AN OVERVIEW OF OBSERVATIONAL SLEEP RESEARCH WITH APPLICATION TO SLEEP STAGE TRANSITIONING

In this manuscript we give an overview of observational sleep research with a particular emphasis on sleep stage transitions. Sleep states represent a categorization of sleep electroencephalogram behavior over the night. We postulate that the rate of transitioning between sleep states is an important predictor of health. This claim is evaluated by comparing subjects with sleep disordered breathing to matched controls

Respiratory patient experience of measures to reduce risk of COVID-19: findings from a descriptive cross-sectional UK wide survey

Objectives: To assess the experience of people with long-term respiratory conditions regarding the impact of measures to reduce risk of COVID-19. Design: Analysis of data (n=9,515) from the Asthma UK and British Lung Foundation partnership COVID-19 survey collected online between 1st and 8th of April 2020. Setting: Community Participants: 9,515 people with self-reported long term respiratory conditions. 81% female, age ranges from <17 years to 80 and above, from all nations of the UK. Long term respiratory conditions reported included asthma (83%), Chronic Obstructive Pulmonary Disease (COPD) (10%), bronchiectasis (4%), Interstitial Lung Disease (ILD) (2%), and ‘other’ (<1%) (e.g. lung cancer and pulmonary endometriosis). Outcome measures: Study responses related to impacts on key elements of health care, as well as practical, psychological and social consequences related to the COVID-19 pandemic and social distancing measures. Results: 45% reported disruptions to care, including cancellations of appointments, investigations, pulmonary rehabilitation, treatment, and monitoring. Other practical impacts such as difficulty accessing healthcare services for other issues, and getting basic necessities such as food, were also common. 36% did not use online prescriptions and 54% had not accessed online inhaler technique videos. Psycho-social impacts including anxiety, loneliness and concerns about personal health and family were prevalent. 81% reported engaging in physical activity. Among the 11% who were smokers, 48% reported they were planning to quit smoking because of COVID-19. Conclusions: COVID-19 and related social distancing measures are having profound impacts on people with chronic respiratory conditions. Urgent adaptation and signposting of services is required to mitigate the negative health consequences of the COVID-19 response for this group

Inclusive second level religious education in Ireland today: what do teachers say?

The Irish religious landscape is changing. Census data reveal that the percentage of those who identify as Catholic is in steady decline, while the proportion of those with no religion continues to rise. Christian religious practice in Ireland is also decreasing, especially among young people. Catholic schools, once the dominant provider of second level education, are now in a minority. This changing landscape has influenced Religious Education in second level schools. It is now an optional subject, and the historic tradition of denominational, confessional Religious Education has given way to an approach designed to be inclusive of students of all faith and none. Yet the surrounding discourse is unsupported by the perspectives of Religious Education teachers. This study attempts to address this knowledge gap by investigating their views and experiences, particularly with regard to inclusion. Results indicate that teachers are concerned about ‘religious students’. Whereas new to the Irish context, this reflects international research which suggests that in a rapidly secularising society, those who continue to practice any faith, especially the once-majority faith, are vulnerable. Findings signpost evidence of this, with RE teachers most concerned about the bullying of Catholic students and least concerned about the bullying of atheists

Genetic diversity of a flightless dung beetle appears unaffected by wildfire

The wildfires of Australia’s Black Summer in 2019/2020 caused a massive loss of wildlife and habitats, but the effects of the fire on invertebrate species post-burn are unknown. We hypothesised that the fires would negatively affect the genetic diversity of invertebrate species by impeding movement between populations due to habitat loss. We studied the genetic diversity of a flightless dung beetle, Amphistomus primonactus Matthews 1974, to determine the impact of the wildfires on this species. We examined 90 SNPs from 193 individuals across seven localities impacted by the wildfires in north-eastern New South Wales. We used STRUCTURE to determine the overall population structure of the seven localities. We calculated four within-locality genetic diversity measures (observed heterozygosity (Ho), unbiased expected heterozygosity (uHe), Shannon’s Information (1 H), and the inbreeding coefficient (FIS). We calculated three between-locality genetic diversity measures (Fixation Index (FST), Hedrick’s G”ST, and Shannon’s Mutual Information (I). We used partial Mantel tests to compare the between-locality genetic diversity measures with the mean fire intensity along each pairwise linear transect, while accounting for genetic variation due to geographic distance. We compared the within-locality genetic diversity measures to the mean fire intensity at each site. STRUCTURE showed a large degree of intermixing between localities. We found no significant effect of fire on any within-locality genetic diversity measure, or on any between-locality genetic diversity measure. We suggest that the genetic diversity of A. primonactus was not significantly affected by the Black Summer wildfires. Implications for insect conservation: Our results show that the 2019/2020 wildfires had a negligible impact on the genetic structure of A. primonactus. This offers a promising outlook for the species in its recovery from the fires

Proteolysis of the endothelial cell protein C receptor by neutrophil proteinase 3

BACKGROUND: The endothelial cell protein C receptor (EPCR) presents protein C to the thrombin:thrombomodulin complex on the endothelium of large vessels, and enhances the generation of activated protein C (APC) and activation of protease-activated receptor-1. A previous report has demonstrated binding of soluble (s) EPCR to activated neutrophils via surface proteinase 3 (PR3). METHODS: We now report further characterization of this interaction. Activated neutrophils and purified PR3 both decrease endothelial cell (EC) surface EPCR, suggestive of its proteolysis. RESULTS: When added to purified recombinant sEPCR, PR3 produced multiple cleavages, with early products including 20 kDa N-terminal and C-terminal (after Lys(176)) fragments. The binding of active site blocked PR3 to sEPCR was studied by surface plasmon resonance. Estimates of the K(D) of 18.5–102 nm were obtained with heterogeneous binding, suggestive of more than a single interaction site. CONCLUSIONS: This work demonstrates PR3 binding to and proteolysis of EPCR and suggests a mechanism by which anticoagulant and cell protective pathways can be down-regulated during inflammation

Qualitative study of the acceptability and feasibility of acceptance and commitment therapy for adolescents with chronic fatigue syndrome

BACKGROUND: Paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is disabling and relatively common. Although evidenced-based treatments are available, at least 15% of children remain symptomatic after one year of treatment. Acceptance and commitment therapy (ACT) is an alternative therapy option; however, little is known about whether it is an acceptable treatment approach. Our aim was to find out if adolescents who remain symptomatic with CFS/ME after 12 months of treatment would find ACT acceptable, to inform a randomised controlled trial (RCT) of ACT. METHODS: We recruited adolescents (diagnosed with CFS/ME; not recovered after one year of treatment; aged 11–17 years), their parent/carer and healthcare professionals (HCPs) from one specialist UK paediatric CFS/ME service. We conducted semi-structured interviews to explore barriers to recovery; views on current treatments; acceptability of ACT; and feasibility of an effectiveness RCT. Thematic analysis was used to identify patterns in data. RESULTS: Twelve adolescents, eleven parents and seven HCPs were interviewed. All participants thought ACT was acceptable. Participants identified reasons why ACT might be efficacious: pragmatism, acceptance and compassion are valued in chronic illness; values-focussed treatment provides motivation and direction; psychological and physical needs are addressed; normalising difficulties is a useful life-skill. Some adolescents preferred ACT to cognitive behavioural therapy as it encouraged accepting (rather than challenging) thoughts. Most adolescents would consent to an RCT of ACT but a barrier to recruitment was reluctance to randomisation. All HCPs deemed ACT feasible to deliver. Some were concerned patients might confuse ‘acceptance’ with ‘giving up’ and called for clear explanations. All participants thought the timing of ACT should be individualised. CONCLUSIONS: All adolescents with CFS/ME, parents and HCPs thought ACT was acceptable, and most adolescents were willing to try ACT. An RCT needs to solve issues around randomisation and timing of the intervention