An exploration of attitudes towards psychological interventions for pain management amongst Maltese pain chronic sufferers

Chronic pain is a living reality for many individuals. Research reveals that individuals are often reluctant to seek psychological help. Chronic pain research and attitudes towards psychological treatment among a Maltese chronic pain population is solely lacking. This study sought to explore attitudes towards psychological interventions for the management of chronic pain amongst persons with chronic pain. A grounded theory methodology was adopted. Interviews were conducted with 21 participants. Five superordinate categories comprising 12 sub-categories were generated. An attitude model reflecting inter-relationships between categories was developed. The theory entitled ‘Readiness to Try What Ever it Takes’ reveals that a number of facilitating factors contribute to the formation of positive attitudes to psychological help-seeking. Although the study did not reveal polarized views in relation to gender, impeding factors comprising negative affect, lacking resources and stigma hinder help-seeking behaviour. Most participants were unfamiliar with psychological services for pain management. Findings also indicate that individuals who perceive a link between psychological factors and pain are not necessarily more inclined to access psychological help, mostly because help-seeking behaviour is influenced by an array of psychosocial factors which are difficult to quantify. Service uptake can be enhanced by adopting a bio-psychosocial framework incorporating cultural factors and a multi-disciplinary approach to treatment involving not just health care professionals, but also significant others who influence the chronic pain sufferers’ decision-making, including family members and the clergy.peer-reviewe

Consultation and illness behaviour in response to symptoms: a comparison of models from different disciplinary frameworks and suggestions for future research directions

We all get ill and social scientific interest in how we respond – the study of illness behaviour – continues unabated. Existing models are useful, but have been developed and applied within disciplinary silos, resulting in wasted intellectual and empirical effort and an absence of accumulation of knowledge across disciplines. We present a critical review and detailed comparison of three process models of response to symptoms: the Illness Action Model, the Common Sense Model of the Self-Regulation of Health and Illness and the Network Episode Model. We suggest an integrated framework in which symptoms, responses and actions are simultaneously interpreted and evaluated in the light of accumulated knowledge and through interactions. Evaluation may be subconscious and is influenced by the extent to which the symptoms impose themselves, expectations of outcomes, the resources available and understanding of symptoms' salience and possible outcomes. Actions taken are part of a process of problem solving through which both individuals and their immediate social network seek to (re)achieve ‘normality’. Response is also influenced by social structure (directly and indirectly), cultural expectations of health, the meaning of symptoms, and access to and understandings of the legitimate use of services. Changes in knowledge, in embodied state and in emotions can all be directly influential at any point. We do not underestimate the difficulty of operationalising an integrated framework at different levels of analysis. Attempts to do so will require us to move easily between disciplinary understandings to conduct prospective, longitudinal, research that uses novel methodologies to investigate response to symptoms in the context of affective as well as cognitive responses and interactions within social networks. While challenging such an approach would facilitate accumulation of knowledge across disciplines and enable movement beyond description to change in individual and organisational responses

Environmental chemical exposures and breast cancer

As a hormone-sensitive condition with no single identifiable cause, breast cancer is a major health problem. It is characterized by a wide range of contributing factors and exposures occurring in different combinations and strengths across a lifetime that may be amplified during periods of enhanced developmental susceptibility and impacted by reproductive patterns and behaviours. The vast majority of cases are oestrogen-receptor positive and occur in women with no family history of the disease suggesting that modifiable risk factors are involved. A substantial body of evidence now links oestrogen-positive breast cancer with environmental exposures. Synthetic chemicals capable of oestrogen mimicry are characteristic of industrial development and have been individually and extensively assessed as risk factors for oestrogen-sensitive cancers. Existing breast cancer risk assessment tools do not take such factors into account. In the absence of consensus on causation and in order to better understand the problem of escalating incidence globally, an expanded, integrated approach broadening the inquiry into individual susceptibility breast cancer is proposed. Applying systems thinking to existing data on oestrogen-modulating environmental exposures and other oestrogenic factors characteristic of Westernisation and their interactions in the exposure, encompassing social, behavioural, environmental, hormonal and genetic factors, can assist in understanding cancer risks and the pursuit of prevention strategies. A new conceptual framework based on a broader understanding of the “system” that underlies the development of breast cancer over a period of many years, incorporating the factors known to contribute to breast cancer risk, could provide a new platform from which government and regulators can promulgate enhanced and more effective prevention strategies

Potential and limitations of plant virus epidemiology: lessons from the Potato virus Y pathosystem

Abstract Plant virus epidemiology provides powerful tools to investigate key factors that contribute to virus epidemics in agricultural crops. When successful, epidemiological approaches help to guide decisions regarding plant protection strategies. A recent example is epidemiological research on Potato virus Y (PVY) in Finnish seed potato production; this study led to the dentification of the main PVY vector species and helped to determine the timing of virus transmission. However, pathosystems rarely allow research to produce such clear-cut results. In fact, the notorious complexity of plant virus pathosystems, with multiple interactions between virus, vector, plant and environment, makes them often impenetrable even for advanced epidemiological models. This dynamic complexity questions the universal validity of employing epidemiological models that attempt to single out key factors in plant virus epidemics. Therefore, a complementary approach is needed that acknowledges the partly indeterministic nature of complex and evolving pathosystems. Such an approach is the use of diversity, imploying functionally complementary elements that can jointly buffer against environmental changes. I argue that for a wider range of plant production problems, the strategy of combining mechanistic and diversity-based approaches will provide potent and sustainable solutions. In addition, to translate insights from plant virus epidemiology into practice, improvements need to be made in knowledge transfer, both within the scientific community and between researchers and practitioners. Finally, moving towards more appropriate virus control strategies is only possible if economic interests of all stakeholders are in line with changing current practices

Gender relations and couple negotiations of British men's food practice changes after prostate cancer.

Nutrition plays an important role in the health of men diagnosed with prostate cancer and dietary interventions can therefore be a significant part of prostate cancer survivorship supportive care. Family food provision, however, involves complex social interactions, which shape how men engage with their diets and dietary interventions. The role that gender plays in shaping prostate cancer couples' food practices and men's diets after a prostate cancer diagnosis is thought to be important but is little understood. This study explored couples' accounts of nutrition information seeking and diet change to gain a better understanding of how gender relations shaped men's food practices after prostate cancer diagnosis. Qualitative health interviews with men and their partners were conducted and analysed using interpretive descriptive methods. Findings demonstrated how couples navigated food change journeys that involved seeking information, deciding what changes were warranted and implementing and regulating diet changes. Two overarching themes that illustrated couples' food negotiations were called 'Seeking information and deciding on food changes' and 'Monitoring food changes'. Additional sub-themes described who led food changes, women's filtering of information, and moderation or 'treats'. Throughout these food change journeys interactions between men and women were at play, demonstrating how gender relations and dynamics acted to shape couples food negotiations and men's food practices. Findings reveal that attention to gender relations and the men's family food dynamics should inform diet interventions for men with prostate cancer in order to improve uptake

A fruitful fly forward : the role of the fly in drug discovery for neurodegeneration

AD, Alzheimer’s disease; APP, amyloid precursor protein; BBB, blood brain barrier; GFP, green fluorescent protein; HTS, high-throughput screening; HD, Huntington’s disease; LB, Lewy bodies; PD, Parkinson’s disease; PolyQ, Polyglutamine; RNAi, RNA interference; SNCA, α-synuclein gene; UAS, Upstream Activating Sequence.peer-reviewe

Assessment of access to health services and vulnerabilities of female fish traders in the Kafue Flats, Zambia: analysis report

Under the regional programme Fisheries and HIV/AIDS in Africa: Investing in Sustainable Solutions, the WorldFish Center conducted this study on access to health services and vulnerabilities of female fish traders in the Kafue Flats floodplains in Zambia. This report outlines and analyses the particular vulnerabilities of female fish traders in the Kafue Flats fishery and formulates recommendations to facilitate stakeholder uptake of strategic responses to tackle the drivers of the epidemic in fishing communities and improve the livelihoods of fisher folk and fish traders in the Kafue Flats and other fisheries in Zambia. (pdf contains 55 pages