The role of emotions in obsessive-compulsive experiences

The present thesis has investigated the role of emotions in obsessive-compulsive experiences. First, a literature review explored whether specific compulsive presentations were underpinned by consistent affective profiles. A systematic search procedure identified 23 studies which were eligible for inclusion. Analysis of the results reported across the studies led to five key conclusions. First, washing profiles were consistently characterised by elevated levels of disgust. Second, checking profiles were consistently characterised by elevated levels of guilt. Third, hoarding profiles appeared to be characterised by fewer undesirable phenomena. Fourth, aside from hoarding, anxiety and depression were found to be consistently present across the profiles of all compulsions. Fifth, individuals experiencing multiple compulsion types were considered to experience profiles characterised by increased affective phenomena of a potentially distressing nature, for example, anxiety and stress. These findings highlighted the importance of considering affective variables when assessing, formulating, and supporting obsessive-compulsive difficulties. Second, a research project was designed to investigate the influence of self-disgust on obsessive-compulsive experiences, as this emotion had been rarely considered alongside such presentations. An online questionnaire was completed by 149 eligible participants with clinically significant obsessive-compulsive difficulties. The results of a multiple regression analysis revealed that self-disgust was a significant independent predictor of hoarding behaviours; no other compulsive behaviours were predicted by self-disgust. Results were explained in terms of existing theory and empirical evidence. Again, findings were considered with regards to their clinical implications and the importance of using holistic formulations to inform clinical interventions. Third, a critical appraisal was completed to reflect upon the thesis. This comprised an extended discussion of the research paper. Additionally, consideration was given to the research process, including the challenge of balancing the necessary use of the medical model with person-centred values

Food restriction reduces neurogenesis in the avian hippocampal formation

The mammalian hippocampus is particularly vulnerable to chronic stress. Adult neurogenesis in the dentate gyrus is suppressed by chronic stress and by administration of glucocorticoid hormones. Post-natal and adult neurogenesis are present in the avian hippocampal formation as well, but much less is known about its sensitivity to chronic stressors. In this study, we investigate this question in a commercial bird model: the broiler breeder chicken. Commercial broiler breeders are food restricted during development to manipulate their growth curve and to avoid negative health outcomes, including obesity and poor reproductive performance. Beyond knowing that these chickens are healthier than fully-fed birds and that they have a high motivation to eat, little is known about how food restriction impacts the animals' physiology. Chickens were kept on a commercial food-restricted diet during the first 12 weeks of life, or released from this restriction by feeding them ad libitum from weeks 7-12 of life. To test the hypothesis that chronic food restriction decreases the production of new neurons (neurogenesis) in the hippocampal formation, the cell proliferation marker bromodeoxyuridine was injected one week prior to tissue collection. Corticosterone levels in blood plasma were elevated during food restriction, even though molecular markers of hypothalamic-pituitary-adrenal axis activation did not differ between the treatments. The density of new hippocampal neurons was significantly reduced in the food-restricted condition, as compared to chickens fed ad libitum, similar to findings in rats at a similar developmental stage. Food restriction did not affect hippocampal volume or the total number of neurons. These findings indicate that in birds, like in mammals, reduction in hippocampal neurogenesis is associated with chronically elevated corticosterone levels, and therefore potentially with chronic stress in general. This finding is consistent with the hypothesis that the response to stressors in the avian hippocampal formation is homologous to that of the mammalian hippocampus

Optimizing Attachment of Human Mesenchymal Stem Cells on Poly(epsilon-caprolactone) Electrospun Yarns

Research into biomaterials and tissue engineering often includes cell-based in vitro investigations, which require initial knowledge of the starting cell number. While researchers commonly reference their seeding density this does not necessarily indicate the actual number of cells that have adhered to the material in question. This is particularly the case for materials, or scaffolds, that do not cover the base of standard cell culture well plates. This study investigates the initial attachment of human mesenchymal stem cells seeded at a known number onto electrospun poly(ε-caprolactone) yarn after 4 hr in culture. Electrospun yarns were held within several different set-ups, including bioreactor vessels rotating at 9 rpm, cell culture inserts positioned in low binding well plates and polytetrafluoroethylene (PTFE) troughs placed within petri dishes. The latter two were subjected to either static conditions or positioned on a shaker plate (30 rpm). After 4 hr incubation at 37 (o)C, 5% CO(2), the location of seeded cells was determined by cell DNA assay. Scaffolds were removed from their containers and placed in lysis buffer. The media fraction was similarly removed and centrifuged – the supernatant discarded and pellet broken up with lysis buffer. Lysis buffer was added to each receptacle, or well, and scraped to free any cells that may be present. The cell DNA assay determined the percentage of cells present within the scaffold, media and well fractions. Cell attachment was low for all experimental set-ups, with greatest attachment (30%) for yarns held within cell culture inserts and subjected to shaking motion. This study raises awareness to the actual number of cells attaching to scaffolds irrespective of the stated cell seeding density

How cultural competence is conceptualised, developed and delivered in pharmacy education: a systematic review

Background: It is important to have a pharmacy workforce that is culturally competent to recognise a patient’s health beliefs to improve medication adherence and reduce poor treatment outcomes. Aim: This systematic review aimed to identify, critically appraise and summarise how cultural competency is conceptualised, developed and embedded in pre-qualification pharmacy education. Method: Medline, Scopus, PsychInfo, Web of Knowledge, CINAHL, and Embase databases were searched for relevant papers published in English between January 2012 and December 2021 following PRISMA guidelines. Data from included papers were thematically analysed. Educational quality of papers was appraised using the GREET criteria. This systematic review was registered on PROSPERO, CRD42021295875. Results: The review included 47 papers (46 studies) with 18 papers meeting ≥ 9 points on the GREET criteria thus considered of good educational quality. 40 papers focused on educational interventions implemented to pharmacy students only, the remaining included students from different health disciplines. Half of the educational interventions focused on cultural competence in general. Most educational interventions lasted over a week and 21 were compulsory. Cultural competence conceptualisation varied; a focus on knowledge about different cultures or on culturally competent behaviours or a continuum with knowledge at one end and behaviour at the other. Conclusion: There is variation in how cultural competence is embedded, in pharmacy programmes, which could be a reflection of the differences in how educators conceptualised cultural competence. Further research is needed to develop a unified understanding of the meaning of cultural competence and how it can be embedded in pharmacy education

A qualitative study exploring experiences of racial minority stress in pharmacy education and practice

Background: Despite 49.1% of registered pharmacists in the UK being from a Black, Asian and Minority Ethnic (BAME) background, senior management roles within pharmacy are dominated by white males. People from BAME communities may experience minority stress which contributes to a professional attainment gap compared with non-BAME colleagues. Minority stress describes additional stressors, such as unconscious bias, micro-aggression and racial minority stress, experienced by minoritized people to adhere to the social norms of the majority. There is little evidence describing experiences of minority stress in pharmacy practice and education. The aim was to explore experiences of racial minority stress in pharmacy education and practice. Methods: A convenience sample of pharmacy students and pharmacists were recruited via email and social media posts to volunteer to take part in interviews and focus groups. A topic guide was used to explore experiences of unconscious bias, microaggressions and racial minority stress in education and practice. Interviews and focus groups were transcribed verbatim and inductively analysed using thematic analysis underpinned by a phenomenological approach. Ethical approval was granted from Newcastle University (5340/2020, 2430/2593). Results: Forty-five participants were recruited. Six focus groups and sixteen one-to-one semi-structured interviews were conducted. The sample was varied, with 56% (n = 25) students and 33% (n = 15) registered pharmacists from community, hospital, primary care, academia and an additional 11% (n = 5) still in foundation training in these sectors. The sample include diversity of racial identities, including 40% (n = 18) South Asian, 27% (n = 12) White, 15% (n = 7) Black, 7% (n = 3) Chinese and Arab mixed, 2% (n = 1) and 2% (n = 1) Not disclosed. Three themes were identified – Theme 1) Experiences of racial minority stress, Theme 2) Making sense of racial minority stress, and Theme 3) Responding to racial minority stress. Participants characteristics (for example skin colour, dialect, religious dress) made them feel susceptible to judgement, racist comments and microaggressions in education and practice. Participants required time to interpret, understand and make sense of incidents of racial minority stress. Responses to stressors included ‘ignoring ignorance’ and using a ‘professional identity’ to mask feelings. However, malicious comments and actions from other pharmacy staff were responded to differently to experiences from patients. Participants reported poor self-confidence to challenge racist behaviours in the workplace. Conclusions: The aim of this study was to explore experiences of racial minority stress in pharmacy education and practice. This study shows dealing with microaggression, racial minority stress and judgement in pharmacy education and practice is a burden experienced by people from BAME backgrounds. These experiences could contribute to the professional attainment gap in pharmacy, as making sense of these experiences is an additional burden pharmacists and trainees must bear in comparison to people from non-BAME backgrounds. Further work is needed to explore interventions to reduce minority stress in pharmacy practice and education to reduce the attainment gap across the sector

Body size.

<p>FR birds had lower body mass (A; 1467±81g) and shorter tarsometatarsal length (B; 75.4±0.8mm) than AL birds (3458±81g and 85.3±0.8mm resp.).*** p < 0.001.</p

Endocrinological and molecular stress markers.

<p>FR birds had higher baseline CORT levels in plasma than AL birds (A). There were no differences in the expression of pro-opiomelanocortin (<i>POMC</i>) in the pituitary gland (B), nor of steroidogenic acute regulatory protein (<i>STAR</i>) (C) and ADP ribosylation factor like GTPase 10 (<i>ARL10</i>) (D) in the adrenal glands. However, Interleukin-6 (<i>IL6</i>) expression in the spleen was significantly higher in FR than in AL birds (E). *** p<0.001; * p<0.05.</p

Photomicrographs of the HF at different levels.

<p><b>A-C</b> Photomicrographs of a rostral (A), a medium (but still part of the rostral pole; B), and a caudal (C) coronal section through the hippocampal formation (HF). <b>D.</b> BrdU⁺/Hu⁺ (white arrow), BrdU⁺/Hu^- (black arrow), and BrdU^-/Hu⁺ (open arrows) cells from the rostral section of the HF. <b>E.</b> BrdU⁺ cell in the ventricular wall of the caudal section of the HF. The scale bar in C applies to A and B as well. The scale bar in D also applies to E.</p