PubMed Health⌕ Search

Biomedical subjects

Jeremy N V Miles

Publications and source records attributed to Jeremy N V Miles.

13 recordsLinked to original sources
PubMed2007

Distribution of CORE-OM scores in a general population, clinical cut-off points and comparison with the CIS-R.

BACKGROUND: Although measures of psychopathology are designed for use in clinical populations, their meaning derives from comparison with normal populations. AIMS: To compare the distribution of scores on the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) from a general population sample with the distribution in an aggregated clinical sample to derive recommended cut-off points for determining clinical significance. METHOD: The CORE-OM general population sample was based on a weighted subsample of participants in the psychiatric morbidity follow-up survey who completed valid CORE-OM forms following their interview (effective n=535). RESULTS: Comparison of the CORE-OM general population sample with a clinical sample aggregated from previous studies (n=10761) yielded a cut-off score of 9.9 on the 0-40 scale of the CORE-OM. The CORE-OM was highly correlated (r=0.77) with the Clinical Interview Schedule-Revised, supporting convergent validity. CONCLUSIONS: We recommend rounding the CORE-OM cut-off score to 10. However, cut-off scores must be used thoughtfully and adjusted to fit context and purpose.

Adolescent↗
PubMed2006

The four-dimensional stress test: psychological, sympathetic-adrenal-medullary, parasympathetic and hypothalamic-pituitary-adrenal responses following inhalation of 35% CO2.

BACKGROUND: Hypercapnia is a threat to homeostasis and results in neuroendocrine, autonomic and anxiogenic responses. The inhalation of carbon dioxide (CO2) may, therefore, provide a good paradigm for exploring the pathways by which stress can lead to increased susceptibility to ill-health through physiological and psychological stress reactivity. The current study was designed, therefore, to assess the psychological and physiological responses to the inhalation of CO2. METHODS: Healthy participants (N = 24) inhaled a single vital capacity breath of a mixture of CO2 (35%) and oxygen (65%). Blood pressure and heart rate were recorded for 5 min before and after the test and blood and saliva samples were taken immediately before and 2, 10, 20 and 30 min post-inhalation for the measurement of noradrenaline, salivary and serum cortisol and salivary alpha amylase. In addition, psychosomatic symptoms were recorded immediately before and after the test. The same protocol was repeated 4-6 weeks later at the same time of day. RESULTS: A single inhalation of CO2 increased blood pressure, noradrenaline, salivary alpha amylase and psychosomatic symptoms, but decreased heart rate at both testing sessions. Analyses of salivary cortisol data revealed that 70% of the sample could be reliably classified as either responders (i.e. demonstrated a post-CO2 cortisol increase) or non-responders (i.e. responded with a decrease or no change in cortisol following CO2) at both test sessions. Responders also perceived the test to be more aversive than non-responders. CONCLUSIONS: Inhalation of 35% CO2 reliably stimulated the key mechanisms involved in the human stress response. The inter-individual differences in the reactivity of the hypothalamic-pituitary-adrenal axis were also related to differences in the perception of the test.

Administration, Inhalation↗
PubMed2006

Dose-effect relations and responsive regulation of treatment duration: the good enough level.

This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.

Adaptation, Psychological↗
PubMed2006

Efficacy of small group reading intervention for beginning readers with reading-delay: a randomised controlled trial.

BACKGROUND: This study evaluated the effectiveness of an intervention for reading-delayed children in Year-1 classes. METHODS: A sample (N = 77) of children drawn from 14 schools representing those with the weakest reading skills were randomly allocated to one of two groups. A 20-week intervention group received the intervention for two consecutive 10-week periods, while a 10-week intervention group only received the intervention for the second 10 weeks of the study. The programme was delivered in daily 20-minute sessions that alternated between small group (N = 3) and individual teaching. The programme combined phoneme awareness training, word and text reading, and phonological linkage exercises. RESULTS: The children receiving the intervention during the first 10-week period made significantly more progress on measures of letter knowledge, single word reading, and phoneme awareness than children not receiving the intervention. However, the children who only received the intervention during the second 10-week period made rapid progress and appeared to catch up with the children who had been given the more prolonged intervention. Failure to respond to the intervention was predicted by poor initial literacy skills and being in receipt of free school meals. CONCLUSION: A reading intervention programme delivered on a daily basis by trained teaching assistants is an effective intervention for children who show reading delays at the end of their first year in school. However, around one-quarter of the children did not respond to this intervention and these children would appear to need more intensive or more prolonged help to improve their reading skills.

Child↗
PubMed2006

How to identify randomized controlled trials in MEDLINE: ten years on.

OBJECTIVE: The researchers sought to assess whether the widely used 1994 Cochrane Highly Sensitive Search Strategy (HSSS) for randomized controlled trials (RCTs) in MEDLINE could be improved in terms of sensitivity, precision, or parsimony. METHODS: A gold standard of 1,347 RCT records and a comparison group of 2,400 non-trials were randomly selected from MEDLINE. Terms occurring in at least 1% of RCT records were identified. Fifty percent of the RCT and comparison group records were randomly selected, and the ability of the terms to discriminate RCTs from non-trial records was determined using logistic regression. The best performing combinations of terms were tested on the remaining records and in MEDLINE. RESULTS: The best discriminating term was "Clinical Trial" (Publication Type). In years where the Cochrane assessment of MEDLINE records had taken place, the strategies identified few additional unindexed records of trials. In years where Cochrane assessment has yet to take place, "Randomized Controlled Trial" (Publication Type) proved highly sensitive and precise. Adding six more search terms identified further, unindexed trials at reasonable levels of precision and with sensitivity almost equal to the Cochrane HSSS. CONCLUSIONS: Most reports of RCTs in MEDLINE can now be identified easily using "Randomized Controlled Trial" (Publication Type). More sensitive searches can be achieved by a brief strategy, the Centre for Reviews and Dissemination/Cochrane Highly Sensitive Search Strategy (2005 revision).

Abstracting and Indexing↗
PubMed2005

Psychosocial factors associated with indices of cortisol production in women with breast cancer and controls.

The present study was designed to (i) explore which psychosocial factors were associated with indices representing the early morning peak, diurnal cortisol rhythm and area under the curve (AUC); (ii) examine whether the relationships between psychosocial functioning and these cortisol indices were consistent and (iii) explore whether these relationships were influenced by the clinical status of the participant. Newly diagnosed breast cancer patients (n = 85) and healthy control women (n = 59) were recruited. State and trait measures of psychosocial functioning (i.e. anxiety, depression, distress, neuroticism, extraversion, marital satisfaction and mastery) were undertaken. In addition, all participants provided four saliva samples (on waking, 30 min later, between 11 and 1 p.m., before lunch and between 8 and 10 p.m., at least 2h after evening meal) over two consecutive days to assess cortisol levels. The results highlighted the divergent nature of the four cortisol indices; revealed the presence of some significant relationships between the psychosocial measures and the cortisol indices; but highlighted inconsistencies in the relationships evident for patients and those observed for control women.

Adaptation, Psychological↗
PubMed2005

Quality-of-life measurement in chronic heart failure: do we take account of the patient perspective?

The modern management of chronic heart failure has led to improved life expectancy, functioning and health-related quality of life (HRQL). HRQL measures the effects of an illness or a treatment from the patient's perspective. It is now recognised that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. Although there are a number of quality-of-life measures, which can be separated into two types-generic and disease specific-many have been developed, with little or no account being taken of the patient's perspective. Because most of the widely used measures are not patient centred, they may lack sensitivity and specificity in determining those aspects of HRQL important to individual patients. This paper reviews the use of quality-of-life assessment tools in the evaluation of patients with heart failure.

Health Status Indicators↗
PubMed2005

Deprivation and variations in teenage conceptions and abortions in England.

There are substantial variations between local authorities in the conception rate of teenagers and the proportion of these that end in abortion. This study builds two deprivation models that explain part of the variation in conceptions and abortions. It then identifies outliers, local authorities with teenage conception and abortion rates that are above or below those predicted by the model. It is suggested that the local authorities with lower than expected conceptions are the ones to look to when seeking to discover how to prevent teenage conceptions and those with higher than expected abortion rates may have abortion services that are more accessible. In general, spatial comparisons of conceptions and abortion should take into account variations in deprivation.

Abortion, Induced↗
PubMed2005

Confirmatory factor analysis using Microsoft Excel.

This article presents a method for using Microsoft (MS) Excel for confirmatory factor analysis (CFA). CFA is often seen as an impenetrable technique, and thus, when it is taught, there is frequently little explanation of the mechanisms or underlying calculations. The aim of this article is to demonstrate that this is not the case; it is relatively straightforward to produce a spreadsheet in MS Excel that can carry out simple CFA. It is possible, with few or no programming skills, to effectively program a CFA analysis and, thus, to gain insight into the workings of the procedure.

Factor Analysis, Statistical↗
PubMed2004

Interpersonal and role-related schema influence the relationship with the dominant 'voice' in schizophrenia: a comparison of three models.

BACKGROUND: Auditory hallucinations in psychosis often contain critical evaluations of the voice-hearer (for example, attacks on self-worth). A voice-hearer's experience with their dominant voice is a mirror of their social relationships in general, with experiences of feeling low in rank to both voices and others being associated with depression. However, the direction of the relationship between psychosis, depression and feeling subordinate is unclear. METHOD: Covariance structural equation modelling was used with data from 125 participants diagnosed with schizophrenia to compare three 'causal' models: (1) that depression leads to the appraisal of low social rank, voice power and distress; (2) that psychotic illness leads to voice activity (frequency, audibility), which in turn leads to depression and the appraisal of voices' power; (3) our hypothesized model, that perceptions of social rank and social power lead to the appraisal of voice power, distress and depression. RESULTS: Findings supported model 3, suggesting that the appraisal of social power and rank are primary organizing schema underlying the appraisal of voice power, and the distress of voices. CONCLUSIONS: Voices can be seen to operate like external social relationships. Voice content and experience can mirror a person's social sense of being powerless and controlled by others. These findings suggest important new targets for intervention with cognitive and social therapy.

Adult↗
PubMed2003

Inspection times and the selection task: what do eye-movements reveal about relevance.

Three experiments are reported that used eye-movement tracking to investigate the inspection-time effect predicted by Evans' (1996) heuristic-analytic account of the Watson selection task. Evans' account proposes that card selections are based on the operation relevance -determining heuristics, whilst analytic processing only rationalizes selections. As such, longer inspection times should be associated with selected cards (which are subjected to rationalization) than with rejected cards. Evidence for this effect has been provided by Evans (1996) using computer-presented selection tasks and instructions for participants to indicate (with a mouse pointer) cards under consideration. Roberts (1996) has argued that mouse pointing gives rise to artefactual support for Evans' predictions because of biases associated with the task format and the use of mouse pointing. We eradicated all sources of artefact by combining careful task constructions with eye-movement tracking to measure directly on-line attentional processing. All three experiments produced good evidence for the robustness of the inspection-time effect, supporting predictions of the heuristic-analytic account.

Choice Behavior↗