Towards an increased understanding of reminiscence therapy for people with dementia: A narrative analysis

Aim Reminiscence therapy is a popular therapeutic intervention for people with dementia. This review set out to provide a better understanding of reminiscence therapy through a deeper analysis of its contents and delivery. Method This review examined 22 studies from the most recent Cochrane review (Woods, B., O’Philbin, L., Farrell, E. M., Spector, A. E., & Orrell, M. (2018). Reminiscence therapy for dementia. Cochrane Database of Systematic Reviews, 3, Article 001120) and addressed the following research questions: (1) What are the components of reminiscence therapy? (2) Who delivers reminiscence therapy? (3) How is reminiscence therapy delivered? (4) Is reminiscence therapy underpinned by a theoretical framework? (5) Is reminiscence therapy delivered according to a programme/model? (6) Are there commonalities in the reminiscence therapy components utilised? Multiple and layered narrative analyses were completed. Findings Thirteen reminiscence therapy components were identified. ‘Memory triggers’ and ‘themes’ were identified as the most common but were found not to be consistently beneficial. Reminiscence therapy was typically delivered in a care setting using a group approach; however, there was no consistency in session composition, intervention duration, as well as the training and supervision provided to facilitators. Operationalisation of theory within reminiscence therapy was not identified. Reminiscence therapy was not consistently delivered according to a programme/model. Lastly, as a result of a small number of studies, the components ‘life stages’, ‘activities’ and ‘family-only sessions’, showed beneficial promise. In summary, this review highlights that reminiscence therapy needs more consistency in content and delivery, in addition to a clear theoretical framework

Researching 0-3-Year-Old Children’s Language and Literacy Play at Home in a Digital Age

This recently-launched, two-year ESRC-funded study breaks new ground in researching 0-3-year-old children's language and literacy play at home in the digital age, in diverse communities across the four UK nations. Digital technologies feature prominently in contemporary family life (Chaudron et al. 2018; Kumpulainen & Gillen 2020). Even very young children observe and use language playfully in digitally-mediated activities, e.g. e-books, digital toys and interacting via mobile devices (Arnott et al. 2019; Zhao & Flewitt 2020). Drawing on social semiotic theory (Kress 2010), socio-materiality (Barad 2003; Murris 2016) and respecting young children’s participation rights, the study builds empirically-grounded conceptualizations of 0-3-year-olds’ engagement with today’s technology-rich cultural artefacts, where play and meaning making are entangled with ‘humans, nonhumans and more-than-humans’ (Kuby & Rowsell 2017: 285). The multi-phase study design offers a template for interdisciplinary research, including iterative innovation in participatory approaches to researching the home. Research methods include an online survey, remote interviews with families and professionals, followed by 40 in-depth case studies. In alignment with our conceptual and theoretical approach, we emphasise the interpersonal, responsive nature of research ethics, using creative approaches to ensure informed and voluntary child and adult consent. This paper critically evaluates how the study will generate findings related to researching the home environment collaboratively and sensitively with young children and their families in diverse communities. Here, we focus on research impacts, including multi-phase research design and a palette of participatory methods from which families can choose the approach most apt for their circumstances, including self-generated data

Child sexual abuse and social identity loss: a qualitative analysis of survivors' public accounts

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse, but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families

Early Treatment with Fumagillin, an Inhibitor of Methionine Aminopeptidase-2, Prevents Pulmonary Hypertension in Monocrotaline-Injured Rats

Pulmonary Hypertension (PH) is a pathophysiologic condition characterized by hypoxemia and right ventricular strain. Proliferation of fibroblasts, smooth muscle cells, and endothelial cells is central to the pathology of PH in animal models and in humans. Methionine aminopeptidase-2 (MetAP2) regulates proliferation in a variety of cell types including endothelial cells, smooth muscle cells, and fibroblasts. MetAP2 is inhibited irreversibly by the angiogenesis inhibitor fumagillin. We have previously found that inhibition of MetAP2 with fumagillin in bleomycin-injured mice decreased pulmonary fibrosis by selectively decreasing the proliferation of lung myofibroblasts. In this study, we investigated the role of fumagillin as a potential therapy in experimental PH. In vivo, treatment of rats with fumagillin early after monocrotaline injury prevented PH and right ventricular remodeling by decreasing the thickness of the medial layer of the pulmonary arteries. Treatment with fumagillin beginning two weeks after monocrotaline injury did not prevent PH but was associated with decreased right ventricular mass and decreased cardiomyocyte hypertrophy, suggesting a direct effect of fumagillin on right ventricular remodeling. Incubation of rat pulmonary artery smooth muscle cells (RPASMC) with fumagillin and MetAP2-targeting siRNA inhibited proliferation of RPASMC in vitro. Platelet-derived growth factor, a growth factor that is important in the pathogenesis of PH and stimulates proliferation of fibroblasts and smooth muscle cells, strongly increased expression of MetP2. By immunohistochemistry, we found that MetAP2 was expressed in the lesions of human pulmonary arterial hypertension. We propose that fumagillin may be an effective adjunctive therapy for treating PH in patients

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine

Heterozygous Variants in KMT2E Cause a Spectrum of Neurodevelopmental Disorders and Epilepsy.

We delineate a KMT2E-related neurodevelopmental disorder on the basis of 38 individuals in 36 families. This study includes 31 distinct heterozygous variants in KMT2E (28 ascertained from Matchmaker Exchange and three previously reported), and four individuals with chromosome 7q22.2-22.23 microdeletions encompassing KMT2E (one previously reported). Almost all variants occurred de novo, and most were truncating. Most affected individuals with protein-truncating variants presented with mild intellectual disability. One-quarter of individuals met criteria for autism. Additional common features include macrocephaly, hypotonia, functional gastrointestinal abnormalities, and a subtle facial gestalt. Epilepsy was present in about one-fifth of individuals with truncating variants and was responsive to treatment with anti-epileptic medications in almost all. More than 70% of the individuals were male, and expressivity was variable by sex; epilepsy was more common in females and autism more common in males. The four individuals with microdeletions encompassing KMT2E generally presented similarly to those with truncating variants, but the degree of developmental delay was greater. The group of four individuals with missense variants in KMT2E presented with the most severe developmental delays. Epilepsy was present in all individuals with missense variants, often manifesting as treatment-resistant infantile epileptic encephalopathy. Microcephaly was also common in this group. Haploinsufficiency versus gain-of-function or dominant-negative effects specific to these missense variants in KMT2E might explain this divergence in phenotype, but requires independent validation. Disruptive variants in KMT2E are an under-recognized cause of neurodevelopmental abnormalities

A mixed-methods evaluation of Trauma-informed Care in Ireland training in a homeless women's shelter

Trauma-informed care (TIC) staff training assists services for homeless people to increase Service User engagement and positive outcomes through trauma understanding and sensitivity to problematic behaviour. This ecological, mixed-methods evaluation of the efficacy of TIC training in a women's shelter analysed 132 incident reports during the first yearly quarters pre-and post-training, hypothesising post-training reductions in incident numbers and severity. Semi-structured interviews with six shelter staff (n = 6) explored employee views of TIC relative to trauma understanding, incident management and integration in practice, using expansive thematic analysis. Post-TIC, there was a statistically significant reduction in incident severity; however, incident numbers increased. Participant accounts of working practice pre-and post-TIC report increased trauma understanding, self-efficacy, healing relationships and enhanced self-care. Perceptions of TIC implementation in organisational standards were mixed, with changes in managerial follow-up raising organisational hierarchical issues and gaps in training protocol. This paper discusses the potential of TIC for increased staff self-efficacy, which can subtly augment microsystem dynamics within human services. Although these results are important as the first evaluation of TIC in Ireland training, the limitations and implications for future research and policy are discussed