, B, McCrone, JT, Medd, N, Scher, E, Keatley, J-P, Curran, T, Morgan, S, Maxwell, P, Eldirdiri, S, Kenyon, A, Holmes, AH, Price, JR, Wyatt, T, Mather, AE, Skvortsov, T, Hartley, JA, Guest, M, Kitchen, C, Merrick, I, Munn, R, Bertolusso, B, Lynch, J, Vernet, G, Kirk, S, Wastnedge, E, Idle, G, Bradley, DT, Poyner, J, Mori, M, Jones, O, Wright, V, Brooks, E, Churcher, CM, Fragakis, M, Galai, K, Jermy, A, Judges, S, McManus, GM, Smith, KS, Westwick, E, Attwood, SW, Bolt, F, Davies, A, De Lacy, E, Downing, F, Edwards, S, Meadows, L, Jeremiah, S, Smith, N, Charalampous, T, Patel, A, Berry, L, Boswell, T, Fleming, VM, Howson-Wells, HC, Joseph, A, Khakh, M, Lister, MM, Bird, PW, Fallon, K, Helmer, T, McMurray, CL, Odedra, M, Shaw, J, Tang, JW, Willford, NJ, Blakey, V, Raviprakash, V, Sheriff, N, Williams, L-A, Feltwell, T, Bedford, L, Cargill, JS, Hughes, W, Moore, J, Stonehouse, S, Atkinson, L, Lee, JCD, Shah, D, Alcolea, A, Ohemeng-Kumi, N, Ramble, J, Sehmi, J, Williams, R, Chatterton, W, Pusok, M, Everson, W, Castigador, A, Macnaughton, E, El Bouzidi, K, Lampejo, T, Sudhanva, M, Breen, C, Sluga, G, Ahmad, SSY, George, RP, Machin, NW, Binns, D, James, V, Blacow, R, Coupland, L, Smith, L, Barton, E, Padgett, D, Scott, G, Cross, A, Mirfenderesky, M, Greenaway, J, Cole, K, Clarke, P, Duckworth, N, Walsh, S, Bicknell, K, Impey, R, Wyllie, S, Hopes, R, Bishop, C, Chalker, V, Gifford, L, Molnar, Z, Auckland, C, Evans, C, Johnson, K, Partridge, DG, Raza, M, Baker, P, Bonner, S, Essex, S, Murray, LJ, Lawton, AI, Burton-Fanning, S, Payne, BAI, Waugh, S, Gomes, AN, Kimuli, M, Murray, DR, Ashfield, P, Dobie, D, Ashford, F, Best, A, Crawford, L, Cumley, N, Mayhew, M, Megram, O, Mirza, J, Moles-Garcia, E, Percival, B, Ensell, L, Lowe, HL, Maftei, L, Mondani, M, Chaloner, NJ, Cogger, BJ, Easton, LJ, Huckson, H, Lewis, J, Lowdon, S, Malone, CS, Munemo, F, Mutingwende, M, Nicodemi, R, Podplomyk, O, Somassa, T, Beggs, A, Richter, A, Cormie, C, Dias, J, Forrest, S, Higginson, EE, Maes, M, Young, J, Davidson, RK, Jackson, KA, Turtle, L, Keeley, AJ, Ball, J, Byaruhanga, T, Chappell, JG, Dey, J, Hill, JD, Park, EJ, Fanaie, A, Hilson, RA, Yaze, G, Afifi, S, Beer, R, Maksimovic, J, Masters, KM, Spellman, K, Bresner, C, Fuller, W, Marchbank, A, Workman, T, Shelest, E, Debebe, J, Sang, F, Zamudio, ME, Francois, S, Gutierrez, B, Vasylyeva, TI, Flaviani, F, Ragonnet-Cronin, M, Smollett, KL, Broos, A, Mair, D, Nichols, J, Nomikou, K, Tong, L, Tsatsani, I, O’Brien, S, Rushton, S, Sanderson, R, Perkins, J, Cotton, S, Gallagher, A, Allara, E, Pearson, C, Bibby, D, Dabrera, G, Ellaby, N, Gallagher, E, Hubb, J, Lackenby, A, Lee, D, Manesis, N, Mbisa, T, Platt, S, Twohig, KA, Morgan, M, Aydin, A, Baker, DJ, Foster-Nyarko, E, Prosolek, SJ, Rudder, S, Baxter, C, Carvalho, SF, Lavin, D, Mariappan, A, Radulescu, C, Singh, A, Tang, M, Morcrette, H, Bayzid, N, Cotic, M, Balcazar, CE, Gallagher, MD, Maloney, D, Stanton, TD, Williamson, KA, Manley, R, Michelsen, ML, Sambles, CM, Studholme, DJ, Warwick-Dugdale, J, Eccles, R, Gemmell, M, Gregory, R, Hughes, M, Nelson, C, Rainbow, L, Vamos, EE, Webster, HJ, Whitehead, M, Wierzbicki, C, Angyal, A, Green, LR, Whiteley, M, Bronner, IF, Farr, BW, Lensing, SV, McCarthy, SA, Quail, MA, Redshaw, NM, Thurston, SAJ, Rowe, W, Gaskin, A, Le-Viet, T, Birney, E, Volz, E, Funk, S, Martincorena, I, Barrett, JC, and Gerstung, M

Abstract

The evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus leads to new variants that warrant timely epidemiological characterization. Here we use the dense genomic surveillance data generated by the COVID-19 Genomics UK Consortium to reconstruct the dynamics of 71 different lineages in each of 315 English local authorities between September 2020 and June 2021. This analysis reveals a series of subepidemics that peaked in early autumn 2020, followed by a jump in transmissibility of the B.1.1.7/Alpha lineage. The Alpha variant grew when other lineages declined during the second national lockdown and regionally tiered restrictions between November and December 2020. A third more stringent national lockdown suppressed the Alpha variant and eliminated nearly all other lineages in early 2021. Yet a series of variants (most of which contained the spike E484K mutation) defied these trends and persisted at moderately increasing proportions. However, by accounting for sustained introductions, we found that the transmissibility of these variants is unlikely to have exceeded the transmissibility of the Alpha variant. Finally, B.1.617.2/Delta was repeatedly introduced in England and grew rapidly in early summer 2021, constituting approximately 98% of sampled SARS-CoV-2 genomes on 26 June 2021.

Published
2021

33. Understanding the Barriers and Facilitators to Employment for People with Bipolar Disorder.

Author

Filia, K. M., Cotton, S. M., Watson, A. E., Jayasinghe, A., Kerr, M., and Fitzgerald, P. B.

Subjects
*BIPOLAR disorder, *EMPLOYMENT, *TOUGHNESS (Personality trait)
Abstract

People with Bipolar Disorder (BD) consistently report a desire for employment; however, this is not reflected in employment figures. Individuals' perceptions of barriers to employment, along with endorsement of facilitators to employment remain under-investigated. We aimed to address this limitation by: (i) first examining differences in employed versus unemployed individuals (demographic, clinical, functioning); then (ii) identifying barriers and/or facilitators to employment, perception of same, and subsequent impact on employment. We assessed demographics, functioning, and illness-related characteristics in 35 participants with BD (19 employed, 16 unemployed). Participants were asked to indicate perception of common barriers and facilitators to employment. Groups did not differ regarding demographic or clinical variables. High levels of absenteeism, termination of last role and commonly perceived barriers were attributed to mental ill-health. 93.3% of unemployed participants reportedly desired employment, and more perceived barriers were observed in the unemployed group. Identified facilitators included increased support and flexible work strategies. A comprehensive understanding of perceptions of limiting and helpful factors related to employment for people with BD was obtained. These findings have implications for service provision, encouraging targeted discussion, and tailored treatment approaches to individual's unique perceptions of factors related to employment. [ABSTRACT FROM AUTHOR]

Published
2021
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36. Lucas Shelemy - A thesis submitted in partial fulfilment of the requirements of the degree of Doctor of Clinical Psychology (DClinPsych)

Author

Shelemy, L, Knight, M, Cotton, S, Adams, J, Bues, S, Salkovskis, P, McFarlane, F, and Wroe, A

Subjects
Eating disorders in adolescence, Obsessive-compulsive disorder, Transgender people in literature, Mental health
Abstract

Critical Review of the Literature Many trans* people experience high levels of mental health difficulties. Different gender-affirmative interventions exist which aim to alleviate gender dysphoria, with the hope that this in turn will improve the mental health and quality of life of trans* people. This systematic review aims to examine the effectiveness of affirmative dysphoria-focused interventions in improving mental health outcomes. Only studies with pre- and post-intervention measurements were included. Database searches were conducted from Medline, PsycInfo, Web of Science, Scopus and Embase with additional hand-searching (database inception to May 2022). Quality assessment of studies used the EPHPP Quality Assessment Tool. Twenty-six studies were identified that quantitatively assessed, via prospective pre- and post-test design, mental health outcomes (including depression, anxiety and self-esteem) following hormone, surgical and/or psychotherapeutic interventions. The majority of studies of hormone treatments found that mental health significantly improved following intervention and at follow-up. There was no significant change following surgical interventions at post-test to 6-month follow-up, although improvements were reported at longer follow-up time points. The majority of psychological interventions reported improvements in various mental health outcomes. The quality of the majority of included studies was assessed as being ‘medium’ or ‘weak’. There were no found qualitative pre- and post-intervention research or research examining voice and communication therapy or hair removal/electrolysis. This review indicates that interventions for gender dysphoria, especially hormone and psychological treatments, may have mental health benefits for trans* people. Further research is required to examine the relationship between mental health post-intervention and minority stressors, visual congruity with one’s gender and intersectional factors. Service Improvement Project Adolescents with eating disorders experience higher levels of psychological distress compared to the general population. Distress is particularly pronounced during the first stage of the Family Based Treatment due to the focus on refeeding and weight restoration. It is feasible that equipping adolescents to manage distress early on in treatment may positively impact on later engagement and recovery. This service improvement project describes the feasibility and implementation of a brief distress-tolerance intervention delivered alongside the first phase of FBT in a community Child and Adolescent Eating Disorder Service. This study was approved by the service NHS Research and Development team (ID: 286525). 15 adolescents (aged 11-18) in the first phase of FBT received two fortnightly 1-1 sessions with an Assistant Psychologist. Intervention content was based on distress tolerance dialectical-behavioural strategies. The Distress Tolerance Inventory (DTI) was administered at pre-test and two-week follow-up. Participants were interviewed about their experience and usefulness of the intervention sessions. Paired sample t-tests indicated tentative effectiveness of the intervention. Thematic analysis identified key superordinate themes: ‘Empowerment and Skilling Up’, ‘Delivery and Relevance’ and ‘Connection and Psychological Support’. The intervention was seen as highly acceptable and empowering for participants starting FBT. More sessions may be needed to ensure consolidation of newly learnt skills. Next steps regarding wider service implementation and empirically evaluating impact (e.g. on crisis referrals) are discussed. Theoretically Driven Research Project Individuals suffering from OCD experience a heightened sense of responsibility compared to community sample and anxious controls. This responsibility may vary depending on the subject of potential harm (e.g. I am responsible for my own safety vs I am responsible for other people’s safety). 5 causal factors or ‘pathways’ to the development of heightened responsibility have been proposed. This study aims to examine the relationship between the pathways to heightened responsibility towards oneself vs towards others. 60 participants with OCD and 60 community controls completed an online questionnaire measuring childhood and early adulthood experiences and responsibility dimensions. Regression analyses established the predictive value of each pathway. ‘Responsibility for oneself’, ‘responsibility for others’ and four of the five pathway subscales were significantly higher for the OCD group. The extent that participants had acted to influence misfortune was a significant predictor of heightened responsibility for oneself. Increased responsibility as a child and experience of overprotective parenting significantly predicted responsibility for others. This study indicates that heightened responsibility for oneself vs others may develop via separate pathways. Prospective studies are needed to understand how responsibility and other OCD-related beliefs develop in adolescence and early adulthood.

Published
2022

37. Clinical outcomes in comorbid COVID-19 and TB cases.

Author

Sierra CJ, Huang Y, Cotton SA, Hughes TD, Pinto MD, Rahmani A, Subramanian A, and Downs CA

Subjects
Humans, Comorbidity, Male, Female, SARS-CoV-2, Middle Aged, Tuberculosis epidemiology, Coinfection, Adult, Aged, COVID-19 epidemiology, COVID-19 complications
Published
2024
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