‘‘Bursting’’ to Go and Other Experiences: Children’s Views on Using the Toilet in the First School Year

Children’s use of the toilet at school, although rarely explored, is an important facet of school experience with consequences for physical and psychological health. A mixed methods study investigated views of 25 children (4–5 years) regarding potential stressors in the first school year, including views of toileting, in Dublin, Ireland. Despite very positive responses to school, most responses to toileting (15 of 25) were mixed or negative. Although some liked to go, or noted the toilets were clean, most indicated delayed toilet use (‘‘bursting’’ to go) and ambivalent or negative experiences such as fear of not identifying the right toilet, fear of being alone, lack of privacy, and potential bullying. Many children did not expect to receive help from the teacher. As delaying toilet use can have lasting health consequences, teacher–nurse collaboration could be used to develop whole-school policies to support children’s early adjustment in this sensitive area of functioning

‘Look, I have my ears open’: Resilience and early school experiences among children in an economically deprived suburban area in Ireland

Children from economically disadvantaged communities frequently lack the socio- emotional, cognitive and behavioural skills needed for successful early school adjustment. Assessments of early school experience often rely on parent and teacher perspectives, yet children’s views are essential to design effective, resilience-promoting school ecologies. This mixed methods study explored children’s appraisals of potential stressors in the first school year with 25 children from a disadvantaged suburban community in Ireland. School scenarios were presented pictorially (Pictorial Measure of School Stress and Wellbeing, or PMSSW), to elicit children’s perspectives on social ecological factors that enable or constrain resilience. Salient positive factors included resource provision, such as food, toys and books; school activities and routines, including play; and relationships with teachers. Negative factors included bullying; difficulties engaging with peers; and using the toilet. Drawing on these factors, we indicate how school psychologists can develop resilience-fostering educational environments for children in vulnerable communitie

Cervico-vaginal mucus (CVM) – an accessible source of immunologically informative biomolecules

peer-reviewedCervico-vaginal mucus (CVM), the product of epithelial cells lining the uterus, cervix and vagina, is secreted to facilitate uterine lubrication and microbial clearance. Predominantly composed of water and mucins, CVM also contains high levels of immuno-active proteins such as immunoglobulin A (IgA), lactoferrin and lysozyme which protect against infection by blocking adhesion and mediating microbial killing. The repertoire of cytokines, chemokines and antimicrobial peptides is predominantly generated by the secretions of endometrial epithelial cells into the uterine lumen and concentrated in the CVM. The quantity and relative proportions of these inflammatory biomarkers are affected by diverse factors including the estrus cycle and health status of the animal and therefore potentially provide important diagnostic and prognostic indicators. We propose that measuring molecular signatures in bovine CVM could be a useful approach to identifying and monitoring genital tract pathologies in beef and dairy cows

The CD4+ T cell methylome contributes to a distinct CD4+ T cell transcriptional signature in Mycobacterium bovis-infected cattle

peer-reviewedWe hypothesised that epigenetic regulation of CD4+ T lymphocytes contributes to a shift toward a dysfunctional T cell phenotype which may impact on their ability to clear mycobacterial infection. Combined RNA-seq transcriptomic profiling and Reduced Representation Bisulfite Sequencing identified 193 significantly differentially expressed genes and 760 differentially methylated regions (DMRs), between CD4+ T cells from M. bovis infected and healthy cattle. 196 DMRs were located within 10 kb of annotated genes, including GATA3 and RORC, both of which encode transcription factors that promote TH2 and TH17 T helper cell subsets respectively. Gene-specific DNA methylation and gene expression levels for the TNFRSF4 and Interferon-γ genes were significantly negatively correlated suggesting a regulatory relationship. Pathway analysis of DMRs identified enrichment of genes involved in the anti-proliferative TGF-β signaling pathway and TGFB1 expression was significantly increased in peripheral blood leukocytes from TB-infected cattle. This first analysis of the bovine CD4+ T cell methylome suggests that DNA methylation directly contributes to a distinct gene expression signature in CD4+ T cells from cattle infected with M. bovis. Specific methylation changes proximal to key inflammatory gene loci may be critical to the emergence of a non-protective CD4+ T cell response during mycobacterial infection in cattle

<i>It’s up to you if you want to take part</i>. Supporting young children’s informed choice about research participation with simple visual booklets

Formal consent for children’s research participation legally resides with adults, and guidelines typically recommend consulting children about their participation only from 7 years of age. How can researchers support younger children’s informed decision-making about their research participation, particularly in larger-scale studies without extended researcher-participant engagement? In this paper, we share our experience of four studies (270 children) using drawings, observations, interviews, and biological and anthropometric measures and the visual information booklets we devised to support young children’s informed agreement. Critically evaluating the notion that ‘evolving capacities’ necessarily increase with age, we consider young children’s contextualised decision-making capacity. Reflecting on process and outcomes, we conclude that simple visual information booklets benefit not only children but all actors in the research process, functioning as material artefacts that remind adults as well as children of young children’s right to choice about research participation

Risk factors for the development of depression in patients with hepatitis C taking interferon-α

Interferon-α, currently used for the treatment of hepatitis C, is associated with a substantially elevated risk of depression. However, not everyone who takes this drug becomes depressed, so it is important to understand what particular factors may make some individuals more ‘at risk’ of developing depression than others. Currently there is no consensus as to why interferon-induced depression occurs and the range of putative risk factors is wide and diverse. The identification of risk factors prior to treatment may allow identification of patients who will become depressed on interferon, allowing the possibility of improved treatment support and rates of treatment adherence. Here, we consolidate and review the literature on risk factors, and we discuss the potential confounds within the research examined in order to better isolate the risk factors that may be important in the development of depression in these patients and which might help predict patients likely to become depressed on treatment. We suggest that interactions between psychobehavioral, genetic, and biological risk factors are of particular importance in the occurrence of depression in patients with hepatitis C taking interferon-α

Maternal anxiety and depression and their associations with mother–child pretend play: a longitudinal observational study

Funder: National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College LondonFunder: LEGO FoundationAbstract: Background: Parental anxiety and depression have been associated with changes to parent–child interactions. Although play constitutes an important part of parent–child interactions and affords critical developmental opportunities, little is known regarding how parental anxiety and depression are related to parent–child play. This is an important knowledge gap because parents play a crucial role in children’s early play experience. The purpose of the current study was to examine whether levels of maternal anxiety and depression respectively predicted frequencies of pretend play in both mothers and their children, and whether mothers’ engagement in pretend play predicted child behaviour problems two years later. Methods: Pretend play in 60 mother-toddler dyads (Mage of child = 29.67 months, SD = 3.25, 41.7% girls) was assessed during home visits. Maternal anxiety and depression were assessed using self-report questionnaires. Children’s behaviour problems were rated by mothers at baseline and two years later. Hierarchical regression analyses examined concurrent associations between mother–child pretend play and maternal anxiety and depression at baseline, and longitudinal associations between baseline mother pretend play and child behavioural problems two years later. Results: Higher maternal anxiety predicted less pretend play in mothers and children (β = − .23, BCa 95% CI: [− .018, − .001]) and β = − .22, BCa 95% CI [− .014, − .001]). Higher maternal depression predicted less child pretend play (β = − .20, BCa 95% CI [− .012, − .001]). There was evidence (albeit weak) that more mother pretend play at baseline predicted fewer child behaviour problems two years later (β = − .18, BCa 95% CI [− 62.38, 11.69]), when baseline child behaviour problems and maternal anxiety were controlled for. Conclusions: Maternal anxiety and depression are associated with less pretend play during mother–child interaction. Mother’s pretend play might help reduce child behavioural problems risks, suggesting that play might be one mechanism by which maternal mental health influences children’s development

Differential Expression of NK Receptors CD94 and NKG2A by T Cells in Rheumatoid Arthritis Patients in Remission Compared to Active Disease

TNF inhibitors (TNFi) have revolutionised the treatment of rheumatoid arthritis (RA). Natural killer (NK) cells and Natural Killer Cell Receptor+ T (NKT) cells comprise important effector lymphocytes whose activity is tightly regulated through surface NK receptors (NKRs). Dysregulation of NKRs in patients with autoimmune diseases has been shown, however little is known regarding NKRs expression in patients with TNFi-induced remission and in those who maintain remission vs disease flare following TNFi withdrawal.Patients with RA were recruited for this study, (i) RA patients in clinical remission following a minimum of one year of TNFi therapy (n = -15); (2) Active RA patients, not currently or ever receiving TNFi (n = 18); and healthy control volunteers (n = 15). Patients in remission were divided into two groups: those who were maintained on TNFi and those who withdrew from TNFi and maintained on DMARDS. All patients underwent full clinical assessment. Peripheral blood mononuclear cells were isolated and NKR (CD94, NKG2A, CD161, CD69, CD57, CD158a, CD158b) expression on T-(CD3+CD56-), NK-(CD3-CD56+) and NKT-(CD3+CD56+) cells was determined by flow cytometry.Following TNFi withdrawal, percentages and numbers of circulating T cells, NK cells or NKT cell populations were unchanged in patients in remission versus active RA or HCs. Expression of the NKRs CD161, CD57, CD94 and NKG2A was significantly increased on CD3+CD56-T cells from patients in remission compared to active RA (p<0.05). CD3+CD56-T cell expression of CD94 and NKG2A was significantly increased in patients who remained in remission compared with patients whose disease flared (p<0.05), with no differences observed for CD161 and CD57. CD3+CD56- cell expression of NKG2A was inversely related to DAS28 (r = -0.612, p<0.005).High CD94/NKG2A expression by T cells was demonstrated in remission patients following TNFi therapy compared to active RA, while low CD94/NKG2A were associated with disease flare following withdrawal of therapy

Does a video clip enhance recruitment into a parenting trial? Learnings from a study within a trial

Funder: NIHR Imperial Biomedical Research Centre; doi: http://dx.doi.org/10.13039/501100013342Abstract: Background: Reaching recruitment targets in randomised controlled trials is a challenge. Media tools are increasingly used to engage participants, yet there is a paucity of research into the use of video to optimise recruitment. We therefore tested whether adding a participant information video clip to a standard participant information sheet improved recruitment into a parenting trial. Methods: One hundred seven participants were randomised to receive either a participant information sheet (n = 51) or an informational video clip (n = 56) as part of an email contact following a screening phase. All participants went on to receive the information sheet as part of the existing consent procedure. Results: The video condition did not increase the odds of recruitment into the trial, such that those in the video condition were significantly less likely to participate in the main trial (OR = 0.253, CI = 0.104–0.618, p = 0.003). Conclusion: The introduction of a video clip into the recruitment stages of a parenting trial did not lead to an improvement in recruitment; however, the small sample size precludes definitive inferences. We offer reflections on challenges encountered in implementing the SWAT and suggestions for other researchers seeking to embed recruitment SWATs into similar trials. Trial registration: Current controlled trials ISRCTN 58327365. Registered on 19 March 2015. SWAT registration: SWAT 106; Effects of a video clip on recruitment into a randomised trial. Registered on 20 December 2016

Qualitative and quantitative differences in endometrial inflammatory gene expression precede the development of bovine uterine disease

peer-reviewedThe transcriptome of the endometrium early postpartum was profled to determine if infammatory gene expression was elevated in cows which subsequently developed uterine disease. Endometrial cytobrush samples were collected at 7 days postpartum (DPP) from 112 Holstein–Friesian dairy cows, from which 27 were retrospectively chosen for RNA-seq on the basis of disease classifcation [ten healthy and an additional 17 diagnosed with cytological endometritis (CYTO), or purulent vaginal discharge (PVD)] at 21 DPP. 297 genes were signifcantly diferentially expressed between cows that remained healthy versus those that subsequently developed PVD, including IL1A and IL1B (adjusted p < 0.05). In contrast, only 3 genes were signifcantly diferentially expressed in cows which subsequently developed CYTO. Accounting for the early physiological infammatory status present in cows which do not develop disease enhanced the detection of diferentially expressed genes associated with CYTO and further expression profling in 51 additional cows showed upregulation of multiple immune genes, including IL1A, IL1B and TNFA. Despite the expected heterogeneity associated with natural infection, enhanced activation of the infammatory response is likely a key contributory feature of both PVD and CYTO development. Prognostic biomarkers of uterine disease would be particularly valuable for seasonal-based dairy systems where any delay to conception undermines sustainability