Empirical Study: ‘Treated as a person, not a case’: exploring meaning-making in an open dialogue informed mental health service

Empirical Study Abstract - Background: Against a tradition that has given preference to the ‘expert’ view of practitioners, a growing number of former service users have campaigned for mental health services to restore personal meaning to their mental health. Open Dialogue is an approach to mental health services that facilitates shared meaning-making among service users and professionals. Aims: This study investigated how individuals currently engaged in an Open Dialogue informed mental health clinic in Ireland made sense of their mental health. Method: Six individual semi-structured interviews were conducted and analysed using interpretative phenomenological analysis. Results: Two superordinate themes and related subthemes are discussed: ‘The Context of Meaning-Making: Relationships and Conversations’ and ‘New Meanings’. Conclusions: The participants provided evocative accounts of meaning-making within an OD informed mental health service, drawing from experiences of non-dialogical services to make valuable comparisons. The narratives provide evidence to support OD as a humanising approach to mental health services, which facilitates, rather than imposes meaning, and may lead to relational and individualised narratives that reduce self-blame.Systematic Review Abstract - Background: A father’s understanding, management and support of his partner through maternal postpartum depression (PPD) has implications for the mother’s recovery, the couple relationship and infant development. Aim: To systematically review qualitative research investigating fathers’ experiences of their partners’ PPD. Method: The following databases were searched from inception to October 2018: Academic Search Complete, MEDLINE, PsycINFO, PsycARTICLES, Psychology & Behavioral Sciences Collection, CINAHL and Maternity & Infant Care. Inclusion criteria were qualitative or mixed methodology, English language papers, and fathers as primary informants, whose partners had a current or previous diagnosis of PPD. Eight studies were included for thematic synthesis, with a combined sample size of 67. Overarching themes were: Understanding PPD; Relationships; Supporting a Partner with PPD; Burden of PPD; and Supporting Fathers. Conclusion: There has been limited research on this topic over the past two decades. Key limitations of studies include the prevalence of snowball sampling methods and lack of information about fathers’ previous mental health history. Findings point to fathers’ limited understanding of maternal PPD, a desire to be included in interventions, and a negative impact on fathers’ well-being and parenting capacity. There is a need for increased psychoeducation, father support, and partner-inclusive intervention

Technology use in everyday life: Implications for designing for older users

This study examines the experience and attitudes of older adults towards technology and how they compare with younger age groups. Two hundred and thirty seven participants completed an extensive questionnaire exploring their daily lifestyle, use of technology, attitudes towards technology, and perceived difficulty of household devices. The main findings from the study were; (1) there was a strong motivation to learn or to continue learning to use computers by the older group; (2) social connectedness influenced how the older group used or would like to use technology and also why some preferred not to use it; and finally (3) there was an age-related increase in perceived difficulty for many household devices, however some devices maintained intergenerational usability. These finding can be used to inform the design of future intergenerational household technologies

Exploring school bullying: designing the research question with young co-researchers

Participatory Action Research (PAR) empowers young people to work alongside adult researchers to determine the purpose/scope of research projects. By naming the purpose of the research, young people have the potential to transform it. Beginning with a broad question, we worked in collaboration with secondary school students (co-researchers) and staff to decide on the focal research question. Prior to recruiting the co-researchers, we conducted an ‘exploration study’ using a qualitative online questionnaire distributed to the wider school population, to ascertain the core bullying issues. Although the questionnaire highlighted complexities in recognising bullying, misogynistic behaviour was stressed as a particular concern. In-depth discussions with the co-researchers and reflections on the questionnaire findings over several months gave us further insight into this issue, as well as the complexities of determining bullying/banter. Our research question was determined as: “Does gender bullying happen at this school?” Two distinct methodological and process-related insights arose from this work: power dynamics and the construct of time as duration and a non-linear process. This paper contributes to the literature on hearing stakeholder views as well as on actively including students in designing and developing research foundations, that is the research question, an under-explored topic in the wider literature

Exploring School Bullying: Designing the Research Question with Young Co-Researchers

Participatory Action Research (PAR) empowers young people to work alongside adult researchers to determine the purpose/scope of research projects. By naming the purpose of the research, young people have the potential to transform it. Beginning with a broad question, we worked in collaboration with secondary school students (co-researchers) and staff to decide on the focal research question. Prior to recruiting the co-researchers, we conducted an ‘exploration study’ using a qualitative online questionnaire distributed to the wider school population, to ascertain the core bullying issues. Although the questionnaire highlighted complexities in recognising bullying, misogynistic behaviour was stressed as a particular concern. In-depth discussions with the co-researchers and reflections on the questionnaire findings over several months gave us further insight into this issue, as well as the complexities of determining bullying/banter. Our research question was determined as: “Does gender bullying happen at this school?” Two distinct methodological and process-related insights arose from this work: power dynamics and the construct of time as duration and a non-linear process. This paper contributes to the literature on hearing stakeholder views as well as on actively including students in designing and developing research foundations, that is the research question, an under-explored topic in the wider literature

The economic impact of living with a rare disease for children and their families: a scoping review protocol [version 2; peer review: 2 approved, 1 not approved]

Background Rare diseases are an often chronic, progressive and life-limiting group of conditions affecting more than 30 million people in Europe. These diseases are associated with significant direct and indirect costs to a spectrum of stakeholders, ranging from individuals and their families to society overall. Further quantitative research on the economic cost for children and their families living with a rare disease is required as there is little known on this topic. This scoping review aims to document the extent and type of evidence on the economic impacts of living with a rare disease for children and their families. Methods This scoping review will follow the PRISMA-ScR and Joanna Briggs Institute guidelines and follow the six-stage methodology for scoping reviews: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting results and (6) knowledge user consultation. Key inclusion criteria have been developed according to the Population-Concept-Context (PCC) framework. The databases EconLit, ABI/Inform, MEDLINE, PubMed, CINAHL, and Scopus will be searched for possible articles for inclusion. Two independent reviewers will screen titles and abstracts of potential articles using a dual review process to ensure all relevant studies are included. All included articles will be assessed using a validated quality appraisal tool. A panel of patient and public involvement representatives experiencing rare diseases and knowledge users will validate the review results. Conclusions This scoping review will map the current literature on the economic impact of paediatric rare diseases to understand how these impacts affect children living with rare diseases and their families. This evidence has the potential to influence policy and future research in this area and will support further research on the economic impact of rare diseases on families

The Microenvironment of Visceral Adipose Tissue and Liver Alter Natural Killer Cell Viability and Function

The role of NK cells in visceral adipose tissue (VAT) and liver inflammation in obesity is not fully understood. This study investigated the frequency, cytokine expression, chemokine receptor, and cytotoxicity receptor profile of NK cells in the blood, omentum, and liver of patients with the obesity-associated cancer, oesophageal adenocarcinoma (OAC). The effect of chronically inflamed tissue microenvironments on NK cell viability and function was also examined. We identified significantly lower NK cell frequencies in the liver of OAC patients compared with healthy controls and within the omentum and liver of OAC patients compared with blood, whereas IL-10-producing populations were significantly higher. Interestingly, our data suggest that reduced frequencies of NK cells in omentum and liver of OAC patients are not a result of impaired NK cell chemotaxis to these tissues. In fact, our functional data revealed that secreted factors from omentum and liver of OAC patients induce significant levels of NK cell death and lead to reduced percentages of TNF-α+ and NKP46+ NK cells and higher frequencies of IL-10-producing NK cells. Together, these data suggest that the omental and hepatic microenvironments of OAC patients alter the NK cell phenotype to a more anti-inflammatory homeostatic role

Creation of a universal experimental protocol for the investigation of transfer and persistence of trace evidence:Part 2 – Implementation and preliminary data

This is the second paper on the development and implementation of a universal experimental protocol for transfer and persistence of trace evidence. Here, we present the results of five individual researchers who implemented the universal experimental protocol for the first time. Over 2500 images were collected, computationally analysed and statistically compared. The results were shown to be reliable and consistent under all conditions tested and were used to model the rate of loss of transferred particles over a 7-day timescale. The protocol was additionally extended to include a test of camera settings. The protocol was found to be useable and robust in this preliminary trial paving the way for it to be deployed more widely

Visceral Adipose Tissue Modulates Radiosensitivity in Oesophageal Adenocarcinoma

Oesophageal adenocarcinoma (OAC) is an exemplar model of obesity-associated cancer. Response to neoadjuvant chemoradiotherapy (NA CRT) is a clinical challenge. We examined if visceral adipose tissue and obesity status alter radiosensitivity in OAC. The radioresistant (OE33R) and radioresponsive (OE33P) OAC isogenic model was cultured with adipose tissue conditioned media from three patient cohorts: non-cancer patients, surgery only OAC patients and NA CRT OAC patients. Cell survival was characterised by clonogenic assay, metabolomic profiling by nuclear magnetic resonance spectroscopy and adipokine receptor gene expression by qPCR. A retrospective in vivo study compared tumour response to NA CRT in normal weight (n=53) versus overweight/obese patients (n=148). Adipose conditioned media (ACM) from all patient cohorts significantly increased radiosensitivity in radioresistant OE33R cells. ACM from the NA CRT OAC cohort increased radiosensitivity in OE33P cells. Metabolomic profiling demonstrated separation of the non-cancer and surgery only OAC cohorts and between the non-cancer and NA CRT OAC cohorts. Gene expression profiling of OE33P versus OE33R cells demonstrated differential expression of the adiponectin receptor-1 (AR1), adiponectin receptor-2 (AR2), leptin receptor (LepR) and neuropilin receptor-1 (NRP1) genes. In vivo overweight/obese OAC patients achieved an enhanced tumour response following NA CRT compared to normal weight patients. This study demonstrates that visceral adipose tissue modulates the cellular response to radiation in OA

Attenuated CSF-1R signalling drives cerebrovascular pathology

Cerebrovascular pathologies occur in up to 80% of cases of Alzheimer's disease; however, the underlying mechanisms that lead to perivascular pathology and accompanying blood-brain barrier (BBB) disruption are still not fully understood. We have identified previously unreported mutations in colony stimulating factor-1 receptor (CSF-1R) in an ultra-rare autosomal dominant condition termed adult-onset leucoencephalopathy with axonal spheroids and pigmented glia (ALSP). Cerebrovascular pathologies such as cerebral amyloid angiopathy (CAA) and perivascular p-Tau were some of the primary neuropathological features of this condition. We have identified two families with different dominant acting alleles with variants located in the kinase region of the CSF-1R gene, which confer a lack of kinase activity and signalling. The protein product of this gene acts as the receptor for 2 cognate ligands, namely colony stimulating factor-1 (CSF-1) and interleukin-34 (IL-34). Here, we show that depletion in CSF-1R signalling induces BBB disruption and decreases the phagocytic capacity of peripheral macrophages but not microglia. CSF-1R signalling appears to be critical for macrophage and microglial activation, and macrophage localisation to amyloid appears reduced following the induction of Csf-1r heterozygosity in macrophages. Finally, we show that endothelial/microglial crosstalk and concomitant attenuation of CSF-1R signalling causes re-modelling of BBB-associated tight junctions and suggest that regulating BBB integrity and systemic macrophage recruitment to the brain may be therapeutically relevant in ALSP and other Alzheimer's-like dementias