The impact of non-harmonious goals on partner support and taking on opportunities

Romantic partners often support each other to progress toward goals. However, at times partners’ goals are not in harmony and conflict with partner or relationship needs, leading to negative consequences for couple members. The present study examined whether non-harmonious opportunities were associated with support provider’s and recipient’s behavior, perceived partner support, and goal outcomes. We further examined whether these effects were moderated by attachment styles. Findings from two experimental (n1= 296, n2= 117) and one dyadic daily diary (n3= 267) showed how having non-harmonious goals lead to problematic goal pursuit. Partners are less likely to behave positively toward the support provider, provide partner support, view their partners as supportive, and report less commitment to partners, and make less goal progress when goal non-harmony is present. Importantly, we did not find moderation effects of attachment styles for these processes. The findings highlight the importance of managing goal non-harmony in couples

Constraints to liberty of movement and attachment styles significantly account for well-being in three Palestinian samples

Background: Political violence and constraints on liberty of movement can have consequences for health and well-being but affect individuals differently. Objective: In three Palestinian samples, we sought to examine the relationship between key environmental and psychological factors and general and mental health, including the previously unexplored roles of constraints to liberty of movement and attachment orientation. Method: Participants (n=519) in the Occupied Palestinian Territories and Jordan completed questionnaires on constraints to liberty of movement (4-item scale devised by the authors for the purpose of the current study), attachment insecurity (Experiences in Close Relationships Scale – Short Form, Wei et al., 2007), resource loss (Conservation of Resources Evaluation scale, Hobfoll & Lilly, 1993), experience of political violence (Experience and fear of political violence, Hobfoll et al., 2011), demographics, general health (adapted from DeSalvo et al, 2006) and mental health (PHQ4 for depression, and Ballenger et al.’s, (2001) 2 item screener for anxiety). All measures were translated from English to Arabic and back-translated into English. Results: Findings from regression and mediation analyses indicated that (i) differences in general and mental health among Palestinians in the Occupied Palestinian Territories and the diaspora in Jordan, can be explained by the assessed constructs; (ii) constraints to liberty of movement, attachment avoidance, and resource loss significantly accounted for poor general health; (iii) constraints to liberty of movement, attachment anxiety, and resource loss significantly explained general anxiety symptoms; and (iv) attachment anxiety, resource loss, and experience of political violence significantly explained depression symptoms. Conclusion: Findings have theory-building implications for psychological models of human flourishing and suffering, suggesting that they are incomplete without consideration of liberty as a context, as well as implications for policymakers and champions of global health initiatives, as they highlight the psychological effects of constraints to liberty of movement on health

Validation of a CT-free navigation system for the measurement of native acetabular alignment

Computer assisted surgery is becoming more frequently used in medical world. OrthoPilot Hip Suite CT-free navigation system (BBraun Aesculap) is one such computer assisted navigation system used for total hip replacement surgery. The validity of OrthoPilot system remains to be determined independent of the manufacturer. The main aims of this study were to investigate the accuracy of OrthoPilot data, while using surgical instruments and to confirm the suitability of the cup navigation algorithm. OrthoPilot was compared with the gold standard of a VICON movement analysis system. An aluminium pelvic phantom was machined with high accuracy to perform the experiments. Data were captured simultaneously from both OrthoPilot and VICON systems and acetabular angles were compared. Both systems produce comparable results for the distance between anatomical landmarks and acetabular angles. It can be concluded that data from OrthoPilot system, if used correctly, are sufficiently accurate for orthopaedic applications

RUMAH SUSUN:Laporan perencangan tugas akhir

In 2 studies, we investigated the validity and usefulness of a bull's eye hierarchical mapping measure to examine the content and structure of attachment networks. The bull's eye identified network differences between people of different attachment styles and between different ages. Attachment networks varied in the number of members and their hierarchical organization as a function of attachment style. Secure individuals included a higher number of secure relationships in their networks and placed them closer to the core self than their insecure relationships, as well as closer than did dismissing-avoidant individuals. The bull's eye also allowed for the observation of meaningful interrelations between network members. Study 2 utilized a cross-sectional design by which we observed network fluidity from mid- to late-adolescence in addition to attachment style differences. One important finding was that late-adolescents placed their friends closer to the core self than did midadolescents, reflecting increased use of peers as close attachment figures

The influence of sex and empathy on putting oneself in the shoes of others

We tested whether putting oneself in the shoes of others is easier for women, possibly as a function of individuals' empathy levels, and whether any sex difference might be modulated by the sex of presented figures. Participants (N=100, 50 women) imagined (a) being in the spatial position of front-facing and back-facing female and male figures (third person perspective (3PP) task) and (b) that the figures were their own mirror reflections (first person perspective (1PP) task). After mentally taking the figure's position, individuals decided whether the indicated hand of the figure would be their own left or right hand. Contrary to our hypothesis, results from the 3PP-task showed higher rotational costs for women than men, suggesting that mental rotation rather than social strategies had been employed. However, faster responding by women with higher empathy scores would appear to indicate that some women engaged social perspective taking strategies irrespective of the figures' position. Figures' sex was relevant to task performance as higher rotational costs were observed for male figures in the 3PP-task for both sexes and for female figures in the 1PP-task for women. We argue that these latter findings indicate that performance was facilitated and/or inhibited towards figures associated with specific social and emotional implications

Improving outcomes in adults with epilepsy and intellectual disability (EpAID) using a nurse-led intervention: study protocol for a cluster randomised controlled trial.

BACKGROUND: In adults with intellectual disability (ID) and epilepsy there are suggestions that improvements in management may follow introduction of epilepsy nurse-led care. However, this has not been tested in a definitive clinical trial and results cannot be generalised from general population studies as epilepsy tends to be more severe and to involve additional clinical comorbidities in adults with ID. This trial investigates whether nurses with expertise in epilepsy and ID, working proactively to a clinically defined role, can improve clinical and quality of life outcomes in the management of epilepsy within this population, compared to treatment as usual. The trial also aims to establish whether any perceived benefits represent good value for money. METHODS/DESIGN: The EpAID clinical trial is a two-arm cluster randomised controlled trial of nurse-led epilepsy management versus treatment as usual. This trial aims to obtain follow-up data from 320 participants with ID and drug-resistant epilepsy. Participants are randomly assigned either to a 'treatment as usual' control or a 'defined epilepsy nurse role' active arm, according to the cluster site at which they are treated. The active intervention utilises the recently developed Learning Disability Epilepsy Specialist Nurse Competency Framework for adults with ID. Participants undergo 4 weeks of baseline data collection, followed by a minimum of 20 weeks intervention (novel treatment or treatment as usual), followed by 4 weeks of follow-up data collection. The primary outcome is seizure severity, including associated injuries and the level of distress manifest by the patient in the preceding 4 weeks. Secondary outcomes include cost-utility analysis, carer strain, seizure frequency and side effects. Descriptive measures include demographic and clinical descriptors of participants and clinical services in which they receive their epilepsy management. Qualitative study of clinical interactions and semi-structured interviews with clinicians and participants' carers are also undertaken. DISCUSSION: The EpAID clinical trial is the first cluster randomised controlled trial to test possible benefits of a nurse-led intervention in adults with epilepsy and ID. This research will have important implications for ID and epilepsy services. The challenges of undertaking such a trial in this population, and the approaches to meeting these are discussed. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number: ISRCTN96895428 version 1.1. Registered on 26 March 2013.Cambridgeshire and Peterborough NHS Foundation TrustThis is the final version of the article. It first appeared from BioMed Central via https://doi.org/10.1186/s13063-016-1429-

Training nurses in a competency framework to support adults with epilepsy and intellectual disability: the EpAID cluster RCT.

BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial. OBJECTIVE: To determine whether or not ID nurses, using a competency framework developed to optimise nurse management of epilepsy in people with an ID, can cost-effectively improve clinical and quality-of-life outcomes in the management of epilepsy compared with treatment as usual. DESIGN: Cluster-randomised two-arm trial. SETTING: Community-based secondary care delivered by members of community ID teams. PARTICIPANTS: Participants were adults aged 18-65 years with an ID and epilepsy under the care of a community ID team and had had at least one seizure in the 6 months before the trial. INTERVENTIONS: The experimental intervention was the Learning Disability Epilepsy Specialist Nurse Competency Framework. This provides guidelines describing a structure and goals to support the delivery of epilepsy care and management by ID-trained nurses. MAIN OUTCOME MEASURES: The primary outcome was the seizure severity scale from the Epilepsy and Learning Disabilities Quality of Life questionnaire. Measures of mood, behaviour, AED side effects and carer strain were also collected. A cost-utility analysis was undertaken along with a qualitative examination of carers' views of participants' epilepsy management. RESULTS: In total, 312 individuals were recruited into the study from 17 research clusters. Using an intention-to-treat analysis controlling for baseline individual-level and cluster-level variables there was no significant difference in seizure severity score between the two arms. Altogether, 238 complete cases were included in the non-imputed primary analysis. Analyses of the secondary outcomes revealed no significant differences between arms. A planned subgroup analysis identified a significant interaction between treatment arm and level of ID. There was a suggestion in those with mild to moderate ID that the competency framework may be associated with a small reduction in concerns over seizure severity (standard error 2.005, 95% confidence interval -0.554 to 7.307;p = 0.092). However, neither subgroup showed a significant intervention effect individually. Family members' perceptions of nurses' management depended on the professional status of the nurses, regardless of trial arm. Economic analysis suggested that the competency framework intervention was likely to be cost-effective, primarily because of a reduction in the costs of supporting participants compared with treatment as usual. LIMITATIONS: The intervention could not be delivered blinded. Treatment as usual varied widely between the research sites. CONCLUSIONS: Overall, for adults with an ID and epilepsy, the framework conferred no clinical benefit compared with usual treatment. The economic analysis suggested that there may be a role for the framework in enhancing the cost-effectiveness of support for people with epilepsy and an ID. Future research could explore the specific value of the competency framework for those with a mild to moderate ID and the potential for greater long-term benefits arising from the continuing professional development element of the framework. TRIAL REGISTRATION: Current Controlled Trials ISRCTN96895428. FUNDING: This trial was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 10. See the NIHR Journals Library website for further project information.This trial was funded by the NIHR Health Technology Assessment programm

Integration of kinase and calcium signaling at the level of chromatin underlies inducible gene activation in T cells

TCR signaling pathways cooperate to activate the inducible transcription factors NF-κB, NFAT, and AP-1. In this study, using the calcium ionophore ionomycin and/or PMA on Jurkat T cells, we show that the gene expression program associated with activation of TCR signaling is closely related to specific chromatin landscapes. We find that calcium and kinase signaling cooperate to induce chromatin remodeling at ∼2100 chromatin regions, which demonstrate enriched binding motifs for inducible factors and correlate with target gene expression. We found that these regions typically function as inducible enhancers. Many of these elements contain composite NFAT/AP-1 sites, which typically support cooperative binding, thus further reinforcing the need for cooperation between calcium and kinase signaling in the activation of genes in T cells. In contrast, treatment with PMA or ionomycin alone induces chromatin remodeling at far fewer regions (∼600 and ∼350, respectively), which mostly represent a subset of those induced by costimulation. This suggests that the integration of TCR signaling largely occurs at the level of chromatin, which we propose plays a crucial role in regulating T cell activation