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  • 11
    Online Resource
    Online Resource
    Influence of systemic factors on pre-existing intimal hyperplasia and their effect on the outcome of infrainguinal arterial reconstruction with vein
    Oxford University Press (OUP) ; 2002
    In:  British Journal of Surgery Vol. 86, No. 11 ( 2002-12-10), p. 1441-1447
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 86, No. 11 ( 2002-12-10), p. 1441-1447
    Abstract: The association between raised levels of homocysteine, fibrinogen and lipoprotein (a), and the presence of pre-existing intimal hyperplasia (IH) in vein has not been assessed. The positive association between such hyperplasia and graft failure following infrainguinal arterial reconstruction, and between lipoprotein (a) and graft failure, is disputed. The influence of homocysteine on outcome has not been investigated prospectively. Methods Fifty-seven patients (63 grafts) undergoing infrainguinal arterial reconstruction with saphenous vein were studied. Homocysteine, fibrinogen and lipoprotein (a) levels were measured, and a vein biopsy was taken at operation. Patients underwent graft surveillance and outcome at 12 months was determined. Results Fifty-seven per cent of patients had hyperhomocysteinaemia. Patients with pre-existing IH had significantly higher homocysteine levels. There was no association between homocysteine and outcome, or between fibrinogen and pre-existing IH or outcome. Lipoprotein (a) levels were significantly lower in patients with pre-existing disease, and were lower, but not significantly, in those whose grafts failed. The correlation between pre-existing IH and vein graft failure was highly significant. Conclusion Hyperhomocysteinaemia is associated with peripheral vascular disease and the development of pre-existing IH in vein, which itself is associated with vein graft failure.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1046/j.1365-2168.1999.01259.x
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2002
    detail.hit.zdb_id: 2006309-X
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  • 12
    Online Resource
    Online Resource
    Exclusive Breastfeeding Duration and Perceptions of Infant Sleep: The Mediating Role of Postpartum Anxiety
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 8 ( 2022-04-08), p. 4494-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 8 ( 2022-04-08), p. 4494-
    Abstract: (1) Background: Existing literature has identified associations between exclusive breastfeeding, maternal mental health, and infant sleep. This study aims to examine these relationships simultaneously and consider the mediating role of postpartum anxiety. (2) Methods: Participants completed validated measures of postpartum anxiety, infant sleep, and reported exclusive breastfeeding duration. Postpartum mothers with infants between six and twelve months (n = 470) were recruited to a cross-sectional online survey containing a battery of psychological measures. (3) Results: Correlation analyses examined the relationships between the predictor (exclusive breastfeeding duration), outcome (perceptions of infant sleep), and mediator (postpartum anxiety). Exclusive breastfeeding duration was significantly associated with postpartum anxiety (p 〈 0.05), postpartum anxiety was significantly associated with perceptions of infant sleep (p 〈 0.001), and exclusive breastfeeding duration was significantly associated with perceptions of infant sleep (p 〈 0.001). A simple mediation model was conducted, showing a significant total (B = −0.029 (0.010), p 〈 0.05), direct (B = −0.035 (0.009), p 〈 0.001), and indirect effect (B = 0.007, SE = 0.003, 95% CI = 0.000 to 0.014) of exclusive breastfeeding duration on perceptions of infant sleep via postpartum anxiety. (4) Conclusions: Associations were identified between exclusive breastfeeding duration, postpartum anxiety, and perceptions of infant sleep. The mediation model suggests postpartum anxiety may be an underlying mechanism which reduces exclusive breastfeeding duration and negatively affects maternal perceptions of infant sleep quality.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19084494
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 13
    Online Resource
    Online Resource
    Preventive Digital Mental Health for Children in Primary Schools: Acceptability and Feasibility Study
    JMIR Publications Inc. ; 2021
    In:  JMIR Formative Research Vol. 5, No. 12 ( 2021-12-13), p. e30668-
    Details
    In: JMIR Formative Research, JMIR Publications Inc., Vol. 5, No. 12 ( 2021-12-13), p. e30668-
    Abstract: The incidence of mental health problems in children and adolescents in the United Kingdom has significantly increased in recent years, and more people are in contact with mental health services in Greater Manchester than in other parts of the country. Children and young people spend most of their time at school and with teachers. Therefore, schools and other educational settings may be ideal environments in which to identify those experiencing or those at the risk of developing psychological symptoms and provide timely support for children most at risk of mental health or related problems. Objective This study aims to test the feasibility of embedding a low-cost, scalable, and innovative digital mental health intervention in schools in the Greater Manchester area. Methods Two components of a 6-week digital intervention were implemented in a primary school in Greater Manchester: Lexplore, a reading assessment using eye-tracking technology to assess reading ability and detect early atypicality, and Lincus, a digital support and well-being monitoring platform. Results Of the 115 children approached, 34 (29.6%) consented and took part; of these 34 children, all 34 (100%) completed the baseline Lexplore assessment, and 30 (88%) completed the follow-up. In addition, most children were classified by Lincus as regular (≥1 per week) survey users. Overall, the teaching staff and children found both components of the digital intervention engaging, usable, feasible, and acceptable. Despite the widespread enthusiasm and recognition of the potential added value from staff, we met significant implementation barriers. Conclusions This study explored the acceptability and feasibility of a digital mental health intervention for schoolchildren. Further work is needed to evaluate the effectiveness of the digital intervention and to understand whether the assessment of reading atypicality using Lexplore can identify those who require additional help and whether they can also be supported by Lincus. This study provides high-quality pilot data and highlights the potential benefits of implementing digital assessment and mental health support tools in a primary school setting.
    Type of Medium: Online Resource
    ISSN: 2561-326X
    URL: Article
    DOI: 10.2196/30668
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2941716-8
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  • 14
    Online Resource
    Online Resource
    A validation of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises with five translations
    Springer Science and Business Media LLC ; 2021
    In:  BMC Pregnancy and Childbirth Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Pregnancy and Childbirth, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: Global crises inevitably increase levels of anxiety in postpartum populations. Effective and efficient measurement is therefore essential. This study aimed to create a 12-item research short form of the 51-item Postpartum Specific Anxiety Scale [PSAS] and validate it for use in rapid response research at a time of global crises [PSAS-RSF-C] . We also present the same 12-items, in five other languages (Italian, French, Chinese, Spanish, Dutch) to increase global accessibility of a psychometric tool to assess maternal mental health. Methods Twelve items from the PSAS were selected on the basis of a review of their factor loadings. An on-line sample of UK mothers ( N  = 710) of infants up to 12 weeks old completed the PSAS-RSF-C during COVID-19 ‘lockdown’. Results Principal component analyses on a randomly split sample ( n  = 344) revealed four factors, identical in nature to the original PSAS, which in combination explained 75% of the total variance. Confirmatory factor analyses ( n  = 366) demonstrated the four-factor model fit the data well. Reliability of the overall scale and of the underlying factors in both samples proved excellent. Conclusions Findings suggest the PSAS-RSF-C may prove useful as a clinical screening tool and is the first postpartum-specific psychometric scale to be validated during the COVID-19 pandemic. This offers psychometrically sound assessment of postpartum anxiety. By increasing the accessibility of the PSAS, we aim to enable researchers the opportunity to measure maternal anxiety, rapidly, at times of global crisis.
    Type of Medium: Online Resource
    ISSN: 1471-2393
    URL: Article
    DOI: 10.1186/s12884-021-03597-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059869-5
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  • 15
    Online Resource
    Online Resource
    Psychometric evaluation of the postpartum specific anxiety scale – research short-form among Iranian women (PSAS-IR-RSF)
    Springer Science and Business Media LLC ; 2023
    In:  BMC Pregnancy and Childbirth Vol. 23, No. 1 ( 2023-07-21)
    Details
    In: BMC Pregnancy and Childbirth, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-07-21)
    Abstract: The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women’s lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) among Iranian women has not been assessed in Iran until now, so we decided to conduct this study with the aim of psychometric evaluation of the PSAS-IR-RSF. Methods We included 180 women (six weeks to six months postpartum) in the study by random sampling during the period from December 2021 to June 2022. We examined the validity of the PSAS-IR-RSF tool in terms of face, content and construct (through exploratory and confirmatory factor analyses). We used internal consistency and test-retest reliability to determine the reliability of the scale. Results In the present study, content validity index (CVI) and content validity ratio (CVR) of the PSAS-IR-RSF tool were equal to 0.91 and 0.97, respectively. We extracted a four-factor structure through the process of exploratory factor analysis. The values of fitting indices confirmed the validity of the model. Cronbach’s alpha coefficient was equal to 0.72 and intra-class correlation coefficient (with 95% confidence interval) was 0.97 (0.98 to 0.93). Conclusions The Persian version of the PSAS-IR-RSF is a valid and reliable tool for the specific evaluation of postpartum anxiety among Iranian women.
    Type of Medium: Online Resource
    ISSN: 1471-2393
    URL: Article
    DOI: 10.1186/s12884-023-05855-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2059869-5
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  • 16
    Online Resource
    Online Resource
    Content of Health Economics Analysis Plans (HEAPs) for Trial-Based Economic Evaluations: Expert Delphi Consensus Survey
    Elsevier BV ; 2021
    In:  Value in Health Vol. 24, No. 4 ( 2021-04), p. 539-547
    Details
    In: Value in Health, Elsevier BV, Vol. 24, No. 4 ( 2021-04), p. 539-547
    Type of Medium: Online Resource
    ISSN: 1098-3015
    URL: Article
    DOI: 10.1016/j.jval.2020.10.002
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2011039-X
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  • 17
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    Online Resource
    The feasibility of team care for women seeking to plan a vaginal breech birth (OptiBreech 1): an observational implementation feasibility study in preparation for a pilot trial
    Springer Science and Business Media LLC ; 2023
    In:  Pilot and Feasibility Studies Vol. 9, No. 1 ( 2023-05-12)
    Details
    In: Pilot and Feasibility Studies, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2023-05-12)
    Abstract: OptiBreech Care is a care pathway for breech presentation at term, including where chosen, physiological breech birth attended by professionals with advanced training and/or proficiency. We aimed to assess the feasibility of implementing OptiBreech team care prior to proceeding with a planned pilot randomised controlled trial. Methods Our design was an observational implementation feasibility assessment across England and Wales, January 2021–June 2022. Our objectives were to determine whether Trusts could provide attendants with advanced training (implementation feasibility), who deliver protocol-consistent care (fidelity), within existing resources (costs), while maintaining low neonatal admission rates (safety) and adequate recruitment rates (trial feasibility). Participants included women  〉  37 weeks pregnant with a breech-presenting foetus, requesting support for a vaginal breech birth following standard counselling, and staff involved in the study. No randomisation occurred in this first stage of feasibility work. Results Thirteen National Health Service sites were recruited. A total of 82 women planned births in the study. Sites with a breech specialist midwife recruited at double the rate of sites without (0.90/month, 95% CI 0.64–1.16 vs 0.40, 95% CI 0.12–0.68). Referrals into the study came from midwives (46%), obstetricians (34%) and women themselves (20%). Vaginal births were attended by staff with OptiBreech training at 87.5% (35/40, 95% CI 0.732–0.958) and by staff who met additional proficiency criteria at 67.5% (27/40, 95% CI 0.509–0.814). Fidelity criteria were more consistently met by staff who also met proficiency criteria. There were four neonatal admissions (4.9%, 4/82), including one serious adverse outcome (1.2%, 1/82). Conclusions A prospective observational cohort of OptiBreech collaborative care, which could potentially support nested or cluster randomisation, appears feasible in sites willing to establish a dedicated clinic and strategically develop further proficient members of staff, with back-up plans for supporting rapidly progressing births. Randomisation procedures remain to be feasibility tested. It is funded by the NIHR (NIHR300582).
    Type of Medium: Online Resource
    ISSN: 2055-5784
    URL: Article
    DOI: 10.1186/s40814-023-01299-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2809935-7
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  • 18
    Online Resource
    Online Resource
    Psychosocial experiences of postnatal women during the COVID-19 pandemic. A UK-wide study of prevalence rates and risk factors for clinically relevant depression and anxiety
    Elsevier BV ; 2021
    In:  Journal of Psychiatric Research Vol. 136 ( 2021-04), p. 157-166
    Details
    In: Journal of Psychiatric Research, Elsevier BV, Vol. 136 ( 2021-04), p. 157-166
    Type of Medium: Online Resource
    ISSN: 0022-3956
    URL: Article
    DOI: 10.1016/j.jpsychires.2021.01.048
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1500641-4
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  • 19
    Online Resource
    Online Resource
    Creation and validation of the Postpartum Specific Anxiety Scale Research Short-Form (PSAS-RSF)
    Springer Science and Business Media LLC ; 2021
    In:  Archives of Women's Mental Health Vol. 24, No. 6 ( 2021-12), p. 957-969
    Details
    In: Archives of Women's Mental Health, Springer Science and Business Media LLC, Vol. 24, No. 6 ( 2021-12), p. 957-969
    Abstract: The Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure of postpartum anxiety (PPA). However, it contains 51 items, so is limited by its length. This study aimed to reduce the number of items in the PSAS, produce a small number of high-performing short-form tools, and confirm the factor structure of the most statistically and theoretically meaningful model. A pooled sample of English-speaking mothers ( N = 2033) with infants up to 12 months were randomly split into three samples. (1) A principal component analysis (PCA) was conducted to initially reduce the items ( n  = 672). (2) Four short-form versions of varying length (informed by statistical, theoretical, lay-person, and expert-guided feedback) were developed and their factor structure examined ( n  = 673). (3) A final confirmatory factor analysis (CFA) was performed to confirm the factor structure of the PSAS Research Short-Form (PSAS-RSF) ( n  = 688). PCA and theoretical review reduced the items from 51 to 34 (version 1). Statistical review retained 22 items (version 2). Quantitative expert panel data retained 17 items (version 3). Qualitative expert panel data retained 16 items (version 4). The 16-item version was deemed the most theoretically and psychometrically robust. The resulting 16-item PSAS-RSF demonstrated good psychometric properties and reliability. The PSAS-RSF is the first brief research tool which has been validated to measure PPA. Our findings demonstrate it is theoretically meaningful, statistically robust, reliable, and valid. This study extends the use of the measure up to 12 months postpartum, offering broader opportunity for measurement while further enhancing accessibility through brevity.
    Type of Medium: Online Resource
    ISSN: 1434-1816 , 1435-1102
    URL: Article
    DOI: 10.1007/s00737-021-01114-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1480651-4
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  • 20
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    The antenatal psychological experiences of women during two phases of the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis
    Public Library of Science (PLoS) ; 2023
    In:  PLOS ONE Vol. 18, No. 6 ( 2023-6-8), p. e0285270-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 6 ( 2023-6-8), p. e0285270-
    Abstract: Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of women during different phases of pandemic-related lockdown restrictions in the UK. Semi-structured interviews were held with 24 women about their antenatal experiences: twelve were interviewed after the initial lockdown restrictions (Timepoint 1; T1), and a separate twelve women were interviewed after the subsequent lifting of those restrictions (Timepoint 2; T2). Interviews were transcribed and a recurrent, cross-sectional thematic analysis was conducted. Two themes were identified for each timepoint, and each theme contained sub-themes. T1 themes were: ‘A Mindful Pregnancy’ and ‘It’s a Grieving Process’, and T2 themes were: ‘Coping with Lockdown Restrictions’ and ‘Robbed of Our Pregnancy’. COVID-19 related social distancing restrictions had an adverse effect on women’s mental health during the antenatal period. Feeling trapped, anxious, and abandoned were common at both timepoints. Actively encouraging conversations about mental wellbeing during routine care and adopting a prevention opposed to cure attitude toward implementing additional support provisions may serve to improve antenatal psychological wellbeing during health crises.
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
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    DOI: 10.1371/journal.pone.0285270
    DOI: 10.1371/journal.pone.0285270.t001
    DOI: 10.1371/journal.pone.0285270.t002
    DOI: 10.1371/journal.pone.0285270.s001
    DOI: 10.1371/journal.pone.0285270.s002
    DOI: 10.1371/journal.pone.0285270.s003
    DOI: 10.1371/journal.pone.0285270.r001
    DOI: 10.1371/journal.pone.0285270.r002
    DOI: 10.1371/journal.pone.0285270.r003
    DOI: 10.1371/journal.pone.0285270.r004
    DOI: 10.1371/journal.pone.0285270.r005
    DOI: 10.1371/journal.pone.0285270.r006
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2023
    detail.hit.zdb_id: 2267670-3
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