Acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS): A novel intervention for anorexia nervosa

Investigate the acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS), a novel intervention for anorexia nervosa (AN), conducted as a feasibility trial to provide an initial test of the intervention. SPEAKS therapy lasting 9-12 months was provided to 34 people with AN or atypical AN by eight specialist eating disorder therapists trained in the model across two NHS Trusts in the UK (Kent and Sussex) during a feasibility trial. All participants were offered a post-therapy interview; sixteen patients and six therapists agreed. All patient participants were adult females. Interviews were semi-structured and asked questions around individuals' experience of SPEAKS, the acceptability of the intervention and of the research methods. Interviews were analyzed using thematic analysis. Key areas explored in line with research questions led to 5 overarching themes and 14 subthemes: (1) shift in treatment focus and experience, (2) balancing resources and treatment outcomes, (3) navigating the online treatment environment, (4) therapist adaptation and professional development, and (5) research processes. SPEAKS was found to be an acceptable intervention for treating AN from the perspective of patients and therapists. The findings provide strong support for delivery of a larger scale randomized control trial. Recommendations for future improvements, particularly pertaining to therapist understanding of the treatment model are detailed, alongside broader clinical implications. We aimed to evaluate the acceptability of a new anorexia nervosa treatment called SPEAKS. Interviews were conducted with patients and therapists involved in the pilot study and responses were analyzed. Results showed that both patients and therapists found SPEAKS to be an acceptable treatment for anorexia nervosa. The study suggests that SPEAKS meets the criteria for moving forward with a larger trial to assess its effectiveness. [Abstract copyright: © 2024 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.

Japanese version of the family dermatology life quality index: translation and validation

Skin conditions affect the quality of life (QoL) of patients and their family. To assess family members' QoL, a questionnaire uniquely designed for family members is necessary. We translated the Family Dermatology Life Quality Index (FDLQI), originally created and validated by Basra et al., into Japanese, and evaluated its reliability and validity. For psychometric evaluations, 150 dermatology patients and their family members were included. The Japanese version of the FDLQI showed high test–retest reliability (intraclass correlation coefficient = 0.95) and internal consistency reliability (Cronbach's alpha = 0.86). FDLQI scores significantly correlated with DLQI scores (r = 0.58, P < 0.01, Spearman's rho) and global question (GQ) which measured the patient's skin condition on a visual analog scale (r = 0.36, P < 0.01). Family members of patients with inflammatory skin diseases showed higher FDLQI scores than those with isolated lesions, but the difference was not statistically significant (P = 0.062, Mann–Whitney U-test). Responsiveness to change was demonstrated in a group in which the patient's skin condition was assessed as improved (n = 37, r = 0.46, P < 0.01) but not in that in which it became worse. The difference of the change between the two groups was statistically significant (P < 0.01). Additionally, the change in FDLQI scores and GQ were significantly correlated (r = 0.40, P < 0.01). Exploratory factor analysis suggested essential unidimensionality of the instrument. We showed acceptable validity and responsiveness of this Japanese version of FDLQI. Further clinical epidemiological studies are required to confirm this

Genetic analysis indicate superiority of perfomance of cape goosberry (Physalis peruviana L.) hybrids

The use of hybrids as a new type of cape gooseberry (Physalis peruviana L.) cultivars could improve yield in this crop, but little or no information is available on hybrid perfomance. We studied several vegetative characters, yield, fruit weight and fruit shape, soluble solids content (SSC), titratable acidity (TA) and ascorbic acid content (AAC) in three hybrids of cape gooseberry and their parents grown outdoors and in a glasshouse. The highest yields were obtained with hybrids, specially in a glasshouse. Interaction dominance environment for yield was very important; a higher dominance effect was detected in the glasshouse, than that observed outdoors. Quality characters were highly affected by the environment and showed variable results for the different families. For fruit composition traits, the additive and additive environment interactions were most important. Broad-sense heritability for all characters was high to medium (0.48-0.91), indicating that a high response to selection would be expected. Hybrids can improve cape gooseberry yield without impairing fruit quality.Leiva-Brondo, M.; Prohens Tomás, J.; Nuez Viñals, F. (2001). Genetic analysis indicate superiority of perfomance of cape goosberry (Physalis peruviana L.) hybrids. Journal of New Seeds. 3(3):71-84. doi:10.1300/J153v03n03_04718433Abak, K., Güler, H. Y., Sari, N., & Paksoy, M. (1994). EARLINESS AND YIELD OF PHYSALIS (P. IXOCARPA BROT. AND P. PERUVIANA L.) IN GREENHOUSE, LOW TUNNEL AND OPEN FIELD. Acta Horticulturae, (366), 301-306. doi:10.17660/actahortic.1994.366.37Kang, M. S. (1997). Using Genotype-by-Environment Interaction for Crop Cultivar Development. Advances in Agronomy Volume 62, 199-252. doi:10.1016/s0065-2113(08)60569-6Klinac, D. J. (1986). Cape gooseberry (Physalis peruviana) production systems. New Zealand Journal of Experimental Agriculture, 14(4), 425-430. doi:10.1080/03015521.1986.10423060Mather, K., & Jinks, J. L. (1977). Introduction to Biometrical Genetics. doi:10.1007/978-94-009-5787-9Mazer, S. J., & Schick, C. T. (1991). Constancy of population parameters for life history and floral traits in Raphanus sativus L. I. Norms of reaction and the nature of genotype by environment interactions. Heredity, 67(2), 143-156. doi:10.1038/hdy.1991.74Nyquist, W. E., & Baker, R. J. (1991). Estimation of heritability and prediction of selection response in plant populations. Critical Reviews in Plant Sciences, 10(3), 235-322. doi:10.1080/07352689109382313Pearcy, R. W. (1990). Sunflecks and Photosynthesis in Plant Canopies. Annual Review of Plant Physiology and Plant Molecular Biology, 41(1), 421-453. doi:10.1146/annurev.pp.41.060190.002225Péron, J. Y., Demaure, E., & Hannetel, C. (1989). POSSIBILITIES OF TROPICAL SOLANACEAE AND CUCURBITACEAE INTRODUCTION IN FRANCE. Acta Horticulturae, (242), 179-186. doi:10.17660/actahortic.1989.242.24Proctor, F. J. (1990). THE EUROPEAN COMMUNITY MARKET FOR TROPICAL FRUIT AND FACTORS LIMITING GROWTH. Acta Horticulturae, (269), 29-40. doi:10.17660/actahortic.1990.269.

Past as global trade governance prelude: reconfiguring debate about reform of the multilateral trading system

This paper peers backwards into the history of the multilateral trading system and its development over the past half century as a means of considering what may lie beyond the horizon for the future of global trade governance. Its purpose is to underscore the necessity and urgency for root-and-branch reform of the multilateral trading system. It achieves this by comparing and contrasting the global trading system of 50 years ago with its modern-day equivalent and its likely future counterpart half-a-century hence. In so doing, the paper throws into sharp relief not only the inadequacies of global trade governance today but also the damaging consequences of not fundamentally reforming the system in the near future, with a particular emphasis on the past, present and future development of the world’s poorest and most marginalised countries

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Life Quality Impairment Caused by Hookworm-Related Cutaneous Larva Migrans in Resource-Poor Communities in Manaus, Brazil

Hookworm-related cutaneous larva migrans (CLM) is a parasitic skin disease common in developing countries with hot climates. In resource-poor settings, CLM is associated with considerable morbidity. The disease is caused by animal hookworm larvae that penetrate the skin and migrate aimlessly in the epidermis as they cannot penetrate the basal membrane. Particularly in the rainy season, the intensity of infection is high with up to 40 larval tracks in an affected individual. Tracks are very itchy and are surrounded by a significant inflammation of the skin. Bacterial superinfection is common and intensifies the inflammation. The psychosocial consequences caused by CLM have never been investigated. We showed that CLM causes skin disease-associated life quality impairment in 91 patients with CLM. Skin disease-associated life quality was significantly impaired. The degree of impairment correlated to the intensity of infection and the number of body areas affected. After treatment with ivermectin, life quality was rapidly restored

The GOLMePsA study protocol: an investigator-initiated, double-blind, parallel-group, randomised, controlled trial of GOLimumab and methotrexate versus methotrexate in early diagnosed psoriatic arthritis using clinical and whole body MRI outcomes

Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis which impacts significantly on the quality of life and work capacity of affected individuals. Recent evidence has shown that early control of inflammation in PsA leads to improved long-term outcomes. It is postulated that prompt intervention after diagnosis using a remission-induction treatment strategy will lead to improved outcomes and optimal disease control of PsA. The aim of the present study was to compare the clinical efficacy of a treatment strategy in newly diagnosed, treatment naïve PsA subjects, using the combination of golimumab (GOL), methotrexate (MTX) and steroids versus standard care (MTX monotherapy plus steroids). Methods/design: GOLMePsA is an investigator initiated, phase IIIb, single-centre, randomised, double-blind, placebo-controlled, two-armed, parallel-group, imaging-supplemented study. Eighty-eight PsA patients, diagnosed within 24 months prior to screening and treatment naïve, will be randomised at baseline to receive: (arm 1) the combination of intramuscular/intra-articular prednisolone, MTX and GOL or (arm 2) the combination of intramuscular/intra-articular prednisolone, MTX and placebo for 24 weeks (interventional period). Primary outcome measure is clinical improvement (at least 1 unit difference) in the Psoriatic ArthritiS Disease Activity Score (PASDAS) composite index. Reflecting a “step down” therapeutic approach, all participants successfully completing the interventional period will be followed up for a further 28 weeks. During this observational period, stable maintenance MTX monotherapy will continue for both arms, unless in case of intolerance or PsA relapse. In the latter case, additional treatment will be provided. Overall, the GOLMePsA study length is planned to be 52 weeks. Discussion: The hypothesis underlining this study is that very early treatment with first-line GOL reduces disease activity in PsA, in comparison to conventional therapy. Trial registration: EudraCT 2013–004122-28. 24/09/2013