Edinburgh Napier University

About: Edinburgh Napier University is a education organization based out in Edinburgh, United Kingdom. It is known for research contribution in the topics: Population & Health care. The organization has 2665 authors who have published 6859 publications receiving 175272 citations.

Personalized medicine could transform healthcare (Review)

Abstract: Personalized medicine (PM) is about tailoring a treatment as individualized as the disease The approach relies on identifying genetic, epigenomic, and clinical information that allows the breakthroughs in our understanding of how a person's unique genomic portfolio makes them vulnerable to certain diseases PM approach is a complete extension of traditional approach (One-Size-Fits-All) to increasing our ability to predict which medical treatments will be safe and effective for individual patient, and which ones will not be, based on the patient's unique genetic profile Implementation of PM has the potential to reduce financial and time expenditure, and increase quality of life and life extension of patients Knowledge of PM facilitates earlier disease detection via enhanced use of existing biomarkers and detection of early genomic and epigenomic events in disease development, particularly carcinogenesis The PM approach predominantly focuses on preventative medicine and favours taking pro-active actions rather than just reactive This approach delays or prevents the need to apply more severe treatments which are usually less tolerated and with increased quality of life and financial considerations Increasing healthcare costs have placed additional pressure on government funded healthcare systems globally, especially regarding end of life care PM may increase the effectiveness of existing treatments and negate the inherent problems associated with non-PM approaches PM is a young but rapidly expanding field of healthcare where a physician can select a treatment based on a patient's genetic profile that may not only minimize harmful side effects and guarantee a more successful result, but can be less cost effective compared with a 'trial-and-error' approach to disease treatment The less efficient non-PM ('trial-and-error') approach, which can lead to drug toxicity, severe side effects, reactive treatment and misdiagnosis continue to contribute to increasing healthcare costs Increased patient stratification will allow for the enhanced application of PM and pro-active treatment regimens, resulting in reduced costs and quality of life enhancement

Career Development of Expert Coaches

Abstract: Careers in coaching are a relatively new phenomenon in the UK and at present appear to be limited to the performance coach. This study, using an interview approach, examined the transition of expert coaches (n = 9) through various stages in their careers. The main aim of this study was to ascertain if expert coaches could explain the process of their development to perceived expert status. The interviewed coaches could offer no real insight into their designation as experts. They did raise some questions regarding the value of current coach education provision, especially as it related to their current role as coaches of elite athletes. Their methods of development were considered to be informal, with networking with other coaches of like mind believed to be essential to their progress. The ability to contextualise knowledge and information to suit both the individual and situation, as well as appropriate mentors at the initial stages of their coaching careers were also regarded as vital.

Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis

Abstract: Background The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions. Methods We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality. Results Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = −0.90 (CBT; k = 27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome. Conclusions The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.