Developing an emotional coping skills workbook for inpatient psychiatric settings: a focus group investigation

Background: Evidence suggests an unmet need for provision of psychological interventions in inpatient psychiatric settings. However, inpatient wards can present a challenging environment in which to implement interventions. The authors developed the Emotional Coping Skills workbook, a psychosocial intervention designed to overcome these challenges and provide inpatients with an opportunity for psychologically-informed therapeutic engagement. The workbook includes information and exercises to empower inpatients to understand their emotions and learn to cope with their distress. Methods: A qualitative study using thematic analysis was undertaken in two UK inpatient psychiatric hospitals to explore staff’s views about whether and how the workbook could be implemented, and on barriers to its use. Thirty-five nursing and occupational therapy staff members participated in four focus groups, and a further two psychologists in semi-structured interviews. Results: Staff identified key barriers to successful implementation of the workbook. These were firstly, the difficulty in finding time and space for therapeutic work in the stressful ward environment. Secondly, staff identified a culture of emotional neglect whereby neither staff nor inpatients felt able to talk about emotions, and patients’ physical needs and medication were prioritised. Thirdly, staff discussed how psychotic symptoms and emotional distress could limit patients’ ability to engage with the workbook material. Staff suggested ways in which the feasibility of using the workbook could be enhanced. Firstly, they discussed the importance of encouraging staff to value psychological approaches and to view the workbook as a resource to help them manage their existing tasks. Secondly, they emphasised the value of staff drawing on their expertise to deliver the workbook flexibly in different formats and settings, depending on each patient’s particular presentation. Thirdly, they advocated empowering staff to decide the timing of intervention delivery in the context of each inpatient’s fluctuations in distress and progress towards recovery. Conclusions: The study has highlighted key principles for flexible and well-integrated intervention delivery; these principles will be helpful for enhancing the feasibility of any nurse-delivered psychological intervention in inpatient settings

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Wallace the rEvolutionary Man

The rEvolutionary Man is a video forming part of the exhibition commemorating the eminent naturalist Alfred Russel Wallace showcased at the Museum and Art Gallery of the Northern Territory (MAGNT) from Friday, 8 November 2013 until Sunday, 22 June 2014. The exhibition was timed to commemorate 100 years since Wallace's passing. Wallace, a cofounder of the Theory of Natural Selection (with Charles Darwin), has been called the father of biogeography and is the author of one of the most popular adventure books of all time, The Malay Archipelago The exhibition showcased Wallace's exploration of the tropical jungles of Southeast Asia and New Guinea and his ideas on Evolution by Natural Selection and animal biogeography.Video to accompany Wallce Exhibition: The rEvolutionary Ma

Description and phylogeny of Namalycastis jaya sp. n. (Polychaeta, Nereididae, Namanereidinae) from the southwest coast of India

Namalycastis jaya sp. n. (Polychaeta: Nereididae: Namanereidinae) is described from the southern coast of Kerala in southwest India. One important characteristic feature of the species is the lack of notochaetae in all parapodia, a characteristic that it shares with at least two other species, Namalycastis elobeyensis Glasby, 1999 and Namalycastis hawaiiensis Johnson, 1903. It differs from N. elobeyensis by virtue of its smaller antennae, unequal eye size, bilobed acicular neuropodial ligule and multi-incised pygidium rim. Moreover, it differs from N. hawaiiensis byfewer teeth on the serrated blades of the sub-neuroacicular falciger in chaetiger 10, and by possessing finely serrated falcigers in posterior segments. Beyond morphological analyses, molecular phylogenetics was used for the first time for Namalycastis to support population monophyly and recognition of the new species. The analysis, using both mitochondrial and nuclear data, corroborated the morphological analysis in suggesting that our specimens represent an as yet undescribed species, Namalycastis jaya sp. n., which forms a monophyletic group among the sampled nereidid taxa. Finally, a taxonomic key for Namalycastis species recorded from the Indian region is provided

Figure 1 from: Bonyadi-Naeini A, Rahimian H, Glasby CJ (2016) A new substance to relax polychaete worms (Annelida) prior to morphological study. ZooKeys 594: 1-9. https://doi.org/10.3897/zookeys.594.8061

A variety of chemical substances have been used to relax and/or immobilize polychaete worms, and other invertebrates, prior to specimen preparation for morphological examination. To solve difficulties encountered during the study of nereidid polychaetes (Annelida: Phyllodocida), an experiment was designed and carried out to investigate a new relaxing agent to immobilize nereidid specimens and stimulate pharynx eversion. The new substance, Dentol® (Khoraman laboratory, Iran), a dental anesthetic and antiseptic medicine containing 10% Carvacrol as the effective ingredient, was used for the first time and compared with other substances that have been used traditionally in polychaete studies. Crosstab analysis showed significant differences between different treatment groups, with Dentol® providing much better results for all considered criteria

The transcriptome and proteome are altered in marine polychaetes (Annelida) exposed to elevated metal levels

Polychaetes are often used in toxicological studies to understand mechanisms of resistance and for biomarker detection, however, we know of only a few genetic pathways involved in resistance. We found the marine polychaete Ophelina sp.1 (Opheliidae) in sediment containing high copper levels and investigated this phenomenon by measuring metal accumulation in the worms and changes in gene and protein expression. We sequenced the transcriptome of Ophelina sp.1 from both the impacted and reference sediments using 454-sequencing and analysed their proteomes using differential in gel electrophoresis (DIGE). We used the sequenced transcriptome to guide protein identification. Transcripts coding for the copper chaperone, Atox1, were up-regulated in the worms inhabiting the high copper sediment. In addition, genes coding for respiratory proteins, detoxification proteins and cytoskeletal proteins were significantly altered in metal-exposed worms; many of these changes were also detected in the proteome. This dual approach has provided a better understanding of heavy metal resistance in polychaetes and we now have a wider range of suitable indicator genes and proteins for future biomarker development

Invertebrate diversity of the unexplored marine western margin of Australia: taxonomy and implications for global biodiversity

However derived, predictions of global marine species diversity rely on existing real data. All methods, whether based on past rates of species descriptions, on expert opinion, on the fraction of undescribed species in samples collected, or on ratios between taxa in the taxonomic hierarchy, suffer the same limitation. Here we show that infaunal macrofauna (crustaceans and polychaetes) of the lower bathyal depth range are underrepresented among available data and documented results from Australia. The crustacean and polychaete fauna (only partially identified) of the bathyal continental margin of Western Australia comprised 805 species, representing a largely novel and endemic fauna. Overall, 94.6% of crustacean species were undescribed, while 72% of polychaete species were new to the Australian fauna, including all tanaidaceans, amphipods, and cumaceans, as well as most isopods. Most species were rare, and the species accumulation rate showed no sign of reaching an asymptote with increasing area sampled. Similar data are likely for the largely unexplored bathyal regions. This leads us to conclude that the numbers upon which extrapolations to larger areas are based are too low to provide confidence. The Southern Australian and Indo-West Pacific deep-sea regions contribute significantly to global species diversity. These regions and bathyal and abyssal habitats generally are extensive, but are so-far poorly sampled. They appear to be dominated by taxonomically poorly worked and species-rich taxa with limited distributions. The combination of high species richness among infaunal taxa-compared to better known taxa with larger individuals, higher endemism than presently acknowledged because of the presence of cryptic species, the low proportion of described species in these taxa, and the vast extent of unexplored bathyal and abyssal environments-will lead to further accumulation of new species as more and more deep sea regions are explored. It remains to be tested whether ratios of 10 or more undescribed to described species, found in this study for the dominant taxa and for the deep Southern Ocean and the Indo-West Pacific, are replicable in other areas. Our data and similar figures from other remote regions, and the lack of faunal overlap, suggest that Appeltans et al.\u27s (Current Biology 22:1-14, 2012) estimate that between one-third and two-thirds of the world\u27s marine fauna is undescribed is low, and that Mora et al.\u27s (PLoS Biol 9(8):e1001127. doi:10.1371/journal.pbio.1001127, 2011) of 91% is more probable. We conclude that estimates of global species, however made, are based on limited data. © 2014 Senckenberg Gesellschaft für Naturforschung and Springer-Verlag Berlin Heidelberg