Experiences of Voluntary Psychiatric Admissions to Acute Wards in East London: An Interpretative Phenomenological Analysis

Background: Voluntary Psychiatric admission was introduced almost a century ago and has become an increasingly popular method of admission, aiming to promote patient autonomy within the admission experience. A burst of literature over the last decade indicates that, contra to this aim, experiences of coercion and injustice are common in voluntary admission. However, relatively little research explores the individual’s nuanced experience and understanding of these admissions in depth. Aims: To explore patient understandings of their experience of voluntary admission, the concept of “voluntary”, and how these understandings change over time. Method: Five female participants were recruited from acute psychiatric wards and completed a semi-structured interview within eight weeks of discharge from a voluntary psychiatric admission. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Findings: Three themes were generated to describe participant’s understanding of their experience of voluntary admission: Need, Boundaries, and Identity. Participants experienced admission through needs of safety and validation, and whether these were met. Whilst dialogue, inclusion, and trust facilitated meeting these needs, coercion and inconsistent boundaries led to experiences of powerlessness and mistrust which prevented needs being met. Stigma was implicated in perpetuating experiences of judgement and negative sense of self on the wards. Being “voluntary” was associated with increased freedom, choice and agency, creating the possibility of experiencing empowerment in admission. However, it also invited comparisons and promoted “othering” between patients on wards which led to experiences of both gratitude and fear. Implications: The findings promote the need for increased dialogue during admission, further transparency of information about patient rights and employment of practices which reduce the impact of stigma on wards. This increased dialogue and understanding, may serve to increase feelings of safety and validation on the ward and help to harness the opportunity given through voluntary admission for positive experiences of empowerment and change

Are Women’s Mate Preferences for Altruism Also Influenced by Physical Attractiveness?

Altruism plays a role in mate choice, particularly in women’s preferences, and particularly for long-term relationships. The current study analyzed how these preferences interacted with another important mate choice variable, physical attractiveness. Here, female participants were presented with photographs of men of varying levels of physical attractiveness, alongside descriptions of them behaving either altruistically or not in different scenarios. The results showed women preferred altruistic men, particularly in long-term relationships, and that this interacted with physical attractiveness such that being both attractive and altruistic made a man more desirable than just the sum of the two desirable parts. Also, being altruistic made low attractive men more desirable, but only for long-term relationships. Finally, men who were just altruistic were rated more desirable than men who were just attractive, especially for long-term relationships. Overall these findings are discussed in terms of the role of altruism in mate choice, particularly in long-term relationships and directions of future research

Beyond Performance Management by Observation: An Enquiry into Effective Professional Development for Teachers across a Multi Academy Trust

Performative lesson observation is widely used in schools, proportedly, as a tool through which leaders may improve standards of teaching and learning. However, the high­pressure and judgemental nature often associated with such an approach is largely considered to mitigate any potentially positive outcomes of the observation process. This action research project sought to explore whether a Multi Academy Trust (MAT) was able to change a performative lesson observation model to a more effective strategy for teacher growth in confidence and self­esteem, thus impacting positively upon teacher practice and self­efficacy. The project was funded by the Carey Philpott Partner Research Fund via the Carnegie School of Education at Leeds Beckett University and it involved the three founding primary schools of a newly established MAT. The project developed from an original intention to introduce Video Enhanced Observation (VEO) to support peer and self­observation practices into a wider approach based upon coaching models. There is strong evidence to suggest that models of observation that are non­judgemental and development­focused have the potential to remove the barriers of the traditional performative model and to reap the benefits of increased motivation, collaboration and culture of scholarship to improve teaching and learning. Yet underlying issues around professional autonomy and the involvement of teachers in their own development adds to the complex nature of teacher evaluation. As such, there is more work to be done in ensuring that such changes have a lasting and sustainable impact upon the profession. A growing appreciation for the complex, phenomenological nature of teacher development led the study towards an investigation of the nature of professional autonomy and teacher agency. The findings of this study contribute to wider discourses among practitioner researcher communities as it argues that teachers should be involved in the processes of improving their own practice ­ as agents of change, not objects of surveillance. Further that collaboration and the opportunity to be involved in professional dialogue enhances professional learning

Maintaining hepatic stem cell gene expression on biological and synthetic substrata

The liver is a highly resilient organ that possesses enormous regenerative capacity. This is mediated mainly through the most abundant cell type found in the liver, the hepatocyte. When the regenerative capacity of the hepatocyte is compromised, during chronic or acute liver injury, hepatic progenitor cells (HPCs) are activated to replace the damaged tissue. The HPC resides in a laminin-rich environment; as HPCs differentiate toward a hepatic or biliary fate, the extracellular matrix (ECM) composition changes, influencing cell behavior. To assess the impact that the biological ECM and the synthetic ECM have on the maintenance of hepatic stem cell gene expression, a murine hepatic stem cell line was employed. We demonstrate that hepatic stem cell gene expression could be maintained using a biological or synthetic substratum, but not on plastic alone

Origins of fibrosis:pericytes take centre stage

Pericytes are ubiquitous perivascular cells that have recently attracted interest as potential myofibroblast precursors. In turn, myofibroblasts are the major source of extracellular matrix components that accumulate during tissue fibrosis. Given the worldwide burden of fibrotic disease and paucity of therapeutic options available to halt its progression, elucidating the origins of myofibroblasts is of prime importance. The advent of genetic strategies that permit fate-mapping of specific cell populations through permanent and heritable expression of reporter proteins has begun to shed light on the source of the fibrogenic myofibroblast. Here we discuss recent studies in multiple organs that highlight the central role of pericytes in the origins of fibrosis

In utero exposures to perfluoroalkyl substances and the human fetal liver metabolome in Scotland : a cross-sectional study

The Fetal Human study was funded by the UK Medical Research Council (MR/L010011/1) to PAF, PJO’S, JPI, DCH, and AD, by the Seventh Framework Programme of the European Union under Grant Agreement 212885, and by NHS Grampian Endowments grants (08/02, 09/12, 13/56, and 15/1/010) to PAF. The metabolomics and exposomics study was supported by the Swedish Research Council (to TH and MO; grants 2016-05176 and 2020-03674), Formas (to TH and MO; grant 2019-00869), Novo Nordisk Foundation (to TH; grant NNF20OC0063971), Research Council of Finland (to MO; grant 333981), the Inflammation in human early life: targeting impacts on life-course health consortium funded by the Horizon Europe Program of the European Union (Grant Agreement 101094099 to MO, TH, and PAF), and the framework of the European Partnership for the Assessment of Risks from Chemicals, and has received funding from the European Union's Horizon Europe research and innovation programme (grant agreement 101057014). Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the Health and Digital Executive Agency. Neither the European Union nor the granting authority can be held responsible for them. The authors would like to thank (1) the Fowler team members, NHS Grampian research nurses, and staff at the Pregnancy Counselling Service for their essential work in recruiting, collecting, and processing fetuses; and (2) the Centre for Genome Enabled Biology and Medicine, University of Aberdeen, for carrying out the RNA-Seq. The RNA-Seq data analysis was supported by use of the University of Aberdeen Maxwell High Performance Computer Cluster.Peer reviewedPublisher PD

A prospective cohort study assessing clinical referral management & workforce allocation within a UK regional medical genetics service

Abstract Ensuring patient access to genomic information in the face of increasing demand requires clinicians to develop innovative ways of working. This paper presents the first empirical prospective observational cohort study of UK multi-disciplinary genetic service delivery. It describes and explores collaborative working practices including the utilisation and role of clinical geneticists and non-medical genetic counsellors. Six hundred and fifty new patients referred to a regional genetics service were tracked through 850 clinical contacts until discharge. Referral decisions regarding allocation of lead health professional assigned to the case were monitored, including the use of initial clinical contact guidelines. Significant differences were found in the cases led by genetic counsellors and those led by clinical geneticists. Around a sixth, 16.8% (109/650) of referrals were dealt with by a letter back to the referrer or re-directed to another service provider and 14.8% (80/541) of the remaining patients chose not to schedule an appointment. Of the remaining 461 patients, genetic counsellors were allocated as lead health professional for 46.2% (213/461). A further 61 patients did not attend. Of those who did, 86% (345/400) were discharged after one or two appointments. Genetic counsellors contributed to 95% (784/825) of total patient contacts. They provided 93.7% (395/432) of initial contacts and 26.8% (106/395) of patients were discharged at that point. The information from this study informed a planned service re-design. More research is needed to assess the effectiveness and efficiency of different models of collaborative multi-disciplinary working within genetics services. Keywords (MeSH terms) Genetic Services, Genetic Counseling, Interdisciplinary Communication, Cohort Studies, Delivery of Healthcare, Referral and Consultation

Recurrent lower gastrointestinal bleeding from idiopathic ileocolonic varices: a case report

<p>Abstract</p> <p>Introduction</p> <p>Varices of the colon are a rare cause of lower gastrointestinal bleeding, usually associated with portal hypertension due to liver cirrhosis or other causes of portal venous obstruction. Idiopathic colonic varices are extremely rare. Recognition of this condition is important as idiopathic colonic varices may be a cause of recurrent lower gastrointestinal bleeding.</p> <p>Case presentation</p> <p>We report the case of a 21-year-old Asian man from north India who presented with recurrent episodes of lower gastrointestinal bleeding. Colonoscopy revealed varices involving the terminal ileum and colon to the sigmoid. Thorough evaluation was undertaken to rule out any underlying portal hypertension. Our patient underwent subtotal colectomy including resection of involved terminal ileum and an ileorectal anastomosis.</p> <p>Conclusion</p> <p>Colonic varices are an uncommon cause of lower gastrointestinal bleeding. Idiopathic colonic varices are diagnosed after excluding underlying liver disease and portal hypertension. Recognition of this condition is important as prognosis is good in the absence of liver disease and is curable by resection of the involved bowel.</p

Echoes of time. The mobility of Brazilian researchers and students in Portugal

A investigação que apresentamos, de caráter exploratório, recaiu sobre histórias biográficas de brasileiros que escolhem Portugal para prosseguir formação e ou investigação. Procura-se encontrar na sua experiência elos de ligação explicativos sobre as motivações e os processos que os trazem para Portugal, assim como as expetativas e os projetos que comportam para os seus futuros e que incluem, ou não, este país. Temos em conta, especialmente, a forma como essa narrativa transporta sentidos identitários decorrentes das formas de relacionamento intercultural e político entre Portugal e Brasil e formas de cooperação implícitas, assim como mapas representacionais acerca dos lugares de eleição para desenvolvimento de carreiras científicas e académicas. A nossa pesquisa incide sobre as informações recolhidas através de um inquérito por questionário e entrevistas realizadas junto de estudantes e bolseiros brasileiros em Portugal.We present an exploratory study that investigated biographical stories of Brazilians who choose to continue their education or develop research in Portugal. We sought to find in their experiences explanatory links connecting the motivations and processes that bring them to Portugal, as well as the expectations and projects that they hold for the future, which may include, or not, this country. We take into account, particularly, the way this narrative carries senses of identity arising from the forms of intercultural and political relationship between Portugal and Brazil, as well as implicit forms of cooperation and representations about the places chosen for the development of scientific and academic careers. Our research draws on information collected through a survey based on questionnaires and interviews with Brazilian students and scholarship holders in Portugal.(undefined