Developing an intervention to facilitate family communication about inherited genetic conditions, and training genetic counsellors in its delivery.

Many families experience difficulty in talking about an inherited genetic condition that affects one or more of them. There have now been a number of studies identifying the issues in detail, however few have developed interventions to assist families. The SPRinG collaborative have used the UK Medical Research Council's guidance on Developing and Evaluating Complex Interventions, to work with families and genetic counsellors (GCs) to co-design a psycho-educational intervention to facilitate family communication and promote better coping and adaptation to living with an inherited genetic condition for parents and their children (<18 years). The intervention is modelled on multi-family discussion groups (MFDGs) used in psychiatric settings. The MFDG was developed and tested over three phases. First focus groups with parents, young people, children and health professionals discussed whether MFDG was acceptable and proposed a suitable design. Using evidence and focus group data, the intervention and a training manual were developed and three GCs were trained in its delivery. Finally, a prototype MFDG was led by a family therapist and co-facilitated by the three GCs. Data analysis showed that families attending the focus groups and intervention thought MFDG highly beneficial, and the pilot sessions had a significant impact on their family' functioning. We also demonstrated that it is possible to train GCs to deliver the MFDG intervention. Further studies are now required to test the feasibility of undertaking a definitive randomised controlled trial to evaluate its effectiveness in improving family outcomes before implementing into genetic counselling practice.The National Institute of Health Research funded the study but any views expressed do not necessarily reflect those of the Authority. Funded by NIHR reference number: RP-DG-1211-10015

Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their views and experience of facilitating multi-family discussion groups

Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors' professional development

A normal gem-dimethyl effect in the base-catalyzed cyclization of -( p-nitrophenyl)hydantoic acids: evidence for hindered proton transfer in the permethylated esters †

The cyclization of hydantoic acids 2-UA and 3-UA -kinetics, solvent kinetic isotope effects (SKIE) and buffer catalysis -were studied in an attempt to explain the disappearance of the gem-dimethyl effect (GDME) in the specific base-catalyzed cyclization of hydantoic esters. pH-Rate profiles for both acids (after correction for ionization and for reversibility at high pH) show two regions of unit slope corresponding to different mechanisms. For 2-UA at high pH and 3-UA at lower pH the mechanism is considered to involve rate-determining attack by the ureido anion on the neutral carboxy group, consistent with the observed inverse SKIE. The normal GDME of 15 provides strong evidence that anomalies observed with the esters do indeed result from steric hindrance to proton transfer. The change to rate determining departure of OH Ϫ with 2-UA is caused at low pH by acid catalysis of the reversion of the tetrahedral intermediate (T Ϫ ) to reactants, while with 3-UA at high pH this takes place through T 2Ϫ . The GDME favours attack on the carboxylate anion but makes ring opening more difficult, thus decreasing acid inhibition. The observed β = 0.44 for general base catalysis of the cyclization of 2-UA is consistent with concerted deprotonation and attack of the ureido group. With 3-UA two simultaneous general base-catalyzed reactions take place: slow deprotonation of the ureido group (β = 1.0) and attack of the ureide anion on the carboxy anion aided by the buffer conjugate acid. The estimated GDME is 2800 for the equilibrium between acid anion and hydantoin, ‡ but only 45 and 15 for catalysis by H 3 O ϩ and OH Ϫ , respectively: both reactions are presumed to go through early transition states. A convenient way to accelerate the bioorganic reactions of small molecules is to introduce steric strain into the substrate. In cyclization reactions this is readily done by introducing substituents into the interconnecting chain: the resulting increase in rate defines the gem-dimethyl effect (GDME). 1 However, in a recent study 2,3 of catalytic mechanisms for the ring closure of hydantoic esters, we found no GDME for the base-catalyzed reaction. We concluded that the rate determining step had changed, for the most heavily substituted compounds, from the formation of the tetrahedral intermediate to its breakdown, because of steric hindrance in proton transfer to the leaving ethoxy group. In the tetrahedral intermediate, T Ϫ , the two methyl groups screen one side and the N-aryl substituent the other, while R (ethyl was studied) in its least hindered conformation blocks easy access of a general acid. If this analysis is correct, and the effect depends on steric hindrance in proton † Pseudo-first-order rate constants are available as supplementary data. For direct electronic access see http://www.rsc.org/suppdata/p2/b0/ b002276o ‡ The IUPAC name for hydantoin is imidazolidine-2,4-dione. transfer to the developing ethoxide by its ethyl group, it should be reduced or removed if a smaller group replaces ethyl. We have tested this proposition by studying the cyclization of the hydantoic acids shown in Scheme 1. We find that hydantoic acids 2 and 3 undergo base-catalyzed ring closure more slowly than the esters when the pH is higher than the pK of the COOH group; and that the results confirm our prediction. The hydroxide-catalyzed cyclization of the fully methylated acid 3-UA shows a normal GDME, and the solvent kinetic isotope effects (SKIE) suggest that acids 2-UA and 3-UA are cyclized by the same mechanism. Experimental Materials Inorganic reagents and buffer components were of analytical Scheme

Struggles over access to the Muslim public sphere: Multiple publics and discourses on agency, belonging and citizenship (Introduction to the Themed Section)

Abstract This introductory essay provides the context for the articles in this Themed Section. Despite the diversity in locations, historical backgrounds and contemporary processes of change, all contributors to this Themed Section focus on the struggle of Muslim groups over access to an emergent Muslim public sphere. They highlight the contestations of and shifts in the notions of agency, belonging, and citizenship in nation-states with Muslim communities within its borders. The introduction consists of two parts. The first part reviews the notion of the public sphere as conceptualized by Habermas and critiqued by scholars of a diversity of backgrounds. In relation to the concept of the Muslim public sphere, three aspects of critique are given closer c

A Negative Feedback Loop That Limits the Ectopic Activation of a Cell Type–Specific Sporulation Sigma Factor of Bacillus subtilis

Two highly similar RNA polymerase sigma subunits, σF and σG, govern the early and late phases of forespore-specific gene expression during spore differentiation in Bacillus subtilis. σF drives synthesis of σG but the latter only becomes active once engulfment of the forespore by the mother cell is completed, its levels rising quickly due to a positive feedback loop. The mechanisms that prevent premature or ectopic activation of σG while discriminating between σF and σG in the forespore are not fully comprehended. Here, we report that the substitution of an asparagine by a glutamic acid at position 45 of σG (N45E) strongly reduced binding by a previously characterized anti-sigma factor, CsfB (also known as Gin), in vitro, and increased the activity of σG in vivo. The N45E mutation caused the appearance of a sub-population of pre-divisional cells with strong activity of σG. CsfB is normally produced in the forespore, under σF control, but sigGN45E mutant cells also expressed csfB and did so in a σG-dependent manner, autonomously from σF. Thus, a negative feedback loop involving CsfB counteracts the positive feedback loop resulting from ectopic σG activity. N45 is invariant in the homologous position of σG orthologues, whereas its functional equivalent in σF proteins, E39, is highly conserved. While CsfB does not bind to wild-type σF, a E39N substitution in σF resulted in efficient binding of CsfB to σF. Moreover, under certain conditions, the E39N alteration strongly restrains the activity of σF in vivo, in a csfB-dependent manner, and the efficiency of sporulation. Therefore, a single amino residue, N45/E39, is sufficient for the ability of CsfB to discriminate between the two forespore-specific sigma factors in B. subtilis

A Normative Pragmatic Theory of Exhorting

The final publication is available at Springer via http://dx.doi.org/10.1007/s10503-018-9465-y.We submit a normative pragmatic theory of exhorting—an account of conceptually necessary and potentially efficacious components of a coherent strategy for securing a sympathetic hearing for efforts to urge and inspire addressees to act on high-minded principles. Based on a Gricean analysis of utterance-meaning, we argue that the concept of exhorting comprises making statements openly urging addressees to perform some high-minded, principled course of action; openly intending to inspire addressees to act on the principles; and intending that addressees’ recognition of the intentions to urge and inspire creates reasons for addressees to grant a sympathetic hearing to what the speaker has to say. We show that the theory accounts for the design of Abraham Lincoln’s Cooper Union address. By doing so we add to the inventory of reasons why social actors make arguments, continue a line of research showing the relationship of arguing to master speech acts, and show that making arguments can be an effective strategy for inspiring principled action

The Antarctic ozone hole during 2017

We review the 2017 Antarctic ozone hole, making use of various meteorological reanalyses, and in-situ, satellite and ground-based measurements of ozone and related trace gases, and ground-based measurements of ultraviolet radiation. The 2017 ozone hole was associated with relatively high-ozone concentrations over the Antarctic region compared to other years, and our analysis ranked it in the smallest 25% of observed ozone holes in terms of size. The severity of stratospheric ozone loss was comparable with that which occurred in 2002 (when the stratospheric vortex exhibited an unprecedented major warming) and most years prior to 1989 (which were early in the development of the ozone hole). Disturbances to the polar vortex in August and September that were associated with intervals of anomalous planetary wave activity resulted in significant erosion of the polar vortex and the mitigation of the overall level of ozone depletion. The enhanced wave activity was favoured by below-average westerly winds at high southern latitudes during winter, and the prevailing easterly phase of the quasi-biennial oscillation (QBO). Using proxy information on the chemical make-up of the polar vortex based on the analysis of nitrous oxide and the likely influence of the QBO, we suggest that the concentration of inorganic chlorine, which plays a key role in ozone loss, was likely similar to that in 2014 and 2016, when the ozone hole was larger than that in 2017. Finally, we found that the overall severity of Antarctic ozone loss in 2017 was largely dictated by the timing of the disturbances to the polar vortex rather than interannual variability in the level of inorganic chlorine