Brief Engagement and Acceptance Coaching for Community and Hospice Settings (the BEACHeS Study): Protocol for the development and pilot testing of an evidence-based psychological intervention to enhance wellbeing and aid transition into palliative care
AuthorsHulbert-Williams, Nicholas J.; orcid: 0000-0001-9041-5485; email: firstname.lastname@example.org
Norwood, Sabrina; email: email@example.com
Gillanders, David; email: firstname.lastname@example.org
Finucane, Anne; email: email@example.com
Spiller, Juliet; email: firstname.lastname@example.org
Strachan, Jenny; email: email@example.com
Millington, Sue; email: firstname.lastname@example.org
Swash, Brooke; email: email@example.com
MetadataShow full item record
AbstractAbstract: Background: Cancer affects millions of individuals globally, with a mortality rate of over eight million people annually. Although palliative care is often provided outside of specialist services, many people require, at some point in their illness journey, support from specialist palliative care services, for example, those provided in hospice settings. This transition can be a time of uncertainty and fear, and there is a need for effective interventions to meet the psychological and supportive care needs of people with cancer that cannot be cured. Whilst Acceptance and Commitment Therapy (ACT) has been shown to be effective across diverse health problems, robust evidence for its effectiveness in palliative cancer populations is not extensive. Method: This mixed-methods study uses a single-case experimental design with embedded qualitative interviews to pilot test a novel intervention for this patient group. Between 14 and 20 patients will be recruited from two hospices in England and Scotland. Participants will receive five face-to-face manualised sessions with a psychological therapist. Sessions are structured around teaching core ACT skills (openness, awareness and engagement) as a way to deal effectively with challenges of transition into specialist palliative care services. Outcome measures include cancer-specific quality of life (primary outcome) and distress (secondary outcome), which are assessed alongside measures of psychological flexibility. Daily diary outcome assessments will be taken for key measures, alongside more detailed weekly self-report, through baseline, intervention and 1-month follow-up phases. After follow-up, participants will be invited to take part in a qualitative interview to understand their experience of taking part and acceptability and perceived effectiveness of the intervention and its components. Discussion: This study is the first investigation of using ACT with terminally ill patients at the beginning of their transition into palliative treatment. Using in-depth single-case approaches, we will refine and manualise intervention content by the close of the study for use in follow-up research trials. Our long-term goal is then to test the intervention as delivered by non-psychologist specialist palliative care practitioners thus broadening the potential relevance of the approach. Trial registration: Open Science Framework, 46033. Registered 19 April 2018.
CitationPilot and Feasibility Studies, volume 5, issue 1, page 104
DescriptionFrom Springer Nature via Jisc Publications Router
History: received 2018-11-23, registration 2019-08-12, accepted 2019-08-12, epub 2019-08-20, online 2019-08-20, collection 2019-12
Publication status: Published
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Introducing experiences from African pastoralist communities to cope with climate change risks, hazards and extremes: Fostering poverty reductionFilho, Walter Leal; email: firstname.lastname@example.org; Taddese, Habitamu; email: email@example.com; Balehegn, Mulubrhan; email: firstname.lastname@example.org; Nzengya, Daniel; email: email@example.com; Debela, Nega; email: Nega.firstname.lastname@example.org; Abayineh, Amare; email: email@example.com; Mworozi, Edison; email: firstname.lastname@example.org; Osei, Sampson; email: email@example.com; Ayal, Desalegn Y.; email: firstname.lastname@example.org; Nagy, Gustavo J.; email: email@example.com; et al.Abstract Pastoralist communities all over Africa have been facing a variety of social and economic problems, as well as climate risks and hazards for many years. They have also been suffering from climate change and extremes events, along with a variety of weather and climate threats, which pose many challenges to herders. On the one hand, pastoralist communities have little influence on policy decisions; however, on the other hand, they suffer to a significant extent from such policies, which limit their options for sustainable development and poverty alleviation. Also, the socio-cultural legacy of herders, and their role in food security and provision of ecosystem services, as well as their efforts towards climate change adaptation, are little documented, particularly in Eastern and Southern African countries. There is a perceived need for international studies on the risks and impacts of climate change and extreme events on the sustainability of pastoralist communities in Africa, especially in eastern and southern Africa. Based on the need to address this research gap, this paper describes the climate change risks and challenges that climate threats pose to the sustainability and livelihoods of pastoralist communities in eastern and southern Africa. Also, it discusses the extent to which such problems affect their well-being and income. Additionally, the paper reports on the socioeconomic vulnerability indices at country-level. Also, it identifies specific problems pastoralists face, and a variety of climate adaptation strategies to extreme events through field survey among pastoralist communities in a sample of five countries, namely Ethiopia, Kenya, Malawi, Uganda, and Zimbabwe. The study has shown that the long-term sustainability of the livelihoods of pastoral communities is currently endangered by climate change and the risks and hazards it brings about, which may worsen poverty among this social group. Also, the study suggests that a more systematic and structured approach is needed when assessing the climate vulnerability of individual pastoral communities, since this may help in designing suitable disaster risk reduction strategies. Moreover, the paper shows that it is also necessary to understand better the socio-ecological systems (SES) of the various communities, and how their livelihoods are influenced by the changing conditions imposed by a changing climate.
Validation of CIP2A as a Biomarker of Subsequent Disease Progression and Treatment Failure in Chronic Myeloid LeukaemiaClark, Richard E.; email: firstname.lastname@example.org; Basabrain, Ammar A.; email: email@example.com; Austin, Gemma M.; email: firstname.lastname@example.org; Holcroft, Alison K.; email: email@example.com; Loaiza, Sandra; email: firstname.lastname@example.org; Apperley, Jane F.; email: email@example.com; Law, Christopher; email: K.C.Law@liverpool.ac.uk; Scott, Laura; email: firstname.lastname@example.org; Parry, Alexandra D.; email: email@example.com; Bonnett, Laura; orcid: 0000-0002-6981-9212; email: L.J.Bonnett@liverpool.ac.uk; et al. (MDPI, 2021-04-29)Background: It would be clinically useful to prospectively identify the risk of disease progression in chronic myeloid leukaemia (CML). Overexpression of cancerous inhibitor of protein phosphatase 2A (PP2A) (CIP2A) protein is an adverse prognostic indicator in many cancers. Methods: We examined CIP2A protein levels in diagnostic samples from the SPIRIT2 trial in 172 unselected patients, of whom 90 received imatinib and 82 dasatinib as first-line treatment. Results: High CIP2A levels correlated with inferior progression-free survival (p = 0.04) and with worse freedom from progression (p = 0.03), and these effects were confined to dasatinib recipients. High CIP2A levels were associated with a six-fold higher five-year treatment failure rate than low CIP2A levels (41% vs. 7.5%; p = 0.0002), in both imatinib (45% vs. 11%; p = 0.02) and dasatinib recipients (36% vs. 4%; p = 0.007). Imatinib recipients with low CIP2A levels had a greater risk of treatment failure (p = 0.0008). CIP2A levels were independent of Sokal, Hasford, EUTOS (EUropean Treatment and Outcome Study), or EUTOS long-term survival scores (ELTS) or the presence of major route cytogenetic abnormalities. No association was seen between CIP2A levels and time to molecular response or the levels of the CIP2A-related proteins PP2A, SET, SET binding protein 1 (SETBP1), or AKT. Conclusions: These data confirm that high diagnostic CIP2A levels correlate with subsequent disease progression and treatment failure. CIP2A is a simple diagnostic biomarker that may be useful in planning treatment strategies.
Impacts of Reducing UK Beef Consumption Using a Revised Sustainable Diets FrameworkChalmers, Neil; email: firstname.lastname@example.org; Stetkiewicz, Stacia; email: email@example.com; Sudhakar, Padhmanand; orcid: 0000-0003-1907-4491; email: Padhmanand.Sudhakar@earlham.ac.uk; Osei-Kwasi, Hibbah; orcid: 0000-0001-5084-6213; email: firstname.lastname@example.org; Reynolds, Christian J; orcid: 0000-0002-1073-7394; email: email@example.com (MDPI, 2019-12-02)The impact of beef consumption on sustainability is a complex and evolving area, as sustainability covers many areas from human nutrient adequacy to ecosystem stability. Three sustainability assessment frameworks have been created to help policy makers unpack the complexities of sustainable food systems and healthy sustainable dietary change. However, none of these frameworks have yet to be applied to a case study or individual policy issue. This paper uses a hybrid version of the sustainability assessment frameworks to investigate the impact of reducing beef consumption (with a concurrent increase in consumption of plant-based foods, with a focus on legumes) on sustainability at a UK level. The aim of this paper is to understand the applicability of these overarching frameworks at the scale of an individual policy. Such an assessment is important, as this application of previously high-level frameworks to individual policies makes it possible to summarise, at a glance, the various co-benefits and trade-offs associated with a given policy, which may be of particular value in terms of stakeholder decision-making. We find that many of the proposed metrics found within the sustainability assessment frameworks are difficult to implement at an individual issue level; however, overall they show that a reduction in beef consumption and an increase in consumption of general plant-based foods, with a focus around legumes production, would be expected to be strongly beneficial in five of the eight overarching measures which were assessed.