Psoriasis today: experiences of healthcare and impact on quality of life in a major UK cohort

Aim: To establish how people with psoriasis in the United Kingdom today experience living with their condition including diagnosis, treatment, healthcare provision and impact on daily life. Background: Psoriasis is a debilitating long-term inflammatory skin disease which can result in severe itching, discomfort and soreness, and may be associated with problems beyond the specific symptoms related to the skin. For many it is accompanied by difficult-to-manage treatment regimes, emotional distress and a negative impact on their quality of life and psychosocial functioning. To date there is little published information about the health experiences of people in the United Kingdom with psoriasis. Methods A postal self-administered questionnaire was completed by members of the Psoriasis Association and the responses analysed (n=1564). Findings The findings suggest some similarities to surveys in other nations, but specifically highlighted that patients feel under-informed and are dissatisfied with current treatment regimes. Responses provided an insight into aspects of the condition that treatments should be targeting. Specific areas of negative impact on psychosocial functioning were identified, including the lack of available support for those experiencing emotional distress. The research provides important information about how the care of patients with psoriasis can be improved, especially at primary care level. This includes: improved training in psoriasis knowledge and awareness at general practitioner level and greater use of dermatology specialist nurses in primary care settings; more effective and manageable treatment regimes that target visible areas and general well-being; greater support for emotional distress and psychosocial functioning.Peer reviewedFinal Accepted Versio

'When no means no' - adolescent right to refuse an elective surgical procedure : a case study

At law, adults are presumed to have legal competency to provide consent for or refusal to consent to health care treatments unless they have cognitive impairment. But what of the adolescent who is, at law, a child but who refuses to undergo elective surgical treatment? This paper discusses the issues surrounding the case of Keith, a 14-year-old boy with ulcerative colitis, who refuses consent to undergo an elective ileostomy

Nurse leadership in promoting and supporting civility in health care settings : a scoping review

Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd

Behavioral discrimination between monogyne and polygyne red fire ants (Hymenoptera: Formicidae) in their native range

Nestmate recognition among social insects is presumed to restrict non-nestmates from exploiting nest resources. Here, we developed aggression bioassays to assess the discrimination behaviors of both polygynous and monogynous forms of the red fire ant, Solenopsis invicta Buren, during symmetrical interactions in neutral arenas. Workers from polygyne colonies exhibited risk avoidance behaviors; that is, defensive postures or the avoidance of direct contact during interactions. Workers from monogyne colonies always exhibited aggressive behaviors in the form of physical or chemical attacks. In interactions between both, monogyne workers usually started the aggression by surrounding and biting the polygyne ants. Polygyne S. invicta workers also distinguished nestmates from foreigners, but their response was not as aggressive as that of monogynes. The proposed ethogram that we constructed identified monogyne and polygyne forms of S. invicta colonies in concordance with current measures, including number of queens, and expression of the Gp-9 gene.Fil: Chirino, Monica Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes. Centro de Estudios e Investigación; ArgentinaFil: Gilbert, Lawrence E.. University of Texas at Austin; Estados UnidosFil: Folgarait, Patricia Julia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes. Centro de Estudios e Investigación; Argentin

Pseudacteon tricuspis: Its behavior and development according to the social form of its host and the role of interference competition among females

We studied how the behavior and performance of Pseudacteon tricuspis Borgmeier varies with the social form of its host Solenopsis invicta Buren, in its native range in Argentina where monogyne colonies are more abundant than polygynes (≈75 vs. 25%). Female, P. tricuspis took 44% less time (50 vs. 89 s) to attack monogyne than polygyne ants, but oviposition attempts were similar (23 vs. 18 attacks). The presence of the parasitoid affected the average size of foragers on the trail, with the proportion of minor workers increasing on both social forms. In the laboratory, P. tricuspis selected similar host sizes, although pupal survival was 25% higher on monogynes than on polygynes. Developmental times of both genders were similar (3335 d), although larger females emerged from bigger hosts. The sex ratio of P. tricuspis was more male biased when exploiting polygyne ants. Intraspecific competition significantly affected parasitoid reproductive success, being significantly higher for a solitary female than when three females were present, although the size of workers selected did not vary. The male:female ratio also changed, being 1:1 without competition but 2:1 with competition. We demonstrated for the first time the consequences of interference competition among P. tricuspis females, a common behavior observed in others parasitoids. We discuss why P. tricuspis sex ratios are always biased toward males in both social forms and suggest that similar studies of interference competition within and between already naturalized Pseudacteon species in the United States could help predict establishment patterns.Fil: Chirino, Monica Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes. Centro de Estudios e Investigación; ArgentinaFil: Folgarait, Patricia Julia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes. Centro de Estudios e Investigación; ArgentinaFil: Gilbert, Lawrence E.. University of Texas at Austin; Estados Unido

The Evolution of an Architectural Paradigm - Using Blockchain to Build a Cross-Organizational Enterprise Service Bus

Cross-organizational collaboration and the exchange of process data are indispensable for many processes in federally organized governments. Conventional IT solutions, such as cross-organizational workflow management systems, address these requirements through centralized process management and architectures. However, such centralization is difficult and often undesirable in federal contexts. One alternative solution that emphasizes decentralized process management and a decentralized architecture is the blockchain solution of Germany’s Federal Office for Migration and Refugees. Here, we investigate the architecture of this solution and examine how it addresses the requirements of federal contexts. We find that the solution’s architecture resembles an improvement and cross-organizational adaption of an old architectural paradigm, the enterprise service bus

Abnormal functional specialization within medial prefrontal cortex in high-functioning autism: a multi-voxel similarity analysis

Multi-voxel pattern analyses have proved successful in ‘decoding’ mental states from fMRI data, but have not been used to examine brain differences associated with atypical populations. We investigated a group of 16 (14 males) high-functioning participants with autism spectrum disorder (ASD) and 16 non-autistic control participants (12 males) performing two tasks (spatial/verbal) previously shown to activate medial rostral prefrontal cortex (mrPFC). Each task manipulated: (i) attention towards perceptual versus self-generated information and (ii) reflection on another person's mental state (‘mentalizing'versus ‘non-mentalizing’) in a 2 × 2 design. Behavioral performance and group-level fMRI results were similar between groups. However, multi-voxel similarity analyses revealed strong differences. In control participants, the spatial distribution of activity generalized significantly between task contexts (spatial/verbal) when examining the same function (attention/mentalizing) but not when comparing different functions. This pattern was disrupted in the ASD group, indicating abnormal functional specialization within mrPFC, and demonstrating the applicability of multi-voxel pattern analysis to investigations of atypical populations

Bandwidth, expansion, treewidth, separators, and universality for bounded degree graphs

We establish relations between the bandwidth and the treewidth of bounded degree graphs G, and relate these parameters to the size of a separator of G as well as the size of an expanding subgraph of G. Our results imply that if one of these parameters is sublinear in the number of vertices of G then so are all the others. This implies for example that graphs of fixed genus have sublinear bandwidth or, more generally, a corresponding result for graphs with any fixed forbidden minor. As a consequence we establish a simple criterion for universality for such classes of graphs and show for example that for each gamma>0 every n-vertex graph with minimum degree ((3/4)+gamma)n contains a copy of every bounded-degree planar graph on n vertices if n is sufficiently large