Psychosocial outcomes of enhanced external counterpulsation treatment : illness perceptions and psychological wellbeing

The portfolio has three parts: Part 1 is a systematic literature review, in which the theoretical, conceptual and empirical literature relating to the relationship between illness perceptions, mood and quality of life in coronary heart disease populations is reviewed. The results of this study provide support that illness perceptions are related to outcomes across CHD populations and disease progression, however the results do not selectively support one particular model. Recommendations are consistent with cardiac rehabilitation guidelines. Further research should focus on the systemic impact of illness perceptions.Part 2 is divided into two empirical papers:Paper 1 utilises a qualitative methodology to explore refractory angina patients' experiences of undergoing EECP, and their lives before and after the treatment. The study adds to existing literature by proposing that the process of undergoing EECP treatment not only leads to physiological improvement, but also effects psychological pathways, through providing hope, establishing a therapeutic relationship and increasing confidence and self-efficacy to confront positive and challenging health-behaviour changes.Paper 2 utilises a quantitative methodology to explore the relationship between illness perceptions, mood and quality of life in chronic refractory angina patients that have undergone EECP treatment. The current study supports constructs from relevant models; the self-regulatory model, theory of planned behaviour and an adapted version of the fear-avoidance model. A possible model demonstrating the process between illness perceptions and outcomes specific for chronic refractory angina patients is proposed. Future research could focus on concomitant interventions to improve physical and psychological outcomes, for example the Angina Plan could be delivered in conjunction with EECP to establish an integrated, multidisciplinary model of care and service delivery.Part 3 comprises the appendices. This includes a reflective statement and supplementary information relevant to all three papers

A Phenomenological Study of Clergy Job-Related Stress and Stress-Coping During COVID-19

The purpose of this phenomenological study was to explore the lived experience of stress and stress-coping of five Michigan pastors who led their Evangelical Free Church of America (EFCA) congregations through the 2020-21 COVID-19 pandemic. Stress is generally defined as the psychophysiological response to a perceived threat or stressor, and stress-coping is generally defined as intentional behaviors designed to manage stress. The theoretical background of this study is the transactional theory of stress and coping (TTSC) (Lazarus, 1966; Lazarus & Folkman, 1984) as it relates to pastors’ lived experience of ministry-related stress and coping in crisis conditions. The rationales for the study were 1) a relative lack of qualitative research into clergy job related stress during the 2020-21 coronavirus outbreak, and 2) the relatively thin descriptions provided by quantitative methods, and 3) the value of thick, rich descriptions of pastors’ experiences provided by qualitative phenomenological analysis. The research was conducted through in-depth interviews that were coded, analyzed, and interpreted. The interview questions were designed to explore the participants’ lived experiences, especially the phenomenon of job-related stress and stress coping experienced during the COVID-19 pandemic. Since the research involved in-depth interviews, new information came to light about the sources and symptoms of stress in pastors’ lives, as well as their strategies for coping, during a pandemic. Four themes emerged from the analysis of the data along with one major concept

Connections between RNA Polymerase II transcriptional regulation, nucleosome arrangement and DNA damage

Transcription by RNA polymerase II (RNAPII) is a central process in gene expression and so subject to many layers of regulation: post-translational modifications of the RNAPII C-terminal domain (CTD), transcription factor association, chromatin compaction and the control of polymerase access to DNA. Transcription can also be altered when DNA damage is encountered. My thesis addressed different aspects of these regulatory mechanisms. Firstly I studied the role of RNA:DNA hybrids (R-loops) in pause-type termination, and assessed whether data based on the β-actin gene could be extended to further genes. I also investigated whether DNA damage repair (DDR) factor Rad51 is present over R-loop associated pause regions. Secondly I studied the roles of tyrosine and threonine phosphorylation (Y1P and T4P) of the RNAPII CTD, by testing their association with DDR and transcription termination respectively. I also developed a modified MNase-seq protocol using mNET-seq isolation conditions to allow close comparison between chromatin configuration and the nascent RNA signal. The outcome of my research was that I found the PKM gene exhibits the same basic characteristics of pause-type termination, including R-loop formation. However, little evidence for heterochromatin formation as observed for β-actin termination was identified. I also showed that Rad51 accumulates at R-loop regions in pause-type termination, but does not appear to induce R-loops. More likely Rad51 is recruited by downstream DDR factors. Y1P is associated with factors involved in UV DDR. My studies showed that UV damage causes a global RNAPII elongation defect with altered chromatin associated histone marks and defective recruitment of elongation factors including the PAF1 complex and SPT6 to the polymerase. Finally my studies on T4P-associated termination cis-elements indicated that positions of cleavage-independent termination are formed relative to mRNA 3’ ends but not based on specific DNA sequence. Also cleavage factor depletion increased mononucleosome signals in these termination regions

The Nature of Certain Catarrhal Affections.1

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Could the Tree of Life model be a useful approach for UK mental health contexts? A review of the literature

Some suggest the ethos of the Tree of Life (ToL) group aligns with the concept of “personal-recovery” promoted in mental health policy. Thus, it is claimed that the group could be a useful approach within UK mental health services. This review collated 14 papers to explore whether existing literature regarding the ToL group supports this assertion. The papers were synthesized using the thematic analysis method and three broad themes were identified, which support the argument for its utility within services. These were recovery-aligned themes, the inclusivity of the model, and group processes relevant to mental health contexts. The papers are critically appraised, key concerns regarding the wider literature discussed, and clinical implications summarized

Having, making and feeling home as a European immigrant in the United Kingdom post-Brexit referendum: An interpretative phenomenological study

Migrants' subjective sense of home deserves further research attention. In the particular context of the United Kingdom's (UK's) decision to leave the European Union (‘Brexit’), we interviewed 10 European citizens living in the UK about their sense of home, using interpretative phenomenological analysis (IPA). In our analysis, we identified themes of (1) having more than one home, (2) making and finding a new home, (3) being permanently different from the non-migrant population and (4) a concern about feeling safe and welcome. Migration and sense of home involved building and rebuilding personal and social identity. Making a new home was effortful, and neither the old home nor the difference from the native population ever disappeared psychologically. This adds an experiential aspect to the idea of ‘integration’ in acculturation. Different notions of home were linked to different experiences of the impact of the Brexit referendum. We discuss the connections between acculturation, sense of home and lived experience and propose lived identity as a fruitful subject matter for social psychology

Could the Tree of Life Model Be a Useful Approach for UK Mental Health Contexts? A Review of the Literature

Some suggest the ethos of the Tree of Life (ToL) group aligns with the concept of “personal-recovery” promoted in mental health policy. Thus, it is claimed that the group could be a useful approach within UK mental health services. This review collated 14 papers to explore whether existing literature regarding the ToL group supports this assertion. The papers were synthesized using the thematic analysis method and three broad themes were identified, which support the argument for its utility within services. These were recovery-aligned themes, the inclusivity of the model, and group processes relevant to mental health contexts. The papers are critically appraised, key concerns regarding the wider literature discussed, and clinical implications summarized