Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention

Purpose: Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships. Methods: Interviews (n=24) and two focus groups (n=13) were conducted as part of a process evaluation and included purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data. Results: Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention. Conclusion: Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used, in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured

The detection of fraud activities on the stock market through forward analysis methodology of financial discussion boards

Financial discussion boards (FDBs) have been widely used for a variety of financial knowledge exchange activities through the posting of comments on the FDBs. Popular public FDBs are prone to be used as a medium to spread false financial information due to having a larger group of audiences. Although online forums, in general, are usually integrated with anti-spam tools such as Akismet, moderation of posted contents heavily relies on human moderators. Unfortunately, popular FDBs attract many comments per day which realistically prevents human moderators from continuously monitoring and moderating possibly fraudulent contents. Such manual moderation can be extremely time-consuming. Moreover, due to the absence of useful tools, no relevant authorities are actively monitoring and handling potential financial crimes on FDBs. This paper presents a novel forward analysis methodology implemented in an Information Extraction (IE) prototype system named FDBs Miner (FDBM). This methodology aims to detect potentially illegal comments on FDBs while integrating share prices in the detection process as this helps to categorise the potentially illegal comments into different risk levels for investigation priority. The IE prototype system will first extract the public comments and per minute share prices from FDBs for the selected listed companies on London Stock Exchange (LSE). In the forward analysis process, the comments are flagged using a predefined Pump and Dump financial crime related keyword template. By only flagging the comments against the keyword template yields an average of 9.82% potentially illegal comments. It is unrealistic and unaffordable for human moderators to read these comments on a daily basis in long run. Hence, by integrating the share prices’ hikes and falls to categorise the flagged comments based on risk levels, it saves time and allows relevant authorities to prioritise and investigate into the higher risk flagged comments as it can potentially indicate real Pump and Dump crimes on FDBs

Marine Dynamics and Productivity in the Bay of Bengal

The Bay of Bengal provides important ecosystem services to the Bangladesh delta. It is also subject to the consequences of climate change as monsoon atmospheric circulation and fresh water input from the major rivers are the dominating influences. Changes in marine circulation will affect patterns of biological production through alterations in the supply of nutrients to photosynthesising plankton. Productivity in the northern Bay will also be sensitive to changes in riverborne nutrients. In turn, these changes could influence potential fish catch. The Bay also affects the physical environment of Bangladesh: relative sea-level rise is expected to be in the range of 0.5–1.7 m by 2100, and changing climate could affect the development of tropical cyclones over the Bay

Electrophysical properties of nanoporous cerium dioxide–water system

The impedance of nanoporous cerium dioxide with adsorbed water is investigated in the frequency range 103–104 Hz at temperatures near the water–ice phase transition. Here we show that the manifestation of impedance peculiarities at phase transition is caused by the dielectric constant of the matrix

Surveillance of the short-term impact of fine particle air pollution on cardiovascular disease hospitalizations in New York State

<p>Abstract</p> <p>Background</p> <p>Studies have shown that the effects of particulate matter on health vary based on factors including the vulnerability of the population, health care practices, exposure factors, and the pollutant mix.</p> <p>Methods</p> <p>We used time-stratified case-crossover to estimate differences in the short-term impacts of PM_2.5on cardiovascular disease hospital admissions in New York State by geographic area, year, age, gender, co-morbid conditions, and area poverty rates.</p> <p>Results</p> <p>PM_2.5had a stronger impact on heart failure than other cardiovascular diagnoses, with 3.1% of heart failure admissions attributable to short-term PM_2.5exposure over background levels of 5 ug/m³. Older adults were significantly more susceptible to heart failure after short-term ambient PM_2.5exposure than younger adults.</p> <p>Conclusion</p> <p>The short-term impact of PM_2.5on cardiovascular disease admissions, and modifications of that impact, are small and difficult to measure with precision. Multi-state collaborations will be necessary to attain more precision to describe spatiotemporal differences in health impacts.</p

Staff understanding of recovery-orientated mental health practice: a systematic review and narrative synthesis

Background: Mental health policy is for staff to transform their practice towards a recovery orientation. Staff understanding of recovery-orientated practice will influence the implementation of this policy. The aim of this study was to conduct a systematic review and narrative synthesis of empirical studies identifying clinician and manager conceptualisations of recovery-orientated practice. Methods: A systematic review of empirical primary research was conducted. Data sources were online databases (n = 8), journal table of contents (n = 5), internet, expert consultation (n = 13), reference lists of included studies and references to included studies. Narrative synthesis was used to integrate the findings. Results: A total of 10,125 studies were screened, 245 full papers were retrieved, and 22 were included (participants, n = 1163). The following three conceptualisations of recovery-orientated practice were identified: clinical recovery, personal recovery and service-defined recovery. Service-defined recovery is a new conceptualisation which translates recovery into practice according to the goals and financial needs of the organisation. Conclusions: Organisational priorities influence staff understanding of recovery support. This influence is leading to the emergence of an additional meaning of recovery. The impact of service-led approaches to operationalising recovery-orientated practice has not been evaluated. Trial Registration: The protocol for the review was pre-registered (PROSPERO 2013: CRD42013005942)

RNA Silencing of Mcl-1 Enhances ABT-737-Mediated Apoptosis in Melanoma: Role for a Caspase-8-Dependent Pathway

BACKGROUND: Malignant melanoma is resistant to almost all conventional forms of chemotherapy. Recent evidence suggests that anti-apoptotic proteins of the Bcl-2 family are overexpressed in melanoma and may contribute to melanoma's striking resistance to apoptosis. ABT-737, a small-molecule inhibitor of Bcl-2, Bcl-xl and Bcl-w, has demonstrated efficacy in several forms of leukemia, lymphoma as well as solid tumors. However, overexpression of Mcl-1, a frequent observance in melanoma, is known to confer ABT-737 resistance. METHODOLOGY/PRINCIPAL FINDINGS: Here we report that knockdown of Mcl-1 greatly reduces cell viability in combination with ABT-737 in six different melanoma cell lines. We demonstrate that the cytotoxic effect of this combination treatment is due to apoptotic cell death involving not only caspase-9 activation but also activation of caspase-8, caspase-10 and Bid, which are normally associated with the extrinsic pathway of apoptosis. Caspase-8 (and caspase-10) activation is abrogated by inhibition of caspase-9 but not by inhibitors of the death receptor pathways. Furthermore, while caspase-8/-10 activity is required for the full induction of cell death with treatment, the death receptor pathways are not. Finally, we demonstrate that basal levels of caspase-8 and Bid correlate with treatment sensitivity. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that the combination of ABT-737 and Mcl-1 knockdown represents a promising, new treatment strategy for malignant melanoma. We also report a death receptor-independent role for extrinsic pathway proteins in treatment response and suggest that caspase-8 and Bid may represent potential markers of treatment sensitivity

Burnout among chiropractic practitioners: real or imagined an exploratory study protocol

Burnout is a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that has been found to exist in a significant number of healthcare and helping professionals. It imposes a significant societal burden by shortened practitioner lifespan, decreased efficiency, negative health outcomes and poorer levels of patient care. Theoretical models suggest that it appears to be the result of a complex interaction between job resources and job demands. It may be reasonable to conclude that Chiropractic professionals experience similar vocational demands and thus experience significant levels of occupational stress and subsequent burnout. However the data on burnout within the chiropractic profession is limited. It is possible that this results in significant negative outcomes on chiropractors and their patients. Therefore, the objective of this paper is to demonstrate the need to explore burnout in chiropractic practice and offer a research protocol for a potential study