An examination of the criteria governing the selection of role-playing techniques employed in a rehabilitation programme of adult psychiatric patients

The purpose of this study is to examine the criteria which govern a role-play group leader’s decisions in the selection of techniques and to define and categorise the possible techniques available. It is not intended to measure outcome, although as the leader's evaluation of 'effect’ may influence the future selection of techniques, this feedback of response and consequent action is included in the analysis of factors determining decisions. The particular role-play sessions studied were held weekly, under the leadership of the writer of this thesis. They took place in the rehabilitation unit of a large psychiatric hospital where the groups of patients involved were in a transitional phase between hospital ward and discharge to independent living. Role-play was intended to aid that transition. This investigation into role-play direction takes account of factors arising from background sources, such as the theory and practice of role-play as therapy and psychiatric illness and treatment, and from more immediate influences such as the needs and wants of the group members. It is a consideration of the continual appraisal and re-appraisal of the face-to-face situations occurring in role-play sessions; of alternative strategies and leader's choices. The points raised in discussion are empirically supported by: (a) a case study, including the leader's written observations and comments made at the time of the patient's membership of the role-play group; and (b) tape recorded extracts of selected role-play sessions

The influence of conversational setting and cognitive load on reference in 2-party spoken dialogue

The main objective of this thesis is to investigate the way in which the conversational setting (video-mediated compared with face-to-face) and cognitive load (as illustrated by time pressure) influence spoken dialogue, with particular emphasis on the way speakers refer to objects in a discourse. Two studies were carried out which examined dialogues of pairs of participants performing a problem-solving task. Study 1 examined word duration in a video-mediated conversational setting. In Study 2, pairs of participants performed the Map Task (Brown et al., 1984) under time pressure and without the pressure of time. One group of participants performed the task in a face-to-face conversational setting and the other in a video-mediated setting. Consistent with the Dual Process Model (Bard et al., 2000), cognitive load influenced complex processes, such as task strategy and the establishment of common ground, or mutual knowledge. In contrast, automatic processes, such as articulatory priming (the faster articulation of repeated mentions of words referring to the same object), occurred irrespective of the setting in which the conversation took place or of any increase in cognitive load. Under time pressure, interlocutors were less collaborative and less co-ordinated in the way they established common ground than without the pressure of time. Time pressure also led interlocutors to adopt a strategy of making fewer references to objects, or landmarks on the map. While articulatory reduction occurred irrespective of the conversational setting, participants in a video-mediated setting spoke more slowly than participants in a face-to-face setting. Following Lindblom (1995), this suggested that participants adjusted their articulation in order to be understood in the relatively unfamiliar video-mediated environment. Interlocutors in a video-mediated conversational setting were also less collaborative and less coordinated in the way they established common ground compared with participants communicating in a face-to-face setting. Speakers may have felt socially distant (Short, Williams and Christie, 1976) from their interlocutor and the communicative situation in a video-mediated setting. The findings of this research imply a distinction between consciously controlled processes and automatic processes. Characteristics of spoken dialogue, such as the setting in which a conversation takes place or the cognitive load associated with the communicative task or goal, are more likely to impact on consciously controlled processes than automatic processes. Thus, for example, when participants in a dialogue converse in the usual face-to-face manner and where the cognitive demands associated with the communicative task are relatively low, interlocutors tend to be relatively collaborative in their communication (Clark and Wilkes-Gibbs, 1986; Pickering and Garrod, in press). However, when the communicative circumstances are less than ideal, because the conversational setting is unfamiliar, or because time is short, then complex facets of spoken discourse, such as collaborating with one's interlocutor to establish common ground, may be disrupted. An adequate account of spoken dialogue must account for the effect of dynamic aspects of dialogue such as where the conversation takes place and the cognitive demands associated with the communicative task or goal

Enjoying the third age! Discourse, identity and liminality in extra-care communities

Extra-care housing has been an important and growing element of housing and care for older people in the United Kingdom since the 1990s. Previous studies have examined specific features and programmes within extra-care locations, but few have studied how residents negotiate social life and identity. Those that have, have noted that while extra care brings many health-related and social benefits, extra-care communities can also be difficult affective terrain. Given that many residents are now ‘ageing in place’ in extra care, it is timely to revisit these questions of identity and affect. Here we draw on the qualitative element of a three-year, mixed-method study of 14 extra-care villages and schemes run by the ExtraCare Charitable Trust. We follow Alemàn in regarding residents' ambivalent accounts of life in ExtraCare as important windows on the way in which liminal residents negotiate the dialectics of dependence and independence. However, we suggest that the dialectic of interest here is that of the third and fourth age, as described by Gilleard and Higgs. We set that dialectic within a post-structuralist/Lacanian framework in order to examine the different modes of enjoyment that liminal residents procure in ExtraCare's third age public spaces and ideals, and suggest that their complaints can be read in three ways: as statements about altered material conditions; as inter-subjective bolstering of group identity; and as fantasmatic support for liminal identities. Finally, we examine the implications that this latter psycho-social reading of residents' complaints has for enhancing and supporting residents' wellbeing

Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA(2)LEN) Survey

Background: Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases. Objective: We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults. Methods: A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA(2)LEN) screening survey, in which 55,000 adults aged 15-75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA(2)LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing. Results: A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score >= 1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (beta-coefficient -2.34;95% confidence interval [CI] -4.09,-0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted beta-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing. Conclusion and clinical relevance: There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.Peer reviewe

Fine-mapping of the HNF1B multicancer locus identifies candidate variants that mediate endometrial cancer risk.

Common variants in the hepatocyte nuclear factor 1 homeobox B (HNF1B) gene are associated with the risk of Type II diabetes and multiple cancers. Evidence to date indicates that cancer risk may be mediated via genetic or epigenetic effects on HNF1B gene expression. We previously found single-nucleotide polymorphisms (SNPs) at the HNF1B locus to be associated with endometrial cancer, and now report extensive fine-mapping and in silico and laboratory analyses of this locus. Analysis of 1184 genotyped and imputed SNPs in 6608 Caucasian cases and 37 925 controls, and 895 Asian cases and 1968 controls, revealed the best signal of association for SNP rs11263763 (P = 8.4 × 10(-14), odds ratio = 0.86, 95% confidence interval = 0.82-0.89), located within HNF1B intron 1. Haplotype analysis and conditional analyses provide no evidence of further independent endometrial cancer risk variants at this locus. SNP rs11263763 genotype was associated with HNF1B mRNA expression but not with HNF1B methylation in endometrial tumor samples from The Cancer Genome Atlas. Genetic analyses prioritized rs11263763 and four other SNPs in high-to-moderate linkage disequilibrium as the most likely causal SNPs. Three of these SNPs map to the extended HNF1B promoter based on chromatin marks extending from the minimal promoter region. Reporter assays demonstrated that this extended region reduces activity in combination with the minimal HNF1B promoter, and that the minor alleles of rs11263763 or rs8064454 are associated with decreased HNF1B promoter activity. Our findings provide evidence for a single signal associated with endometrial cancer risk at the HNF1B locus, and that risk is likely mediated via altered HNF1B gene expression

Towards evidence-based conservation of subterranean ecosystems

Subterranean ecosystems are among the most widespread environments on Earth, yet we still have poor knowledge of their biodiversity. To raise awareness of subterranean ecosystems, the essential services they provide, and their unique conservation challenges, 2021 and 2022 were designated International Years of Caves and Karst. As these ecosystems have traditionally been overlooked in global conservation agendas and multilateral agreements, a quantitative assessment of solution-based approaches to safeguard subterranean biota and associated habitats is timely. This assessment allows researchers and practitioners to understand the progress made and research needs in subterranean ecology and management. We conducted a systematic review of peer-reviewed and grey literature focused on subterranean ecosystems globally (terrestrial, freshwater, and saltwater systems), to quantify the available evidence-base for the effectiveness of conservation interventions. We selected 708 publications from the years 1964 to 2021 that discussed, recommended, or implemented 1,954 conservation interventions in subterranean ecosystems. We noted a steep increase in the number of studies from the 2000s while, surprisingly, the proportion of studies quantifying the impact of conservation interventions has steadily and significantly decreased in recent years. The effectiveness of 31% of conservation interventions has been tested statistically. We further highlight that 64% of the reported research occurred in the Palearctic and Nearctic biogeographic regions. Assessments of the effectiveness of conservation interventions were heavily biased towards indirect measures (monitoring and risk assessment), a limited sample of organisms (mostly arthropods and bats), and more accessible systems (terrestrial caves). Our results indicate that most conservation science in the field of subterranean biology does not apply a rigorous quantitative approach, resulting in sparse evidence for the effectiveness of interventions. This raises the important question of how to make conservation efforts more feasible to implement, cost-effective, and long-lasting. Although there is no single remedy, we propose a suite of potential solutions to focus our efforts better towards increasing statistical testing and stress the importance of standardising study reporting to facilitate meta-analytical exercises. We also provide a database summarising the available literature, which will help to build quantitative knowledge about interventions likely to yield the greatest impacts depending upon the subterranean species and habitats of interest. We view this as a starting point to shift away from the widespread tendency of recommending conservation interventions based on anecdotal and expert-based information rather than scientific evidence, without quantitatively testing their effectiveness.Peer reviewe

Limited Occurrence of Denitrification in Four Shallow Aquifers in Agricultural Areas of the United States

The ability of natural attenuation to mitigate agricultural nitrate contamination in recharging aquifers was investigated in four important agricultural settings in the United States. The study used laboratory analyses, field measurements, and flow and transport modeling for monitoring well transects (0.5 to 2.5 km in length) in the San Joaquin watershed, California, the Elkhorn watershed, Nebraska, the Yakima watershed, Washington, and the Chester watershed, Maryland. Ground water analyses included major ion chemistry, dissolved gases, nitrogen and oxygen stable isotopes, and estimates of recharge date. Sediment analyses included potential electron donors and stable nitrogen and carbon isotopes. Within each site and among aquifer-based medians, dissolved oxygen decreases with ground water age, and excess N2 from denitrification increases with age. Stable isotopes and excess N2 imply minimal denitrifying activity at the Maryland and Washington sites, partial denitrification at the California site, and total denitrification across portions of the Nebraska site. At all sites, recharging electron donor concentrations are not sufficient to account for the losses of dissolved oxygen and nitrate, implying that relict, solid phase electron donors drive redox reactions. Zero-order rates of denitrification range from 0 to 0.14 μmol N L−1d−1, comparable to observations of other studies using the same methods. Many values reported in the literature are, however, orders of magnitude higher, which is attributed to a combination of method limitations and bias for selection of sites with rapid denitrification. In the shallow aquifers below these agricultural fields, denitrification is limited in extent and will require residence times of decades or longer to mitigate modern nitrate contamination