Constraints to liberty of movement and attachment styles significantly account for well-being in three Palestinian samples

Background: Political violence and constraints on liberty of movement can have consequences for health and well-being but affect individuals differently. Objective: In three Palestinian samples, we sought to examine the relationship between key environmental and psychological factors and general and mental health, including the previously unexplored roles of constraints to liberty of movement and attachment orientation. Method: Participants (n=519) in the Occupied Palestinian Territories and Jordan completed questionnaires on constraints to liberty of movement (4-item scale devised by the authors for the purpose of the current study), attachment insecurity (Experiences in Close Relationships Scale – Short Form, Wei et al., 2007), resource loss (Conservation of Resources Evaluation scale, Hobfoll & Lilly, 1993), experience of political violence (Experience and fear of political violence, Hobfoll et al., 2011), demographics, general health (adapted from DeSalvo et al, 2006) and mental health (PHQ4 for depression, and Ballenger et al.’s, (2001) 2 item screener for anxiety). All measures were translated from English to Arabic and back-translated into English. Results: Findings from regression and mediation analyses indicated that (i) differences in general and mental health among Palestinians in the Occupied Palestinian Territories and the diaspora in Jordan, can be explained by the assessed constructs; (ii) constraints to liberty of movement, attachment avoidance, and resource loss significantly accounted for poor general health; (iii) constraints to liberty of movement, attachment anxiety, and resource loss significantly explained general anxiety symptoms; and (iv) attachment anxiety, resource loss, and experience of political violence significantly explained depression symptoms. Conclusion: Findings have theory-building implications for psychological models of human flourishing and suffering, suggesting that they are incomplete without consideration of liberty as a context, as well as implications for policymakers and champions of global health initiatives, as they highlight the psychological effects of constraints to liberty of movement on health

Adaptation of the PERCEPT myeloma prehabilitation trial to virtual delivery: changes in response to the COVID-19 pandemic

Introduction and objective Research activity was impacted by the novel COVID-19 pandemic, the PERCEPT myeloma trial was no exception. This pilot randomised trial delivered a face-to-face exercise intervention prior to and during autologous stem cell transplantation (ASCT) in myeloma patients, as a consequence of COVID-19 it required significant adaptions to continue. This brief communication describes how the previously published study protocol was adapted for virtual delivery. In addition, we highlight the challenge of continuing the study which was embedded within a clinical pathway also impacted by the pandemic. Summary The original trial protocol was amended and continued to recruit and deliver an exercise prehabilitation intervention virtually. Continued delivery of the intervention was deemed important to participants already enrolled within the trial and the adapted virtual version of the trial was acceptable to the research ethics committee as well as participants. Development of effective, remotely delivered rehabilitation and physical activity programmes are likely to benefit people living with myeloma. The COVID-19 pandemic provided an opportunity to explore the feasibility of a virtual programme for ASCT recipients, however, continued changes to the clinical pathway within which the study was embedded posed the greatest challenge and ultimately led to early termination of recruitment. Trial registration number ISRCTN15875290; pre-result

Acceleration of hippocampal atrophy rates in asymptomatic amyloidosis.

Increased rates of brain atrophy measured from serial magnetic resonance imaging precede symptom onset in Alzheimer's disease and may be useful outcome measures for prodromal clinical trials. Appropriate trial design requires a detailed understanding of the relationships between β-amyloid load and accumulation, and rate of brain change at this stage of the disease. Fifty-two healthy individuals (72.3 ± 6.9 years) from Australian Imaging, Biomarkers and Lifestyle Study of Aging had serial (0, 18 m, 36 m) magnetic resonance imaging, (0, 18 m) Pittsburgh compound B positron emission tomography, and clinical assessments. We calculated rates of whole brain and hippocampal atrophy, ventricular enlargement, amyloid accumulation, and cognitive decline. Over 3 years, rates of whole brain atrophy (p < 0.001), left and right hippocampal atrophy (p = 0.001, p = 0.023), and ventricular expansion (p < 0.001) were associated with baseline β-amyloid load. Whole brain atrophy rates were also independently associated with β-amyloid accumulation over the first 18 months (p = 0.003). Acceleration of left hippocampal atrophy rate was associated with baseline β-amyloid load across the cohort (p < 0.02). We provide evidence that rates of atrophy are associated with both baseline β-amyloid load and accumulation, and that there is presymptomatic, amyloid-mediated acceleration of hippocampal atrophy. Clinical trials using rate of hippocampal atrophy as an outcome measure should not assume linear decline in the presymptomatic phase

Narratives of self and identity in women's prisons: stigma and the struggle for self-definition in penal regimes

A concern with questions of selfhood and identity has been central to penal practices in women's prisons, and to the sociology of women's imprisonment. Studies of women's prisons have remained preoccupied with women prisoners’ social identities, and their apparent tendency to adapt to imprisonment through relationships. This article explores the narratives of women in two English prisons to demonstrate the importance of the self as a site of meaning for prisoners and the central place of identity in micro-level power negotiations in prisons

The neuropeptidome of the Crown-of-Thorns Starfish, Acanthaster planci

This study was supported by funds from the Australian federal government Department of the Environment Reef Rescue ‘Caring for Country’ program for funding the ‘The Crown-of-Thorns secretome: Towards a control technology’ project (M. R. H., S. C.). M.R.E. was supported by grants from the BBSRC (BB/M001644/1) and Leverhulme Trust (RPG-2013-351)

Pericytes support neutrophil subendothelial cell crawling and breaching of venular walls in vivo

Wellcome Trust (081172/Z/06/Z) to S. Nourshargh. D. Proebstl was supported by a Medical Research Council PhD studentship awarded to Barts and The London Medical School, and J. Whiteford is an Arthritis Research UK Fellow

The implementation of medical revalidation: an assessment using normalisation process theory

Abstract Background Medical revalidation is the process by which all licensed doctors are legally required to demonstrate that they are up to date and fit to practise in order to maintain their licence. Revalidation was introduced in the United Kingdom (UK) in 2012, constituting significant change in the regulation of doctors. The governing body, the General Medical Council (GMC), envisages that revalidation will improve patient care and safety. This potential however is, in part, dependent upon how successfully revalidation is embedded into routine practice. The aim of this study was to use Normalisation Process Theory (NPT) to explore issues contributing to or impeding the implementation of revalidation in practice. Methods We conducted seventy-one interviews with sixty UK policymakers and senior leaders at different points during the development and implementation of revalidation: in 2011 (n = 31), 2013 (n = 26) and 2015 (n = 14). We selected interviewees using purposeful sampling. NPT was used as a framework to enable systematic analysis across the interview sets. Results Initial lack of consensus over revalidation’s purpose, and scepticism about its value, decreased over time as participants recognised the benefits it brought to their practice (coherence category of NPT). Though acceptance increased across time, revalidation was not seen as a legitimate part of their role by all doctors. Key individuals, notably the Responsible Officer (RO), were vital for the successful implementation of revalidation in organisations (cognitive participation category). The ease with which revalidation could be integrated into working practices varied greatly depending on the type of role a doctor held and the organisation they work for and the provision of resources was a significant variable in this (collective action category). Formal evaluation of revalidation in organisations was lacking but informal evaluation was taking place. Revalidation had not yet reached the stage where feedback was being used for improvement (reflexive monitoring category). Conclusions Requiring all organisations to use the same revalidation model made revalidation easy to integrate into existing work for some but problematic for others. In order for revalidation to be fully embedded and successful, impeding factors, such as a lack of resources, need to be addressed

Exploring the market for Compressed Natural Gas light commercial vehicles in the United Kingdom

This paper examines the potential market for natural gas as a transportation fuel in the light commercial vehicle sector in the United Kingdom. In order to understand this market and identify barriers to growth and possible solutions interviews were conducted with a number of professionals with experience in this market. These interviews were open and exploratory enabling the application of grounded theory techniques in analysis. Clear priorities for potential users were cost and carbon reduction and the main constraint a lack of refuelling infrastructure. Small scale and low cost policy interventions were identified, at national level including maintaining tax differentials; easing payload restrictions; and limited support for refuelling facilities alongside local policy initiatives, for example, restoring the exemption from the London Congestion Charge for gas vehicles, that could help to kick-start the market at least at a niche level

Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context

© 2015 Taylor & Francis. Background and Objectives: Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students. Design: A randomized, controlled study. Methods: Students were randomly allocated to intervention (“Anxiety Relief”: n = 43; “Insomnia Relief”: n = 48; control: n = 47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index. Results: Significant within-group reductions in anxiety (t(31) = 2.00, p =.03) with moderate between-groups (compared to control) effect size (d =.64) and increases in sleep quality (t(31) = 3.46, p =.002) with a moderate between-groups effect size (d =.55) were found for completers of the anxiety program from pre-to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre-to post-intervention (t(35) = 4.28, p >.001) with a moderate between-groups effect size (d =.51). Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed