Problem-Solving Treatment for People Recently Diagnosed with Visual Impairment: Pilot Randomised Controlled Trial

BACKGROUND: Problem-Solving Treatment (PST) has been used to treat and prevent depression in a variety of settings. However, the impact of PST on improving psychological well-being in those with recent vision loss remains unknown. The aim of this study was to evaluate whether PST may lead to better psychological well-being in people with recent vision loss through a pilot parallel-group randomised controlled trial. METHODS: Participants who were diagnosed with visual impairment during the previous 3 months were randomly allocated to either an 8-week PST or treatment as usual (N = 61). Outcome measures were administered at baseline, 3, 6, and 9-months. RESULTS: A linear mixed model demonstrated that PST significantly improved psychological well-being (measured by the Warwick Edinburgh Mental Well-being Scale) (treatment effect = 2.44; 95% CI = 0.40-4.47; p = 0.019). Significant improvements in the PST group for symptoms of distress, quality of life and self-efficacy were also observed. There was no significant difference in mobility. The treatment effect was consistent at all follow-ups. Attrition rate was low (13%). CONCLUSIONS: PST was associated with a significant and sustained improvement in a range of outcomes in people with recent vision loss. Further large scale RCT is now required

The Global Garden project: Imagining plant science

Plants are rich sources of drugs and other high-value chemicals that are used by humans. Many of the plant species that produce important molecules grow in remote locations and have extensive histories of indigenous use. Global concerns about sustainable supply have in some cases led to the development of alternative methods for production using biotechnological approaches. Consideration of responsible stewardship and use of the world's plants and associated traditional knowledge for the greater human good are at the heart of the Convention on Biological Diversity and the recently implemented Nagoya Protocol. The development of fora that enable open discussion and exploration of issues relating to these aspects will be critical in endeavors to protect and preserve both the environment and present and future generations. Summary: Here, we investigate the application of cross-disciplinary approaches to explore societal perceptions of plants and their uses, focusing on high-value chemicals. The Global Garden project engages the public, researchers, and regulators in day-long workshops that combine science, poetry, and visual arts practice to foster participants’ skill in imagining and re-imagining relationships between high-value plant products, biotechnology, and social and ethical aspects of these. The project represents an intervention into discussions of science communications and public engagement, addressing the uses and benefits of arts-based approaches to foster imaginative engagement with plant science. The workshop reported here began with real plant case studies and a discussion of the aims of scientists using them. Participants were invited to respond to the issues of relationships among plants, chemicals, and people raised by the case studies through poetry and visual artwork. The poems and artwork that were produced show variation in the participants’ imaginings of plant science. They present distinctive visions of research and innovation and of the associated ethical and social implications. This type of forum, based on creative immersion, opens up opportunities for engaging with and exploring complex relations between plant biotechnology, society, and ethics. This article offers a reflection on the uses, challenges, and implications of arts-based approaches to research communications and public engagement that disrupts traditional knowledge transfer structures. In doing so, we frame the project within science communication pedagogies and consider public engagement a form of pedagogy

Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries.

BACKGROUND: Escalation in the global rates of labour interventions, particularly cesarean section and oxytocin augmentation, has renewed interest in a better understanding of natural labour progression. Methodological advancements in statistical and computational techniques addressing the limitations of pioneer studies have led to novel findings and triggered a re-evaluation of current labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset. METHODS AND FINDINGS: This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves. All analyses were conducted according to three parity groups: parity = 0 (n = 2,166), parity = 1 (n = 1,488), and parity = 2+ (n = 1,952). We performed sensitivity analyses to assess the impact of oxytocin augmentation on labour progression by re-examining the progression patterns after excluding women with augmented labours. Labour was augmented with oxytocin in 40% of nulliparous and 28% of multiparous women. The median time to advance by 1 cm exceeded 1 hour until 5 cm was reached in both nulliparous and multiparous women. Based on a 95th percentile threshold, nulliparous women may take up to 7 hours to progress from 4 to 5 cm and over 3 hours to progress from 5 to 6 cm. Median cumulative duration of labour indicates that nulliparous women admitted at 4 cm, 5 cm, and 6 cm reached 10 cm within an expected time frame if the dilatation rate was ≥ 1 cm/hour, but their corresponding 95th percentiles show that labour could last up to 14, 11, and 9 hours, respectively. Substantial differences exist between actual plots of labour progression of individual women and the 'average labour curves' derived from study population-level data. Exclusion of women with augmented labours from the study population resulted in slightly faster labour progression patterns. CONCLUSIONS: Cervical dilatation during labour in the slowest-yet-normal women can progress more slowly than the widely accepted benchmark of 1 cm/hour, irrespective of parity. Interventions to expedite labour to conform to a cervical dilatation threshold of 1 cm/hour may be inappropriate, especially when applied before 5 cm in nulliparous and multiparous women. Averaged labour curves may not truly reflect the variability associated with labour progression, and their use for decision-making in labour management should be de-emphasized

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Investigating the relationship between telephone-delivered therapy, therapeutic alliance and psychological well-being

This literature review examines the current research on structured telephone therapies. Literature searches were conducted to identify studies of structured telephone-delivered therapies targetting a range of mental health disorders. Twenty studies met the criteria, with depression the most frequently represented. Key data was extracted to contrast and compare study designs and report findings. Findings overall support the use of telephone-delivered therapy to help alleviate symptoms of mental distress. Conclusions from several of the studies are limited by small sample size and design limitations. Research and clinical implications are considered in light of the current research findings and limitations. Empirical paper This study describes the use of an adapted Therapy Rating Scale (TRS) to measure therapeutic alliance and adherence to protocol, in a study of telephone- delivered CBT or supportive listening for adjustment to multiple sclerosis (saMS). Three raters listened to audiotapes of sessions conducted by general nurses trained specifically for the trial. Substantial inter-rater reliability was achieved and the TRS was shown to have good reliability. Two factors were identified by principal component analysis - therapist contribution and patient contribution. Correlational analyses were performed with these factors and GHQ and WSAS outcome measures. Therapeutic alliance as measured by the TRS was not found to moderate treatment outcome in saMS. Limitations of the TRS are discussed, as well as clinical implications and directions for future research.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A study of attitudes, beliefs and organisational barriers related to safe emergency oxygen therapy for patients with COPD (chronic obstructive pulmonary disease) in clinical practice and research

Background: Patients can be harmed by receiving too little or too much oxygen. There is ongoing disagreement about the use of oxygen in medical emergencies. Methods: This was a mixed methods study (survey, telephone interviews and focus groups) involving patients, the public and healthcare professionals (HCPs). Results: 62 patients with chronic obstructive pulmonary disease (COPD), 65 members of the public, 68 ambulance crew members, 22 doctors, 22 nurses and 10 hospital managers took part. For five factual questions about oxygen therapy, the average score for correct answers was 28% for patients with COPD, 33% for the general public and 75% for HCPs. The HCPs had an average score of 66% for five technical questions. Patients (79%) and members of the public (68%) were more likely than HCPs (36%) to believe that oxygen was beneficial in most medical emergencies and less likely to have concerns that it might harm some people (35%, 25% and 68%). All groups had complex attitudes about research into oxygen use in medical emergencies. Many participants would not wish for themselves or their loved ones to have their oxygen therapy determined by a randomised protocol, especially if informed consent was not possible in an emergency situation. Conclusions: We have found low levels of factual knowledge about oxygen use among patients with COPD and the general public and many false beliefs about the potential benefits and harms of using oxygen. HCPs had a higher level of factual knowledge. All groups had complex attitudes towards research into emergency oxygen use. https://bmjopenrespres.bmj.com/content/bmjresp/3/1/e000102.full.pdf This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/bmjresp-2015-00010