The role of hemispheric lateralisation in immunity & human immunodeficiency virus Type 1 (HIV-1)

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Neuromodulation of the immune system has been described to be influenced by hemispheric lateralisation (HL), the stable tendency to relatively utilise one hemisphere or its functions over another. To date there has not been a systematic review of research in this phenomenon conducted, and only one study has examined the effects of HL on the progression of a disease – Human Immunodeficiency Virus (HIV). That research was conducted on a small sample with little control for confounders. The present work sought to compile a systematic review of literature concerning HL and immunity in humans, using effect size analysis. Further, the present work also describes an empirical advancement of this earlier HIV study with stricter control over confounds in a larger sample. The findings corroborated the theory of asymmetrical immune influence by HL via the systematic review showing clear, relatively consistent and strong relationships between left-HL and immunopotentiation. The empirical prospective study extended current knowledge of this relationship in HIV to identify a moderator – HAART treatment. Specifically, left-HL predicted better immunity in HIV-1 patients independent of confounders, with further findings of the same pattern in untreated patients, but not in HAART-treated patients. Further observations were made between HL and HIV-relevant behaviours, again adding to current knowledge. The finding of left-HL being associated with fewer sexual partners in Europeans presents new information of relevance to public health. The combined findings of the present work suggest that left-HL has predictive value in illness (HIV-1) and in general immunity. The present work adds to the existing knowledge new information concerning a moderating factor of the HLimmunity relationship in HIV, and behavioural implications of HL which impact upon HIV disease. Potential explanations for moderation, proposals for neurobiological mechanisms and direction towards future, more rigourous study in the field, both in HIV and immunity, are discussed

Understanding well-being outcomes in primary care arts on referral interventions: a mixed method study

Background: Arts on Prescription programmes are designed to support mental health and well-being of patients with a variety of clinical needs within the community. Despite a number of studies reporting benefits, there are some patients that do not see improvements in well-being. Yet, there is limited research investigating the reasons for this. Methods: Using a sequential mixed-methods design the present study sought to understand why some participants (N=312) experienced an increase in well-being and others did not (N=95) after attending an Arts on Prescription intervention based in the South West of England between 2009 and 2016. Results: Quantitative comparisons between the two groups identified little differences, aside from age and baseline well-being (WEMWBS scores), with those that improved being slightly younger, and having lower well-being at the outset compared with those that did not improve. A process model depicting the perceived facilitative and inhibitive factors of attending the programme was developed from the qualitative findings. This model suggests that the social aspect of the course may be implicated in the participants differential outcomes; with those that showed a decrease in well-being reporting difficulties in interacting with others during the intervention. Further, the participants who reported an increase in well-being felt vulnerable to “relapse” when finishing the course due to uncertainties regarding future support and at their ability to maintain their well-being without the provision of the programme. Conclusions: This research suggests a need to promote communication amongst groups in such interventions with the hope that this will provide a more facilitative environment for all participants to benefit. Also, such programmes should consider follow-on options to ensure the participants feel supported and confident in managing their well-being once the course comes to an end. Findings will be pertinent to those commissioning primary care art interventions, ensuring that referral policies and pathways are designed for optimal effectiveness and for potentially tailoring social prescribing programmes to suit the participants specific needs

Machine Learning Based Model for the Detection of Brain Aneurysms from MR Angiography

A brain aneurysm is a thin or weak spot on a blood vessel wall that expands and fills with blood. Brain aneurysms are very dangerous due to the fact that in most cases, patients do not show any symptoms. Because of this, aneurysms are difficult to diagnose unless it becomes very large or ruptures, resulting in fatal hemorrhage. Aneurysms can be detected by a number of different brain imaging methods including Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA), Computed Tomography Angiography (CTA) and other imaging methods but for the sake of this report we will only be focusing on MRA. MRA scans are optimal for the detection of brain aneurysms because they produce images that can be used to distinguish blood vessels from surrounding stationary tissue. Since aneurysms happen only in the blood vessels, MRA scans are an ideal image type to train a predictive machine learning model for our purposes. Artificial intelligence, machine learning, and deep learning are all growing fields that are leading to breakthroughs in the medical community. For machine learning models and algorithms specifically, they have greatly helped in analyzing, locating, and predicting critical health conditions including brain aneurysms. With the help of this technology, medical professionals, such as radiologists, can greatly benefit from the predictions these models can provide. Image interpretation by human experts can be limited due to subjectivity, complexity of the image, extensive variations across different interpreters, and fatigue. With the help of these models, physicians and radiologists will be able to make more accurate and precise diagnoses with predictive algorithms serving as a second opinion. More specifically, with the help of machine learning and MR Angiography, a predictive model can be trained to help detect brain aneurysms that might otherwise go unnoticed by radiologists. Here, we have developed four convolutional neural network (CNN) models that successfully detect aneurysm presence within MRA scans. Further investigation should be done to validate and improve these models to create a more accurate and sensitive diagnostic platform

All-Party Group on Coronavirus - Oral Evidence Session 20. Workers: Wellbeing, Burnout, and NHS Capacity

Evidence given on 23rd March 2021 by Dr Rachel Sumner (UoG) and Dr Elaine Kinsella (UL) to the All Party Parliamentary Group on Coronavirus inquiry on the impact of the pandemic on frontline healthcare workers. Evidence based on work by Dr Rachel Sumner and Dr Elaine Kinsella

The Madrid International Plan of Action on Ageing: Where is Eastern Europe and Central Asia region fifteen years later?

This report represents UNFPA’s contribution to a global stocktaking exercise to mark the 15th anniversary of the Madrid International Plan of Action on Ageing (MIPAA) which was adopted at the Second World Assembly on Ageing in April 2002. This report is one of six that are are being prepared by UNFPA and which complement the regional review reports prepared by respective UN Regional Commissions. It contributes to the cooperation programme on ageing that exists between the UN Economic Commission for Europe (UNECE) and the UNFPA Regional Office for Eastern Europe and Central Asia (EECARO). It is a technical, analytical report that reflects demographic analysis, direct experiences, literature review and policy and programme assessments. In addition, it focuses on a specific subset of countries: in this case the UNFPA programme countries in the Eastern Europe and Central Asia (EECA) region. It is hoped that this analytical UNFPA report will contribute to a comprehensive understanding of the implementation and challenges ahead of the Madrid International Plan of Action and inspire governments and non-governmental actors to share good practices and learn from successful examples

White noise, white heat: A call to action from the frontline

Whilst the Covid-19 pandemic moves into a new phase with the successful roll out of vaccines in adults in the UK, there is an opportunity to reflect, re-evaluate, and reconfigure public health responses. Of importance is the need to defend and protect the frontline workforce who have sacrificed so much over the last 18 months. The present essay summarises key recommendations from frontline workers to policymakers with specific reference to the preparation needed for the Autumn and Winter to come. The participants from the CV19 Heroes Project give voice to concerns over the unique challenges posed by the coming months, and speak of the need to embed evidence into future policy to both compensate existing, and prevent future, occupational exposure to Covid-19, the experience of Long Covid, and the overall psychological and physical scars experienced from what has been a traumatic period of their working lives

A walk on the wild side: How interactions with non‐companion animals might help reduce human stress

1. The literature addressing the potential for nature and natural environments to reduce stress and improve health outcomes has a relative paucity of work regarding interactions with animals, particularly those that are not domestic pets. 2. The present observational study sought to understand whether a brief encounter with non-domestic animals might reduce stress and improve wellbeing of participants, and whether participants’ nature relatedness, and their appraisals of the interaction might influence these changes. 3. Participants (N=86, mean age=20.8 years, 81.8% female) took part in a brief wildlife encounter at a UK safari park, walking for approximately 11 minutes around an enclosure with free-roaming lemurs. Heart rate, cortisol, and measures of mood were taken before and after the encounter to understand whether this activity could reduce biological levels of stress and improve psychological wellbeing. 4. There was no decrease in participants’ heart rate after their encounter but there was a statistically significant decrease in salivary cortisol. Measures of mood significantly improved immediately after the encounter. Reductions in cortisol were associated with dimensions of an individual’s nature relatedness, as well as aspects of the animal encounter (number of lemurs and lemur proximity). 5. The findings contribute to parallel literature on nature-health relationships, with the addition of factors seemingly driving the interaction (individuals’ nature relatedness, and the number and proximity of the animals) providing important contributory information. The present study provides new information on how encounters with nature, particularly those involving animals, may be beneficial for health and wellbeing. Critically, this study was carried out in a setting where potential impact of visitors on animals is negligible, thereby demonstrating the potential for creating environments where both human and animal wellbeing is maximised

Diversity and Inclusion as Essential Elements of 4-H Youth Development Programs

Diversity and inclusion are essential elements of 4-H’s goals related to positive youth development, workforce development, and organizational sustainability. Previous research has examined Cooperative Extension professionals’ attitudes on this topic, demonstrating that most of them recognize the importance of diversity and inclusion in 4-H. Here we present results from a survey of adolescents participating in New York state 4-H programs assessing their endorsement of racial/ethnic diversity and inclusion in 4-H. Results revealed that, overall, youth felt positively toward this kind of diversity and inclusion in 4-H, and endorsement was most strongly predicted by a learning orientation that emphasizes acquiring new information through intergroup contact. We conclude with considerations for 4-H programs seeking to help young people develop and maintain an openness to diversity and inclusion