A review of the effectiveness of a brief (8 session) Cognitive Analytic Therapy (CAT) for clients with anger problems

This report represents evaluative data from 12 months of psychotherapeutic intervention using Cognitive Analytic Therapy at Winn Gardens and some reflections on the subsequent development of the project into Burngreave. The focus of the intervention was primarily managing anger but other psychological problems underlying anger have also been treated. In total 23 referrals were received and 8 completed case of „evaluation‟ are presented here. Results indicate a significant improvement in general health, psychological health and behaviour change from what is a brief therapy consisting of 8 sessions and a follow up. The intervention has diverted clients from assaulting behaviour, both to themselves and others, reducing the impact of violence on partners, others, health and social care services and police and court services. It is difficult to quantify this but the associated costs for anger and violence are significant and incalculable. Up to July 2010 14 referrals were received at Burngreave all of whom were contacted, offered an appointment and/or undertook therapy. Four clients have completed therapy with a number of others taking up a number of sessions. It is anticipated that similar positive therapeutic outcomes to Winn Gardens will be found in the population at Burngreave on completion.</p

Budding and Domain Shape Transformations in Mixed Lipid Films and Bilayer Membranes

We study the stability and shapes of domains with spontaneous curvature in fluid films and membranes, embedded in a surrounding membrane with zero spontaneous curvature. These domains can result from the inclusion of an impurity in a fluid membrane, or from phase separation within the membrane. We show that for small but finite line and surface tensions and for finite spontaneous curvatures, an equilibrium phase of protruding circular domains is obtained at low impurity concentrations. At higher concentrations, we predict a transition from circular domains, or "caplets", to stripes. In both cases, we calculate the shapes of these domains within the Monge representation for the membrane shape. With increasing line tension, we show numerically that there is a budding transformation from stable protruding circular domains to spherical buds. We calculate the full phase diagram, and demonstrate a two triple points, of respectively bud-flat-caplet and flat-stripe-caplet coexistence.Comment: 14 pages, to appear in Phys Rev

Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis

The aim of this meta-analysis was to quantify the change in sedentary time during the COVID-19 pandemic and its effect on health outcomes in the general population. One thousand six hundred and one articles published after 2019 were retrieved from five databases, of which 64 and 40 were included in the systematic review and meta-analysis, respectively. Studies were grouped according to population: children (65 years). Average sedentary time was calculated, with sub-analyses performed by country, behaviour type and health outcomes. Children were most affected, increasing their sedentary time by 159.5 ± 142.6 min day−1, followed by adults (+126.9 ± 42.2 min day−1) and older adults (+46.9 ± 22.0 min day−1). There were no sex differences in any age group. Screen time was the only consistently measured behaviour and accounted for 46.8% and 57.2% of total sedentary time in children and adults, respectively. Increases in sedentary time were negatively correlated with global mental health, depression, anxiety and quality of life, irrespective of age. Whilst lockdown negatively affected all age groups, children were more negatively affected than adults or older adults, highlighting this population as a key intervention target. As lockdowns ease worldwide, strategies should be employed to reduce time spent sedentary. Trial registration: PROSPERO (CRD42020208909

Moving Forward: Understanding Correlates of Physical Activity and Sedentary Behaviour during COVID-19—An Integrative Review and Socioecological Approach

Population-level physical activity (PA) and sedentary time/behaviour estimates represent a significant public health issue exacerbated by restrictions enforced to control COVID-19. This integrative review interrogated available literature to explore the pandemic's impact on correlates of such behaviours in adults (≥18 years). Five electronic databases were systematically searched in January 2021. Data extracted from 64 articles were assessed for risk-of-bias using the Mixed Methods Assessment Tool, with correlates identified, coded, and themed via thematic analysis. A socioecological model of during-pandemic PA was conceptualized and mapped to the Capability, Opportunity, Motivation, and Behaviour (COM-B) model of behaviour change mechanisms, which illustrates influences over five levels: Individual (biological)-general health; Individual (psychological)-mental health, cognition, motivation, and behaviour; Social-domestic situation, sociodemographic factors, support, and lifestyle choices; Environmental-resources and area of residence; and Policy-COVID-19-related rules. For sedentary time/behaviour, individual level factors, namely general and mental health, may be important correlates. Neither age or sex were clearly correlated with either behaviour. As we transition into a new normal, understanding which behaviour mechanisms could effectively challenge physical inactivity is essential. Targeting capability on a psychological level may facilitate PA and limit sedentary time/behaviour, whereas, on a physical level, maximizing PA opportunities could be crucial

Use of cigarettes with flavor-changing capsules among smokers in the United Kingdom: An online survey

Introduction Cigarettes with flavour-changing capsules in the filter have experienced phenomenal global growth in the last decade. We explore socio-demographic and smoking-related factors associated with using capsule cigarettes, how frequently users burst the capsule, and reasons for using them. Methods An online survey was conducted in the United Kingdom between April-May 2016 with 6234 factory-made and/or hand-rolled cigarette smokers. This analysis focuses on 3620 factory-made cigarette smokers, aged 18 years and over, who had smoked in the past month. Results Thirteen percent smoked capsule cigarettes, with younger smokers more likely than older smokers to do so. Capsule use was significantly more common among white non-British than white British, and among those planning to quit in the next six months than those not planning to quit. Most capsule users who crushed the capsule did so always (51%) or most of the time (18%), with more frequent crushing of capsules more common among females, younger and middle-aged participants, white-British and those with a lower score on the Heaviness of Smoking Index. The most common reasons for using capsule cigarettes were that they taste better (52%), are smoother (41%), provide a choice of flavours (32%) and the enjoyment of clicking the capsule (25%). Capsule and non-capsule smokers did not differ significantly in their perceptions of the harmfulness of their brand relative to other brands. Conclusions Our study provides an insight into how and why smokers of capsule cigarettes use these products, with the key drivers of use being taste, flavour choice and interactivity

Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta‐analysis

publishedVersio

Peripheral limb ischaemia from peripherally inserted central catheter (PICC) line insertion in an extreme preterm neonate : case report

Background: There is extensive literature on incorrect positioning of peripherally inserted central catheter (PICC) line tips, particularly concerning advancement into the right atrium causing cardiac tamponade. However, there is little literature concerning inadvertent arterial cannulation as a complication of PICC insertion and what steps could be taken to prevent it. Case presentation: An extreme preterm neonate had a PICC line inserted into the left arm to provide central venous access for parenteral nutrition. Following the insertion, an anteroposterior chest X-ray was used to confirm positioning and was deemed acceptable. It was reviewed by a consultant radiologist the next day. Fifteen hours after insertion, the nursing staff raised concerns that the fingertips on the neonate’s left hand appeared dusky and were getting progressively darker. Upon removal of the PICC line, an upper limb Doppler was performed, showing severe stenosis of the brachial artery with no flow distally in the radial or ulnar arteries. Conclusions: This case demonstrates that glyceryl trinitrate (GTN) patches can be used to reverse peripheral ischaemia in neonates with good effect. After reflecting on the case, we decided that monitoring distal limb colour and perfusion should be part of observations in neonates with central venous lines in situ and documentation should reflect this. Furthermore, when concerns are raised about distal perfusion in a limb with lines in situ, all lines should be removed immediately. We would like to emphasise that it is of vital importance to promote a culture of openness where all team members are empowered to raise concerns about patient safety

In vitro biomarker discovery in the parasitic flatworm Fasciola hepatica for monitoring chemotherapeutic treatment

The parasitic flatworm Fasciola hepatica is a global food security risk. With no vaccines, the sustainability of triclabendazole (TCBZ) is threatened by emerging resistance. F. hepatica excretory/secretory (ES) products can be detected in host faeces and used to estimate TCBZ success and failure. However, there are no faecal based molecular diagnostics dedicated to assessing drug failure or resistance to TCBZ in the field. Utilising in vitro maintenance and sub-proteomic approaches two TCBZ stress ES protein response fingerprints were identified: markers of non-killing and lethal doses. This study provides candidate protein/peptide biomarkers to validate for detection of TCBZ failure and resistance

A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children

PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions at increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5 to 11 years, as well as to explore effectiveness in relation to categories of the theory of expanded, extended and enhanced opportunity (TEO).MethodsAdhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using pre-defined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a five-level rating system utilising a published decision tree.ResultsOverall evidence ratings for interventions implemented within school settings were no evidence on moderate-to-vigorous physical activity and inconclusive evidence on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analysis of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size (ES) = 0.51; 95% Confidence Interval (CI): 0.02–0.99) and a large but non-significant effect for ST 1.15 (95%CI: –1.03 to 3.33); both meta-analysis demonstrated low precision, considerable inconsistency, and high heterogeneity.ConclusionThe findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation