Outcome studies in group psychotherapy

The treatment manual is intended to serve more than one purpose. It is designed to be a research tool, making possible the standardization and validation of a treatment method. It is also a highly condensed primer and a practicum, offering a description of psychoanalytic group therapy which will act as a handbook for the beginner and as an aide-memoirefor the more experienced therapist. Many therapists will have had some experience with individual patients but wonder how they are to convert that knowledge into the practicalities of running a group, in which seven or eight patients are seen simultaneously. For young practitioners in a National Health Service setting, this can be a daunting prospect. It is difficult to do group therapy well, yet when it is done well it provides an invaluable therapeutic medium for a collection of patients it might be neither possible nor wise nor even necessary to see in individual treatment. In other words, there are many patients for whom a group is the treatment of choice

Questionnaire surveys to discover academic staff and library staff perceptions of a National Union catalogue

During the feasibility study into a National Union catalogue for the UK (UKNUC), a questionnaire survey was undertaken of the needs of both academic staff in higher education and library staff. A response rate of 40-50 per cent was achieved, 846 questionnaires being returned for academics and 724 for librarians. The analysis suggests that a UKNUC would be highly valued and heavily used by all categories. Academics felt it would have a positive effect on their information searching, and wished to include the holdings of the British Library, and libraries of both the major research universities and the ``traditional’’ universities. They wanted it to be comprehensive and easy to use, to include locations of both books and journals, and to facilitate subject collection searching. Library staff have similar priorities to academics, although there are more variations by sector and a recognition of a UKNUC’s value as a potential source of bibliographic records

Serious religion and the improvement of public manners : the scope and limitations of Evangelicalism in Hull 1770-1914.

SIGLEAvailable from British Library Document Supply Centre- DSC:D97240 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Clinical characteristics of persistent frequent attenders in primary care: case–control study

Background. Most frequent attendance in primary care is temporary, but persistent frequent attendance is expensive and may be suitable for psychological intervention. To plan appropriate intervention and service delivery, there is a need for research involving standardized psychiatric interviews with assessment of physical health and health status. Objective. To compare the mental and physical health characteristics and health status of persistent frequent attenders (FAs) in primary care, currently and over the preceding 2 years, with normal attenders (NAs) matched by age, gender and general practice. Methods. Case–control study of 71 FAs (30 or more GP or practice nurse consultations in 2 years) and 71 NAs, drawn from five primary care practices, employing standardized psychiatric interview, quality of life, health anxiety and primary care electronic record review over the preceding 2 years. Results. Compared to NAs, FAs were more likely to report a lower quality of life (P < 0.001), be unmarried (P = 0.03) and have no educational qualifications (P = 0.009) but did not differ in employment status. FAs experienced greater health anxiety (P < 0.001), morbid obesity (P = 0.02), pain (P < 0.001) and long-term pathological and ill-defined physical conditions (P < 0.001). FAs had more depression including dysthymia, anxiety and somatoform disorders (all P < 0.001). Conclusions. Persistent frequent attendance in primary care was associated with poor quality of life and high clinical complexity characterized by diverse and often persistent physical and mental multimorbidity. A brokerage model with GPs working in close liaison with skilled psychological therapists is required to manage such persistent complexity

The churches and the iron and steel industry in Middlesbrough 1890-1914

This thesis surveys the rapid, growth of Middlesbrough, its basic Industry, and the establishment and growth of the Christian churches in the town between 1830 and 1914; but the work is particularly concerned with the years I89O-I9I4. It aims to discover the church's understanding of its mission in relation to the iron and steel industry and the society which it produced, in order to evaluate the church's successes and failures. The thesis begins with a summary of Christian social teaching in the second half of the nineteenth century to establish what ideas were current at national level (Chapter l). It proceeds to a study of Middlesbrough and its iron industry, as the environment with which the local churches had to contend (Chapter 2). The attitudes and activities of the churches are then examined in two chapters. The first of these (Chapter 3), discusses their institutional response in church extension, schools, hospitals, church life, missionary activity, and the 1904 religious census. The second (Chapter 4), considers the churches’ concern for personal morality, temperance, gambling, Sunday observance, the 1912 Church Congress, and the churches’ reactions to the iron and steel industry as the determining factor in the life of the community. The concluding chapter (Chapter 5), uses Richard Niebuhr's study, Christ and Culture, as a framework for a theological assessment of the church's work in Middlesbrough on the basis of what, in the earlier chapters, has been established historically

Cognitive behaviour therapy for long-term frequent attenders in primary care: a feasibility case series and treatment development study

Background: Most frequent attendance in primary care is temporary. Long-term frequent attendance may be suitable for psychological intervention to address health management and service use. Aim: To explore the feasibility and acceptability of cognitive-behaviour therapy (CBT) for long-term frequent attendance in primary care and obtain preliminary evidence regarding clinical and cost-effectiveness. Design and Setting: A CBT case series was carried out in five GP practices. Method: Frequent attenders (FAs) were identified from case notes and invited by their practice for assessment, then offered CBT. Feasibility and acceptability were assessed by CBT session attendance and thematic analysis of semi-structured questionnaires. Clinical and cost effectiveness was assessed by primary care use and clinically important change on a range of health and quality of life instruments. Results: Of 462 FAs invited to interview, 87 (19%) consented to assessment. Thirty-two (7%) undertook CBT over median three months. Twenty-four (75%) attended > 6 sessions. Eighteen FAs (86%, n=21) reported overall satisfaction with treatment. Patients reported valuing listening without judgement alongside support to develop coping strategies. Thirteen (55%, n=24) achieved clinically important improvement on the SF-36 Mental-Component Scale at six month follow-up and improved quality of life, but no improvement on other outcomes. Primary care use reduced from median eight contacts in three months at baseline (n=32) to three contacts in three months at one year (n=18). Conclusion: CBT appears feasible and acceptable to a sub-set of long-term FAs in primary care who halved their primary care use. With improved recruitment strategies, this approach might contribute to decreasing GP workload and merits larger-scale evaluation

Experimental studies and simulations of shock-compressed silicon

The response of silicon to shock-compression has been an area of active research for decades. However, despite considerable improvements in both experimental techniques and computer simulations, the behaviour has not been unanimously constrained. This work introduces a new Lagrangian Elastic code which aims to approach the modelling of solids from a different direction to traditional hydrodynamics codes. We present data from a white-light Laue diffraction experiment, which along with molecular dynamics simulations, suggest that a kinetically inhibited phase-change may be indirectly responsible for the previously reported anomalous elastic response of silicon. We also present data from a monochromatic x-ray diffraction experiment which show the first observed diffraction from a shock-induced high-pressure phase in silicon

Protocol investigating the clinical outcomes and cost-effectiveness of cognitive–behavioural therapy delivered remotely for unscheduled care users with health anxiety: randomised controlled trial

Background Health anxiety and medically unexplained symptoms cost the National Health Service (NHS) an estimated £3 billion per year in unnecessary costs with little evidence of patient benefit. Effective treatment is rarely taken up due to issues such as stigma or previous negative experiences with mental health services. An approach to overcome this might be to offer remotely delivered psychological therapy, which can be just as effective as face-to-face therapy and may be more accessible and suitable. Aims To investigate the clinical outcomes and cost-effectiveness of remotely delivered cognitive–behavioural therapy (CBT) to people with high health anxiety repeatedly accessing unscheduled care (trial registration: NCT02298036). Method A multicentre randomised controlled trial (RCT) will be undertaken in primary and secondary care providers of unscheduled care across the East Midlands. One hundred and forty-four eligible participants will be equally randomised to receive either remote CBT (6–12 sessions) or treatment as usual (TAU). Two doctoral research studies will investigate the barriers and facilitators to delivering the intervention and the factors contributing to the optimisation of therapeutic outcome. Results This trial will be the first to test the clinical outcomes and costeffectiveness of remotely delivered CBT for the treatment of high health anxiety. Conclusions The findings will enable an understanding as to how this intervention might fit into a wider care pathway to enhance patient experience of care