27 results on '"O'Hanlon, Puffin"'
Search Results
2. From the horse's mouth : a grounded theory study of client and staff views and experiences of the role of horse-human interactions in equine-assisted therapy and learning for disadvantaged young people
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O'Hanlon, Puffin
- Subjects
615.8 - Abstract
This thesis explores the role of interactions between people and horses in Equine-Assisted Therapy and Learning interventions (EAT/L) for disadvantaged young people (YP). Part one is a conceptual review of the theories, methods, and techniques currently used in EAT/L research and practice for disadvantaged YP. Part two is an empirical research paper that explores the role of interactions between people and horses in interventions at a charity offering EAT/L for disadvantaged YP. It aimed to develop a theory of the role of horse-human interactions in EAT/L from the views and experiences of people facilitating and participating in it. It is a qualitative study using semi-structured interviews with 13 young people and 6 staff, and observations of EAT/L sessions that they participated in. Part three is a critical appraisal of the research process. It focuses on the ways in which the researcher’s worldview, experiences, preconceptions and intentions influenced the research process, and how the process of the research influenced the researcher’s personal development and clinical and research practice.
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- 2021
3. Implementation of a Crisis Resolution Team service improvement programme: A qualitative study of the critical ingredients for success
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Lamb, Danielle, primary, Milton, Alyssa, additional, Forsyth, Rebecca, additional, Lloyd-Evans, Brynmor, additional, Akther, Syeda, additional, Fullarton, Kate, additional, O'Hanlon, Puffin, additional, Johnson, Sonia, additional, and Morant, Nicola, additional
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- 2023
- Full Text
- View/download PDF
4. A qualitative study of stakeholder views on the use of a digital app for supported self-management in early intervention services for psychosis
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Steare, Thomas, Giorgalli, Maria, Free, Katherine, Harju-Seppänen, Jasmine, Akther, Syeda, Eskinazi, Michelle, O’Hanlon, Puffin, Rostill, Helen, Amani, Sarah, Lloyd-Evans, Brynmor, Osborn, David, and Johnson, Sonia
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- 2021
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5. Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review
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Aref-Adib, Golnar, McCloud, Tayla, Ross, Jamie, O'Hanlon, Puffin, Appleton, Victoria, Rowe, Sarah, Murray, Elizabeth, Johnson, Sonia, and Lobban, Fiona
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- 2019
- Full Text
- View/download PDF
6. IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use
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Lobban, Fiona, Appelbe, Duncan, Appleton, Victoria, Billsborough, Julie, Fisher, Naomi Ruth, Foster, Sheena, Gill, Bethany, Glentworth, David, Harrop, Chris, Johnson, Sonia, Jones, Steven H., Kovacs, Tibor Zoltan, Lewis, Elizabeth, Mezes, Barbara, Morton, Charlotte, Murray, Elizabeth, O’Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ronald, Smith, Jo, Sutton, Chris J., Viglienghi, Pietro, and Walker, Andrew
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- 2020
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7. A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention in a Non-clinical Population: Replication and Extension
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Cavanagh, Kate, Churchard, Alasdair, O’Hanlon, Puffin, Mundy, Thomas, Votolato, Phoebe, Jones, Fergal, Gu, Jenny, and Strauss, Clara
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- 2018
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8. An online supported self-management toolkit for relatives of people with psychosis or bipolar experiences:the IMPART multiple case study
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Lobban, Fiona, Appelbe, Duncan, Appleton, Victoria, Arref-Adib, Golnar, Barraclough, Johanna, Billsborough, Julie, Fisher, Naomi, Foster, Sheena, Gill, Bethany, Glentworth, David, Harrop, Chris, Johnson, Sonia, Jones, Steven, Kovacs, Tibor, Lewis, Elizabeth, Mezes, Barbara, Morton, Charlotte, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Christopher, Viglienghi, Pietro, Walker, Andrew, Wintermeyer, Catherine, Lobban, Fiona, Appelbe, Duncan, Appleton, Victoria, Arref-Adib, Golnar, Barraclough, Johanna, Billsborough, Julie, Fisher, Naomi, Foster, Sheena, Gill, Bethany, Glentworth, David, Harrop, Chris, Johnson, Sonia, Jones, Steven, Kovacs, Tibor, Lewis, Elizabeth, Mezes, Barbara, Morton, Charlotte, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Christopher, Viglienghi, Pietro, Walker, Andrew, and Wintermeyer, Catherine
- Abstract
Headline There were many factors impacting on implementation of the toolkit, including high staff caseloads, technical difficulties and lack of training, but staff and relatives were generally positive about the concept. Abstract Background: Digital health interventions have the potential to improve the delivery of psychoeducation to people with mental health problems and their relatives. Despite substantial investment in the development of digital health interventions, successful implementation into routine clinical practice is rare. Objectives: Use the implementation of the Relatives’ Education And Coping Toolkit (REACT) for psychosis/bipolar disorder to identify critical factors affecting uptake and use, and develop an implementation plan to support the delivery of REACT. Design: This was an implementation study using a mixed-methods, theory-driven, multiple case study approach. A study-specific implementation theory for REACT based on normalisation process theory was developed and tested, and iterations of an implementation plan to address the key factors affecting implementation were developed. Setting: Early-intervention teams in six NHS mental health trusts in England (three in the north and three in the south). Participants: In total, 281 staff accounts and 159 relatives’ accounts were created, 129 staff and 23 relatives took part in qualitative interviews about their experiences, and 132 relatives provided demographic data, 56 provided baseline data, 21 provided data at 12 weeks’ follow-up and 20 provided data at 24 weeks’ follow-up. Interventions: REACT is an online supported self-management toolkit, offering 12 evidence-based psychoeducation modules and support via a forum, and a confidential direct messaging service for relatives of people with psychosis or bipolar disorder. The implementation intervention was developed with staff and iteratively adapted to address identified barriers. Adaptations included modifications to the toolkit and how it was deli
- Published
- 2020
9. An online supported self-management toolkit for relatives of people with psychosis or bipolar experiences : the IMPART multiple case study
- Author
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Lobban, Fiona, Appelbe, Duncan, Appleton, Victoria, Arref-Adib, Golnar, Barraclough, Johanna, Billsborough, Julie, Fisher, Naomi, Foster, Sheena, Gill, Bethany, Glentworth, David, Harrop, Chris, Johnson, Sonia, Jones, Steven, Kovacs, Tibor, Lewis, Elizabeth, Mezes, Barbara, Morton, Charlotte, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Christopher, Viglienghi, Pietro, Walker, Andrew, Wintermeyer, Catherine, Lobban, Fiona, Appelbe, Duncan, Appleton, Victoria, Arref-Adib, Golnar, Barraclough, Johanna, Billsborough, Julie, Fisher, Naomi, Foster, Sheena, Gill, Bethany, Glentworth, David, Harrop, Chris, Johnson, Sonia, Jones, Steven, Kovacs, Tibor, Lewis, Elizabeth, Mezes, Barbara, Morton, Charlotte, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Christopher, Viglienghi, Pietro, Walker, Andrew, and Wintermeyer, Catherine
- Abstract
Headline There were many factors impacting on implementation of the toolkit, including high staff caseloads, technical difficulties and lack of training, but staff and relatives were generally positive about the concept. Abstract Background: Digital health interventions have the potential to improve the delivery of psychoeducation to people with mental health problems and their relatives. Despite substantial investment in the development of digital health interventions, successful implementation into routine clinical practice is rare. Objectives: Use the implementation of the Relatives’ Education And Coping Toolkit (REACT) for psychosis/bipolar disorder to identify critical factors affecting uptake and use, and develop an implementation plan to support the delivery of REACT. Design: This was an implementation study using a mixed-methods, theory-driven, multiple case study approach. A study-specific implementation theory for REACT based on normalisation process theory was developed and tested, and iterations of an implementation plan to address the key factors affecting implementation were developed. Setting: Early-intervention teams in six NHS mental health trusts in England (three in the north and three in the south). Participants: In total, 281 staff accounts and 159 relatives’ accounts were created, 129 staff and 23 relatives took part in qualitative interviews about their experiences, and 132 relatives provided demographic data, 56 provided baseline data, 21 provided data at 12 weeks’ follow-up and 20 provided data at 24 weeks’ follow-up. Interventions: REACT is an online supported self-management toolkit, offering 12 evidence-based psychoeducation modules and support via a forum, and a confidential direct messaging service for relatives of people with psychosis or bipolar disorder. The implementation intervention was developed with staff and iteratively adapted to address identified barriers. Adaptations included modifications to the toolkit and how it was deli
- Published
- 2020
10. An online supported self-management toolkit for relatives of people with psychosis or bipolar experiences: the IMPART multiple case study
- Author
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Lobban, Fiona, primary, Appelbe, Duncan, additional, Appleton, Victoria, additional, Aref-Adib, Golnar, additional, Barraclough, Johanna, additional, Billsborough, Julie, additional, Fisher, Naomi R, additional, Foster, Sheena, additional, Gill, Bethany, additional, Glentworth, David, additional, Harrop, Chris, additional, Johnson, Sonia, additional, Jones, Steven H, additional, Kovacs, Tibor Z, additional, Lewis, Elizabeth, additional, Mezes, Barbara, additional, Morton, Charlotte, additional, Murray, Elizabeth, additional, O’Hanlon, Puffin, additional, Pinfold, Vanessa, additional, Rycroft-Malone, Jo, additional, Siddle, Ronald, additional, Smith, Jo, additional, Sutton, Chris J, additional, Viglienghi, Pietro, additional, Walker, Andrew, additional, and Wintermeyer, Catherine, additional
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- 2020
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11. Smartphone-delivered self-management for first-episode psychosis: the ARIES feasibility randomised controlled trial
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Steare, Thomas, primary, O’Hanlon, Puffin, additional, Eskinazi, Michelle, additional, Osborn, David, additional, Lloyd-Evans, Brynmor, additional, Jones, Rebecca, additional, Rostill, Helen, additional, Amani, Sarah, additional, and Johnson, Sonia, additional
- Published
- 2020
- Full Text
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12. Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends:a systematic review
- Author
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Aref-Adib, Golnar, McCloud, Tayla, Ross, Jamie, O'Hanlon, Puffin, Appleton, Victoria, Rowe, Sarah, Murray, Elizabeth, Johnson, Sonia, and Lobban, Fiona
- Abstract
Summary Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.
- Published
- 2018
13. Crisis resolution teams for people experiencing mental health crises: the CORE mixed-methods research programme including two RCTs
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Lloyd-Evans, Brynmor, primary, Christoforou, Marina, additional, Osborn, David, additional, Ambler, Gareth, additional, Marston, Louise, additional, Lamb, Danielle, additional, Mason, Oliver, additional, Morant, Nicola, additional, Sullivan, Sarah, additional, Henderson, Claire, additional, Hunter, Rachael, additional, Pilling, Stephen, additional, Nolan, Fiona, additional, Gray, Richard, additional, Weaver, Tim, additional, Kelly, Kathleen, additional, Goater, Nicky, additional, Milton, Alyssa, additional, Johnston, Elaine, additional, Fullarton, Kate, additional, Lean, Melanie, additional, Paterson, Beth, additional, Piotrowski, Jonathan, additional, Davidson, Michael, additional, Forsyth, Rebecca, additional, Mosse, Liberty, additional, Leverton, Monica, additional, O’Hanlon, Puffin, additional, Mundy, Edward, additional, Mundy, Tom, additional, Brown, Ellie, additional, Fahmy, Sarah, additional, Burgess, Emma, additional, Churchard, Alasdair, additional, Wheeler, Claire, additional, Istead, Hannah, additional, Hindle, David, additional, and Johnson, Sonia, additional
- Published
- 2019
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14. App to support Recovery in Early Intervention Services (ARIES) study: protocol of a feasibility randomised controlled trial of a self-management Smartphone application for psychosis
- Author
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Steare, Thomas, primary, O’Hanlon, Puffin, additional, Eskinazi, Michelle, additional, Osborn, David, additional, Lloyd-Evans, Brynmor, additional, Jones, Rebecca, additional, Rostill, Helen, additional, Amani, Sarah, additional, and Johnson, Sonia, additional
- Published
- 2019
- Full Text
- View/download PDF
15. Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends : a systematic review
- Author
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Aref-Adib, Golnar, McCloud, Tayla, Ross, Jamie, O'Hanlon, Puffin, Appleton, Victoria, Rowe, Sarah, Murray, Elizabeth, Johnson, Sonia, Lobban, Fiona, Aref-Adib, Golnar, McCloud, Tayla, Ross, Jamie, O'Hanlon, Puffin, Appleton, Victoria, Rowe, Sarah, Murray, Elizabeth, Johnson, Sonia, and Lobban, Fiona
- Abstract
Summary Digital health interventions present an important opportunity to improve health care for people with psychosis or bipolar disorder, but despite their potential, integrating and implementing them into clinical settings has been difficult worldwide. This Review aims to identify factors affecting implementation of digital health interventions for people affected by psychosis or bipolar disorder. We searched seven databases and synthesised data from 26 studies using the Consolidated Framework for Implementation Research. Attitudes and beliefs about interventions were crucial factors for both staff and service users, with negative attitudes and scepticism resulting in a lack of motivation to engage with interventions or complete them. The complexity of the interventions was a barrier for people with psychiatric symptoms, low premorbid intelligence quotient, or minimal information technology skills. The accessibility and adaptability of interventions were key facilitators, but insufficient resources, finances, and staff time were barriers to implementation. Interventions need to be user friendly and adaptable to the needs and capabilities of people with psychosis or bipolar disorder, and the staff who support their implementation. Service users and staff should cofacilitate the process of developing and implementing the interventions.
- Published
- 2018
16. IMPlementation of A Relatives’ Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol
- Author
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Lobban, Fiona, primary, Appleton, Victoria, additional, Appelbe, Duncan, additional, Barraclough, Johanna, additional, Bowland, Julie, additional, Fisher, Naomi R, additional, Foster, Sheena, additional, Johnson, Sonia, additional, Lewis, Elizabeth, additional, Mateus, Céu, additional, Mezes, Barbara, additional, Murray, Elizabeth, additional, O’Hanlon, Puffin, additional, Pinfold, Vanessa, additional, Rycroft-Malone, Jo, additional, Siddle, Ron, additional, Smith, Jo, additional, Sutton, Chris J., additional, Walker, Andrew, additional, and Jones, Steven H., additional
- Published
- 2017
- Full Text
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17. IMPlementation of A Relatives' Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol
- Author
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Lobban, Fiona, Appleton, Victoria, Appelbe, Duncan, Barraclough, Johanna, Bowland, Julie, Fisher, Naomi R, Foster, Sheena, Johnson, Sonia, Lewis, Elizabeth, Mateus, Céu, Mezes, Barbara, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Chris J, Walker, Andrew, Jones, Steven H, Lobban, Fiona, Appleton, Victoria, Appelbe, Duncan, Barraclough, Johanna, Bowland, Julie, Fisher, Naomi R, Foster, Sheena, Johnson, Sonia, Lewis, Elizabeth, Mateus, Céu, Mezes, Barbara, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Chris J, Walker, Andrew, and Jones, Steven H
- Abstract
Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives' Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives' distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process under observation. We outline our s
- Published
- 2017
18. IMPlementation of A Relatives’ Toolkit (IMPART study): an iterative case study to identify key factors impacting on the implementation of a web-based supported self-management intervention for relatives of people with psychosis or bipolar experiences in a National Health Service: a study protocol
- Author
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Lobban, Anne Fiona, Appleton, Victoria Cathering Jane, Applebe, Duncan, Barraclough, Johanna, Bowland, Julie, Fisher, Naomi Ruth, Foster, Sheena, Johnson, Sonia, Lewis, Elizabeth Ann, Mateus, Ceu, Mezes, Barbara, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Chris J., Walker, Andrew John, Jones, Steven Huntley, Lobban, Anne Fiona, Appleton, Victoria Cathering Jane, Applebe, Duncan, Barraclough, Johanna, Bowland, Julie, Fisher, Naomi Ruth, Foster, Sheena, Johnson, Sonia, Lewis, Elizabeth Ann, Mateus, Ceu, Mezes, Barbara, Murray, Elizabeth, O'Hanlon, Puffin, Pinfold, Vanessa, Rycroft-Malone, Jo, Siddle, Ron, Smith, Jo, Sutton, Chris J., Walker, Andrew John, and Jones, Steven Huntley
- Abstract
Background: Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions. Methods: A multiple case study design within six early intervention in psychosis (EIP) services in England, will be used to test and refine theory-driven hypotheses about factors impacting on implementation of the Relatives’ Education And Coping Toolkit (REACT). Qualitative data including behavioural observation, document analysis, and in-depth interviews collected in the first two EIP services (wave 1) and analysed using framework analysis, combined with quantitative data describing levels of use by staff and relatives and impact on relatives’ distress and wellbeing, will be used to identify factors impacting on implementation. Consultation via stakeholder workshops with staff and relatives and co-facilitated by relatives in the research team will inform development of an implementation plan to address these factors, which will be evaluated and refined in the four subsequent EIP services in waves 2 and 3. Transferability of the implementation plan to non-participating services will be explored. Discussion: Observation of implementation in a real world clinical setting, across carefully sampled services, in real time provides a unique opportunity to understand factors impacting on implementation likely to be generalizable to other web-based interventions, as well as informing further development of implementation theories. However, there are inherent challenges in investigating implementation without influencing the process un
- Published
- 2017
19. A qualitative study of online mental health information seeking behaviour by those with psychosis
- Author
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Aref-Adib, Golnar, primary, O’Hanlon, Puffin, additional, Fullarton, Kate, additional, Morant, Nicola, additional, Sommerlad, Andrew, additional, Johnson, Sonia, additional, and Osborn, David, additional
- Published
- 2016
- Full Text
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20. Tomorrow's world: current developments in the therapeutic use of technology for psychosis.
- Author
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O'Hanlon, Puffin, Aref-Adib, Golnar, Fonseca, Andres, Lloyd-Evans, Brynmor, Osborn, David, and Johnson, Sonia
- Abstract
There is now an established evidence base for the use of information and communication technology (ICT) to support mental healthcare ('e-mental health') for common mental health problems. Recently, there have been significant developments in the therapeutic use of computers, mobile phones, gaming and virtual reality technologies for the assessment and treatment of psychosis. We provide an overview of the therapeutic use of ICT for psychosis, drawing on searches of the scientific literature and the internet and using interviews with experts in the field. We outline interventions that are already relevant to clinical practice, some that may become available in the foreseeable future and emerging challenges for their implementation. LEARNING OBJECTIVES * Appreciate the potential uses of technology in the management of psychosis * Understand the current evidence base for the use of technology in the management of psychosis * Be aware of challenges involved in the development, evaluation and implementation of technology-based interventions for psychosis [ABSTRACT FROM AUTHOR]
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- 2016
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21. Antarctic ice loss creates new carbon sink
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O'Hanlon, Puffin
- Subjects
Southern Ocean -- Environmental aspects ,Carbon sinks -- Environmental aspects ,Ice -- Research ,Geography - Abstract
THE LOSS of the Antarctic ice is having an unforeseen environmental benefit: allowing phytoplankton to thrive in the open water and store millions of tonnes of carbon dioxide, according to [...]
- Published
- 2010
22. First measurement of tsunami erosion
- Author
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O'Hanlon, Puffin
- Subjects
Tsunamis -- Research -- United Kingdom ,Erosion -- Research ,Geography - Abstract
First measurement of tsunami erosion: A team of scientists whose detailed coastline survey fortuitously bracketed two tsunami events in the Kuril Islands off the east coast of Russia have collected [...]
- Published
- 2010
23. Deforestation led to ancient Peruvians' downfall
- Author
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O'Hanlon, Puffin
- Subjects
Deforestation -- Research -- Peru ,Peruvians -- Environmental aspects ,Geography - Abstract
THE SUDDEN demise 1,500 years ago of the Nazca people of Peru, best known for the enigmatic lines and drawings they carved into the landscape, was most likely the result [...]
- Published
- 2010
24. A qualitative study of online mental health information seeking behaviour by those with psychosis
- Author
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Aref-Adib, Golnar, O'Hanlon, Puffin, Fullarton, Kate, Morant, Nicola, Sommerlad, Andrew, Johnson, Sonia, Osborn, David, and Apollo - University of Cambridge Repository
- Subjects
Male ,Digital Technology ,Internet ,Information Seeking Behavior ,Patient Acceptance of Health Care ,Psychosis ,Psychiatry and Mental health ,Mental Health ,Psychotic Disorders ,Severe Mental Illness ,London ,Humans ,Health Information ,Online ,Attitude to Health ,Qualitative Research - Abstract
BACKGROUND: The Internet and mobile technology are changing the way people learn about and manage their illnesses. Little is known about online mental health information seeking behaviour by people with psychosis. This paper explores the nature, extent and consequences of online mental health information seeking behaviour by people with psychosis and investigates the acceptability of a mobile mental health application (app). METHODS: Semi-structured interviews were carried out with people with psychosis (n = 22). Participants were purposively recruited through secondary care settings in London. The main topics discussed were participants' current and historical use of online mental health information and technology. Interviews were audio-recorded, transcribed and analysed by a team of researchers using thematic analysis. RESULTS: Mental health related Internet use was widespread. Eighteen people described searching the Internet to help them make sense of their psychotic experiences, and to read more information about their diagnosis, their prescribed psychiatric medication and its side-effects. Whilst some participants sought 'expert' online information from mental health clinicians and research journals, others described actively seeking first person perspectives. Eight participants used this information collaboratively with clinicians and spoke of the empowerment and independence the Internet offered them. However nine participants did not discuss their use of online mental health information with their clinicians for a number of reasons, including fear of undermining their clinician's authority. For some of these people concerns over what they had read led them to discontinue their antipsychotic medication without discussion with their mental health team. CONCLUSIONS: People with psychosis use the Internet to acquire mental health related information. This can be a helpful source of supplementary information particularly for those who use it collaboratively with clinicians. When this information is not shared with their mental health team, it can affect patients' health care decisions. A partnership approach to online health-information seeking is needed, with mental health clinicians encouraging patients to discuss information they have found online as part of a shared decision-making process. Our research suggests that those with psychosis have active digital lives and that the introduction of a mental health app into services would potentially be well received.
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25. Ocean acidification may cause global shellfish decline.
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O'HANLON, PUFFIN
- Subjects
- *
OCEAN acidification , *SHELLFISH - Abstract
The article deals with the results of research on the impact of ocean acidification on shellfish.
- Published
- 2010
26. An online supported self-management toolkit for relatives of people with psychosis or bipolar experiences: the IMPART multiple case study
- Author
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Lobban F, Appelbe D, Appleton V, Aref-Adib G, Barraclough J, Billsborough J, Fisher NR, Foster S, Gill B, Glentworth D, Harrop C, Johnson S, Jones SH, Kovacs TZ, Lewis E, Mezes B, Morton C, Murray E, O’Hanlon P, Pinfold V, Rycroft-Malone J, Siddle R, Smith J, Sutton CJ, Viglienghi P, Walker A, and Wintermeyer C
- Abstract
Background: Digital health interventions have the potential to improve the delivery of psychoeducation to people with mental health problems and their relatives. Despite substantial investment in the development of digital health interventions, successful implementation into routine clinical practice is rare., Objectives: Use the implementation of the Relatives’ Education And Coping Toolkit (REACT) for psychosis/bipolar disorder to identify critical factors affecting uptake and use, and develop an implementation plan to support the delivery of REACT., Design: This was an implementation study using a mixed-methods, theory-driven, multiple case study approach. A study-specific implementation theory for REACT based on normalisation process theory was developed and tested, and iterations of an implementation plan to address the key factors affecting implementation were developed., Setting: Early-intervention teams in six NHS mental health trusts in England (three in the north and three in the south)., Participants: In total, 281 staff accounts and 159 relatives’ accounts were created, 129 staff and 23 relatives took part in qualitative interviews about their experiences, and 132 relatives provided demographic data, 56 provided baseline data, 21 provided data at 12 weeks’ follow-up and 20 provided data at 24 weeks’ follow-up., Interventions: REACT is an online supported self-management toolkit, offering 12 evidence-based psychoeducation modules and support via a forum, and a confidential direct messaging service for relatives of people with psychosis or bipolar disorder. The implementation intervention was developed with staff and iteratively adapted to address identified barriers. Adaptations included modifications to the toolkit and how it was delivered by teams., Main Outcome Measures: The main outcome was factors affecting implementation of REACT, assessed primarily through in-depth interviews with staff and relatives. We also assessed quantitative measures of delivery (staff accounts and relatives’ invitations), use of REACT (relatives’ logins and time spent on the website) and the impact of REACT [relatives’ distress (General Health Questionnaire-28), and carer well-being and support (Carer Well-being and Support Scale questionnaire)]., Results: Staff and relatives were generally positive about the content of REACT, seeing it as a valuable resource that could help services improve support and meet clinical targets, but only within a comprehensive service that included face-to-face support, and with some additional content. Barriers to implementation included high staff caseloads and difficulties with prioritising supporting relatives; technical difficulties of using REACT; poor interoperability with trust information technology systems and care pathways; lack of access to mobile technology and information technology training; restricted forum populations leading to low levels of use; staff fears of managing risk, online trolling, or replacement by technology; and uncertainty around REACT’s long-term availability. There was no evidence that REACT would reduce staff time supporting relatives (which was already very low), and might increase it by facilitating communication. In all, 281 staff accounts were created, but only 57 staff sent relatives invitations. In total, 355 relatives’ invitations were sent to 310 unique relatives, leading to the creation of 159 relatives’ accounts. The mean number of logins for relatives was 3.78 (standard deviation 4.43), but with wide variation from 0 to 31 (median 2, interquartile range 1–8). The mean total time spent on the website was 40.6 minutes (standard deviation 54.54 minutes), with a range of 0–298 minutes (median 20.1 minutes, interquartile range 4.9–57.5 minutes). There was a pattern of declining mean scores for distress, social dysfunction, depression, anxiety and insomnia, and increases in relatives’ well-being and eHealth literacy, but no changes were statistically significant., Conclusions: Digital health interventions, such as REACT, should be iteratively developed, evaluated, adapted and implemented, with staff and service user input, as part of a long-term strategy to develop integrated technology-enabled services. Implementation strategies must instil a sense of ownership for staff and ensure that they have adequate training, risk protocols and resources to deliver the technology. Cost-effectiveness and impact on workload and inequalities in accessing health care need further testing, along with the generalisability of our findings to other digital health interventions., Limitations: REACT was offered by the same team running the IMPlementation of A Relatives’ Toolkit (IMPART) study, and was perceived by staff and relatives as a time-limited research study rather than ongoing clinical service, which affected engagement. Access to observational data was limited., Trial Registration: Current Controlled Trials ISRCTN16267685., Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research ; Vol. 8, No. 37. See the NIHR Journals Library website for further project information., (Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Lobban et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.)
- Published
- 2020
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27. Crisis resolution teams for people experiencing mental health crises: the CORE mixed-methods research programme including two RCTs
- Author
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Lloyd-Evans B, Christoforou M, Osborn D, Ambler G, Marston L, Lamb D, Mason O, Morant N, Sullivan S, Henderson C, Hunter R, Pilling S, Nolan F, Gray R, Weaver T, Kelly K, Goater N, Milton A, Johnston E, Fullarton K, Lean M, Paterson B, Piotrowski J, Davidson M, Forsyth R, Mosse L, Leverton M, O’Hanlon P, Mundy E, Mundy T, Brown E, Fahmy S, Burgess E, Churchard A, Wheeler C, Istead H, Hindle D, and Johnson S
- Abstract
Background: Crisis resolution teams (CRTs) seek to avert hospital admissions by providing intensive home treatment for people experiencing a mental health crisis. The CRT model has not been highly specified. CRT care is often experienced as ending abruptly and relapse rates following CRT discharge are high., Aims: The aims of CORE (Crisis resolution team Optimisation and RElapse prevention) workstream 1 were to specify a model of best practice for CRTs, develop a measure to assess adherence to this model and evaluate service improvement resources to help CRTs implement the model with high fidelity. The aim of CORE workstream 2 was to evaluate a peer-provided self-management programme aimed at reducing relapse following CRT support., Methods: Workstream 1 was based on a systematic review, national CRT manager survey and stakeholder qualitative interviews to develop a CRT fidelity scale through a concept mapping process with stakeholders ( n = 68). This was piloted in CRTs nationwide ( n = 75). A CRT service improvement programme (SIP) was then developed and evaluated in a cluster randomised trial: 15 CRTs received the SIP over 1 year; 10 teams acted as controls. The primary outcome was service user satisfaction. Secondary outcomes included CRT model fidelity, catchment area inpatient admission rates and staff well-being. Workstream 2 was a peer-provided self-management programme that was developed through an iterative process of systematic literature reviewing, stakeholder consultation and preliminary testing. This intervention was evaluated in a randomised controlled trial: 221 participants recruited from CRTs received the intervention and 220 did not. The primary outcome was re-admission to acute care at 1 year of follow-up. Secondary outcomes included time to re-admission and number of days in acute care over 1 year of follow-up and symptoms and personal recovery measured at 4 and 18 months’ follow-up., Results: Workstream 1 – a 39-item CRT fidelity scale demonstrated acceptability, face validity and promising inter-rater reliability. CRT implementation in England was highly variable. The SIP trial did not produce a positive result for patient satisfaction [median Client Satisfaction Questionnaire score of 28 in both groups at follow-up; coefficient 0.97, 95% confidence interval (CI) –1.02 to 2.97]. The programme achieved modest increases in model fidelity. Intervention teams achieved lower inpatient admission rates and less inpatient bed use. Qualitative evaluation suggested that the programme was generally well received. Workstream 2 – the trial yielded a statistically significant result for the primary outcome, in which rates of re-admission to acute care over 1 year of follow-up were lower in the intervention group than in the control group (odds ratio 0.66, 95% CI 0.43 to 0.99; p = 0.044). Time to re-admission was lower and satisfaction with care was greater in the intervention group at 4 months’ follow-up. There were no other significant differences between groups in the secondary outcomes., Limitations: Limitations in workstream 1 included uncertainty regarding the representativeness of the sample for the primary outcome and lack of blinding for assessment. In workstream 2, the limitations included the complexity of the intervention, preventing clarity about which were effective elements., Conclusions: The CRT SIP did not achieve all its aims but showed potential promise as a means to increase CRT model fidelity and reduce inpatient service use. The peer-provided self-management intervention is an effective means to reduce relapse rates for people leaving CRT care., Study Registration: The randomised controlled trials were registered as Current Controlled Trials ISRCTN47185233 and ISRCTN01027104. The systematic reviews were registered as PROSPERO CRD42013006415 and CRD42017043048., Funding: The National Institute for Health Research Programme Grants for Applied Research programme., (Copyright © Queen’s Printer and Controller of HMSO 2019. This work was produced by Lloyd-Evans et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.)
- Published
- 2019
- Full Text
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