Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and primary health care professional perspectives

The problem: Insomnia is the most commonly reported psychological complaint in Britain. Although hypnotic drugs are widely used for treatment of insomnia, they are only licensed short term and adverse effects are common. Cognitive Behavioural Therapy for insomnia (CBT-I), which is effective and safe long term, is recommended first line but is not widely used nor available, in part because of the lack of trained providers. In response to this, Computerised Cognitive Behavioural Therapy (CCBT) has been advocated. Existing CCBT programmes can suffer from poor rates of uptake, adherence and completion. We aimed to investigate patients and practitioners’ views on how CCBT for insomnia (CCBT-I) could be improved by incorporating features of modern technology including social networking functions. The approach: We used a qualitative design and the theory of planned behaviour to underpin the study. Interviews and focus groups were held with adult service users and health professionals using a topic guide designed to elicit participants’ beliefs, intentions and controlling factors that might facilitate or create barriers to the uptake and adherence to CCBT-I. We explored the data using thematic analysis supported by Nvivo. Findings: We interviewed 23 health professionals and 28 patients. We identified multi-faceted issues focused on meta-themes of trust and functionality which were perceived to increase likelihood of successful uptake and adherence. Trust and confidence would be increased if CCBT-I was perceived to be evidence-based and accredited; when referral was from a trusted professional within a supervised package of care; and when online support and follow-up were provided. Interaction with other users, by integrating CCBT-I with social networking, was perceived to provide mutual support but concerns from people with sleep problems included apprehension about online ‘strangers’ and concerns from practitioners included information security. Asynchronous communication such as posting a note, commenting on a forum or adding to a thread was considered safer than engaging in real-time on-line communication. To improve functionality patients wanted mobile applications; access in short periods; self-assessment of insomnia and its causes; more personalised information on sleep; an interactive approach; and contact with other users to be moderated or overseen. Consequences: Although previous qualitative studies have looked at CCBT uptake and adherence, none have looked at insomnia exclusively or explored the feasibility, advantages and drawbacks of online communication between participants. Improving uptake and adherence to online programmes for insomnia requires attention to design features which are focused on trust and functionality. Although computerised therapies for insomnia would allow more people to access treatment, some would not be suitable for online therapies because of lack of online access or poor computer literacy. The results of the study are being used the development of a novel platform for CCBT for insomnia and other health conditions

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and multiprofessional primary health care perspectives

Purpose: We explored patient and multiprofessional health perspectives to inform the development of a computerised cognitive behavioural therapy programme for insomnia (CCBT-I) that includes social networking. Theory: We used a qualitative design and theory of planned behaviour to underpin the analysis. Methods: Interviews and focus groups were held with service users and health professionals to elicit beliefs and intentions that might facilitate or create barriers to the uptake and adherence to CCBT-I. Findings: We interviewed 23 health professionals and 28 patients. Features designed to increase confidence in CCBT-I; engender trust in professional relationships; provide online support and improve programme functionality were perceived to increase the successful uptake and adherence. Interaction with other users via integrated social networking would provide mutual support but concerns included apprehension about online ‘strangers’ and information security. Patients wanted mobile applications; access in short periods; self-assessment; more interactive, personalised information on sleep and moderated contact with other users. Discussion: Improving uptake and adherence to online programmes for insomnia requires design features which are focused on trust and functionality. Computerised therapies for insomnia would allow access treatment for more people across geographical and heath system borders

The Bodies in the ‘Bog’ : A Multi-Isotope Investigation of Individual Life-Histories at an Unusual 6th/7th AD Century Group Burial from a Roman Latrine at Cramond, Scotland

Open access via springer compact agreement.Funding for the isotopic research was provided to KB and OC by the City of Edinburgh Council the Development Trust Student Fund, University of Aberdeen. The Leverhume Trust (PLP-2019-284 to KB) and the AHRC (award ref: 1775362 to OC) provided financial support during the preparation of this manuscript.Peer reviewedPublisher PD

The role of the gap junction protein connexin43 in B lymphocyte motility and migration

AbstractThe gap junction family of proteins is widely expressed in mammalian cells and form intercellular channels between adjacent cells, as well as hemichannels, for transport of molecules between the cell and the surrounding environment. In addition, gap junction proteins have recently been implicated as important for the regulation of cell adhesion and migration in a variety of cell types. The gap junction protein connexin43 (Cx43) regulates B lymphocyte adhesion, BCR- and LFA-1-mediated activation of the GTPase Rap1, and cytoskeletal rearrangements resulting in changes to cell shape and membrane spreading. We demonstrate here that the actin cytoskeleton is important for the distribution of Cx43 in the B cell plasma membrane and for other cell processes involving the cytoskeleton. Using shRNA knockdown of Cx43 in B lymphoma cells we show that Cx43 is also necessary for chemokine-mediated Rap 1 activation, motility, CXCL12-directed migration, and movement across an endothelial cell monolayer. These results demonstrate that in addition to its role in B cell spreading, Cx43 is an important regulator of B-cell motility and migration, processes essential for normal B-cell development and immune responses

What motivates the masses: understanding why people contribute to conservation citizen science projects

Participation in conservation citizen science projects is growing rapidly and approaches to project design are diversifying. There has been a recent shift towards projects characterised by contributors collecting data in isolation and submitting findings online, with little training or opportunities for direct social interaction with other citizen scientists. While research is emerging on developing citizen science projects by optimising technological modalities, little consideration has been given to understanding what motivates individuals to voluntarily contribute data. Here, we use the Volunteer Functions Inventory, combined with open-ended questions, to demonstrate that the two strongest motivations underpinning participation, for both individuals who contribute data systematically (regularly; n=177) and opportunistically (ad hoc basis; n=218), are ‘Values’ and ‘Understanding’. People take part in such projects because they have an intrinsic value for the environment and want to support research efforts (representing ‘Values’), as well as wanting to learn and gain knowledge (signifying ‘Understanding’). Unlike more traditional citizen science projects that involve specific training and considerable time investments, contributors to these newer types of project are not motivated by the potential to develop their career or opportunities for social interaction. The person36 level characteristics of contributors considered in this study did not reliably forecast levels of motivation, suggesting that predicting high levels of motivation is inherently more complex than is often speculated. We recommend avenues for future research that may further enhance our understanding of contributor motivations and the characteristics that may underpin levels of motivation

Opinions of women from deprived communities on the NHS stop smoking service in England - person-centered perspectives

Background: In most European countries, women are relatively more susceptible to smoking-related diseases, find it more difficult to quit and are more likely to relapse than men. With the aim of improving the understanding of women’s needs from smoking cessation services, this qualitative study examines perceptions of women from deprived communities on the National Health Service stop smoking service in England, UK. Methods: A qualitative study of 11 women, smokers and ex-smokers, who had used the stop smoking service located in disadvantaged communities in East Sussex, England, UK. Data were collected through focus group and semi-structured interviews and were subjected to thematic analysis. Results: Women felt that services tailored to their needs would improve cessation rates. They expect smoking cessation facilitators to be non-judgemental and to offer psychological insight into addiction. However, women’s opinions differed on the importance for facilitators to be female or ex-smokers and on the preference of group or one-to-one services, some women expressed a preference for women only groups. The women praised the continuity of care, capacity for peer support, flexibility of time and location and free cessation aids offered. Conversely, the women felt that services were poorly advertised, that access was not universally good and that services at the work place and drop-in groups would improve access for working women and women with young children. Conclusion: Flexible, person-centered services that are tailored towards the needs of individual smokers and better dissemination of information regarding the range of services available could facilitate greater uptake of smoking cessation services for women in deprived communities

Reading for Charles Burchfield

Featuring poets who participated in the March 8th Heat Waves in a Swamp workshop