Publications by authors named "Lucy Webster"

Background: Digitalisation within English care homes offers potential to make more effective use of substantial data collected by staff during care planning and recording. A pilot minimum data set was co-designed with stakeholders based on two digital care records with additional structured measures. Our objectives were to explore (1) care home staff opinions and experiences of collecting structured measures of quality of life, cognition and function for residents and (2) how a minimum data set data might be used by staff and other professionals interested in care homes.

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Background: Magnetic resonance imaging (MRI) can personalise the site of transcranial magnetic stimulation (TMS) delivered as a course of 20 sessions for treatment-resistant depression (TRD). Facilitators and barriers to a randomised controlled trial (RCT) of MRI personalised TMS is understudied.

Aim: Qualitative analysis to explore facilitators and barriers behind RCT participants' experience of personalised MRI-targeted TMS in people with TRD.

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Background: Sleep disturbances are common for people with dementia and can be distressing for them and their family. People with dementia live with an average of five other long-term conditions (LTCs). Little is known about the impact of LTCs on dementia and sleep.

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Background: People living at home with dementia frequently have disturbed sleep. The multicomponent, non-pharmacological intervention DREAMS START has shown to be effective at improving sleep in this population. We aimed to conduct a cost-utility analysis of DREAMS START compared with treatment as usual (TAU).

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Background: To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes' Adoption (DACHA) study, we assessed the discriminant construct validity of QoL measures, using hypothesis testing to assess the factors associated with QoL.

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Introduction: DREAMS-START is a multicomponent intervention targeting sleep disturbance in people with dementia. To enhance understanding of the DREAMS-START randomised controlled trial, which showed improved sleep in the intervention compared to the control arm, we conducted a process evaluation exploring (i) DREAMS-START delivery, (ii) behaviour change mechanisms and (iii) contextual factors impacting outcomes.

Methods: Mixed-methods design.

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For genetic data to be used in forensic casework, it has to be produced within a controlled environment that follows strict quality standards. However, recent reviews have suggested that wildlife forensic laboratories are behind in the development and adherence to appropriate standards for casework. This paper will address these concerns by documenting the standards that have been produced, highlighting the systems of assessment and competency testing available, and reviewing the status of validated reference genetic databases.

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Hydrogen internal combustion engines offer a near-term decarbonisation pathway for hard to electrify sectors such as non-road mobile machinery (NRMM). However, few hydrogen-specific engines have ever been developed with the twin-goals of maximising low carbon energy efficiency and delivering air quality co-benefits. We present analyses of dynamometer-derived nitrogen oxides (NO) tailpipe emissions from four variants of a ∼55 kW four-cylinder port fuelled injection spark ignition hydrogen internal combustion engine (H2ICE) suitable for a range of uses within the NRMM industry.

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Objectives: To assess the feasibility of capturing older care home residents' quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach's alpha) of four QoL measures.

Design: Cross-sectional data collected in wave 1 of the DACHA (eveloping resources nd minimum dataset for are omes' doption) study, a mixed-methods pilot of a prototype minimum dataset (MDS).

Setting: Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia.

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Background: We developed a prototype minimum data set (MDS) for English care homes, assessing feasibility of extracting data directly from digital care records (DCRs) with linkage to health and social care data.

Methods: Through stakeholder development workshops, literature reviews, surveys and public consultation, we developed an aspirational MDS. We identified ways to extract this from existing sources, including DCRs and routine health and social care datasets.

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Objective: Aging-related changes and caregiver burden may increase the risk for sleep disturbances among older caregivers, yet few studies have examined the prevalence of insomnia and daytime sleepiness in this group. We examined the relationship of caregiver status with insomnia and daytime sleepiness among persons of advanced age (>75 years of age).

Design: Cross-sectional.

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Background: The BRIGhTMIND study was a double-blind RCT comparing repetitive transcranial magnetic stimulation at a standard simulation site (the "F3" location given by the International 10-20 system, F3-rTMS) versus connectivity-guided intermittent theta burst stimulation (cgiTBS) for treatment-resistant depression. This present study reports the acceptability, safety, and tolerability of F3-rTMS versus cgiTBS.

Methods: The present study used quantitative and qualitative methods.

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Background: Sleep disturbances are common and distressing for people with dementia and their families. Non-pharmacological interventions should be first-line management, avoiding harmful pharmacological side-effects, but there is none with known effectiveness. We aimed to establish whether DREAMS START, a multicomponent intervention, reduced sleep disturbance in people with dementia living at home compared with usual care.

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Background: The Developing research resources And minimum data set for Care Homes' Adoption and use or DACHA study aims to create a prototype minimum data set combining residents' information recorded by care homes with their data held in health and social care data sets. The DACHA minimum data set will contain information on quality of life. Internationally and in the UK, there is no consensus on collecting information on quality of life in a standardised format equivalent to the consensus for health measures.

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Purpose: This study aimed to adapt and assess the content validity of the ASCOT Easy Read (ASCOT-ER) for older people accessing social care.

Methods: A co-production working group of 8 older social care users and their supporters was established to evaluate the comprehensibility and relevance of the ASCOT-ER images, wording and layout. Changes made by the working group were iteratively tested using cognitive interviewing techniques (think aloud) with 25 older social care users not able to self-complete the original ASCOT.

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Purpose: Rasch analysis and exploratory factor analysis (EFA) were used to evaluate the structural validity of the ASCOT-Proxy measures completed by staff on behalf of older adults resident in care homes, by comparison to the ASCOT-SCT4, the measure of social care-related quality of life (SCRQoL) from which the ASCOT-Proxy was developed.

Methods: EFA was conducted on the ASCOT-SCT4 and the two ASCOT-Proxy measures (Proxy-Proxy, Proxy-Resident), to determine if they retained the single factor of the original ASCOT-SCT4 measure found in samples of older community-dwelling adults. Rasch analysis was also applied to measures with a single factor structure in the EFA.

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Introduction: Many people living with dementia experience sleep disturbance and there are no known effective treatments. Non-pharmacological treatment options should be the first-line sleep management. For family carers, relatives' sleep disturbance leads to interruption of their sleep, low mood and breakdown of care.

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Repetitive transcranial magnetic stimulation (rTMS), delivered to left dorsolateral prefrontal cortex, is an FDA-approved, and NICE-recommended, neuromodulation therapy for major depressive disorder (MDD). However, there is considerable inter-individual variability in rate and extent of clinical response, leading to a focus on approaches for optimising its effectiveness. We present findings from a non-patient study evaluating an approach that combines an efficient type of rTMS-"intermittent theta burst stimulation" (iTBS)-with a second neuromodulation technique-"transcranial alternating current stimulation" (tACS).

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Disruption in reciprocal connectivity between the right anterior insula and the left dorsolateral prefrontal cortex is associated with depression and may be a target for neuromodulation. In a five-center, parallel, double-blind, randomized controlled trial we personalized resting-state functional magnetic resonance imaging neuronavigated connectivity-guided intermittent theta burst stimulation (cgiTBS) at a site based on effective connectivity from the right anterior insula to the left dorsolateral prefrontal cortex. We tested its efficacy in reducing the primary outcome depression symptoms measured by the GRID Hamilton Depression Rating Scale 17-item over 8, 16 and 26 weeks, compared with structural magnetic resonance imaging (MRI) neuronavigated repetitive transcranial magnetic stimulation (rTMS) delivered at the standard stimulation site (F3) in patients with 'treatment-resistant depression'.

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Objective: This systematic review identified key components of risk assessment for people with dementia, examined attitudes toward risk identification and risk assessment, and appraised existing risk assessment tools.

Methods: Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool.

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Purpose: There has been little research providing an in-depth exploration of the reasons behind research participants, particularly in mental health settings, requesting copies of their research data, such as magnetic resonance imaging (MRI) scans. BRIGhTMIND is a large double blind randomised controlled trial using functional and structural magnetic resonance imaging to create personalised targets for transcranial magnetic stimulation delivery, and a number of trial participants requested copies of these scans.

Methods: Seven participants involved in the BRIGhTMIND trial completed semi-structured interviews exploring their reasons behind their request for copies of their MRI scans.

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Introduction: Health and care data are routinely collected about care home residents in England, yet there is no way to collate these data to inform benchmarking and improvement. The Developing research resources And minimum data set for Care Homes' Adoption and use study has developed a prototype minimum data set (MDS) for piloting.

Methods And Analysis: A mixed-methods longitudinal pilot study will be conducted in 60 care homes (approximately 960 residents) in 3 regions of England, using resident data from cloud-based digital care home records at two-time points.

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Objectives: We culturally adapted STrAtegies for RelaTives (START), a clinically and cost-effective intervention for dementia family carers, for Black and South Asian families. It had previously been delivered to family carers around the time of diagnosis, when most people with dementia had very mild, mild or moderate dementia.

Methods: We interviewed a maximum variation sample of family carers (phase one; n = 15 South Asian; n = 11 Black) about what aspect of START, required cultural adaptation, then analysed it thematically using the Cultural Treatment Adaptation Framework then adapted it in English and into Urdu.

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