ORCID Profile
0000-0002-7890-3926
Current Organisations
International School of Geneva
,
University of Bristol
,
University of Sussex
,
Guy's Hospital Medical School
,
Helios Medical Centre
,
Chengdu University
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Publications
Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care
Publisher: Oxford University Press (OUP)
Date: 06-2004
Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial
Publisher: Elsevier BV
Date: 11-2011
Psychological therapies for women who experience intimate partner violence
Publisher: Wiley
Date: 15-05-2018
Linking abuse and recovery through advocacy: an observational study
Publisher: Cambridge University Press (CUP)
Date: 30-04-2013
DOI: 10.1017/S2045796013000206
Abstract: High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial. Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' ( n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' ( n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected. Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up ( p 0.05). Service users receiving the intervention reported significant reductions in violence ( p 0.001) and unmet needs at follow-up ( p 0.05). Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.
Surface Chemistry and Band Engineering in AgSbSe2: Toward High Thermoelectric Performance
Publisher: American Chemical Society (ACS)
Date: 13-06-2023
A cluster-randomised controlled trial of a brief training session to facilitate general practitioner referral to smoking cessation treatment
Publisher: BMJ
Date: 19-02-2008
Abstract: General practitioners (GPs) are the main source of referrals to specialist smoking cessation services (SSCS), but the referral rates are low. We evaluated effects of a brief GP training session on the number of referrals received by their local SSCS. A cluster-randomised controlled trial was undertaken across three East London primary care trusts. A total of 91 GPs were randomly allocated to a training session or usual care. Participants in the intervention arm were offered a 40-min training session addressing the rationale and skills for referral of smokers for treatment. Participants in the usual care arm received referral guidance by post. The main outcome measure was the number of referrals recorded by the SSCS over 3 months after the intervention. Over the 3-month baseline period the average number of referrals per GP was 1.0 and 0.6 in the intervention and usual care arms, respectively. During the post-intervention period the mean number of referrals was 6.4 and 1.8 per GP. When adjusting for baseline variables the incidence rate ratio for the referrals from the intervention arm compared to usual care was 4.9 (p<0.001 95% CI 1.7 to 14.7). A brief training session can significantly increase GP referral to smoking cessation services. National Research Register, Department of Health, UK N0261148824 (available online at: www.nrr.nhs.uk/ViewDocument.asp?ID = N0261148824).
Screening for domestic violence
Publisher: BMJ
Date: 14-12-2002
Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study
Publisher: Royal College of Psychiatrists
Date: 03-2011
DOI: 10.1192/BJP.BP.109.072389
Abstract: Mental health service users are at high risk of domestic violence but this is often not detected by mental health services. To explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective. A qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive s ling of community mental health service users and mental healthcare professionals was used to recruit participants for in idual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence the hidden nature of the violence actions of the perpetrator and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the in idual and professional. Mental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.
Cost-effectiveness of a programme to detect and provide better care for female victims of intimate partner violence
Publisher: SAGE Publications
Date: 07-2010
DOI: 10.1258/JHSRP.2009.009032
Abstract: Primary care clinicians often fail to detect women who are victims of intimate partner violence (IPV). Our aim wasto investigate the cost-effectiveness of a programme in primary care to detect and support such women. We developed a Markov model to estimate the cost-effectiveness of education and support for primary care clinicians to increase their identification of survivors of IPV and to refer them to a specialist advocacy agency or a psychologist with specialist skills. The programme was implemented in three general practices in the United Kingdom (with an additional practice acting as a control) and provided cost data and rates of identification and referral. Other cost data and the effectiveness of IPV advocacy came from published sources. The model gave an incremental cost-effectiveness ratio (ICER) of approximately £2,450 per quality adjusted life year (QALY). Although the ratio increased in some of the sensitivity analyses, most were under a conventional willingness to pay threshold (£30,000/QALY). While there is considerable uncertainty in the underlying parameters, a training programme for primary care teams to increase identification and referral of women experiencing IPV is likely to be cost-effective.
Screening women for intimate partner violence in healthcare settings
Publisher: John Wiley & Sons, Ltd
Date: 30-04-2013
Screening women for intimate partner violence in health care settings
Publisher: John Wiley & Sons, Ltd
Date: 23-01-2008
Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): A cluster randomised controlled trial
Publisher: Elsevier BV
Date: 07-2013
Authors' reply to Whitehouse and Fabre
Publisher: BMJ
Date: 18-06-2014
DOI: 10.1136/BMJ.G3943
Cost-effectiveness of health care interventions to address intimate partner violence: What do we know and what else should we look for?
Publisher: SAGE Publications
Date: 22-02-2011
Abstract: Intimate partner violence (IPV) creates a substantial burden of disease and significant costs to families, communities, and governments. Building the evidence for effective interventions to reduce violence and its sequelae requires increased use of economic evaluation to inform policy through the analysis of costs and potential savings of interventions. The authors review existing economic evaluations and present case studies of current research from the United Kingdom and Australia to illustrate the strengths and limitations of two approaches to generating economic evidence: economic evaluation alongside randomized controlled trials and economic modeling. Economic evaluation should always be considered in the design of IPV intervention research.
Women’s experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-041339
Abstract: To identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP). The databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women’s experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of in idual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis. Thirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women’s experiences and expectations of HCPs: (1) connection through kindness and care (2) see the evil, hear the evil, speak the evil (3) do more than just listen and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women. Our findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their in idual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.
Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis
Publisher: BMJ
Date: 12-05-2014
DOI: 10.1136/BMJ.G2913
The Response of Mental Health Services to Domestic Violence
Publisher: SAGE Publications
Date: 17-09-2012
Abstract: PURPOSE: Despite numerous policies advocating for routine enquiry of abuse by mental health professionals, it is not known if such enquiry is acceptable to service users and clinicians. Furthermore, limited evidence exists on clinicians’ response to domestic violence. This study aims to explore the acceptability of routine enquiry and experiences of responding to domestic violence from service user and professional perspectives. METHODS: A qualitative study design was used to conduct in idual interviews with a purposive s le of community mental health service users ( n = 24) and professionals ( n = 25). Thematic analysis was employed to establish superordinate and subordinate themes, which were transformed into conceptual maps. RESULTS: All service users considered routine enquiry about domestic violence in mental health settings to be acceptable but a small minority of professionals did not. Service users described positive experiences of help seeking, including receiving acknowledgement for the abuse and support for their multiple needs, and negative experiences, including nonvalidating responses from clinicians following disclosure, discrimination, and an absence of support from services. Main themes for professionals included difficulties in assessment and management of domestic violence, reporting requirements, and unclear referral pathways. CONCLUSIONS: To respond to the needs of mental health service users experiencing domestic violence, services need to articulate a clear care and referral pathway.
Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
Publisher: John Wiley & Sons, Ltd
Date: 08-07-2009
Effect of Type and Severity of Intimate Partner Violence on Women's Health and Service Use: Findings From a Primary Care Trial of Women Afraid of Their Partners
Publisher: SAGE Publications
Date: 27-08-2013
Abstract: Intimate partner violence (IPV) has major affects on women’s wellbeing. There has been limited investigation of the association between type and severity of IPV and health outcomes. This article describes socio-demographic characteristics, experiences of abuse, health, safety, and use of services in women enrolled in the Women’s Evaluation of Abuse and Violence Care (WEAVE) project. We explored associations between type and severity of abuse and women’s health, quality of life, and help seeking. Women (aged 16–50 years) attending 52 Australian general practices, reporting fear of partners in last 12 months were mailed a survey between June 2008 and May 2010. Response rate was 70.5% (272/386). In the last 12 months, one third (33.0%) experienced Severe Combined Abuse, 26.2% Physical and Emotional Abuse, 26.6% Emotional Abuse and/or Harassment only, 2.7% Physical Abuse only and 12.4% scored negative on the Composite Abuse Scale. A total of 31.6% of participants reported poor or fair health and 67.9% poor social support. In the last year, one third had seen a psychologist (36.6%) or had 5 or more general practitioner visits (34.3%) 14.7% contacted IPV services and 24.4% had made a safety plan. Compared to other abuse groups, women with Severe Combined Abuse had poor quality of life and mental health, despite using more medications, counseling, and IPV services and were more likely to have days out of role because of emotional issues. In summary, women who were fearful of partners in the last year, have poor mental health and quality of life, attend health care services frequently, and domestic violence services infrequently. Those women experiencing severe combined physical, emotional, and sexual abuse have poorer quality of life and mental health than women experiencing other abuse types. Health practitioners should take a history of type and severity of abuse for women with mental health issues to assist access to appropriate specialist support.
Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
Publisher: Wiley
Date: 03-12-2015
Interventions for intimate partner violence
Publisher: Elsevier BV
Date: 2015
Interventions in Health Settings for Male Perpetrators or Victims of Intimate Partner Violence
Publisher: SAGE Publications
Date: 04-12-2017
Abstract: Intimate partner violence (IPV) is common in patients attending health-care services and is associated with a range of health problems. The majority of IPV perpetrators are men, and a substantial minority of men are victims, yet health-care professionals have little evidence or guidance on how to respond to male patients who perpetrate or experience violence in their intimate relationships. We conducted a systematic review to determine the effectiveness of interventions for male perpetrators or victims of IPV in health settings. Online databases, reference lists, Google Scholar, and gray literature were searched, and inclusion/exclusion criteria were applied. Narrative synthesis methods were used due to the heterogeneity of study types and outcome measures. Fourteen studies describing 10 interventions met our inclusion criteria: nine randomized controlled trials, four cohort studies, and one case-control study. Interventions were predominantly therapeutic in nature and many were conducted in alcohol treatment settings. Overall, the evidence for effectiveness of interventions in health-care settings was weak, although IPV interventions conducted concurrently with alcohol treatment show some promise. More work is urgently needed in health-care services to determine what interventions might be effective, and in what settings, to improve the response to male perpetrators or victims of IPV.
Patients' descriptions of angina symptoms: a qualitative study of primary care patients
Publisher: Royal College of General Practitioners
Date: 10-2010
Screening women for intimate partner violence in healthcare settings
Publisher: Wiley
Date: 22-07-2015
Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2017-020222
Abstract: To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs). Scoping review of SRs. We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring % on Assessing the Methodological Quality of Systematic Reviews (AMSTAR) quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, s le size and indication of cost-effectiveness and safety. We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK–MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind–body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety—only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data. Only one SR studied MSK–MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.
Cost-effectiveness of a domestic violence and abuse training and support programme in primary care in the real world: updated modelling based on an MRC phase IV observational pragmatic implementation
Publisher: BMJ
Date: 08-2018
DOI: 10.1136/BMJOPEN-2017-021256
Abstract: To evaluate the cost-effectiveness of the implementation of the Identification and Referral to Improve Safety (IRIS) programme using up-to-date real-world information on costs and effectiveness from routine clinical practice. A Markov model was constructed to estimate mean costs and quality-adjusted life-years (QALYs) of IRIS versus usual care per woman registered at a general practice from a societal and health service perspective with a 10-year time horizon. Cost–utility analysis in UK general practices, including data from six sites which have been running IRIS for at least 2 years across England. Based on the Markov model, which uses health states to represent possible outcomes of the intervention, we stipulated a hypothetical cohort of 10 000 women aged 16 years or older. The IRIS trial was a randomised controlled trial that tested the effectiveness of a primary care training and support intervention to improve the response to women experiencing domestic violence and abuse, and found it to be cost-effective. As a result, the IRIS programme has been implemented across the UK, generating data on costs and effectiveness outside a trial context. The IRIS programme saved £14 per woman aged 16 years or older registered in general practice (95% uncertainty interval −£151 to £37) and produced QALY gains of 0.001 per woman (95% uncertainty interval −0.005 to 0.006). The incremental net monetary benefit was positive both from a societal and National Health Service perspective (£42 and £22, respectively) and the IRIS programme was cost-effective in 61% of simulations using real-life data when the cost-effectiveness threshold was £20 000 per QALY gained as advised by National Institute for Health and Care Excellence. The IRIS programme is likely to be cost-effective and cost-saving from a societal perspective in the UK and cost-effective from a health service perspective, although there is considerable uncertainty surrounding these results, reflected in the large uncertainty intervals.
How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK, National Screening Committee critieria
Publisher: National Institute for Health and Care Research
Date: 03-2009
DOI: 10.3310/HTA13160
Abstract: The two objectives were: (1) to identify, appraise and synthesise research that is relevant to selected UK National Screening Committee (NSC) criteria for a screening programme in relation to partner violence and (2) to judge whether current evidence fulfils selected NSC criteria for the implementation of screening for partner violence in health-care settings. Fourteen electronic databases from their respective start dates to 31 December 2006. The review examined seven questions linked to key NSC criteria: QI: What is the prevalence of partner violence against women and what are its health consequences? QII: Are screening tools valid and reliable? QIII: Is screening for partner violence acceptable to women? QIV: Are interventions effective once partner violence is disclosed in a health-care setting? QV: Can mortality or morbidity be reduced following screening? QVI: Is a partner violence screening programme acceptable to health professionals and the public? QVII: Is screening for partner violence cost-effective? Data were selected using different inclusion/exclusion criteria for the seven review questions. The quality of the primary studies was assessed using published appraisal tools. We grouped the findings of the surveys, diagnostic accuracy and intervention studies, and qualitatively analysed differences between outcomes in relation to study quality, setting, populations and, where applicable, the nature of the intervention. We systematically considered each of the selected NSC criteria against the review evidence. The lifetime prevalence of partner violence against women in the general UK population ranged from 13% to 31%, and in clinical populations it was 13-35%. The 1-year prevalence ranged from 4.2% to 6% in the general population. This showed that partner violence against women is a major public health problem and potentially appropriate for screening and intervention. The HITS (Hurts, Insults, Threatens and Screams) scale was the best of several short screening tools for use in health-care settings. Most women patients considered screening acceptable (range 35-99%), although they identified potential harms. The evidence for effectiveness of advocacy is growing, and psychological interventions may be effective, but not necessarily for women identified through screening. No trials of screening programmes measured morbidity and mortality. The acceptability of partner violence screening among health-care professionals ranged from 15% to 95%, and the NSC criterion was not met. There were no cost-effectiveness studies, but a Markov model of a pilot intervention to increase identification of survivors of partner violence in general practice found that such an intervention was potentially cost-effective. Currently there is insufficient evidence to implement a screening programme for partner violence against women either in health services generally or in specific clinical settings. Recommendations for further research include: trials of system-level interventions and of psychological and advocacy interventions trials to test theoretically explicit interventions to help understand what works for whom, when and in what contexts qualitative studies exploring what women want from interventions cohort studies measuring risk factors, resilience factors and the lifetime trajectory of partner violence and longitudinal studies measuring the long-term prognosis for survivors of partner violence.
Complementary medicine and the NHS: Experiences of integration with UK primary care
Publisher: Elsevier BV
Date: 12-2018
Primary care Identification and Referral to Improve Safety of women experiencing domestic violence (IRIS): protocol for a pragmatic cluster randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 02-02-2010
Abstract: Domestic violence, which may be psychological, physical, sexual, financial or emotional, is a major public health problem due to the long-term health consequences for women who have experienced it and for their children who witness it. In populations of women attending general practice, the prevalence of physical or sexual abuse in the past year from a partner or ex-partner ranges from 6 to 23%, and lifetime prevalence from 21 to 55%. Domestic violence is particularly important in general practice because women have many contacts with primary care clinicians and because women experiencing abuse identify doctors and nurses as professionals from whom they would like to get support. Yet health professionals rarely ask about domestic violence and have little or no training in how to respond to disclosure of abuse. This protocol describes IRIS, a pragmatic cluster randomised controlled trial with the general practice as unit of randomisation. Our trial tests the effectiveness and cost-effectiveness of a training and support programme targeted at general practice teams. The primary outcome is referral of women to specialist domestic violence agencies. Forty-eight practices in two UK cities (Bristol and London) are randomly allocated, using minimisation, into intervention and control groups. The intervention, based on an adult learning model in an educational outreach framework, has been designed to address barriers to asking women about domestic violence and to encourage appropriate responses to disclosure and referral to specialist domestic violence agencies. Multidisciplinary training sessions are held with clinicians and administrative staff in each of the intervention practices, with periodic feedback of identification and referral data to practice teams. Intervention practices have a prompt to ask about abuse integrated in the electronic medical record system. Other components of the intervention include an IRIS ch ion in each practice and a direct referral pathway to a named domestic violence advocate. This is the first European randomised controlled trial of an intervention to improve the health care response to domestic violence. The findings will have the potential to inform training and service provision. ISRCTN74012786
Modulating microenvironments to enhance CO2 electroreduction performance
Publisher: Elsevier BV
Date: 06-2023
A High Conductivity 1D π–d Conjugated Metal–Organic Framework with Efficient Polysulfide Trapping‐Diffusion‐Catalysis in Lithium–Sulfur Batteries
Publisher: Wiley
Date: 28-01-2022
Abstract: The shuttling behavior and sluggish conversion kinetics of the intermediate lithium polysulfides (LiPS) represent the main obstructions to the practical application of lithium–sulfur batteries (LSBs). Herein, a 1D π–d conjugated metal–organic framework (MOF), Ni‐MOF‐1D, is presented as an efficient sulfur host to overcome these limitations. Experimental results and density functional theory calculations demonstrate that Ni‐MOF‐1D is characterized by a remarkable binding strength for trapping soluble LiPS species. Ni‐MOF‐1D also acts as an effective catalyst for S reduction during the discharge process and Li 2 S oxidation during the charging process. In addition, the delocalization of electrons in the π–d system of Ni‐MOF‐1D provides a superior electrical conductivity to improve electron transfer. Thus, cathodes based on Ni‐MOF‐1D enable LSBs with excellent performance, for ex le, impressive cycling stability with over 82% capacity retention over 1000 cycles at 3 C, superior rate performance of 575 mAh g −1 at 8 C, and a high areal capacity of 6.63 mAh cm −2 under raised sulfur loading of 6.7 mg cm −2 . The strategies and advantages here demonstrated can be extended to a broader range of π–d conjugated MOFs materials, which the authors believe have a high potential as sulfur hosts in LSBs.
Cost-effectiveness of Identification and Referral to Improve Safety (IRIS), a domestic violence training and support programme for primary care: a modelling study based on a randomised controlled tria
Publisher: BMJ
Date: 2012
HARMONY: a pragmatic cluster randomised controlled trial of a culturally competent systems intervention to prevent and reduce domestic violence among migrant and refugee families in general practice:
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2020-046431
Abstract: Domestic violence and abuse (DVA) is prevalent, harmful and more dangerous among diaspora communities because of the difficulty accessing DVA services, language and migration issues. Consequently, migrant/refugee women are common among primary care populations, but evidence for culturally competent DVA primary care practice is negligible. This pragmatic cluster randomised controlled trial aims to increase DVA identification and referral (primary outcomes) threefold and safety planning (secondary outcome) among erse women attending intervention vs comparison primary care clinics. Additionally, the study plans to improve recording of DVA, ethnicity, and conduct process and economic evaluations. Recruitment of ≤28 primary care clinics in Melbourne, Australia with high migrant/refugee communities. Eligible clinics need ≥1 South Asian general practitioner (GP) and one of two common software programmes to enable aggregated routine data extraction by GrHanite. Intervention staff undertake three DVA training sessions from a GP educator and bilingual DVA advocate/educator. Following training, clinic staff and DVA affected women 18+ will be supported for 12 months by the advocate/educator. Comparison clinics are trained in ethnicity and DVA data entry and offer routine DVA care. Data extraction of DV identification, safety planning and referral from routine GP data in both arms. Adjusted regression analysis by intention-to-treat by staff blinded to arm. Economic evaluation will estimate cost-effectiveness and cost–utility. Process evaluation interviews and analysis with primary care staff and women will be framed by Normalisation Process Theory to maximise understanding of sustainability. Harmony will be the first primary care trial to test a culturally competent model for the care of erse women experiencing DVA. Ethical approval from La Trobe University Human Ethics Committee (HEC18413) and dissemination by policy briefs, journal articles and conference and community presentations. ANZCTR- ACTRN12618001845224 Pre-results.
Women's evaluation of abuse and violence care in general practice: A cluster randomised controlled trial (weave)
Publisher: Springer Science and Business Media LLC
Date: 02-01-2010
Performing stable angina pectoris: An ethnographic study
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.SOCSCIMED.2007.12.010
Abstract: Symptoms play a crucial part in the formulation of medical diagnoses, yet the construction and interpretation of symptom narratives is not well understood. The diagnosis of angina is largely based on symptoms, but a substantial minority of patients diagnosed with "non-cardiac" chest pain go on to have a heart attack. In this ethnographic study our aims were to understand: (1) how the patients' accounts are performed or enacted in consultations with doctors (2) the ways in which ambiguity in the symptom narrative is managed by doctors and (3) how doctors reach or do not reach a diagnostic decision. We observed 59 consultations of patients in a UK teaching hospital with new onset chest pain who had been referred for a specialist opinion in ambulatory care. We found that patients rarely gave a history that, without further interrogation, satisfied the doctors, who actively restructured the complex narrative until it fitted a diagnostic canon, detaching it from the patient's interpretation and explanation. A minority of doctors asked about chest pain symptoms outside the canon. Re-structuring into the canonical classification was sometimes resisted by patients who contested key concepts, like exertion. Symptom narratives were sometimes unstable, with central features changing on interrogation and re-telling. When translation was required for South Asian patients, doctors considered the history less relevant to the diagnosis. Diagnosis and effective treatment could be enhanced by research on the diagnostic and prognostic value of the terms patients use to describe their symptoms.
Phase Engineering of Defective Copper Selenide toward Robust Lithium-Sulfur Batteries.
Publisher: American Chemical Society (ACS)
Date: 27-06-2022
Abstract: The shuttling of soluble lithium polysulfides (LiPS) and the sluggish Li-S conversion kinetics are two main barriers toward the practical application of lithium-sulfur batteries (LSBs). Herein, we propose the addition of copper selenide nanoparticles at the cathode to trap LiPS and accelerate the Li-S reaction kinetics. Using both computational and experimental results, we demonstrate the crystal phase and concentration of copper vacancies to control the electronic structure of the copper selenide, its affinity toward LiPS chemisorption, and its electrical conductivity. The adjustment of the defect density also allows for tuning the electrochemically active sites for the catalytic conversion of polysulfide. The optimized S/Cu
Selecting outcomes for intimate partner violence intervention trials: Overview and recommendations
Publisher: Elsevier BV
Date: 11-2014
“Even ‘Daily’ is Not Enough”: How Well Do We Measure Domestic Violence and Abuse?—A Think-Aloud Study of a Commonly Used Self-Report Scale
Publisher: Springer Publishing Company
Date: 2016
DOI: 10.1891/0886-6708.VV-D-15-00024
Abstract: This article explores the challenges of providing a quantitative measure of domestic violence and abuse (DVA), illustrated by the Composite Abuse Scale, a validated multidimensional measure of frequency and severity of abuse, used worldwide for prevalence studies and intervention trials. Cognitive “think-aloud” and qualitative interviewing with a s le of women who had experienced DVA revealed a tendency toward underreporting their experience of abuse, particularly of coercive control, threatening behavior, restrictions to freedom, and sexual abuse. Underreporting was linked to inconsistency and uncertainty in item interpretation and response, fear of answering truthfully, and unwillingness to identify with certain forms of abuse. Suggestions are made for rewording or reconceptualizing items and the inclusion of a distress scale to measure the in idual impact of abuse. The importance of including qualitative methods in questionnaire design and in the interpretation of quantitative findings is highlighted.
Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis
Publisher: Public Library of Science (PLoS)
Date: 16-06-2020
Disclosure of domestic violence in mental health settings: A qualitative meta-synthesis
Publisher: Informa UK Limited
Date: 08-2014
The health-systems response to violence against women
Publisher: Elsevier BV
Date: 04-2015
Erratum
Publisher: Oxford University Press (OUP)
Date: 03-2005
Violence between intimate partners: working with the whole family
Publisher: BMJ
Date: 04-08-2008
DOI: 10.1136/BMJ.A839
Related Organisations
University Of Bristol
Location: United Kingdom of Great Britain and Northern Ireland
University Of Sussex
Location: United Kingdom of Great Britain and Northern Ireland
Guy's Hospital Medical School
Location: United Kingdom of Great Britain and Northern Ireland
Helios Medical Centre
Location: United Kingdom of Great Britain and Northern Ireland
University Of Electronic Science And Technology Of China
Location: China
Related Funding Activities
No related grants have been discovered for Gene Feder.