18 results on '"Emma Dalrymple"'
Search Results
2. Patient and public involvement within epidemiological studies of long COVID in the UK
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Ash Routen, Lauren O’Mahoney, Olalekan Lee Aiyegbusi, Yvonne Alder, Amitava Banerjee, Lewis Buckland, Chris Brightling, Melanie Calvert, Jenny Camaradou, Nishi Chaturvedi, Amy Chong, Emma Dalrymple, Rosalind M. Eggo, Paul Elliott, Rachael A. Evans, Andy Gibson, Shamil Haroon, Emily Herrett, Linzy Houchen-Wolloff, Sarah E. Hughes, Flic Jeyes, Karen Matthews, Christel McMullan, Jessica Morley, Roz Shafran, Nikki Smith, David Stanton, Terence Stephenson, Jonathan Sterne, Grace M. Turner, Helen Ward, and Kamlesh Khunti
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General Medicine ,General Biochemistry, Genetics and Molecular Biology - Published
- 2023
3. Developing survey weights to ensure representativeness in a national, matched cohort study: results from the Children and young people with Long Covid (CLoCk) study
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Natalia K Rojas, Bianca L De Stavola, Tom Norris, Mario Cortina-Borja, Manjula D Nugawela, Dougal Hargreaves, Emma Dalrymple, Kelsey McOwat, Ruth Simmons, Terence Stephenson, Roz Shafran, CLoCk Consortium, and Snehal M Pinto Pereira
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Background: Findings from studies assessing Long Covid in children and young people (CYP) need to be viewed in light of their methodological limitations. For example, if non-response and/or attrition over time systematically differ by sub-groups of CYP, findings could be biased and generalisation limited. The present study aimed to (i) construct survey weights for the Children and young people with Long Covid (CLoCk) study, and (ii) apply them to published CLoCk findings showing the prevalence of shortness of breath and tiredness increased over time from baseline to 12-months post-baseline in both SARS-CoV-2 Positive and Negative CYP. Methods: Logistic regression was used to compute the probability of (i) Responding given envisioned to take part, (ii) Responding timely given responded, and (iii) (Re)infection given timely response. Response, timely response and (re)infection weights were generated as the reciprocal of the corresponding probability, with an overall ‘envisioned population’ survey weight derived as the product of these weights. Survey weights were trimmed, and an interactive tool developed to re-calibrate target population survey weights to the general population using data from the 2021 UK Census. Results: Flexible survey weights for the CLoCk study were successfully developed. In the illustrative example re-weighted results (when accounting for selection in response, attrition, and (re)infection) were consistent with published findings. Conclusions: Flexible survey weights to address potential bias and selection issues were created for and used in the CLoCk study. Previously reported prospective findings from CLoCk are generalisable to the wider population of CYP in England. This study highlights the importance of considering selection into a sample and attrition over time when considering generalisability of findings.
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- 2023
4. Long COVID in children and young after infection or reinfection with the Omicron variant: a prospective observational study
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Snehal M. Pinto Pereira, Anna Mensah, Manjula D. Nugawela, Terence Stephenson, Shamez N. Ladhani, Emma Dalrymple, Jake Dudley, Kelsey McOwat, Ruth Simmons, Isobel Heyman, Terry Segal, Malcolm G. Semple, Laila Xu, Roz Shafran, Marta Buszewicz, Trudie Chalder, Esther Crawley, Bianca De Stavola, Tamsin Ford, Shruti Garg, Anthony Harnden, Dougal Hargreaves, Michael Levin, Vanessa Poustie, Calum Semple, Kishan Sharma, Olivia Swann, Elizabeth Whittaker, and Apollo - University of Cambridge Repository
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Pediatrics, Perinatology and Child Health ,prospective ,long COVID ,omicron ,young people ,post COVID-19 condition - Abstract
To describe the prevalence of long COVID in children infected for the first time (n = 332) or reinfected (n = 243) with Omicron compared with test-negative children (n = 311). Overall, 12%-16% of those infected with Omicron met the research definition of long COVID at 3 and 6 months after infection, with no evidence of difference between cases of first positive and reinfected (Pχ2 = 0.17).
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- 2023
5. A Cross-Sectional Study of the Health of Emerging Young Adults in England Following a COVID-19 Infection
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Fiona Newlands, Natalia K. Rojas, Manjula Nugawela, Snehal M. Pinto Pereira, Marta Buszewicz, Trudie Chalder, Emily Y. Cheung, Emma Dalrymple, Tamsin Ford, Isobel Heyman, Shamez N. Ladhani, Kelsey McOwat, Ruth Simmons, Terence Stephenson, and Roz Shafran
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Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Public Health, Environmental and Occupational Health - Published
- 2023
6. Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months
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Snehal M. Pinto Pereira, Roz Shafran, Manjula D. Nugawela, Laura Panagi, Dougal Hargreaves, Shamez N. Ladhani, Sophie D. Bennett, Trudie Chalder, Emma Dalrymple, Tamsin Ford, Isobel Heyman, Kelsey McOwat, Natalia K. Rojas, Kishan Sharma, Ruth Simmons, Simon R. White, Terence Stephenson, Heyman, Isobel [0000-0001-7358-9766], and Apollo - University of Cambridge Repository
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Long COVID ,Oncology ,CYP, Children and young people ,Children and young people ,Health Policy ,Symptoms ,Well-being ,Internal Medicine ,Longitudinal ,IQR, Interquartile range ,UKHSA, United Kingdom Health Security Agency - Abstract
BACKGROUND: Despite high numbers of children and young people (CYP) having acute COVID, there has been no prospective follow-up of CYP to establish the pattern of health and well-being over a year following infection. METHODS: A non-hospitalised, national sample of 5086 (2909 SARS-COV-2 Positive; 2177 SARS-COV-2 Negative at baseline) CYP aged 11-17 completed questionnaires 6- and 12-months after PCR-tests between October 2020 and March 2021 confirming SARS-CoV-2 infection (excluding CYP with subsequent (re)infections). SARS-COV-2 Positive CYP was compared to age, sex and geographically-matched test-negative CYP. FINDINGS: Ten of 21 symptoms had a prevalence less than 10% at baseline, 6- and 12-months post-test in both test-positives and test-negatives. Of the other 11 symptoms, in test-positives who had these at baseline, the prevalence of all symptoms declined greatly by 12-months. For CYP first describing one of these at 6-months, there was a decline in prevalence by 12-months. The overall prevalence of 9 of 11 symptoms declined by 12-months. As many CYP first described shortness of breath and tiredness at either 6- or 12-months, the overall prevalence of these two symptoms in test-positives appeared to increase by 6-months and increase further by 12-months. However, within-individual examination demonstrated that the prevalence of shortness of breath and tiredness actually declined in those first describing these two symptoms at either baseline or 6-months. This pattern was also evident for these two symptoms in test-negatives. Similar patterns were observed for validated measures of poor quality of life, emotional and behavioural difficulties, poor well-being and fatigue. Moreover, broadly similar patterns and results were noted for the sub-sample (N = 1808) that had data at baseline, 3-, 6- and 12-months post-test. INTERPRETATION: In CYP, the prevalence of adverse symptoms reported at the time of a positive PCR-test declined over 12-months. Some test-positives and test-negatives reported adverse symptoms for the first time at six- and 12-months post-test, particularly tiredness, shortness of breath, poor quality of life, poor well-being and fatigue suggesting they are likely to be caused by multiple factors. FUNDING: NIHR/UKRI (ref: COVLT0022).
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- 2023
7. The benefits of continuing patient and public involvement as part of a randomised controlled trial during the Covid-19 global pandemic
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Amy Lewins, Tyler Hughes, Emma Dalrymple, Roz Shafran, Peter Fonagy, Helen Cross, Tamsin Ford, Isobel Heyman, Terence Stephenson, and Sophie D. Bennett
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General Medicine - Abstract
Patient and public involvement (PPI) in clinical research strengthens the quality and relevance of research, and has been crucial to ensure that researchers continue to investigate relevant and important topics during the global Covid-19 pandemic. The MICE (Mental Health Intervention for Children with Epilepsy) randomised controlled trial relies upon PPI to steer the direction and delivery of the trial, and the PPI Research Advisory Group (RAG) adapted to remote online meetings during the pandemic. This article first describes how the PPI RAG supported the research trial during the course of the pandemic, particularly with key trial stages of recruitment, retention and follow-up. It considers how the PPI tasks were adapted to ensure that they remained meaningful throughout this period, particularly for children and young people. Second, the article explores the acceptability of PPI in research using teleconferencing methods, via a co-produced survey of the PPI group members. Survey results indicated that, while participants valued face-to-face meetings, having remote PPI meetings was preferable to having nothing. There was some suggestion that teleconferencing platforms make it challenging for reserved members of the group, and for children, to contribute. Our findings emphasise the importance of continuing PPI even when circumstances are sub-optimal. We hope that our findings will contribute to the wider conversation about what makes PPI effective, particularly in a digital world.
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- 2023
8. Predictive model for long COVID in children 3 months after a SARS-CoV-2 PCR test
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Manjula D. Nugawela, Terence Stephenson, Roz Shafran, Bianca L. De Stavola, Shamez N. Ladhani, Ruth Simmons, Kelsey McOwat, Natalia Rojas, Emma Dalrymple, Emily Y. Cheung, Tamsin Ford, Isobel Heyman, Esther Crawley, Snehal M. Pinto Pereira, Heyman, Isobel [0000-0001-7358-9766], and Apollo - University of Cambridge Repository
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Public health ,Long COVID ,Adolescent ,SARS-CoV-2 ,COVID-19 ,General Medicine ,Polymerase Chain Reaction ,Post-Acute COVID-19 Syndrome ,Children and young people ,Predictive model ,Symptoms ,Quality of Life ,Humans ,Child - Abstract
Funder: NIHR Great Ormond Street Hospital Biomedical Research Centre, BACKGROUND: To update and internally validate a model to predict children and young people (CYP) most likely to experience long COVID (i.e. at least one impairing symptom) 3 months after SARS-CoV-2 PCR testing and to determine whether the impact of predictors differed by SARS-CoV-2 status. METHODS: Data from a nationally matched cohort of SARS-CoV-2 test-positive and test-negative CYP aged 11-17 years was used. The main outcome measure, long COVID, was defined as one or more impairing symptoms 3 months after PCR testing. Potential pre-specified predictors included SARS-CoV-2 status, sex, age, ethnicity, deprivation, quality of life/functioning (five EQ-5D-Y items), physical and mental health and loneliness (prior to testing) and number of symptoms at testing. The model was developed using logistic regression; performance was assessed using calibration and discrimination measures; internal validation was performed via bootstrapping and the final model was adjusted for overfitting. RESULTS: A total of 7139 (3246 test-positives, 3893 test-negatives) completing a questionnaire 3 months post-test were included. 25.2% (817/3246) of SARS-CoV-2 PCR-positives and 18.5% (719/3893) of SARS-CoV-2 PCR-negatives had one or more impairing symptoms 3 months post-test. The final model contained SARS-CoV-2 status, number of symptoms at testing, sex, age, ethnicity, physical and mental health, loneliness and four EQ-5D-Y items before testing. Internal validation showed minimal overfitting with excellent calibration and discrimination measures (optimism-adjusted calibration slope: 0.96575; C-statistic: 0.83130). CONCLUSIONS: We updated a risk prediction equation to identify those most at risk of long COVID 3 months after a SARS-CoV-2 PCR test which could serve as a useful triage and management tool for CYP during the ongoing pandemic. External validation is required before large-scale implementation.
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- 2022
9. Factor associated with the occurrence of epilepsy in autism: a systematic review
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Eleni Zarakoviti, Roz Shafran, David Skuse, Amy McTague, Neha Batura, Tom Palmer, Emma Dalrymple, Sophie D. Bennett, and Colin Reilly
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Developmental and Educational Psychology - Abstract
This systematic review aimed to identify factors significantly associated with the occurrence of epilepsy in autistic individuals and to consider the impact of study quality on findings. Electronic databases were systematically searched on October 2nd, 2020 and records retrieved were limited to those published from 2000 onwards. Study quality was categorised as ‘good’, ‘moderate’ or ‘weak’. Fifty-three studies were included and in studies where the prevalence of epilepsy was reported (n = 257,892), 18,254 (7%) had co-occurring epilepsy. Intellectual disability/cognitive impairment was the most commonly reported risk factor associated with occurrence of epilepsy in autistic individuals. The evidence supporting other, potentially relevant factors was weak and inconsistent and requires further evaluation. Only 9/53 studies were considered ‘good’ quality.
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- 2022
10. Post-COVID-19 condition at 6 months and COVID-19 vaccination in non-hospitalised children and young people
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Snehal M, Pinto Pereira, Manjula D, Nugawela, Natalia K, Rojas, Roz, Shafran, Kelsey, McOwat, Ruth, Simmons, Tamsin, Ford, Isobel, Heyman, Shamez N, Ladhani, Emily Y, Cheung, Lana, Fox-Smith, Emma, Dalrymple, and Terence, Stephenson
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To describe the physical and mental health of children and young people (CYP) 6 months after infection with SARS-CoV-2 and explore whether this varies by COVID-19 vaccination.A non-hospitalised, national cohort of people aged 11-17 years old with PCR-confirmed SARS-CoV-2 infection and PCR negatives matched at study invitation, by age, sex, region and date of testing who completed questionnaires 6 months after PCR testing. The questionnaire included 21 symptoms and standardised scales (eg, EQ-5D-Y and Chalder Fatigue Scale).6407 test-positive and 6542 test-negative CYP completed the 6-month questionnaire: 60.9% of test-positive vs 43.2% of test-negative CYP reported at least one symptom 6 months post-test; 27.6% of test-positive vs 15.9% of test-negative CYP reported 3+ symptoms. Common symptoms at 6 months were tiredness and shortness of breath among both test-positive and test-negative CYP; however, the prevalence of both was higher in test-positive (38.4% and 22.8%, respectively) compared with test-negative CYP (26.7% and 10.9%, respectively). 24.5% test-positive vs 17.8% test-negative CYP met the Delphi research definition of long COVID. Mental health, well-being, fatigue and health-related quality of life scores were similar among test-positive and test-negative CYP 6 months post-test. Similarly, symptomatology was similar among COVID-19-vaccinated and COVID-19-unvaccinated test-positive and test-negative CYP.Six-months post-PCR testing, CYP who tested positive for SARS-CoV-2 had similar symptoms to those who tested negative, but test-positive CYP had higher symptom prevalence. Mental health, well-being, fatigue and health-related quality of life were similar among test-positive and test-negative CYP, and symptoms at 6 months were similar in COVID-19 vaccinated and unvaccinated.ISRCTN 34804192.
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- 2022
11. School Attendance and Anxiety
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Emma Dalrymple
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- 2022
12. Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk):a national matched cohort study
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Terence Stephenson, Snehal M Pinto Pereira, Roz Shafran, Bianca L de Stavola, Natalia Rojas, Kelsey McOwat, Ruth Simmons, Maria Zavala, Lauren O'Mahoney, Trudie Chalder, Esther Crawley, Tamsin J Ford, Anthony Harnden, Isobel Heyman, Olivia Swann, Elizabeth Whittaker, Shamez N Ladhani, Marta Buszewicz, Emma Dalrymple, Tamsin Ford, Shruti Garg, Malcolm Semple, Dougal Hargreaves, Shamez Ladhani, Michael Levin, Vanessa Poustie, Terry Segal, Kishan Sharma, National Institute of Health and Medical Research, and Apollo - University of Cambridge Repository
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Male ,Adolescent ,SARS-CoV-2 ,COVID-19 ,Polymerase Chain Reaction ,Cohort Studies ,COVID-19 Testing ,Post-Acute COVID-19 Syndrome ,England ,Surveys and Questionnaires ,Pediatrics, Perinatology and Child Health ,CLoCk Consortium ,Developmental and Educational Psychology ,Humans ,Female ,Child - Abstract
Background: We describe post-COVID symptomatology in a non-hospitalised, national sample of adolescents aged 11-17 years with PCR-confirmed SARS-CoV-2 infection compared with matched adolescents with negative PCR status. Methods: In this national cohort study, adolescents aged 11-17 years from the Public Health England database who tested positive for SARS-CoV-2 between January and March, 2021, were matched by month of test, age, sex, and geographical region to adolescents who tested negative. 3 months after testing, a subsample of adolescents were contacted to complete a detailed questionnaire, which collected data on demographics and their physical and mental health at the time of PCR testing (retrospectively) and at the time of completing the questionnaire (prospectively). We compared symptoms between the test-postive and test-negative groups, and used latent class analysis to assess whether and how physical symptoms at baseline and at 3 months clustered among participants. This study is registered with the ISRCTN registry (ISRCTN 34804192). Findings: 23 048 adolescents who tested positive and 27 798 adolescents who tested negative between Jan 1, 2021, and March 31, 2021, were contacted, and 6804 adolescents (3065 who tested positive and 3739 who tested negative) completed the questionnaire (response rate 13·4%). At PCR testing, 1084 (35·4%) who tested positive and 309 (8·3%) who tested negative were symptomatic and 936 (30·5%) from the test-positive group and 231 (6·2%) from the test-negative group had three or more symptoms. 3 months after testing, 2038 (66·5%) who tested positive and 1993 (53·3%) who tested negative had any symptoms, and 928 (30·3%) from the test-positive group and 603 (16·2%) from the test-negative group had three or more symptoms. At 3 months after testing, the most common symptoms among the test-positive group were tiredness (1196 [39·0%]), headache (710 [23·2%]), and shortness of breath (717 [23·4%]), and among the test-negative group were tiredness (911 [24·4%]), headache (530 [14·2%]), and other (unspecified; 590 [15·8%]). Latent class analysis identified two classes, characterised by few or multiple symptoms. The estimated probability of being in the multiple symptom class was 29·6% (95% CI 27·4-31·7) for the test-positive group and 19·3% (17·7-21·0) for the test-negative group (risk ratio 1·53; 95% CI 1·35-1·70). The multiple symptoms class was more frequent among those with positive PCR results than negative results, in girls than boys, in adolescents aged 15-17 years than those aged 11-14 years, and in those with lower pretest physical and mental health. Interpretation: Adolescents who tested positive for SARS-CoV-2 had similar symptoms to those who tested negative, but had a higher prevalence of single and, particularly, multiple symptoms at the time of PCR testing and 3 months later. Clinicians should consider multiple symptoms that affect functioning and recognise different clusters of symptoms. The multiple and varied symptoms show that a multicomponent intervention will be required, and that mental and physical health symptoms occur concurrently, reflecting their close relationship. Funding: UK Department of Health and Social Care, in their capacity as the National Institute for Health Research, and UK Research and Innovation. Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.
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- 2022
13. Optimising Evidence-Based Psychological Treatment for the Mental Health Needs of Children with Epilepsy: Principles and Methods
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Sophie Bennett, Fahreen Walji, Alice Sibelli, Alice Welch, Rona Moss-Morris, Sophia Varadkar, Isobel Heyman, J. Helen Cross, Emma Dalrymple, Jamie Ross, Anna E. Coughtrey, Jessica Smith, and Roz Shafran
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050103 clinical psychology ,medicine.medical_specialty ,Evidence-based practice ,Social Stigma ,Psychological intervention ,Comorbidity ,Scientific literature ,Anxiety ,Article ,Education ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Patient Education as Topic ,Health care ,Developmental and Educational Psychology ,medicine ,Humans ,Behaviour ,0501 psychology and cognitive sciences ,Psychiatry ,Depression ,business.industry ,Mental Disorders ,05 social sciences ,medicine.disease ,Focus group ,Mental health ,Psychotherapy ,Psychiatry and Mental health ,Clinical Psychology ,Evidence-Based Practice ,Pediatrics, Perinatology and Child Health ,Implementation science ,medicine.symptom ,business ,Psychology ,030217 neurology & neurosurgery - Abstract
There are potent evidence-based psychological treatments for youth with mental health needs, yet they are rarely implemented in clinical practice, especially for youth with mental health disorders in the context of chronic physical illness such as epilepsy. Implementation science, the study of the translation of research into practice, can promote the uptake of existing effective interventions in routine clinical practice and aid the sustainable integration of psychological treatments with routine health care. The aim of this report was to use four implementation science methods to develop a version of an existing effective psychological treatment for mental health disorders [the Modular Approach to Treatment of Children with Anxiety, Depression or Conduct Problems (MATCH-ADTC)] for use within paediatric epilepsy services: (a) literature search; (b) iterative focus groups underpinned by normalisation process theory; (c) Plan–Do–Study–Act methods; and (d) qualitative patient interviews. Findings: Three modifications were deemed necessary to facilitate implementation in children with both mental health disorders and epilepsy. These were (a) a universal brief psychoeducational component addressing the relationship between epilepsy and mental health; (b) supplementary, conditionally activated interventions addressing stigma, parental mental health and the transition to adulthood; and (c) additional training and supervision. The intervention needed relatively little alteration for implementation in paediatric epilepsy services. The modified treatment reflected the scientific literature and the views of clinicians and service users. The multi-method approach used in this report can serve as a model for implementation of evidence-based psychological treatments for children with mental health needs in the context of other chronic illnesses.
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- 2020
14. Association between Parents Experiencing Ongoing Problems from COVID-19 and Adolescents Reporting Long COVID Six Months after a Positive or Negative SARS-CoV-2 PCR-Test: Prospective, National Cohort Study in England
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Marta Bertran, Snehal Pinto Pereira, Manjula Nugawela, Terence J. Stephenson, Roz Shafran, Tamsin Ford, Marta Buszewicz, Elizabeth Whittaker, Isobel Heyman, Terry Segal, Emma Dalrymple, and Shamez N. Ladhani
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History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
15. 'A greatest hits compilation of mental health support': A qualitative study of health professionals' perceptions of modular CBT in pediatric epilepsy services
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Brian C. F. Ching, Anna E. Coughtrey, Peter Fonagy, Rona Moss-Morris, Roz Shafran, Mice Study Team, Bruce F. Chorpita, Alice Sibelli, Tamsin Ford, Emma Dalrymple, Isobel Heyman, and Sophie Bennett
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Adolescent ,medicine.medical_treatment ,media_common.quotation_subject ,Health Personnel ,education ,Behavioral Neuroscience ,Nursing ,Intervention (counseling) ,Perception ,medicine ,Humans ,Child ,Qualitative Research ,media_common ,Pediatric epilepsy ,Service (business) ,Epilepsy ,Mental health ,Cognitive behavioral therapy ,Mental Health ,Neurology ,Neurology (clinical) ,Thematic analysis ,Psychology ,Qualitative research - Abstract
Objectives The primary aim of this qualitative study was to explore the views of health professionals, with little previous clinical mental health training, of an adapted modular cognitive-behavioral intervention (MATCH-ADTC) for common mental health problems in children and young people with epilepsy. Methods Healthcare Professionals (HCPs) and their supervisors were interviewed at the start (n = 23) and end (n = 15) of the six-month training period. The interviews were transcribed verbatim and analyzed using thematic analysis. Results Three higher order themes with sub-themes were identified: (1) strengths of the MATCH-ADTC content and manual; (2) expectations of the treatment; and (3) improving practice with MATCH-ADTC. Overall impressions of the training and treatment were largely positive, with HCPs viewing MATCH-ADTC as an acceptable treatment for the families that they worked with. HCPs highlighted some challenges in delivering an integrated service, particularly relating to the time commitment involved and their own confidence in delivering the intervention, as many participants did not have a mental health background. Conclusions The findings suggested that the intervention and training was acceptable to HCPs working in pediatric epilepsy services, and confidence grew over the six-month training period. Further research is needed to understand how to best train, supervise, and support HCPs in pediatric epilepsy services to deliver mental health treatments.
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- 2021
16. M.I.C.E—Mental Health Intervention for Children with Epilepsy: a randomised controlled, multi-centre clinical trial evaluating the clinical and cost-effectiveness of MATCH-ADTC in addition to usual care compared to usual care alone for children and young people with common mental health disorders and epilepsy—study protocol
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Isobel Heyman, Rona Moss-Morris, Colin Reilly, Emma Dalrymple, Sarah Byford, J. Helen Cross, Mice Study Team, Bruce F. Chorpita, Caroline J Doré, Sophie Bennett, Terence Stephenson, Tamsin Ford, James Blackstone, Liz Deane, Kashfia Chowdhury, Anna E. Coughtrey, Roz Shafran, Poushali Ganguli, Sophia Varadkar, Bennett, Sophie D [0000-0002-1076-7112], and Apollo - University of Cambridge Repository
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medicine.medical_specialty ,Adolescent ,Cost effectiveness ,Cost-Benefit Analysis ,Psychological intervention ,Medicine (miscellaneous) ,Context (language use) ,Disruptive behaviour ,Teletherapy ,Anxiety ,law.invention ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Quality of life (healthcare) ,Randomized controlled trial ,law ,030225 pediatrics ,Medicine ,Humans ,Multicenter Studies as Topic ,Pharmacology (medical) ,Psychiatry ,Child ,Randomized Controlled Trials as Topic ,lcsh:R5-920 ,Epilepsy ,business.industry ,Depression ,Cognitive behaviour therapy ,Strengths and Difficulties Questionnaire ,Mental health ,Mental Health ,Neurology ,Paediatric ,Quality of Life ,medicine.symptom ,lcsh:Medicine (General) ,business ,030217 neurology & neurosurgery - Abstract
Background Mental health disorders in the context of long-term conditions in children and young people are currently overlooked and undertreated. Evidence-based psychological treatments for common childhood mental health disorders (anxiety, depression and disruptive behaviour disorders) have not been systematically evaluated in young people with epilepsy despite their high prevalence in this population. The aim of this multi-site randomised controlled trial is to determine the clinical and cost-effectiveness of adding a modular psychological intervention to usual care for the mental health disorders in comparison to assessment-enhanced usual care alone. Methods In total, 334 participants aged 3–18 years attending epilepsy services will be screened for mental health disorders with the Strengths and Difficulties Questionnaire (SDQ) and the diagnostic Development and Wellbeing Assessment (DAWBA). Those identified as having a mental health disorder and consenting to the trial will be randomised to either receive up to 22 sessions of the modular psychological intervention (MATCH-ADTC) delivered over the telephone over 6 months by non-mental health professionals in addition to usual care or to assessment-enhanced usual care alone. Outcomes will be measured at baseline, 6 months and 12 months post-randomisation. It is hypothesised that MATCH-ADTC plus usual care will be superior to assessment-enhanced usual care in improving emotional and behavioural symptoms. The primary outcome is the SDQ reported by parents at 6 months. Secondary outcomes include parent-reported mental health measures such as the Revised Children’s Anxiety and Depression Scale, quality of life measures such as the Paediatric Quality of Life Inventory and physical health measures such as the Hague Seizure Severity Scale. Outcome assessors will be blinded to group assignment. Qualitative process evaluations and a health economic evaluation will also be completed. Discussion This trial aims to determine whether a systematic and integrated approach to the identification and treatment of mental health disorders in children and young people with epilepsy is clinically and cost-effective. The findings will contribute to policies and practice with regard to addressing mental health needs in children and young people with other long-term conditions. Trial registration ISRCTN ISRCTN57823197. Registered on 25 February 2019.
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- 2021
17. Long COVID and the mental and physical health of children and young people: national matched cohort study protocol (the CLoCk study)
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Roz Shafran, Michael Levin, Shamez N Ladhani, Isobel Heyman, Marta Buszewicz, Terence Stephenson, Anthony Harnden, Trudie Chalder, Ruth Simmons, Elizabeth Whittaker, Bianca De Stavola, Zahin Amin-Chowdhury, Felicity Aiano, Natalia Rojas, Vanessa Poustie, Shruti Garg, Terry Segal, Kelsey McOwat, Maria Zavala, CLoCk Consortium, Olivia Swann, Emma Dalrymple, Tamsin Jane Ford, Kishan Sharma, and National Institute of Health and Medical Research
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medicine.medical_specialty ,Adolescent ,Computer-assisted web interviewing ,Latent variable ,infectious diseases ,1117 Public Health and Health Services ,Cohort Studies ,paediatrics ,Post-Acute COVID-19 Syndrome ,Prevalence ,medicine ,Humans ,Child ,Protocol (science) ,SARS-CoV-2 ,Operational definition ,business.industry ,Public health ,public health ,COVID-19 ,Paediatrics ,1103 Clinical Sciences ,General Medicine ,Mental health ,virology ,Test (assessment) ,Family medicine ,Medicine ,business ,1199 Other Medical and Health Sciences ,Cohort study - Abstract
IntroductionThere is uncertainty surrounding the diagnosis, prevalence, phenotype, duration and treatment of Long COVID. This study aims to (A) describe the clinical phenotype of post-COVID symptomatology in children and young people (CYP) with laboratory-confirmed SARS-CoV-2 infection compared with test-negative controls, (B) produce an operational definition of Long COVID in CYP, and (C) establish its prevalence in CYP.Methods and analysisA cohort study of SARS-CoV-2-positive CYP aged 11–17 years compared with age, sex and geographically matched SARS-CoV-2 test-negative CYP. CYP aged 11–17 testing positive and negative for SARS-CoV-2 infection will be identified and contacted 3, 6, 12 and 24 months after the test date. Consenting CYP will complete an online questionnaire. We initially planned to recruit 3000 test positives and 3000 test negatives but have since extended our target. Data visualisation techniques will be used to examine trajectories over time for symptoms and variables measured repeatedly, separately by original test status. Summary measures of fatigue and mental health dimensions will be generated using dimension reduction methods such as latent variables/latent class/principal component analysis methods. Cross-tabulation of collected and derived variables against test status and discriminant analysis will help operationalise preliminary definitions of Long COVID.Ethics and disseminationResearch Ethics Committee approval granted. Data will be stored in secure Public Health England servers or University College London’s Data Safe Haven. Risks of harm will be minimised by providing information on where to seek support. Results will be published on a preprint server followed by journal publication, with reuse of articles under a CC BY licence. Data will be published with protection against identification when there are small frequencies involved.Trial registration numberISRCTN34804192; Pre-results.
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- 2021
18. Feasibility of telephone-delivered therapy for common mental health difficulties embedded in pediatric epilepsy clinics
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Laila Xu, Emma Dalrymple, J. Helen Cross, Sarah Byford, Sophie Bennett, Rona Moss-Morris, Peter Fonagy, Isobel Heyman, Tamsin Ford, Colin Reilly, Amy Lewins, Bruce F. Chorpita, Christy Au, Anna E. Coughtrey, and Roz Shafran
- Subjects
medicine.medical_specialty ,Adolescent ,education ,Psychological intervention ,law.invention ,Competence (law) ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,Quality of life (healthcare) ,Randomized controlled trial ,law ,Intervention (counseling) ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Epilepsy ,Cognitive Behavioral Therapy ,Depression ,business.industry ,Mental health ,Telephone ,Integrated care ,Mental Health ,Neurology ,Physical therapy ,Feasibility Studies ,Anxiety ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background Mental and physical health treatment should be delivered together for children and young people with epilepsy. Training healthcare professionals (HCPs) in epilepsy services to deliver mental health interventions is an important way to facilitate integrated care. Objective To determine the feasibility of remotely delivered assessment and psychological treatment for mental health difficulties delivered by HCPs in pediatric epilepsy clinics with limited formal training in psychological interventions. We hypothesized that it would be (i) feasible to train HCPs to deliver the psychological intervention and (ii) that participants receiving the psychological therapy would report reductions in symptoms of mental health difficulties including anxiety, depression, and behavior difficulties and improve quality of life. Methods Thirty-four children and young people with epilepsy who had impairing symptoms of a common mental health difficulty (anxiety, depression, disruptive behavior, and/or trauma) were allocated to receive 6 months of a modular cognitive behavioral intervention delivered by a HCP with limited formal psychological therapy experience. Thirteen HCPs were trained in delivery of the intervention. Healthcare professional competence was assessed in a two-stage process. Parent-reported measures of mental health symptoms and quality of life were completed at baseline and following the intervention. Paired t-tests were used to analyze changes in symptoms over time. Results All thirteen HCPs who participated in the training were considered competent in therapeutic delivery by the end of the training period. Twenty-three patients completed pre- and post-intervention measures and were included in the analysis. There were statistically significant improvements in: symptoms of mental health problems (p = 0.01; Cohen’s d = 0.62), total impact of mental health problems (p = 0.03; Cohen’s d = 0.52), anxiety and depression symptoms (p = 0.02; Cohen’s d = 0.57) and quality of life (p = 0.01; Cohen’s d = 0.57). Conclusion A modular cognitive behavioral treatment delivered over the telephone by HCPs with limited experience of psychological therapy was feasible and effective in treating mental health problems in children and young people with epilepsy. Health-related Quality of Life also improved over the duration of treatment. A randomized controlled trial (RCT) is needed to demonstrate efficacy of the intervention.
- Published
- 2021
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