Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis.

OBJECTIVE: The concept of living with and beyond cancer is now emerging in policy and literature. Rather than viewing this notion simply as a linear timeline, developing an agreed understanding of the lived experience of people affected by cancer will aid the development of person-centred models of care. METHODS: A systematic review was conducted. The review question was "What does the term 'living with and beyond cancer' mean to people affected by cancer?" The protocol for the review was preregistered in the PROSPERO database (PROSPERO CRD42017059860). All included studies were qualitative, so narrative synthesis was used to integrate descriptions and definitions of living with and beyond cancer into an empirically based conceptual framework. RESULTS: Out of 2345 papers that were identified and 180 that were reviewed, a total of 73 papers were included. The synthesis yielded three interlinked themes: Adversity (realising cancer), Restoration (readjusting life with cancer), and Compatibility (reconciling cancer), resulting in the ARC framework. CONCLUSIONS: Three themes describe the experience of living with and beyond cancer: adversity, restoration, and compatibility. The ARC framework provides an empirically informed grounding for future research and practice in supportive cancer care for this population

Ectopic BASL Reveals Tissue Cell Polarity throughout Leaf Development in Arabidopsis thaliana

Tissue-wide polarity fields, in which cell polarity is coordinated across the tissue, have been described for planar organs such as the Drosophila wing and are considered important for coordinating growth and differentiation [1]. In planar plant organs, such as leaves, polarity fields have been identified for subgroups of cells, such as stomatal lineages [2], trichomes [3, 4], serrations [5], or early developmental stages [6]. Here, we show that ectopic induction of the stomatal protein BASL (BREAKING OF ASYMMETRY IN THE STOMATAL LINEAGE) reveals a tissue-wide epidermal polarity field in leaves throughout development. Ectopic GFP-BASL is typically localized toward the proximal end of cells and to one lobe of mature pavement cells, revealing a polarity field that aligns with the proximodistal axis of the leaf (base to tip). The polarity field is largely parallel to the midline of the leaf but diverges in more lateral positions, particularly at later stages in development, suggesting it may be deformed during growth. The polarity field is observed in the speechless mutant, showing that it is independent of stomatal lineages, and is observed in isotropic cells, showing that cell shape anisotropy is not required for orienting polarity. Ectopic BASL forms convergence and divergence points at serrations, mirroring epidermal PIN polarity patterns, suggesting a common underlying polarity mechanism. Thus, we show that similar to the situation in animals, planar plant organs have a tissue-wide cell polarity field, and this may provide a general cellular mechanism for guiding growth and differentiation

Statement on Spectroscopic Imaging in Art Conservation: A New Tool for Materials Investigations

http://leoalmanac.org/journal/Vol_10/lea_v10_n09.tx

Electronic screening for mental illness in patients with psoriasis

In this cross sectional study from a large UK centre, screening for mental illness in individuals with psoriasis has demonstrated a high burden of depression and anxiety. 85% of the cohort report that their psoriasis had affected their quality of life. Quality of life scores correlate with depression scores, emphasing the importance of managing individual's mental health alongside their psoriasis to improve overall quality of life

Factors associated with depression, anxiety, and severe mental illness among adults with atopic eczema or psoriasis: a systematic review and meta-analysis

Background: Evidence suggests an association between atopic eczema (AE) or psoriasis and mental illness. However, factors associated with mental illness are unclear. / Objectives: To synthesise and evaluate all available evidence on factors associated with depression, anxiety, and severe mental illness (SMI) among adults with AE or psoriasis. / Methods: We searched electronic databases, grey literature databases, and clinical trial registries from inception to February 2022 for studies in adults with AE or psoriasis. Eligible studies were randomised controlled trials (RCTs), cohort, cross-sectional or case-control studies where effect estimates of factors associated with depression, anxiety, or SMI were reported. We did not apply language or geographical restrictions. We assessed risk of bias using the Quality in Prognosis Studies tool. We synthesised results narratively, and if at least two studies were sufficiently homogenous, we pooled effect estimates in a random-effects meta-analysis. / Results: We included 21 studies (11 observational, 10 RCT). No observational studies in AE fulfilled our eligibility criteria. Observational studies in people with psoriasis mostly investigated factors associated with depression or anxiety – one cross-sectional study investigated factors associated with schizophrenia. Pooled effect estimates suggest being female, and psoriatic arthritis, were associated with depression (female sex:OR = 1.62,95%CI = 1.09-2.40,95%PI = 0.62-4.23, I2 = 24.90%, Tau2 = 0.05; psoriatic arthritis:OR = 2.26,95%CI = 1.56-3.25,95%PI = 0.21-24.23, I2 = 0.00%, Tau2 = 0.00) and anxiety (female sex:OR = 2.59,95%CI = 1.32-5.07,95%PI = 0.00-3956.27, I2 = 61.90%, Tau2 = 0.22; psoriatic arthritis:OR = 1.98,95%CI = 1.33-2.94, I2 = 0.00%, Tau2 = 0.00). Moderate/severe psoriasis was associated with anxiety (OR = 1.14,95%CI = 1.05-1.25, I2 = 0.00%, Tau2 = 0.00), but not depression. Evidence from RCTs suggested adults with AE or psoriasis given placebo had higher depression and anxiety scores compared to comparators given targeted treatment (e.g., biologic agents). / Conclusions: Our review highlights limited existing research on factors associated with depression, anxiety, and SMI in adults with AE or psoriasis. Observational evidence on factors associated with depression or anxiety in people with psoriasis was conflicting or from single studies, but some identified factors were consistent with those in the general population. Evidence on factors associated with SMIs in people with AE or psoriasis was particularly limited. Evidence from RCTs suggested AE and psoriasis treated with placebo was associated with higher depression and anxiety scores compared to skin disease treated with targeted therapy, however, follow-up was limited, therefore long-term effects on mental health are unclear

A systematic review of the subjective wellbeing outcomes of engaging with visual arts for adults (“working-age”, 15-64 years) with diagnosed mental health conditions

The importance of the visual arts in contributing to the wellbeing of adults with mental health conditions has been little documented beyond some insightful and influential interventions and exploratory studies. Initiatives such as Arts on Prescription projects have, in the UK provided examples of the positive effects that engagement in artistic and creative activity can have, and some of these have been documented in small-scale studies of interventions. Most of the evidence has been perceived as positive but of limited scale. In this context, this review was carried out to examine in a more focused way the ‘subjective wellbeing’ (SWB) outcomes of engagement with the visual arts for adults with a background history of mental health conditions. SWB embraces both the positive and negative feelings that arise in individuals based on their view of the world, how they think about themselves and others, and what they do in the interactions and practices of everyday life. Adult subjects in the studies included in this review were of ‘working-age’ (15-64 years). The focus of the review and the precise research question were agreed at inception sessions of the research team, and in collaborative engagement with stakeholders in the areas of policy, service-delivery, project and evaluation commissioning, and research and scholarship in the spheres of the visual arts and mental health. Published studies from the past 10 years were studied for the review, and their findings synthesised and integrated into an evaluation of the state of knowledge in the field, in terms of the specifics of the research questions. We found that there is limited high-quality evidence, though case studies from the UK have provided important and consistent findings, corroborated by grey literature that has reported on interventions and projects. The review includes published findings based on data on/from 163 participants across four countries – Australia, Sweden, the UK, and the USA. Overall, female respondents outnumbered male respondents. A wide variety of wellbeing measures were used in some quantitative, statistical studies. In-depth interviews dominated the qualitative studies, giving voice to the experiences of individual subjects. The visual arts practices that featured in the studies included forms of painting or drawing, art appreciation with selected art forms, artmaking culminating in an exhibition, and more general creative and craft activities that included visual artefacts such as ceramics or sculpture. Evidence we include from recent unpublished reports (grey literature) was produced by or for visual arts organisations since 2014. Participants in the evaluations were both male and female and were engaged in UK-based arts interventions, many via community arts or ‘Arts on Prescription’ types of intervention. Overall, the evidence available in this review has shown that engagement in the visual arts for adults with mental health conditions can reduce reported levels of depression and anxiety; increase self-respect, self-worth and self-esteem; encourage and stimulate re-engagement with the wider, everyday social world; and support in participants a potential renegotiation of identity through practice-based forms of making or doing. The most effective ‘working ways to wellbeing’ are also confirmed in processes of implementation that ensure provision of secure safe-space and havens for interventions; that recognise the value of non-stigmatising settings; and that support and sustain collaborative facilitation of programmes and sessions. 4 Some negative dimensions of engagement with the visual arts were also identified, including stress and pressure felt to complete activities or commit to artmaking, and the very real fear that the end of an intervention would mean the return to a world of anxiety, decreasing confidence and social isolation. The review shows that for adults starting visual arts activities or programmes, the subjective wellbeing outcomes are, for the majority of participants, positive. This applies to men and women alike across the studies. The most convincing evidence has emerged from focused qualitative research designs, and makes clear that the most effective work in the field continues to lack the necessary resources and infrastructure that would ensure sustainable practices and interventions. Overall, there is some evidence of benefit in a weak field that could be strengthened by fuller monitoring of cohorts to evaluate the long-term effects of participants’ engagement with the visual arts

A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis

The paper reports an evidence synthesis of how loneliness is conceptualised in qualitative studies in adults. Using PRISMA guidelines, our review evaluated exposure to or experiences of loneliness by adults (aged 16+) in any setting as outcomes, processes, or both. Our initial review included any qualitative or mixed-methods study, published or unpublished, in English, from 1945 to 2018, if it employed an identified theory or concept for understanding loneliness. The review was updated to include publications up to November 2020. We used a PEEST (Participants, Exposure, Evaluation, Study Design, Theory) inclusion criteria. Data extraction and quality assessment (CASP) were completed and cross-checked by a second reviewer. The Evidence of Reviews of Qualitative Research (CERQual) was used to evaluate confidence in the findings. We undertook a thematic synthesis using inductive methods for peer-reviewed papers. The evidence identified three types of distinct but overlapping conceptualisations of loneliness: social, emotional, and existential. We have high confidence in the evidence conceptualising social loneliness and moderate confidence in the evidence on emotional and existential loneliness. Our findings provide a more nuanced understanding of these diverse conceptualisations to inform more effective decision-making and intervention development to address the negative wellbeing impacts of loneliness

Spectroscopic Imaging in Art Conservation: A New Tool for Materials Investigations

https://www.mitpressjournals.org/doi/10.1162/00240940332225873