The 'British Policy Style' and Mental Health: Beyond the Headlines

Recent Mental Health Acts provide evidence of diverging UK and Scottish government policy styles. The UK legislative process lasted almost ten years following attempts by ministers to impose decisions and an unprecedented level of sustained opposition from interest groups. In contrast, the consultation process in Scotland was consensual, producing high levels of stakeholder ‘ownership'. This article considers two narratives on the generalisability of this experience. The first suggests that it confirms a ‘majoritarian' British policy style, based on the centralisation of power afforded by a first-past-the-post electoral system (Lijphart, 1999). Diverging styles are likely because widespread hopes for consensus politics in the devolved territories have been underpinned by proportional representation. The second suggests that most policy-making is consensual, based on the diffusion of power across policy sectors and the ‘logic of consultation' between governments and interest groups (Jordan and Richardson, 1982). The legislative process deviated temporarily from the ‘normal' British policy style which is more apparent when we consider mental health policy as a whole. Overall, the evidence points to more than one picture of British styles; it suggests that broad conclusions on ‘majoritarian' systems must be qualified by detailed empirical investigation

Post-traumatic stress disorder and health problems among medically ill Canadian peacekeeping veterans

OBJECTIVE: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). METHOD: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. RESULTS: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD\u27s relationships with the three significant health conditions. CONCLUSIONS: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems

Electrochemical Energy Storage Subsystems Study, Volume 2

The effects on life cycle costs (LCC) of major design and performance technology parameters for multi kW LEO and GEO energy storage subsystems using NiCd and NiH2 batteries and fuel cell/electrolysis cell devices were examined. Design, performance and LCC dynamic models are developed based on mission and system/subsystem requirements and existing or derived physical and cost data relationships. The models are exercised to define baseline designs and costs. Then the major design and performance parameters are each varied to determine their influence on LCC around the baseline values

Electrochemical energy storage subsystems study, volume 1

The effects on life cycle costs (LCC) of major design and performance technology parameters for multi kW LEO and GEO energy storage subsystems using NiCd and NiH2 batteries and fuel cell/electrolysis cell devices were examined. Design, performance and LCC dynamic models are developed based on mission and system/subsystem requirements and existing or derived physical and cost data relationships. The models define baseline designs and costs. The major design and performance parameters are each varied to determine their influence on LCC around the baseline values

Distinctiveness of long-term pain that does not interfere with life: an observational cohort study.

BACKGROUND: Reporting of pain that does not interfere with life is common in the older population but little is known about people with such long-term non-interfering pain. OBJECTIVES: To assess whether non-interfering pain can be a long-term state, and to compare this group with those who continuously report no pain, and with those with chronic pain that interferes with life. METHODS: This was a prospective general population cohort study set within the North Staffordshire Osteoarthritis Project (NorStOP). People aged 50 plus were sent baseline, 3-year and 6-year questionnaires. Those who reported the same pain status (no pain, non-interfering pain, interfering pain) at each time point were compared on pain intensity, widespread pain and medication, and on sociodemographic and co-morbid characteristics at 6 years. RESULTS: Forty percent of responders reported the same pain status at each time point; 12% reported long-term non-interfering pain. Fifty-nine percent of those with non-interfering pain reported at least one site of high pain intensity, 33% reported widespread pain, and 90% had used pain medication in the past 4 weeks. This group was similar to the no-pain group but distinct on sociodemographic and co-morbid measures from those with pain that interfered. CONCLUSIONS: Long-term non-interfering pain is common, but despite often suffering from high pain intensity and widespread pain, those within this group seem to be able to control their pain without allowing it to affect their everyday lives. Future work is needed to assess how people with long-term pain ensure it does not cause interference with life

Relationship Among Emotional Intelligence and/or Extrovert Bias on Perceived Stress Levels in DPT Students

Purpose/Hypothesis: Students in graduate level DPT programs function at varying levels. Some students thrive and others struggle to maintain required minimum levels of academic performance. When considering admission of applicants, and when assisting enrolled students, consideration of factors contributing to academic success is of interest. Stress has been shown to be prevalent in a wide range of students and has many negative effects including poor life satisfaction, increased clinical burnout, and reduced academic performance. Research has shown a correlation between higher emotional intelligence (EI) and decreased stress levels in medical, nursing, and undergraduate students. The purpose of this study was to examine if emotional intelligence (EI) and/or extrovert bias correlates with perceived stress levels in Doctor of Physical Therapy (DPT) students. It was hypothesized that students with higher emotional intelligence and more extroverted personalities would experience lower levels of perceived stress. Participants: After providing consent, a convenience sample of 60 first and second year DPT students (33 female) with age range 23 to 38 participated in the current study. Participation was voluntary and 60 of a possible 72 students chose to participate. Materials/Methods: After obtaining informed consent, participants completed Goldberg’s IPIP-Neo questionnaire (extraversion), Perceived Stress Scale (PSS) and Assessing Emotions Scale (emotional intelligence). Each of these tools have demonstrated validity and reliability for the respective areas measured. Surveys were administered to students and results were analyzed for possible relationships between extraversion and stress levels as well as EI and stress levels using a Spearman Correlation test. Results: Spearman Correlation analyses were conducted with a significant negative correlation between EI and perceived stress rs = -0.291, p= 0.026 and a non-significant negative correlation between extraversion and perceived stress rs = -1.36, p= 0.305. Discussion: In the current sample, EI had a significant negative relationship with perceived stress levels, with higher EI scores correlating to lower levels of stress. The relationship between extraversion and perceived stress was non-significant. Clinical Relevance: Doctorate level graduate programs can be considered intense and very stressful. Admission of qualified students equipped to meet the demands of a DPT program has great importance. Establishing a correlation between EI, introversion/extraversion bias, and stress may help DPT programs further assess prospective students. Consideration of factors correlated with higher perceived stress may be useful when providing resources to admitted students to facilitate academic success

Chronic pain self-management support with pain science education and exercise (COMMENCE): Study protocol for a randomized controlled trial

© 2015 Miller et al. Background: Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. Methods/Design: This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list control. The primary outcome will be function measured by the Short Musculoskeletal Function Assessment - Dysfunction Index. Secondary outcomes will include pain intensity measured by a numeric pain rating scale, pain interference measured by the eight-item PROMIS pain interference item-bank, how much patients are bothered by functional problems measured by the Short Musculoskeletal Function Assessment - Bother Index, catastrophic thinking measured by the Pain Catastrophizing Scale, fear of movement/re-injury measured by the 11-item Tampa Scale of Kinesiophobia, sense of perceived injustice measured by the Injustice Experience Questionnaire, self-efficacy measured by the Pain Self-Efficacy Questionnaire, pain sensitivity measured by pressure pain threshold and cold sensitivity testing, fatigue measured by a numeric fatigue rating scale, pain neurophysiology knowledge measured by the Neurophysiology of Pain Questionnaire, healthcare utilization measured by number of visits to a healthcare provider, and work status. Assessments will be completed at baseline, 7 and 18 weeks. After the 18-week assessment, the groups will crossover; however, we anticipate carry-over effects with the treatment. Therefore, data from after the crossover will be used to estimate within-group changes and to determine predictors of response that are not for direct between-group comparisons. Mixed effects modelling will be used to determine between-group differences for all primary and secondary outcomes. A series of multiple regression models will be used to determine predictors of treatment response. Discussion: This study has the potential to inform future self-management programming through evaluation of a self-management program that aims to improve function as the primary outcome. Trial registration: ClinicalTrials.gov NCT02422459 , registered on 13 April 2015

Sarcospan Regulates Cardiac Isoproterenol Response and Prevents Duchenne Muscular Dystrophy-Associated Cardiomyopathy.

BackgroundDuchenne muscular dystrophy is a fatal cardiac and skeletal muscle disease resulting from mutations in the dystrophin gene. We have previously demonstrated that a dystrophin-associated protein, sarcospan (SSPN), ameliorated Duchenne muscular dystrophy skeletal muscle degeneration by activating compensatory pathways that regulate muscle cell adhesion (laminin-binding) to the extracellular matrix. Conversely, loss of SSPN destabilized skeletal muscle adhesion, hampered muscle regeneration, and reduced force properties. Given the importance of SSPN to skeletal muscle, we investigated the consequences of SSPN ablation in cardiac muscle and determined whether overexpression of SSPN into mdx mice ameliorates cardiac disease symptoms associated with Duchenne muscular dystrophy cardiomyopathy.Methods and resultsSSPN-null mice exhibited cardiac enlargement, exacerbated cardiomyocyte hypertrophy, and increased fibrosis in response to β-adrenergic challenge (isoproterenol; 0.8 mg/day per 2 weeks). Biochemical analysis of SSPN-null cardiac muscle revealed reduced sarcolemma localization of many proteins with a known role in cardiomyopathy pathogenesis: dystrophin, the sarcoglycans (α-, δ-, and γ-subunits), and β1D integrin. Transgenic overexpression of SSPN in Duchenne muscular dystrophy mice (mdx(TG)) improved cardiomyofiber cell adhesion, sarcolemma integrity, cardiac functional parameters, as well as increased expression of compensatory transmembrane proteins that mediate attachment to the extracellular matrix.ConclusionsSSPN regulates sarcolemmal expression of laminin-binding complexes that are critical to cardiac muscle function and protects against transient and chronic injury, including inherited cardiomyopathy

Provoking Curricula of Care: Weaving Stories of Rupture Towards Repair

We are five scholars of education, provoking curriculum on the topic of “care”—as practice, theory, and struggle, through our stories of living, teaching, and learning. Our inquiries surface threads of rupture, where we find that “care” indicates our efforts to address suffering. Our care-work consists of restorative, creative, and contemplative practices. We tell our stories through a literary métissage (weaving) of creative non-fiction, poetic writing, artwork, and images. We thus creatively expand the meaning of care by evoking our understandings, lived experiences, and practices of caring. In this way, we hope to create more attuned relationships, and open the way for more stories of “care” to emerge