Self-Harm in Eating Disorders (SHINE):a mixed-methods exploratory study

Introduction Self-harm is highly prevalent among young people with eating disorders. However, why a young person may develop and continue to experience both an eating disorder and self-harm is unclear. This study will investigate the frequency, intensity, duration, function, context and processes of self-harm among people aged 16–25 diagnosed with an eating disorder. It will explore participants’ perspectives on the genesis and functions of both their self-harm and eating disorder, as well as their support needs. The study was designed with the input of members of a Young Persons’ Advisory Group, who will be key to study delivery and dissemination.Methods and analysis This exploratory study has a sequential mixed-methods explanatory design. Between 70 and 100 young people aged 16–25 with both an eating disorder diagnosis and self-harm thoughts and/or behaviours will be recruited from three NHS Eating Disorder outpatient services in England. Phase 1: a 14-day (six prompts per day) ecological momentary assessment (EMA) of participants’ feelings, thoughts, motivations, behaviours and experiences of self-harm. Phase 2: 20–30 participants from phase 1 will be reapproached to take part in an in-depth qualitative interview on the psychological, emotional and social factors that underlie their self-harm and eating disorder as well as their support needs. EMA data from phase 1 will be analysed using descriptive and multilevel statistics. Qualitative interview data from phase 2 will be analysed using inductive and deductive thematic analysis. Results from both phases will be integrated using a mixed-methods matrix, with each participant’s data from both phases compared alongside comparative analysis of the datasets as a whole.Ethics and dissemination The study gained ethical approval from the NHS HRA West Midlands–Black Country Research Ethics Committee (number: 296032). We anticipate disseminating findings to clinical, academic and lived experience audiences, at academic conferences, through peer-reviewed articles, and through various public engagement activities (eg, infographics, podcasts)

Sorghum-Sudangrass Production Guide

Sudex is a warm-season forage crop that performs well in Utah’s dry climate due to its drought tolerance. It can be especially useful during drought years or when irrigation supplies are limited. As well as being a high-quality feed, Sudex has many benefits, including weed suppression and soil-building properties. Although there are concerns for prussic acid and nitrate poisoning, these concerns can be reduced and often eliminated with proper management. This fact sheet provides information to producers about using Sudex and best production practices. Much of the information may also apply to forage sorghum and a few of the major differences will be noted throughout

Unlocking education through relationship building: Discourses of identity and agency in English educational institutions during Covid-19

This article reports on a longitudinal study in the North of England with educational practitioners in schools, colleges and universities during two lockdowns. The project was designed to ‘unlock’ education by providing spaces to co-create new ways of thinking about education in light of the Covid-19 pandemic. Focus groups were conducted with school and college teachers as well as university staff at the end of the first and second English lockdown, in summer 2020 and spring 2021. A thematic analysis identified issues with expectations, communication and agency, and that participants framed them as impacting on their identity. Therefore, the framework of tactics of intersubjectivity was adopted to explore how educational practitioners discursively positioned themselves and others through constructions of similarity and difference, realness and power, and how their professional identities were affected by the experience of working through the pandemic and by those around them. Whilst educational practitioners took opportunities to authenticate their identity and reimagine education, their agency was undermined by top-down governing involving little successful communication, leading to denaturalising and illegitimising experiences for staff. Executive management were perceived as lacking engagement with staff and understanding of the implications of their decisions on them. The findings call for relationship building and recognition of the voice of educational practitioners. Keywords: educator identity, authentication, voice, pandemi

Cutaneous Granulomatosis: a Comprehensive Review

Cutaneous granulomatosis is a heterogeneous group of diseases, characterized by a skin inflammatory reaction triggered by a wide variety of stimuli, including infections, foreign bodies, malignancy, metabolites, and chemicals. From a pathogenic point of view, they are divided into non-infectious and infectious granulomas. Pathophysiological mechanisms are still poorly understood. Non-infectious granulomatous skin diseases include granuloma annulare, necrobiosis lipoidica, rheumatic nodules, foreign body granulomas, cutaneous sarcoidosis, and interstitial granulomatous dermatitis. Necrobiosis lipoidica is more frequent in diabetic patients. Infectious granulomas of the skin are caused by mycobacteria, in particular Mycobacterium tuberculosis or atypical mycobacteria; parasites, such as Leishmania; or fungi. Pathogenic mechanisms of M. tuberculosis-related granuloma are discussed. From a clinical point of view, it is useful to divide cutaneous granulomatosis into localized and more disseminated forms, although this distinction can be sometimes artificial. Three types of localized granulomatous lesions can be distinguished: palisaded granulomas (granuloma annulare, necrobiosis lipoidica, and rheumatoid nodules), foreign body granulomas, and infectious granulomas, which are generally associated with localized infections. Disseminated cutaneous granulomas can be divided into infectious, in particular tuberculosis, and non-infectious forms, among which sarcoidosis and interstitial granulomatous dermatitis. From a histological point of view, the common denominator is the presence of a granulomatous inflammatory infiltrate in the dermis and/or hypodermis; this infiltrate is mainly composed of macrophages grouped into nodules having a nodular, palisaded or interstitial architecture. Finally, we propose which diagnostic procedure should be performed when facing a patient with a suspected cutaneous granulomatosis