In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simp... more In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation.
Background. Since the start of an unprecedented vaccination campaign against Covid-19 the authors... more Background. Since the start of an unprecedented vaccination campaign against Covid-19 the authors have started to come across rheumatology patients who were reluctant to have vaccination. Due to the diversity of the local population it was hypothesised that certain socio economic characteristics were predictive of vaccine hesitancy. The aim of this study was to assess the uptake of Covid-19 vaccine among patients attending rheumatology clinics in a large District General Hospital (DGH) in the East of England, as well as to establish perceived barriers in receiving Covid-19 vaccine and to assess the extent of vaccine hesitancy among the target population. Methods. This single centre cross-sectional observational pilot study was conducted using questionnaires distributed to patients attending rheumatology outpatients for a face to face appointment. Data were collected on baseline social and demographic characteristics as well as knowledge, attitude and behaviours regarding coronavirus...
SUMMARYBackgroundWe evaluated the use of baricitinib, a Janus kinase (JAK) 1/2 inhibitor, for the... more SUMMARYBackgroundWe evaluated the use of baricitinib, a Janus kinase (JAK) 1/2 inhibitor, for the treatment of patients admitted to hospital because of COVID-19.MethodsThis randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting patients were randomly allocated (1:1) to either usual standard of care alone (usual care group) or usual care plus baricitinib 4 mg once daily by mouth for 10 days or until discharge if sooner (baricitinib group). The primary outcome was 28-day mortality assessed in the intention-to-treat population. A meta-analysis was conducted that included the results from the RECOVERY trial and all previous randomised controlled trials of baricitinib or other JAK inhibitor in patients hospitalised with COVID-19. The RECOVERY trial is registered with ISRCTN (50189673) andclinicaltrials.gov(NCT04381936).FindingsBetween...
to establish test-retest reliability. Convergent validation was established by administering the ... more to establish test-retest reliability. Convergent validation was established by administering the Revised Children’s Manifest Anxiety Scale (RCMAS) at 2 months. Factor analysis was conducted to examine the underlying structure of the Y-CCIIS. 44 children completed the Y-CCIIS 2 months post-ENT day surgery to establish construct validation. Results: Y-CCIIS means scores were significantly higher in the PICU group (t(142)=3.421, p=.001). Factor analysis supported a 3 factor solution: worries about getting sick/not getting better; feeling things have changed (externally & internally); feeling anxious and fearful when thinking about hospital. PICU children scored significantly higher than ENT children on all factors. The Y-CCIIS demonstrated good internal consistency (Cronbach’s alpha=0.78), and test-retest reliability (Intraclass Correlation Coefficient=0.72). Convergent validation was supported by a moderate correlation between Y-CCIIS and RCMAS scores (Pearson’s correlation coefficient=0.54). Conclusions: Psychometrically sound instruments are essential to identify children requiring psychological support services postPICU hospitalization. The Y-CCIIS is a promising self-report measure for young children.
Journal of Prenatal and Perinatal Psychology and Health, 2007
The emotional distress resulting from the experience of giving birth to a preterm infant (gestati... more The emotional distress resulting from the experience of giving birth to a preterm infant (gestational age , 37 weeks) and the subsequent neonatal unit hospitalisation may be a traumatic experience for parents. In the present systematic literature review, studies on parental posttraumatic symptomatology following birth of a premature infant were reviewed. A total of 5 studies were identified. All studies reviewed found that posttraumatic symptomatology is quite common in parents or primary caregivers of premature infants. However, methodological weaknesses of relevant studies (e.g. use of convenience samples, lack of pre – delivery assessments) make it difficult to draw consistent conclusions regarding prevalence of posttraumatic symptomatology in this population group or whether the experience of a premature birth could be responsible for the development of PTSD. Directions for future research are discussed.
Background: Poor recruitment is a widespread problem in health research, especially for studies r... more Background: Poor recruitment is a widespread problem in health research, especially for studies recruiting children and families in community settings. The Theoretical Domains Framework provides a theory-based lens through which recruitment behaviour can be understood, with a view to developing theory based strategies to improve recruitment. Aim: To explore influences on study recruitment behaviour of health visitors and community midwives. Method: Health visitors and community midwives working in England in four NHS Trusts and one Community Partnership were invited to take part in the study. Participants completed a self-reported, anonymous, online, cross-sectional survey with questions about recruitment behaviour adapted from the Theoretical Domains Framework. Qualitative data from open-answered survey questions were analysed using directed content analysis. Results: The survey was completed by 114 health visitors and community midwives (37% response rate).Two theoretical domains ...
This literature review is part of the Review of Nursing in the Community in Scotland. The review ... more This literature review is part of the Review of Nursing in the Community in Scotland. The review aims to explore the evidence base for nursing in the community in relation to the key messages within the Kerr Report (Scottish Executive (SE), 2005a) and Delivering for Health (SE, 2005b) . The remit of the literature review was to conduct a literature search, synthesise the findings and produce a report within a three month period. This timescale has impacted on the scale of work undertaken. To fully evaluate the effectiveness of nursing interventions would have involved carrying out rigorous systematic reviews of each area of nursing in the community. Restricting the review to pooling evidence from systematic reviews would have strengthened the results, conclusions and recommendations drawn. However, systematic reviews of interventions carried out by nurses in the community are limited and this would have severely restricted the coverage of the review and utility of the conclusions. T...
The emotional distress resulting from the experience of giving birth to a preterm infant (gestati... more The emotional distress resulting from the experience of giving birth to a preterm infant (gestational age <37 weeks) and the subsequent neonatal unit hospitalisation may be a traumatic experience for parents. In the present systematic literature review, studies on parental posttraumatic symptomatology following birth of a premature infant were reviewed. A total of 5 studies were indentified. All studies reviewed found that posttraumatic symptomatology is quite common in parents or primary caregivers of premature infants. However, methodological weaknesses of relevant studies (e.g. use of convenience samples, lack of pre-delivery assessments) make it difficult to draw consistent conclusions regarding prevalence of posttraumatic symptomatology in this population group or whether the experience of a premature birth could be responsible for the development of PTSD. Directions for future research are discussed.
This literature review is part of the Review of Nursing in the Community in Scotland. The review ... more This literature review is part of the Review of Nursing in the Community in Scotland. The review aims to explore the evidence base for nursing in the community in relation to the key messages within the Kerr Report (Scottish Executive (SE), 2005a) and Delivering for ...
Background Recruitment of pregnant or postnatal women and young families into health research is ... more Background Recruitment of pregnant or postnatal women and young families into health research is a challenge. Community midwives and health visitors are well placed to invite service users to participate, but evidence suggests that they do not always invite all potentially eligible service users. Our aim was to use the Theoretical Domains Framework to explore health visitors’ and community midwives’ perceived barriers and enablers to approaching service users about participation in research and to use the Behaviour Change Wheel to suggest theory-based strategies to improve future recruitment. Methods Health visitors and community midwives working in four NHS Trusts and one community partnership in England were invited to complete an anonymous, online survey. The sample comprised health visitors (n=39) and community midwives (n=22). Qualitative data from open-ended questions about recruitment behaviour informed by the Theoretical Domains Framework were analysed using directed content...
Background: Successful research is frequently hampered by poor study recruitment, especially in c... more Background: Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors (HVs) and community midwives (CMs) are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively. Aim: This study uses the Theoretical Domains Framework (TDF) to explore the factors that influence whether HVs and CMs invite eligible patients to take part in research opportunities. Method: HVs (n = 39) and CMs (n = 22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in the research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patien...
In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simp... more In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation.
Background. Since the start of an unprecedented vaccination campaign against Covid-19 the authors... more Background. Since the start of an unprecedented vaccination campaign against Covid-19 the authors have started to come across rheumatology patients who were reluctant to have vaccination. Due to the diversity of the local population it was hypothesised that certain socio economic characteristics were predictive of vaccine hesitancy. The aim of this study was to assess the uptake of Covid-19 vaccine among patients attending rheumatology clinics in a large District General Hospital (DGH) in the East of England, as well as to establish perceived barriers in receiving Covid-19 vaccine and to assess the extent of vaccine hesitancy among the target population. Methods. This single centre cross-sectional observational pilot study was conducted using questionnaires distributed to patients attending rheumatology outpatients for a face to face appointment. Data were collected on baseline social and demographic characteristics as well as knowledge, attitude and behaviours regarding coronavirus...
SUMMARYBackgroundWe evaluated the use of baricitinib, a Janus kinase (JAK) 1/2 inhibitor, for the... more SUMMARYBackgroundWe evaluated the use of baricitinib, a Janus kinase (JAK) 1/2 inhibitor, for the treatment of patients admitted to hospital because of COVID-19.MethodsThis randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting patients were randomly allocated (1:1) to either usual standard of care alone (usual care group) or usual care plus baricitinib 4 mg once daily by mouth for 10 days or until discharge if sooner (baricitinib group). The primary outcome was 28-day mortality assessed in the intention-to-treat population. A meta-analysis was conducted that included the results from the RECOVERY trial and all previous randomised controlled trials of baricitinib or other JAK inhibitor in patients hospitalised with COVID-19. The RECOVERY trial is registered with ISRCTN (50189673) andclinicaltrials.gov(NCT04381936).FindingsBetween...
to establish test-retest reliability. Convergent validation was established by administering the ... more to establish test-retest reliability. Convergent validation was established by administering the Revised Children’s Manifest Anxiety Scale (RCMAS) at 2 months. Factor analysis was conducted to examine the underlying structure of the Y-CCIIS. 44 children completed the Y-CCIIS 2 months post-ENT day surgery to establish construct validation. Results: Y-CCIIS means scores were significantly higher in the PICU group (t(142)=3.421, p=.001). Factor analysis supported a 3 factor solution: worries about getting sick/not getting better; feeling things have changed (externally & internally); feeling anxious and fearful when thinking about hospital. PICU children scored significantly higher than ENT children on all factors. The Y-CCIIS demonstrated good internal consistency (Cronbach’s alpha=0.78), and test-retest reliability (Intraclass Correlation Coefficient=0.72). Convergent validation was supported by a moderate correlation between Y-CCIIS and RCMAS scores (Pearson’s correlation coefficient=0.54). Conclusions: Psychometrically sound instruments are essential to identify children requiring psychological support services postPICU hospitalization. The Y-CCIIS is a promising self-report measure for young children.
Journal of Prenatal and Perinatal Psychology and Health, 2007
The emotional distress resulting from the experience of giving birth to a preterm infant (gestati... more The emotional distress resulting from the experience of giving birth to a preterm infant (gestational age , 37 weeks) and the subsequent neonatal unit hospitalisation may be a traumatic experience for parents. In the present systematic literature review, studies on parental posttraumatic symptomatology following birth of a premature infant were reviewed. A total of 5 studies were identified. All studies reviewed found that posttraumatic symptomatology is quite common in parents or primary caregivers of premature infants. However, methodological weaknesses of relevant studies (e.g. use of convenience samples, lack of pre – delivery assessments) make it difficult to draw consistent conclusions regarding prevalence of posttraumatic symptomatology in this population group or whether the experience of a premature birth could be responsible for the development of PTSD. Directions for future research are discussed.
Background: Poor recruitment is a widespread problem in health research, especially for studies r... more Background: Poor recruitment is a widespread problem in health research, especially for studies recruiting children and families in community settings. The Theoretical Domains Framework provides a theory-based lens through which recruitment behaviour can be understood, with a view to developing theory based strategies to improve recruitment. Aim: To explore influences on study recruitment behaviour of health visitors and community midwives. Method: Health visitors and community midwives working in England in four NHS Trusts and one Community Partnership were invited to take part in the study. Participants completed a self-reported, anonymous, online, cross-sectional survey with questions about recruitment behaviour adapted from the Theoretical Domains Framework. Qualitative data from open-answered survey questions were analysed using directed content analysis. Results: The survey was completed by 114 health visitors and community midwives (37% response rate).Two theoretical domains ...
This literature review is part of the Review of Nursing in the Community in Scotland. The review ... more This literature review is part of the Review of Nursing in the Community in Scotland. The review aims to explore the evidence base for nursing in the community in relation to the key messages within the Kerr Report (Scottish Executive (SE), 2005a) and Delivering for Health (SE, 2005b) . The remit of the literature review was to conduct a literature search, synthesise the findings and produce a report within a three month period. This timescale has impacted on the scale of work undertaken. To fully evaluate the effectiveness of nursing interventions would have involved carrying out rigorous systematic reviews of each area of nursing in the community. Restricting the review to pooling evidence from systematic reviews would have strengthened the results, conclusions and recommendations drawn. However, systematic reviews of interventions carried out by nurses in the community are limited and this would have severely restricted the coverage of the review and utility of the conclusions. T...
The emotional distress resulting from the experience of giving birth to a preterm infant (gestati... more The emotional distress resulting from the experience of giving birth to a preterm infant (gestational age <37 weeks) and the subsequent neonatal unit hospitalisation may be a traumatic experience for parents. In the present systematic literature review, studies on parental posttraumatic symptomatology following birth of a premature infant were reviewed. A total of 5 studies were indentified. All studies reviewed found that posttraumatic symptomatology is quite common in parents or primary caregivers of premature infants. However, methodological weaknesses of relevant studies (e.g. use of convenience samples, lack of pre-delivery assessments) make it difficult to draw consistent conclusions regarding prevalence of posttraumatic symptomatology in this population group or whether the experience of a premature birth could be responsible for the development of PTSD. Directions for future research are discussed.
This literature review is part of the Review of Nursing in the Community in Scotland. The review ... more This literature review is part of the Review of Nursing in the Community in Scotland. The review aims to explore the evidence base for nursing in the community in relation to the key messages within the Kerr Report (Scottish Executive (SE), 2005a) and Delivering for ...
Background Recruitment of pregnant or postnatal women and young families into health research is ... more Background Recruitment of pregnant or postnatal women and young families into health research is a challenge. Community midwives and health visitors are well placed to invite service users to participate, but evidence suggests that they do not always invite all potentially eligible service users. Our aim was to use the Theoretical Domains Framework to explore health visitors’ and community midwives’ perceived barriers and enablers to approaching service users about participation in research and to use the Behaviour Change Wheel to suggest theory-based strategies to improve future recruitment. Methods Health visitors and community midwives working in four NHS Trusts and one community partnership in England were invited to complete an anonymous, online survey. The sample comprised health visitors (n=39) and community midwives (n=22). Qualitative data from open-ended questions about recruitment behaviour informed by the Theoretical Domains Framework were analysed using directed content...
Background: Successful research is frequently hampered by poor study recruitment, especially in c... more Background: Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors (HVs) and community midwives (CMs) are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively. Aim: This study uses the Theoretical Domains Framework (TDF) to explore the factors that influence whether HVs and CMs invite eligible patients to take part in research opportunities. Method: HVs (n = 39) and CMs (n = 22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in the research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patien...
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Papers by Fiona Maxton