Do not forget them. Thousands of Indigenous children suffered and died in residential ‘schools’ around the world. Their stories must be heard.

https://aeon.co/essays/we-must-not-forget-what-happened-to-the-worlds-indigenous-children?fbclid=IwAR13hmPmkGyxkUKeCV-LH-BjcUQNcNvqdjpbQ9QlzvP9aLHkYN5hmNP3ED

Rethinking well-being measures in bullying and cyberbullying research

The impact of bullying and cyberbullying is usually measured in terms of deficits. Most of the research that focuses on well-being measures absence of ill-being, rather than presence of well-being. This chapter provides an alternative view on well-being measuring tools that derives from the field of positive psychology. It introduces the concept of Subjective Well-Being, Psychological Well-Being, Authentic Happiness Model, Dual Continua Model, the Mental Health Spectrum and the Wellbeing Theory. Each of the approaches are reviewed and tools for measuring them are discussed

Rethinking well-being measures in bullying and cyberbullying research

The impact of bullying and cyberbullying is usually measured in terms of deficits. Most of the research that focuses on well-being measures absence of ill-being, rather than presence of well-being. This chapter provides an alternative view on well-being measuring tools that derives from the field of positive psychology. It introduces the concept of Subjective Well-Being, Psychological Well-Being, Authentic Happiness Model, Dual Continua Model, the Mental Health Spectrum and the Wellbeing Theory. Each of the approaches are reviewed and tools for measuring them are discussed

Recombinant expression and characterisation of the oxygen-sensitive 2-enoate reductase from Clostridium sporogenes

‘Ene’-reductases have attracted significant attention for the preparation of chemical intermediates and biologically active products. To date, research has been focussed primarily on Old Yellow Enzyme-like proteins, due to their ease of handling, whereas 2-enoate reductases from clostridia have received much less attention, because of their oxygen sensitivity and a lack of suitable expression systems. A hypothetical 2-enoate reductase gene, fldZ, was identified in Clostridium sporogenes DSM 795. The encoded protein shares a high degree of homology to clostridial FMN- and FAD-dependent 2-enoate reductases, including the cinnamic acid reductase proposed to be involved in amino acid metabolism in proteolytic clostridia. The gene was cloned and overexpressed in Escherichia coli. Successful expression depended on the use of strictly anaerobic conditions for both growth and enzyme preparation, since FldZ was oxygen-sensitive. The enzyme reduced aromatic enoates, such as cinnamic acid or p-coumaric acid, but not short chain unsaturated aliphatic acids. The b,b-disubstituted nitroalkene, (E)-1-nitro-2-phenylpropene, was reduced to enantiopure (R)-1-nitro-2-phenylpropane with a yield of 90 %. By contrast, the a,b-disubstituted nitroalkene, (E)-2-nitro-1-phenylpropene, was reduced with a moderate yield of 56% and poor enantioselectivity (16% ee for (S)-2-nitro-1-phenylpropane). The availability of an expression system for this recombinant clostridial 2-enoate reductase will facilitate future characterisation of this unusual class of ‘ene’-reductases, and expand the biocatalytic toolbox available for enantioselective hydrogenation of carbon-carbon double bonds

‘It should be more outspoken and not hushed away, not like put in a dark box’: An interpretative phenomenological analysis of experiences of menopause voiced by women with learning disabilities

Background: There is little research into experiences of menopause voiced by women with learning disabilities, who can be neglected in academic research. There is a particular lack of knowledge around the psychological and social experiences of menopause in this population, and how changes are managed. This study sought to explore these experiences. Methods: Experiences of five women with lived experience of menopause, being seen by community National Health Services specialising in learning disabilities, were captured with semistructured interviews and analysed using interpretive phenomenological analysis. Findings: Five superordinate themes were identified, involving the importance of having information about menopause, challenges of periods, observable changes in menopause, the importance of social connection, and managing menopause independently. Conclusions: This study highlights the need for clinicians and carers to understand the variety of impacts menopause can have on women with learning disabilities, including emotional and social aspects, and the need to initiate conversations regarding menopause and available treatments

UK Men’s experience of the Gender-Role Journey and Implications for Clinicians and Mental Health Services

Gender-role journey (GRJ) theory (O’Neil, 2015; O’Neil & Egan, 1992) provides a framework for exploring men’s transition from accepting traditional gender roles toward pro-feminist activism and gender-role transcendence on a bipolar continuum. Previous research findings suggest that men may experience distress and ambivalence when questioning traditional gender roles. A better understanding of this distress could help therapists effectively explore gender-role attitudes with men. In this study, latent profile analysis was used to identify distinct categories of men in the U.K. (N = 569) from a convenience, general population sample based on GRJ-phase attitudes. Six categories were identified and labeled based on GRJ theory: not questioning/accepting of traditional gender roles (not-questioning), do not acknowledge the importance of gender (DAIG), questioning with ambivalence (QWA), moderately feminist with ambivalence (MFWA), moderately feminist, and pro-feminist activists. Mental health measure scores showed that, compared to not-questioning categorization, MFWA categorization predicted increased anxiety and depression, and QWA categorization predicted increased depression. MFWAs were more likely to be younger, single, Asian, and unemployed. Low resilience was also associated with MFWA categorization. Knowledge of personal characteristics associated with ambivalence and psychological distress could help practitioners explore masculinity more effectively with men. Future research should explore the factors influencing which gender-role journey measure-category men are in

How are secure attachment relationships fostered through talk between teachers and students who have been adopted? A conversation analysis

Despite the growing recognition of the importance of supportive teacher–student relationships to create safety for young people who have experienced early adversity and trauma, there is not a clear understanding of what factors make for positive school relationships and how these can be fostered. The aims of the study were to explore how children with challenging emotional backgrounds are supported by their key adult in school and how this occurs in the process of conversations between them. Three student–teacher pairs from a specialist school took part in a semi-structured interview about their relationship. Data was analysed using conversation analysis. Analysis found how teaching staff use several conversational markers in talk with children with attachment difficulties when emotional experiences are raised and when troubles occur in navigating difficult conversations. Recommendations for clinical practice and future research are made. </jats:p

A randomised controlled trial and cost-effectiveness evaluation of 'booster' interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

Background: More evidence is needed on the potential role of 'booster' interventions in the maintenance of increases in physical activity levels after a brief intervention in relatively sedentary populations. Objectives: To determine whether objectively measured physical activity, 6 months after a brief intervention, is increased in those receiving physical activity 'booster' consultations delivered in a motivational interviewing (MI) style, either face to face or by telephone. Design: Three-arm, parallel-group, pragmatic, superiority randomised controlled trial with nested qualitative research fidelity and geographical information systems and health economic substudies. Treatment allocation was carried out using a web-based simple randomisation procedure with equal allocation probabilities. Principal investigators and study statisticians were blinded to treatment allocation until after the final analysis only. Setting: Deprived areas of Sheffield, UK. Participants: Previously sedentary people, aged 40-64 years, living in deprived areas of Sheffield, UK, who had increased their physical activity levels after receiving a brief intervention. Interventions: Participants were randomised to the control group (no further intervention) or to two sessions of MI, either face to face ('full booster') or by telephone ('mini booster'). Sessions were delivered 1 and 2 months post-randomisation. Main outcome measures: The primary outcome was total energy expenditure (TEE) per day in kcal from 7-day accelerometry, measured using an Actiheart device (CamNtech Ltd, Cambridge, UK). Independent evaluation of practitioner competence was carried out using the Motivational Interviewing Treatment Integrity assessment. An estimate of the per-participant intervention costs, resource use data collected by questionnaire and health-related quality of life data were analysed to produce a range of economic models from a short-term NHS perspective. An additional series of models were developed that used TEE values to estimate the long-term cost-effectiveness. Results: In total, 282 people were randomised (control = 96; mini booster = 92, full booster = 94) of whom 160 had a minimum of 4 out of 7 days' accelerometry data at 3 months (control = 61, mini booster = 47, full booster = 52). The mean difference in TEE per day between baseline and 3 months favoured the control arm over the combined booster arm but this was not statistically significant (-39 kcal, 95% confidence interval -173 to 95, p = 0.57). The autonomy-enabled MI communication style was generally acceptable, although some participants wanted a more paternalistic approach and most expressed enthusiasm for monitoring and feedback components of the intervention and research. Full boosters were more popular than mini boosters. Practitioners achieved and maintained a consistent level of MI competence. Walking distance to the nearest municipal green space or leisure facilities was not associated with physical activity levels. Two alternative modelling approaches both suggested that neither intervention was likely to be cost-effective. Conclusions: Although some individuals do find a community-based, brief MI 'booster' intervention supportive, the low levels of recruitment and retention and the lack of impact on objectively measured physical activity levels in those with adequate outcome data suggest that it is unlikely to represent a clinically effective or cost-effective intervention for the maintenance of recently acquired physical activity increases in deprived middle-aged urban populations. Future research with middle-aged and relatively deprived populations should explore interventions to promote physical activity that require less proactive engagement from individuals, including environmental interventions

The analysis of para-cresol production and tolerance in Clostridium difficile 027 and 012 strains

<p>Abstract</p> <p>Background</p> <p><it>Clostridium difficile </it>is the major cause of antibiotic associated diarrhoea and in recent years its increased prevalence has been linked to the emergence of hypervirulent clones such as the PCR-ribotype 027. Characteristically, <it>C. difficile </it>infection (CDI) occurs after treatment with broad-spectrum antibiotics, which disrupt the normal gut microflora and allow <it>C. difficile </it>to flourish. One of the relatively unique features of <it>C. difficile </it>is its ability to ferment tyrosine to <it>para</it>-cresol via the intermediate <it>para</it>-hydroxyphenylacetate (<it>p-</it>HPA). <it>P</it>-cresol is a phenolic compound with bacteriostatic properties which <it>C. difficile </it>can tolerate and may provide the organism with a competitive advantage over other gut microflora, enabling it to proliferate and cause CDI. It has been proposed that the <it>hpdBCA </it>operon, rarely found in other gut microflora, encodes the enzymes responsible for the conversion of <it>p-</it>HPA to <it>p</it>-cresol.</p> <p>Results</p> <p>We show that the PCR-ribotype 027 strain R20291 quantitatively produced more <it>p</it>-cresol <it>in-vitro </it>and was significantly more tolerant to <it>p</it>-cresol than the sequenced strain 630 (PCR-ribotype 012). Tyrosine conversion to <it>p</it>-HPA was only observed under certain conditions. We constructed gene inactivation mutants in the <it>hpdBCA </it>operon in strains R20291 and 630Δ<it>erm </it>which curtails their ability to produce <it>p</it>-cresol, confirming the role of these genes in <it>p-</it>cresol production. The mutants were equally able to tolerate <it>p</it>-cresol compared to the respective parent strains, suggesting that tolerance to <it>p</it>-cresol is not linked to its production.</p> <p>Conclusions</p> <p><it>C. difficile </it>converts tyrosine to <it>p</it>-cresol, utilising the <it>hpdBCA </it>operon in <it>C. difficile </it>strains 630 and R20291. The hypervirulent strain R20291 exhibits increased production of and tolerance to <it>p-</it>cresol, which may be a contributory factor to the virulence of this strain and other hypervirulent PCR-ribotype 027 strains.</p

Cancer centre supportive oncology service: health economic evaluation

Objectives: There have been many models of providing oncology and palliative care to hospitals. Many patients will use the hospital non-electively or semielectively, and a large proportion are likely to be in the last years of life. We describe our multidisciplinary service to treatable but not curable cancer patients at University Hospitals Sussex. The team was a mixture of clinical nurse specialists and a clinical fellow supported by dedicated palliative medicine consultant time and oncology expertise. / Methods: We identified patients with cancer who had identifiable supportive care needs and record activity with clinical coding. We used a baseline 2019/2020 dataset of national (secondary uses service) data with discharge code 79 (patients who died during that year) to compare a dataset of patients seen by the service between September 2020 and September 2021 in order to compare outcomes. While this was during COVID-19 this was when the funding was available. / Results: We demonstrated a reduction in length of stay by an average of 1.43 days per admission and a reduction of 0.95 episodes of readmission rates. However, the costs of those admissions were found to be marginally higher. Even with the costs of the service, there is a clear return on investment with a benefit cost ratio of 1.4. / Conclusions: A supportive oncology service alongside or allied to acute oncology but in conjunction with palliative care is feasible and cost-effective. This would support investment in such a service and should be nationally commissioned in conjunction with palliative care services seeing all conditions