Living with childhood asthma: parental perceptions of risk in the household environment and strategies for coping

Aim To explore parents’ perceptions of environmental household risks to their child’s asthma and to identify the strategies they adopt in relation to these perceived risks. Background The prevalence of childhood asthma is increasing worldwide and especially in the UK. Asthma is more common in areas of socio-economic disadvantage. Household environmental factors have been implicated in some of this increase. A number of factors in the home environment have been found to act as triggers to asthma symptoms, including high humidity levels, poor ventilation, mould, second-hand tobacco smoke and pet allergens. Little is known about how parents, as the main care-givers and decision makers in the home, perceive and cope with the risks posed by these triggers. Methods Semi-structured interviews were conducted with a purposive sample of parents of 32 children with asthma aged 4 to 16 years and living in a socio-economically disadvantaged urban community in the North East of England. Interviews were audiotaped, transcribed verbatim and analysed using constant comparison techniques. Findings All parents were aware of some of the risks their children faced at home. Some appeared to know more than others and coping styles varied. A typology of three groups of parents was identified: those who actively seek advice and adopt clear preventative strategies (preventers); those who minimize the risks and only react when things go wrong (reactors); and those who engage in compensatory activities in an attempt to trade-off between harms and benefits (compensators). The unifying themes underpinning these different styles are that all parents are motivated to maintain normal family life but that they adopt different strategies to achieve this

A systematic review of sport and dance participation in healthy young people (15-24 years) to promote subjective wellbeing

We know that taking part in physical activity like sport and dance can bring wellbeing benefits, such as being more satisfied with life and happier, and feeling less anxious and depressed. Most of the evidence is however about adults. This review was carried out to investigate the relationships between subjective wellbeing (SWB) and taking part in sport and dance for healthy young people (15-24 years). Healthy people were defined as those without a condition diagnosed by a health professional. SWB describes wellbeing in terms of the good and bad feelings arising from what people do and how they think. The focus of this review was agreed through on-going collaborative engagement with UK-wide stakeholders representing policy, commissioning and managing, service delivery, and scholars from both academic and non-academic organisations. We examined studies from the past 10 years and found that there is limited good quality evidence, and very little conducted in the UK. The review includes published findings from 977 participants across six countries - China, Korea, India, Turkey, Sweden and the USA. In some studies, participants were predominantly female. A wide variety of wellbeing measures were used. The most common form of sport/dance related activity was based on meditative practices (yoga and Baduanjin Qigong). Other physical activities reported included body conditioning, aerobic exercise, dance training, hip hop dance and sports including volleyball, ice skating, Nintendo Wii Active Games. We included evidence from recent unpublished reports (grey literature) produced by or for sport and dance organisations since 2013. Participants in the evaluations were both male and female with a mean age between 13-24 years and were engaged in UK-based programmes of sport and dance. Findings illustrate that depending on activity type and delivery mode, taking part is associated with wellbeing improvements connected to social connectedness, pleasure, sense of purpose, confidence, interpersonal skills, happiness, relaxation, creative skills and expression, aspiration and ambition. Taking part was also associated with negative wellbeing connected to concerns about competency and capability. Overall, the evidence available in this review suggests that yoga-type activities have the potential to improve subjective wellbeing and that group-based and peer supported sport and dance programmes may promote wellbeing enhancement in youth groups. The evidence in this review provides limited promising findings upon which sport and dance programmes for wellbeing improvement could be developed. The lack of evidence identified in this review does not necessarily mean that wellbeing benefits are not accrued from taking part in sport and dance. There is scope to build evidence on wellbeing outcomes of sport and dance in healthy young people through well-designed, rigorous and appropriate research methods which are underpinned by relevant theory and use established methods of analysis

HIV- 1 lentivirus tethering to the genome is associated with transcription factor binding sites found in genes that favour virus survival

Lentiviral vectors (LV) are attractive for permanent and effective gene therapy. However, integration into the host genome can cause insertional mutagenesis highlighting the importance of understanding of LV integration. Insertion site (IS) tethering is believed to involve cellular proteins such as PSIP1/LEDGF/p75, which binds to the virus pre-integration complexes (PICs) helping to target the virus genome. Transcription factors (TF) that bind both the vector LTR and host genome are also suspected influential to this. To determine the role of TF in the tethering process, we mapped predicted transcription factor binding sites (pTFBS) near to IS chosen by HIV-1 LV using a narrow 20 bp window in infected human induced pluripotent stem cells (iPSCs) and their hepatocyte-like cell (HLC) derivatives. We then aligned the pTFBS with these sequences found in the LTRs of native and self-inactivated LTRs. We found significant enrichment of these sequences for pTFBS essential to HIV-1 life cycle and virus survival. These same sites also appear in HIV-1 patient IS and in mice infected with HIV-1 based LV. This in silco data analysis suggests pTFBS present in the virus LTR and IS sites selected by HIV-1 LV are important to virus survival and propagation

Multi-membership gene regulation in pathway based microarray analysis

This article is available through the Brunel Open Access Publishing Fund. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Gene expression analysis has been intensively researched for more than a decade. Recently, there has been elevated interest in the integration of microarray data analysis with other types of biological knowledge in a holistic analytical approach. We propose a methodology that can be facilitated for pathway based microarray data analysis, based on the observation that a substantial proportion of genes present in biochemical pathway databases are members of a number of distinct pathways. Our methodology aims towards establishing the state of individual pathways, by identifying those truly affected by the experimental conditions based on the behaviour of such genes. For that purpose it considers all the pathways in which a gene participates and the general census of gene expression per pathway. Results: We utilise hill climbing, simulated annealing and a genetic algorithm to analyse the consistency of the produced results, through the application of fuzzy adjusted rand indexes and hamming distance. All algorithms produce highly consistent genes to pathways allocations, revealing the contribution of genes to pathway functionality, in agreement with current pathway state visualisation techniques, with the simulated annealing search proving slightly superior in terms of efficiency. Conclusions: We show that the expression values of genes, which are members of a number of biochemical pathways or modules, are the net effect of the contribution of each gene to these biochemical processes. We show that by manipulating the pathway and module contribution of such genes to follow underlying trends we can interpret microarray results centred on the behaviour of these genes.The work was sponsored by the studentship scheme of the School of Information Systems, Computing and Mathematics, Brunel Universit

A systematic review of the subjective wellbeing outcomes of engaging with visual arts for adults (“working-age”, 15-64 years) with diagnosed mental health conditions

The importance of the visual arts in contributing to the wellbeing of adults with mental health conditions has been little documented beyond some insightful and influential interventions and exploratory studies. Initiatives such as Arts on Prescription projects have, in the UK provided examples of the positive effects that engagement in artistic and creative activity can have, and some of these have been documented in small-scale studies of interventions. Most of the evidence has been perceived as positive but of limited scale. In this context, this review was carried out to examine in a more focused way the ‘subjective wellbeing’ (SWB) outcomes of engagement with the visual arts for adults with a background history of mental health conditions. SWB embraces both the positive and negative feelings that arise in individuals based on their view of the world, how they think about themselves and others, and what they do in the interactions and practices of everyday life. Adult subjects in the studies included in this review were of ‘working-age’ (15-64 years). The focus of the review and the precise research question were agreed at inception sessions of the research team, and in collaborative engagement with stakeholders in the areas of policy, service-delivery, project and evaluation commissioning, and research and scholarship in the spheres of the visual arts and mental health. Published studies from the past 10 years were studied for the review, and their findings synthesised and integrated into an evaluation of the state of knowledge in the field, in terms of the specifics of the research questions. We found that there is limited high-quality evidence, though case studies from the UK have provided important and consistent findings, corroborated by grey literature that has reported on interventions and projects. The review includes published findings based on data on/from 163 participants across four countries – Australia, Sweden, the UK, and the USA. Overall, female respondents outnumbered male respondents. A wide variety of wellbeing measures were used in some quantitative, statistical studies. In-depth interviews dominated the qualitative studies, giving voice to the experiences of individual subjects. The visual arts practices that featured in the studies included forms of painting or drawing, art appreciation with selected art forms, artmaking culminating in an exhibition, and more general creative and craft activities that included visual artefacts such as ceramics or sculpture. Evidence we include from recent unpublished reports (grey literature) was produced by or for visual arts organisations since 2014. Participants in the evaluations were both male and female and were engaged in UK-based arts interventions, many via community arts or ‘Arts on Prescription’ types of intervention. Overall, the evidence available in this review has shown that engagement in the visual arts for adults with mental health conditions can reduce reported levels of depression and anxiety; increase self-respect, self-worth and self-esteem; encourage and stimulate re-engagement with the wider, everyday social world; and support in participants a potential renegotiation of identity through practice-based forms of making or doing. The most effective ‘working ways to wellbeing’ are also confirmed in processes of implementation that ensure provision of secure safe-space and havens for interventions; that recognise the value of non-stigmatising settings; and that support and sustain collaborative facilitation of programmes and sessions. 4 Some negative dimensions of engagement with the visual arts were also identified, including stress and pressure felt to complete activities or commit to artmaking, and the very real fear that the end of an intervention would mean the return to a world of anxiety, decreasing confidence and social isolation. The review shows that for adults starting visual arts activities or programmes, the subjective wellbeing outcomes are, for the majority of participants, positive. This applies to men and women alike across the studies. The most convincing evidence has emerged from focused qualitative research designs, and makes clear that the most effective work in the field continues to lack the necessary resources and infrastructure that would ensure sustainable practices and interventions. Overall, there is some evidence of benefit in a weak field that could be strengthened by fuller monitoring of cohorts to evaluate the long-term effects of participants’ engagement with the visual arts

What works for wellbeing? A systematic review of wellbeing outcomes for music and singing in adults

Aims: The role of arts and music in supporting subjective wellbeing (SWB) is increasingly recognised. Robust evidence is needed to support policy and practice. This article reports on the first of four reviews of Culture, Sport and Wellbeing (CSW) commissioned by the Economic and Social Research Council (ESRC)-funded What Works Centre for Wellbeing (https://whatworkswellbeing.org/). Objective: To identify SWB outcomes for music and singing in adults. Methods: Comprehensive literature searches were conducted in PsychInfo, Medline, ERIC, Arts and Humanities, Social Science and Science Citation Indexes, Scopus, PILOTS and CINAHL databases. From 5,397 records identified, 61 relevant records were assessed using GRADE and CERQual schema. Results: A wide range of wellbeing measures was used, with no consistency in how SWB was measured across the studies. A wide range of activities was reported, most commonly music listening and regular group singing. Music has been associated with reduced anxiety in young adults, enhanced mood and purpose in adults and mental wellbeing, quality of life, self-awareness and coping in people with diagnosed health conditions. Music and singing have been shown to be effective in enhancing morale and reducing risk of depression in older people. Few studies address SWB in people with dementia. While there are a few studies of music with marginalised communities, participants in community choirs tend to be female, white and relatively well educated. Research challenges include recruiting participants with baseline wellbeing scores that are low enough to record any significant or noteworthy change following a music or singing intervention. Conclusions: There is reliable evidence for positive effects of music and singing on wellbeing in adults. There remains a need for research with sub-groups who are at greater risk of lower levels of wellbeing, and on the processes by which wellbeing outcomes are, or are not, achieved

What Works for Wellbeing? A systematic review of wellbeing outcomes for music and singing in adults

IMS: The role of arts and music in supporting subjective wellbeing (SWB) is increasingly recognised. Robust evidence is needed to support policy and practice. This article reports on the first of four reviews of Culture, Sport and Wellbeing (CSW) commissioned by the Economic and Social Research Council (ESRC)-funded What Works Centre for Wellbeing ( https://whatworkswellbeing.org/ ). OBJECTIVE: To identify SWB outcomes for music and singing in adults. METHODS: Comprehensive literature searches were conducted in PsychInfo, Medline, ERIC, Arts and Humanities, Social Science and Science Citation Indexes, Scopus, PILOTS and CINAHL databases. From 5,397 records identified, 61 relevant records were assessed using GRADE and CERQual schema. RESULTS: A wide range of wellbeing measures was used, with no consistency in how SWB was measured across the studies. A wide range of activities was reported, most commonly music listening and regular group singing. Music has been associated with reduced anxiety in young adults, enhanced mood and purpose in adults and mental wellbeing, quality of life, self-awareness and coping in people with diagnosed health conditions. Music and singing have been shown to be effective in enhancing morale and reducing risk of depression in older people. Few studies address SWB in people with dementia. While there are a few studies of music with marginalised communities, participants in community choirs tend to be female, white and relatively well educated. Research challenges include recruiting participants with baseline wellbeing scores that are low enough to record any significant or noteworthy change following a music or singing intervention. CONCLUSIONS: There is reliable evidence for positive effects of music and singing on wellbeing in adults. There remains a need for research with sub-groups who are at greater risk of lower levels of wellbeing, and on the processes by which wellbeing outcomes are, or are not, achieved

Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction:New Pathophysiological Insights

Objectives: The aim of this study was to mechanistically investigate associations among cigarette smoking, microvascular pathology, and longer term health outcomes in patients with acute ST-segment elevation myocardial infarction (MI). Background: The pathophysiology of myocardial reperfusion injury and prognosis in smokers with acute ST-segment elevation MI is incompletely understood. Methods: Patients were prospectively enrolled during emergency percutaneous coronary intervention. Microvascular function in the culprit artery was measured invasively. Contrast-enhanced magnetic resonance imaging (1.5-T) was performed 2 days and 6 months post-MI. Infarct size and microvascular obstruction were assessed using late gadolinium enhancement imaging. Myocardial hemorrhage was assessed with T2* mapping. Pre-specified endpoints included: 1) all-cause death or first heart failure hospitalization; and 2) cardiac death, nonfatal MI, or urgent coronary revascularization (major adverse cardiovascular events). Binary logistic regression (odds ratio [OR] with 95% confidence interval [CI]) with smoking status was used. Results: In total, 324 patients with ST-segment elevation MI were enrolled (mean age 59 years, 73% men, 60% current smokers). Current smokers were younger (55 ± 11 years vs. 65 ± 10 years, p < 0.001), with fewer patients with hypertension (52 ± 27% vs. 53 ± 41%, p = 0.007). Smokers had better TIMI (Thrombolysis In Myocardial Infarction) flow grade (≥2 vs. ≤1, p = 0.024) and ST-segment resolution (none vs. partial vs. complete, p = 0.010) post–percutaneous coronary intervention. On day 1, smokers had higher circulating C-reactive protein, neutrophil, and monocyte levels. Two days post-MI, smoking independently predicted infarct zone hemorrhage (OR: 2.76; 95% CI: 1.42 to 5.37; p = 0.003). After a median follow-up period of 4 years, smoking independently predicted all-cause death or heart failure events (OR: 2.20; 95% CI: 1.07 to 4.54) and major adverse cardiovascular events (OR: 2.79; 95% CI: 2.30 to 5.99). Conclusions: Smoking is associated with enhanced inflammation acutely, infarct-zone hemorrhage subsequently, and longer term adverse cardiac outcomes. Inflammation and irreversible myocardial hemorrhage post-MI represent mechanistic drivers for adverse long-term prognosis in smokers. (Detection and Significance of Heart Injury in ST Elevation Myocardial Infarction. [BHF MR-MI]; NCT02072850)