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Biomedical subjects

Daniel Kelly

Publications and source records attributed to Daniel Kelly.

26 records · Page 2Linked to original sources

The PACE Clinic: identification and management of young people at "ultra" high risk of psychosis.

Over the past decade, both clinical and research interest in the early stages of psychotic disorders has grown. This has been associated with research suggesting that early intervention in these disorders may limit their impact on the life of the affected individual and his or her family. It has also been recognized that the biological and psychological changes underpinning the development of psychotic disorders may already be active in the prepsychotic or prodromal phase. It has been suggested that efforts to prevent psychotic disorders should be focused on this phase of emerging illness. In this article, the authors review work conducted at the PACE Clinic in Melbourne, Australia since 1994. This clinical research program was established to develop strategies for identifying young people at high risk for developing a psychotic disorder within a short period. The program has also investigated biological and psychological processes thought to underlie the development of psychosis and evaluated potential preventive interventions.

Journal Article↗

The implications of improvements in screening for prostate cancer.

With Men's Health Week running from 10 to 16 June this year, there is an increasing focus on men's health. Prostate cancer may be traditionally associated with elderly men, but with improvements in screening techniques increasing numbers of patients are being diagnosed at a younger age, perhaps changing the view of this disease.

Adult↗

Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States.

OBJECTIVE: Recognizing the prodrome of a first psychotic episode prospectively creates the opportunity of intervention, which could delay, ameliorate or even prevent onset. Valid criteria and a reliable methodology for identifying possible prodromes are needed. This paper describes an instrument, the Comprehensive Assessment of At-Risk Mental States (CAARMS), which has been designed for such a purpose. It has two functions: (i) to assess psychopathology thought to indicate imminent development of a first-episode psychotic disorder; and (ii) to determine if an individual meets criteria for being at ultra high risk (UHR) for onset of first psychotic disorder. This paper describes the pilot evaluation of the CAARMS. METHOD: Several methodologies were used to test the CAARMS. First, CAARMS scores in a group of UHR young people and the association between CAARMS scores and the risk of transition to psychotic disorder, were analysed. Second, CAARMS scores in a UHR group were compared to a control group. To assess concurrent validity, CAARMS-defined UHR criteria were compared to the existing criteria for identifying the UHR cohort. To assess predictive validity, the CAARMS-defined UHR criteria were applied to a sample of 150 non-psychotic help-seekers and rates of onset of psychotic disorder at 6-month follow-up determined for the CAARMS-positive (i.e. met UHR criteria) group and the CAARMS-negative (i.e. did not meet UHR criteria) group. The inter-rater reliability of the CAARMS was assessed by using pairs of raters. RESULTS: High CAARMS score in the UHR group was significantly associated with onset of psychotic disorder. The control group had significantly lower CAARMS scores than the UHR group. The UHR criteria assessed by the CAARMS identified a similar group to the criteria measured by existing methodology. In the sample of non-psychotic help-seekers those who were CAARMS-positive were at significantly increased risk of onset of psychotic disorder compared to those who were CAARMS-negative (relative risk of 12.44 (95% CI = 1.5-103.41, p = 0.0025)). The CAARMS had good to excellent reliability. CONCLUSIONS: In these preliminary investigations, the CAARMS displayed good to excellent concurrent, discriminant and predictive validity and excellent inter-rater reliability. The CAARMS instrument provides a useful platform for monitoring subthreshold psychotic symptoms for worsening into full-threshold psychotic disorder.

Adolescent↗

Training needs analysis: an evaluation framework.

Training needs analysis (TNA) is the first step in the training and educational strategy of an organisation and is crucial to meeting the continuing professional development needs of the healthcare workforce and service. TNA must be carefully planned, conducted and have clear outcomes to ensure that training interventions are implemented effectively and that they lead to meaningful changes in service delivery. However, there is a death of literature on approaches to critique TNA. This article describes a framework developed specifically to evaluate the effectiveness of TNA. The framework combines approaches that have been used to evaluate conventional research studies and audit.

Attitude of Health Personnel↗

Healthcare assistants: the new registration route.

A number of locally organised schemes now exist to help healthcare assistants access programmes leading to qualified nursing status. Although some schemes have been operating for some time, little has been done to evaluate their effectiveness. However, drawing on the literature that has addressed indicators of successful completion among entrants taking a more conventional route into nursing, it is possible to predict which individuals are most likely to complete courses and course-related factors that encourage successful completion.

Career Mobility↗