38 research outputs found
Upward spirals of positive emotion and coping: Replication, extension, and initial exploration of neurochemical substrates
The broaden-and-build theory (Fredrickson, 1998, 2001) predicts that positive emotions broaden the scopes of attention and cognition, thereby facilitating the building of personal resources and initiating upward spirals toward increasing emotional well-being. This study attempts to replicate and extend previous empirical support for this model. Using a sample of 185 undergraduates, we assessed whether positive affect and broad-minded coping, interpersonal trust, and social support reciprocally and prospectively predict one another over a two-month period, and whether this upward spiral might be partially based in changes in dopaminergic functioning. As hypothesized, PA and positive coping did mutually build on one another, as did PA and interpersonal trust. Contrary to expectation, PA did not demonstrate an upward spiral relation with social support. Results suggest further study of the relationship between PA and changes in dopamine metabolite levels over time is warranted
Implementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled trial
Standards for the care of people with cystic fibrosis (CF); recognising and addressing CF health issues
This is the third in a series of four papers updating the European Cystic Fibrosis Society (ECFS) standards for the care of people with CF. This paper focuses on recognising and addressing CF health issues. The guidance was produced with wide stakeholder engagement, including people from the CF community, using an evidence-based framework. Authors contributed sections, and summary statements which were reviewed by a Delphi consultation. Monitoring and treating airway infection, inflammation and pulmonary exacerbations remains important, despite the widespread availability of CFTR modulators and their accompanying health improvements. Extrapulmonary CF-specific health issues persist, such as diabetes, liver disease, bone disease, stones and other renal issues, and intestinal obstruction. These health issues require multidisciplinary care with input from the relevant specialists. Cancer is more common in people with CF compared to the general population, and requires regular screening. The CF life journey requires mental and emotional adaptation to psychosocial and physical challenges, with support from the CF team and the CF psychologist. This is particularly important when life gets challenging, with disease progression requiring increased treatments, breathing support and potentially transplantation. Planning for end of life remains a necessary aspect of care and should be discussed openly, honestly, with sensitivity and compassion for the person with CF and their family. CF teams should proactively recognise and address CF-specific health issues, and support mental and emotional wellbeing while accompanying people with CF and their families on their life journey
Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study
Introduction:
The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures.
Methods:
In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025.
Findings:
Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation.
Interpretation:
After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification
Utility Cooperation & Work Plan Development
This presentation focuses on how to develop work plans effectively and efficiently and the information required to understand the needs of the utilities with regard to the project
Simulating the Impact of Hormonal Signaling and Non-Uniform Soil Water Distribution on Plant Transpiration
Deciphering soil plant relations with a detailed numerical model
⇨ to develop a biophysically-based model, where our current knowledge on plant functioning is included ⇨ to use this biophysical model to investigate the impact of coupled processes on plant water relations (process understanding) ⇨ to use this biophysical model to test current simplified sink term hypotheses and update or confirm current sink term functions ⇨ to develop upscaling procedures to improve hydrological, land surface and crop models
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The impact of surface heterogeneity on the diurnal cycle of deep convection
Despite some recent improvements, there remain major deficiencies in model simulations using parameterised convection in capturing both the phase and amplitude of the daily cycle of precipitation in tropical regions. The difficulties are particularly acute in regions of heterogeneous surface conditions, since the simulations need not only to respond appropriately to the local forcing from surface fluxes but also to capture the interactions with near-surface mesoscale circulations. Here we examine such a situation by means of idealised cloud-resolving simulations of deep convection over a heterogeneous surface, performed using the cloud-resolving simulation model MONC. In these simulations, we show that precipitation forms preferentially over dry and warm patches ("DRY") as compared to wet and cold patches ("WET"), with the peak precipitation rates differing by a factor of approximately 4. The initiation of precipitation occurs approximately 1.5 hours earlier in the DRY patches compared to the WET. Moreover, within the WET and DRY patches there are marked differences in the spatial distribution of the precipitation. These cloud-resolving simulations are then used as a benchmark to assess the behaviour of simulations using parameterised convection, performed using the idealised configuration of the MetUM. The MetUM simulations do produce a response with some qualitative similarities to the cloud-resolving simulations. In particular, although the simulations with parameterised
convection initiate precipitation too early they are capable of capturing the relative amounts of daily-mean precipitation in the DRY and WET patches. We propose that the cloud-resolving simulations could be further used to investigate the impact of fully interactive surface schemes and as benchmark simulations to evaluate new parameterisation schemes
A paired, double-blind, randomized comparison of a moisturizing durable barrier cream to 10% glycerine cream in the prophylactic management of postmastectomy irradiation skin care: Trans Tasman Radiation Oncology Group (TROG) 04.01
Abstract not availablePeter H. Graham, Natalie Plant, Jennifer L. Graham, Lois Browne, Martin Borg, Anne Capp, Geoff P. Delaney, Jennifer Harvey, Lisbeth Kenny, Michael Francis and Yvonne Zissiadi