Summary: Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked the... more Summary: Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counselling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging...
The aim of the study was to determine the reliability and validity of a self-report symptom check... more The aim of the study was to determine the reliability and validity of a self-report symptom checklist designed for use in HIV infection. One hundred and seventy-one gay men completed a 28-item symptom checklist which produces 3 dimensions: physical, cognitive and psychological. The validity of each dimension was examined by comparing scores on the checklist with indices of disease progression and previously validated psychological scales. People with more advanced HIV disease had higher scores on the physical and cognitive checklists, though the psychological scale was not related to disease stage. All the scales showed moderate correlations with measures of psychological health. Examination of individual item responses suggested that patients over-reported the presence of some symptoms. Although individual items should be interpreted with caution, the overall scores of the RSC are reliable and valid as measures of subjective health status in HIV infection. The importance of psychol...
In 2011 Sussex Partnership NHS Foundation Trust introduced formulation as a central part of its n... more In 2011 Sussex Partnership NHS Foundation Trust introduced formulation as a central part of its new service model. This paper documents the final phase of the project: evaluating to what extent, one year on from the initial training, teams have been successful in integrating formulation into their practice.
This study evaluates psychology-led formulation sessions within an assessment and treatment servi... more This study evaluates psychology-led formulation sessions within an assessment and treatment service. Five staff members completed interviews exploring their experiences of formulation and their perception of its usefulness to clients. Results suggested that they perceived formulation to be beneficial on a number of levels for themselves and their practice but were uncertain about the tangible benefits for clients.
The effect of early antiretroviral medication with zidovudine on neurophysiological functions was... more The effect of early antiretroviral medication with zidovudine on neurophysiological functions was evaluated in subjects with asymptomatic HIV-l infection. Patients were recruited participants of a larger double-blind randomised placebo-controlled treatment trial with zidovudine (Concorde). The main outcome measures included: quantitative electroencephalography (QEEG), auditory event-related potentials (AEP) and pattern-reversal visual evoked potentials (PRVEP), as well as standard clinical, virological and immunological markers. No significant impairment and no difference between treatment groups was found in visual PlOO latency and auditory long-latency P3 responses which is in agreement with the absence of neurological and neuropsychological impairment over the study period. Significant treatment effects were revealed by quantitative electroencephalography (QEEG). While the placebo group showed a significant increase in delta and theta slow frequency QEEG activity over the study p...
Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views ... more Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counseling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging in high r...
Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychologi... more Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychological and medical assessment in neurologically healthy subjects with asymptomatic and symptomatic human immunodeficiency virus type 1 (HIV-1) infection. Auditory and visual ERPs, recorded using standard oddball paradigms, disclosed delays in late waves (N2 and P3) in symptomatic subjects (CDC stage IV) when compared with matched controls. Abnormally delayed P3 waves in at least one modality were recorded in 41% of symptomatics and this was associated with deficits in neuropsychological performance, particularly psychomotor slowing. However, no differences in late wave latencies between asymptomatic and control subjects were found, though asymptomatics showed delays in auditory N1 and P2 latencies. The number of morphological abnormalities, such as indiscernible late waves as well as topographical variability of the P3 wave, was increased in both HIV seropositive groups and possibly indicates a distinct mechanism of impairment, different from latency delay. Whilst P3 delay in symptomatics was not associated with changes in immune function (T4 cells) there was, however, a link with anaemia and subclinical hepatic dysfunction.
The effect of early antiretroviral medication with zidovudine on neurophysiological functions was... more The effect of early antiretroviral medication with zidovudine on neurophysiological functions was evaluated in subjects with asymptomatic HIV-1 infection. Patients were recruited participants of a larger double-blind randomised placebo-controlled treatment trial with zidovudine (Concorde). The main outcome measures included: quantitative electroencephalography (QEEG), auditory event-related potentials (AEP) and pattern-reversal visual evoked potentials (PRVEP), as well as standard clinical, virological and immunological markers. No significant impairment and no difference between treatment groups was found in visual P100 latency and auditory long-latency P3 responses which is in agreement with the absence of neurological and neuropsychological impairment over the study period. Significant treatment effects were revealed by quantitative electroencephalography (QEEG). While the placebo group showed a significant increase in delta and theta slow frequency QEEG activity over the study period, slow wave amplitude remained unchanged in the zidovudine group after a mean follow-up period of 28 months. In summary, the data provide evidence for a low level neuropathological process in asymptomatic HIV-1 infection which can be effectively suppressed by antiretroviral medication.
The aim of the study was to determine the reliability and validity of a self-report symptom check... more The aim of the study was to determine the reliability and validity of a self-report symptom checklist designed for use in HIV infection. One hundred and seventy-one gay men completed a 28-item symptom checklist which produces 3 dimensions: physical, cognitive and psychological. The validity of each dimension was examined by comparing scores on the checklist with indices of disease progression and previously validated psychological scales. People with more advanced HIV disease had higher scores on the physical and cognitive checklists, though the psychological scale was not related to disease stage. All the scales showed moderate correlations with measures of psychological health. Examination of individual item responses suggested that patients over-reported the presence of some symptoms. Although individual items should be interpreted with caution, the overall scores of the RSC are reliable and valid as measures of subjective health status in HIV infection. The importance of psychological factors in the reporting of symptoms suggests that symptom checklists should be interpreted in the light of adequate measures of psychological state.
Summary: Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked the... more Summary: Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counselling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging...
The aim of the study was to determine the reliability and validity of a self-report symptom check... more The aim of the study was to determine the reliability and validity of a self-report symptom checklist designed for use in HIV infection. One hundred and seventy-one gay men completed a 28-item symptom checklist which produces 3 dimensions: physical, cognitive and psychological. The validity of each dimension was examined by comparing scores on the checklist with indices of disease progression and previously validated psychological scales. People with more advanced HIV disease had higher scores on the physical and cognitive checklists, though the psychological scale was not related to disease stage. All the scales showed moderate correlations with measures of psychological health. Examination of individual item responses suggested that patients over-reported the presence of some symptoms. Although individual items should be interpreted with caution, the overall scores of the RSC are reliable and valid as measures of subjective health status in HIV infection. The importance of psychol...
In 2011 Sussex Partnership NHS Foundation Trust introduced formulation as a central part of its n... more In 2011 Sussex Partnership NHS Foundation Trust introduced formulation as a central part of its new service model. This paper documents the final phase of the project: evaluating to what extent, one year on from the initial training, teams have been successful in integrating formulation into their practice.
This study evaluates psychology-led formulation sessions within an assessment and treatment servi... more This study evaluates psychology-led formulation sessions within an assessment and treatment service. Five staff members completed interviews exploring their experiences of formulation and their perception of its usefulness to clients. Results suggested that they perceived formulation to be beneficial on a number of levels for themselves and their practice but were uncertain about the tangible benefits for clients.
The effect of early antiretroviral medication with zidovudine on neurophysiological functions was... more The effect of early antiretroviral medication with zidovudine on neurophysiological functions was evaluated in subjects with asymptomatic HIV-l infection. Patients were recruited participants of a larger double-blind randomised placebo-controlled treatment trial with zidovudine (Concorde). The main outcome measures included: quantitative electroencephalography (QEEG), auditory event-related potentials (AEP) and pattern-reversal visual evoked potentials (PRVEP), as well as standard clinical, virological and immunological markers. No significant impairment and no difference between treatment groups was found in visual PlOO latency and auditory long-latency P3 responses which is in agreement with the absence of neurological and neuropsychological impairment over the study period. Significant treatment effects were revealed by quantitative electroencephalography (QEEG). While the placebo group showed a significant increase in delta and theta slow frequency QEEG activity over the study p...
Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views ... more Fifty surgeons and 72 preoperative patients in 2 central London hospitals were asked their views on preoperative HIV antibody testing, who is at risk of HIV infection and HIV test counseling. A substantial proportion of both surgeons and preoperative patients, 48% and 54% respectively, supported compulsory HIV antibody testing without patient consent. They believed this should occur as a routine practice prior to surgery. However, surgeons and patients differed in the preoperative patients to be considered for such testing. All surgeons advocating compulsory testing believed that it was only necessary for those patients belonging to high risk groups whilst preoperative patients believed that all patients should be HIV tested prior to surgery. Surgeons and patients also differed in their views on who was at risk of HIV infection. Surgeons believed those at risk to be members of identifiable risk groups whilst patients believed everyone was at risk, especially those engaging in high r...
Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychologi... more Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychological and medical assessment in neurologically healthy subjects with asymptomatic and symptomatic human immunodeficiency virus type 1 (HIV-1) infection. Auditory and visual ERPs, recorded using standard oddball paradigms, disclosed delays in late waves (N2 and P3) in symptomatic subjects (CDC stage IV) when compared with matched controls. Abnormally delayed P3 waves in at least one modality were recorded in 41% of symptomatics and this was associated with deficits in neuropsychological performance, particularly psychomotor slowing. However, no differences in late wave latencies between asymptomatic and control subjects were found, though asymptomatics showed delays in auditory N1 and P2 latencies. The number of morphological abnormalities, such as indiscernible late waves as well as topographical variability of the P3 wave, was increased in both HIV seropositive groups and possibly indicates a distinct mechanism of impairment, different from latency delay. Whilst P3 delay in symptomatics was not associated with changes in immune function (T4 cells) there was, however, a link with anaemia and subclinical hepatic dysfunction.
The effect of early antiretroviral medication with zidovudine on neurophysiological functions was... more The effect of early antiretroviral medication with zidovudine on neurophysiological functions was evaluated in subjects with asymptomatic HIV-1 infection. Patients were recruited participants of a larger double-blind randomised placebo-controlled treatment trial with zidovudine (Concorde). The main outcome measures included: quantitative electroencephalography (QEEG), auditory event-related potentials (AEP) and pattern-reversal visual evoked potentials (PRVEP), as well as standard clinical, virological and immunological markers. No significant impairment and no difference between treatment groups was found in visual P100 latency and auditory long-latency P3 responses which is in agreement with the absence of neurological and neuropsychological impairment over the study period. Significant treatment effects were revealed by quantitative electroencephalography (QEEG). While the placebo group showed a significant increase in delta and theta slow frequency QEEG activity over the study period, slow wave amplitude remained unchanged in the zidovudine group after a mean follow-up period of 28 months. In summary, the data provide evidence for a low level neuropathological process in asymptomatic HIV-1 infection which can be effectively suppressed by antiretroviral medication.
The aim of the study was to determine the reliability and validity of a self-report symptom check... more The aim of the study was to determine the reliability and validity of a self-report symptom checklist designed for use in HIV infection. One hundred and seventy-one gay men completed a 28-item symptom checklist which produces 3 dimensions: physical, cognitive and psychological. The validity of each dimension was examined by comparing scores on the checklist with indices of disease progression and previously validated psychological scales. People with more advanced HIV disease had higher scores on the physical and cognitive checklists, though the psychological scale was not related to disease stage. All the scales showed moderate correlations with measures of psychological health. Examination of individual item responses suggested that patients over-reported the presence of some symptoms. Although individual items should be interpreted with caution, the overall scores of the RSC are reliable and valid as measures of subjective health status in HIV infection. The importance of psychological factors in the reporting of symptoms suggests that symptom checklists should be interpreted in the light of adequate measures of psychological state.
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