Experience of depression in older adults with and without a physical long-term condition: findings from a qualitative interview study

OBJECTIVE: To understand how the lived experience of depression differs among patients with a long-term condition (LTC) compared with those without an LTC, and how the experience differs across different types of LTC. DESIGN: Face-to-face, semistructured interviews. SETTING: Primary care; General Practitioner (GP) surgeries in and around North London. PARTICIPANTS: 41 primary care patients with depression were recruited. Our sample comprised participants aged 55–75 years with depression only (n=12), depression and coronary heart disease (n=5), depression and type 2 diabetes (n=10) and depression and arthritis (n=14). RESULTS: Interviews were conducted, audio recorded, transcribed and analysed using thematic analysis. The results revealed that the cardinal diagnostic symptoms of depression (anhedonia, sadness) were experienced by all our participants regardless of LTC. However, the LTC did interact with depression by compounding somatic, cognitive and emotional symptoms, increasing disability and reducing independence, and hindering attempts at coping with mental illness. Our findings demonstrate common experiences across patients as well as key differences based on LTC. CONCLUSIONS: We suggest four key implications for future care practices of these patients: (1) not all participants with depression and LTC view their mental and physical health as interconnected; there should be allowances in care plans for separate treatment pathways; (2) key features of depression that affect LTC management are social withdrawal and lack of motivation to self-manage or access healthcare; (3) key features of LTCs that worsen depression are pain, the unpredictability of future health and progressive disability; (4) positive self-management of LTC could improve self-efficacy and therefore mood, and should be encouraged

The Surrogacy Arrangements Act 1985

Surrogacy is the act of a woman bearing a child for another person/couple who are unable to carry a child themselves. Sometimes this can be the only way for people to have a child genetically and therefore is commonly used. This process is governed by The Surrogacy Arrangements Act 1985 and some provisions of the Human Fertilisation and Embryology Act 1990-2008. This is an area of law which has provoked controversy and is in need of being critically examined. The Law Commission have identified possible issues surrounding the law on surrogacy, these include, how the law is regulated, the exploitation of surrogates and parental orders. Until parental orders are granted, which is not done until six weeks after the birth of the child, the parents are not permitted to make any medical decisions about their child. The Law Commission have looked into these areas in the Law Commissions 13th programme of law reform. As a group, we have researched into these areas but also expanded our research to see what happens if the surrogate mother or parents die, if the surrogate mother changes her mind and wants to keep the child and if the parents refuse the child/abortion rights

Prospectus, October 8, 1971

KNOW YOUR CANDIDATES: FOR SECRETARY, FOR ATHLETICS SENATOR, FOR TREASURER, FOR PUBLIC RELATIONS SENATOR, FOR STUDENT SERVICES, FOR DAY SENATORS; Student Gov.\u27t. Elections; Student Activity Budget 1971-72; What is PSA?: Bull Sheet: C-U Community Theater, Tournament of Roses Float Queen Contest, Parking Problems, SASLA, Cheerleaders Soon Chosen, Conveniamus Needs You, Campus Crusade for Christ, Election Board, Bus Token, Free Pictures, Merchandise For Sale, Calendar of Events, Help A Child, Chi Gamma Iota; More Bull: Key Notes, IOC, Intramurals Flag Football, Gradutes, Gemini Househttps://spark.parkland.edu/prospectus_1971/1004/thumbnail.jp

Factors affecting consistency and accuracy in identifying modern macroperforate planktonic foraminifera

Planktonic foraminifera are widely used in biostratigraphic, palaeoceanographic and evolutionary studies, but the strength of many study conclusions could be weakened if taxonomic identifications are not reproducible by different workers. In this study, to assess the relative importance of a range of possible reasons for among-worker disagreement in identification, 100 specimens of 26 species of macroperforate planktonic foraminifera were selected from a core-top site in the subtropical Pacific Ocean. Twenty-three scientists at different career stages – including some with only a few days experience of planktonic foraminifera – were asked to identify each specimen to species level, and to indicate their confidence in each identification. The participants were provided with a species list and had access to additional reference materials. We use generalised linear mixed-effects models to test the relevance of three sets of factors in identification accuracy: participant-level characteristics (including experience), species-level characteristics (including a participant’s knowledge of the species) and specimen-level characteristics (size, confidence in identification). The 19 less experienced scientists achieve a median accuracy of 57 %, which rises to 75 % for specimens they are confident in. For the 4 most experienced participants, overall accuracy is 79 %, rising to 93 % when they are confident. To obtain maximum comparability and ease of analysis, everyone used a standard microscope with only 35× magnification, and each specimen was studied in isolation. Consequently, these data provide a lower limit for an estimate of consistency. Importantly, participants could largely predict whether their identifications were correct or incorrect: their own assessments of specimen-level confidence and of their previous knowledge of species concepts were the strongest predictors of accuracy

Tobacco use, smoking identities and pathways into and out of smoking among young adults: a meta-ethnography

Background This meta-ethnography investigates how young adults describe their tobacco use, smoking identities and pathways into and out of regular smoking, to inform future smoking prevention and harm reduction interventions. Methods Eight databases were systematically searched using keywords and indexed terms. Studies were included if they presented qualitative data from young adults aged 16–25 reporting smoking histories and/or smoking identities from countries culturally similar to the UK. A systematic and rigorous meta-ethnographic approach was employed, consistent with Noblit and Hare’s methodology. Results Thirty papers were included. Reasons stated for taking up smoking and becoming a smoker included alleviating stress, transforming one’s identity, and coping with the transition to further education, employment or leaving home. Many used smoking to aid acceptance within new peer groups, particularly when alcohol was present. Smoking was also perceived as an act of resistance and a coping mechanism for those with marginalised identities. Barriers to quitting smoking included young adults’ minimisation or denial of the health risks of smoking and not identifying with “being a smoker”. Conclusions This meta-ethnography may provide a blueprint to inform the development of health and wellbeing interventions designed specifically for young adults. Smoking cessation interventions should be co-designed with young adults based on their perceived needs, resonant with their desire to quit in the future at key milestones. Harm reduction interventions should address the social aspect of addiction, without reinforcing stigma, particularly for those with marginalised identities

Refining dosing by oral gavage in the dog: A protocol to harmonise welfare

Introduction: The dog is a frequently-used, non-rodent species in the safety assessment of new chemical entities. We have a scientific and ethical obligation to ensure that the best quality of data is achieved from their use. Oral gavage is a technique frequently used to deliver a compound directly into the stomach. As with other animals, in the dog, gavage is aversive and the frequency of its use is a cause for welfare concern but little research has been published on the technique nor how to Refine it. A Welfare Assessment Framework (Hall, 2014) was previously developed for use with the laboratory-housed dog and a contrasting pattern of behaviour, cardiovascular and affective measures were found in dogs with positive and negative welfare. Methods: Using the framework, this study compared the effects of sham dosing (used to attempt to habituate dogs to dosing) and a Refined training protocol against a control, no-training group to determine the benefit to welfare and scientific output of each technique. Results: Our findings show that sham dosing is ineffective as a habituation technique and ‘primes' rather than desensitises dogs to dosing. Dogs in the control group showed few changes in parameters across the duration of the study, with some undesirable changes during dosing, while dogs in the Refined treatment group showed improvements in many parameters. Discussion: It is recommended that if there is no time allocated for pre-study training a no-sham dosing protocol is used. However, brief training periods show a considerable benefit for welfare and quality of data to be obtained from the dogs' use

Functional consequences of the first reported mutations of the proto-oncogene PTTG1IP/PBF

Pituitary tumor-transforming gene 1-binding factor (PTTG1IP; PBF) is a multifunctional glycoprotein, which is overexpressed in a wide range of tumours, and significantly associated with poorer oncological outcomes, such as early tumour recurrence, distant metastasis, extramural vascular invasion and decreased disease-specific survival. PBF transforms NIH 3T3 fibroblasts and induces tumours in nude mice, while mice harbouring transgenic thyroidal PBF expression show hyperplasia and macrofollicular lesions. Our assumption that PBF becomes an oncogene purely through increased expression has been challenged by the recent report of mutations in PBF within the Catalogue of Somatic Mutations in Cancer (COSMIC) database. We therefore sought to determine whether the first 10 PBF missense substitutions in human cancer might be oncogenic. Anisomycin half-life studies revealed that most mutations were associated with reduced protein stability compared to wild-type (WT) PBF. Proliferation assays narrowed our interest to two mutational events which significantly altered cell turnover: C51R and R140W. C51R was mainly confined to the endoplasmic reticulum while R140W was apparent in the Golgi apparatus. Both C51R and R140W lost the capacity to induce cellular migration and significantly reduced cell invasion. Colony formation and soft agar assays demonstrated that, in contrast to WT PBF, both mutants were unable to elicit significant colony formation or anchorage-independent growth. However, C51R and R140W retained the ability to repress radioiodide uptake, a functional hallmark of PBF. Our data reveal new insight into PBF function and confirm that, rather than being oncogenic, mutations in PBF are likely to be passenger effects, with overexpression of PBF the more important aetiological event in human cancer.</jats:p