Nonverbal communication in schizophrenia: A 3-D Analysis of patients’ social interactions

PhDBackground: Schizophrenia is a severe mental illness affecting approximately 0.4% of the population. A core feature of schizophrenia is social dysfunction, however, the precise nature of patients’ social deficits remain unknown. During face-to-face interaction we use nonverbal cues to coordinate, regulate and manage conversation. Patients have difficulty perceiving nonverbal cues in social cognitive tests, but it is unclear if this difficulty persists in their social encounters. The aim of this thesis is to determine if patients’ social deficits are manifest in the nonverbal behaviour of their social interactions, specifically investigating; (1) interpersonal coordination between the head movements of interacting partners and (2) the head and hand movements of patients and their partners in the context of conversation role. The relationship between nonverbal behaviour and patients’ symptoms, social cognition, rapport and social outcomes will also be assessed. Methods: The experimental study involved twenty patient (1 patient, 2 healthy participants) and twenty control (3 healthy participants) three-way groups. Groups were motion captured while discussing a moral dilemma. Healthy participants were unaware a patient was present. Results: (1) interpersonal coordination was reduced in patients’ three-way interactions (2) patients displayed less head and hand movement, while their healthy participant partners displayed more. Increased patients’ negative symptoms intensified this pattern and were associated with reduced patient rapport. Patients spending more time actively involved in their three-way interactions had poorer social outcomes. Patients’ performance on social cognitive assessments showed no association with their nonverbal behaviour. Interpretation: Patients’ three-way interactions display atypical patterns of nonverbal behaviour. The presence of a patient changes the behaviour of the healthy participants they are interacting with; even when they are unaware a patient is present. Patients’ symptoms mediate the behaviour of patients and their partners, and influence patients’ rapport

MBRRACE in simulation: an evaluation of a multi-disciplinary simulation training for medical emergencies in obstetrics (MEmO)

he majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as ‘indirect deaths’. The MBRRACE report identified serious gaps in clinicians’ human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49). The training improved participants’ clinical management of medical deterioration in pregnancy (p=.003) alongside improving their human factors skills (p=.004). Furthermore, participants reported the translation of these skills to their routine clinical practice. This flexible training is responsive to the changing national needs and contextualises the MBRRACE findings for healthcare staff. It is a promising avenue for reducing the rates of in-direct death in pregnancy. Impact statement What is already known on this subject? The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions. The management of medical conditions in pregnancy relies on a multi-professional approach. However, serious gaps in clinicians’ human factors skills, highlighted by the MBRRACE report, may contribute to maternal death. What do the results of this study add? This study evaluated the first multi-disciplinary, simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Training significantly improved participants’ management of medical deterioration in pregnancy and human factors skills, particularly in the areas of leadership, communication and teamwork. Moreover, the participants learning translated into their clinical practice. What are the implications of these findings for clinical practice and/or further research? The delivery of multi-disciplinary team training for all healthcare staff involved in the complex management of medical conditions in pregnancy can help develop a greater understanding of others’ professional roles, and demonstrate the importance of interprofessional teamwork. Furthermore, it provides the space to reflect on team working approaches, including the leadership and professional autonomy, and their potential impact on patient care. Future research should evaluate the impact of this training on the objective outcome measures of medical emergencies in pregnancy

Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: a mixed methods evaluation study

BACKGROUND: In the UK, people with severe mental illness die up to 20years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness. OBJECTIVES: To evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings. Investigating the impact of training on: 1. Participants' knowledge, confidence, and attitudes towards managing medical deterioration; and 2. Incident reporting, as an objective index of incident management. Participants' perceptions of the impact on their practice were qualitatively explored. DESIGN: This evaluation employed a mixed-methods pre-post intervention design. PARTICIPANTS & SETTINGS: Fifty-three healthcare professionals participated including: mental health nurses, psychiatrists, healthcare assistants, and activity co-ordinators from two busy psychiatric triage wards in South London, UK. METHODS: The intervention comprised eight half-day sessions delivered weekly across two wards. Structured surveys assessed participants' knowledge, confidence, and attitudes towards medical deterioration pre and post training. Participants' experience of training was qualitatively captured through post-course surveys and focus groups three months post training. Incident reporting rates for seven-month periods pre and post training were compared. RESULTS: Following training, participants showed significant improvement in knowledge (p<0.001), confidence (p<0.001), and attitudes towards (p<0.02) managing medical deterioration. Incident reporting increased by 33% following training. Participants' reported improved confidence in managing medical deterioration, better understanding of effective communication, improved self-reflection and team working, and an increased sense of responsibility for patients' physical health. CONCLUSIONS: Interprofessional, in situ simulation training for medical deterioration yielded promising outcomes for individuals and teams. Simulation is an under-used training modality in mental health, offering a holistic training approach with the potential to provide educational and clinical benefits while supporting workforce resilience

Helping hands? Gesture and self-repair in schizophrenia

Howes C, LaVelle M, Healey P, Hough J, McCabe R. Helping hands? Gesture and self-repair in schizophrenia. In: Proceedings of the Resources and Processing of Linguistic and Extra-Linguistic Data from People with Various Forms of Cognitive/Psychiatric Impairments (RaPID-2016). 2016

Hormone replacement therapy and false positive recall in the Million Women Study: patterns of use, hormonal constituents and consistency of effect

INTRODUCTION: Current and recent users of hormone replacement therapy (HRT) have an increased risk of being recalled to assessment at mammography without breast cancer being diagnosed ('false positive recall'), but there is limited information on the effects of different patterns of HRT use on this. The aim of this study is to investigate in detail the relationship between patterns of use of HRT and false positive recall. METHODS: A total of 87,967 postmenopausal women aged 50 to 64 years attending routine breast cancer screening at 10 UK National Health Service Breast Screening Units from 1996 to 1998 joined the Million Women Study by completing a questionnaire before screening and were followed for their screening outcome. RESULTS: Overall, 399 (0.5%) participants were diagnosed with breast cancer and 2,629 (3.0%) had false positive recall. Compared to never users of HRT, the adjusted relative risk (95% CI) of false positive recall was: 1.62 (1.43–1.83), 1.80 (1.62–2.01) and 0.76 (0.52–1.10) in current users of oestrogen-only HRT, oestrogen-progestagen HRT and tibolone, respectively (p (heterogeneity) < 0.0001); 1.65 (1.43–1.91), 1.49 (1.22–1.81) and 2.11 (1.45–3.07) for current HRT used orally, transdermally or via an implant, respectively (p (heterogeneity) = 0.2); and 1.84 (1.67–2.04) and 1.75 (1.49–2.06) for sequential and continuous oestrogen-progestagen HRT, respectively (p (heterogeneity) = 0.6). The relative risk of false positive recall among current users appeared to increase with increasing time since menopause, but did not vary significantly according to any other factors examined, including duration of use, hormonal constituents, dose, whether single- or two-view screening was used, or the woman's personal characteristics. CONCLUSION: Current use of oestrogen-only and oestrogen-progestagen HRT, but not tibolone, increases the risk of false positive recall at screening

Evaluation of the Trivedi Effect®- Energy of Consciousness Energy Healing Treatment on the Physical, Spectral, and Thermal Properties of Zinc Chloride

Zinc chloride has the importance in pharmaceutical/nutraceutical industries for the prevention and treatment of several diseases. The objective of the current study was to investigate the impact of The Trivedi Effect®-Energy of Consciousness Healing Treatment (Biofield Energy Healing Treatment) on physical, structural, and thermal properties of zinc chloride using PXRD, PSD, FT-IR, UV-vis, TGA, and DSC analysis. Zinc chloride was divided into two parts. One part was denoted as the control without any, while the other part was defined as the Trivedi Effect® Treated sample, which received the Trivedi Effect® Treatment remotely from eighteen renowned Biofield Energy Healers. The PXRD analysis revealed that the crystallite size and relative intensities of the PXRD peaks significantly altered in the treated sample compared with the control sample. The crystallite size of treated sample was decreased by 4.19% compared with the control sample. The particle size at d10 and d50 of the Biofield Energy Treated sample decreased by 4.72% and 2.70%, respectively compared with the control sample. But, the particle size of the treated sample increased at d90 by 0.83 compared with the control sample. Consequently, the surface area was increased by 3.22% in the treated sample compared with the control sample. The FT-IR spectroscopic analysis revealed that Zn-Cl stretching in the control and treated sample was at 520 cm-1 and 521 cm-1, respectively. The UV-vis analysis exhibited that the wavelength of the maximum absorbance of the control and treated samples was at 196.4 and 196.2 nm, respectively. The TGA thermograms revealed two steps of the thermal degradation and the weight loss of the treated sample was significantly reduced by 22.54% in the 1st step of degradation compared with the control sample. The DSC analysis showed that the enthalpy of decomposition was significantly increased by 34.9% in the treated sample (89.17 J/g) compared with the control sample (66.10 J/g). Overall, DSC and TGA analysis indicated that the thermal stability of the treated sample was increased compared with the control sample. The current study anticipated that The Trivedi Effect®-Energy of Consciousness Healing Treatment might lead to generate a new polymorphic form of zinc chloride, which would be more soluble, stable, and higher absorption rate compared with the control sample. Hence, the treated zinc chloride could be very useful to design the various forms of nutraceuticals and pharmaceutical formulation which might be providing a better therapeutic response against inflammatory diseases, immunological disorders, aging, stress, cancer, etc. https://www.trivedieffect.com/science/evaluation-of-the-trivedi-effect-energy-of-consciousness-energy-healing-treatment-on-the-physical-spectral-and-thermal-properties-of-zinc-chloride http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=118&doi=10.11648/j.ajls.20170501.1

Liquid Chromatography – Mass Spectrometry (LC-MS) Analysis of Withania somnifera (Ashwagandha) Root Extract Treated with the Energy of Consciousness

Withania somnifera (ashwagandha) root extract is very popular ancient herbal medicine. The objective of the study was to characterize and evaluate the impact of The Trivedi Effect®-Biofield Energy Healing Treatment (Energy of Consciousness) on phytoconstituents present in the ashwagandha root extract using LC-MS. Ashwagandha root extract was divided into two parts. One part was denoted as the control, while the other part was defined as The Trivedi Effect® - Biofield Energy Treated sample, which received Energy of Consciousness Healing Treatment remotely from eighteen renowned Biofield Energy Healers. The LC-MS analysis of the control and treated samples showed a very close retention time (Rt), indicated that the polarity of the phytoconstituents present in the root extract are same. The numbers of peaks observed in the total ion chromatograms were 28 and 29 in the control and treated samples, respectively. The change in the peak height% of the phytoconstituents in the treated sample was altered significantly within the range of -50.91% to 118.12% compared with the control sample. Similarly, the change in the peak area% of most of the phytoconstituents in the treated ashwagandha was significantly altered within the range of -54.95% to 66.95% compared with the control sample. An additional peak was appeared in the treated sample at Rt of 5.72 minutes, which was not found in the control sample. The LC-MS spectra indicated the presence of possible withanolides like -hydroxy-2,3-dihydro-withanolide F, withanolide A, withaferine A, withanone, withanolide D, ixocarpalactone A, withanolide S, thiowithanolide, etc. in both the samples. The peak are percentage (%) was altered in the identified withanolides, but withanolide sulfoxide was increased significantly by 12.44% in the treated sample compared with the control sample. These results indicated that The Trivedi Effect® - Biofield Energy Treatment might have an impact on the intrinsic physicochemical properties of the phytoconstituents present in the ashwagandha root extract. This could be the probable cause of alteration in the peak height, peak area, and appearance of a new peak in the treated sample. As a result, the concentrations of the phytoconstituents altered in the treated sample compared with the control sample. The treated ashwagandha root extract would be helpful for designing better pharmaceutical/nutraceutical formulations which might be providing a better therapeutic response against autoimmune diseases, nervous and sexual disorders, infectious diseases, antiaging, diabetes, cancer, ulcer, immunological disorders, stress, arthritis, etc. Source: https://www.trivedieffect.com/science/liquid-chromatography-mass-spectrometry-lc-ms-analysis-of-withania-somnifera-ashwagandha-root-extract-treated-with-the-energy-of-consciousness http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=398&doi=10.11648/j.ajqcms.20170101.1

Effect of the Energy of Consciousness (The Trivedi Effect®) on Withania somnifera Root Extract Using Gas Chromatography – Mass Spectrometry and Nuclear Magnetic Resonance Spectroscopy

Withania somnifera (Ashwagandha) root extract is very popular ancient herbal medicine. The objective of the study was to characterize and evaluate the impact of The Trivedi Effect® - Energy of Consciousness Healing Treatment (Biofield Energy Healing) on phytoconstituents present in the ashwagandha root extract using GC-MS and NMR. Ashwagandha root extract was divided into two parts. One part was denoted as the control, while the other part was defined as The Trivedi Effect® - Biofield Energy Treated sample, which received The Trivedi Effect® - Energy of Consciousness Healing Treatment remotely from eighteen renowned Biofield Energy Healers. The GC-MS data indicated that the peak height and peak area of The Trivedi Effect® treated sample were found to be altered compared with the control sample. The peak height of the phytoconstituents present in the treated ashwagandha sample was altered significantly in the range of -8.32% to 89.25% compared with the control sample. Similarly, the peak area of the treated sample was altered significantly in the range of - 4.28% to 216.30% compared with the control sample. Overall, the change in the peak area% of the treated sample was significantly altered in the range of -18.29% to 170.18% compared with the control sample. The GC-MS and NMR analysis results identified the presence of withanolides such as glyco-withanolides, alkaloids, and sugars in the root extract in both the sample. The peak area of 2,3,4,5-tetrahydropyridazine (1), methyl ethyl sulfoxide (2), 5,6-dihydro-2-methyl-4(H)pyran-3,4-dione (4), diethoxy-2-methyl-propane (5), 2,3,4,5-tetrahydroxy-tetrahydro-pyran (6), and 3,4-dimethyl-2(3H)-furanone (7) were significantly increased by 170.18%, 58.21%, 7.74%, 139.50%, 23.16%, and 45.63%, respectively in the treated sample compared with the control sample. On the contrary, the peak area% of 2-hydroxy-γ-butyrolactone (3) was decreased by - 14.96% in the treated ashwagandha compared with the control sample. From the results, it can be hypothesized that The Trivedi Effect® - Biofield Energy Treatment might have the impact on the intrinsic physicochemical properties of the phytoconstituents present in the ashwagandha root extract and responsible for the alteration in the relative peak height/area of treated sample compared with the control sample. As a result, the concentrations of the phytoconstituents assumed to be increased in treated sample compared with the control sample. This treated ashwagandha root extract would be helpful for designing better nutraceutical/pharmaceutical formulations which might be providing a better therapeutic response against autoimmune diseases, nervous and sexual disorders, infectious diseases, antiaging, diabetes, cancer, immunological disorders, stress, arthritis, etc. Source: https://www.trivedieffect.com/science/effect-of-the-energy-of-consciousness-the-trivedi-effect-on-withania-somnifera-root-extract-using-gas-chromatography-mass-spectrometry-and-nuclear-magnetic-resonance-spectroscopy http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=320&doi=10.11648/j.jdmp.20170302.1

A Role for TLR4 in Clostridium difficile Infection and the Recognition of Surface Layer Proteins

Clostridium difficile is the etiological agent of antibiotic-associated diarrhoea (AAD) and pseudomembranous colitis in humans. The role of the surface layer proteins (SLPs) in this disease has not yet been fully explored. The aim of this study was to investigate a role for SLPs in the recognition of C. difficile and the subsequent activation of the immune system. Bone marrow derived dendritic cells (DCs) exposed to SLPs were assessed for production of inflammatory cytokines, expression of cell surface markers and their ability to generate T helper (Th) cell responses. DCs isolated from C3H/HeN and C3H/HeJ mice were used in order to examine whether SLPs are recognised by TLR4. The role of TLR4 in infection was examined in TLR4-deficient mice. SLPs induced maturation of DCs characterised by production of IL-12, TNFα and IL-10 and expression of MHC class II, CD40, CD80 and CD86. Furthermore, SLP-activated DCs generated Th cells producing IFNγ and IL-17. SLPs were unable to activate DCs isolated from TLR4-mutant C3H/HeJ mice and failed to induce a subsequent Th cell response. TLR4−/− and Myd88−/−, but not TRIF−/− mice were more susceptible than wild-type mice to C. difficile infection. Furthermore, SLPs activated NFκB, but not IRF3, downstream of TLR4. Our results indicate that SLPs isolated from C. difficile can activate innate and adaptive immunity and that these effects are mediated by TLR4, with TLR4 having a functional role in experimental C. difficile infection. This suggests an important role for SLPs in the recognition of C. difficile by the immune system