Developing a psychotropic medication education group on a secure ward for men with intellectual disabilities

Purpose: The purpose of this paper is to establish and evaluate a psychotropic medication education group for men with intellectual disability on a secure psychiatric ward. Design/methodology/approach: A multi-disciplinary team was convened to oversee the project. A curriculum was developed that covered major classes of psychotropic drugs as well as broader themes related to taking medication and general wellbeing. Each group session incorporated a range of teaching methods supported by accessible materials. Evaluation was by qualitative and quantitative methods. Findings: There was interest and enthusiasm for the group. Participant feedback was generally positive and most of those who completed the group reported achieving their personal learning goals. There was no significant difference in results of a medication knowledge test at baseline and at the end of the course. Feedback from group members and reflections of the course facilitators are discussed. Research limitations/implications: The results of this small-scale study may not be applicable to other groups or settings. Evaluation measures seemed unable to capture some elements of the group processes and outcomes. Practical implications: Establishing and running a psychoeducational group on a low-secure ward for men with intellectual disabilities is possible and potentially valuable. Learning from this project will be useful for others considering group-based interventions for people with intellectual disability. Originality/value: This paper adds to the limited literature describing interventions to improve medication knowledge in people with intellectual disability

Kinematics of the Final Approach and Take-Off Phases in World-Class Men and Women Pole Vaulters

The pole vault is a highly technical event where the athletes must successfully convert horizontal velocity during the run-up to vertical velocity at take-off. The aim of this study was to compare the kinematics of men's and women's world-class pole vaulting. Video data were collected of the best clearances by 14 men and 11 women at the 2018 IAAF World Indoor Championships using three high-speed cameras (200 Hz). Running velocity, step lengths, step times, and pole angles were measured during the run-up; during take-off, distance from the plant box, angle and velocity of take-off, and relative positions of the foot and hands were measured. Men achieved greater clearance heights with faster run-ups, faster take-off velocities and higher hand grip positions (all p < 0.001), with each of the last three steps longer for men when expressed as absolute values (all p < 0.001), but not when expressed relative to stature. There were no differences in run-up pole angles, step times, take-off angle, take-off contact time or time from pole plant to take-off. Women differed in their approach and take-off for characteristics affected by stature and strength, such as fewer run-up steps, shorter take-off distances, and lower grip heights. These lower grips result from a shorter, lighter pole, and this disadvantage was greater than slower run-up velocities. Coaches should therefore note that sex-based differences occur in the pole vault that result from anthropometric differences, but which do not negate the adoption of similar technical models of vaulting

The macro-and micro-fossil record of the Cambrian priapulid Ottoia

The stem-group priapulid Ottoia Walcott, 1911, is the most abundant worm in the mid-Cambrian Burgess Shale, but has not been unambiguously demonstrated elsewhere. High-resolution electron and optical microscopy of macroscopic Burgess Shale specimens reveals the detailed anatomy of its robust hooks, spines and pharyngeal teeth, establishing the presence of two species: Ottoia prolifica Walcott, 1911, and Ottoia tricuspida sp. nov. Direct comparison of these sclerotized elements with a suite of shale-hosted mid-to-late Cambrian microfossils extends the range of ottoiid priapulids throughout the middle to upper Cambrian strata of the Western Canada Sedimentary Basin. Ottoiid priapulids represented an important component of Cambrian ecosystems: they occur in a range of lithologies and thrived in shallow water as well as in the deep-water setting of the Burgess Shale. A wider survey of Burgess Shale macrofossils reveals specific characters that diagnose priapulid sclerites more generally, establishing the affinity of a wide range of Small Carbonaceous Fossils and demonstrating the prominent role of priapulids in Cambrian seas

Research priorities for young people with cancer : a UK priority setting partnership with the James Lind Alliance

OBJECTIVES: To conduct a UK-wide survey of young people who have experienced cancer, carers and professionals, to identify and prioritise research questions to inform decisions of research funders and support the case for research with this unique cancer population. DESIGN: James Lind Alliance Priority Setting Partnership. SETTING: UK health service and community. METHODS: A steering group oversaw the initiative and partner organisations were recruited. Unanswered questions were collected in an online survey. Evidence searching verified uncertainties. An interim survey was used to rank questions prior to a final prioritisation workshop. PARTICIPANTS: Young people aged 13-24 years with a current or previous cancer diagnosis, their families, friends, partners and professionals who work with this population. RESULTS: Two hundred and ninety-two respondents submitted 855 potential questions. Following a refining process and removal of 'out of scope' questions, 208 unique questions remained. Systematic evidence checking identified seven answered questions and 16 were the subject of ongoing studies. The interim survey was completed by 174 participants. The top 30 questions were prioritised at a workshop attended by 25 young people, parents and multidisciplinary professionals. The top three priorities are: (1) What psychological support package improves psychological well-being, social functioning and mental health during and after treatment? (2) What interventions, including self-care, can reduce or reverse adverse short-term and long-term effects of cancer treatment? (3) What are the best strategies to improve access to clinical trials? The remaining questions reflect the complete cancer pathway: new therapies, life after cancer, support, education/employment, relapse and end-of-life care. CONCLUSIONS: We have identified shared research priorities for young people with cancer using a rigorous, person-centred approach involving stakeholders typically not involved in setting the research agenda. The breadth of priorities suggest future research should focus on holistic and psychosocial care delivery as well as traditional drug/biology research

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Short-Lived Trace Gases in the Surface Ocean and the Atmosphere

The two-way exchange of trace gases between the ocean and the atmosphere is important for both the chemistry and physics of the atmosphere and the biogeochemistry of the oceans, including the global cycling of elements. Here we review these exchanges and their importance for a range of gases whose lifetimes are generally short compared to the main greenhouse gases and which are, in most cases, more reactive than them. Gases considered include sulphur and related compounds, organohalogens, non-methane hydrocarbons, ozone, ammonia and related compounds, hydrogen and carbon monoxide. Finally, we stress the interactivity of the system, the importance of process understanding for modeling, the need for more extensive field measurements and their better seasonal coverage, the importance of inter-calibration exercises and finally the need to show the importance of air-sea exchanges for global cycling and how the field fits into the broader context of Earth System Science

Small shelly fossils and carbon isotopes from the early Cambrian (Stage 3-4) Mural Formation of western Laurentia

The extraordinary window of phosphatised and phosphatic Small Shelly Fossils (SSFs) during the early and middle Cambrian is an important testament to the radiation of biomineralising metazoans. While SSF are well known from most Cambrian palaeocontinents during this time interval, western Laurentia has relatively few SSF faunas. Here we describe a diverse SSF fauna from the early Cambrian (Stage 3-4) Mural Formation at three localities in Alberta and British Columbia, Canada, complemented by carbon isotope measurements to aid in a potential future bio-chemostratigraphic framework. The fauna expands the recorded SSF assemblage diversity in western Laurentia and includes several brachiopods, four bradoriids, three chancelloriids, two hyoliths, a tommotiid and a helcionellid mollusc as well as echinoderm ossicles and specimens of Microdictyon, Volborthella and Hyolithellus. New taxa include the tommotiid genus Canadiella gen. nov., the new bradoriid species Hipponicharion perforata sp. nov. and Pseudobeyrichona taurata sp. nov. Compared to contemporaneous faunas from western Laurentia, the fauna is relatively diverse, particularly in taxa with originally phosphatic shells, which appear to be associated with archaeocyathid buildups. This suggests that the generally low faunal diversity in western Laurentia may be at least partly a consequence of poor sampling of suitable archaeocyathan reef environments. In addition, the tommotiid Canadiella filigrana appears to be of biostratigraphic significance in Cambrian Stage 3 strata of western Laurentia and the unexpected high diversity of bradoriid arthropods in the fauna also suggests that this group may prove useful for biostratigraphic resolution in the region

Toward a Behavioral Ecology of Stressful Marital Interactions

In order to assess the behavioral ecology of stressful marital interactions, each partner from 16 maritally distressed and 16 nondistressed couples monitored the occurrence, antecedents and consequences of stressful interactions in their relationship for two weeks. As hypothesized, stressful interactions were more likely to occur in particular locations, on weekdays rather than weekends, and in association with life stress. The topics of stressful interactions were strongly associated with partners' activities prior to the interaction. The same setting variables were associated with stressful interactions in both distressed and nondistressed couples. Compared with nondistressed individuals, distressed individuals were more likely to report that stressful interactions were terminated by one or other partner exiting, and less likely to report interactions being resolved. Discussion focuses on generalization to high-risk settings of those communication skills taught during marital therapy and the potential clinical applications of the marital diary developed in this study