Browsing by Author "Jenkins, Rachel"

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    Putting evidence into practice: the PLoS medicine series on global mental health practice
    (Public Library of Science, 2012) Patel, Vikram; Jenkins, Rachel; Lund, Crick; Editors, the PLoS Medicine
    Today we are delighted to announce the launch of the PLoS Medicine series on Global Mental Health Practice, and to issue a call for case studies that can help broaden our understanding of global mental health in "real-life" contexts. The series was initiated by the lead author (VP), who is joined by two other leaders in global mental health (RP and CL) to serve as guest editors. Together, they bring an international, broad, and multidisciplinary perspective that will assist the PLoS Medicine senior Magazine editor (JC) in developing this vital series. We aim to address the gap between public health approaches to mental health, exemplified by two series in The Lancet [1],[2], and clinical approaches to addressing mental disorders (such as the packages of care published in this journal [3] and efficacy studies often published in specialist psychiatric journals). Lying between these two realms is a niche for demonstrating how the principles of global mental health are put into practice in real-world contexts. These principles, reflected in the goals of international efforts such as the Movement for Global Mental Health (http://www.globalmentalhealth.org), explicitly aim to (1) improve access to evidence-based care for people with mental, neurological, or substance use disorders and (2) promote the human rights of people affected by these disorders. Articles in the PLoS Medicineseries will report a diverse range of health interventions from around the world where action has demonstrated tangible improvements in one or both of these goals.
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    Treatment outcomes in palliative care: the TOPCare study. A mixed methods phase III randomised controlled trial to assess the effectiveness of a nurse-led palliative care intervention for HIV positive patients on antiretroviral therapy
    (BioMed Central Ltd, 2012) Lowther, Keira; Simms, Victoria; Selman, Lucy; Sherr, Lorraine; Gwyther, Liz; Kariuki, Hellen; Ahmed, Aabid; Ali, Zipporah; Jenkins, Rachel; Higginson, Irene; Harding, Richard
    BACKGROUND: Patients with HIV/AIDS on Antiretroviral Therapy (ART) suffer from physical, psychological and spiritual problems. Despite international policy explicitly stating that a multidimensional approach such as palliative care should be delivered throughout the disease trajectory and alongside treatment, the effectiveness of this approach has not been tested in ART-experienced populations.METHODS/DESIGN:This mixed methods study uses a Randomised Controlled Trial (RCT) to test the null hypothesis that receipt of palliative care in addition to standard HIV care does not affect pain compared to standard care alone. An additional qualitative component will explore the mechanism of action and participant experience. The sample size is designed to detect a statistically significant decrease in reported pain, determined by a two tailed test and a p value of [less than or equal to]0.05. Recruited patients will be adults on ART for more than one month, who report significant pain or symptoms which have lasted for more than two weeks (as measured by the African Palliative Care Association (APCA) African Palliative Outcome Scale (POS)). The intervention under trial is palliative care delivered by an existing HIV facility nurse trained to a set standard. Following an initial pilot the study will be delivered in two African countries, using two parallel independent Phase III clinical RCTs. Qualitative data will be collected from semi structured interviews and documentation from clinical encounters, to explore the experience of receiving palliative care in this context.DISCUSSION:The data provided by this study will provide evidence to inform the improvement of outcomes for people living with HIV and on ART in Africa.ClinicalTrials.gov Identifier: NCT01608802