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Article ; Online: Rate of stroke death after depression: a 40-year longitudinal study extension of Chichester/Salisbury Catchment area study.

Thomson, Wendy

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2014 Volume 23, Issue 7, Page(s) 1837–1842

Abstract: Background: This study examined clinically diagnosed depression as a risk factor for incidence of death by stroke in a prospective clinically based design study. Risk for stroke was examined separately by sex in a long-term follow-up study spanning 40 ... ...

Abstract	Background: This study examined clinically diagnosed depression as a risk factor for incidence of death by stroke in a prospective clinically based design study. Risk for stroke was examined separately by sex in a long-term follow-up study spanning 40 years. Methods: Patients who were diagnosed with depression in the Chichester (population 100,000)/Salisbury (population 85,000) Catchment Area Study were followed up for 40 years. Death certificates were used to determine the cause of death in the cohort. Death rates in the general population, adjusted for age, gender, and year, were used as a control. Results: Clinical depression was found to be a risk factor for subsequent death from stroke in men but not in women. Death by stroke was a statistically significant cause of death in the men with diagnoses of endogenous depression but not in those men diagnosed with reactive depression. The strength of the relationship of depression with stroke increased over time. Conclusions: These findings suggest that the identification of depressive symptoms at younger ages may have an impact on the primary prevention of stroke in later life. The notion that depression has stronger effects over a long period is consistent with a view that severe clinical depression and physical illness occur concurrently, one exacerbating the other, and health is degraded through slow-acting, cumulative processes. Data were unavailable for the type of stroke or the health-risk behaviors (smoking, diet, and so forth) in the cohort which constituted a limitation of the study. Neither is it known what proportion of the cohort suffered a nonlethal stroke nor to what extent the treatment of clinical depression militates against suffering a lethal stroke.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Cohort Studies ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/mortality ; England/epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Stroke/complications ; Stroke/mortality
Language	English
Publishing date	2014-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2014.03.013
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Article ; Online: Long term follow up of suicide in a clinically depressed community sample.

Thomson, Wendy

Journal of affective disorders

2012 Volume 139, Issue 1, Page(s) 52–55

Abstract: Background: The purpose of this study was to examine how sex differences in suicide rates unfolded in a long-term follow up of patients who had been diagnosed with major depression.: Method: Patients who were diagnosed with major depression in the ... ...

Abstract	Background: The purpose of this study was to examine how sex differences in suicide rates unfolded in a long-term follow up of patients who had been diagnosed with major depression. Method: Patients who were diagnosed with major depression in the Chichester/Salisbury Catchment Area Study were followed for 49 years. Recorded deaths from suicide were compared with rates that were predicted from historical data on suicide mortality rates from 1960 onwards. Findings: An overall suicide rate of 3.4% was found in the present sample. Sixteen women and three men died from suicide. Women's suicide rates were significantly higher than the level predicted based on general population trends. Men showed a barely non-significant trend in the same direction. The diagnosis of clinical depression was associated more strongly with increased risk for suicide among women compared with men. Of the female suicides, 13 had been diagnosed with endogenous depression. Conclusions: While suicide rates are significantly higher for men in the general population, and for depressed patients of both sexes, the depression may be a particularly strong predictor of suicide risk among women. Limitations: The dataset does not provide information about processes that mediate the relationship between depression and suicide mortality.
MeSH term(s)	Adult ; Aged ; Depressive Disorder/diagnosis ; Depressive Disorder/mortality ; Depressive Disorder, Major/mortality ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Residence Characteristics ; Sex Factors ; Suicide/statistics & numerical data
Language	English
Publishing date	2012-06
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2012.02.012
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Article ; Online: Lifting the shroud on depression and premature mortality: a 49-year follow-up study.

Thomson, Wendy

Journal of affective disorders

2011 Volume 130, Issue 1-2, Page(s) 60–65

Abstract: Unlabelled: Numerous studies have shown higher rates of death from natural causes in the years immediately following an episode of clinical depression. The longer term relationship of depression to excess mortality is less clear because relatively few ... ...

Abstract	Unlabelled: Numerous studies have shown higher rates of death from natural causes in the years immediately following an episode of clinical depression. The longer term relationship of depression to excess mortality is less clear because relatively few studies have followed the same cohort of patients for more than 10 years. The present paper reports on the findings following the same cohort of patients 49 years after discharge. Method: Patients who were diagnosed with depression in the Chichester/Salisbury Catchment Area Study were followed for 49 years. The incidence of death from natural causes in the clinical population was compared with population rates adjusted for age and sex. Results: The results suggest that clinical depression may have enduring effects on physical health that emerge later in life, the significance of which have so far remained undetected. Further analyses of death rates by age and sex suggest that: a.) Depression has a stronger impact on mortality among women. b.) Excess mortality starts to emerge at an earlier age among women. Discussion: Because prior studies of depression and mortality have typically followed patients for fewer than 25 years, the long-term impact of major depression has remained undetected. The results are consistent with the view that depression has a negative impact on health that spans multiple decades. Limitations: The association between mortality and depression could arise if prolonged treatment with antidepressant medication increases mortality. The association found between depression and mortality might also reflect differences in the quality of medical care that is provided to clinically depressed individuals. The present study does not control for factors that are confounded with depression (e.g., diet, exercise), nor does it utilize a matched control group. Conclusion: The pathways linking depression and mortality are likely to be complex and multifactorial in nature. The major implication of the present work is to suggest that such pathways link depression with long-term, as well as short-term differences in mortality.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Depressive Disorder/mortality ; England/epidemiology ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Mortality ; Psychiatric Status Rating Scales ; Sex Factors ; Young Adult
Language	English
Publishing date	2011-04
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2010.09.028
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Article ; Online: Use of Simulation in Undergraduate and Graduate Education.

Gore, Teresa / Thomson, Wendy

AACN advanced critical care

2016 Volume 27, Issue 1, Page(s) 86–95

Abstract: Simulation is not just technology but a teaching method used to allow students to practice in a safe environment. The focus of simulation is to improve patient safety, communication, and the ability of the student to think and act as a nurse or advanced ... ...

Abstract	Simulation is not just technology but a teaching method used to allow students to practice in a safe environment. The focus of simulation is to improve patient safety, communication, and the ability of the student to think and act as a nurse or advanced practice nurse. As use of simulation in nursing education increases, more regulations, guidelines, and standards are being developed to assist nursing programs to obtain best outcomes. This article provides readers with an overview of simulation use in undergraduate and graduate nursing education.
MeSH term(s)	Clinical Competence ; Computer Simulation ; Curriculum ; Education, Nursing, Baccalaureate/organization & administration ; Education, Nursing, Graduate/organization & administration ; Patient Simulation ; United States
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2239949-5
ISSN	1559-7776 ; 1559-7768
ISSN (online)	1559-7776
ISSN	1559-7768
DOI	10.4037/aacnacc2016329
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Article: Pour la contractualisation stratégique au sein du système de santé du Québec

Thomson, Wendy

Le Québec économique (2011), p. 251-266

2012 , Page(s) 251–266

Author's details	Wendy Thomson
Language	French
Publisher	Pr. de l'Université Laval
Publishing place	Québec
Document type	Article
ZDB-ID	2823630-0
Database	ECONomics Information System

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Article ; Online: "Reluctant to Assess Pain": A Qualitative Study of Health Care Professionals' Beliefs About the Role of Pain in Juvenile Idiopathic Arthritis.

Lee, Rebecca Rachael / Rashid, Amir / Thomson, Wendy / Cordingley, Lis

Arthritis care & research

2019 Volume 72, Issue 1, Page(s) 69–77

Abstract: Objective: Reducing pain is one of the main health priorities for children and young people with juvenile idiopathic arthritis (JIA); however, some studies indicate that pain is not routinely assessed in this patient group. The aim of this study was to ... ...

Abstract	Objective: Reducing pain is one of the main health priorities for children and young people with juvenile idiopathic arthritis (JIA); however, some studies indicate that pain is not routinely assessed in this patient group. The aim of this study was to explore health care professionals' (HCPs) beliefs about the role of pain and the prioritization of its assessment in children and young people with JIA. Methods: Semi-structured interviews were conducted with HCPs who manage children and young people with JIA in the UK (including consultant and trainee pediatric rheumatologists, nurses, physical therapists, and occupational therapists). Data were analyzed qualitatively following a framework analysis approach. Results: Twenty-one HCPs participated. Analyses of the data identified 6 themes, including lack of training and low confidence in pain assessment, reluctance to engage in pain discussions, low prioritization of pain assessment, specific beliefs about the nature of pain in JIA, treatment of pain in JIA, and undervaluing pain reports. Assessment of pain symptoms was regarded as a low priority and some HCPs actively avoided conversations about pain. Conclusion: These findings indicate that the assessment of pain in children and young people with JIA may be limited by knowledge, skills, and attitudinal factors. HCPs' accounts of their beliefs about pain in JIA and their low prioritization of pain in clinical practice suggest that a shift in perceptions about pain management may be helpful for professionals managing children and young people with this condition.
MeSH term(s)	Adolescent ; Arthralgia/diagnosis ; Arthralgia/etiology ; Arthralgia/therapy ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/diagnosis ; Child ; Female ; Health Personnel/statistics & numerical data ; Humans ; Male ; Pain Management/methods ; Pain Measurement/methods ; Qualitative Research
Language	English
Publishing date	2019-01-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.23827
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Zs.A 2446: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.A 24: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)

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Article ; Online: "Asking Too Much?": Randomized N-of-1 Trial Exploring Patient Preferences and Measurement Reactivity to Frequent Use of Remote Multidimensional Pain Assessments in Children and Young People With Juvenile Idiopathic Arthritis.

Lee, Rebecca Rachael / Shoop-Worrall, Stephanie / Rashid, Amir / Thomson, Wendy / Cordingley, Lis

Journal of medical Internet research

2020 Volume 22, Issue 1, Page(s) e14503

Abstract: Background: Remote monitoring of pain using multidimensional mobile health (mHealth) assessment tools is increasingly being adopted in research and care. This assessment method is valuable because it is challenging to capture pain histories, ... ...

Abstract	Background: Remote monitoring of pain using multidimensional mobile health (mHealth) assessment tools is increasingly being adopted in research and care. This assessment method is valuable because it is challenging to capture pain histories, particularly in children and young people in diseases where pain patterns can be complex, such as juvenile idiopathic arthritis (JIA). With the growth of mHealth measures and more frequent assessment, it is important to explore patient preferences for the timing and frequency of administration of such tools and consider whether certain administrative patterns can directly impact on children's pain experiences. Objective: This study aimed to explore the feasibility and influence (in terms of objective and subjective measurement reactivity) of several time sampling strategies in remote multidimensional pain reporting. Methods: An N-of-1 trial was conducted in a subset of children and young people with JIA and their parents recruited to a UK cohort study. Children were allocated to 1 of 4 groups. Each group followed a different schedule of completion of MPT for 8 consecutive weeks. Each schedule included 2 blocks, each comprising 4 different randomized time sampling strategies, with each strategy occurring once within each 4-week block. Children completed MPT according to time sampling strategies: once-a-day, twice-a-day, once-a-week, and as-and-when pain was experienced. Adherence to each strategy was calculated. Participants completed the Patient-Reported Outcomes Measurement Information System Pain Interference Scale at the end of each week to explore objective reactivity. Differences in pain interference scores between time sampling strategies were assessed graphically and using Friedman tests. Children and young people and their parents took part in a semistructured interview about their preferences for different time sampling strategies and to explore subjective reactivity. Results: A total of 14 children and young people (aged 7-16 years) and their parents participated. Adherence to pain reporting was higher in less intense time sampling strategies (once-a-week=63% [15/24]) compared with more intense time sampling strategies (twice-a-day=37.8% [127/336]). There were no statistically significant differences in pain interference scores between sampling strategies. Qualitative findings from interviews suggested that children preferred once-a-day (6/14, 43%) and as-and-when pain reporting (6/14, 43%). Creating routine was one of the most important factors for successful reporting, while still ensuring that comprehensive information about recent pain was captured. Conclusions: Once-a-day pain reporting provides rich contextual information. Although patients were less adherent to this preferred sampling strategy, once-a-day reporting still provides more frequent assessment opportunities compared with other less intense or overburdensome schedules. Important issues for the design of studies and care incorporating momentary assessment techniques were identified. We demonstrate that patient reporting preferences are key to accommodate and are important where data capture quality is key. Our findings support frequent administration of such tools, using daily reporting methods where possible.
MeSH term(s)	Adolescent ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/epidemiology ; Child ; Chronic Pain/etiology ; Cohort Studies ; Female ; Humans ; Male ; Pain Measurement/methods ; Patient Preference/psychology ; Patient Reported Outcome Measures
Language	English
Publishing date	2020-01-30
Publishing country	Canada
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1439-4456
ISSN (online)	1438-8871
ISSN	1439-4456
DOI	10.2196/14503
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Article ; Online: Patient-reported wellbeing and clinical disease measures over time captured by multivariate trajectories of disease activity in individuals with juvenile idiopathic arthritis in the UK: a multicentre prospective longitudinal study.

Shoop-Worrall, Stephanie J W / Hyrich, Kimme L / Wedderburn, Lucy R / Thomson, Wendy / Geifman, Nophar

The Lancet. Rheumatology

2020 Volume 3, Issue 2, Page(s) e111–e121

Abstract: Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease, the signs and symptoms of which can be summarised with use of composite disease activity measures, including the clinical Juvenile Arthritis Disease Activity Score (cJADAS). ... ...

Abstract	Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous disease, the signs and symptoms of which can be summarised with use of composite disease activity measures, including the clinical Juvenile Arthritis Disease Activity Score (cJADAS). However, clusters of children and young people might experience different global patterns in their signs and symptoms of disease, which might run in parallel or diverge over time. We aimed to identify such clusters in the 3 years after a diagnosis of JIA. The identification of these clusters would allow for a greater understanding of disease progression in JIA, including how physician-reported and patient-reported outcomes relate to each other over the JIA disease course. Methods: In this multicentre prospective longitudinal study, we included children and young people recruited before Jan 1, 2015, to the Childhood Arthritis Prospective Study (CAPS), a UK multicentre inception cohort. Participants without a cJADAS score were excluded. To assess groups of children and young people with similar disease patterns in active joint count, physician's global assessment, and patient or parental global evaluation, we used latent profile analysis at initial presentation to paediatric rheumatology and multivariate group-based trajectory models for the following 3 years. Optimal models were selected on the basis of a combination of model fit, clinical plausibility, and model parsimony. Finding: Between Jan 1, 2001, and Dec 31, 2014, 1423 children and young people with JIA were recruited to CAPS, 239 of whom were excluded, resulting in a final study population of 1184 children and young people. We identified five clusters at baseline and six trajectory groups using longitudinal follow-up data. Disease course was not well predicted from clusters at baseline; however, in both cross-sectional and longitudinal analyses, substantial proportions of children and young people had high patient or parent global scores despite low or improving joint counts and physician global scores. Participants in these groups were older, and a higher proportion of them had enthesitis-related JIA and lower socioeconomic status, compared with those in other groups. Interpretation: Almost one in four children and young people with JIA in our study reported persistent, high patient or parent global scores despite having low or improving active joint counts and physician's global scores. Distinct patient subgroups defined by disease manifestation or trajectories of progression could help to better personalise health-care services and treatment plans for individuals with JIA. Funding: Medical Research Council, Versus Arthritis, Great Ormond Street Hospital Children's Charity, Olivia's Vision, and National Institute for Health Research.
Language	English
Publishing date	2020-12-04
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(20)30269-1
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Article ; Online: What women want: Women's health in Rural and Regional Australia - Insights from an interprofessional research collaboration between academic researchers, nursing clinicians, and industry professionals.

Sivertsen, Nina / Abigail, Wendy / Tieu, Matthew / Eastman, Maree / McCloud, Christine / Thomson, Wendy / Tonkin, Helen

Health & social care in the community

2021 Volume 30, Issue 5, Page(s) e2236–e2244

Abstract: The aim of this study was to (a) investigate community women's knowledge and experiences of women's health community services in northern rural and regional New South Wales, Australia; (b) identify any existing gaps in community women's health programs ... ...

Abstract	The aim of this study was to (a) investigate community women's knowledge and experiences of women's health community services in northern rural and regional New South Wales, Australia; (b) identify any existing gaps in community women's health programs in this region and (c) to contribute to service provision, strategic planning, and industry professional development of community nurse researchers in collaboration with industry. The research took place in Northern New South Wales Local Health District (NNSWLHD) Australia, which is comprised of Tweed/Byron, Richmond and Clarence Health Service Groups, during May to September 2019. Participants comprised 13 women's health service clients over the age of 18 years and less than 74 years, attending health services clinics within NNSWLHD. The research was undertaken as a partnership between three senior healthcare professionals (Clinical Nurse Consultants), one from each Health Service Group, and academic researchers, who provided the key senior healthcare professionals with research training and guidance. Key themes related to primary healthcare experiences and needs of women living in NNSWLHD, and the quality of women's primary healthcare services in that region. Thematic analysis revealed four key themes and several sub-themes. These were (1) Knowledge and Awareness of Services, (2) Barriers to Access, (3) Personal Issues and (4) A Need for Women-Centred Care. The major issues women experienced were deficits in services, lengthy wait times and poor access. Additional funding is necessary to uphold community women's health nurse positions in rural health to improve women's health outcomes in these locations.
MeSH term(s)	Adult ; Australia ; Female ; Health Personnel ; Humans ; Middle Aged ; Qualitative Research ; Rural Health Services ; Rural Population ; Women's Health
Language	English
Publishing date	2021-11-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1155902-0
ISSN	1365-2524 ; 0966-0410
ISSN (online)	1365-2524
ISSN	0966-0410
DOI	10.1111/hsc.13661
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Article: "Seeing Pain Differently": A Qualitative Investigation Into the Differences and Similarities of Pain and Rheumatology Specialists' Interpretation of Multidimensional Mobile Health Pain Data From Children and Young People With Juvenile Idiopathic Arthritis.

Lee, Rebecca Rachael / Rashid, Amir / Ghio, Daniela / Thomson, Wendy / Cordingley, Lis

JMIR mHealth and uHealth

2019 Volume 7, Issue 7, Page(s) e12952

Abstract: Background: In contrast to the use of traditional unidimensional paper-based scales, a mobile health (mHealth) assessment of pain in children and young people (CYP) with juvenile idiopathic arthritis (JIA) enables comprehensive and complex ... ...

Abstract	Background: In contrast to the use of traditional unidimensional paper-based scales, a mobile health (mHealth) assessment of pain in children and young people (CYP) with juvenile idiopathic arthritis (JIA) enables comprehensive and complex multidimensional pain data to be captured remotely by individuals. However, how professionals use multidimensional pain data to interpret and synthesize pain reports gathered using mHealth tools is not yet known. Objective: The aim of this study was to explore the salience and prioritization of different mHealth pain features as interpreted by key stakeholders involved in research and management of pain in CYP with JIA. Methods: Pain and rheumatology specialists were purposively recruited via professional organizations. Face-to-face focus groups were conducted for each specialist group. Participants were asked to rank order 9 static vignette scenarios created from real patient mHealth multidimensional pain data. These data had been collected by a researcher in a separate study using My Pain Tracker, a valid and acceptable mHealth iPad pain communication tool that collects information about intensity, severity, location, emotion, and pictorial pain qualities. In the focus groups, specialists discussed their decision-making processes behind each rank order in the focus groups. The total group rank ordering of vignette scenarios was calculated. Qualitative data from discussions were analyzed using latent thematic analysis. Results: A total of 9 pain specialists took part in 1 focus group and 10 rheumatology specialists in another. In pain specialists, the consensus for the highest pain experience (44%) was poorer than their ranking of the lowest pain experiences (55%). Conversely, in rheumatology specialists, the consensus for the highest pain experience (70%) was stronger than their ranking of the lowest pain experience (50%). Pain intensity was a high priority for pain specialists, but rheumatology specialists gave high priority to intensity and severity taken together. Pain spread was highly prioritized, with the number of pain locations (particular areas or joints) being a high priority for both groups; radiating pain was a high priority for pain specialists only. Pain emotion was challenging for both groups and was only perceived to be a high priority when specialists had additional confirmatory evidence (such as information about pain interference or clinical observations) to validate the pain emotion report. Pain qualities such as particular word descriptors, use of the color red, and fire symbols were seen to be high priority by both groups in interpretation of CYP pain reports. Conclusions: Pain interpretation is complex. Findings from this study of specialists' decision-making processes indicate which aspects of pain are prioritized and weighted more heavily than others by those interpreting mHealth data. Findings are useful for developing electronic graphical summaries which assist specialists in interpreting patient-reported mHealth pain data more efficiently in clinical and research settings.
MeSH term(s)	Adult ; Arthritis, Juvenile/complications ; Arthritis, Juvenile/psychology ; Female ; Focus Groups/methods ; Humans ; Male ; Middle Aged ; Pain/classification ; Pain/psychology ; Pain Management/instrumentation ; Pain Management/psychology ; Pain Management/standards ; Pain Measurement/methods ; Qualitative Research ; Rheumatologists/psychology ; Rheumatologists/statistics & numerical data ; Rheumatology/instrumentation ; Rheumatology/methods ; Telemedicine/trends
Language	English
Publishing date	2019-07-02
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2719220-9
ISSN	2291-5222
ISSN	2291-5222
DOI	10.2196/12952
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