"Where did I park my car?" : a mixed methods investigation on mild cognitive impairment diagnosis in New Zealand : a thesis submitted in partial fulfilment of the requirements for the degree of a Doctor of Philosophy in Psychology at Massey University, Wellington, New Zealand

Mild cognitive impairment (MCI) is defined as an objective impairment in cognitive function which spares everyday functional ability. The syndrome is shrouded in controversy regarding definition, cut-off criteria, and clinical utility. Consequently, it is an uncertain label for the client being diagnosed by their healthcare practitioner. To date, minimal research in New Zealand has focused on MCI within specialist assessment services. Reasons for this paucity of literature will be discussed throughout this thesis. The current research aimed to identify how practitioners deliver and perceive cognitive impairment diagnosis, and examine how clients respond to receiving this diagnosis. Client experiences were framed within the common sense model (CSM). This theory originates from health psychology, where coping behaviour is said to be influenced by the cognitive representations that a person has about their condition. Although the framework is previously discussed in relation to chronic illness, international researchers have started to examine the utility of the model in explaining MCI diagnosis response. Given this context, the CSM framework guided the client-focused components of this thesis. In Study One, 57 practitioners who diagnose cognitive impairment completed a questionnaire on labels applied to MCI and beliefs about the value of diagnosis delivery. Responses were analysed using content analysis to gain an impression of professional practice. Cognitive disorder - not otherwise specified (CD-NOS), early dementia, and normal ageing were reported to additionally label the symptoms of MCI in clinical practice. In Study Two, client responses were examined in a small clinical sample (N = 9) diagnosed with MCI and CD-NOS. Participants were interviewed twice within six months of initial diagnosis. Interpretative phenomenological analysis was used to gain insight into how people cope and make sense of their diagnosis over time. Descriptive analyses were also undertaken with a subset of Study Two data to examine changes and differences in coping strategies over time. Findings suggest that participants may not see their diagnosis as an illness or significant health threat in the first six months following diagnosis. This prompts a question on the suitability of an illness model with reference to diagnosis response. Findings from this research add to the literature by highlighting practice associated with an evolving form of clinical diagnosis in NZ

Post-traumatic stress disorder interventions for children and adolescents affected by war in low- and middle-income countries in the Middle East: systematic review

Background Millions of children and adolescents are exposed to wars, affecting their psychological well-being. This review focuses on psychosocial interventions in low and middle-income countries (LMICs) in the Middle East, where mental health services are limited. Aims Our primary aim was to evaluate the effectiveness of trial-assessed psychosocial interventions in reducing post-traumatic stress disorder (PTSD) symptoms in children and adolescents aged ≤18 years who were exposed to war in LMICs in the Middle East. Changes in other psychological conditions and symptoms were evaluated where reported. Method PubMed, Cochrane Library and Ovid were searched without year restriction, in December 2021. Previous review reference lists were also checked. Only studies published in English were included. Each study was evaluated for risk of bias and results are presented as a narrative synthesis. Results Three group-based interventions were identified and evaluated across six studies: ‘Teaching Recovery Techniques’, ‘Writing for Recovery’ and ‘Advancing Adolescents’. Two studies took place in post-war settings, and four in a context of ongoing conflict. Positive experiences and improved social skills were indicated following most interventions, but Teaching Recovery Techniques was the only programme associated with a statistically significant reduction in PTSD score. Differences in follow-up interval limited comparability of outcomes. Conclusions This review highlights a paucity of evidence for effective treatment options for children and adolescents affected by war from LMICs in the Middle East. Promising indications of reductions in PTSD symptoms, specifically from Teaching Recovery Techniques, require further rigorous evaluation and long-term follow-up

A qualitative study of positive psychological experiences and helpful coping behaviours among young people and older adults in the UK during the COVID-19 pandemic

While much research has focused on challenges that younger and older people have faced during the COVID-19 pandemic, little attention has been given to the capacity for resilience among these groups. We therefore explored positive psychological experiences and coping behaviours that protected mental health and well-being. Participants were 40 young people (aged 13–24) and 28 older adults (aged 70+) living in the UK during the COVID-19 pandemic. Interviews were held between May 2020 and January 2021. We generated six themes using qualitative thematic analysis, including: engagement in self-fulfilling activities, increased sense of social cohesion, personal growth, use of problem-focused strategies to manage pandemic-related stressors, giving and receiving social and community support, and utilising strategies to regulate thoughts and emotions. While all six themes were relevant both to younger and older adults, there were nuances in how each was experienced and enacted. For example, many older adults adjusted their routines given worries about virus vulnerability, while some young people experienced greater personal growth amidst increased awareness of mental health as they navigated the various lockdown restrictions

‘You’re just there, alone in your room with your thoughts’: a qualitative study about the psychosocial impact of the COVID-19 pandemic among young people living in the UK

OBJECTIVES: Adolescents and young adults have been greatly affected by quarantine measures during the COVID-19 pandemic, but little is understood about how restrictions have affected their well-being, mental health, and social life. We therefore aimed to learn more about how UK quarantine measures affected the social lives, mental health and well-being of adolescents and young adults. DESIGN: Qualitative interview study. The data were analysed using reflexive thematic analysis, with particular attention paid to contextual factors (such as age, gender, ethnicity and health status) when analysing each individual transcript. SETTING: Data collection took place remotely across the UK via audio or video call, between June 2020 and January 2021. PARTICIPANTS: We conducted semi-structured interviews with 37 participants (aged 13–24 years) to elicit their views. RESULTS: Authors generated four themes during the qualitative analysis: (a) concerns about disruption to education, (b) missing social contact during lockdown, (c) changes to social relationships and (d) improved well-being during lockdown. Many participants said they struggled with a decline in mental health during the pandemic, lack of support and concern about socialising after the pandemic. However, some participants described experiences and changes brought on by the pandemic as helpful, including an increased awareness of mental health and feeling more at ease when talking about it, as well as stronger relationship ties with family members. CONCLUSIONS: Findings suggest that young people may have felt more comfortable when talking about their mental health compared with prepandemic, in part facilitated by initiatives through schools, universities and employers. However, many were worried about how the pandemic has affected their education and social connections, and support for young people should be tailored accordingly around some of these concerns

A genomic perspective on the potential of Actinobacillus succinogenes for industrial succinate production

<p>Abstract</p> <p>Background</p> <p>Succinate is produced petrochemically from maleic anhydride to satisfy a small specialty chemical market. If succinate could be produced fermentatively at a price competitive with that of maleic anhydride, though, it could replace maleic anhydride as the precursor of many bulk chemicals, transforming a multi-billion dollar petrochemical market into one based on renewable resources. <it>Actinobacillus succinogenes </it>naturally converts sugars and CO₂into high concentrations of succinic acid as part of a mixed-acid fermentation. Efforts are ongoing to maximize carbon flux to succinate to achieve an industrial process.</p> <p>Results</p> <p>Described here is the 2.3 Mb <it>A. succinogenes </it>genome sequence with emphasis on <it>A. succinogenes</it>'s potential for genetic engineering, its metabolic attributes and capabilities, and its lack of pathogenicity. The genome sequence contains 1,690 DNA uptake signal sequence repeats and a nearly complete set of natural competence proteins, suggesting that <it>A. succinogenes </it>is capable of natural transformation. <it>A. succinogenes </it>lacks a complete tricarboxylic acid cycle as well as a glyoxylate pathway, and it appears to be able to transport and degrade about twenty different carbohydrates. The genomes of <it>A. succinogenes </it>and its closest known relative, <it>Mannheimia succiniciproducens</it>, were compared for the presence of known Pasteurellaceae virulence factors. Both species appear to lack the virulence traits of toxin production, sialic acid and choline incorporation into lipopolysaccharide, and utilization of hemoglobin and transferrin as iron sources. Perspectives are also given on the conservation of <it>A. succinogenes </it>genomic features in other sequenced Pasteurellaceae.</p> <p>Conclusions</p> <p>Both <it>A. succinogenes </it>and <it>M. succiniciproducens </it>genome sequences lack many of the virulence genes used by their pathogenic Pasteurellaceae relatives. The lack of pathogenicity of these two succinogens is an exciting prospect, because comparisons with pathogenic Pasteurellaceae could lead to a better understanding of Pasteurellaceae virulence. The fact that the <it>A. succinogenes </it>genome encodes uptake and degradation pathways for a variety of carbohydrates reflects the variety of carbohydrate substrates available in the rumen, <it>A. succinogenes</it>'s natural habitat. It also suggests that many different carbon sources can be used as feedstock for succinate production by <it>A. succinogenes</it>.</p

‘What’s it like to have ME?’ The discursive construction of ME in computer-mediated communication and face-to-face interaction

ME/CFS (chronic fatigue syndrome) is a debilitating illness for which no cause or medical tests have been identified. Debates over its nature have generated interest from qualitative researchers. However, participants are difficult to recruit because of the nature of their condition. Therefore, this study explores the utility of the internet as a means of eliciting accounts. We analyse data from focus groups and the internet in order to ascertain the extent to which previous research findings apply to the internet domain. Interviews were conducted among 49 members of internet (38 chatline, 11 personal) and 7 members of two face-to-face support groups. Discourse analysis of descriptions and accounts of ME/CFS revealed similar devices and interactional concerns in both internet and face-to-face communication. Participants constructed their condition as serious, enigmatic and not psychological. These functioned to deflect problematic assumptions about ME/CFS and to manage their accountability for the illness and its effects

The Electromyographic Threshold in Girls and Women.

BACKGROUND: The electromyographic threshold (EMGTh) is thought to reflect increased high-threshold/type-II motor-unit (MU) recruitment and was shown higher in boys than in men. Women differ from men in muscular function. PURPOSE: Establish whether females' EMGTh and girls‒women differences are different than males'. METHODS: Nineteen women (22.9±3.3yrs) and 20 girls (10.3±1.1yrs) had surface EMG recorded from the right and left vastus lateralis muscles during ramped cycle-ergometry to exhaustion. EMG root-mean-squares were averaged per pedal revolution. EMGTh was determined as the least residual sum of squares for any two regression-line data divisions, if the trace rose ≥3SD above its regression line. EMGTh was expressed as % final power-output (%Pmax) and %VO2pk power (%PVO2pk). RESULTS: EMGTh was detected in 13 (68%) of women, but only 9 (45%) of girls (p<0.005) and tended to be higher in the girls (%Pmax= 88.6±7.0 vs. 83.0±6.9%, p=0.080; %PVO2pk= (101.6±17.6 vs. 90.6±7.8%, p=0.063). When EMGTh was undetected it was assumed to occur at 100%Pmax or beyond. Consequently, EMGTh values turned significantly higher in girls than in women (94.8±7.4 vs. 88.4±9.9 %Pmax, p=0.026; and 103.2±11.7 vs. 95.2±9.9 %PVO2pk, p=0.028). CONCLUSIONS: During progressive exercise, girls appear to rely less on higher-threshold/type-II MUs than do women, suggesting differential muscle activation strategy

Gamma-ray bursts and terrestrial planetary atmospheres

We describe results of modeling the effects on Earth-like planets of long-duration gamma-ray bursts (GRBs) within a few kiloparsecs. A primary effect is generation of nitrogen oxide compounds which deplete ozone. Ozone depletion leads to an increase in solar UVB radiation at the surface, enhancing DNA damage, particularly in marine microorganisms such as phytoplankton. In addition, we expect increased atmospheric opacity due to buildup of nitrogen dioxide produced by the burst and enhanced precipitation of nitric acid. We review here previous work on this subject and discuss recent developments, including further discussion of our estimates of the rates of impacting GRBs and the possible role of short-duration bursts.Comment: 12 pages including 5 figures (4 in color). Added discussion of GRB rates and biological effects. Accepted for publication in New Journal of Physics, for special issue "Focus on Gamma-Ray Bursts